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
(171, 171, '<p>Betahistine Mesilate dilates precapiilary sphincters, increasing the blood flow in the inner ear. It controls the permeability of capillaries in the inner ear, thereby removes endolymphatic hydrops. It also improves cerebral circulation, increasing blood flow in the internal carotid artery. Thus, Betahistine Mesylate is clinically useful for the relief of vertigo and dizziness.</p>', '<p>The mechanism of action of betahistine is known partially. Betahistine has a very strong affinity as an antagonist for histamine H3 receptors and a weak affinity as an agonist for histamine H1 receptors. The active ingredient is a specific histamine agonist with virtually no H2-activity.<br />\r\n<br />\r\nBetahistine has two modes of action. Primarily, it has a direct stimulating (agonistic) effect on H1 receptors located on blood vessels in the inner ear. It appears to act on the precapillary sphincter in the stria vascularis of the inner ear, thus reducing the pressure in the endolymphatic space.<br />\r\n<br />\r\nIn addition, betahistine has a powerful antagonistic effects at H3 receptors, and increases the levels of neurotransmitters released from the nerve endings. The increased amounts of histamine released from histaminergic nerve endings stimulates H1 receptors, thus augmenting the direct agonistic effects of betahistine on these receptors. This explains the potent vasodilatory effects of betahistine in the inner ear. This explains the efficacy of betahistine in the treatment of vertigo.</p>', '<p>Usually for adults, administer orally 6 mg to 12 mg three times per day after meals. The dose may be adjusted according to the age of patient and severity of symptoms.</p>', NULL, '<p>Hypersensitivity to betahistine mesylate, pheochromocytoma, peptic ulcer, acute bronchial asthma.</p>', '<p>Nausea or vomiting may rarely occur. Hypersensitivity reactions, such as skin rash, may rarely occur.</p>', '<p>Safety of Betahistine during pregnancy has not been established. This drug should be administered to pregnant patients or women suspected of being pregnant, only if the expected therapeutic benefit is thought to outweigh any possible risk.</p>', '<p>Patients with a history of digestive ulcer or an active digestive ulcer, Patients with bronchial asthma, Patients with pheochromocytoma.</p>', NULL, '<p>Drugs used in meniere&#39;s diseases</p>', '<p>Store in cool and dry place. Protect from light &amp; moisture.</p>', NULL, '2022-02-15 05:36:23', '2022-03-21 02:17:41'),
(172, 172, '<p>Betamethasone Soluble Tablets belong to a group of medicines called steroids. Their full name is corticosteroids. These corticosteroids occur naturally in the body and help to maintain health and well being. Boosting your body with extra corticosteroids (such as Betamethasone Soluble Tablets) is an effective way to treat various illnesses involving inflammation in the body. Betamethasone Soluble Tablets reduce this inflammation, which could otherwise go on making your condition worse. You must take this medicine regularly to get maximum benefit from it. Many different conditions can be improved by the use of corticosteroids, as they reduce inflammation (redness, tenderness, heat and swelling) in the body. Betamethasone Soluble Tablets are used to treat:</p>\r\n\r\n<ul>\r\n	<li>Asthma</li>\r\n	<li>Severe allergic reactions</li>\r\n	<li>Rheumatoid arthritis</li>\r\n	<li>Autoimmune diseases such as systemic lupus erythematosus (SLE) and polyarteritis nodosa; inflammatory conditions of the skin, kidney (such as acute interstitial nephritis or minimal change nephrotic syndrome), bowels (such as ulcerative colitis and Crohn&rsquo;s disease) and heart</li>\r\n	<li>Some connective tissue diseases</li>\r\n	<li>Certain conditions of the blood</li>\r\n	<li>Some types of cancer, such as malignant lymphoma</li>\r\n	<li>Corticosteroids are also used to help prevent organ transplant rejection following organ transplant surgery.</li>\r\n</ul>', '<p>Corticosteroids bind to the glucocorticoid receptor, inhibiting pro-inflammatory signals, and promoting anti-inflammatory signals. Betamethasone phosphate has a short duration of action as it is rapidly hydrolyzed to betamethasone. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients taking corticosteroids should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.</p>', '<p>Short term treatment:</p>\r\n\r\n<ul>\r\n	<li>2000-3000 mcg (4-6 tablets) daily for the first few days, then</li>\r\n	<li>Your doctor may reduce the daily dose by 250-500 mcg (1/2 or 1 tablet) every two to five days, depending upon the response.</li>\r\n</ul>\r\n\r\n<p>Rheumatoid arthritis:</p>\r\n\r\n<ul>\r\n	<li>500-2000 mcg (1-4 tablets) daily</li>\r\n	<li>For long-term treatment the dose may be lower.</li>\r\n</ul>\r\n\r\n<p>Most other conditions:</p>\r\n\r\n<ul>\r\n	<li>1500-5000 mcg (3-10 tablets) daily for one to three weeks</li>\r\n	<li>Your doctor may then gradually reduce this to a lower dose</li>\r\n	<li>Larger doses may be needed for mixed connective tissue diseases and ulcerative colitis</li>\r\n	<li>If you need to take half a tablet you should break one in half. Use the break line on one side of the tablet to help you snap it.</li>\r\n</ul>', NULL, '<p>Do not take Betamethasone Soluble Tablets:</p>\r\n\r\n<ul>\r\n	<li>if you are allergic to betamethasone or any of the other ingredients of this medicine</li>\r\n	<li>if you have an infection and have not yet started taking medicine (e.g. antibiotics) to treat it.</li>\r\n</ul>', '<p>Feeling depressed, including thinking about suicide; Feeling high (mania) or moods that go up and down; Feeling anxious, having problems sleeping, difficulty in thinking or being confused and losing your memory; Feeling, seeing or hearing things which do not exist. Having strange and frightening thoughts, changing how you act or having feelings of being alone.</p>', '<p>If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Taking steroids often or for a long time during pregnancy can slow the baby&rsquo;s growth in the womb or may temporarily affect the baby&rsquo;s heart and body movements. If you are breast-feeding, the steroid may enter the baby and lower their hormone levels, if you are taking high doses for a long time.</p>', '<p>&nbsp;</p>\r\n\r\n<p>Talk to your doctor, pharmacist or nurse before taking Betamethasone Soluble Tablets-</p>\r\n\r\n<ul>\r\n	<li>if you have ever had severe depression or manic depression (bipolar disorder). This includes having had depression before while taking steroid medicines like Betamethasone Soluble Tablets;</li>\r\n	<li>if any of your close family has had these illnesses;</li>\r\n	<li>if you have or have ever had tuberculosis (TB);</li>\r\n	<li>if you have epilepsy (fits), severe mental illness, heart disease, hypertension (high blood pressure), stomach or duodenal ulcers;</li>\r\n	<li>if you have osteoporosis (thinning of the bones). Post menopausal women are particularly at risk of this;</li>\r\n	<li>if you or any of your family have ever had glaucoma (raised eye pressure);</li>\r\n	<li>if you have recently had a heart attack;</li>\r\n	<li>if you have recently been in contact with someone who has chickenpox, shingles or measles or recently had chickenpox, shingles or measles yourself. This product may make chickenpox, shingles or measles much worse;</li>\r\n	<li>if you or any of your family are diabetic;</li>\r\n	<li>if you have an underactive thyroid gland;</li>\r\n	<li>if you have myasthenia gravis (a disease which causes muscle weakness);</li>\r\n	<li>if you have ever suffered from muscle wasting due to corticosteroids;</li>\r\n	<li>if you have liver, kidney or heart disease;</li>\r\n	<li>if you have just been or are about to be immunised;</li>\r\n	<li>if you have an infection;</li>\r\n	<li>if you are pregnant or breast-feeding</li>\r\n	<li>if you experience blurred vision or other visual disturbances.</li>\r\n</ul>', NULL, '<p>Corticosteroid</p>', '<p>Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the label. The expiry date refers to the last day of that month. Do not store above 25&ordm;C.</p>', NULL, '2022-02-15 05:36:35', '2022-03-21 02:20:03'),
(173, 173, '<ul>\r\n	<li>This Ointment is indicated for the topical treatment of plaque-type psoriasis vulgaris amenable to topical therapy.</li>\r\n	<li>This Topical Suspension is indicated for the topical treatment of plaque psoriasis of the scalp and body.</li>\r\n</ul>', '<p><strong>Betamethasone</strong>&nbsp;Dipropionate is a potent topically-active corticosteroid producing prompt, marked and prolonged anti-inflammatory, antipruritic, vasoconstrictive and immunosuppressive properties, without curing the underlying condition. These effects can be enhanced under occlusive conditions due to increased penetration of stratum corneum (by approximately a factor of 10).<br />\r\n<br />\r\n<strong>Calcipotriol</strong>&nbsp;is a non-steroidal antipsoriatic agent, derived from vitamin D. Calcipotriol exhibits a vitamin D-like effect by competing for the 1,25(OH)2D3&nbsp;receptor. Calcipotriol is as potent as 1,25(OH)2D3, the naturally occurring active form of vitamin D, in regulating cell proliferation and cell differentiation, but much less active than 1,25(OH)2D3&nbsp;in its effect on calcium metabolism. Calcipotriol induces differentiation and suppresses proliferation (without any evidence of a cytotoxic effect) of keratinocytes, thus reversing the abnormal keratinocyte changes in psoriasis. The therapeutic goal envisaged with Calcipotriol is thus a normalization of epidermal growth.</p>', '<p><strong>Ointment</strong>: This Ointment is indicated for topical use only. The phototoxic effects have not been studied in psoriasis patients. All psoriasis-affected areas treated with this Ointment should be, where possible, protected from direct sunlight and UV-light with items of clothing.</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: This ointment should be applied topically to the affected area once daily. The maximum daily dose should not exceed 15 gm. The maximum recommended weekly dose of ointment is 100 gm/week. The treated area should not be more than 30% of the body surface. The use of this ointment should be intermittent for up to one year under close medical supervision. Treatment should be limited to four week periods with Calcipotriol used alone for one month between periods of use of this ointment as needed.</li>\r\n	<li><strong>Children</strong>: This ointment is not recommended for use in children and adolescents below the age of 18 years.</li>\r\n</ul>\r\n\r\n<p><strong>Topical Suspension</strong>: Apply required quantity of spray of Topical Suspension once daily to the affected areas and gently rub in using the tips of the fingers. Treatment may be continued for up to 8 weeks. Treatment may be discontinued earlier, if symptoms are&nbsp;cleared. The maximum weekly dose should not exceed 100 gm. Shake before use. This Topical Suspension is not for oral, ophthalmic or intravaginal use.</p>', '<p>Additive adverse effects when used with other steroids.</p>', '<p>Betamethasone and Calcipotriol containing preparation is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. It is also contraindicated in patients with known disorders of calcium metabolism. Patients with severe renal insufficiency or severe hepatic disorders are also contraindicated.</p>', '<p>The most common adverse reactions are folliculitis and burning sensation of skin.There are no adequate and well-controlled studies in pregnant women. Ointment or suspension should be used during pregnancy only if the potential benefit to the patient justifies the potential risk to the fetus. Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topically administered calcipotriene or corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk. Because many drugs are excreted in human milk, caution should be exercised when Calcipotriol and Betamethasone ointment or suspension is administered to a nursing woman.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Ointment or suspension should be used during pregnancy only if the potential benefit to the patient justifies the potential risk to the fetus. Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topically administered calcipotriene or corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk. Because many drugs are excreted in human milk, caution should be exercised when Calcipotriol and Betamethasone ointment or suspension is administered to a nursing woman.</p>', '<p>Hypercalcemia and hypercalciuria have been reported. If either occurs, discontinue until parameters of calcium metabolism normalize. Topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing&rsquo;s syndrome and unmask latent diabetes. Rate of adrenal suppression increased with treatment duration. Systemic absorption may require evaluation for HPA axis suppression. Modify use if HPA axis suppression develops. Potent corticosteroids, use on large areas, prolonged use or occlusive use may increase systemic absorption. Local adverse reactions may include atrophy, striae, irritation, acne form eruptions, hypopigmentation, and allergic contact dermatitis and may be more likely with occlusive use or more potent corticosteroids. Use is not recommended on face, axillae, groin or where atrophy is present. Children may be more susceptible to systemic toxicity when treated with topical corticosteroids.</p>', NULL, '<p>Betamethasone &amp; Combined preparations</p>', '<p>Store in a cool (below 25&ordm;C) &amp; dry place &amp; protect from light. Do not refrigerate. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:37:13', '2022-03-21 16:45:05'),
(174, 174, '<p>This topical preparation is indicated for the topical treatment of inflammatory dermal infections like-</p>\r\n\r\n<ul>\r\n	<li>Tinea pedis</li>\r\n	<li>Tinea cruris</li>\r\n	<li>Tinea corporis etc.</li>\r\n</ul>', '<p>Clotrimazole is a broad-spectrum antifungal agent used for the treatment of superficial infections caused by species of pathogenic dermatophytes, yeasts and Malassezia furfur. The mechanism of action involves inhibition of the synthesis of ergosterol, a major sterol in the fungal cell membrane. This leads to instability of the cell membrane and eventual death of the fungus. Betamethasone dipropionate is a corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. But the exact mechanism of action of corticosteroids is not clearly known.</p>', '<p>Sufficient topical preparation should be applied onto the affected and surrounding skin areas twice a day, in the morning and evening, for 2 weeks in tinea cruris and tinea corporis and for 4 weeks in tinea pedis. The use of this cream for longer than four weeks is not recommended.<br />\r\n<br />\r\nThe safety and effectiveness of the preparation have not been established in children below the age of 12 years.</p>', '<p>No information is available of drug interaction.</p>', '<p>This topical preparation is contraindicated to those patients who are sensitive to any of its components or to other corticosteroids or to imidazoles. If irritation or sensitization develops with the use of the cream, treatment should be discontinued and appropriate therapy instituted. The cream is contraindicated in facial rosacea, acne vulgaris, perioral dermatits, perianal and genital pruritus, napkin eruptions and bacterial or viral infections. Systemic absorption of topical corticosteroides can produce reversible hypothalmic-pituitary-adrenal (HPA) axis suppression. If HPA axis suppression is noted, an attempt should be made to withdraw the drug or to reduce the frequency of application. Pediatric patients may be more susceptible to systemic toxicity from equivalent doses due to their large skin surface to body mass ratios</p>', '<p>Adverse reactions reported for the preparation in clinical trials were paresthesia in 1.9% of patients, rash, edema and secondary infection, each in less than 1% of patients. Other adverse reactions reported with the preparation were burning and dry skin in 1.6% of patients and stinging in less than 1% of patients</p>', '<p>There is inadequate evidence of safety in pregnancy. Clotrimazole has no teratogenic effect in animals but is foetotoxic at high oral doses. Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development. Hence the cream should only be used in pregnancy if the benefit justifies the potential risk to the fetus and such use should not be extensive,i.e. in large amounts or for long periods. It is not known whether the components of the preparation are excreted in human milk and therefore caution should be exercised when treating nursing mothers.</p>', NULL, '<p>Acute overdose with the cream is unlikely and would not be expected to lead to a life-threatening situation. The cream should not be used for longer than the prescribed time period.</p>', '<p>Betamethasone &amp; Combined preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:39:03', '2022-03-21 16:48:00'),
(175, 175, '<p>This Cream is indicated for the treatment of corticosteroid-responsive dermatoses when complicated by infections caused by bacteria and fungi. This&nbsp;is also effective in the treatment of tinea pedis, tinea cruris &amp; tinea corporis, acute and chronic eczema.</p>', '<p>This&nbsp;Cream combines the anti-inflammatory, antipruritic and vasoconstrictive actions of Betamethasone Dipropionate with the broad spectrum antifungal activity of Clotrimazole and the wide-spectrum bactericidal antibiotic activity of Gentamicin Sulfate. Clotrimazole appears to act on the fungal cell membrane, causing leakage of cell contents. Gentamicin provides highly effective topical treatment in primary and secondary bacterial infections of the skin.</p>', '<p>This&nbsp;Cream combines the anti-inflammatory, antipruritic and vasoconstrictive actions of Betamethasone Dipropionate with the broad spectrum antifungal activity of Clotrimazole and the wide-spectrum bactericidal antibiotic activity of Gentamicin Sulfate. Clotrimazole appears to act on the fungal cell membrane, causing leakage of cell contents. Gentamicin provides highly effective topical treatment in primary and secondary bacterial infections of the skin.</p>', '<p>Concomitant use with nephrotoxic drugs including other aminoglycosides, vancomycin and some of cephalosporins; or ototoxic drugs such as ethacrynic acid and furosemide may increase the risk of toxicity.</p>', '<p>This&nbsp;Cream is contraindicated in those patients with a history of sensitivity reactions to any of its components.</p>', '<p>Adverse reactions have been reported very rarely and include hypochromia, burning, erythema, exudation etc.</p>', '<p>Since safety of topical corticosteroid in pregnant women has not been established, it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nA decision should be made to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the lactating mother.</p>', '<p>Do not combine with any other product containing corticosteroid. Not for application to the face, avoid contact with eyes. Not for prolonged use or use in extensive areas, under an occlusive dressing, open wound, injured areas, exterior genital areas and skin folds.</p>', NULL, '<p>Betamethasone &amp; Combined preparations</p>', NULL, NULL, '2022-02-15 05:39:45', '2022-03-21 16:50:19'),
(176, 176, '<p>The topical treatment of corticosteroid responsive dermatoses when complicated by secondary infection caused by organisms sensitive to gentamicin or when the possibility of such infection is suspected. The cream is recommended for wet, oozing primary infections, and greasy, secondary infections such as pustular acne or infected seborrheic dermatitis. The ointment helps retain moisture and has been useful in infection on dry eczematous or psoriatic skin.</p>', '<p>Betamethasone dipropionate with gentamicin combines the anti-inflammatory, antipruritic and vasoconstrictive activity of a synthetic corticosteroid, betamethasone dipropionate, with the broad spectrum anti-bacterial effect of gentamicin.<br />\r\n<br />\r\nIn secondary skin infections, gentamicin facilitates the treatment of the underlying dermatosis by controlling the infection. Bacteria susceptible to the action of gentamicin include sensitive strains of streptococci (group A beta hemolytic, alpha hemolytic), S. aureus (coagulase positive, coagulase negative, and some penicillinase producing strains), and the gram-negative bacteria P. aeruginosa, E. aerogenes, E. coli, Proteus (both indole positive and indole negative), K. pneumoniae, and S. marcescens.<br />\r\n<br />\r\nThis cream is slightly acidic so that it is within the pH range of the normal skin. On application, it leaves minimum residue without stickiness or greasiness. The presence of petrolatum in both cream and ointment offers lubricating qualities and helps to prevent excessive drying.</p>', '<p>A sufficient quantity of the cream or ointment should be applied to cover completely the affected area and should be massaged gently and thoroughly into the skin. The usual frequency of application is twice daily although some patients may be maintained adequately with less frequent application.</p>', NULL, '<p>Viral diseases including vaccinia, varicella, herpes simplex, fungal infections, tuberculosis of the skin and hypersensitivity to any of the components.</p>', '<p>The following local adverse skin reactions have been reported with the use of topical steroids: dryness, itching, burning, local irritation, striae, skin atrophy, hypertrichosis, change in pigmentation and secondary infection. Adrenal suppression has also been reported following topical corticosteroid therapy. Posterior subcapsular cataracts have been reported following systemic use of corticosteroids..</p>', '<p>Since safety of topical corticosteroid use in pregnant women has not been established, drugs of this class should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Drugs of this class should not be used extensively in large amounts or for prolonged periods of time in pregnant patients. Since it is not known whether topical administration of corticosteroids can result in sufficient systemic absorption to produce detectable quantities in breast milk, a decison should be made to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. This drug should not be used in or near the eyes since the vehicle is not formulated for ophthalmic use.</p>', '<p>Gentamicin is not effective against fungi, yeasts or viruses. Patients with superficial fungus or yeast infections also must receive specific therapy and the use of the drug may have to be discontinued. The use of such topical preparations may result in an overgrowth of non-susceptible organisms.<br />\r\n<br />\r\nSuitable precautions should be taken in using topical corticosteroids in patients with stasis dermatitis and other skin diseases with impaired circulation.<br />\r\n<br />\r\nProlonged use of corticosteroid preparations may produce striae or atrophy of the skin or s.c. tissue. If this occurs, treatment should be discontinued.<br />\r\n<br />\r\nCausal factors should be sought and eliminated whenever possible and the sensitivity of an infecting organism to gentamicin should be verified.<br />\r\n<br />\r\nPatients should be advised to inform subsequent physicians of the prior use of corticosteroids.<br />\r\n<br />\r\nWhile no systemic effects have been observed following the topical application of gentamicin, toxic systemic concentrations can cause permanent impairment of vestibular function in the presence of renal insufficiency or existing 8th cranial nerve damage.<br />\r\n<br />\r\nCaution should be exercised if gentamicin is used in individuals who are known to be sensitive to topically applied antibacterials. If irritation or sensitization develops, treatment should be discontinued.<br />\r\n<br />\r\nApplication over extensive lesions may result in significant systemic absorption producing hypercortisonism manifesting itself by adrenal suppression, moon face, striae and suppression of growth in children.<br />\r\n<br />\r\nPatients should be followed up regularly, and the product should be discontinued when the infection has cleared.<br />\r\n<br />\r\nOcclusive dressing should not be used.</p>', '<p><strong>Symptoms</strong>: Excessive prolonged use of topical corticosteroids can suppress pituitary-adrenal function leading to secondary adrenal insufficiency.<br />\r\n<br />\r\n<strong>Treatment</strong>: Correct electrolyte imbalance, if needed. Slow withdrawal of corticosteroids may be needed.</p>', '<p>Other Topical corticosteroids</p>', '<p>Store between 2-30&deg; C.</p>', NULL, '2022-02-15 05:40:14', '2022-03-21 16:53:33'),
(177, 177, '<p><strong>Eye</strong>: Inflammatory conditions (eg. uveitis, marginal keratitis, allergic conjunctivitis, blepharitis and episcleritis) where development of bacterial infection is likely.<br />\r\n<br />\r\n<strong>Ear</strong>: Otitis externa and other inflammatory conditions where bacterial infection is present or suspected.<br />\r\n<br />\r\n<strong>Nose</strong>: Inflammatory conditions where infection is present or suspected.</p>', '<p><strong>Betamethasone&nbsp;</strong>is a corticosteroid which is effective in inflammatory dermatoses. It is also effective in less responsive conditions such as psoriasis. &nbsp;Betamethasone has a 16&beta;-methyl group that enhances the anti-inflammatory action of the molecule and reduces the sodium and water retaining properties of the fluorine atom bound at carbon 9.<br />\r\n<br />\r\n<strong>Neomycin sulfate</strong>&nbsp;is bactericidal against many bacteria which are commonly associated with skin infections. Neomycin is a broad spectrum antibiotic which actively transported across the bacterial cell membrane, binds to a specific receptor protein on the 30s subunit of bacterial ribosomes, and interferes with an initiation complex between mRNA (messenger RNA) and the 30s subunit, inhibiting protein synthesis. DNA may be misread, thus producing nonfunctional proteins; polyribosomes are split apart and are unable to synthesize protein.</p>', '<p><strong>Drops</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Eye</strong>: 1 drop instilled into the eye every one or two hours until control is achieved, when the frequency may be reduced.</li>\r\n	<li><strong>Ear</strong>: 2 or 3 drops instilled into the ear, every two or three hours until control is achieved, when the frequency can be reduced.</li>\r\n	<li><strong>Nose</strong>: 2 or 3 drops instilled into each nostril two or three times daily.</li>\r\n</ul>\r\n\r\n<p><strong>Eye Ointment</strong>: It should be applied thinly and evenly to the conjunctival sac at night (If eye drops used during day) or 3-4 times daily (if ointment used alone).</p>', NULL, '<p>Viral, fungal, tuberculous or purulent conditions. Use in the eye is contra-indicated if glaucoma is present or where herpetic keratitis (e.g. dendritic ulcer) is considered a possibility. Inadvertent use of topical steroids in the latter condition can lead to extension of the ulcer and marked visual deterioration. Preparations containing neomycin should not be used for treating otitis externa when the ear drum is perforated, because of the risk of ototoxicity.</p>', '<p>Acute sensitization to neomycin is a rare event but can occur after topical application to the eye. Eye drops containing corticosteroids cause a serious rise in intra-ocular pressure in a small percentage of the population, including most of those with a family history of glaucoma. A milder rise may be experienced by a larger proportion of subjects if treatment is continued for longer than a few weeks. Thinning of the cornea leading to perforation has occurred with use of topical corticosteroids. Cataract is reported to have occurred after unduly prolonged treatment of eye conditions with topical corticosteroids.</p>', '<p>Pregnancy&nbsp;Category-Not Classified. FDA has not yet classified the drug into a specified pregnancy category.&nbsp;Topical administration of corticosteroid to pregnant animals can cause abnormalities of fetal development. The relevance of this finding to human beings has not been established; however, topical steroids should not be used extensively in pregnancy, i.e. in large amounts or for prolonged periods.</p>', '<p>Steroids should not be administered to &quot;red eyes&quot; until a definitive diagnosis has been made. Ophthalmological treatment with steroid preparations should not be repeated or prolonged without regular review to exclude raised intra-ocular pressure or unsuspected infections. The unnecessary topical use of neomycin containing products should be avoided in order to minimize the occurrence of neomycin-resistant organisms (and organism cross-resistant to other aminoglycosides).</p>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations</p>', '<p>Store below 25&deg; C</p>', NULL, '2022-02-15 05:40:38', '2022-03-21 16:56:20'),
(178, 178, '<p>This cream is usually useful for the treatment of superficial infections caused by gram-positive and gramnegative microorganisms. It is also useful in burns, regeneration of new skin in wounds and ulceration, otitis externa, postoperative infections, neuro-dermatitis and eczema. It may be used as an adjunct to systemic steroid therapy in special kind of pyoderma.</p>', '<p>Betamethasone is an active topical corticosteroid, which produces a rapid response in the inflammatory dermatoses and cures psoriasis types of skin diseases. Neomycin Sulfate is a topical broad-spectrum bactericidal amino-glycoside effective against various kinds of gram-positive and gramnegative pathogens such as Proteus vulgaris, Staphylococcus aureus etc. This preparation has effective penetration and uniform distribution capacity, so it is very effective in hairy and intertriginous places. This preparation is very effective for the treatment of wet ulceration of the skin.</p>', '<p><strong>Use in adults</strong>: This preparation should be applied to the affected parts of the skin as a thin layer for 3 to 4 times daily. In chronic conditions, withdrawal of treatment is carried out by decreasing the frequency of application until the cream is applied as infrequently as once a week. Or as directed by the physician.<br />\r\n<br />\r\n<strong>Use in children</strong>: Do not use it on children under 1 year of age. A course of treatment for a child should not normally last more than 5 days unless otherwise stated by your physician.</p>', '<p>There are no significant drug interactions reported with Betamethasone Valerate BP and Neomycin Sulphate BP Cream/Ointment.</p>', '<p>This preparation is contraindicated to the patients who are hypersensitive to any of its components. It should not be used for the treatment of otitis externa when the eardrum is perforated. It is contraindicated in skin lesions caused by infection with viruses and fungi.</p>', '<p>This preparation is well tolerated. But prolonged and high doses may cause Cushing&#39;s syndrome, acne, thinning and dilatation of blood vessels, particularly when occlusive dressings are used.</p>', '<p>This preparation should not be used extensively in pregnancy.</p>', '<p>Long term continuous topical therapy of this preparation should be avoided, which may produce many resistant micro organisms. So, accurate dose of this preparation should be used in infected areas only.</p>', NULL, '<p>Aural steroid &amp; antibiotic combined preparations</p>', '<p>This cream is usually useful for the treatment of superficial infections caused by gram-positive and gramnegative microorganisms. It is also useful in burns, regeneration of new skin in wounds and ulceration, otitis externa, postoperative infections, neuro-dermatitis and eczema. It may be used as an adjunct to systemic steroid therapy in special kind of pyoderma.</p>', NULL, '2022-02-15 05:40:56', '2022-03-21 17:35:19'),
(179, 179, '<p>Local anorectal conditions like haemorrhoids and fissures where, there is inflammation &amp; pain.</p>', '<p><strong>Betamethasone</strong>&nbsp;is a corticosteroid with mainly glucocorticoid activity. It induces phospholipase A2 inhibitory lipase (lipocortins) and sequentially inhibits the release of arachidonic acid, thereby depressing the formation, release, and activity of prostaglandins, leukotrienes, and other inflammatory mediators.<br />\r\n<br />\r\n<strong>Phenylephrine</strong>&nbsp;is a sympathomimetic with mainly direct effects on alpha-adrenergic receptors and weak beta-adrenergic activity. It causes vasoconstriction of the arterioles of the nasal mucosa and conjunctiva; activates the dilator muscle of the pupil to cause contraction; produces vasoconstriction of arterioles in the body and produces systemic arterial vasoconstriction.<br />\r\n<br />\r\n<strong>Lidocaine</strong>&nbsp;alters signal conduction in neurons by blocking the fast voltage-gated Na+ channels in the neuronal cell membrane responsible for signal propagation. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarize and will thus fail to transmit an action potential.</p>', '<p>Apply locally 2 or 3 times daily initially, using the applicator if internal administration is required, When inflammation is subsiding once-daily application is sufficient in most cases,</p>', '<p>Not known</p>', '<p>Topical corticosteroids are contraindicated in: Primarily infected skin lesions caused by viral infections e.g herpes simplex, vaccinia or varicella (chicken pox), by bacteria e.g impetigo, by fungal infections e.g candidiasis, tineasis or by tuberculous infection of the anal region; Sensitivity to any of the components of the product; Dermatoses in children under 1 year of age.</p>', '<p>As with all topical corticosteroids, its use for prolonged periods, may cause systemic absorption, specially in children. Prolonged and intensive treatment with active corticosteroid preparations may also cause local atrophic changes in the skin. There are reports of pigmentation changes and hypertrichosis with topical steroids, and in this situation it should be discontinued. Some patients may experience burning upon application, specially if the mucous membrane is not intact.</p>', '<p>The safe use of topical corticosteroids in human pregnancy has not been fully established. Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development including cleft palate and intrauterine growth retardation.<br />\r\n<br />\r\nTherefore, there may be a very small risk of such effects in the human fetus. So, it should not be used unnecessarily in large amounts or for prolonged period.</p>', '<p>Long-term continuous treatment should be avoided. Discontinue if sensitization occurs.</p>', NULL, '<p>4-Quinolone preparations, Phlebotonic &amp; Vascular protecting preparation</p>', NULL, NULL, '2022-02-15 05:41:14', '2022-03-21 17:41:40'),
(180, 180, '<p>Betamethasone Dipropionate cream and ointment is<br />\r\nindicated for the relief of the inflammatory and pruritic manifestations of resistant or severe corticosteroid-responsive dermatoses. These include-</p>\r\n\r\n<ul>\r\n	<li>Atopic eczema</li>\r\n	<li>Nummular eczema</li>\r\n	<li>Contact dermatitis</li>\r\n	<li>Neurodermatitis</li>\r\n	<li>Anogenital and senile pruritus</li>\r\n	<li>Lichen planus</li>\r\n	<li>Psoriasis</li>\r\n</ul>', '<p>Betamethasone Dipropionate is a topical corticosteroid with anti-inflammatory, antipruritic and vasoconstrictive properties. Betamethasone Dipropionate induces peptides called lipocortins. Lipocortins antagonize phospholipase A2, an enzyme that causes the breakdown of leukocyte lysosomal membranes to release arachidonic acid. This action decreases the subsequent formation and release of endogenous inflammatory mediators including prostaglandins, kinins, histamine.<br />\r\n<br />\r\nPharmacokinetics: Betamethasone Dipropionate can be absorbed from normal intact skin. Corticosteroids are bound to plasma proteins in varying degrees. Corticosteroids are metabolized primarily in the liver.lt excreted by the kidneys.</p>', '<p>Apply a thin film once or twice daily to cover completely the affected area. Patients with chronic psoriasis who have achieved at least a marked improvement in their psoriatic lesion (i.e., approximately 80% improvement) with Betamethasone Dipropionate may be maintained in remission with a pulse dosing regimen consisting of three consecutive applications of up to 3.5 g each of Betamethasone Dipropionate cream and ointment, twelve hours apart (e.g., morning, evening, following morning) to the previously affected areas once each week. For this purpose, Betamethasone Dipropionate cream and ointment should be applied to the lesion sites previously affected and treated. Patients on this pulse dose regimen who relapse should be reverted back to the conventional dosing regimen.</p>', '<p>There is no evidence of any kind of interaction.</p>', '<p>Hypersensitivity to Betamethasone Dipropionate, other corticosteroids or any components in this preparation. Like other topical corticosteroids, Betamethasone Dipropionate is contraindicated in viral infections of the skin, such as vaccinia, varicella and Herpes simplex, also tuberculosis, acne rosacea, fungal skin infections (moniliasis), perioral dermatitis and ulcerative conditions.</p>', '<p>The most frequent side effects reported with Betamethasone Dipropionate are mild to moderate transient burning/stinging, dry skin, pruritus, irritation and folliculitis. Rarely reported adverse effects include tingling, prickly skin/tightening or cracking of skin, warm feeling,laminar scaling and perilesional scaling,follicular rash, skin atrophy, erythema, urticaria, vesiculation, telangiectasia, acneiform papules and hyperaesthesia.<br />\r\n<br />\r\nAdverse reactions reported with the use of the Betamethasone Dipropionate ointment pulse dose regimen were mild intermittent hypertension and paraesthesia. Other local adverse reactions that have been reported with the use of topical corticosteroids include: itching, hypertrichosis, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, striae, miliaria and exacerbation of untreated infections</p>', NULL, '<p>Betamethasone Dipropionate should not be used in or near the eyes, as there is a potential risk of developing glaucoma and cataract. If irritation or sensitisation develops with the use of Betamethasone Dipropionate, treatment should be discontinued and appropriate therapy instituted. In the presence of an infection, an appropriate antifungal or antibacterial agent should be administered. If a favourable response does not occur promptly, Betamethasone Dipropionate should be discontinued until the infection has been controlled adequately.<br />\r\n<br />\r\nCorticosteroids are known to be absorbed percutaneously, therefore in patients under prolonged and extensive topical treatment, the possibility of systemic effects should be kept in mind. Betamethasone Dipropionate is not intended for use under occlusive dressings since this will also increase systemic absorption of the corticosteroid. In infants the napkin may act as an occlusive dressing and increase absorption. Suitable precautions should be taken when using topical corticosteroids in patients with stasis dermatitis and other skin diseases with impaired circulation. Prolonged use of topical corticosteroid preparations may produce striae or atrophy of the skin or subcutaneous tissue. If this occurs, treatment should be discontinued.</p>', '<p>Acute overdose with the ointment is unlikely and would not be expected to lead to a life-threatening situation. The ointment should not be used for longer than the prescribed time period.</p>', '<p>Corticosteroid</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:42:27', '2022-03-21 17:44:23'),
(181, 181, '<p>This Scalp preparation is used to treat inflammatory, dry and scaly skin disorders, such as Eczema, Psoriasis.</p>', '<p>Betamethasone Dipropionate is a glucocorticoid which have primarily anti-inflammatory and immunosuppressive effects and Salicylic Acid which has keratolytic properties and is applied topically in the treatment of hyperkeratotic. Keratolytic action helps to facilitate the penetration of the corticosteroids easily and Betamethasone Dipropionate is an effective treatment of dermatoses because of their anti-inflammatory, antipruritic and vasoconstrictive actions.</p>', '<p><strong>Scalp Ointment</strong>-</p>\r\n\r\n<ul>\r\n	<li>Adults: Once twice daily. In most cases, the ointment should be applied to the affected area twice daily for two weeks and is reviewed at that time. The maximum weekly dose should not exceed 60 gm.</li>\r\n	<li>Children: Dosage in children should be limited to 5 days.</li>\r\n</ul>\r\n\r\n<p><strong>Scalp Lotion</strong>-</p>\r\n\r\n<ul>\r\n	<li>Apply few drops of this scalp lotion to the affected area and massage gently and thoroughly onto the scalp or skin. The usual frequency of application is twice daily, in the morning and at night.</li>\r\n</ul>', '<p>If other drugs or over-the-counter products use at the same time, this may increase the side effects or cause drug not to work properly. This Scalp preparation may interact with the following products such as Acetaminophen, Atropine, Carbonic anhydrase inhibitors, Chlorpropamide, Glucocorticoids.</p>', '<p>Contraindicated to the hypersensitivity to any of the ingredients of this Scalp preparation. Also contraindicated to use in tuberculosis and most viral lesions of the skin, particularly herpes simplex, vacinia, varicella. This Scalp preparation&nbsp;should not be used in fungal or bacterial skin infections.</p>', '<p>Side effects that have been reported with the application of topical corticosteroids include burning, itching, irritation, dryness, hypopigmentation, perioral dermatitis and allergic contact dermatitis.</p>', '<p>It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus and should not be used for prolonged periods of time in pregnant patients. It is not known this drug is secreted in human milk.</p>', '<p>These drugs should not be used in or near the eyes. This Scalp preparation&nbsp;should not be used in various skin infections (Bacterial, Viral or Fungal). If irritation and sensitization develop with the use of this Scalp preparation, treatment should be discontinued. Application of Salicylic Acid to open wounds or damaged skin should be avoided. Long-term continuous therapy should be avoided in all patients irrespective of age.</p>', NULL, '<p>Topical anti-inflammatory preparations</p>', '<p>Store in a cool &amp; dry place, protected from light and keep out of the reach of children.</p>', NULL, '2022-02-15 05:54:03', '2022-03-21 17:47:04'),
(182, 182, '<p>Short-term treatment of steroid responsive in inflammatory conditions of the eye after clinical exclusion of bacterial, viral or fungal infections. Non-infected inflammatory conditions of the ear or nose.</p>', '<p>Corticosteroids bind to the glucocorticoid receptor, inhibiting pro-inflammatory signals, and promoting anti-inflammatory signals. Betamethasone phosphate has a short duration of action as it is rapidly hydrolyzed to betamethasone. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients taking corticosteroids should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.</p>', '<p><strong>Eye</strong>: 1 or 2 drops to each affected eye every 1 or 2 hours until control is achieved, then the frequency may be reduced.<br />\r\n<strong>Ear</strong>: 2 or 3 drops to each affected ear every 2 or 3 hours until control is achieved, then the frequency may be reduced.<br />\r\n<strong>Nose</strong>: 2 or 3 drops instilled into each nostril 2 or 3 times daily.</p>', '<p>Specific drug interaction studies have not been conducted.</p>', NULL, '<p>Hypersensitivity reactions may occur leading to irritation, burning, stinging, itching and dermatitis. Topical corticosteroid use may result in corneal ulceration, increased intraocular pressure leading to optic nerve damage, reduced visual acuity. Intensive or prolonged use of topical corticosteroids may lead to formation of posterior subcapsular cataracts. In those diseases causing thinning of the cornea or sclera, corticosteroid therapy may result in thinning of the globe leading to perforation. Mydriasis, ptosis and epithelial punctate keratitis have also been reported following ophthalmic use of corticosteroids.</p>', '<p>There are no adequate and well controlled studies for pregnant woman. It should not be used extensively in pregnant woman. There is no information available whether it is secreted in the milk or not.</p>', '<p>Topical corticosteroids should never be given for an undiagnosed red eye. Ophthalmic treatment with corticosteroid preparations should not be repeated or prolonged without regular review to exclude raised intraocular pressure, cataract formation or unsuspected infections.</p>', '<p>Long-term intensive topical use may lead to systemic effects.</p>', '<p>Corticosteroid</p>', '<p>This should be protected from light, store below 25&deg;C. Keep out of reach of children. Do not use more than 4 weeks after opening.</p>', NULL, '2022-02-15 05:54:32', '2022-03-21 17:49:11');
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
(183, 183, '<p>Betamethasone Valerate cream or ointment is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Eczema in children and adults including atopic</li>\r\n	<li>Infantile and descoid eczema</li>\r\n	<li>Prurigo nodularis</li>\r\n	<li>Psoriasis (excluding wide spread plaque psoriasis)</li>\r\n	<li>Neurodermatoses including lichen simplex and lichen planus</li>\r\n	<li>Seborrhoic dermatitis</li>\r\n	<li>Contact sensitivity reaction</li>\r\n	<li>Discoid lupus erythematoses and may be used as adjunct to systemic steroid therapy in generalized erythroderma.</li>\r\n</ul>', '<p>Betamethasone Valerate BP is a synthetic adrenocorticosteroid, which is glucocorticoid in nature. It is an analog of prednisolone that also possesses a slight degree of mineral corticosteroid&nbsp;activity. Due to its anti-inflammatory, antipruritic and vasoconstrictive activity, it is very effective and suitable for dermatological use. It is absorbed from the skin and inflammation and/or another disease process in the skin increase percutaneous absorption from the skin. Occlusive dressings substantially increase its percutaneous absorption.</p>', '<p>Apply sparingly to the affected area two or three times daily until improvement occurs, then twice daily or less. The usual maximum duration of therapy is three weeks.</p>', '<p>There are no significant drug interactions reported with Betamethasone Cream/Ointment.</p>', '<p>Betamethasone Valerate cream or ointment is contraindicated in the following conditions :</p>\r\n\r\n<ul>\r\n	<li>Hypersensitivity to any of the ingredients in the preparation.</li>\r\n	<li>Rosaceae &amp; acne vulgaris.</li>\r\n	<li>Perioral dermatitis, perianal &amp; genital pruritis.</li>\r\n	<li>Viral infections of the skin, e.g. herpes simplex &amp; chicken pox.</li>\r\n	<li>Primary infected skin lesions caused by fungi or bacteria.</li>\r\n	<li>Dermatoses in children under one year of age.</li>\r\n</ul>', '<p>The following local adverse reactions are more common with the use of high doses, long term use and with the use of occlusive dressings of Cream/Ointment: dryness, itching, burning, skin thinning, local irritation, features of hypercorticolism, telagiectasia, striaea, skin atrophy. hypertrichosis, change in pigmentation, secondary infection, perioral dermatiis, allergic contact dermatitis, maceration of the skin, acneform eruption, exacerbation of symptoms.</p>', '<p>It should not be used extensively in pregnancy.</p>', '<p>Betamethasone Cream/Ointment is usually well tolerated but if signs of hypersensitivity appear, application should be stopped. Long term continuous topical therapy should be avoided where possible, particularly in children as adrenal suppression may occur even without occlusion. When extensive areas are treated, sufficient systemic absorption may occur to produce symptoms of hypercorticolism. This effect is more likely if occlusive dressings are used, or if the treatment is prolonged. The face or other areas of the body may exhibit atrophic changes after prolonged treatment. If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye, as glaucoma might result. Any spread of the infection requires withdrawal of topical corticosteroid therapy.</p>', NULL, '<p>Corticosteroid</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:54:53', '2022-03-21 17:53:53'),
(184, 184, '<p>Betaxolol ophthalmic solution has been shown to be effective in lowering intraocular pressure and is indicated in the treatment of ocular hypertension and chronic open-angle glaucoma. May be used alone or in combination with other intraocular pressure-lowering medication.</p>', '<p>Betaxolol is a selective (beta-1-adrenergic) receptor blocking agent that does not have significant membrane stabilizing (local anesthetic) activity and is free from intrinsic sympathomimetic action. When instilled into the eye, Betaxolol reduces elevated as well as normal intraocular pressure, whether or not accompanied by glaucoma. Optic nerve head damage and visual field loss are results of a sustained elevated intraocular pressure and poor ocular perfusion. The ocular hypotensive action of Betaxolol appears to be mediated by a reduction of aqueous production as demonstrated by tonography and aqueous flurophotometry. Betaxolol ophthalmic solution does not produce miosis or accommodative spasm which is frequently seen with miotic.<br />\r\n<br />\r\nThe onset of action with Betaxolol can generally be noted within 30 minutes and the maximal effect can usually be detected two hours after topical administration. A single dose provides a 12-hour reduction in intraocular pressure (IOP) and twice daily administration maintains the IOP below 22 mm Hg in most patients.</p>', '<p><strong>0.5% ophthalmic solution</strong>: The usual dose is 1 drop of Betaxolol Hydrochloride ophthalmic solution in the affected eye(s) twice daily. In some patients, the intraocular pressure-lowering response may require a few weeks to stabilize. Clinical follow-up should include a determination of the intraocular pressure during the first month of treatment. Thereafter, intraocular pressure should be determined on an individual basis at the judgment of the physician.<br />\r\n<br />\r\n<strong>0.25% ophthalmic solution</strong>: The recommended dose is one to two drops of Betaxolol Hydrochloride ophthalmic solution in the affected eye(s) twice daily.<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 in safety or effectiveness have been observed between elderly and younger patients.</p>', '<p>Patients who are receiving a beta-adrenergic blocking agent orally and Betaxolol Hydrochloride Ophthalmic Solution should be observed for a potential additive effect either on the intraocular pressure or on the known systemic effects of beta blockade. Close observation of the patient is recommended when a beta blocker is administered to patients receiving catecholamine-depleting drugs such as reserpine, because of possible additive effects and the production of hypotension and/or bradycardia. Caution should be exercised in patients using concomitant adrenergic psychotropic drugs. In patients with angle-closure glaucoma, the immediate treatment objective is to reopen the angle by constriction of the pupil with a miotic agent. Betaxolol has little or no effect on the pupil. When Betaxolol Hydrochloride Ophthalmic Solution is used to reduce elevated intraocular pressure in angle-closure glaucoma, it should be used with a miotic and not alone.</p>', '<p>Hypersensitivity to any component of this product. Betaxolol should not be used in patients with sinus bradycardia, atrioventricular block greater than first degree, cardiogenic shock, or patients with a history of overt cardiac failure.</p>', '<p><strong>Ocular</strong>: Discomfort of short duration, occasional tearing has been reported. Rare instances of decreased corneal sensitivity, erythema, itching sensation, corneal punctuate staining, keratitis, edema and photophobia have been reported.<br />\r\n<br />\r\n<strong>Systemic</strong>: Systemic reactions following administration of Betaxolol hydrochloride ophthalmic solution 0.5% have been rarely reported. These include:</p>\r\n\r\n<ul>\r\n	<li>Cardiovascular: bradycardia, heart block, congestive heart failure.</li>\r\n	<li>Respiratory: bronchospasm, respiratory failure.</li>\r\n	<li>Others: Hives, toxic epidermal necrolysis, hair loss and glossitis.</li>\r\n</ul>', '<p>There are no adequate &amp; well controlled studies in pregnant women. Betaxolol ophthalmic solution should be used during pregnancy only if the potential benefit justifies the potential risk. It is not known whether Betaxolol is excreted in human milk. The risk of hypoglycemia &amp; bradycardia in nursing infant has not been evaluated. Breast feeding is not recommended during treatment.</p>', '<p>In patients with angle-closure glaucoma, the immediate treatment objective is to re-open the angle by constriction of the pupil with miotic agent. Betaxolol has no effect on the pupil; therefore, Betaxolol&nbsp;should be used with a miotic to reduce elevated intraocular pressure in angle-closure glaucoma. Beta-adrenergic blocking agents should be administered with caution in patients subjected to spontaneous hypoglycemia or to diabetic patients as these agents may mask the signs and symptoms of acute hypoglycemia.</p>', '<p>No information is available on overdosage. A topical overdosage of Betaxolol ophthalmic solution may be flushed from the eye(s) with warm tap water.</p>', '<p>Drugs for miotics and glaucoma</p>', '<p>Store at room temperature. It is desirable that the content should not be used more than one month after first opening of the bottle.</p>', NULL, '2022-02-15 05:56:00', '2022-03-21 17:58:20'),
(185, 185, '<p>Betrixaban is indicated for the prophylaxis of venous thromboembolism (VTE) in adult patients hospitalized for an acute medical illness and at risk for thromboembolic complications due to moderate or severe restricted mobility and other risk factors for VTE.</p>', '<p>Betrixaban is a factor Xa inhibitor that selectively blocks the active site of factor Xa and does not require a cofactor (such as Anti-thrombin III) for activity. Betrixaban inhibits free factor Xa and prothrombinase activity. By directly inhibiting factor Xa, Betrixaban decreases thrombin generation (TG). Betrixaban has no direct effect on platelet aggregation.</p>', '<p>The recommended dose of Betrixaban is an initial single dose of 160 mg, followed by 80 mg once daily. Daily oral doses should be given at the same time of day with food. The recommended duration of treatment is 35 to 42 days.</p>', '<p><strong>P-gp Inhibitors</strong>: Increase the blood level of Betrixaban.<br />\r\n<strong>P-gp Inducers</strong>: Decrease the blood level of Betrixaban.<br />\r\n<strong>Anticoagulants, Antiplatelets and Thrombolytics</strong>: May increase the risk of bleeding</p>', '<p>Betrixaban is contraindicated in patients with active pathological bleeding. It is also contraindicated in patients with severe hypersensitivity reaction to Betrixaban</p>', '<p>Most common adverse reaction is bleeding, epidural or spinal hematoma may develop during spinal/epidural anesthesia or puncture.</p>', '<p><strong>Use in Pregnancy</strong>: There are no data with the use of Betrixaban in pregnant women, but treatment is likely to increase the risk of hemorrhage during pregnancy and delivery.<br />\r\n<br />\r\n<strong>Lactation</strong>: No data are available regarding the presence of Betrixaban or its metabolites in human milk, the effects of the drug on the breastfed infant, or the effects of the drug on milk production.</p>', '<p><strong>Risk of Bleeding</strong>: Can cause bleeding. Promptly evaluate any signs or symptoms of blood loss.<br />\r\n<br />\r\n<strong>Spinal/Epidural Anesthesia or Puncture</strong>: When neuraxial anesthesia (spinal/epidural anesthesia) or spinal/epidural puncture is employed, patients treated with antithrombotic agents for prevention of thromboembolic complications are at risk of developing an epidural or spinal hematoma which can result in long-term or permanent paralysis. Do not remove an epidural catheter earlier than 72 hours after the last administration of Betrixaban. Do not administer the next Betrixaban dose earlier than 5 hours after the removal of the catheter. If traumatic puncture occurs, delay the administration of Betrixaban for 72 hours.<br />\r\n<br />\r\n<strong>Severe Renal Impairment</strong>: Increase risk of bleeding events.<br />\r\n<br />\r\n<strong>Concomitant P-gp Inhibitors</strong>: Increase risk of bleeding events</p>', NULL, '<p>Anti-platelet drugs</p>', '<p>Protect from light and moisture, store below 30&deg;C. Keep the medicine out of reach of children.</p>', '<p><strong>Patients with Severe Renal Impairment</strong>: No dose adjustment is needed for mild or moderate renal impairment (CrCl&gt;30 mL/min). For patients with severe renal impairment (CrCl&ge;15 to &lt;30 mL/min) the recommended dose of Betrixaban is an initial single dose of 80 mg followed by 40 mg once daily.<br />\r\n<br />\r\n<strong>Patients with Hepatic Impairment</strong>: No dose adjustment is required in patients with mild hepatic impairment. Avoid use in patients with moderate to severe hepatic impairment.</p>', '2022-02-15 05:56:21', '2022-03-21 18:37:01'),
(186, 186, '<p><strong>Bevacizumab is indiated for</strong>-</p>\r\n\r\n<ul>\r\n	<li>Metastatic Colorectal Cancer (mCRC)</li>\r\n	<li>Non-Squamous Non&ndash;Small Cell Lung Cancer (NSCLC)</li>\r\n	<li>Glioblastoma</li>\r\n	<li>Metastatic Renal Cell Carcinoma (mRCC)</li>\r\n	<li>Persistent, Recurrent, or Metastatic Carcinoma of the Cervix</li>\r\n	<li>Platinum-Resistant Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer</li>\r\n</ul>', '<p>Bevacizumab binds VEGF and prevents the interaction of VEGF to its receptors (Flt-1 and KDR) on the surface of endothelial cells. The interaction of VEGF with its receptors leads to endothelial cell proliferation and new blood vessel formation in in vitro models of angiogenesis. Administration of bevacizumab to xenotransplant models of colon cancer in nude (athymic) mice caused reduction of microvascular growth and inhibition of metastatic disease progression.</p>', '<p><strong>Metastatic Colorectal Cancer (mCRC)</strong>: The recommended doses are 5 mg/kg or 10 mg/kg every 2 weeks when used in combination with intravenous 5-FU-based chemotherapy.</p>\r\n\r\n<ul>\r\n	<li>Administer 5 mg/kg when used in combination with bolus-IFL.</li>\r\n	<li>Administer 10 mg/kg when used in combination with FOLFOX4.</li>\r\n	<li>Administer 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks when used in combination with a fluoropyrimidine-irinotecan or fluoropyrimidine-oxaliplatin based chemotherapy regimen in patients who have progressed on a first-line Bevacizumab-containing regimen.</li>\r\n</ul>\r\n\r\n<p><strong>Non-Squamous Non-Small Cell Lung Cancer (NSCLC)</strong>: The recommended dose is 15 mg/kg every 3 weeks in combination with carboplatin and paclitaxel.<br />\r\n<br />\r\n<strong>Glioblastoma</strong>: The recommended dose is 10 mg/kg every 2 weeks.<br />\r\n<br />\r\n<strong>Metastatic Renal Cell Carcinoma (mRCC)</strong>: The recommended dose is 10 mg/kg every 2 weeks in combination with interferon alfa.<br />\r\n<br />\r\n<strong>Cervical Cancer</strong>: The recommended dose of Bevacizumab is 15 mg/kg every 3 weeks as an intravenous infusion administered in combination with one of the following chemotherapy regimens: paclitaxel and cisplatin, or paclitaxel and topotecan.<br />\r\n<br />\r\n<strong>Platinum-Resistant Recurrent Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Cancer</strong>: The recommended dose is 10mg/ kg every 2 weeks in combination with one of the following intravenous chemotherapy regimens: paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly); or 15 mg/kg every 3 weeks in combination with topotecan (every 3 weeks).</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Do not administer as an intravenous push or bolus. Administer only as an intravenous (IV) infusion. Do not initiate Bevacizumab until at least 28 days following major surgery. Administer Bevacizumab after the surgical incision has fully healed.<br />\r\n<br />\r\nFirst infusion: Administer infusion over 90 minutes. Subsequent infusions: Administer second infusion over 60 minutes if first infusion is tolerated; administer all subsequent infusions over 30 minutes if infusion over 60 minutes is tolerated.</p>', '<p>A drug interaction study was performed in which irinotecan was administered as part of the FOLFIRI regimen with or without Bevacizumab. The results demonstrated no significant effect of Bevacizumab on the pharmacokinetics of irinotecan or its active metabolite SN38.<br />\r\n<br />\r\nIn a randomized study in 99 patients with NSCLC, based on limited data, there did not appear to be a difference in the mean exposure of either carboplatin or paclitaxel when each was administered alone or in combination with Bevacizumab. However, 3 of the 8 patients receiving Bevacizumab plus paclitaxel/carboplatin had substantially lower paclitaxel exposure after four cycles of treatment (at Day 63) than those at Day 0, while patients receiving paclitaxel/carboplatin without Bevacizumab had a greater paclitaxel exposure at Day 63 than at Day 0.</p>', '<p>There are no contraindications listed in the manufacturer&rsquo;s labeling.</p>', '<p>dry mouth, cough, voice changes, loss of appetite, diarrhea, nausea, vomiting, constipation, loss of appetite, mouth sores, headache, back , pain, cold symptoms (stuffy nose, sneezing, sore throat), dry or watery eyes, dry or flaky skin, hair loss, changes in your sense of taste, jaw pain/swelling/numbness, loose teeth, or gum infection.</p>', '<p>Pregnancy Category C. There are no adequate or well controlled studies of bevacizumab in pregnant women. &nbsp;It is not known whether Avastin is secreted in human milk.</p>', '<p>Arterial Thromboembolic Events. Among patients receiving Bevacizumab in combination with chemotherapy, the risk of developing ATE during therapy was increased in patients with a history of arterial thromboembolism, diabetes, or age greater than 65</p>', '<p>The highest dose tested in humans (20 mg/kg IV) was associated with headache in nine of 16 patients and with severe headache in three of 16 patients.</p>', '<p>Targeted Cancer Therapy</p>', '<p>Bevacizumab vials are stable at 2 to 8&deg; C. Bevacizumab vials should be protected from light. Do not freeze or shake. Diluted Bevacizumab solutions may be stored at 2 to 8&deg; C for up to 8 hours. Store in the original carton until time of use. No incompatibilities between Bevacizumab and polyvinylchloride or polyolefin bags have been observed.</p>', '<p>The safety, effectiveness and pharmacokinetic profile of Bevacizumab in pediatric patients have not been established. In published literature reports, cases of non-mandibular osteonecrosis have been observed in patients under the age of 18 years who have received Bevacizumab. Bevacizumab is not approved for use in patients under the age of 18 years.<br />\r\n<br />\r\nAntitumor activity was not observed among eight children with relapsed glioblastoma treated with Bevacizumab and irinotecan. There is insufficient information to determine the safety and efficacy of Bevacizumab in children with glioblastoma.</p>', '2022-02-15 05:56:43', '2022-03-21 18:42:18'),
(187, 187, '<p>Bicalutamide 50 mg daily is indicated&nbsp;for use in combination&nbsp;therapy&nbsp;with a&nbsp;luteinizing hormone-releasing hormone&nbsp;(LHRH)&nbsp;analog&nbsp;for the treatment of Stage D2 metastatic carcinoma of the&nbsp;prostate.<br />\r\n<br />\r\nBicalutamide 150 mg daily is not approved&nbsp;for use alone or with other treatments</p>', '<p>Bicalutamide is a non-steroidal androgen receptor&nbsp;inhibitor. It competitively inhibits the action of androgens by binding to cytosol androgen receptors in the target tissue. Prostatic&nbsp;carcinoma&nbsp;is known to be androgen sensitive and responds to treatment that counteracts the effect of androgen and/or removes the source of androgen.<br />\r\n<br />\r\nWhen Bicalutamide is combined with luteinizing hormone releasing hormone (LHRH) analog&nbsp;therapy, the suppression of&nbsp;serum&nbsp;testosterone&nbsp;induced by the LHRH analog is not affected. However, in&nbsp;clinical trials&nbsp;with Bicalutamide as a single agent for&nbsp;prostate cancer, rises in serum testosterone and estradiol have been noted.<br />\r\n<br />\r\nIn a subset of patients who have been treated with Bicalutamide and an&nbsp;LHRH agonist, and who discontinue Bicalutamide therapy due to progressive advanced prostate&nbsp;cancer, a reduction in&nbsp;Prostate Specific Antigen&nbsp;(PSA) and/or clinical improvement (antiandrogen&nbsp;withdrawal phenomenon) may be observed.</p>', '<p>The recommended dose for Bicalutamide therapy in combination with an LHRH analog is one 50 mg tablet once daily (morning or evening), with or without food. It is recommended that Bicalutamide be taken at the same time each day. Treatment with Bicalutamide should be started at the same time as treatment with an LHRH analog.</p>', '<p>May induce torsade de pointes or QT prolongation if co-administered with class IA (e.g. quinidine) or class III (e.g. amiodarone) antiarrhythmic agents, methadone, antipsychotics, moxifloxacin. Enhanced anticoagulant effect of warfarin. Increased adverse effects when used with drugs that may inhibit oxidation (e.g. cimetidine, ketoconazole). May increase serum levels of ciclosporin and Ca channel blockers.</p>', '<p>Females, children, Pregnancy and lactation. Concomitant use of terfenadine, astemizole or cisapride.</p>', '<p>Anaemia; angioedema, urticaria; decreased appetite, DM, wt gain, dehydration, gout; decreased libido, depression, anxiety, hypertonia, confusion, neuropathy, nervousness, dizziness, somnolence; hot flush; abdominal pain, constipation, nausea, dyspepsia, flatulence, anorexia, rectal haemorrhage, dry mouth, melaena; hepatotoxicity, jaundice, hypertransaminasaemia; alopecia, hirsutism, dry skin, pruritus/rash, photosensitivity; haematuria, dysuria, urinary retention, impaired urination, urinary frequency; gynaecomastia, breast tenderness, erectile dysfunction; asthenia, oedema, chest pain, neck pain, fever, sepsis, chills, neoplasm; cough, pharyngitis, bronchitis, pneumonia, rhinitis.</p>', '<p>Pregnancy category X. 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.<br />\r\n<br />\r\nNursing Mothers: Bicalutamide is not indicated for use in women.</p>', '<p>Patient with decreased bone density, history of or risk factors for QT prolongation, diabetes, Moderate to severe hepatic and severe renal impairment (CrCl &lt;30 mL/min).</p>', '<p>Long-term&nbsp;clinical trials&nbsp;have been conducted with dosages up to 200 mg of Bicalutamide daily and these dosages have been well tolerated. A single dose of Bicalutamide that results in symptoms of an overdose considered to be life threatening has not been established. There is no specific antidote; treatment of an overdose should be&nbsp;symptomatic.<br />\r\n<br />\r\nIn the management of an overdose with Bicalutamide, vomiting may be induced if the patient is alert. It should be remembered that, in this patient population, multiple drugs may have been taken.&nbsp;Dialysis&nbsp;is not likely to be helpful since Bicalutamide is highly protein bound and is extensively metabolized. General supportive care, including frequent monitoring of&nbsp;vital&nbsp;signs and close observation of the patient, is indicated.</p>', '<p>Hormonal Chemotherapy</p>', '<p>Store at controlled room temperature, 20&deg; to 25&deg; C.</p>', '<p><strong>Renal Impairment</strong>: No dosage adjustment is necessary for patients with renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment is necessary for patients with mild to moderate hepatic impairment. In patients with severe liver impairment (n=4), although there was a 76% increase in the half-life (5.9 and 10.4 days for normal and impaired patients, respectively) of the active enantiomer of bicalutamide no dosage adjustment is necessary.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Bicalutamide in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: In two studies in patients given 50 or 150 mg daily, no significant relationship between age and steady-state levels of total bicalutamide or the active R-enantiomer has been shown.<br />\r\n<br />\r\n<strong>Women</strong>: Bicalutamide has not been studied in women.</p>', '2022-02-15 05:57:01', '2022-03-21 18:48:42'),
(188, 188, '<p>Bicarbonate Component [HCO3 Hemodialysis Solution] solution is indicated in renal failure, Chronic renal failure and Haemodialysis. Bicarbonate serves a crucial biochemical role in the physiological pH buffering system.</p>', '<p>Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives. Sodium bicarbonate raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide.</p>', '<p>Acidic component &amp; Bicarbonate Component should be used in the dilution ratio of-</p>\r\n\r\n<ul>\r\n	<li>Acidic component: 1.00 Volume</li>\r\n	<li>Bicarbonate Component: 1.83 Volume</li>\r\n	<li>Purified Water: 34.00 Volume</li>\r\n</ul>', '<p>Sodium bicarbonate: Increases toxicity of amphetamines, ephedrine, pseudoephedrine, flecainide, quinidine and quinine. Decreases effects of lithium, chlorpropamide and salicylates due to increased clearance. May affect the absorption of certain drugs due to raised intra-gastric pH. Sodium chloride: May affect serum concentrations of lithium.</p>', '<p>Known hypersensitivity to any of the ingredients of this preparation.</p>', NULL, NULL, '<ul>\r\n	<li>Bicarbonate Component needs to be used with Acidic component (not to be used alone).</li>\r\n	<li>Before use, the mixed solution must be diluted with</li>\r\n	<li>highly purified water.</li>\r\n	<li>Close the container tightly immediately after use.</li>\r\n	<li>Discard solution in case of visible solid particles inside.</li>\r\n	<li>Discard solution after 96 hours of first opening.</li>\r\n</ul>', NULL, '<p>Haemodialysis solutions</p>', '<p>Keep out of reach of children. Not for Injection. Store below 30&deg;C.</p>', NULL, '2022-02-15 05:57:19', '2022-03-21 18:50:51'),
(189, 189, '<p>Bilastine is indicated for symptomatic treatment of allergic rhino-conjunctivitis (seasonal and perennial) and urticaria.</p>', '<p>Bilastine is a non-sedating, long-acting histamine antagonist with selective peripheral H 1 receptor antagonist affinity and no affinity for muscarinic receptors. Bilastine inhibits histamine-induced wheal and flare skin reactions for 24 hours following single doses.</p>', '<p><strong>Adults &amp; adolescents (12 years of age and over)</strong>: 20 mg tablet once daily for symptomatic relief of allergic rhinitis, urticaria and allergic rhinoconjunctivitis. The maximum recommended daily dose is 20 mg Bilastine (1 tablet) and should not be exceeded. If a dose is missed, the next scheduled dose should be taken. An extra dose should not be taken. 20 mg Bilastine tablet (1 tablet) once daily should be swallowed with water on an empty stomach to achieve optimal exposure to Bilastine.<br />\r\n<br />\r\n<strong>Children between 6 to 11 years</strong>: 10 mg mouth dissolving tablet for the symptomatic relief of allergic rhinitis, allergic rhinoconjunctivitis and urticaria. The Mouth dissolving tablet is for oral use only. It should be placed in the mouth. It will disperse rapidly in saliva and can be easily swallowed. Alternatively, the mouth dissolving tablet can be dispersed in a tea spoon of water before being swallowed by the children. The maximum recommended daily dose for children in between 6 to 11 years is 10 mg Bilastine mouth dissolving tablet (1 tablet) and should not be exceeded. If a dose is missed, the next scheduled dose should be taken. An extra dose should not be taken.<br />\r\n<br />\r\n<strong>Children between 2 to 11 years</strong>: 4 ml once daily.</p>', '<p>Concomitant intake of Bilastine and Ketoconazole or Erythromycin or Diltiazem increased C max of Bilastine. The psychomotor performance after concomitant intake of alcohol and Bilastine was similar to that observed after intake of alcohol and placebo. Concomitant intake of Bilastine and Lorazepam 3 mg for 8 days did not potentiate the depressant CNS effects of Lorazepam.</p>', '<p>Bilastine is contraindicated in patients with hypersensitivity to the active substance or to any of the excipients of the tablet.</p>', '<p>The most commonly reported side effects in clinical trial are headache, dizziness, somnolence and fatigue. These adverse events occurred with a comparable frequency in patients receiving placebo.</p>', '<p>There are no or limited amount of data from the use of Bilastine in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity, parturition or postnatal development. As a precautionary measure, it is preferable to avoid the use of Bilastine during pregnancy. The excretion of Bilastine in milk has not been studied in humans. A decision must be made taking into account the benefit of breast-feeding for the child and the benefit of Bilastine therapy for the mother.</p>', '<p>Co-administration of Bilastine and P-glycoprotein inhibitors (e.g. Ketoconazole, Erythromycin, Cyclosporine, Ritonavir or Diltiazem) should be avoided in patients with moderate or severe renal impairment.</p>', '<p>In clinical trials, after administration of Bilastine at doses 10 to 11 times the therapeutic dose (220 mg as single dose; or 200 mg/day for 7 days) frequency of treatment-emergent adverse events was two times higher than with placebo. The adverse reactions most frequently reported were dizziness, headache and nausea. No serious adverse events and no significant prolongation in the QTc interval were reported.</p>', '<p>Non-sedating antihistamines</p>', '<p>Keep below 30&deg;C temperature, protected from light and moisture. Keep out of reach of children.</p>', '<p>Efficacy and safety of Bilastine in children under 2 years of age have not been established and there is little clinical experience in children aged 2 to 5 years, therefore Bilastine should not be used in these age groups.</p>', '2022-02-15 05:57:46', '2022-03-21 18:54:02'),
(190, 190, '<p>Bimatoprost is indicated for Ocular hypertension, Open-angle glaucoma</p>', '<p>Bimatoprost is believed to lower intraocular pressure (IOP) in humans by increasing outflow of aqueous humor through both the trabecular meshwork and uveoscleral routes. Bimatoprost reduces the pressure in the eye by mimicking the action of a naturally-occuring prostaglandin. Prostaglandins are a group of chemicals found in many places in the body. In the eye, they increase the drainage of the aqueous humour out of the eyeball. Bimatoprost is a synthetic compound related to one of the natural prostaglandins, and works by increasing the drainage of aqueous humour out of the eyeball. Bimatoprost may also lower the rate of aqueous formation in the eye. Both these effects decrease the pressure within the eye.</p>', '<p><strong>Adult:</strong>&nbsp;Instill 1 drop into affected eye(s) once every night.</p>', '<p>There is not known drug interactions and none well documented.</p>', '<p>Known hypersensitivity.</p>', '<p>Common side effects are: Burning/stinging/irritation/ redness/discomfort of the eye, Feeling as if something is in your eye, Dry eyes, Watering eyes, Temporary unstable vision, Increased sensitivity to light, Dizziness.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the fetus (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 fetus.</p>', '<p>May increase pigmentation of the iris, periorbital tissue and eyelashes. Active intraocular inflammation. Safety and efficacy have not been evaluated in the treatment of inflammatory, neovascular or angle closure glaucoma. Ensure at least an interval of 5 minutes between admin of ophthalmic preparations. Contact lenses should be removed prior to admin. Pregnancy, lactation.</p>', '<p>Treatment is symptomatic.</p>', '<p>Drugs for miotics and glaucoma</p>', '<p>Store at 2-25&deg; C.</p>', NULL, '2022-02-15 05:58:07', '2022-03-21 19:08:00'),
(191, 191, '<p>This Eye Drops is indicated for the reduction of intraocular pressure in adult patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to mono-therapy.</p>', '<p>Bimatoprost is believed to lower intraocular pressure (IOP) in humans by increasing outflow of aqueous humor through both the trabecular meshwork and uveoscleral routes. Bimatoprost reduces the pressure in the eye by mimicking the action of a naturally-occuring prostaglandin. Prostaglandins are a group of chemicals found in many places in the body. In the eye, they increase the drainage of the aqueous humour out of the eyeball. Bimatoprost is a synthetic compound related to one of the natural prostaglandins, and works by increasing the drainage of aqueous humour out of the eyeball. Bimatoprost may also lower the rate of aqueous formation in the eye. Both these effects decrease the pressure within the eye.<br />\r\n<br />\r\nSimilar to propranolol and nadolol, timolol is a non-selective, beta-adrenergic receptor antagonist. Timolol does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anesthetic (membrane-stabilizing) activity, but does possess a relatively high degree of lipid solubility. Timolol, when applied topically to the eye, has the action of reducing elevated, as well as normal, intraocular pressure, whether or not accompanied by glaucoma. Elevated intraocular pressure is a major risk factor in the pathogenesis of glaucomatous visual field loss and optic nerve damage.</p>', '<p>The recommended dose is one drop in the affected eye(s) once-daily.</p>', '<p>There is a potential for bradycardia when ophthalmic beta blockers solution is administered concomitantly with oral calcium channel blockers, guanethidine, beta-adrenergic blocking agents, parasympathomimetics, anti-arrhythmics and digitalis glycosides. Concomitant ocular medications should be administered at least 5 min apart from the instillations of this&nbsp;Eye Drops</p>', '<p>It is contraindicated in patients with known hypersensitivity to any ingredient of this formulation.</p>', '<p>In clinical trials, Ocular hyperemia was reported in approximately 26% of patients. 5 to 10 % in these clinical studies included decreased visual acuity, eye discomfort, foreign body sensation, pain and pruritis.</p>', '<p><strong>Use in Pregnancy</strong>: There are no adequate data from the use of the Bimatoprost / Timolol fixed combination in pregnant women. It should not be used during pregnancy unless clearly necessary.<br />\r\n<br />\r\n<strong>Use in Lactation</strong>: Animal studies showed Bimatoprost is excreted in rat&rsquo;s milk. &amp; Timolol is excreted in human milk. Therefore, Bimatoprost / Timolol should not be used during breastfeeding.</p>', '<p>Like other topically applied ophthalmic medicinal products, the active substances Timolol/ Bimatoprost may be absorbed systemically. Due to the beta-adrenergic component, Timolol, the same types of cardiovascular, pulmonary and other adverse reactions as seen with systemic beta-blockers may occur. Caution should be exercised in treating patients with severe or unstable and uncontrolled cardiovascular Disease.</p>', NULL, '<p>Other ophthalmic preparations</p>', '<p>Store below 25&deg; C in a dry place protected from light. Keep out of reach of children. Solution can be used up to 28 days after first opening.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and other adult patients.</p>', '2022-02-15 05:58:36', '2022-03-21 19:12:28'),
(192, 192, '<p>Biphasic Insulin Aspart (rDNA) is indicated to improve glycemic control in adults and children with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus.</p>', '<p>30% Insulin Aspart and 70% Insulin Aspart Protamine (rDNA) is a human insulin analog suspension containing 30 % soluble Insulin Aspart and 70% Insulin Aspart Protamine crystals. This is a blood glucose lowering agent with an earlier onset and an intermediate duration of action. Insulin Aspart is homologous with regular human insulin with the exception of a single substitution of the proline by aspartic acid in position B28, and is produced by recombinant DNA technology utilizing Saccharomyces cerevisiae (baker&rsquo;s yeast).<br />\r\n<br />\r\nPrimary function of insulin, including Insulin Aspart, is regulation of glucose metabolism. Insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, primarily by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin inhibits lipolysis and proteolysis, and enhances protein synthesis.</p>', '<p>The dosage of insulin aspart must be individualized.<br />\r\n<br />\r\n<strong>Subcutaneous injection</strong>: insulin aspart should generally be given immediately (within 5-10 minutes) prior to the start of a meal.<br />\r\n<br />\r\n<strong>Use in pumps</strong>: Change the insulin aspart in the reservoir at least every 6 days, change the infusion set, and the infusion set insertion site at least every 3 days. insulin aspart should not be mixed with other insulins or with a diluent when it is used in the pump.<br />\r\n<br />\r\n<strong>Intravenous use</strong>: insulin aspart should be used at concentrations from 0.05 U/mL to 1.0 U/mL insulin aspart in infusion systems using polypropylene infusion bags. insulin aspart has been shown to be stable in infusion fluids such as 0.9% sodiumchloride.</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Before going for administration of Biphasic Insulin Aspart (rDNA) please follow the below mentioned check list:</p>\r\n\r\n<ul>\r\n	<li>Insulin syringe of the right size (100 units/ml)</li>\r\n	<li>Prescribed type of insulin injection</li>\r\n	<li>Check the expiry date on Biphasic Insulin Aspart (rDNA) vial</li>\r\n	<li>Ensure that the flip off cap on the Biphasic Insulin Aspart (rDNA) vial is intact</li>\r\n</ul>\r\n\r\n<p>After that follow the below mentioned instructions:</p>\r\n\r\n<ul>\r\n	<li>Wash your hands carefully. Shake or roll the vial 10 times to completely Mix the insulin.</li>\r\n	<li>lnspect the vial. Vial should appear white and cloudy after mixing.</li>\r\n	<li>When using a new vial, flip off the plastic protective cap, but do not remove the stopper. The tip of the vial should be wiped with an alcohol swab.</li>\r\n	<li>Draw air into the syringe equal to your insulin dose.</li>\r\n	<li>Insert needle into vial through rubber top &amp; push plunger to empty the air into the vial.</li>\r\n	<li>Turn the bottle and syringe upside down. Hold the bottle and syringe firmly in one hand and shake gently. Make sure that the tip of the needle is in the liquid; withdraw the correct dose of insulin into the syringe.</li>\r\n	<li>Before removing the needle from the vial, check the insulin syringe for air bubbles, which reduces the amount of insulin in it, if bubbles are present, hold the insulin straight up and tap its side until the bubbles float to the top. Push them out with the plunger and withdraw the correct dose again.</li>\r\n	<li>Lightly pinch up the skin, holding the syringe like a pencil.</li>\r\n	<li>Insert the needle into the skin &amp; push the plunger slowly. Make sure that the needle is all the way in.</li>\r\n	<li>Wait for 5 seconds &amp; pull out the syringe. Do not rub the area.</li>\r\n</ul>', '<p>A number of substances affect glucose metabolism and may require dose adjustment and particularly close monitoring.<br />\r\n<br />\r\n<strong>The following are examples that may increase the blood glucose lowering effect and susceptibility to hypoglycemia</strong>: oral anti-diabetic products, pramlintide and angiotensin converting enzyme (ACE) inhibitors, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, propoxyphene, salicylates and sulfonamide antibiotics.<br />\r\n<br />\r\n<strong>The following substances are examples that may reduce the blood glucose lowering effect</strong>: corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, isoniazid, phenothiazine derivatives, somatropin, estrogens, progestogens, atypical antipsychotics and danazol. Beta-blockers, clonidine, lithium salts, and alcohol may either potentiate or weaken the blood-glucose-lowering effect of insulin. Pentamidine may cause hypoglycemia, which may sometimes be followed by hyperglycemia.</p>', '<p>Biphasic Insulin Aspart (rDNA) is contraindicated</p>\r\n\r\n<ul>\r\n	<li>During episodes of hypoglycemia</li>\r\n	<li>In patients with hypersensitivity to Insulin Aspart or any of its excipients.</li>\r\n</ul>', '<p>Side effects of Insulin Aspart are hypoglycemia, lipodystrophy, weight gain, peripheral edema.</p>', '<p>Pregnancy category B. Careful monitoring of glucose control is essential in such patients because insulin requirements change during different stages of pregnancy. Therefore female patients should be advised to tell their physician if they intend to become or if they become pregnant while taking insulin aspart<br />\r\n<br />\r\nLactation: It is unknown whether Insulin Aspart is excreted in human milk as occurs with human insulin. There are no adequate and well-controlled studies of the use of insulin aspart in lactating women. Lactating Women may require adjustments of their insulin doses.</p>', '<p><strong>Dose adjustment and monitoring</strong>: Blood glucose should be monitored in all patients treated with insulin. Insulin regimens should be modified cautiously and only under medical supervision.<br />\r\n<br />\r\n<strong>Renal or hepatic impairment</strong>: Reduction in the Insulin Aspart dose may require in these cases.</p>', '<p>Insulin Aspart overdose may result in hypoglycemia. Mild episodes of hypoglycemia can usually be treated with oral carbohydrates. Severe hypoglycemia may be treated with parenteral glucose or injections of glucagon. Adjustments in drug dosage, meal patterns, or exercise may be needed.</p>', '<p>Combination Insulin</p>', '<p>Store at 2&deg;C to 8&deg;C in a refrigerator. Do not freeze. In case of insulin for recent use need not be refrigerated, try to keep it in a cool place and keep away from heat and light. The insulin in use can be kept under the room temperature for a month.</p>', '<p><strong>Pediatric</strong>: Has not been studied in children with type 2 diabetes. Has not been studied in children with type 1 diabetes &lt;2 years of age</p>', '2022-02-15 05:59:17', '2022-03-21 19:15:59'),
(193, 193, '<p>Bisacodyl is indicated in the-</p>\r\n\r\n<ul>\r\n	<li>Treatment of constipation.</li>\r\n	<li>Preparation for radiographic or endoscopic examination of the colon.</li>\r\n</ul>', '<p>Bisacodyl is a diphenolic compound. Its chemical structure is similar to that of phenolphthalein. It is widely used as a laxative. Bisacodyl acts on the colon to stimulate peristalsis and on the small bowel and colon to increase intraluminal water and electrolytes. When applied to the caecum, Bisacodyl initiates a response in the entire colon.</p>', '<p>Constipation-</p>\r\n\r\n<ul>\r\n	<li>Adult: 5-10 mg at night; occasionally necessary to increase to 15-20 mg;</li>\r\n	<li>Child under 10 years: 5 mg.</li>\r\n</ul>\r\n\r\n<p>Before radiological procedures and surgery-</p>\r\n\r\n<ul>\r\n	<li>Adult: 10 mg orally at bed-time for 2 days before the examination.</li>\r\n	<li>Child: half of the adult dose.</li>\r\n</ul>', NULL, '<p>Ileus, intestinal obstruction, acute surgical abdominal conditions such as acute appendicitis, and acute inflammatory bowel diseases, severe dehydration.</p>', '<p>Bisacodyl is free of side effects if taken in the recommended doses. Overuse of bisacodyl may result in diarrhea and malabsorption. Bisacodyl overuse might be expected to deplete potassium.</p>', '<p>Bisacodyl like other medicines, should not be used during pregnancy especially the first trimester. In breastfeeding women, bisacodyl should be cautiously used.</p>', '<p>Excessive use of bisacodyl may lead to fluid and electrolyte imbalance. Chronic use can cause dependence.</p>', NULL, '<p>Stimulant purgatives</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-15 05:59:58', '2022-03-21 19:19:12'),
(194, 194, '<p>Bismuth Subsalicylate is indicated for-</p>\r\n\r\n<ul>\r\n	<li>upset stomach</li>\r\n	<li>indigestion</li>\r\n	<li>heartburn</li>\r\n	<li>nausea and</li>\r\n	<li>diarrhea.</li>\r\n</ul>', '<p><strong>Antacid action</strong>: Bismuth Subsalicylate coats ulcer surface, protecting it from acid and pepsin. It stimulates mucus and bicarbonate secretion and also reacts with HCl, produces bismuth oxychloride and salicylic acid thus reduces HCl.<br />\r\n<br />\r\n<strong>Anti-diarrheal action</strong>: It stimulates absorption of water and electrolytes across the intestinal wall. In infectious diarrhea it binds with toxin produced by E.coli, disrupts cell, causing lysis of H.pylori and prevents adhesion of H.pylori in the cell wall of intestine.<br />\r\n<br />\r\n<strong>Anti-inflammatory action</strong>: When hydrolyzed to salicylic acid, it inhibits prostaglandin G/H synthase &frac12;. Thus reduces inflammation and Coats the irritated tissue to retard the expulsion of fluid.</p>', '<p><strong>Adult (&gt;16)</strong>: 30 ml in dosing cup provided or 6x5 ml spoonful<br />\r\n<strong>Children (10-14 years)</strong>: 15 mL (3 teaspoons)<br />\r\n<strong>Children (5-9 years)</strong>: 7.5 mL (1.5 teaspoons)<br />\r\n<strong>Children (3-4 years)</strong>: 5 mL (1 teaspoon)<br />\r\n<strong>Children under 3 years</strong>: Ask a doctor.<br />\r\n<strong>Use in the elderly</strong>: No special precaution is needed.<br />\r\n<strong>Patient is suffering from renal insufficiency</strong>: caution should be taken.<br />\r\n<br />\r\nRepeat dose every &frac12; to 1 hour if needed. Not more than 8 doses to be taken in 24 hours.</p>', '<p>Bismuth Subsalicylate Contains salicylates therefore care should be exercised if receiving drugs to thin the blood (anticoagulant therapy) or oral therapy for diabetes or treatment for gout or arthritis.</p>', '<p>Bismuth Subsalicylate should not be used by patients hypersensitive to Aspirin or other salicylates or any ingredient in this formulation. Keep all medicines out of reach and sight of children.</p>', '<p>Black stool and black tongue is common with use of Bismuth Subsalicylate. Bismuth Subsalicylate should not be used if symptoms are severe or persist for more than 2 days. Do not exceed the recommended dose, shake the bottle before use. For oral use only.</p>', '<p>There are no adequate data concerning the use of Bismuth Subsalicylate in pregnant women. Animal studies are insufficient with respect to effects on pregnancy, embryonal/foetal development, parturition and postnatal development. The potential risk for humans is unknown. Bismuth Subsalicylate should not be used during lactation unless clearly necessary.</p>', '<p>Do not take with aspirin or other salicylates. Caution should be exercised by patients taking medicines for anti-coagulation (thinning of the blood), diabetes or gout.</p>', '<p>Bismuth intoxication may present as an acute encephalopathy with confusion, myoclonic movements, tremor, dysarthria and walking and standing disorders. Bismuth intoxication may also cause gastrointestinal disturbances, skin reactions, discoloration of mucous membranes, and renal dysfunction as a result of acute tubular necrosis. Treatment includes gastric lavage, purgation and hydration. Chelating agents may be effective in the early stages following ingestion and haemodialysis may be necessary. Overdose of Bismuth Subsalicylate may also give symptoms of salicylate intoxification e.g. dizziness, tinnitus, sweating, nausea, headache. If symptoms occur, use of Bismuth Subsalicylate&nbsp; should be discontinued. Management of overdose is the same as that for salicylate overdose.</p>', NULL, '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 06:00:22', '2022-03-21 19:21:26');
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
(195, 195, '<p>Bisoprolol &amp; Amlodipine combination is indicated for the treatment of hypertension as substitution therapy in patients adequately controlled with the individual products given concurrently at the same dose level as in the combination, but as separate tablets</p>', '<p>This consists of Amlodipine and Bisoprolol Fumarate. Amlodipine is a dihydropyridine calcium antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. 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. Amlodipine acts directly on vessels to cause a reduction in peripheral vascular resistance and reduction in blood pressure.<br />\r\n<br />\r\nBisoprolol Fumarate is a synthetic, beta1-selective (cardioselective) adrenoceptor blocking agent, lacking intrinsic sympathomimetic and relevant membrane stabilizing activity. It only shows low affinity to the beta2 receptor of the smooth muscles of bronchi and vessels as well as to the beta2-receptors concerned with metabolic regulation. Therefore, bisoprolol is generally not to be expected to influence airway resistance and beta2-mediated metabolic effects. Its beta1-selectivity extends beyond the therapeutic dose range.</p>', '<p>One tablet once daily in patients whose blood pressure is adequately controlled with separately administered monocomponent products of the same doses as the recommended fixed-dose combination.</p>', '<p><strong>Combinations not recommended</strong>: Calcium antagonists of the verapamil and diltiazem type, centrally-acting antihypertensive drugs.<br />\r\n<br />\r\n<strong>Combinations to be used with caution</strong>: Strong or moderate CYP3A4 inhibitors, CYP3A4 inducers, simvastatin, Tacrolimus, Cyclosporine, class I antiarrhythmic drugs, class III antiarrhythmic drugs, parasympathomimetic drugs, topical beta-blockers (e.g. eye drops), insulin and oral antidiabetic drugs, anesthetic agents, digitalis glycosides, non-steroidal anti-inflammatory drugs (NSAIDs), sympathomimetic agents, antihypertensive agents and other drugs with blood pressure lowering potential.<br />\r\n<br />\r\n<strong>Combinations to be considered</strong>: Mefloquine, Rifampicin, Ergotamine derivatives, MAO inhibitors (except MAO-B inhibitor).</p>', '<p>Acute heart failure or during episodes of heart failure decompensation, obstruction of the outflow tract of the left ventricle (e.g. high grade aortic stenosis), cardiogenic shock, second or third degree AV block, sick sinus syndrome, sinoatrial block, symptomatic bradycardia or hypotension, severe bronchial asthma, severe forms of peripheral arterial occlusive disease or severe forms of Raynaud&rsquo;s syndrome, untreated phaeochromocytoma metabolic acidosis, hypersensitivity to bisoprolol, amlodipine, dihydropyridine derivates or to any of the excipients.</p>', '<p><strong>Common</strong>: Dizziness, headache, somnolence, palpitations, flushing, feeling of coldness or numbness in the extremities, gastrointestinal complaints such as nausea, vomiting, diarrhea, constipation, abdominal pain; edema (e.g. ankle edema), fatigue.<br />\r\n<br />\r\n<strong>Uncommon</strong>: Insomnia, mood changes (incl. anxiety), depression, sleep disorders, hypaesthesia, paresthesia, dysgeusia, tremor, visual disturbances (incl. diplopia), tinnitus, AV conduction disturbances, worsening of pre existing heart failure, bradycardia, hypotension, syncope, dyspnea, bronchospasm in patients with bronchial asthma or a history of obstructive airway disease, rhinitis, dyspepsia, dry mouth, alopecia, purpura, skin discoloration, pruritus, exanthema, arthralgia, myalgia, muscular weakness, muscle cramps, back pain, micturition disorder, nocturia, pollakisuria, potency disorders, gynecomastia, asthenia, chest pain, pain, malaise, weight increase, weight decrease.<br />\r\n<br />\r\n<strong>Rare</strong>: Allergic reactions mainly affecting the skin, nightmares, hallucinations, confusion, decreased tear secretion, hearing disorders, allergic rhinitis, hepatitis, increased triglycerides, increased liver enzymes (ALAT, ASAT).</p>', '<p>Pregnancy and Lactation: Not recommended.</p>', '<p>Patients with heart failure should be treated with caution. An increased risk of a further deterioration of the ventricular pump function cannot be excluded. Since the abrupt withdrawal of bisoprolol may lead to a transitory worsening of the clinical condition, especially in patients with ischemic heart disease, the treatment must not be stopped abruptly. Caution is advised in patients with impaired hepatic function. Beta-blockers should be avoided in patients with obstructive airways diseases unless there are compelling clinical reasons for their use. Due to the bisoprolol component treatment must be used with caution in: bronchospasm (bronchial asthma, chronic obstructive airways disease; concomitant bronchodilating therapy may be recommended); diabetes mellitus showing large fluctuations in blood glucose values, symptoms of hypoglycemia can be masked; strict fasting; ongoing desensitization therapy; first degree AV block; Prinzmetal&rsquo;s angina; peripheral arterial occlusive disease. Patients with psoriasis or with a history of psoriasis should only be given beta-blockers (e.g. bisoprolol) after a careful balancing of benefits and risks. Symptoms of thyrotoxicosis may be masked. In patients undergoing general anesthesia, the anesthetist must be aware of beta-blockade. If it is thought necessary to withdraw beta blocker therapy before surgery, this should be done gradually and completed about 48 hours before anesthesia.</p>', '<p>Most common signs expected with overdose of a beta-blocker are bradycardia, hypotension, bronchospasm, acute cardiac insufficiency, hypoglycemia. According to available data gross overdose of amlodipine could result in excessive peripheral vasodilation and possibly reflex tachycardia. Marked and probably prolonged systemic hypotension up to and including shock with fatal outcome have been reported. In general, if overdose occurs, discontinuation of treatment and supportive and symptomatic treatment is recommended.</p>', '<p>Anti-hypertensive</p>', '<p>Keep in a dry place, below 30&deg;C. Protect from light. Keep out of the reach of children.</p>', '<p><strong>Geriatric use</strong>: The usual doses can be administered to elderly people; however, caution is advised when the dose is increased.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: The safety and efficacy of Bisoprolol fumarate/amlodipine in children and adolescents below the age of 18 years have not been established. No data are available.<br />\r\n<br />\r\n<strong>Patients with Liver disease</strong>: In case of hepatic impairment elimination of amlodipine may be elongated. Exact dosage recommendations concerning amlodipine have not been established, but the drug should therefore be administered with special caution in these patients. In case of severe hepatic impairment, the daily dose of bisoprolol must not exceed 10 mg.<br />\r\n<br />\r\n<strong>Patients with Kidney disease</strong>: No dosage adjustment is required for patients with mild to moderate renal impairment. Amlodipine is not dialyzable. Amlodipine should be administered with particular caution to patients undergoing dialysis. In case of severe renal impairment (creatinine clearance &lt;20 ml/min) the daily dose of bisoprolol must not exceed 10 mg</p>', '2022-02-15 06:01:13', '2022-03-21 19:24:19'),
(196, 196, '<p>Bisoprolol plus Hydrochlorothiazide is indicated in the treatment of Hypertension.</p>', '<p>Bisoprolol Fumarate and Hydrochlorothiazide have been used individually and in combination for the treatment of hypertension. The antihypertensive effects of these agents are additive; Hydrochlorothiazide 6.25 mg significantly increases the antihypertensive effect of Bisoprolol Fumarate. The incidence of hypokalemia with the Bisoprolol Fumarate and Hydrochlorothiazide 6.25 mg combination is significantly lower than with Hydrochlorothiazide 25 mg. Bisoprolol Fumarate is a &beta;1-selective (cardioselective) adrenoceptor blocking agent without significant membrane stabilizing or intrinsic sympathomimetic activities in its therapeutic dose range. Hydrochlorothiazide is a benzothiadiazine diuretic. Thiazides affect renal tubular mechanisms of electrolyte reabsorption and increase excretion of sodium and chloride in approximately equivalent amounts</p>', '<p>Bisoprolol is an effective treatment of hypertension in once-daily doses of 2.5 to 40 mg, while Hydrochlorothiazide is effective in doses of 12.5 to 50 mg. In clinical trials of Bisoprolol/Hydrochlorothiazide combination therapy using Bisoprolol doses of 2.5 to 20 mg and Hydrochlorothiazide doses of 6.25 to 25 mg, the antihypertensive effects increased with increasing doses of either component.<br />\r\n<br />\r\n<strong>Initial Therapy</strong>: Antihypertensive therapy may be initiated with the lowest dose of this conbination, one 2.5/6.25 mg tablet once daily. Subsequent titration (14 day intervals) may be carried out with this tablets up to the maximum recommended dose 20/12.5 mg once daily, as appropriate.<br />\r\n<br />\r\n<strong>Replacement Therapy</strong>: The combination may be substituted for the titrated individual components.<br />\r\n<br />\r\n<strong>Therapy Guided by Clinical Effect</strong>: A patient whose blood pressure is not adequately controlled with 2.5-20 mg Bisoprolol daily may instead be given this conbination. Patients whose blood pressures are adequately controlled with 50 mg of hydrochlorothiazide daily, but who experience significant potassium loss with this regimen, may achieve similar blood pressure control without electrolyte disturbance if they are switched to this conbination.</p>', '<p>This combination drug may potentiate the action of other antihypertensive agents used concomitantly. This combination drug should not be combined with other beta-blocking agents. Patients receiving catecholamine-depleting drugs, such as reserpine or guanethidine, should be closely monitored because the added beta-adrenergic blocking action of Bisoprolol Fumarate may produce excessive reduction of sympathetic activity. In patients receiving concurrent therapy with clonidine, if therapy is to be discontinued, it is suggested that this combination drug be discontinued for several days before the withdrawal of clonidine. This combination drug should be used with caution when myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes) or antiarrhythmic agents, such as disopyramide, are used concurrently. Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.</p>', '<p>It is contraindicated in patients in cardiogenic shock, overt cardiac failure, second or third degree AV block, marked sinus bradycardia, anuria and hypersensitivity to either component of this product or to other sulfonamide-derived drugs.</p>', '<p>Generally well tolerated. Most side effects have been mild and transient. Side effects which may occur: fatigue, dizziness, headache, bradycardia, arrhythmia, peripheral ischemia, chest pain, palpitations, rhythm disturbances, cold extremities, claudication, orthostatic hypotension, diarrhoea, constipation, nausea, dyspepsia, rhinitis, pharyngitis etc.</p>', '<p><strong>Use in Pregnancy</strong>: Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Bisoprolol Fumarate and Hydrochlorothiazide should be used during pregnancy only if the potential benefit justifies the risk to the fetus.<br />\r\n<br />\r\n<strong>Use in Nursing Mothers</strong>: Bisoprolol Fumarate alone or in combination with Hydrochlorothiazide has not been studied in nursing mothers. Thiazides are excreted in human breast milk. Small amounts of Bisoprolol Fumarate have been detected in the milk of lactating rats. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Hyperuricemia or acute gout may be precipitated in certain patients receiving thiazide diuretics. Warning signs or symptoms of fluid and electrolyte imbalance include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia and gastrointestinal disturbances such as nausea and vomiting. Hypokalemia may develop. If withdrawal of this combination therapy is planned, it should be achieved gradually over a period of about 2 weeks. Patients should be carefully observed.</p>', '<p>There are limited data on overdose with this combination product. The most frequently observed signs expected with overdosage of a beta-blocker are bradycardia and hypotension. Lethargy is also common and with severe overdoses, delirium, coma, convulsions, and respiratory arrest have been reported to occur. Congestive heart failure, bronchospasm, and hypoglycemia may occur. With thiazide diuretics, acute intoxication is rare. The most prominent feature of overdose is acute loss of fluid and electrolytes. Signs and symptoms include cardiovascular (tachycardia, hypotension, shock), neuromuscular (weakness, confusion, dizziness, cramps of the calf muscles, paresthesia, fatigue, impairment of consciousness), gastrointestinal (nausea, vomiting, thirst), renal (polyuria, oliguria, or anuria), and laboratory findings (hypokalemia, hyponatremia, hypochloremia, alkalosis, increased BUN [especially in patients with renal insufficiency]).</p>', '<p>Combined antihypertensive preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 06:01:51', '2022-03-21 19:27:05'),
(197, 197, '<p>Bisoprolol is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Hypertension</li>\r\n	<li>Angina</li>\r\n	<li>Moderate to severe heart failure</li>\r\n</ul>\r\n\r\n<p>Bisoprolol is not recommended for the emergency treatment of hypertensive crises.</p>', '<p>Bisoprolol Hemifumarate is the most selective &szlig;1 blocker. It displays highest level of affinity for the &szlig;1 receptor than any other beta-blocker available up to now. Selectively blocks &szlig;1 adrenergic receptor in the heart and vascular smooth muscle and reduces heart rate and cardiac output resulting in decrease of arterial hypertension. Lipid metabolism can be adversely affected by &szlig;-blockers, in patients with non-&szlig;1 selective &szlig;1-blocker, but Bisoprolol does not cause any change in the cholesterol fraction including the cardioprotective HDL-cholesterol, in long-term therapy.</p>', '<p><strong>Adult</strong>: In the treatment of mild to moderate hypertension, Bisoprolol fumarate must be individualized to the needs of the patient. The usual starting dose is 5 mg once daily either added to a diuretic or alone. If the response to 5 mg is inadequate, the dose may be increased to 10 mg and then, if necessary, to 20 mg once daily. An appropriate interval for dose titration is 2 weeks. Increasing the dose beyond 20 mg once daily produces only a small incremental benefit.<br />\r\n<br />\r\n<strong>Children</strong>: Safety and effectiveness in children have not been established.<br />\r\n<br />\r\n<strong>Patients With Renal or Hepatic Impairment</strong>: In patients with hepatic impairment (hepatitis or cirrhosis) or renal dysfunction (creatinine clearance less than 40 mL/min) as in other patients, the initial daily dose should be 5 mg. Because of the possibility of accumulation, caution must be used in dose titration. Since limited data suggest that bisoprolol fumarate is not dialysable, drug replacement is not necessary in patients undergoing dialysis.<br />\r\n<br />\r\n<strong>Geriatrics</strong>: In the elderly, it is not usually necessary to adjust the dose, unless there is also significant renal or hepatic dysfunction</p>', '<p><strong>Other &beta;-blocking Agents</strong>: Bisoprolol fumarate should not be combined with other &beta;-blocking agents.<br />\r\n<br />\r\n<strong>Catecholamine-Depleting Drugs</strong>: Patients receiving catecholamine-depleting drugs, such as reserpine or guanethidine, should be monitored closely because the added &beta;-adrenergic blocking action of bisoprolol fumarate may produce excessive reduction of sympathetic activity.<br />\r\n<br />\r\n<strong>Centrally Active Antihypertensive Agents</strong>: &beta;-blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine. If the two drugs are coadministered, the &beta;-blocker should be withdrawn several days before discontinuing clonidine. If replacing clonidine by &beta;-blocker therapy, the introduction of &beta;-blockers should be delayed for several days after clonidine administration has stopped (see also prescribing information for clonidine).<br />\r\n<br />\r\n<strong>Antiarrhythmic Agents</strong>: Bisoprolol fumarate should be used with care when myocardial depressants or inhibitors of A-V conduction, such as certain calcium antagonists (particularly of the phenyl alkylamine (verapamil) and benzothiazepine (diltiazem) classes), or antiarrhythmic agents, such as disopyramide, are used concurrently.<br />\r\n<br />\r\n<strong>Calcium Channel Blockers</strong>: Combined use of &beta;-blockers and calcium channel blockers with negative inotropic effects can lead to prolongation of S-A and A-V conduction, particularly in patients with impaired ventricular function or conduction abnormalities. This may result in severe hypotension, bradycardia and cardiac failure.</p>', '<p>In patients with cardiogenic shock, overt heart failure, second or third degree A-V block, right ventricular failure secondary to pulmonary hypertension and sinus bradycardia.</p>', '<p>Bisoprolol, like any medication, may have some side effects. It is important that you keep your doctor informed of all side effects especially if you experience one of the following for several days. The most common side effects, whether or not caused by Bisoprolol, are: headache, fatigue, urinary tract infection, rhinitis or sinusitis (inflammation in the nose), diarrhea, dizziness, peripheral edema (swelling of the ankles), joint pain, cough, insomnia (trouble sleeping), nausea (feeling like vomiting), and sore throat. You must seek medical attention immediately if you experience an allergic reaction with symptoms of rash, itching, swelling, dizziness or trouble breathing.<br />\r\n<br />\r\nMedicines affect different people in different ways. Just because side effects have occurred in other patients does not mean you will get them. Discuss how you feel on Bisoprolol with your doctor or pharmacist. Do not stop or restart Bisoprolol on your own.</p>', '<p><strong>Pregnancy</strong>: Bisoprolol fumarate was not teratogenic in rats at doses up to 150 mg/kg/day, which is 375 times the maximum recommended human daily dose. Bisoprolol fumarate was fetotoxic (increased late resorptions) at 50 mg/kg/day and maternotoxic (decreased food intake and body-weight gain) at 150 mg/kg/day. Bisoprolol fumarate was not teratogenic in rabbits at doses up to 12.5 mg/kg/day, which is 31 times the maximum recommended human daily dose, but was embryolethal (increased early resorptions) at 12.5 mg/kg/day. There are no studies in pregnant women. Bisoprolol fumarate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: Small amounts of bisoprolol fumarate (&lt;2% of the dose) have been detected in the milk of lactating rats. It is not known whether this drug is excreted in human milk. If use of bisoprolol fumarate is considered essential, then mothers should stop nursing.</p>', '<p>Monitoring of renal, hepatic and hematopoietic function should be performed at regular intervals during long-term treatment with bisoprolol.</p>', NULL, '<p>Anti adrenergic agent (Beta blockers), Beta-adrenoceptor blocking drugs, Beta-blockers</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-15 06:02:22', '2022-03-21 19:30:04'),
(198, 198, '<p>Bivalirudin is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Anticoagulant in Patients Undergoing PTCA/PCI or PCI with HITS/HITTS</li>\r\n	<li>Unstable Angina/Non-ST-Elevation MI (Off-label)</li>\r\n	<li>STEMI Undergoing Primary PCI (Off-label)</li>\r\n	<li>Heparin-induced Thrombocytopenia</li>\r\n</ul>', '<p>Bivalirudin directly inhibits thrombin by specifically binding both to the catalytic site and to the anion-binding exosite of circulating and clot-bound thrombin. Thrombin is a serine proteinase that plays a central role in the thrombotic process, acting to cleave fibrinogen into fibrin monomers and to activate Factor XIII to Factor XIIIa, allowing fibrin to develop a covalently cross-linked framework which stabilizes the thrombus; thrombin also activates Factors V and VIII, promoting further thrombin generation, and activates platelets, stimulating aggregation and granule release. The binding of bivalirudin to thrombin is reversible as thrombin slowly cleaves the bivalirudin-Arg3-Pro4 bond, resulting in recovery of thrombin active site functions.<br />\r\n<br />\r\nIn in vitro studies, bivalirudin inhibited both soluble (free) and clot-bound thrombin, was not neutralized by products of the platelet release reaction, and prolonged the activated partialthromboplastin time (aPTT), thrombin time (TT), and prothrombin time (PT) of normal human plasma in a concentration-dependent manner. The clinical relevance of these findings is unknown.</p>', '<p><strong>PCI/PTCA</strong>: IV Bolus dose of 0.75 mg/kg followed by an infusion of 1.75 mg/kg/h for duration of PCI procedure. Five minutes after bolus dose, obtain ACT and administer additional bolus of 0.3 mg/kg if indicated.<br />\r\n<br />\r\n<strong>HIT/HITTS</strong>: IV Bolus dose of 0.75 mg/kg, followed by a continuous infusion at a rate of 1.75 mg/kg/h for the duration of the procedure.<br />\r\n<br />\r\n<strong>Continuation of Therapy</strong>: IV Infusion may be continued for up to 4 h post-procedure as indicated. After 4 h, an additional IV infusion of 0.2 mg/kg/h for up to 20 h may be given if needed.<br />\r\n<br />\r\n<strong>Concomitant Therapy</strong>: Bivalirudin is intended for concurrent use with aspirin (300 to 325 mg/day).</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>For IV administration only. Not for intradermal, subcutaneous, IM, or intra-arterial administration.</li>\r\n	<li>Reconstitute powder for injection with 5 mL sterile water for injection. Gently swirl until powder is dissolved.</li>\r\n	<li>For initial bolus infusion, further dilute each reconstituted via in 50 mL of 5% dextrose in water or sodium chloride 0.9% for injection to yield a final concentration of 5 mg/mL.</li>\r\n	<li>For low rate infusion, further dilute each reconstituted vial in 500 mL of 5% dextrose in water or sodium chloride 0.9% for injection to yield a final concentration of 0.5 mg/mL.</li>\r\n	<li>Do not mix with the following drugs in the same IV line: alteplase, amiodarone, amphotericin B, chlorpromazine, diazepam, dobutamine, prochlorperazine, reteplase, streptokinase, vancomycin.</li>\r\n	<li>Reconstituted bivalirudin should be a clear to slightly opalescent, colorless to slightly yellow solution. Do not administer if reconstituted or diluted solution is discolored, cloudy, or contains particulate matter.</li>\r\n	<li>Maintain meticulous catheter technique, with frequent aspiration and flushing, paying special attention to minimizing conditions of stasis within the catheter or vessels.</li>\r\n	<li>Discard any unused reconstituted or diluted solution.</li>\r\n</ul>', '<p>Co-administration of Bivalirudin with heparin, warfarin, thrombolytics, or GPIs was associated with increased risks of major bleeding events.</p>', '<p>Bivalirudin is contraindicated in patients with: Active major<br />\r\nbleeding &amp; Hypersensitivity (e.g., anaphylaxis) to Bivalirudin or its components</p>', '<ul>\r\n	<li>Bleeding, Body as a Whole: fever,infection, sepsis;</li>\r\n	<li>Cardiovascular: hypotension, syncope, vascular anomaly,ventricular fibrillation;</li>\r\n	<li>Nervous: cerebral ischemia, confusion, facialparalysis;</li>\r\n	<li>Respiratory: lung edema;</li>\r\n	<li>Urogenital: kidney failure, oliguria.</li>\r\n</ul>', '<p><strong>Pregnancy</strong>&nbsp;Category B. No adequate and well-controlled studies in pregnant women. As animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Bivalirudin&nbsp;is intended for use with aspirin . Because of possible adverse effects on the neonate and the potential for increased maternal bleeding, particularly during the third trimester, Bivalirudin and aspirin should be used together during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether bivalirudin is excreted in human milk. As many drugs are excreted in human milk, caution should be exercised when Bivalirudin is administered to a nursing woman.</p>', '<p><strong>Bleeding Events</strong>: Although most bleeding associated with the use of Bivalirudin in PCI/PTCA occurs at the site of arterial puncture, hemorrhage can occur at any site. An unexplained fall in blood pressure or hematocrit should lead to serious consideration of a hemorrhagic event and cessation of Bivalirudin administration. Bivalirudin&nbsp;should be used with caution in patients with disease states associated with an increased risk of bleeding.<br />\r\n<br />\r\n<strong>Coronary Artery Brachy therapy</strong>: An increased risk of thrombus formation, including fatal outcomes, has been associated with the use of Bivalirudin in gamma brachytherapy. If a decision is made to use Bivalirudin during brachytherapy procedures, maintain meticulous catheter technique, with frequent aspiration and flushing, paying special attention to minimizing conditions of stasis within the catheter or vessels.</p>', '<p>Cases of overdose of up to 10 times the recommended bolus or continuous infusion dose of Bivalirudin have been reported in clinical trials and in postmarketing reports. A number of the reported overdoses were due to failure to adjust the infusion dose of bivalirudin in persons with renal dysfunction including persons on hemodialysis . Bleeding, as well as deaths due to hemorrhage, have been observed in some reports of overdose. In cases of suspected overdosage, discontinue Bivalirudin immediately and monitor the patient closely for signs of bleeding. There is no known antidote to Bivalirudin. Bivalirudin is hemodialyzable</p>', '<p>Anti-platelet drugs</p>', '<p>Store at temperature not exceeding 30&ordm; C in a dry place. Do not freeze. Keep out of reach of children</p>', '<p><strong>Renal Impairment</strong>: The clearance of Bivalirudin was reduced approximately 20% in patients with moderate and severe renal impairment and was reduced approximately 80% in dialysis-dependent patients.The infusion dose of Bivalirudin may need to be reduced, and anticoagulant status monitored in patients with renal impairment</p>\r\n\r\n<ul>\r\n	<li><strong>ClCr 30 to 50 mL/min</strong>: Administer infusion at rate of 1.75 mg/kg/h.</li>\r\n	<li><strong>ClCr less than 30 mL/min</strong>: Reduce infusion rate to 1 mg/kg/h.</li>\r\n</ul>\r\n\r\n<p><strong>Hemodialysis</strong>: Reduce infusion rate to 0.25 mg/kg/h. No reduction in bolus dose needed.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Bivalirudin in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Elderly patients experienced more bleeding events than younger patients. Patients treated with Bivalirudin experienced fewer bleeding events in each age stratum, compared to heparin.</p>', '2022-02-15 06:02:45', '2022-03-21 19:33:16'),
(199, 199, '<p>Bleomycin sulfate should be considered a palliative treatment. It has been shown to be useful in the management of the following neoplasms either as a single agent or in proven combinations with other approved chemotherapeutic agents:<br />\r\n<br />\r\n<strong>Squamous Cell Carcinoma</strong>: Head and neck (including mouth, tongue, tonsil, nasopharynx, oropharynx, sinus, palate, lip, buccal mucosa, gingivae, epiglottis, skin, larynx), penis, cervix, and vulva. The response to Bleomycin sulfate is poorer in patients with previously irradiated head and neck cancer.<br />\r\n<br />\r\n<strong>Lymphomas</strong>: Hodgkin&rsquo;s disease, non-Hodgkin&rsquo;s lymphoma.<br />\r\n<br />\r\n<strong>Testicular Carcinoma</strong>: Embryonal cell, choriocarcinoma, and teratocarcinoma. Bleomycin sulfate has also been shown to be useful in the management of Malignant Pleural Effusion</p>', '<p>Although the exact mechanism of action of bleomycin sulfate is unknown, available evidence indicates that the main mode of action is the inhibition of DNA synthesis with some evidence of lesser inhibition of RNA and protein synthesis.<br />\r\n<br />\r\nBleomycin is known to cause single, and to a lesser extent, double-stranded breaks in DNA. In&nbsp;in vitro&nbsp;and in vivo experiments, bleomycin has been shown to cause cell cycle arrest in G2 and in mitosis. When administered into the pleural cavity in the treatment of malignant pleural effusion, bleomycin sulfate acts as a sclerosing agent.</p>', '<p>Because of the possibility of an anaphylactoid reaction, lymphoma patients should be treated with 2 units or less for the first 2 doses. If no acute reaction occurs, then the regular dosage schedule may be followed.<br />\r\n<br />\r\n<strong>Squamous cell carcinoma, non-Hodgkin&rsquo;s lymphoma, testicular carcinoma</strong>: 0.25 to 0.50 units/kg (10 to 20 units/m2) given intravenously, intramuscularly, or subcutaneously weekly or twice weekly.<br />\r\n<br />\r\n<strong>Hodgkin&rsquo;s disease</strong>: 0.25 to 0.50 units/kg (10 to 20 units/m2) given intravenously, intramuscularly, or subcutaneously weekly or twice weekly. After a 50% response, a maintenance dose of 1 unit daily or 5 units weekly intravenously or intramuscularly should be given.<br />\r\n<br />\r\nPulmonary toxicity of Bleomycin sulfat appears to be dose-related with a striking increase when the total dose is over 400 units. Total doses over 400 units should be given with great caution.<br />\r\n<br />\r\n<strong>Note</strong>: When Bleomycin sulfat is used in combination with other antineoplastic agents, pulmonary toxicities may occur at lower doses.<br />\r\n<br />\r\nImprovement of Hodgkin&rsquo;s disease and testicular tumors is prompt and noted within 2 weeks. If no improvement is seen by this time, improvement is unlikely. Squamous cell cancers respond more slowly, sometimes requiring as long as 3 weeks before any improvement is noted.<br />\r\n<br />\r\n<strong>Malignant Pleural Effusion</strong>: 60 units administered as a single dose bolus intrapleural injection</p>', '<p>Increased incidence and severity of lung toxicity with previous or concurrent radiotherapy to the chest. Combination with vinca alkaloids may result to a syndrome corresponding to morbus Raynaud, ischaemia which can lead to necrosis of peripheral parts of the body (fingers, toes, nose tip). May reduce the absorption of phenytoin. Increased risk of agranulocytosis with clozapine.</p>', '<p>Acute pulmonary infection or greatly reduced lung function. Concomitant brentuximab, cisplatin or oxygen. Lactation.</p>', '<p>Common side effects of Bleomycin Sulfate include injection site reactions (pain, redness, warmth, itching, or swelling), fever, chills, vomiting, loss of appetite, weight loss, darkening or discoloration of the skin, changes in fingernails or toenails, itching, or pain near your tumor.</p>', '<p>Pregnancy Category D. It is not known whether the drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, it is recommended that nursing be discontinued by women receiving Bleomycin Sulfate therapy.</p>', '<p>Caution should be taken in patient with severe heart disease, Renal impairment, Elderly &amp; Pregnancy.</p>', '<p><strong>Symptoms</strong>: Hypotension, fever, rapid pulse and general symptoms of shock.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic. In case of resp complications, treat with a corticosteroid and a broad-spectrum antibiotic.</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>Store between 2-8&deg;C. Protect from light and should not be used after the expiration date is reached.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Bleomycin&nbsp;in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: In clinical trials, pulmonary toxicity was more common in patients older than 70 years than in younger patients</p>', '2022-02-15 06:03:06', '2022-03-21 19:36:51'),
(200, 200, '<p>Bortezomib is a proteasome inhibitor indicated for:</p>\r\n\r\n<ul>\r\n	<li>Treatment of patients with multiple myeloma</li>\r\n	<li>Treatment of patients with mantle cell lymphoma who have received at least 1 prior therapy</li>\r\n</ul>', '<p>Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26S proteasome in mammalian cells. The 26S proteasome is a large protein complex that degrades ubiquitinated proteins. The ubiquitin-proteasome pathway plays an essential role in regulating the intracellular concentration of specific proteins, thereby maintaining homeostasis within cells. Inhibition of the 26S proteasome prevents this targeted proteolysis, which can affect multiple signaling cascades within the cell. This disruption of normal homeostatic mechanisms can lead to cell death. Experiments have demonstrated that bortezomib is cytotoxic to a variety of cancer cell types in vitro. Bortezomib causes a delay in tumor growth in vivo in nonclinical tumor models, including multiple myeloma.</p>', '<p>The recommended dose of Bortezomib is 1.3 mg/m2 administered as a 3 to 5 second bolus intravenous injection. Dose adjustment may be used to manage adverse events that occur during treatment</p>', '<p><strong>Ketoconazole</strong>: Co-administration of ketoconazole, a potent CYP3A inhibitor, increased the exposure of bortezomib. Therefore, patients should be closely monitored when given bortezomib in combination with potent CYP3A4 inhibitors (e.g. ketoconazole, ritonavir).<br />\r\n<br />\r\n<strong>Melphalan-Prednisone</strong>: Co-administration of melphalan prednisone increased the exposure of bortezomib. However, this increase is unlikely to be clinically relevant.<br />\r\n<br />\r\n<strong>Omeprazole</strong>: Co-administration of omeprazole, a potent inhibitor of CYP2C19, had no effect on the exposure of bortezomib.<br />\r\n<br />\r\n<strong>Cytochrome P450</strong>: Patients who are concomitantly receiving Bortezomib and drugs that are inhibitors or inducers of cytochrome P450 3A4 should be closely monitored for either toxicities or reduced efficacy</p>', '<p>Bortezomib is contraindicated in patients with hypersensitivity to bortezomib, boron, or mannitol</p>', '<p>Most commonly reported adverse reactions (incidence &ge;30%) in clinical studies include asthenic conditions, diarrhea, nausea, constipation, peripheral neuropathy, vomiting, pyrexia, thrombocytopenia, psychiatric disorders, anorexia and decreased appetite, neutropenia, neuralgia, leukopenia and anemia. Other adverse reactions, including serious adverse reactions, have been reported</p>', '<p>Pregnancy Category D. Women of childbearing potential should avoid becoming pregnant while being treated with Bortezomib. Bortezomib administered to rabbits during organogenesis at a dose approximately 0.5 times the clinical dose of 1.3 mg/m2 based on body surface area caused post implantation loss and a decreased number of live fetuses.</p>', '<p>Women should avoid becoming pregnant while being treated with Bortezomib. Pregnant women should be apprised of the potential harm to the fetus<br />\r\n<br />\r\nPeripheral neuropathy, including severe cases, may occur - manage with dose modification or discontinuation. Patients with preexisting severe neuropathy should be treated with Bortezomib only after careful risk-benefit assessment.<br />\r\n<br />\r\nHypotension can occur. Caution should be used when treating patients receiving antihypertensives, those with a history of syncope, and those who are dehydrated.&nbsp;<br />\r\n<br />\r\nPatients with risk factors for, or existing heart disease, should be closely monitored.<br />\r\n<br />\r\nAcute diffuse infiltrative pulmonary disease has been reported.<br />\r\n<br />\r\nNausea, diarrhea, constipation, and vomiting have occurred and may require use of antiemetic and antidiarrheal medications or fluid replacement.<br />\r\n<br />\r\nThrombocytopenia or neutropenia can occur; complete blood counts should be regularly monitored throughout treatment.<br />\r\n<br />\r\nTumor Lysis Syndrome, Reversible Posterior Leukoencephalopathy Syndrome, and acute hepatic failure&nbsp;have been reported.</p>', NULL, '<p>Targeted Cancer Therapy</p>', '<p>Unopened vials may be stored at controlled room temperature 25&ordm; C</p>', NULL, '2022-02-15 06:03:22', '2022-03-21 19:40:08'),
(201, 201, '<p>Treatment of pulmonary arterial hypertension (PAH) to improve exercise capacity and symptoms in patients with WHO functional class Ill. Efficacy has been shown in: Some improvements have also been shown in patients with PAH WHO functional class ll.</p>', '<p>Bosentan is a dual endothelin receptor antagonist (ERA) with affinity for both endothelin A and B (ETA and ETB) receptors. Bosentan decreases both pulmonary and systemic vascular resistance resulting in increased cardiac output without increasing heart rate.<br />\r\n<br />\r\nThe neurohormone endothelin-1 (ET-1) is one of the most potent vasoconstrictors known and can also promote fibrosis, cell proliferation, cardiac hypertrophy and remodelling, and is pro-inflammatory. These effects are mediated by endothelin binding to ETA and ETB receptors located in the endothelium and vascular smooth muscle cells. ET-1 concentrations in tissues and plasma are increased in several cardiovascular disorders and connective tissue diseases, including pulmonary arterial hypertension, scleroderma, acute and chronic heart failure, myocardial ischaemia, systemic hypertension and atherosclerosis, suggesting a pathogenic role of ET-1 in these diseases. In pulmonary arterial hypertension and heart failure, in the absence of endothelin receptor antagonism, elevated ET-1 concentrations are strongly correlated with the severity and prognosis of these diseases</p>', '<p>Tablets are to be taken orally morning and evening, with or without food.<br />\r\n<br />\r\n<strong>Pulmonary arterial hypertension</strong>: ln adult patients, Bosentan treatment should be initiated at a dose of 62.5 mg twice daily for 4 weeks and then increased to the maintenance dose of 125 mg twice daily.<br />\r\n<br />\r\nFor paediatric patients aged 2 years or older, the optimal maintenance dose has not been defined in well-controlled studies. However, paediatric pharmacokinetic data have shown that Bosentan plasma concentrations in children were on average lower than in adult patients and were not increased by increasing the dose of Bosentan above 2 mg/kg body weight twice daily.<br />\r\n<br />\r\n<strong>Discontinuation of treatment</strong>: lf the decision to withdraw Bosentan is taken, it should be done gradually while an alternative therapy is introduced.</p>', '<p>Increased bosentan levels with CYP3A4 inhibitors (e.g. ketoconazole, ritonavir, diltiazem), CYP2C9 inhibitors (e.g. amiodarone, fluconazole), tacrolimus. Rifampicin initially increases but subsequently decreases bosentan concentration. May decrease plasma levels of warfarin, statins (e.g. simvastatin, lovastatin), hormonal contraceptives, sildenafil, tadalafil.</p>', '<ul>\r\n	<li>Hypersensitivity to the active substance or to any of the excipients</li>\r\n	<li>Moderate to severe hepatic impairment, i.e., Child-Pugh class B or C.</li>\r\n	<li>Baseline values of liver aminotransferases, i.e., aspartate aminotransferases (AST) and/or alanine aminotransferases (ALT), greater than 3 times the upper limit of normal</li>\r\n	<li>Concomitant use of cyclosporine A.</li>\r\n	<li>Pregnancy</li>\r\n</ul>\r\n\r\n<p>Special warnings and precautions for use Liver aminotransferase levels must be measured prior to initiation of treatment and subsequently at monthly intervals for the duration of treatment with Bosentan. ln addition, liver aminotransferase levels must be measured 2 weeks after any dose increase.</p>', '<p>Treatment with bosentan has been associated with dose dependent elevations in liver aminotransferases and decreases in haemoglobin concentration. Other side effects include Anaemia, haemoglobin decrease, Thrombocytopenia, Neutropenia, leucopenia, Hypersensitivity reactions, Headache, Syncope, Palpitations, Flushing, Hypotension, Gastroesophageal reflux disease, Aminotransferase elevations associated with hepatitis and/or jaundice, Liver cirrhosis, liver failure (rarely), Erythema, Diarrhoea, Oedema, fluid retention.</p>', '<p><strong>Pregnancy</strong>:&nbsp;Bosentan is contraindicated in pregnancy.<br />\r\n<br />\r\n<strong>Use during lactation</strong>: lt is not known whether bosentan is excreted into human breast milk. Breast-feeding is not recommended during treatment with Bosentan.<br />\r\n<br />\r\n<strong>Effects on ability to drive and use machines</strong>:&nbsp;Bosentan may cause dizziness, which could affect the ability to drive or use machines.</p>', '<p>Consider discontinuation of therapy if pulmonary oedema occurs. Avoid abrupt withdrawal and consider dose reduction (e.g. half the dose for 3-7 days) to minimise risk of clinical deterioration. Lactation.</p>', '<p><strong>Symptoms</strong>: Nausea, vomiting, hypotension, dizziness, sweating and blurred vision.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment.</p>', '<p>Anti-hypertensive, Endothelin receptor antagonist</p>', '<p>Store below 30&deg;C. Store in a cool and dry place, protected from light. Keep out of children&rsquo;s reach.</p>', '<p><strong>Dosage in hepatic impairment</strong>: No dose adjustment is needed in patients with mild hepatic impairment. Bosentan is contraindicated in patients with moderate to severe liver dysfunction.<br />\r\n<br />\r\n<strong>Dosage in renal impairment</strong>: No dose adjustment is required in patients with renal impairment. No dose adjustment is required in patients undergoing dialysis.<br />\r\n<br />\r\n<strong>Dosage in elderly patients</strong>: No dose adjustment is required in patients over the age of 65 years.</p>', '2022-02-15 06:03:55', '2022-03-21 19:50:28'),
(202, 202, '<p>Brexpiprazole is an atypical antipsychotic indicated for:</p>\r\n\r\n<ul>\r\n	<li>Use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD)</li>\r\n	<li>Treatment of schizophrenia</li>\r\n</ul>', '<p>The mechanism of action of brexpiprazole in the treatment of major depressive disorder or schizophrenia is unknown. However, the efficacy of brexpiprazole may be mediated through a combination of partial agonist activity at serotonin 5-HT1A&nbsp;and dopamine D2&nbsp;receptors, and antagonist activity at serotonin 5-HT2A&nbsp;receptors.</p>', '<p><strong>Adjunctive Treatment of Major Depressive Disorder</strong>: The recommended starting dosage for Brexpiprazole as adjunctive treatment is 0.5 mg or 1 mg once daily, taken orally with or without food. Titrate to 1 mg once daily, then up to the target dosage of 2 mg once daily. Dosage increases should occur at weekly intervals based on the patient&#39;s clinical response and tolerability. The maximum recommended daily dosage is 3 mg. Periodically reassess to determine the continued need and appropriate dosage for treatment.<br />\r\n<br />\r\n<strong>Treatment of Schizophrenia</strong>: The recommended starting dosage for Brexpiprazole is 1 mg once daily on Days 1 to 4, taken orally with or without food. The recommended target Brexpiprazole dosage is 2 mg to 4 mg once daily. Titrate to 2 mg once daily on Day 5 through Day 7, then to 4 mg on Day 8 based on the patient&rsquo;s clinical response and tolerability. The maximum recommended daily dosage is 4 mg.</p>', NULL, '<p>Brexpiprazole is contraindicated in patients with a known hypersensitivity to brexpiprazole or any of its components. Reactions have included rash, facial swelling, urticaria, and anaphylaxis.</p>', NULL, '<p>There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Brexpiprazole during pregnancy.<br />\r\n<br />\r\nLactation studies have not been conducted to assess the presence of brexpiprazole in human milk, the effects of brexpiprazole on the breastfed infant, or the effects of brexpiprazole on milk production. Brexpiprazole is present in rat milk. The development and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Brexpiprazole and any potential adverse effects on the breastfed infant from Brexpiprazole or from the underlying maternal condition.</p>', '<p>Cerebrovascular Adverse Reactions in Elderly Patients with Dementia-</p>\r\n\r\n<ul>\r\n	<li>Related Psychosis: Increased incidence of cerebrovascular adverse reactions (e.g. stroke, transient ischemic attack)</li>\r\n	<li>Neuroleptic Malignant Syndrome: Manage with immediate discontinuation and close monitoring</li>\r\n	<li>Tardive Dyskinesia: Discontinue if clinically appropriate</li>\r\n	<li>Metabolic Changes: Monitor for hyperglycemia/diabetes mellitus, dyslipidemia and weight gain</li>\r\n	<li>Pathological Gambling and Other Compulsive Behaviors: Consider dose reduction or discontinuation</li>\r\n	<li>Leukopenia, Neutropenia, and Agranulocytosis: Perform complete blood counts (CBC) in patients with pre-existing low white blood cell count (WBC) or history of leukopenia or neutropenia. Consider discontinuing Brexpiprazole if a clinically significant decline in WBC occurs in absence of other causative factors</li>\r\n	<li>Orthostatic Hypotension and Syncope: Monitor heart rate and blood pressure and warn patients with known cardiovascular or cerebrovascular disease, and risk of dehydration or syncope</li>\r\n	<li>Seizures: Use cautiously in patients with a history of seizures or with conditions that lower the seizure threshold</li>\r\n</ul>', NULL, '<p>Benzodiazepine antagonist</p>', '<p>Store Brexpiprazole tablets at 20&deg;C to 25&deg;C; excursions permitted to 15&deg;C to 30&deg;C</p>', '<p><strong>Dosage Adjustments for Hepatic Impairment</strong>: For patients with moderate to severe hepatic impairment, the maximum recommended dosage is 2 mg once daily for patients with MDD, and 3 mg once daily for patients with schizophrenia<br />\r\n<br />\r\n<strong>Dosage Adjustments for Renal Impairment</strong>: For patients with moderate, severe or end-stage renal impairment (creatinine clearance ClCr&lt;60 mL/minute), the maximum recommended dosage is 2 mg once daily for patients with MDD and 3 mg once daily for patients with schizophrenia<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established. Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric patients<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, and cardiac function, concomitant diseases, and other drug therapy.</p>', '2022-02-15 06:04:17', '2022-03-21 19:52:48');
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
(203, 203, '<p>Brigatinib is indicated for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) as detected by an FDA-approved test.</p>', '<p>Brigatinib is a tyrosine kinase inhibitor with in vitro activity at clinically achievable concentrations against multiple kinases including ALK, ROS1, insulin-like growth factor-1 receptor (IGF-1R), and FLT-3 as well as EGFR deletion and point mutations. Brigatinib inhibited autophosphorylation of ALK and ALK-mediated phosphorylation of the downstream signalin&nbsp; proteins STAT3, AKT, ERK1/2, and S6 in in vitro and in vivo assays. Brigatinib also inhibited the in vitro proliferation of cell lines expressing EML4-ALK and NPM-ALK fusion proteins and demonstrated dose-dependent inhibition ofEML4-ALK-positive NSCLC xenograft growth in mice.<br />\r\n<br />\r\nAt clinically achievable concentrations (&le;500 nM), brigatinib inhibited the in vitro viability of cells expressing EML4-ALK and 17 mutant forms associated with resistance to ALK inhibitors including crizotinib, as well as EGFR-Del (E746-A750), ROS1 L2026M, FLT3-F691L, and FLT3-D835Y. Brigatinib exhibited in vivo antitumor activity against 4 mutant forms of EML4-ALK, including G1202R and L1196M mutants identified in NSCLC tumors in patients who have progressed on crizotinib. Brigatinib also reduced tumor burden and prolonged survival in mice implanted intracranially with an ALK-driven tumor cell line.</p>', '<p>The recommended dosage for Brigatinib is 90 mg orally once daily for the first 7 days; then increase the dose to 180 mg orally once daily. Administer Brigatinib until disease progression or unacceptable toxicity. If Brigatinib is interrupted for 14 days or longer for reasons other than adverse reactions, resume treatment at 90 mg once daily for 7 days before increasing to the previously tolerated dose. Brigatinib may be taken with or without food. Instruct patients to swallow tablets whole. Do not crush or chew tablets.</p>', '<ul>\r\n	<li>CYP3A Inhibitors: Avoid coadministration of Brigatinib with strong or moderate CYP3A inhibitors. If coadministration of a strong or moderate CYP3A inhibitor is unavoidable, reduce the dose of Brigatinib.</li>\r\n	<li>CYP3A Inducers: Avoid coadministration of Brigatinib with strong or moderate CYP3A inducers. If coadministration of a moderate CYP3A inducer is unavoidable, increase the dose of Brigatinib.</li>\r\n</ul>', NULL, '<p>The most common adverse reactions (&ge;25%) with Brigatinib were diarrhea, fatigue, nausea, rash, cough, myalgia, headache, hypertension, vomiting, and dyspnea.</p>', '<p>Based on its mechanism of action and findings in animals, Brigatinib can cause fetal harm when administered to a pregnant woman. There are no clinical data on the use of Brigatinib in pregnant women. There are no data regarding the secretion of Brigatinib in human milk or its effects on the breastfed infant or milk production. Because of the potential for adverse reactions in breastfed infants, advise lactating women not to breastfeed during treatment with Brigatinib and for 1 week following the final dose.</p>', '<ul>\r\n	<li>Interstitial Lung Disease (ILD)/Pneumonitis: Monitor for new or worsening respiratory symptoms, particularly during the first week of treatment. Withhold Brigatinib for new or worsening respiratory symptoms and promptly evaluate for ILD/pneumonitis. Upon recovery, either dose reduce or permanently discontinue Brigatinib.</li>\r\n	<li>Hypertension: Monitor blood pressure after 2 weeks and then at least monthly during treatment. For severe hypertension, withhold Brigatinib, then dose reduce or permanently discontinue.</li>\r\n	<li>Bradycardia: Monitor heart rate and blood pressure regularly during treatment. If symptomatic, withhold Brigatinib, then dose reduce or permanently discontinue.</li>\r\n	<li>Visual Disturbance: Advise patients to report visual symptoms. Withhold Brigatinib and obtain ophthalmologic evaluation, then dose reduce or permanently discontinue Brigatinib.</li>\r\n	<li>Creatine Phosphokinase (CPK) Elevation: Monitor CPK levels regularly during treatment. Based on the severity and with muscle pain or weakness, withhold Brigatinib, then resume or reduce dose.</li>\r\n	<li>Pancreatic Enzymes Elevation: Monitor lipase and amylase levels regularly during treatment. Based on the severity, withhold Brigatinib, then resume or reduce dose.</li>\r\n	<li>Hyperglycemia: Assess fasting serum glucose prior to starting Brigatinib and regularly during treatment. If not adequately controlled with optimal medical management, withhold Brigatinib, then consider dose reduction or permanently discontinue, based on severity.</li>\r\n	<li>Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use a non-hormonal method of effective contraception.</li>\r\n</ul>', NULL, '<p>Cytotoxic Chemotherapy</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>: The safety and effectiveness of Brigatinib in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the 359 patients enrolled in the ALTA 1L Brigatinib arm and in ALTA, 26.7% were 65 and older<br />\r\nand 7.5% were 75 and older. No overall differences in safety or effectiveness were observed between patients &ge;65 years and younger patients.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dose adjustment is recommended for patients with mild hepatic impairment (Child-Pugh A) or<br />\r\nmoderate hepatic impairment (Child-Pugh B). Reduce the dose of Brigatinib for patients with severe hepatic impairment (Child-Pugh C)<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dose adjustment is recommended for patients with mild or moderate renal impairment ClCr 30 to 89 mL/min by Cockcroft-Gault. Reduce the dose of Brigatinib for patients with severe renal impairment (ClCr 15 to 29 mL/min)</p>', '2022-02-15 06:04:37', '2022-03-21 19:55:55'),
(204, 204, '<p>Brimonidine Tartrate 0.025% relieves redness of the eye due to minor eye irritations.</p>', '<p>Brimonidine is an alpha-2 adrenoreceptor agonist that is more selective for the alpha-2 adrenoreceptor than alpha-1. Topical administration of low concentration of Brimonidine Tartrate eye drops reduces ocular redness in humans by constricting the venule, alleviating the potential decrease of blood and oxygen through the eye. It has minimal to no activity on the alpha-1 receptor, which has a low risk of redness rebound of loss of efficacy over time when used as directed.</p>', '<p><strong>Adults and children 5 years of age and over</strong>: Instill 1 drop in the affected eye(s) every 6-8 hours. Do not use more than 4 times daily. If more than one topical ophthalmic product is being used, the products should be administered at least 5 minutes apart.</p>', '<p>Although specific drug interaction studies have not been conducted with Brimonidine Tartrate eye drops, the possibility of an additive effect with CNS depressants (alcohol, barbiturates, opiates, sedatives or anesthetics) should be considered.</p>', '<p>Brimonidine Tartrate sterile eye drops is contraindicated in patients with hypersensitivity to Brimonidine Tartrate or any component of this medication and Neonates and infants (under the age of 5).</p>', '<p>In clinical studies, most adverse events were usually transient and not commonly of a severity requiring discontinuation of treatment. The most frequently reported adverse events were:</p>\r\n\r\n<ul>\r\n	<li><strong>Ocular</strong>: ocular hyperemia, dryness, tearing, burning and stinging, blurring and foreign body sensation, upper respiratory symptoms.</li>\r\n	<li><strong>Systemic</strong>: oral dryness, headache, fatigue, drowsiness.</li>\r\n</ul>', '<p>There are no studies of Brimonidine Tartrate eye drops in pregnant women, however in animal studies, Brimonidine Tartrate crossed the placenta and entered into the fetal circulation to a related extent. Brimonidine Tartrate eye drops should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.<br />\r\n<br />\r\nIt is not known whether Brimonidine Tartrate is excreted in human milk, although in animal studies, Brimonidine Tartrate has been shown to be excreted in breast 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.</p>', '<p>Although Brimonidine Tartrate had minimal effects on blood pressure of patients in clinical studies, caution should be exercised in treating patients with severe cardiovascular disease. It has not been studied in patients with hepatic or renal impairment; caution should be used in treating such patients.</p>', '<p>No information is available on overdose in humans. Treatment of an oral overdose includes supportive and symptomatic therapy; a patent airway should be maintained. In the event of a topical overdosage, flush eye with a topical ocular irrigant.</p>', '<p>Other ophthalmic preparations</p>', '<p>Store at below 30&deg;C in a dry place protected from light. Do not touch dropper tip to any surface. It is desirable that the contents should not be used more than one month after first opening of the bottle.</p>', NULL, '2022-02-15 06:05:16', '2022-03-21 19:58:24'),
(205, 205, '<p>Brimonidine Tartrate ophthalmic solution 0.15% w/v is indicated for the control of intraocular pressure in patients with chronic open-angle glaucoma or ocular hypertension.</p>', '<p>Brimonidine tartrate is a relatively selective alpha-2 adrenergic receptor agonist that, in radioligand binding assays and in functional assays, is approximately 1000 times more selective for the alpha-2 adrenoceptor than the alpha-1 adrenoceptor. This selectivity results in the absence of vasoconstriction in microvessels associated with human retinal xenografts.<br />\r\n<br />\r\nTopical administration of brimonidine decreases IOP in humans. When used as directed, brimonidine tartrate ophthalmic solutions reduce elevated IOP with minimal effect on cardiovascular parameters.<br />\r\n<br />\r\nBrimonidine tartrate has a rapid onset of action, with the peak ocular hypotensive effect occurring at approximately two hours post-dosing. The duration of effect is 12 hours or greater.<br />\r\n<br />\r\nFluorophotometric studies in animals and humans suggest that brimonidine tartrate has a dual mechanism of action. Brimonidine Tartrate ophthalmic solution 0.15% lowers IOP by reducing aqueous humor production and increasing uveoscleral outflow.</p>', '<p>The recommended dose is one drop of Brimonidine Tartrate ophthalmic solution 0.15% in the affected eye(s) three times daily, approximately 8 hours apart.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Do not allow the dropper tip of the bottle to touch the eye or other surrounding structures, because this could cause eye injury or contaminate the tip with common bacteria known to cause eye infections. Serious damage to the eye with subsequent loss of vision may result if you use eye drop solutions that have become contaminated. If you experience any type of eye condition or have surgery, immediately seek your doctor&rsquo;s advice concerning the continued use of the bottle you are using.</p>', '<p>Tricyclic antidepressants have been reported to blunt the hypotensive effect of systemic clonidine. It is not known whether the concurrent use of these agents with Brimonidine Tartrate can lead to an interference in intraocular pressure (IOP) lowering effect. No data are available on the level of circulating catecholamines after Brimonidine Tartrate is instilled. Caution, however, is advised in patients taking tricyclic antidepressants which can affect the metabolism and uptake of circulating amines. Although specific drug interaction studies have not been conducted with Brimonidine Tartrate, the possibility of an additive or potentiating effect with CNS depressants (alcohol, barbiturates, opiates, sedatives, or anesthetics) should be considered.</p>', '<p>Brimonidine Tartrate ophthalmic solution 0.15% is contraindicated in:</p>\r\n\r\n<ul>\r\n	<li>patients with hypersensitivity to brimonidine tartrate or any component of this medication.</li>\r\n	<li>Patients receiving monoamine oxidase (MAO) inhibitor therapy</li>\r\n	<li>Neonates and infants (children under the age of 2 years)</li>\r\n</ul>', '<p>Very common side effects are Red eye. Common side effects are Eye allergy, Itchy eyes, Visual disturbance, Small bumps on the eye surface, Dryness of the mouth, Burning and stinging of the eye, Dry eyes, A feeling that something is in your eye, Watery eyes, Eye and eyelid swelling, Red, itchy eyelids</p>', '<p>There are no studies of Brimonidine Tartrate in pregnant women. Studies in rats have indicated brimonidine is excreted in the milk of the lactating rat. Since it is not known whether this drug 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.</p>', '<p><strong>Potentiation of Vascular Insufficiency</strong>: Brimonidine Tartrate may potentiate syndromes associated with vascular insufficiency. Brimonidine Tartrate should be used with caution in patients with depression, cerebral or coronary insufficiency, Raynaud&rsquo;s phenomenon, orthostatic hypotension, or thromboangiitis obliterans.<br />\r\n<br />\r\n<strong>Severe Cardiovascular Disease</strong>: Although brimonidine tartrate ophthalmic solution had minimal effect on the blood pressure of patients in clinical studies, caution should be exercised in treating patients with severe cardiovascular disease.<br />\r\n<br />\r\n<strong>Contamination of Topical Ophthalmic Products After Use</strong>: There have been reports of bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface</p>', NULL, '<p>Drugs for miotics and glaucoma</p>', '<p>Brimonidine Tartrate ophthalmic solution 0.15% should be stored at 15&deg;C to 25&deg;C. Discard unused solution at the end of treatment.</p>', '<p><strong>Geriatrics (&gt; 65 years of age)</strong>: No overall difference in safety and effectiveness has been observed between elderly and other adult patients.<br />\r\n<br />\r\n<strong>Children under the age of 2 years</strong>: The use of Brimonidine Tartrate ophthalmic solution 0.15% in neonates and infants is contraindicated.<br />\r\n<br />\r\n<strong>Children (2-18 years of age)</strong>: The use of Brimonidine Tartrate ophthalmic solution 0.15% is currently not recommended in children</p>', '2022-02-15 06:05:29', '2022-03-21 20:01:20'),
(206, 206, '<p>Brimonidine 0.2% ophthalmic solution is indicated for lowering intraocular pressure in patients with open-angle glaucoma or ocular hypertension</p>', '<p>Brimonidine is an &alpha;-2 adrenoreceptor agonist that is more selective for the &alpha;-2 adrenoreceptor than &alpha;-1. Topical administration of Brimonidine Tartrate eye drops decreases intraocular pressure (IOP) in humans. When used as directed Brimonidine Tartrate have the action of reducing elevated IOP with minimal effect on cardiovascular parametres. Brimonidine Tartrate eye drops have a rapid onset of action with the peak ocular hypotensive effect occurring at two hours post-dosing. The duration of effect is 12 hours or greater. Fluorophotometric studies in animals and humans suggest that Brimonidine Tartrate has a dual mechanism of action. Brimonidine Tartrate eye drops lower IOP by reducing aqueous humor production and enhancing uveoscleral outflow.</p>', '<p>The recommended dose is one drop of Brimonidine Tartrate ophthalmic solution 0.2% in the affected eye(s) three times daily, approximately 8 hours apart. Brimonidine Tartrate ophthalmic solution 0.2% may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. If more than one topical ophthalmic product is being used, the products should be administered at least 5 minutes apart.</p>', '<p>Although specific drug interaction studies have not been conducted with Brimonidine Tartrate ophthalmic solution 0.2%, the possibility of an additive or potentiating effect with CNS depressants (alcohol, barbiturates, opiates, sedatives, or anesthetics) should be considered. Alpha-agonists, as a class, may reduce pulse and blood pressure. Caution in using concomitant drugs such as beta-blockers (ophthalmic and systemic), antihypertensives and/or cardiac glycosides is advised. Tricyclic antidepressants have been reported to blunt the hypotensive effect of systemic clonidine. It is not known whether the concurrent use of these agents with Brimonidine Tartrate ophthalmic solution 0.2% in humans can lead to resulting interference with the IOP lowering effect. No data on the level of circulating catecholamines after administration of Brimonidine Tartrate ophthalmic solution 0.2% are available. Caution, however, is advised in patients taking Tricyclic antidepressants which can affect the metabolism and uptake of circulating amines.</p>', '<p>Brimonidine Tartrate ophthalmic solution 0.2% is contraindicated in patients with hypersensitivity to Brimonidine Tartrate. It is also contraindicated in patients receiving monoamine oxidase (MAO) inhibitor therapy.</p>', '<p>Adverse events occurring in approximately 10-30% of the subjects, in descending order of incidence, included oral dryness, ocular hyperemia, burning and stinging, headache, blurring, foreign body sensation, fatigue/drowsiness, conjunctival follicles, ocular allergic reactions, and ocular pruritus. Events occurring in approximately 3-9% of the subjects, in descending order included corneal staining/erosion, photophobia, eyelid erythema, ocular ache/pain, ocular dryness, tearing, upper respiratory symptoms, eyelid edema, conjunctival edema, dizziness, blepharitis, ocular irritation, gastrointestinal symptoms, asthenia, conjunctival blanching, abnormal vision and muscular pain. The following adverse reactions were reported in less than 3% of the patients: lid crusting, conjunctival hemorrhage, abnormal taste, insomnia, conjunctival discharge, depression, hypertension, anxiety, palpitations/arrhythmias, nasal dryness and syncope.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. In animal studies, Brimonidine crossed the placenta and entered into the fetal circulation to a limited extent. Brimonidine Tartrate ophthalmic solution 0.2% should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk; in animal studies Brimonidine Tartrate was excreted in breast 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.</p>', '<p>Although Brimonidine Tartrate ophthalmic solution 0.2% had minimal effect on blood pressure of patients in clinical studies, caution should be exercised in treating patients with severe cardiovascular disease. Brimonidine Tartrate ophthalmic solution 0.2% should be used with caution in patients with depression, cerebral or coronary insufficiency, Raynaud&#39;s phenomenon, orthostatic hypotension or thromboangiitis obliterans.</p>', NULL, '<p>Drugs for miotics and glaucoma</p>', '<p>Store below 30&deg;C in a cool and dry place protected from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. Do not use after 30 days of first opening.</p>', NULL, '2022-02-15 06:05:45', '2022-03-21 20:06:00'),
(207, 207, '<p>This eye drops is indicated for the reduction of elevated intraocular pressure (IOP) in patients with glaucoma or ocular hypertension.</p>', '<p>This eye drops is comprised of two components: Brimonidine Tartrate &amp; Timolol Maleate. Brimonidine Tartrate is a selective alpha-2 adrenergic receptor agonist having a dual mechanism of action. It decreases aqueous humor production and increases nonpressure dependent uveoscleral outflow. Timolol Maleate is a &beta;-adrenergic receptor antagonist that does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anesthetic (membrane-stabilizing) activity. It lowers IOP by reducing aqueous humor production. Therefore the combination of both drugs gives a rapid onset of action, with peak ocular hypotensive effect seen within two hours of administration.</p>', '<p>Instill 1 drop in the affected eye(s) twice daily.</p>', '<p>Specific drug interaction studies have not been conducted.</p>', '<p>Contraindicated in patients with hypersensitivity to any component of this product. Also contraindicated in bronchial asthma, severe chronic obstructive pulmonary disease, sinus bradycardia, second or third-degree atrioventricular block, overt cardiac failure and cardiogenic shock.</p>', '<p>The most common side effects are allergic conjunctivitis, conjunctival folliculosis, conjunctival hyperaemia, eye pruritus and ocular burning or stinging.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Combipres should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Timolol has been detected in human milk but it is not known whether Brimonidine Tartrate is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue taking into account the importance of the drug to the mother.</p>', '<p>Like other topically applied ophthalmic agents, it may be absorbed systemically. Due to the presence of Timolol, the same types of cardiovascular and pulmonary adverse reactions as seen with systemic beta-blockers may occur. Cautions should be exercised in treating patients with severe or unstable and uncontrolled cardiovascular or pulmonary diseases.</p>', NULL, '<p>Drugs for miotics and glaucoma</p>', '<p>Store at a cool &amp; dry place, protect from light. Do not use longer than 30 days after the first opening of the bottle. Keep out of the reach of children.</p>', '<p><strong>Use in children</strong>: Safety and effectiveness in children below the age of 2 years have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety or effectiveness have been observed between elderly and other adult patients.</p>', '2022-02-15 06:06:13', '2022-03-21 20:08:19'),
(208, 208, '<p>Brinzolamide Ophthalmic Suspension is indicated as monotherapy, or as adjunctive therapy to beta-blockers in the treatment of elevated intraocular pressure in ocular hypertension, or open-angle glaucoma.</p>', '<p>Carbonic anhydrase (CA) is an enzyme found in many tissues of the body including the eye. It catalyses the reversible reaction involving the hydration of carbon dioxide and the dehydration of carbonic acid. It exists as a number of isoenzymes, the most active being carbonic anhydrase II (CA-II), found primarily in red blood cells, but also in other tissues. Inhibition of carbonic anhydrase in the ciliary processes of the eye decreases aqueous humor secretion, presumably by slowing the formation of bicarbonate ions with subsequent reduction in sodium and fuid transport.<br />\r\n<br />\r\nFollowing topical ocular administration, brinzolamide inhibits aqueous humor formation and reduces elevated intraocular pressure. Elevated intraocular pressure is a major risk factor in the pathogenesis of optic nerve damage and glaucomatous visual feld loss.</p>', '<p>The recommended dose is one drops of this eye drop in the conjunctival sac of the affected eye(s) twice daily. Some patients may have a better response with one drop three times a day. Shake well before use.</p>', '<p>In patients treated with oral carbonic anhydrase inhibitors, rare instances to drug interactions have occurred with high-dose salicylate therapy. Therefore, the potential for such drug interactions should be considered in patients receiving Brinzolamide.</p>', '<p>It is contraindicated in patients who are hypersensitive to any component of this product.</p>', '<p>Reported side effects are blurred vision and bitter, sour or unusual taste. Other side effects are blepharitis, dermatitis, dry eye, foreign body sensation, headache, hyperemia, ocular discharge, ocular discomfort, ocular keratitis, ocular pain, ocular pruritus and rhinitis</p>', '<p>Pregnancy category C. There are no adequate and well-controlled studies in pregnant women. Brinzolamide 1% ophthalmic suspension should be used during pregnancy only if the benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nUse in lactation: It is not known whether Brinzolamide 1% ophthalmic suspension is excreted in human milk. So, lactating mother should discontinue nursing or to discontinue the drug, depending upon the importance of the drug to the mother.</p>', '<ul>\r\n	<li>Brinzolamide ophthalmic suspension and its metabolite are excreted predominantly by the kidney. So, it is not recommended in severe renal impaired patients.</li>\r\n	<li>Brinzolamide ophthalmic suspension has not been studied in patients with hepatic impairment and should be used with caution in such patients.</li>\r\n	<li>The concomitant administration of Brinzolamide ophthalmic suspension and oral carbonic anhydrase inhibitor is not recommended due to no additional benefits.</li>\r\n	<li>If hypersensitivity reaction occurs after instillation patients should be advised to discontinue the use of Brinzolamide and consult with physicians.</li>\r\n</ul>', '<p>Although no human data are available, electrolyte imbalance, development of an acidosis state, and possible nervous system effects may occur following oral administration of an overdose. Serum electrolyte levels (particularly potassium) and blood pH levels should be monitored.</p>', '<p>Drugs for miotics and glaucoma</p>', '<p>Store at room temperature &amp; protect from light. Do not touch dropper tip to any surface. It is desirable that the contents should not be used more than four weeks after first opening of the bottle. Protect from freezing.</p>', NULL, '2022-02-15 06:06:54', '2022-03-21 20:10:34'),
(209, 209, '<p>This is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.</p>', '<p>Brinzolamide is a carbonic anhydrase inhibitor which reduce intraocular pressure (IOP) by decreasing aqueous humor secretion in the ciliary processes of the eye.<br />\r\n<br />\r\nBrimonidine Tartrate is an alpha 2 adrenergic receptor agonist which reduces IOP by decreasing aqueous humor production and increasing uveoscleral outflow.</p>', '<p>Instill one drop in the affected eye(s) three times daily. If more than one topical ophthalmic drug is being used, the drugs should be administered at least five minutes apart. Shake well before use.</p>', '<p>In patients treated with this drop&nbsp;rare instances to drug interactions have occurred with high-dose salicylate therapy, CNS Depressants, Antihypertensives/ Cardiac Glycosides, Tricyclic Antidepressants, Monoamine Oxidase Inhibitors. Therefore, the potential for such drug interactions should be considered in patients receiving Brinzolamide + Brimonidine Tartrate .</p>', '<p>It is contraindicated in patients who are hypersensitivity to Brinzolamide, Brimonidine Tartrate, or to any ingredient in the formulation and Neonates and Infants (under the age of 2 years).</p>', '<p>The most commonly reported side effects include blurred vision, eye irritation, bad taste and dry mouth.</p>', '<p>Pregnancy category C. There are no adequate and well-controlled studies in pregnant women. Brinzolamide and Brimonidine Tartrate ophthalmic suspension should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nIt is not known whether Brinzolamide or Brimonidine Tartrate are excreted in human milk. Caution should be exercised while giving this ophthalmic suspension to a nursing mother.</p>', '<p>Shake well before use. For ophthalmic use only. Contact lenses should be removed during instillation of Brinzolamide and Brimonidine Tartrate ophthalmic suspension, but may be reinserted 15 minutes after instillation.</p>', '<p>Although no human data are available, electrolyte imbalance, development of an acidotic state, and possible nervous system effects may occur following an oral overdose of Brinzolamide. Serum electrolyte levels (particularly potassium) and blood pH levels should be monitored. Very limited information exists on accidental ingestion of Brimonidine Tartrate in adults; the only adverse event reported to date has been hypotension. Symptoms of Brimonidine Tartrate overdose have been reported in neonates, infants, and children receiving Brimonidine Tartrate as part of medical treatment of congenital glaucoma or by accidental oral ingestion. Treatment of an oral overdose includes supportive and symptomatic therapy; a patent airway should be maintained.</p>', '<p>Drugs for miotics and glaucoma</p>', '<p>Store at room temperature &amp; protect from light. Do not touch dropper tip to any surface. It is desirable that the contents should not be used more than one month after first opening of the bottle. Shake well before use &amp; do not freeze.</p>', '<p><strong>Use in children</strong>: Safety &amp; effectiveness in children below the age of 2 years have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '2022-02-15 06:07:27', '2022-03-21 20:13:03'),
(210, 210, '<p>Treatment of elevated IOP in adult patients with open-angle glaucoma or ocular HTN for whom monotherapy provides insufficient IOP reduction.</p>', '<p>Brinzolamide is a highly specific inhibitor of CA-II, which is the main CA isoenzyme involved in the secretion of aqueous humor. Inhibition of CA in the ciliary process of the eye slows the formation of bicarbonate, and reduces sodium and fluid transport. This results in a reduction in the rate of aqueous humor secretion and the intraocular pressure. Brinzolamide is absorbed systemically following topical ocular administration. Since it has a high affinity for CA-II, brinzolamide binds extensively to red blood cells, where CA-II is primarily found. As sufficient CA-II activity remains, adverse effects resulting from the systemic inhibition of CA by brinzolamide are not observed. The metabolite N-desethyl brinzolamide is also formed. This metabolite binds to CA and accumulates in red blood cells as well. In the presence of brinzolamide, the metabolite binds mainly to carbonic anhydrase I (CA-I).<br />\r\n<br />\r\nLike propranolol and nadolol, timolol competes with adrenergic neurotransmitters such as catecholamines for binding at beta(1)-adrenergic receptors in the heart and vascular smooth muscle and beta(2)-receptors in the bronchial and vascular smooth muscle. Beta(1)-receptor blockade results in a decrease in resting and exercise heart rate and cardiac output, a decrease in both systolic and diastolic blood pressure, and, possibly, a reduction in reflex orthostatic hypotension. Beta(2)-blockade results in an increase in peripheral vascular resistance. The exact mechanism whereby timolol reduces ocular pressure is still not known. The most likely action is by decreasing the secretion of aqueous humor.</p>', '<p>1 drop into the affected eye(s) twice daily</p>', '<p>Ketoconazole, itraconazole, clotrimazole, ritonavir, troleandromycin; oral Ca-channel blockers, guanethidine, &beta;-blockers, antiarrhythmics, digitalis glycosides, parasympathomimetics; quinidine, cimetidine.</p>', '<p>Bronchial asthma, severe COPD, sinus bradycardia, 2nd or 3rd degree AV block, overt cardiac failure, cardiogenic shock, severe allergic rhinitis, bronchial hyperreactivity, hyperchloraemic acidosis, severe renal impairment.</p>', '<p>Dysgeusia, blurred vision, eye pain &amp; irritation, foreign body sensation.</p>', '<p>No data available</p>', '<p>Control cardiac failure prior to therapy. History of severe cardiac &amp; resp disease. Patients subject to hypoglycemia or labile insulin-dependent diabetes. May mask hyperthyroidism or worsen Prinzmetal&#39;s angina, severe peripheral &amp; central circulatory disorders &amp; hypotension. History of atopy or severe anaphylactic reaction to a variety of allergens. Avoid concomitant use of 2 local &beta;-adrenergic blockers or 2 local carbonic anhydrase inhibitors. Close monitoring of IOP in patients with pseudoexfoliative or pigmentary glaucoma. Narrow-angle glaucoma. Monitor patients with compromised corneas eg, patients with DM or corneal dystrophies. Remove contact lenses prior to application; reinsert after 15 min. May impair ability to drive or operate machinery. Pregnancy. Childn &lt;18 yr.</p>', NULL, '<p>Drugs for miotics and glaucoma</p>', '<p>Store in cool and dry place</p>', NULL, '2022-02-15 06:07:44', '2022-03-21 20:15:24'),
(211, 211, '<p>Brivaracetam is indicated for the treatment of partial-onset seizures in patients 4 years of age and older. As the safety of Brivaracetam injection in pediatric patients has not been established, Brivaracetam injection is indicated for the treatment of partial-onset seizures only in adult patients (16 years of age and older).</p>', '<p>The precise mechanism by which Brivaracetam exerts its anticonvulsant activity is not known. Brivaracetam displays a high and selective affinity for synaptic vesicle protein 2A (SV2A) in the brain, which may contribute to the anticonvulsant effect.<br />\r\n<br />\r\nBrivaracetam binds SV2A with high affinity. SV2A is known to play a role in epileptogenesis through modulation of synaptic GABA release. It is thought that brivaracetam exerts its anti-epileptogenic effects through its binding to SV2A. Brivaracetam is also known to inhibit Na+&nbsp;channels which may also contribute to its anti-epileptogenic action</p>', '<p><strong>Adults (16 Years and older)</strong>: The recommended starting dosage for monotherapy or adjunctive therapy is 50 mg twice daily (100 mg per day).<br />\r\n<br />\r\nBased on individual patient tolerability and therapeutic response, the dosage may be adjusted down to 25 mg twice daily (50 mg per day) or up to 100 mg twice daily (200 mg per day).<br />\r\n<br />\r\n<strong>Pediatric Patients (4 Years to less than 16 Years)</strong>: The recommended dosage is based on body weight and is administered orally twice daily<br />\r\n<br />\r\n<strong>Injection</strong>: for intravenous and adult use only when oral administration is temporarily not feasible; dosing is the same as oral regimen.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Brivaracetam injection should be administered intravenously over 2 to 15 minutes. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Product with particulate matter or discoloration should not be used. Brivaracetam injection is for single dose only.</p>', '<p><strong>Rifampin</strong>: Because of decreased concentrations, increasing Brivaracetam dosage in patients on concomitant rifampin is recommended.<br />\r\n<br />\r\n<strong>Carbamazepine</strong>: Because of increased exposure to carbamazepine metabolite, if tolerability issues arise, consider reducing carbamazepine dosage in patients on concomitant Brivaracetam.<br />\r\n<br />\r\n<strong>Phenytoin</strong>: Because phenytoin concentrations can increase, phenytoin levels should be monitored in patients on concomitant Brivaracetam.<br />\r\n<br />\r\n<strong>Levetiracetam</strong>: Brivaracetam had no added therapeutic benefit when co-administered with levetiracetam.</p>', '<p>Hypersensitivity to brivaracetam or any of the inactive ingredients in Brivaracetam</p>', '<p>Most common adverse reactions (at least 5% for Brivaracetam and at least 2% more frequently than placebo) are somnolence/sedation, dizziness, fatigue, and nausea or vomiting.</p>', '<p>There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antiepileptic drugs (AEDs), such as Brivaracetam, during pregnancy. No data are available regarding the presence of brivaracetam in human milk, the effects on the breastfed infant, or the effects of the drug on milk production. Studies in lactating rats have shown excretion of brivaracetam or metabolites in milk</p>', '<p><strong>Suicidal Behavior and Ideation</strong>: Monitor patients for suicidal behavior and ideation.<br />\r\n<br />\r\n<strong>Neurological Adverse Reactions</strong>: Monitor for somnolence and fatigue, and advise patients not to drive or operate machinery until they have gained sufficient experience on Brivaracetam.<br />\r\n<br />\r\n<strong>Psychiatric Adverse Reactions</strong>: Behavioral reactions including psychotic symptoms, irritability, depression, aggressive behavior, and anxiety; monitor patients for symptoms.<br />\r\n<br />\r\n<strong>Hypersensitivity</strong>: Bronchospasm and Angioedema: Advise patients to seek immediate medical care. Discontinue and do not restart Brivaracetam if hypersensitivity occurs.&nbsp;<br />\r\n<br />\r\n<strong>Withdrawal of Antiepileptic Drugs</strong>: Brivaracetam should be gradually withdrawn.</p>', NULL, '<p>Adjunct anti-epileptic drugs</p>', '<p>Store at 25&deg;C; excursions permitted between 15&deg;C to 30&deg;C</p>', '<p><strong>Hepatic Impairment</strong>: Dose adjustment is recommended for all stages of hepatic impairment.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Dose adjustments are not required for patients with impaired renal function.</p>', '2022-02-15 06:08:02', '2022-03-21 20:18:34'),
(212, 212, '<p>Bromazepam is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Emotional disturbances, i.e. acute tension and anxiety states. Difficulties in interpersonal contact. Agitation, insomnia, anxious and agitated depressive reactions.</li>\r\n	<li>Functional disturbances in the cardiovascular and respiratory systems, i.e. pseudoangina pectoris, pericardial anxiety, tachycardia, emotiogenic hypertension, dyspnea and hyperventilation.</li>\r\n	<li>Disturbances in the gastrointestinal tract, i.e. irritable bowel syndrome, epigastric pain, spasm, bloating diarrhea etc.</li>\r\n	<li>Disturbances in the urinary tract, i.e. frequency, irritable bladder and dysmenorrhea.</li>\r\n	<li>Psychosomatic disorder, i.e. psychogenic headache, asthma, gastric and duodenal ulcer.</li>\r\n	<li>It is also indicated in emotional reactions to chronic organic disease.</li>\r\n</ul>', '<p>Bromazepam is a powerful psychotropic agent. In lower dosage, it selectively reduces tension and anxiety. In higher dosage, it shows sedative and muscle-relaxant properties. Bromazepam binds to the GABA-A receptor producing a conformational change and potentiating its inhibitory effects. Other neurotransmitters are not influenced.</p>', '<p><strong>Standard dosage</strong>: Average dosage for outpatient therapy is 1.5-3 mg up to three times daily. Treatment of outpatients should begin with low doses, gradually increasing to the optimum level.<br />\r\n<br />\r\n<strong>In severe cases,</strong>&nbsp;<strong>especially in hospital</strong>:&nbsp;6-12 mg 2 or 3 times daily. The overall treatment generally should not be more than 8-12 weeks. In certain cases extension beyond the maximum treatment period may be necessary; if so, it should be taken with re-evaluation of the patient&#39;s status with special expertise.<br />\r\n<br />\r\n<strong>Elderly and debilitated patients</strong>: Elderly patients and those with impaired hepatic functions require lower doses.<br />\r\n<br />\r\n<strong>Children</strong>: Bromazepam is usually not indicated in children, but if the physician feels bromazepam treatment is appropriate, then the dose should be adjusted to their low bodyweight (about 0.1-0.3 mg/kg bodyweight)</p>\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>Bromazepam tablets are for oral administration</p>', '<p>If bromazepam is combined with other centrally active drugs, its sedative effects may be enhanced. These drugs are antidepressants, hypnotics, narcotics, antipsychotics, sedatives, antiepileptic drugs, sedative antihistamines and anesthetics. Co-administration of cimetidine may prolong the eliminiation half-life of bromazepam. Concomitant intake of bromazepam with alcohol should be avoided, because the sedative effect of bromazepam may be intensified by alcohol.</p>', '<p>Bromazepam is contraindicated in patients with known hypersensitivity to bromazepam, severe respiratory insufficiency, severe hepatic insufficiency or sleep apnea syndrome.</p>', '<p>Common side-effects include fatigue, drowsiness, muscle weakness, numbed muscle, reduced alertness, confusion, headache, ataxia etc. These phenomena occur predominantly at the start of therapy and usually disappear with prolonged administration. Anterograde amnesia may occur using therapeutic doses.</p>', '<p>The safety of bromazepam during pregnancy has not been established. As bromazepam is excreted in breast milk, use should be avoided during lactation.</p>', '<p>The use of benzodiazepines and benzodiazepine like agents may lead to the development of physical and psychological dependence upon these products. This dependence depends on the dose and duration of treatment; it is also greater in predisposed patients with a history of alcohol. Once physical dependence has developed, termination of the treatment will be accompanied by withdrawal symptoms. These may consist of headache, muscle pain, extreme anxiety, tension, confusion and irritability. Since the risk of withdrawal phenomena and rebound phenomena is greater after abrupt discontinuation of the treatment, it is recommended that the dosage be decreased gradually. Bromazepam is not recommended for the primary treatment of sleeplessness caused by psychotic illness. Caution should be exercised while driving cars or using machineries.</p>', NULL, '<p>Benzodiazepine sedatives</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-15 06:08:19', '2022-03-21 20:22:43'),
(213, 213, '<p>Bromelain &amp; Trypsin is indicated for inflammatory pains, soft tissue inflammation, edema associated with trauma and surgery such as in gynaecological conditions, breast engorgement, fractures, sprains, injuries, hemorrhoid, anal prolapse</p>', '<p>Trypsin is an enzyme. An enzyme is a protein that speeds up a certain biochemical reaction. Trypsin is found in the small intestine. It can also be made from fungus, plants, and bacteria. But it is usually made for commercial purposes from the pancreas of livestock. Trypsin is given to people who lack enzymes needed for digestion. It is also given in combination with bromelain and rutin for treatment of osteoarthritis.<br />\r\n<br />\r\nBromelain&nbsp;is a&nbsp;protein&nbsp;extract derived from the stems of pineapples, although it exists in all parts of the fresh plant and fruit. The extract has a history of&nbsp;folk medicine&nbsp;use. As a culinary ingredient, it may be used as a&nbsp;meat tenderizer. The term &quot;bromelain&quot; may refer to either of two protease enzymes extracted from the plants of the family Bromeliaceae, or it may refer to a combination of those enzymes along with other compounds produced in an extract.</p>', '<p>Initially 2 tabs 3 times daily. Maintenance 1 tab 3 times daily preferably before meals</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity.</p>', '<p>Trypsin seems to be safe when used by healthcare professionals for wound cleaning and healing. It can cause side effects such as pain and burning. Not enough is known about the safety of trypsin for its other uses.</p>', '<p>Pregnancy Category-Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Allergies: If you are allergic to pineapple, latex, wheat, celery, papain, carrot, fennel, cypress pollen, or grass pollen, you might have an allergic reaction to bromelain.<br />\r\n<br />\r\nSurgery: Bromelain might increase the risk of bleeding during and after surgery. Stop using bromelain at least 2 weeks before a scheduled surgery.</p>', NULL, '<p>Enzymes</p>', NULL, NULL, '2022-02-15 06:08:47', '2022-03-21 20:25:59'),
(214, 214, '<p>Bromfenac is indicated for the treatment of postoperative inflammation and the reduction of ocular pain in patients who have undergone cataract extraction</p>', '<p>Bromfenac is a nonsteroidal anti-inflammatory drug (NSAID). The mechanism of anti-inflammatory activity is thought to be due to its ability to block prostaglandin synthesis by inhibiting cyclooxygenase 1 and 2. Prostaglandins have been shown in many animal models to be mediators of certain kinds of intraocular inflammation. In studies performed in animal eyes, prostaglandins have been shown to produce disruption of the blood-aqueous humor barrier, vasodilation, increased vascular permeability, leukocytosis and increased intraocular pressure.</p>', '<p><strong>Adults</strong>: 1 drop to the problem eye 2 times a day; treatment should start 24 hours after surgery and should continue for 2 weeks<br />\r\n<br />\r\n<strong>Children</strong>: Use and dose must be determined by the doctor.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and efficacy in pediatric patients below the age of 18 have not been established yet.</p>', NULL, '<p>Bromfenac ophthalmic solution is contraindicated in patients with known hypersensitivity to any ingredients of the formulation.</p>', '<p>The most commonly reported adverse reactions following use of Bromfenac after cataract surgery include: abnormal sensation in eye, conjunctival hyperemia, eye irritation (including burning/stinging), eye pain, eye pruritus, eye redness, headache and iritis. These events were reported in 2-7% of patients</p>', '<p>Pregnancy Category C. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution should be exercised when Bromfenac ophthalmic solution is administered to a nursing mother.</p>', '<p>All topical NSAIDs may slow or delay healing. Topical corticosteroids are also known to slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems. It is recommended that Bromfenac ophthalmic solution be used with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time. Bromfenac ophthalmic solution should not be administered while wearing contact lenses.<br />\r\n<br />\r\nBromfenac ophthalmic solution contains Sodium Sulfite, a compound that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Therefore, caution should be used when treating individuals who have previously exhibited sensitivities to these drugs.</p>', NULL, '<p>Ophthalmic Non-Steroid drugs</p>', '<p>Keep out of the reach of children. Store in a cool, dry place, away from heat and direct light. &nbsp;Do not use more than 4 weeks after opening.</p>', NULL, '2022-02-15 06:09:06', '2022-03-21 20:29:50');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(215, 215, '<p>Bromhexine is indicated in the treatment of respiratory tract disorders associated with productive cough. This include-</p>\r\n\r\n<ul>\r\n	<li>Tracheobronchitis</li>\r\n	<li>Bronchitis with emphysema</li>\r\n	<li>Bronchiectasis</li>\r\n	<li>Bronchitis with bronchospasm</li>\r\n	<li>Chronic inflammatory pulmonary conditions and</li>\r\n	<li>Pneumoconiosis.</li>\r\n</ul>', '<p>Bromhexine Hydrochloride is an oral mucolytic agent. It disrupts the structure of acid mucopolysaccharide fibres in mucoid sputum and produces less viscous mucus, which makes easier the expectoration. It is rapidly &amp; completely absorbed from the gastrointestinal tract. It is widely distributed into the body tissues.</p>', '<p>The recommended doses for adults and children are stated below:</p>\r\n\r\n<ul>\r\n	<li>Adult &amp; Children over 12 years: 10 ml (2 teaspoons) 3 times daily</li>\r\n	<li>Children 6-12 years: 5 ml (1 teaspoon) 3 times daily</li>\r\n	<li>Children 2-6 years: 2.5 ml (1/2 teaspoon) 3 times daily</li>\r\n	<li>Bromhexine Hydrochloride is not recommended for children under 2 years of age without advice.</li>\r\n</ul>', '<p>There are no known significant interactions with other drugs.</p>', '<p>It is contraindicated in known hypersensitivity to Bromhexine Hydrochloride or any of the ingredients of this product.</p>', '<p>Gastrointestinal side effects may occur occasionally. A transient rise in serum aminotransferase values has been reported. Other reported side effects include-headache, vertigo (dizziness) and allergic reactions</p>', '<p><strong>Use in Pregnancy</strong>: Special care is recommended during pregnancy. The benefits of bromhexine must be assessed against possible effects on children.<br />\r\n<br />\r\n<strong>Use in Lactation</strong>: Bromhexine is expected to enter breast milk. Therefore it is not recommended that bromhexine be taken by lactating mothers.</p>', '<p>Since mucolytics may disrupt the gastric mucosa bromhexine should be used with care in patients with a history of peptic ulcer disease. Care is also advisable in asthmatic patients. Clearance of bromhexine and its metabolites may be reduced in patients with severe hepatic or renal impairment.</p>', NULL, '<p>Cough expectorants &amp; mucolytics</p>', '<p>Keep in a dry place away from light and heat. Keep out of reach of children.</p>', NULL, '2022-02-15 06:09:30', '2022-03-21 20:32:53'),
(216, 216, '<p><strong>Hyperprolactinemia-Associated Dysfunctions</strong>: Dysfunctions associated with hyperprolactinemia including amenorrhea with or without galactorrhea, infertility or hypogonadism.<br />\r\n<br />\r\n<strong>Prolactin secreting adenomas</strong>: ln cases where adenectomy is elected, a course of bromocriptine mesilate therapy may be used to reduce the tumor mass prior to surgery.<br />\r\n<br />\r\n<strong>Acromegaly</strong>: Parkinson&#39;s Disease: Idiopathic or postencephalitic Parkinson&#39;s disease- As adjunctive treatment to levodopa (alone or with a peripheral decarboxylase inhibitor).</p>', '<p>Bromocriptine mesilate is a nonhormonal, nonestrogenic agent that inhibits the secretion of prolactin in humans, with little or no effect on other pituitary hormones, except in patients with acromegaly, where it lowers elevated blood levels of growth hormone. Bromocriptine mesilate is a dopamine receptor agonist, which activates post-synaptic dopamine receptors.The dopaminergic neurons in the tuberoinfundibular process modulate the secretion of prolactin from the anterior pituitary by secreting a prolactin inhibitory factor (thought to be dopamine); in the corpus striatum the dopaminergic neurons are involved in the control of motor function. Clinically, it significantly reduces plasma levels of prolactin in patients with physiologically elevated prolactin as well as in patients with hyperprolactinemia.</p>', '<p><strong>General</strong>: It is recommended that Bromocriptine mesilate be taken with food. Patients should be evaluated frequently during dose escalation to determine the lowest dosage that produces a therapeutic response.<br />\r\n<br />\r\n<strong>Hyperprolactinemic lndications</strong>: The initial dosage is 0.5 mg to 2.5 mg tablet daily. An additional 2.5 mg tablet may be added to the treatment regimen as tolerated as tolerated every 2-7 days until an optimal therapeutic response is achieved.Based on limited data in children of age 11 to 15 the initial dose is 0.5 to 2.5 mg tablet daily. Dosing may need to be increased as tolerated until a therapeutic response is achieved. The therapeutic dosage ranged from 2.5-10 mg daily in children with prolactin-secreting pituitary adenomas.<br />\r\n<br />\r\n<strong>Acromegaly</strong>: The initial recommended dosage is 0.5 to 2.5 mg on retiring (with food) for 3 days. An additional 0.5 to 2.5 mg should be added to the treatment regimen as tolerated every 3-7 days until patient obtains optimal therapeutic benefit. The maximal dosage should not exceed 100 mg/day.<br />\r\n<br />\r\n<strong>Parkinson&#39;s disease</strong>: The basic principle of bromocriptine mesilate therapy is to initiate treatment at a low dosage. The initial dose of Bromocriptine mesilate is 0.5 of a 2.5 mg tablet twice daily with meals. If necessary,the dosage may be increased every 14-28 days by 2.5 mg/day with meals.The safety of bromocriptine mesilate has not been demonstrated in dosages exceeding 100 mg/day.</p>', '<p>Bromocriptine may interact with dopamine antagonists, butyrophenones, and certain other agents. Compounds in these categories result in a decreased efficacy of Bromocriptine: phenothi-azines, haloperidol, metodopramide, pimozide. Concomitant use of Bromocriptine with other ergot alkaloids is not recommended.</p>', '<ul>\r\n	<li>Uncontrolled hypertension and sensitivity to any ergot alkaloids. In patients being treated for hyperprolactinemia Bromocriptine mesilate should be withdrawn when pregnancy is diagnosed.</li>\r\n	<li>Post partum period in women with a history of coronary artery disease &amp; other severe cardiovascular conditions.</li>\r\n</ul>', '<p>Side effects in decreasing order of frequency are: nausea, headache, dizziness, fatigue, lightheadedness, vomiting, abdominal cramps, nasal congestion constipation, diarrhea and drowsiness. A slight hypotensive effect may accompany treatment. The occurrence of adverse reactions may be lessened by temporarily reducing dosage to 0.5 mg. Abnormalities in laboratory tests may include elevations in blood urea nitrogen, SGOT, SGPT, GGPT, CPK, alkaline phosphatase and uric acid,which are usually transient and not of clinical significance</p>', '<p>Pregnancy category B. Bromocriptine should not be used during lactation in postpartum women.</p>', '<p>Safety and efficacy of bromocriptine mesilate have not been established in patients with renal or hepatic disease. Care should be exercised when administering Bromocriptine therapy concomitantly with other medications known to lower blood pressure.The drug should be used with caution in patients with a history of psychosis or cardiovascular disease. If acromegalic patients or patients with prolactinoma or Parkinson&#39;s disease are being treated with Bromocriptine during pregnancy, they should be cautiously observed.</p>', NULL, '<p>Antiparkinson drugs, Motility stimulants/Dopamine antagonist</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>: No data are available for bromocriptine use in pediatric patients under the age of 8 years</p>', '2022-02-15 06:09:56', '2022-03-21 20:37:14'),
(217, 217, '<p>Budesonide inhaler is indicated for the maintenance treatment of asthma as prophylactic therapy in adult and paediatric patients six years of age or older. It is also indicated for patients requiring oral corticosteroid therapy for asthma, many of those patients may be able to reduce or eliminate their requirement for oral corticosteroids over time. Budesonide inhaler is not indicated for the relief of acute bronchospasm.</p>', '<p>Budesonide inhaler is a corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity. Corticosteroids have been shown to have a wide range of inhibitory activities against multiple cell types (e.g., mast cells, oeosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in allergic and non-allergic inflammation. These anti-inflammatory actions of Budesonide contribute to its efficacy in asthma.</p>', '<p>Budesonide inhaler should be administered by the orally inhaled route in asthmatic patients age 6 years and older. Individual patients will experience a variable onset and degree of symptom relief. Generally, Budesonide inhaler has a relatively rapid onset of action for an inhaled corticosteroid. Improvement in asthma control following inhaled administration of Budesonide inhaler can occur within 24 hours of initiation of treatment, although maximum benefit may not be achieved for 1 to 2 weeks, or longer. The safety and efficacy of Budesonide inhaler, when administered in excess of recommended doses,&nbsp;have not been established.<br />\r\n<br />\r\n<strong>Adult</strong>: Bronchodilators alone-</p>\r\n\r\n<ul>\r\n	<li>Recommended starting dose: 200 to 400 mcg twice daily</li>\r\n	<li>Highest recommended dose: 400 mcg twice daily</li>\r\n</ul>\r\n\r\n<p><strong>Adult</strong>: Inhaled corticosteroids**-</p>\r\n\r\n<ul>\r\n	<li>Recommended starting dose: 200 to 400 mcg twice daily</li>\r\n	<li>Highest recommended dose: 800 mcg twice daily</li>\r\n</ul>\r\n\r\n<p><strong>Adult</strong>: Oral corticosteroids-</p>\r\n\r\n<ul>\r\n	<li>Recommended starting dose: 400 to 800 mcg twice daily</li>\r\n	<li>Highest recommended dose: 800 mcg twice daily</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: Bronchodilators alone-</p>\r\n\r\n<ul>\r\n	<li>Recommended starting dose: 200 mcg twice daily</li>\r\n	<li>Highest recommended dose: 400 mcg twice daily</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: Inhaled corticosteroids**-</p>\r\n\r\n<ul>\r\n	<li>Recommended starting dose: 200 to 400 mcg twice daily</li>\r\n	<li>Highest recommended dose: 400 mcg twice daily</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: Oral corticosteroids-</p>\r\n\r\n<ul>\r\n	<li>Recommended dose: The highest recommended dose in children is 400 mg twice daily</li>\r\n</ul>\r\n\r\n<p>**In patients with mild to moderate asthma who are well controlled on inhaled corticosteroids, dosing with Budesonide inhaler 200 mg or 400 mg once daily may be considered. Budesonide inhaler can be administered once daily either in the morning or in the evening.<br />\r\n<br />\r\nIf the once daily treatment with Budesonide inhaler does not provide adequate control of asthma symptoms, the total daily dose should be increased and/or administered in divided doses.<br />\r\n<br />\r\n<strong>Patients maintained on chronic oral corticosteroids</strong>: Initially, Budesonide inhaler should be used concurrently with the patient&rsquo;s usual maintenance dose of systemic corticosteroid. After approximately one week, gradual withdrawal of the systemic corticosteroid is started by reducing the daily or alternate daily dose. The next reduction is made after an interval of one or two weeks, depending on the response of the patient. Generally, these decrement should not exceed 2.5 mg of Prednisone or its equivalent. A slow rate of withdrawal is strongly recommended. During reduction of oral corticosteroids, patients should be carefully monitored for asthma instability, including objective measures of airway function, and for adrenal insufficiency. During withdrawal, some patients may experience symptoms of systemic corticosteroid withdrawal, e.g., joint and/or muscular pain, lassitude and depression, despite maintenance or even improvement in pulmonary function. Such patients should be encouraged to continue with Budesonide Inhaler but should be monitored for objective signs of adrenal insufficiency. If evidence of adrenal insufficiency occurs, the systemic corticosteroid dose should be increased temporarily and thereafter withdrawal should be continued more slowly. During periods of stress or a severe asthma attack, transferred patients may require supplementary treatment with systemic corticosteroids.</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 Inhale</strong>r: 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>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>&nbsp;</p>', NULL, '<p>Budesonide inhalation aerosol is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. Hypersensitivity to Budesonide contraindicates the use of Budesonide inhaler.</p>', '<p>The following adverse reactions were reported in patients treated with Budesonide inhaler.</p>\r\n\r\n<ul>\r\n	<li>General: Headache, flu-like syndrome, pain, back pain, fever, neck pain, asthenia.</li>\r\n	<li>Respiratory system: Respiratory tract infections, pharyngitis, sinusitis, rhinitis, voice alteration, cough aggravation.</li>\r\n	<li>Digestive system: Oral candidiasis, dyspepsia, gastroenteritis, nausea, abdominal pain, dry mouth, vomiting.</li>\r\n	<li>Metabolic and Nutritional: Weight gain.</li>\r\n	<li>Musculoskeletal: Fracture, myalgia, arthralgia.</li>\r\n	<li>Nervous system: Syncope, hypertonia, migraine.</li>\r\n	<li>Skin: Ecchymosis.</li>\r\n	<li>Psychiatric: Insomnia.</li>\r\n	<li>Resistance Mechanisms: Infection.</li>\r\n	<li>Special Senses: Taste perversion.</li>\r\n</ul>', NULL, '<p>During withdrawal from oral corticosteroids, some patients may experience symptoms of systemically active corticosteroid withdrawal, e.g., joint and/or muscular pain, lassitude, and depression, despite maintenance or even improvement of respiratory function. Budesonide inhaler will often permit control of asthma symptoms with less suppression of hypothalamic-pituitary-adrenal (HPA) function than therapeutically equivalent oral doses of Prednisone. Since Budesonide is absorbed into the circulation and can be systemically active at higher doses, the full beneficial effects of Budesonide inhaler in minimising HPA dysfunction may be expected only when recommended dosages are not exceeded and individual patients are titrated to the lowest effective dose. Since individual sensitivity to effects on cortisol production exists, physicians should consider this fact when prescribing Budesonide inhaler.</p>', NULL, '<p>Nasal Decongestants &amp; Other Nasal Preparations, Respiratory corticosteroids</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Paediatric studies: There were no clinically relevant differences in the pattern or severity of adverse events in children compared with those reported in adults.</p>', '2022-02-15 06:10:21', '2022-03-21 20:40:41'),
(218, 218, '<ul>\r\n	<li>Prophylaxis and treatment of seasonal and perennial allergic rhinitis.</li>\r\n	<li>Prophylaxis and treatment of vasomotor rhinitis.</li>\r\n	<li>Symptomatic relief of nasal polyposis.</li>\r\n	<li>Prevention against nasal polyps after polypectomy.</li>\r\n</ul>', '<p>Budesonide is a synthetic corticosteroid having potent glucocorticoid activity and weak mineralocorticoid activity. It has approximately a 200-fold higher affinity for the glucocorticoid receptor and a 1000-fold higher topical anti-inflammatory potency than cortisol. Corticosteroids have been shown to have a wide range of inhibitory activities against multiple cell types (e.g. mast cell, eosinophil, neutrophil, macrophage, and lymphocyte) and mediators (e.g. histamine, eicosanoids, leukotriene, and cytokine) involved in allergic mediated inflammation.</p>', '<p><strong>Adults and children 6 years of age and older</strong>: 100 mcg per day administered as one spray per nostril once daily.<br />\r\n<br />\r\n<strong>Adults (12 years of age and older)</strong>: The maximum recommended dose is 400 mcg per day administered as four sprays per nostril once daily.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients below 6 years of age 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>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>No significant drug interaction has been reported.</p>', NULL, '<p>Adverse local reactions following budesonide use are mild and usually transient. Systemic side effects have not been reported during clinical studies of budesonide nasal preparations. Sneezing, headache, sore throat, dry mouth, nausea etc. have been reported as the common side effects.</p>', '<p><strong>Pregnancy</strong>: Inhaled budesonide has been assigned to pregnancy category B by the FDA. Budesonide has not been shown to be teratogenic in animals when given in high doses by inhalation. Despite the animal findings, it would appear that the possibility of fetal harm is remote if the inhaled drug is used during pregnancy. Nevertheless, because the studies in humans cannot rule out the possibility of harm, inhaled budesonide should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: The amounts of inhaled budesonide excreted into breastmilk are minute and infant exposure is negligible. Reviewers and an expert panel consider inhaled corticosteroids acceptable to use during breastfeeding. When taken by mouth, budesonide is only about 9% bioavailable; bioavailability in the infant is likely to be similarly low for any budesonide that enters the breastmilk.</p>', '<p>Budesonide nasal spray should be used with caution in patients with active or quiescent tuberculous infection, untreated fungal, bacterial, or systemic viral infections, or ocular herpes simplex infection. Patients with recent nasal septal ulcers, nasal surgery, or nasal trauma should not use a nasal corticosteroid.</p>', '<p>Like any other nasally administered corticosteroids, acute overdosing is unlikely in view of the total amount of active ingredient present. Clinically significant systemic adverse events would most likely not occurs if the entire contents of the bottle were administered all at once, via either oral or nasal application. Chronic overdosage may result in signs/symptoms of hypercorticism.</p>', '<p>Nasal Decongestants &amp; Other Nasal Preparations, Respiratory corticosteroids</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 06:10:56', '2022-03-21 20:43:18'),
(219, 219, '<p>Budesonide nebuliser suspension is indicated for the maintenance treatment and as prophylactic therapy of asthma.</p>', '<p>Budesonide is a synthetic corticosteroid having potent glucocorticoid activity and weak mineralocorticoid activity. It has approximately a 200-fold higher affinity for the glucocorticoid receptor and a 1000-fold higher topical anti-inflammatory potency than cortisol. Corticosteroids have been shown to have a wide range of inhibitory activities against multiple cell types (e.g., mast cell, eosinophil, neutrophil, macrophage, and lymphocyte) and mediators (e.g., histamine, eicosanoids, leukotriene, and cytokine) involved in allergic mediated inflammation.</p>', '<p><strong>Children 3 months to 12 years of age</strong>: 0.5-1 mg twice daily.<br />\r\n<strong>Adults and elderly</strong>: 1-2 mg twice daily.</p>', '<p>No significant drug interactions have been reported.</p>', '<p>Hypersensitivity to any of the ingredients of this preparation.</p>', '<p>Sneezing, headache, sore throat, dry mouth, nausea etc. have been reported as the common side effects</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. Budesonide nebuliser suspension, like other corticosteroids, should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Budesonide is excreted in human milk. Because other corticosteroids are excreted in human milk, caution should be exercised when Budesonide nebuliser suspension is administered to nursing women.</p>', '<p>Budesonide nebuliser suspension should be used with caution in patients with active or quiescent tuberculous infection, untreated fungal, bacterial, or systemic viral infections, or ocular herpes simplex infection.</p>', NULL, '<p>Nasal Decongestants &amp; Other Nasal Preparations, Respiratory corticosteroids</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 06:11:34', '2022-03-21 20:45:34'),
(220, 220, '<p>Budesonide tablet is a glucocorticoid indicated for the induction of remission in patients with active, mild to moderate ulcerative colitis.</p>', '<p>Budesonide is a synthetic corticosteroid having potent glucocorticoid activity and weak mineralocorticoid activity. It has approximately 200-fold higher affinity for the glucocorticoid receptor than cortisol and 15-fold than prednisolone. Budesonide is effective against inflammatory bowel diseases. It reduces inflammation of colon and also helps heal the lining of the colon.</p>', '<p><strong>Adult</strong>: One 9 mg Budesonide extend release tablet should be taken once daily in the morning with or without food for up to 8 weeks or as prescribed by the doctor.<br />\r\n<br />\r\n<strong>Use in children</strong>: Safety and effectiveness of budesonide in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Use in Hepatic Impaired patients</strong>: Monitor patients for signs and/or symptoms of hypercorticism.</p>', '<p>Avoid Cytochrome P450 3A4 inhibitors (e.g. ketoconazole, grapefruit juice). It may cause increased systemic corticosteroid effects. Budesonide does not affect the plasma levels of oral contraceptives.</p>', NULL, '<p>Common side effects are headache, nausea, upper abdominal pain, fatigue, acne, flatulence, joint pain, urinary tract infection, abdominal distension, constipation.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Budesonide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Budesonide is secreted in human milk. So, a decision should be made whether to discontinue nursing or budesonide taking into account the clinical importance of the drug to the mother.</p>', '<ul>\r\n	<li>Since budesonide is a glucocorticoid, general warnings concerning glucocorticoids should be followed.</li>\r\n	<li>Risk of impaired adrenal function when transferring from glucocorticoid treatment with higher systemic effects to glucocorticoid treatment with lower systemic effects, such as budesonide. Taper patients slowly from systemic corticosteroids if transferring to budesonide.</li>\r\n	<li>Potential worsening of infections (e.g., chickenpox, measles, existing tuberculosis, fungal, bacterial, viral, or parasitic infection). Use with caution in patients with these infections.</li>\r\n	<li>Reduced liver function affects the elimination of glucocorticoid, and increases systemic availability of oral budesonide.</li>\r\n</ul>', '<p>If glucocorticoids are used at excessive doses for prolonged periods, systemic glucocorticoid effects such as hypercorticism and adrenal suppression may occur.</p>', '<p>Ulcerative Colitis</p>', '<p>Budesonide extended-release tablets should be stored below 30&deg;C. Store in a cool and dry place protected from light and moisture</p>', NULL, '2022-02-15 06:11:54', '2022-03-21 20:47:36'),
(221, 221, '<p>This is indicated in the regular treatment of asthma. They are also indicated in the symptomatic treatment of severe chronic obstructive pulmonary disease (COPD), with a history of repeated exacerbations despite regular therapy with long-acting bronchodilators.</p>', '<p><strong>Budesonide:</strong>&nbsp;It is an anti-inflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity. Inflammation is an important component in the pathogenesis of asthma. Corticosteroids have a wide range of inhibitory activities against multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in allergic and non-allergic mediated inflammation. These anti-inflammatory actions of corticosteroids may contribute to their efficacy in asthma.<br />\r\n<br />\r\n<strong>Formoterol Fumarate Dihydrate</strong>: It is a long-acting, selective &beta;2 - adrenergic agonist with a rapid onset of action. Inhaled Formoterol Fumarate Dihydrate BP acts locally in the lungs as a bronchodilator. The pharmacological effects of &beta;2-adrenoceptor agonist drugs are attributable to the stimulation of intracellular adenyl cyclase, the enzyme that catalyses the conversion of adenosine triphosphate (ATP) to cyclic AMP. Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibit the release of mediators of immediate hypersensitivity from the cells, especially from mast cells.</p>', '<p><strong>Inhaler (For Asthma)</strong>-</p>\r\n\r\n<ul>\r\n	<li>Adults and adolescents (12 years and older): The recommended maintenance dose is 1 puff twice daily or 2 puffs once daily. For some patients a maintenance dose of 2 puffs twice daily may be appropriate (for 160/4.5 mcg/inhalation only). Patients should take 1 additional puff as needed in response to symptoms. If symptoms persist after a few minutes, the additional puff should be taken. Not more than 6 puffs should be taken on any single occasion.</li>\r\n</ul>\r\n\r\n<ul>\r\n	<li>Children: The usual maintenance dose is 1 -2 puffs once or twice daily. Patients should take 1 additional puff as needed in response to symptoms. If symptoms persist after a few minutes, the additional puff should be taken. Not more than 4 puffs should be taken on any single occasion.</li>\r\n</ul>\r\n\r\n<p><strong>Inhalation Capsule (For Asthma)</strong>: There are two alternative dosage regimens for the treatment of asthma with Budesonide and Formoterol combination. Budesonide and Formoterol 100 &amp; 200 Inhalation Capsule maintenance and reliever therapy.<br />\r\nAdults and adolescents (12 years and older):</p>\r\n\r\n<ul>\r\n	<li>Maintenance dose: Budesonide and Formoterol 100 &amp; 200 Inhalation Capsule twice daily</li>\r\n	<li>Reliever dose: 1 additional Inhalation Capsule as needed in response to symptoms. If symptoms persist after a few minutes, an additional Inhalation Capsule should be taken. Not more than 6 Inhalation Capsule should be taken on any single occasion. A total daily dose of more than 8 Inhalation Capsule is not normally needed, however, a total daily dose of up to 12 Inhalation Capsule can be used temporarily.</li>\r\n</ul>\r\n\r\n<p>Children (4 years and older):</p>\r\n\r\n<ul>\r\n	<li>Maintenance dose: Budesonide and Formoterol 100 Inhalation Capsule once daily.</li>\r\n	<li>Reliever dose: 1 additional Inhalation Capsule as needed in response to symptoms. If symptoms persist after a few minutes, an additional Inhalation Capsule should be taken. Not more than 4 Inhalation Capsule should be taken on any single occasion. A total daily dose of more than 4 Inhalation Capsule is not normally needed, however, a total daily dose of up to 8 Inhalation Capsule could be used temporarily.</li>\r\n</ul>\r\n\r\n<p><strong>Inhalation Capsule (For COPD):&nbsp;</strong>Adults (40 years and older)</p>\r\n\r\n<ul>\r\n	<li>200 Inhalation Capsule: 2 Inhalation Capsule twice daily. Maximum daily maintenance dose: 4 Inhalation Capsule</li>\r\n	<li>400 Inhalation Capsule: 1 Inhalation Capsule twice daily. Maximum daily maintenance dose: 2 Inhalation Capsule.</li>\r\n</ul>\r\n\r\n<p><strong>Administration</strong><br />\r\n</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>Concomitant treatment with Ritonavir, Itraconazole, Ketoconazole or other potent CYP3A4 inhibitors should be avoided.</p>', '<p>Hypersensitivity to Budesonide, Formoterol or to Lactose.</p>', '<p>Budesonide: Hoarseness, and candidiasis (thrush) of the mouth and throat can occur in some patients. Cutaneous hypersensitivity reactions have been reported.<br />\r\n<br />\r\nFormoterol Fumarate Dihydrate: Tremor, palpitations, and headache have been reported. Cardiac arrhythmias, muscle cramps, and hypersensitivity reactions, including rash, oedema, and angio-oedema, may occur in some patients.</p>', '<p>Administration of Budesonide &amp; Formoterol Fumarate in pregnant women and lactating mother should only be considered if the expected benefit to the mother is greater than any possible risk to the foetus</p>', '<p>Treatment with Budesonide and Formoterol combination should not be initiated to treat a severe exacerbation or if patients have significantly worsening or acutely deteriorating asthma.</p>', NULL, NULL, '<p>Protect from light, store in cool &amp; dry place. Do not store above 30&deg; C. Keep out of the reach of children. Protect from freezing.</p>', '<p>It is recommended that the height of children receiving prolonged treatment with inhaled corticosteroids is regularly monitored. If growth is slowed, therapy should be re evaluated with the aim of reducing the dose of inhaled corticosteroid. The benefits of the corticosteroid therapy and the possible risks of growth suppression must be carefully weighed. In addition consideration should be given to referring the patient to a paediatric respiratory specialist.</p>', '2022-02-15 06:12:34', '2022-03-21 20:53:55'),
(222, 222, '<p>Bumetanide is indicated for the treatment of edema associated with- Congestive heart failure, Hepatic ascites and, Renal disease including the nephrotic syndrome</p>', '<p>Bumetanide is a loop diuretic of the sulfamyl category to treat heart failure. It is often used in patients in whom high doses of furosemide are ineffective. There is however no reason not to use bumetanide as a first choice drug. The main difference between the two substances is in bioavailability. It is said to be a more predictable diuretic, meaning that the predictable absorption is reflected in a more predictable effect. Bumetanide is 40 times more potent than furosemide (for patients with normal renal function).<br />\r\n<br />\r\nBumetanide interferes with renal cAMP and/or inhibits the sodium-potassium ATPase pump. Bumetanide appears to block the active reabsorption of chloride and possibly sodium in the ascending loop of Henle, altering electrolyte transfer in the proximal tubule. This results in excretion of sodium, chloride, and water and, hence, diuresis.</p>', '<p><strong>Oral</strong>: 1 mg in the morning , repeated after 6-8 hours if necessary, In severe cases , 5 mg daily increased by 5 mg every 12-24 hours according to response. Elderly , 500 micrograms daily may be sufficient.<br />\r\n<br />\r\n<strong>Parenteral:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>By IV Injection</strong>: 1-2 mg, repeated after 20 minutes if necessary. Elderly, 500 micrograms (1 ml of Bumetanide) daily may be sufficient.</li>\r\n	<li><strong>By IV Infusion</strong>: 2-5 mg over 30-60 minutes.Elderly, 500 micrograms (1 ml of Bumetanide) daily may be sufficient.</li>\r\n	<li><strong>By IM Injection</strong>: 1 mg initially then adjusted according to response , Elderly 500 micrograms (1 ml of Bumetanide) daily may be sufficient.</li>\r\n</ul>', '<p>Concomitant use of Bumetanide may potentiate the effects of antihypertensive drugs. It shows a tendency to increase the excretion of potassium which can lead to an increase in the sensitivity of the myocardium to the toxic effects of digitalis. As with other diuretics, Bumetanide may cause an increase in blood uric acid.</p>', '<p>Loop diuretics should be avoided in severe hypokalaemia, severe hyponatraemia, anuria, comatose and precomatose states associated with liver cirrhosis and in renal failure.</p>', '<p>The side effects of Bumetanide include: headache, dizziness, fatigue, postural hypotension and gastrointestinal symptoms. Various skin reactions, photosensitivity reactions and metabolic disturbances, including reduced glucose tolerance are less frequent. Electrolyte disturbances can occur especially during long term treatment.</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant woman. It is not known wheather this drug is excreted in human milk.</p>', '<p>Serum potassium should be measured periodically and potassium supplements or potassium sparing diuretics added if necessary.</p>', '<p>Symptoms would be those caused by excessive diuresis. Empty stomach by gastric lavage or emesis.</p>', '<p>Loop diuretics</p>', '<p>Store in a cool &amp; dry place. Protect from light.</p>', '<p><strong>Paediatric use</strong>: Safety and effectiveness in paediatric patients below the age of 18 have not been established.</p>', '2022-02-15 06:12:53', '2022-03-21 20:57:01'),
(223, 223, '<p>Bupivacaine is indicated for the production of local or regional anaesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures. The routes of administration and indicated Bupivacaine concentrations are:</p>\r\n\r\n<ul>\r\n	<li>Local infiltration: 0.25%</li>\r\n	<li>Peripheral nerve block: 0.25%, 0.5%</li>\r\n	<li>Sympathetic block: 0.25%</li>\r\n	<li>Lumbar epidural: 0.25%, 0.5% and 0.75% (non-obstetrical)</li>\r\n	<li>Caudal: 0.25%, 0.5%</li>\r\n</ul>', '<p>Bupivacaine binds to the intracellular portion of voltage-gated sodium channels and blocks sodium influx into nerve cells, which prevents depolarization. Without depolarization, no initiation or conduction of a pain signal can occur.<br />\r\n<br />\r\nThe rate of systemic absorption of bupivacaine and other local anesthetics is dependent upon the dose and concentration of drug administered, the route of administration, the vascularity of the administration site, and the presence or absence of epinephrine in the preparation.</p>\r\n\r\n<ul>\r\n	<li>Onset of action (route and dose-dependent): 1-17 min</li>\r\n	<li>Duration of action (route and dose-dependent): 2-9 hr</li>\r\n	<li>Half life: neonates, 8.1 hr, adults: 2.7 hr</li>\r\n	<li>Time to peak plasma concentration (for peripheral, epidural, or caudal block): 30-45 min</li>\r\n	<li>Protein binding: about 95%</li>\r\n	<li>Metabolism: hepatic</li>\r\n	<li>Excretion: renal (6% unchanged)</li>\r\n</ul>', '<p><strong>Percutaneous infiltration anesthesia For prolonged action</strong>: 9 mg with adrenaline (1 in 200,000), may repeat 2-10 mins later if needed. Max: 90 mg per dental sitting.<br />\r\n<br />\r\n<strong>Peripheral nerve block</strong>: 12.5 mg (as 0.25% solution) or 25 mg (as 0.5% solution). Max: 150 mg/dose.<br />\r\n<br />\r\n<strong>Sympathetic nerve block</strong>: As 0.25% solution: 50-125 mg.<br />\r\n<br />\r\n<strong>Retrobulbar block</strong>: As 0.75% solution: 15-30 mg.<br />\r\n<br />\r\n<strong>Caudal block In surgery</strong>: 37.5-75 mg (as 0.25% solution) or 75-150 mg (as 0.5% solution). Lumbar epidural block In surgery: 25-50 mg (as 0.25% solution) and 50-100 mg (as 0.5% solution).</p>', '<p>Bupivacaine should be used with caution in patients receiving other local anaesthetics or agents structurally related to amide‐type local anaesthetics, e.g. certain anti‐arrhythmics, such as lidocaine and mexiletine, since the systemic toxic effects are additive.Specific interaction studies with Bupivacaine and anti arrhythmic drugs class III (e.g. amiodarone) have not been performed, but caution should be advised.</p>', '<p>Hypersensitivity to Bupivacaine, other amide type local anaesthetics or other components of these preparations; Intravenous regional anaesthesia; obstetrical paracervical block anaesthesia.</p>', '<p><strong>Central Nervous System and Neurological</strong>: Restlessness, excitement, nervousness, dizziness, tinnitus, blurred vision, miosis, nausea, vomiting, numbness of the tongue and perioral region, chills, tremors, muscle twitching, convulsions.<br />\r\n<br />\r\n<strong>Cardiovascular System Reactions</strong>: Myocardial depression and peripheral vasodilatation resulting hypotension and bradycardia, ventricular arrhythmia, cardiac arrest.<br />\r\n<br />\r\n<strong>Hypersensitivity</strong>: urticaria, pruritus, erythema, angioneurotic edema ,tachycardia, sneezing, nausea, vomiting, dizziness, syncope, excessive sweating, elevated temperature, and possibly, anaphylactoid reactions.</p>', '<p>There are no adequate and well‐controlled studies in pregnant women of the effect of bupivacaine hydrochloride on the developing fetus. Bupivacaine should not therefore be given in early pregnancy only if the potential benefit justifies the potential risk to the fetus. Bupivacaine enters the mother&#39;s milk, but in such small quantities that there is no risk of affecting the child at therapeutic dose levels.</p>', '<p>Readiness for emergencies.The lowest dosage that gives effective anaesthesia should be used in order to avoid high plasma levels and serious systemic side effects. Injection of repeated doses of Bupivacaine Hydrocholoride may cause significant increase in blood levels with each additional dose, due to accumulation of the drug or its metabolites or due to slow metabolic degradation. Tolerance varies with the status of the patient. Debilitated, elderly patients and acutely ill patients should be given reduced doses commensurate with age and physical condition. Caution is advised in administration of repeat doses of Bupivacaine Hydrocholoride to patients with severe liver disease.Local anaesthetic procedures should be used with caution when there is inflammation and/or sepsis in the region of the proposed injection.</p>', NULL, '<p>Regional anesthesia</p>', '<p>Keep in a cool &amp; dry place, protected from light. Keep out of the reach of children.</p>', '<p><strong>Paediatrics</strong>: For children a reduced dose based on body weight and surface area should be used. The dosage should be calculated for each patient individually and modified in accordance with the physician&#39;s experience and knowledge of the patient.<br />\r\n<br />\r\n<strong>Geriatrics</strong>: A reduction in dosage may be necessary for elderly patients especially those with compromised cardiovascular and/or hepatic function. Where epidural administration is to be used, a small dose may provide sufficient anaesthesia<br />\r\n<br />\r\n<strong>Impaired hepatic function</strong>: Although bupivacaine is metabolised by the liver, dosage reduction is probably not warranted. However, caution should be exercised with repeated doses.&nbsp;&nbsp;<br />\r\n<br />\r\n<strong>Impaired renal function</strong>: Impairment of renal function is unlikely to affect bupivacaine clearance in the short term (up to 24 hours). However, toxicity due to accumulation may develop with prolonged or repeated administration.</p>', '2022-02-15 06:13:15', '2022-03-21 20:59:48');
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
(224, 224, '<p>Bupivacaine Hydrochloride &amp; Dextrose is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Bupivacaine is indicated for lower abdominal surgery (including Caesarean section), urological and lower limb, including hip surgery, lasting 1.5 to 3 hours.</li>\r\n	<li>Bupivacaine are indicated for intrathecal (subarachnoid, spinal) anesthesia for surgical and obstetrical procedures.</li>\r\n	<li>Bupivacaine produces motor blockade of the abdominal muscles makes the solution suitable for performance of abdominal surgery lasting 1.5-2 hours. The duration of motor blockade does not exceed the duration of analgesia.</li>\r\n</ul>', '<p>Bupivacaineis a long acting anaesthetic agent of the amide type. Bupivacaine &amp; Dextrosehas a rapid onset of action and long duration. The duration of analgesia in the T10-T12 segments is 2-3 hours. Bupivacaine Hydrochloride produces a moderate muscular relaxation of the lower extremities lasting 2-2.5 hours. The motor blockade of the abdominal muscles makes the solution suitable for performance of abdominal surgery lasting 45-60 minutes.</p>', '<p>The doses recommended below should be regarded as a guide for use in the average adult. Spinal anaesthesia for surgery: 2-4 ml (10-20 mg Bupivacaine hydrochloride). The spread of anaesthesia obtained with Bupivacaine depends on several factors including the volume of the solutions and the position if the patients during and following the injection. When injected in the L3-L4 intervertebral space with the patient in the sitting position, 3 ml of Bupivacaine spreads to the T7- T10 spinal segments. With the patient receiving the injection in the horizontal position and then turned supine, the blockade spine spreads to T4-T7 spinal segments. It should be understood that the level of spinal anaesthetic can be unpredictable in a given patient.</p>', '<p>Bupivacaine should be used with care in patients receiving antiarrhythmic drugs with local anaesthetic activity, as their toxic effects may be additive. Phenothiazines and Butyrophenones may reduce or reverse the pressor effect of epinephrine.</p>', '<p>Bupivacaine in Dextrose is contraindicated in patients with a known hypersensitivity to it or to any local anaesthetic agent of the amide type. The following conditions preclude the use of spinal anaesthesia: Severe hemorrhage, severe hypotension or shock and arrhythmias, such as complete heart block, which severely restrict cardiac output,Local infection at the site of proposed lumbar puncture ,Septicemia.</p>', '<p>The adverse reaction profile for Bupivacaine is similar to those for other long acting local anesthetics administered intrathecally. Adverse reactions caused by the drug are difficult to distinguish from the physiological effects of the nerve block (e.g. decrease in blood pressure, bradycardia, temporary urinary retention), events caused directly (e.g. nerve trauma) or indirectly (e.g. epidural abscess) by the needle puncture or events associated to cerebrospinal leakage (eg. postdural puncture headache).</p>', '<p>It is reasonable to assume that a large number of pregnant women and women of child-bearing age have been given Bupivacaine. No specific disturbances to the reproductive process have so far been reported, e.g. no increased incidence of malformations. It should be noted that the dose should be reduced in patients in the late stages of pregnancy<br />\r\n<br />\r\nWith recommended doses, Bupivacaine enters breast milk in such small quantities that there is generally no risk of affecting the breast feed child. At maternal serum levels of up to 0.45 &micro;g/ml produced by the epidural use of Bupivacaine for vaginal delivery, Bupivacaine could not be detected in breast milk during the first 24 hours after delivery (detection limit 0.02 &micro;g/ml).</p>', '<p>Bupivacaine should be given cautiously to the elderly, the debilitated patients and to children, to patients with epilepsy, respiratory impairment, impaired cardiac conduction, bradycardia, severe shock; porphyria; myasthenia gravis. Myocardial depression may be more severe and more resistant to treatment.</p>', '<p>Acute emergencies from local anaesthetics are generally related to high plasma levels encountered during therapeutic use or to underventilation (and perhaps apnea) secondary to upward extension of spinal anaesthesia. Hypotension is commonly encountered during the conduct of spinal anaesthesia due to relaxation of sympathetic tone, and sometimes, contributory mechanical obstruction of venous return.</p>', '<p>Regional anesthesia</p>', '<p>Store in a cool and dry place. Protect from light.</p>', '<p><strong>Use in children</strong>: Bupivacaine Hydrochloride is not recommended in patients younger than 18 years of age.<br />\r\n<br />\r\n<strong>Use in elderly and renal impairment</strong>:&nbsp;Patients in poor general condition due to ageing or other compromising factors such as partial or complete heart conduction block, advanced liver or renal dysfunction require special attention, although regional anesthesia may be the optimal choice for surgery in these patients.</p>', '2022-02-15 06:13:32', '2022-03-21 21:02:11'),
(225, 225, '<p>Bupropion Hydrochloride is indicated in the treatment of depression. Bupropion is also indicated in smoking cessation.</p>', '<p>Bupropion is a selective inhibitor of the neuronal re-uptake of catecholamines (noradrenaline and dopamine) with minimal effect on the re-uptake of indolamines (serotonin) and does not inhibit monoamine oxidase. While the mechanism of action of bupropion, as with other antidepressants is unknown, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms.</p>', '<p>The usual adult target dose for Bupropion is 300 mg/day, given as 150 mg, twice daily. Dosing should begin at 150 mg/day given as a single daily dose in the morning. If the 150 mg initial dose is adequately tolerated, an increase to the 300 mg/day target dose, given as 150 mg twice daily, may be made as early as day 4 of dosing. There should be an interval of at least 8 hours between successive doses.<br />\r\n<br />\r\n<strong>Increasing the dosage above 300 mg/day</strong>: As with other antidepressants, the full antidepressant effect of Bupropion Hydrochloride may not be evident until 4 weeks of treatment or longer. An increase in dosage to the maximum of 400 mg/day, given as 200 mg twice daily, may be considered for patients in whom no clinical improvement is noted after several weeks of treatment at 300 mg/day. Bupropion Hydrochloride should be discontinued in patients who do not demonstrate an adequate response after an appropriate period of treatment at 450 mg/day.<br />\r\n<br />\r\n<strong>Maintenance</strong>: The lowest dose that maintains remission is recommended. Although it is not known how long the patient should remain on Bupropion Hydrochloride, it is generally recognised that acute episodes of depression require several months or longer of antidepressant drug treatment.<br />\r\n<br />\r\n<strong>Child and adolescent</strong>: Not recommended for child and adolescent under 18 years of age.</p>', '<p>Bupropion should not be given concurrently with or within 14 days of stopping an MAOI. The use of alcohol should be minimised or avoided completely because it may alter the seizure threshold. Similarly, other drugs that lower the seizure threshold, such as other antidepressants, antimalarials, antipsychotics, sedating antihistamines, Quinolones, Tramadol, Theophylline, or systemic corticosteroids, should be used with extreme caution together with Bupropion. Carbamazepine, Phenobarbital, or Phenytoin may induce the metabolism of Bupropion while other drugs such as Cimetidine or Ritonavir may inhibit its metabolism. Interaction may occur between Bupropion and Orphenadrine, Cyclophosphamide, and Ifosfamide. Caution should be exercised when it is given with drugs such as some antidepressants, antipsychotics, &beta; blockers, and type 1C antiarrhythmics.</p>', '<p>It is contraindicated in patients with a seizure disorder. Bupropion Hydrochloride is contraindicated in patients treated with other medications that contain Bupropion because the incidence of seizure is dose dependent. Bupropion may induce seizure and consequently its use is contraindicated in patients with epilepsy. The drug is also contraindicated in patients with a current or prior diagnosis of bulimia or anorexia nervosa because of a higher incidence of seizures noted in such patients treated for bulimia with Bupropion Hydrochloride. The concurrent administration of Bupropion Hydrochloride and a monoamine oxidase (MAO) inhibitor is contraindicated. At least 14 days should elapse between discontinuation of MAO inhibitor and initiation of treatment with Bupropion Hydrochloride. Bupropion Hydrochloride is contraindicated in patients who have shown an allergic response to Bupropion or the other ingredients that make up Bupropion Hydrochloride.</p>', '<p>Agitation, anxiety, and insomnia often occur during the initial stages of Bupropion therapy. Other relatively common side effects reported with Bupropion include fever, dry mouth, headache or migraine, dizziness, nausea and vomiting, constipation, tremor, sweating, and skin rashes. Hypersensitivity reactions, ranging from pruritus and urticaria, less commonly, angio-oedema, dyspnoea, and anaphylactoid reactions have been reported.</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed.&nbsp;Bupropion and its metabolites are secreted in human milk. Because Bupropion is excreted in human milk, a decision should be made whether to discontinue breast feeding or to discontinue the drug.</p>', '<p>It should be used with extreme caution, in patients with history of seizure disorders or in patients with other predisposing factors such as severe hepatic cirrhosis or a CNS tumour, and in those undergoing abrupt withdrawal from alcohol or Benzodiazepines. The use of Bupropion in patients with other risk factors for seizures (for example, alcohol abuse, a history of head trauma, diabetes, and drugs known to lower the seizure threshold) should only be undertaken when there are compelling clinical reasons. Bupropion should be used with caution in patients with bipolar depression or psychoses and in patients with a recent history of myocardial infarction or unstable heart disease and in hepatic or renal impairment.</p>', NULL, '<p>Atypical anti-depressant drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 06:14:00', '2022-03-21 21:04:18'),
(226, 226, '<p>Busulfan is indicated for Chronic myeloid leukaemia,&nbsp;Polycythemia vera,&nbsp;Essential thrombocythemia, Conditioning regimens for bone marrow transplantation,&nbsp;Conditioning regimens for bone marrow transplantation</p>', '<p>Busulfan is an alkylating agent that contains 2 labile methanesulfonate groups attached to opposite ends of a 4-carbon alkyl chain. Once busulfan is hydrolyzed, the methanesulfonate groups are released and carbonium ions are produced. These carbonium ions alkylate DNA, which results in the interference of DNA replication and RNA transcription, ultimately leading to the disruption of nucleic acid function. Specifically, its mechanism of action through alkylation produces guanine-adenine intrastrand crosslinks. This occurs through an SN2 reaction in which the relatively nucleophilic guanine N7 attacks the carbon adjacent to the mesylate leaving group. This kind of damage cannot be repaired by cellular machinery and thus the cell undergoes apoptosis.</p>', '<p><strong>Polycythemia vera</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;4-6 mg daily continued for 4-6 wk with&nbsp;blood count monitoring, particularly platelet. Further courses may be given if relapse occurs; alternatively, a maintenance therapy approx half the induction dose may be given.</li>\r\n</ul>\r\n\r\n<p><strong>Chronic myeloid leukaemia</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;Remission induction: Initially, 0.06 mg/kg daily. Max: 4 mg daily. May increase dose if response is inadequate after 3 wk. Continue until WBC count falls to 15,000-25,000 cells/mm3&nbsp;(usually 12-20 wk); may stop earlier if platelet count is &lt;100,000 cells/mm3. Maintenance: If WBC count rises to 50,000 cells/mm3&nbsp;or symptoms return: Resume induction dose; if remission is &lt;3 mth: 0.5-2 mg daily, given as continuous maintenance.</li>\r\n	<li><strong>Child</strong>:&nbsp;Same as adult dose.</li>\r\n</ul>\r\n\r\n<p><strong>Essential thrombocythemia</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;2-4 mg daily.</li>\r\n</ul>', '<p>Additive myelosuppression with other myelosuppressive agents. Cytotoxic agents may increase risk of pulmonary toxicity. May reduce response to vaccines, possibility of generalised infections with live vaccines. Increased risk of adverse effects if given in conjunction with or soon after radiotherapy. Decreased clearance when used wit cyclophosphamide, itraconazole or paracetamol. Combination with thioguanine may result in oesophageal varices, hepatotoxicity and portal HTN. Increased clearance by phenytoin.</p>', '<p>Patient with chronic myelogenous leukemia whose disease was resistant to prior therapy with the drug; definitive diagnosis of chronic myelogenous leukemia has not firmly established.</p>', '<p>Bone marrow depression, manifested as leucopenia, thrombocytopenia and anaemia; hyperpigmentation, GI disturbances, impaired fertility and gonadal function. Rarely, dry skin, gynaecomastia, cataract formation, at high doses, CNS effects including convulsions.</p>', '<p>Pregnancy&nbsp;Category D.&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk</p>', '<p>Discontinue if lung toxicity develops. Severe hepatic or renal impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Myelosuppression, bone marrow depression, pancytopenia.<br />\r\n<strong>Management</strong>: Supportive treatment. Consider haemodialysis.</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>Tab: Store below 25&deg;C.<br />\r\nInj concentrate: Store between 2-8&deg;C.<br />\r\nDo not freeze.</p>', NULL, '2022-02-15 06:14:15', '2022-03-21 21:06:26'),
(227, 227, '<p>Butamirate Citrate is used to relieve dry (non-productive) cough. Dry cough may be caused by a recent viral infection. Butamirate Citrate is also used for pre &amp; post-operative cough sedation in patients who will undergo surgical procedures and bronchoscopy. It can be used in the acute cough of any etiology, whooping cough and cough due to acute lower respiratory tract infections (tracheitis, laryngitis, bronchitis) etc.</p>', '<p>Butamirate Citrate acts directly on the brain&#39;s cough center to suppress cough. Butamirate Citrate is safe and non-sedating which is neither chemically nor pharmacologically related to opium alkaloids. Butamirate Citrate is rapidly and completely absorbed after oral administration. Maximum concentration is reached within 9 hours with the sustained-release tablet. This is extremely protein-bound and plasma elimination half-life is about 13 hours. The active metabolites of Butamirate Citrate have also antitussive action.</p>', '<p><strong>Use in adult</strong>:</p>\r\n\r\n<ul>\r\n	<li>Butamirate Citrate 50 mg tablet: 2-3 tablets daily.</li>\r\n	<li>Butamirate Citrate syrup: 15 ml 4 times daily.</li>\r\n</ul>\r\n\r\n<p><strong>Use in children &amp; adolescents</strong>:<br />\r\nButamirate Citrate 50 mg tablet:</p>\r\n\r\n<ul>\r\n	<li>Adolescent over 12 years old: 1-2 tablets daily.</li>\r\n</ul>\r\n\r\n<p>Butamirate Citrate syrup:</p>\r\n\r\n<ul>\r\n	<li>Children (3-6 yrs): 5 ml 3 times daily.</li>\r\n	<li>Children (6-12 yrs): 10 ml 3 times daily.</li>\r\n	<li>Adolescent: 15 ml 3 times daily.</li>\r\n</ul>\r\n\r\n<p>Butamirate Citrate pediatric drops:</p>\r\n\r\n<ul>\r\n	<li>Children ( 2 months- 1 yrs): 0.50 ml 4 times daily.</li>\r\n	<li>Children (1-3 yrs): 0.75 ml 4 times daily.</li>\r\n</ul>', '<p>Concomitant use with expectorants should be avoided.</p>', '<p>Hypersensitivity to the active ingredient.</p>', '<p>Tolerance of Butamirate Citrate is good.Adverse reactions such as rash,nausea,diarrhoea and vertigo have been observed in a few rare cases,resolving after dose reduction or treatment withdrawal.</p>', '<p>Butamirate Citrate should not be used during the first trimester of pregnancy. During the remainder of pregnancy, it can be used if indicated by a physician but with caution. As a general rule, for safety reasons, in the absence of data on elimination of the active substance in breast milk, the benefits of Butamirate Citrate administration during breast feeding should be carefully weighed against the risks.</p>', '<p>Butamirate Citrate suppresses the cough reflex and therefore the concomitant use with expectorants should be avoided, since it may lead to mucus retention in the airways, which increases the risk of bronchospasm and respiratory infections. If the cough persists for more than 7 days (more than 3 days in children younger than12 years of age) doctor must be consulted.</p>', '<p>Accidental overdose with Butamirate Citrate can cause the following symptoms: drowsiness, nausea, vomiting, diarrhoea, loss of balance and hypotension. Standard emergency procedures should be followed: activated charcoal, saline laxatives and standard cardio-respiratory resuscitation.</p>', '<p>Cough suppressant</p>', '<p>Keep away from light and moisture, store below 30&deg;C. Keep all the medicines out of the reach of children.</p>', NULL, '2022-02-15 06:14:34', '2022-03-21 21:09:03'),
(228, 228, '<p>Butenafine cream is indicated for the topical treatment of the following superficial dermatophytosis: Interdigital tinea pedis (athlete&#39;s foot); Tinea corporis (ringworm); Tinea cruris (jock itch) due to E. floccosum, T. mentagrophytes, T. rubrum, and T. tonsurans.</p>', '<p>Butenafine is a synthetic antifungal agent that is structurally and pharmacologically related to allylamine antifungals. The exact mechanism of action has not been established, but it is suggested that butenafine&#39;s antifungal activity is exerted through the alteration of cellular membranes, which results in increased membrane permeability, and growth inhibition.<br />\r\n<br />\r\nButenafine is mainly active against dermatophytes and has superior fungicidal activity against this group of fungi when compared to that of terbinafine, naftifine, tolnaftate, clotrimazole, and bifonazole. It is also active against Candida albicans and this activity is superior to that of terbinafine and naftifine. Butenafine also generates low MICs for Cryptococcus neoformans and Aspergillus spp. as well.</p>', '<p>In the treatment of interdigital tinea pedis, Butenafine should be applied twice daily for 7 days or once daily for 4 weeks. Patients with tinea corporis or tinea cruris should apply Butenafine once daily for two weeks. Sufficient Butenafine cream should be applied to cover affected areas and immediately surrounding skin of patients with interdigital tinea pedis, tinea corporis and tinea cruris.</p>', '<p>Potential drug interactions between butenafine HCl cream and other drugs have not been evaluated.</p>', '<p>Butenafine Hydrochloride is contraindicated in individuals who have known or suspected sensitivity to this cream or any of its components.</p>', '<p>Rarely local mild burning or irritation may be experienced. Hypersensitivity reactions may occur.</p>', '<p>Pregnancy Category C. As no adequate and well-controlled studies have been conducted, this drug should be used during pregnancy only if clearly needed. It is not known if butenafine HCl is excreted in human milk. Caution should be exercised in prescribing butenafine HCl to a nursing woman.</p>', '<p>Butenafine cream is not for ophthalmic, oral, or intravaginal use. This&nbsp;is for external use only. If irritation or sensitivity develops with the use of Butenafine cream, treatment should be discontinued and appropriate therapy instituted.</p>', '<p>Overdosage of butenafine HCl in humans has not been reported to date.</p>', '<p>Topical Antifungal preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Safety and efficacy in pediatric patients below the age of 12 years have not been studied.</p>', '2022-02-15 06:15:29', '2022-03-21 21:11:41'),
(229, 229, '<p>Butoconazole vaginal cream is indicated for the local treatment of vulvovaginal candidiasis (infections caused by Candida). The diagnosis should be confirmed by KOH smears and/or cultures. Butoconazole vaginal cream is safe and effective in non-pregnant women; however, the safety and effectiveness of this product in pregnant women has not been established.</p>', '<p>The exact mechanism of the antifungal action of butoconazole is unknown, however, it is presumed to function as other imidazole derivatives via inhibition of steroid synthesis. Imidazoles generally inhibit the conversion of lanosterol to ergosterol via the inhibition of the enzyme cytochrome P450 14&alpha;-demethylase, resulting in a change in fungal cell membrane lipid composition. This structural change alters cell permeability and, ultimately, results in the osmotic disruption or growth inhibition of the fungal cell.</p>', '<p>The recommended dose of Butoconazole is one applicatorful of cream (approximately 5 grams of the cream) intravaginally. This amount of cream contains approximately 100 mg of butoconazole nitrate.</p>', NULL, '<p>Butoconazole is contraindicated in patients with a history of hypersensitivity to any of the components of the product.</p>', '<p>Of the 314 patients treated with Butoconazole for 1 day in controlled clinical trials, 18 patients (5.7%) reported complaints such as vulvar/vaginal burning, itching, soreness and swelling, pelvic or abdominal pain or cramping, or a combination of two or more of these symptoms. In 3 patients (1%) these complaints were considered treatment-related. Five of the 18 patients reporting adverse events discontinued the study because of them.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. In pregnant rats administered 6 mg/kg/day of butoconazole nitrate intravaginally during the period of organogenesis, there was an increase in resorption rate and decrease in litter size; however, no teratogenicity was noted. This dose represents a 130- to 353-fold margin of safety based on serum levels achieved in rats following intravaginal administration compared to the serum levels achieved in humans following intravaginal administration of the recommended therapeutic dose of butoconazole nitrate.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when butoconazole nitrate is administered to a nursing woman</p>', '<p>If clinical symptoms persist, tests should be repeated to rule out pathogens, to confirm the original diagnosis, and to rule out other conditions that may predispose a patient to recurrent vaginal fungal infections.</p>', NULL, '<p>Drugs used in Vaginal and Vulval condition</p>', '<p>Store at 25&deg;C</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in children have not been established</p>', '2022-02-15 06:15:53', '2022-03-21 21:13:53'),
(230, 230, '<p>In combination with prednisone or prednisolone, for patients with hormone refractory metastatic prostate cancer previously treated with a docetaxel-containing regimen. Due to high incidence of neutropenia, granulocyte-colony stimulating factor (G-CSF) should be administered within 24-72 hr since 1st cycle of Cabazitaxel administration.</p>', '<p>Cabazitaxel is a microtubule inhibitor. Cabazitaxel binds to tubulin and promotes its assembly into microtubules while simultaneously inhibiting disassembly. This leads to the stabilization of microtubules, which results in the interference of mitotic and interphase cellular functions. The cell is then unable to progress further into the cell cycle, being stalled at metaphase, thus triggering apoptosis of the cancer cell.</p>', '<p>25 mg/m2&nbsp;administered as a 1 hr IV infusion every 3 wk in combination with oral prednisone or prednisolone 10 mg administered daily throughout treatment.</p>', '<p>May increase plasma conc with strong CYP3A4 inhibitors. May lead to decreased plasma conc with strong CYP3A4 inducers. Vaccination with a live attenuated vaccine should be avoided.</p>', '<p>Neutrophil counts &lt;1,500/mm3; platelets &gt;100,000/mm3, haemoglobin &gt;10 g/dL, creatinine &lt;1.5 x ULN, hepatic impairment (bilirubin &ge;1 x ULN, or AST &amp;/or ALT &ge;1.5 &times; ULN); concomitant vaccination with yellow fever vaccine.</p>', '<p>Most commonly in all grades, anemia, leukopenia, neutropenia, thrombocytopenia, diarrhea. Most commonly in &ge;3 grade, neutropenia, leukopenia, anemia, febrile neutropenia, diarrhea.</p>', '<p>Pregnancy category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Hypersensitivity reaction; risk of neutropenia; risk of nausea, vomiting, diarrhea, dehydration, peripheral neuropathy; renal failure, cardiac arrhythmias; liver impairment; anemia. Pregnancy &amp; lactation. Elderly.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', '<p>Store between 15-30&deg; C. Do not refrigerate.</p>', '<p><strong>Children</strong>:&nbsp;The safety and the efficacy of Cabazitaxel in children have not been established.<br />\r\n<br />\r\n<strong>Elderly</strong>:&nbsp;No specific dose adjustment for the use of Cabazitaxel in elderly patients is recommended (see Pharmacology: Pharmacokinetics under Actions, Precautions and Adverse Reactions).<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>:&nbsp;Cabazitaxel is extensively metabolized by the liver. Patients with mild hepatic impairment [total bilirubin &gt;1 to &le;1.5 x Upper Limit of Normal (ULN) or AST &gt;1.5 x ULN], should have cabazitaxel dose reduced to 20 mg/m2. Administration of cabazitaxel to patients with mild hepatic impairment should be undertaken with caution and close monitoring of safety. Limited efficacy data for cabazitaxel at 15 mg/m2, the maximum tolerated dose in patients with moderate hepatic impairment (total bilirubin &gt;1.5 to &le;3.0 x ULN), are available to recommend this dose in this population. Cabazitaxel should not be given to patients with severe hepatic impairment (total bilirubin &gt;3 x ULN).<br />\r\n<br />\r\n<strong>Renal Impairment</strong>:&nbsp;Cabazitaxel is minimally excreted through the kidney. No dose adjustment is necessary in patients with renal impairment not requiring hemodialysis. Patients presenting end-stage renal disease (CLCR&nbsp;&lt;15 mL/min/1.73 m2), by their condition and the limited amount of available data, therefore these patients should be treated with caution and monitored carefully during treatment.<br />\r\n<br />\r\n<strong>Concomitant Drug Use</strong>:&nbsp;Concomitant drugs that are strong CYP3A inducers or strong CYP3A inhibitors should be avoided (see Pharmacology: Pharmacokinetics under Actions and Interactions). However, if patients require co-administration of a strong CYP3A inhibitor, a 25% cabazitaxel dose reduction should be considered (see Pharmacology: Pharmacokinetics under Actions and Interactions).</p>', '2022-02-18 18:39:20', '2022-03-21 21:17:45'),
(231, 231, '<p>It is indicated for the treatment of hyperprolactinemic disorders, either idiopathic or due to pituitary adenomas. It is used to stop breast milk production (lactation) soon after childbirth, stillbirth, abortion or miscarriage. It can also be used to treat other conditions caused by hormonal disturbance which can result in high levels of prolactin being produced. This includes high levels of prolactin caused by tumours of the pituitary gland in both men and women.</p>', '<p>Cabergoline is a long-acting dopamine receptor agonist with a high affinity for D2 receptors. It works by reducing the amount of prolactin that is released from pituitary gland. Results of in vitro studies demonstrate that Cabergoline exerts a direct inhibitory effect on the secretion of prolactin.</p>', '<p>The recommended dosage of Cabergoline Tablet for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to the patient&rsquo;s serum prolactin level. Before initiating treatment, cardiovascular evaluation should be performed and echocardiography should be considered to assess for valvular disease.<br />\r\n<br />\r\nDosage increases should not occur more rapidly than every 4 weeks. If the patient does not respond adequately, and no additional benefit is observed with higher doses, the lowest dose that achieved maximal response should be used and other therapeutic approaches considered. Patients receiving long term treatment with Cabergoline should undergo periodic assessment of their cardiac status and echocardiography should be considered.<br />\r\n<br />\r\nAfter a normal serum prolactin level has been maintained for 6 months, Cabergoline may be discontinued, with periodic monitoring of the serum prolactin level to determine whether or when treatment with Cabergoline should be reinstituted.<br />\r\n<br />\r\n<strong>To prevent milk production (lactation)</strong>: 1 mg (two 0.5 mg tablets) on the first day after delivery.<br />\r\n<br />\r\n<strong>To stop lactation once after start of breastfeeding</strong>: 0.25 mg (one half of Cabergoline&nbsp;0.5 mg table) every 12 hours for two days. To reduce prolactin levels in other conditions: Initially, 0.25 mg twice a week. Dose may be increased up to maximum dose of 4.5 mg or until have responded fully to treatment.</p>', '<p>Cabergoline should not be administered concurrently with D2-antagonists, such as Phenothiazines, Butyrophenones, Thioxanthenes, or Metoclopramide, Chlorpromazine, Domperidone, and medicines to lower blood pressure.</p>', '<p>Cabergoline tablet is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Uncontrolled hypertension or known hypersensitivity</li>\r\n	<li>History of cardiac valvular disorders demonstration of valve leaflet thickening</li>\r\n	<li>High blood pressure in pregnancy associated with swelling and protein in urine</li>\r\n	<li>History of pulmonary, pericardial, or retroperitoneal fibrotic disorders &amp; serious mental disease.</li>\r\n</ul>', '<p>Pathological gambling, increased libido, and hypersexuality have been reported in patients treated with dopamine agonists including cabergoline. This has been generally reversible upon reduction of the dose or treatment discontinuation.</p>', '<p>Pregnancy category B. It is not known whether this drug is excreted in human milk.</p>', '<p>Initial doses higher than 1.0 mg may produce orthostatic hypotension. Care should be exercised when administering Cabergoline with other medications known to lower blood pressure, hypersensitivity, severe liver disease &amp; mental illness.</p>', '<p>Over dosage might be expected to produce nasal congestion, syncope, or hallucinations. Measures to support blood pressure should be taken if necessary.</p>', '<p>Antiparkinson drugs</p>', '<p>Store below 25&deg; C. Keep away from light, moisture &amp; out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Cabergoline in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\n<strong>Use in patients with hepatic impairment</strong>: Since cabergoline is extensively metabolized by the liver, caution should be used, and careful monitoring exercised, when administering Cabergoline to patients with hepatic impairment.</p>', '2022-02-18 18:39:41', '2022-03-21 21:20:19'),
(232, 232, '<p>Cabozantinib is a kinase inhibitor indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Patients with advanced renal cell carcinoma (RCC)</li>\r\n	<li>Patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib</li>\r\n</ul>', '<p>In vitro biochemical and/or cellular assays have shown that cabozantinib inhibits the tyrosine kinase activity of MET, VEGFR-1, -2 and -3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3, and TIE-2. These receptor tyrosine kinases are involved in both normal cellular function and pathologic processes such as oncogenesis, metastasis, tumor angiogenesis, drug resistance, and maintenance of the tumor microenvironment.</p>', '<p><strong>Recommended Dosage for Renal Cell Carcinoma</strong>: The recommended dosage of Cabozantinib is 60 mg once daily without food until the patient no longer experiences clinical benefit or experiences unacceptable toxicity.<br />\r\n<br />\r\n<strong>Recommended Dosage for Hepatocellular Carcinoma</strong>: The recommended dosage of Cabozantinib is 60 mg once daily without food until disease progression or unacceptable toxicity.</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>Stop treatment with Cabozantinib at least 28 days prior to scheduled surgery, including dental surgery</li>\r\n	<li>Do not substitute Cabozantinib tablets with cabozantinib capsules.</li>\r\n	<li>Do not administer Cabozantinib with food. Administer at least 1 hour before or at least 2 hours after eating</li>\r\n	<li>Swallow Cabozantinib tablets whole. Do not crush Cabozantinib tablets.</li>\r\n	<li>Do not take a missed dose within 12 hours of the next dose.</li>\r\n	<li>Modify the dose for certain patients with hepatic impairment and for patients taking drugs known to strongly induce or inhibit CYP450</li>\r\n</ul>', '<ul>\r\n	<li>Strong CYP3A4 inhibitors: Reduce the Cabozantinib dosage if coadministration cannot be avoided.</li>\r\n	<li>Strong CYP3A4 inducers: Increase the Cabozantinib dosage if coadministration cannot be avoided.</li>\r\n</ul>', NULL, '<p>Cabozantinib may cause serious side effects, including:</p>\r\n\r\n<ul>\r\n	<li>bleeding (hemorrhage)</li>\r\n	<li>a tear in your stomach or intestinal wall (perforation) or an abnormal connection between 2</li>\r\n	<li>parts of your body (fistula)</li>\r\n	<li>blood clots, stroke, heart attack, and chest pain</li>\r\n	<li>high blood pressure (hypertension)</li>\r\n	<li>diarrhea</li>\r\n	<li>a skin problem called hand-foot skin reaction</li>\r\n	<li>protein in your urine and possible kidney problems</li>\r\n</ul>', '<p>Based on findings from animal studies and its mechanism of action, Cabozantinib can cause fetal harm when administered to a pregnant woman. There is no information regarding the presence of Cabozantinib or its metabolites in human milk, or their effects on the breastfed child or milk production. Because of the potential for serious adverse reactions in breastfed children, advise women not to breastfeed during treatment with Cabozantinib and for 4 months after the final dose.</p>', '<ul>\r\n	<li>Hemorrhage: Do not administer Cabozantinib if recent history of hemorrhage.</li>\r\n	<li>Perforations and Fistulas: Monitor for symptoms. Discontinue Cabozantinib for unmanageable fistula or GI perforation.</li>\r\n	<li>Thrombotic Events: Discontinue Cabozantinib for myocardial infarction, cerebral infarction, or other serious thromboembolic events.</li>\r\n	<li>Hypertension and Hypertensive Crisis: Monitor blood pressure regularly. Interrupt for hypertension that is not adequately controlled with anti-hypertensive therapy. Discontinue Cabozantinib for hypertensive crisis or severe hypertension that cannot be controlled with</li>\r\n	<li>anti-hypertensive therapy.</li>\r\n	<li>Diarrhea: May be severe. Interrupt Cabozantinib immediately until diarrhea resolves or decreases to Grade 1. Recommend standard antidiarrheal treatments.</li>\r\n	<li>Palmar-plantar erythrodysesthesia (PPE): Interrupt Cabozantinib treatment until PPE resolves or decreases to Grade 1.</li>\r\n	<li>Proteinuria: Monitor urine protein. Discontinue for nephrotic syndrome.</li>\r\n	<li>Osteonecrosis of the jaw: Withhold Cabozantinib for at least 28 days prior to invasive dental procedures and for development of ONJ.</li>\r\n	<li>Wound complications: Withhold Cabozantinib for dehiscence or complications requiring medical intervention.&nbsp;</li>\r\n	<li>Reversible posterior leukoencephalopathy syndrome (RPLS): Discontinue Cabozantinib.</li>\r\n	<li>Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception during treatment and for 4 months after the last dose.</li>\r\n</ul>', '<p>One case of overdosage was reported following administration of another formulation of cabozantinib; a patient inadvertently took twice the intended dose for 9 days. The patient suffered Grade 3 memory impairment, Grade 3 mental status changes, Grade 3 cognitive disturbance, Grade 2 weight loss, and Grade 1 increase in BUN. The extent of recovery was not documented.</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>Store Cabozantinib at room temperature 20&deg;C to 25&deg;C</p>', '<ul>\r\n	<li><strong>Pediatric Use</strong>: The safety and effectiveness of Cabozantinib in pediatric patients have not been established.</li>\r\n	<li><strong>Geriatric Use</strong>: No overall differences in safety or effectiveness were observed between these patients and younger patients.</li>\r\n	<li><strong>Renal Impairment</strong>: No dosage adjustment is recommended in patients with mild or moderate renal impairment.</li>\r\n</ul>', '2022-02-18 18:40:23', '2022-03-21 21:22:55'),
(233, 233, '<p>This medication is used to relieve pain, itching, and discomfort from minor skin irritations such as poison ivy, poison oak, and poison sumac. It also helps to dry the oozing and weeping caused by irritation due to these plants.</p>', '<p>Calamine has mild astringent and antipruritic actions. Zinc oxide has astringent, soothing and protective properties and is used in topical preparations for eczema, slight excoriations, wounds and haemorrhoids. It also reflects ultraviolet radiation and can be used as a physical sunscreen.</p>', '<p><strong>Adult</strong>: Apply 3-4 times daily for 3-5 days.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Use this medication on the skin only. Follow all directions on the product package, or use as directed by your doctor. Shake the bottle well before using. Apply the medication with a cotton pad, and allow the medication to dry on the skin. If you are uncertain about any of the information, consult your doctor or pharmacist.</p>', '<p>There are no known drug interactions for calamine/ zinc oxide topical.</p>', '<p>History of hypersensitivity to any of the components.</p>', '<p>A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.</p>', '<p>Category Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>For external use only. Not to be used on open wounds or burns.</p>', NULL, '<p>Local Antipruritic</p>', NULL, '<p><strong>Pediatrics</strong>:&nbsp;Appropriate studies on the relationship of age to the effects of calamine have not been performed in the pediatric population.&nbsp;<br />\r\n<br />\r\n<strong>Geriatrics</strong>:&nbsp;Appropriate studies on the relationship of age to the effects of calamine have not been performed in the geriatric population.</p>', '2022-02-18 18:40:43', '2022-03-22 02:18:05'),
(234, 234, '<p>Calcipotriol cream &amp; ointment is indicated for the topical treatment of chronic stable plaque type psoriasis vulgaris in adult patients.</p>', '<p>Calcipotriol is a non-steroidal antipsoriatic agent, derived from vitamin D. Calcipotriol exhibits a vitamin D-like effect by competing for the 1,25(OH)2D3 receptor. Calcipotriol is as potent as 1,25(OH)2D3, the naturally occurring active form of vitamin D, in regulating cell proliferation and cell differentiation, but much less active than 1,25(OH)2D3 in its effect on calcium metabolism. Calcipotriol induces differentiation and suppresses proliferation (without any evidence of a cytotoxic effect) of keratinocytes, thus reversing the abnormal keratinocyte changes in psoriasis. The therapeutic goal envisaged with calcipotriol is thus a normalization of epidermal growth.</p>', '<p>Calcipotriol cream &amp; ointment should be applied topically to the affected area twice daily (i.e. in the morning and in the evening). Less frequent application may be indicated after the initial period of treatment. After satisfactory improvement has occurred, treatment should be discontinued. If recurrence takes place after discontinuation, the treatment may be reinstituted. Experience is lacking in the use of calcipotriol for periods longer than 1 year. The maximum recommended weekly dose of calcipotriol cream is 100 gm/week.</p>', NULL, '<p>Calcipotriol cream &amp; ointment is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparations. It is also contraindicated in patients with known disorders of calcium metabolism.</p>', '<p>Photosensitivity reactions, skin discolouration, bullous eruption, skin exfoliation, contact dermatitis and allergic reactions have been reported with topical calcipotriol therapy.</p>', '<p>Safety for use in pregnancy has not been established. Therefore calcipotriol should not be used during pregnancy unless benefits clearly outweigh the risks. It is not known whether calcipotriol is excreted in breast milk, therefore, the drug should be used during lactation only if the benefits clearly outweigh the risks. Calcipotriol should not be applied to the chest area during breast feeding to avoid possible ingestion by infants.</p>', '<p>Calcipotriol cream &amp; ointment is not recommended for use in patients with generalized pustular psoriasis, guttate psoriasis and erythrodermic exfoliate psoriasis. Calcipotriol cream &amp; ointment is not recommended for use on the face.</p>', NULL, '<p>Topical Vitamin D &amp; related preparations</p>', '<p>Store below 25&deg; C, away from light and moisture. Do not freeze. Keep all medicines out of reach of children.</p>', '<p>Calcipotriol cream &amp; ointment should not be used in children, as there is inadequate experience with its use</p>', '2022-02-18 18:41:19', '2022-03-22 02:21:12'),
(235, 235, '<p>Calcitriol is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Post-menopausal osteoporosis</li>\r\n	<li>Renal osteodystrophy</li>\r\n	<li>Postsurgical hypoparathyroidism</li>\r\n	<li>Idiopathic hypoparathyroidism</li>\r\n	<li>Pseudohypoparathyroidism</li>\r\n	<li>Secondary hyperparathyroidism in patients with moderate to severe chronic renal failure (pre-dialysis)</li>\r\n	<li>Vitamin D dependent rickets</li>\r\n</ul>', '<p>Calcitriol is one of the most important active metabolites of vitamin D3. It is normally formed in the kidneys from its precursor, 25-hydroxycholecalciferol. Calcitriol promotes intestinal absorption of calcium and regulates bone mineralization. The key role of Calcitriol is the regulation of calcium homeostasis, which includes stimulation effects on osteoblastic activity in the skeleton.</p>', '<p>The optimal daily dose of Calcitriol capsule must be carefully determined for each patient on the basis of serum calcium level.<br />\r\n<br />\r\n<strong>In Post-menopausal Osteoporosis</strong>: The recommended dose of Calcitriol capsule is 0.25 mcg twice daily.<br />\r\n<br />\r\n<strong>In Renal Osteodystrophy (dialysis patients)</strong>: The initial daily dose is 0.25 mcg of Calcitriol capsule. In patients with normal or only slightly reduced calcium levels, doses of 0.25 mcg every other day are sufficient.<br />\r\n<br />\r\n<strong>In Hypoparathyroidism and Rickets</strong>: The recommended initial dosage of Calcitriol capsule is 0.25 mcg/day which given in the morning. If within 2-4 weeks satisfactory response is not observed by usual dose then dose may be increased at 2-4 weeks intervals.<br />\r\n<br />\r\nThe recommended intravenous initial dose of Calcitriol injection, depending on the severity of the hypocalcemia and/or secondary hyperparathyroidism, is 1 mcg (0.02 mcg/kg) to 2 mcg administered three times weekly, approximately every other day. Doses as small as 0.5 mcg and as large as 4 mcg three times weekly have been used as an initial dose. If a satisfactory response is not observed, the dose may be increased by 0.5 to 1 mcg at two to four week intervals.</p>', '<p>Concomitant treatment with a thiazide diuretics increases the risk of hypercalcemia. Calcitriol dosage must be determined with care in patients undergoing treatment with digitalis as hypercalcemia in such patients may precipitate cardiac arrhythmias. Magnesium containing drugs (e.g.,antacids) may cause hypermagnesemia.</p>', '<p>Calcitriol is contraindicated in patients with known hypersensitivity to any of its ingredients. Calcitriol is also contraindicated in all diseases associated with hypercalcemia.</p>', '<p>Occasional symptoms include anorexia, headache, vomiting and constipation. Chronic effects may include dystrophy, fever, polyuria, dehydration, apathy and urinary tract infection.</p>', '<p>There is no evidence that vitamin D is teratogenic in humans. Calcitriol may be used during pregnancy only if the benefits outweigh the potential risk to the fetus. Mothers may breast feed while taking Calcitriol but serum calcium levels of the mother and infant should be monitored.</p>', '<p>During Calcitriol therapy if the serum calcium levels rise to 1 mg/100 ml above normal or serum creatinine rises to &gt;120 &micro;mol/l, the dosage of Calcitriol should be substantially reduced or treatment stopped.</p>', NULL, '<p>Vitamin in bone formation, Vitamin-D preparations</p>', '<p>keep in a dry place away from light and heat. Keep out of the reach of children.</p>', '<p>Secondary hyperparathyroidism in patients with moderate to severe chronic renal failure (pre-dialysis)-</p>\r\n\r\n<ul>\r\n	<li>The recommended initial dosage of Calcitriol is 0.25 mcg/day in adults and pediatric patients 3 years of age or older. This dosage may be increased if necessary to 0.5 mcg/day.</li>\r\n	<li>For pediatric patients less than 3 years of age, the recommended initial dosage of Calcitriol is 10 to 15 ng/kg/day.</li>\r\n	<li>In Elderly: No dosage adjustment are required.</li>\r\n</ul>', '2022-02-18 18:41:34', '2022-03-22 02:27:42');
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
(236, 236, '<p>Calcitriol &amp; Calcium combination is indicated for Osteoporosis, Hypoparathyroidism, Hypocalcaemia, Osteomalacia rickets, Renal osteodystrophy.</p>', '<p>Calcium salt can be used in the prevention and treatment of calcium deficiency states or negative calcium balance. It is also used as an adjunct in the prevention and treatment of osteoporosis.<br />\r\n<br />\r\nCalcitriol promotes calcium absorption in the intestines and retention at the kidneys thus increasing serum calcium levels. It also increases renal tubule phosphate resorption consequently decreasing serum phosphatase levels, PTH levels and bone resorption.</p>', '<p><strong>Hyperparathyroidism in renal failure</strong>: 0.25 mcg/day or alternate day. May increase slowly.<br />\r\n<br />\r\n<strong>Hypoparathyroidism or pseudohypoparathyroidism</strong>: 0.5-2 mcg once daily.<br />\r\n<br />\r\n<strong>Vitamin D dependent rickets</strong>: 0.015-0.02 mcg/kg/day. Maintenance: 0.03-0.06 mcg/kg/day. Max: 2 mcg/day.<br />\r\n<br />\r\n<strong>Hyperparathyroidism in dialysis patients</strong>: 0.5-4 mcg 3 times/wk. Max: 8 mcg 3 times/wk.<br />\r\n<br />\r\n<strong>Hyperparathyroidism in renal failure</strong>: 0.5 mcg 3 times/wk, may increase by 0.25-0.5 mcg at 2-4 wk intervals. Maintenance: 0.5-3 mcg 3 times/wk.</p>', '<p><strong>Calcium</strong>: Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn and calcium-channel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication.<br />\r\n<br />\r\n<strong>Calcitriol</strong>: Hypermagnesaemia may develop in patients on chronic renal dialysis. Hypercalcaemia in patients on digitalis may precipitate cardiac arrhythmias. Intestinal absorption of calcitriol may be reduced by cholestyramine and colestipol. Phenytoin, barbiturates may decrease the T1/2 of calcitriol. May develop hypercalcaemia with thiazide diuretics.</p>', '<p>Hypercalcaemia; evidence of vitamin D toxicity, pregnancy &amp; lactation.</p>', '<p>Weakness; headache; somnolence; nausea; vomiting; dry mouth; constipation; muscle pain; bone pain; metallic taste; polyuria; polydipsia; anorexia; irritability; weight loss; nocturia; mild acidosis; reversible azotemia; generalized vascular calcification; nephrocalcinosis; conjunctivitis (calcific); pancreatitis; photophobia; rhinorrhoea; pruritus; hyperthermia; decreased libido; elevated BUN; albuminuria; hypercholesterolaemia; elevated AST and ALT; ectopic calcification; hypertension; cardiac arrhythmias.</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>Idiopathic hypercalcaemia. Pediatric doses must be individualised and monitored under close medical supervision. Coronary disease, renal function impairment and arteriosclerosis, especially in the elderly. Hypoparathyroidism.</p>', NULL, '<p>Specific mineral &amp; vitamin combined preparations</p>', NULL, NULL, '2022-02-18 18:41:57', '2022-03-22 02:30:21'),
(237, 237, '<p>This combination&nbsp;is indicated to maintain strong bones and teeth as well as the health of the muscles and nerves. It is also indicated for the prevention &amp; treatment of osteoporosis &amp; post-menopausal osteoporosis. It is needed for bone development and constant regeneration of bone as well.</p>', '<p>This medicine&nbsp;is an absolute bone health formula with more than half a dozen key nutrients. Calcium decreases the rate of bone loss from the femoral neck, the spine and the total body. Since calcium is a nutrient, not a drug, the positive effects of supplemental calcium are most pronounced among women with low to moderate calcium intake. Vitamin D3 helps the body to absorb calcium which helps to reduce age-related bone loss and bone fractures related to osteoporosis. Magnesium helps the body to absorb both calcium and vitamin D3. It also helps to synthesize proteins. Low magnesium status has been associated with postmenopausal osteoporosis. The trace minerals Zinc, Copper and Manganese all play a role in bone development. Zinc is a part of an antioxidant enzyme that helps to prevent cellular destruction, which can cause problems with bone growth and maturation. Copper keeps bones free from thinning. Fifty percent of the total copper content in the body is in the bones and muscles. Manganese, in combination with other trace minerals, helps to prevent bone loss and osteoporosis. Boron works with magnesium and vitamin D3 to enhance calcium absorption and helps to maintain calcium levels in the body. Vitamin C works as an antioxidant. It is also essential for the formation of collagen and aids in iron absorption. Vitamin E serves as an antioxidant, protects biological membranes and stabilizes cellular functions.</p>', '<p>2 tablets per day, preferably 1 tablet in the morning and 1 tablet in the evening or as directed by the physician.</p>', '<p>The risk of hypercalcaemia is increased if calcium salts are given with thiazide diuretics as these drugs reduce urinary calcium excretion. The effects of digitalis glycosides on the heart are enhanced by calcium. Calcium salts may reduce the absorption of fluoride, some fluoroquinolones, tetracyclines and iron.</p>', '<p>Hypersensitivity to any of the ingredients. Periodic checks of plasma calcium levels and urinary calcium excretion should be made in patients with mild to moderate renal failure or mild hypercalciuria.</p>', '<p>Calcium salts may cause mild gastrointestinal side effects such as constipation, flatulence, nausea, abdominal pain &amp; bloating. Hypercalcaemia &amp; in rare cases hypercalciuria have been seen with long term intake of calcium at high doses. Side effects from micronutrients are rare.</p>', '<p>Recommended in pregnancy and lactation.</p>', '<p>If there is any pre-existing heart disease or kidney disease, precautions should be taken.</p>', '<p>Symptoms of overdose may include nausea and vomiting, severe drowsiness, dry mouth, loss of appetite, metalic taste, stomach cramps, unconsciousness, diarrhoea, weakness, headache, constipation, dizziness or irritability.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Store in a dry and cool place, away from direct light.</p>', '<p>Data is insufficient regarding use in children.</p>', '2022-02-18 18:42:12', '2022-03-22 02:34:59'),
(238, 238, '<p>Calcium Acetate is indicated for the control of hyperphosphatemia in end stage renal disease (ESRD) and does not promote aluminum absorption.</p>', '<p>Calcium Acetate when taken with meals, combines with dietary phosphate to form insoluble Calcium Phosphate which is excreted in the feces. Maintenance of serum phosphorus below 6.0 mg/dl is generally considered as a clinically acceptable outcome of treatment with phosphate binders. Calcium Acetate is highly soluble at neutral pH, making the Calcium readily available for binding to phosphate in the proximal small intestine. Orally administered Calcium Acetate from pharmaceutical dosage forms has been demonstrated to be systemically absorbed up to approximately 40% under fasting conditions and up to approximately 30% under non fasting conditions. This range represents data from both healthy subjects and renal dialysis patients under various conditions.</p>', '<p>The recommended initial dose of Calcium Acetate for the adult dialysis patient is 2 tablets with each meal. The dosage may be increased gradually to bring the serum phosphate level below 6 mg/dl, as long as hypercalcemia does not develop. Most patients require 3-4 tablets with each meal.<br />\r\n<br />\r\nPediatric Use: The safety&nbsp;and efficacy of Calcium Acetate have not been established.<br />\r\n<br />\r\nGeriatric Use: In clinical studies, no overall differences in safety or effectiveness were observed between the geriatric and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.</p>', '<p>Calcium Acetate may decrease the bioavailability of tetracycline.</p>', '<p>Calcium Acetate is contraindicated in patients with hypercalcemia.</p>', '<p>Patients may occasionally experience nausea during Calcium Acetate therapy. Hypercalcemia may occur during treatment with Calcium Acetate. Mild hypercalcemia (Ca &gt;10.5 mg/dl) may be asymptomatic or manifest itself as constipation, anorexia, nausea and vomiting. More severe hypercalcemia (Ca &gt;12 mg/dl) is associated with confusion, delirium, stupor and coma. Mild hypercalcemia is easily controlled by reducing the Calcium Acetate dose or temporarily discontinuing therapy. Severe hypercalcemia can be treated by acute hemodialysis and discontinuing Calcium Acetate therapy. Decreasing dialysate calcium concentration could reduce the incidence and severity of Calcium Acetate induced hypercalcemia. The long-term effect of Calcium Acetate on the progression of vascular or soft-tissue calcification has not been determined. Isolated cases of pruritus have been reported which may represent allergic reactions.</p>', '<p>Teratogenic Effects: Category C. Animal reproduction studies have not been conducted with Calcium Acetate. It is also not known whether Calcium Acetate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Calcium Acetate should be given to a pregnant woman only if clearly needed.</p>', '<p>Excessive dosage of Calcium Acetate induces hypercalcemia; therefore, early in the treatment during dosage adjustment serum calcium should be determined twice weekly. Should hypercalcemia develop, the dosage should be reduced or the treatment discontinued immediately depending on the severity of hypercalcemia. Calcium Acetate should not be given to patients on digitalis, because hypercalcemia may precipitate cardiac arrhythmias. Calcium Acetate therapy should always be started at low dose and should not be increased without careful monitoring of serum calcium. The patient should be informed about compliance with dosage instructions, adherence to instructions about diet and avoidance of the use of nonprescription antacids. Patients should be informed about the symptoms of hypercalcemia.</p>', '<p>Administration of Calcium Acetate in excess of the appropriate daily dosage can cause severe hypercalcemia.</p>', NULL, '<p>Administration of Calcium Acetate in excess of the appropriate daily dosage can cause severe hypercalcemia.</p>', NULL, '2022-02-18 18:42:31', '2022-03-22 02:37:41'),
(239, 239, '<p><strong>250 mg or 500 mg tablet</strong>: This is used for the treatment or prevention of calcium depletion in patients in whom dietary measures are inadequate. Conditions that may be associated with calcium deficiency include hypoparathyroidism, achlorhydria, chronic diarrhea, vitamin D deficiency, steatorrhea, sprue, pregnancy and lactation, menopause, pancreatitis, renal failure, alkalosis, and hyperphosphataemia. Calcium Carbonate is being used increasingly often to treat hyperphosphataemia in chronic renal failure as well as those on continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis. Many patients are unable to tolerate sufficient doses for complete phosphate control and require additional measures such as stringent dietary phosphate restriction or relatively small doses of aluminium hydroxide. Calcium Carbonate containing preparations can provide short-term relief of dyspeptic systems but are no longer recommended for long-term treatment of peptic ulceration.<br />\r\n<br />\r\n<strong>1000 mg tablet</strong>: This is indicated for the management of conditions associated with hyperidity and&nbsp;for fast relief of acid indigestion, heartburn, sour stomach and upset stomach.</p>', '<p>Calcium carbonate reacts with gastric acid to produce a salt and water. For calcium carbonate the postulated chemical reaction is: CaCO3&nbsp;+ 2HCl = CaCl2&nbsp;+ H2O + CO2<br />\r\n<br />\r\nTwo grams of calcium carbonate will readily bring 100 ml of hydrochloric acid to a pH above 6. The increase in gastric pH diminishes the activity of pepsin in the gastric secretion. Up to 30% of the oral calcium load may be absorbed.</p>', '<p><strong>250 mg or 500 mg tablet</strong>: Calcium Carbonate is always used orally and when used as an antacid the recommended doses for adults are equivalent to 540-2000 mg Calcium Carbonate per day, doses for children being half of those for adults. As a dietary supplement, such as for the prevention of osteoporosis, 1250-3750 mg Calcium Carbonate (500-1500 mg calcium) daily is recommended in general, but again this will need to be tailored to the individual patient depending on any specific disease such as Calcium deficiency, malabsorption or parathyroid function. In pregnancy and lactation the recommended daily dose of calcium is 1200-1500 mg. In chronic renal failure the doses used vary from 2.5-9.0 gm Calcium Carbonate per day and need to be adjusted according to the individual patient. To maximize effective phosphate binding in this context the Calcium Carbonate should be given with meals.<br />\r\n<br />\r\n<strong>1000 mg tablet</strong>: 2000-3000 mg tablet when symptoms occur; may be repeated hourly if needed or as directed by the physician.</p>', '<p>Calcium Carbonate may enhance the cardiac effects of digoxin and other cardiac glycosides, if systemic hypercalcaemia occurs. Calcium Carbonate may interfere with the absorption of concomitantly administered tetracycline preparations and in chronic renal failure modification of vitamin D therapy may be required to avoid hypercalcaemia when Calcium Carbonate is used as the primary phosphate binder.</p>', '<ul>\r\n	<li>Hypercalcaemia and hyperparathyroidism</li>\r\n	<li>Hypercalciuria and nephrolithiasis</li>\r\n	<li>Zollinger-Ellison syndrome</li>\r\n	<li>Concomitant digoxin therapy (requires careful monitoring of serum calcium level)</li>\r\n</ul>\r\n\r\n<p>When hypercalcaemia occurs, discontinuation of the drug is usually sufficient to return serum calcium concentrations to normal. Calcium salts should be used cautiously in patients with sarcoidosis, renal or cardiac disease, and in patients receiving cardiac glycosides.</p>', '<p>Orally administered Calcium Carbonate may be irritating to the GI tract. It may also cause constipation. Hypercalcaemia is rarely produced by administration of calcium alone, but may occur when large doses are given to patients with chronic renal failure.</p>', '<p>Calcium containing drugs have been widely used in pregnancy by way of oral calcium supplementation or antacid therapy. Calcium Carbonate can be used in lactating women too.</p>', NULL, NULL, '<p>Minerals in bone formation, Specific mineral preparations</p>', '<p>Store in a cool, dry place in controlled room temperature.</p>', '<p><strong>Use in children</strong>: Calcium carbonate has been extensively studied in children and infants with chronic renal failure and is both safe and effective.<br />\r\n<br />\r\n<strong>Use in elderly</strong>: In case of elderly patients with renal failure when calcium carbonate is taken constipation may be troublesome one for this group. For this reason, monitoring of serum calcium and phosphate is of course indicated for elderly patients.</p>', '2022-02-18 18:42:45', '2022-03-22 02:40:25'),
(240, 240, '<ul>\r\n	<li>Treatment of osteoporosis, rickets, osteomalacia, tetany and hypoparathyroidism</li>\r\n	<li>In pregnancy and lactation due to increased demand</li>\r\n	<li>In kidney disease and pancreatitis</li>\r\n	<li>During therapy with antiseizure medications</li>\r\n	<li>The prevention and treatment of Calcium and Vitamin D3 deficiency</li>\r\n</ul>', '<p>This is combination of Calcium (Algae Source) &amp; Vitamin D3. Calcium (Algae Source) is an essential element and plays vital role in the body. It makes body&#39;s framework stronger by building bones. Clinical evidence suggests that calcium is useful for prevention and treatment of osteoporosis and associated fractures. Vitamin D3 is also essential for healthy bones as it aids in calcium absorption from the Gl tract. In addition to this it stimulates bone formation. Controlled clinical studies show that Calcium and Vitamin D3 have synergistic effects on bone growth as well as in osteoporosis and fracture prevention.</p>', '<p>Usual adult dose: 1 tablet in the morning and 1 tablet at night. Tablet should be taken orally.</p>', '<p>With medicine:</p>\r\n\r\n<ul>\r\n	<li>Calcium salts reduce absorption of bisphosphonates, ciprofloxacin, fluorides, iron, levothyroxine, tetracycline and zinc</li>\r\n	<li>Absorption of calcium salts is reduced by corticosteroids</li>\r\n	<li>Increased risk of hypercalcemia when Calcium and Vitamin D3 given with thiazides and related diuretics</li>\r\n</ul>\r\n\r\n<p>With food and others: No clinically significant food drug interaction have been reported.</p>', '<ul>\r\n	<li>Hypocalcemia and hypercalciuria</li>\r\n	<li>Metastatic calcification</li>\r\n	<li>Hypersensitivity to any of the components of Calcium and Vitamin D3 preparation</li>\r\n</ul>', '<p>Common side effects of Calcium and Vitamin D3 may include an irregular heartbeat, nausea, dry mouth, weakness, headache, a metallic taste in mouth, muscle or bone pain and drowsiness. Rare side effects are high amount of Calcium in blood, constipation, diarrhoea, loss of appetite.</p>', '<p>During pregnancy &amp; lactation: Calcium and Vitamin D3 should be used considering the risk-benefit ratio.</p>', '<p>Caution should be taken in patients with renal impairment, sarcoidosis, hypercalcemia and hypercalciuria.</p>', '<p>At high doses it may result in nausea, vomiting, dizziness, anorexia, abdominal cramps, headache, constipation etc. Treatment includes cessation of therapy &amp; adequate rehydration.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Store below 30&deg;C and away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Not recommended for children under 12 years.</p>', '2022-02-18 18:43:30', '2022-03-22 02:43:07'),
(241, 241, '<p>This is indicated for the treatment &amp; prevention of osteoporosis, osteomalacia, tetany, hypoparathyroidism, disorders of osteogenesis. Also used as supplement in case of inadequate intake of Calcium in childhood diet, rickets, pregnancy &amp; lactation, elderly patients. Other indications include pancreatitis, phosphate binder in chronic renal failure etc.</p>', '<p>This is a Calcium and Vitamin D3 preparation where Calcium Carbonate is sourced from coral origin. The Calcium Carbonate from Coral has a chemical structure that is very similar to the composition of human bone. Coral Calcium is similar to other sources but ensures better absorption. Vitamin D3 aids in the absorption of Calcium from GI tract and helps to maintain Calcium balance in the body.</p>', '<p>One tablet once or twice daily with plenty of water or as directed by the physician. Taking in full stomach ensures better absorption.</p>', '<p>Oral Calcium can reduce the absorption of tetracycline &amp; fluoride preparations and minimum 3 hours time should be allowed between ingestion of these medications. Thiazide diuretics reduces the renal excretion of Calcium. Phenytoin, barbiturates, glucocorticoids may induce metabolism of Vitamin D3. Concomitant ingestion of certain foods like spinach, cereals, milk and its derivatives may reduce the intestinal uptake of Calcium.</p>', '<p>Hypersensitivity to any of the components, hypocalcaemia resulting from overdose of Vitamin D3, hyperparathyroidism, bone metastases, severe renal insufficiency, severe hypercalciuria, renal calculi etc.</p>', '<p>Flatulence, diarrhoea, constipation, upper GI discomfort etc. are rare manifestation. Hypercalcaemia due to prolong use has rarely been reported.</p>', '<p>This can be given to pregnant and lactating mothers as per recommendation of physician.</p>', '<p>In presence of mild hypercalciuria, careful monitoring with reduction of dose may be needed. Plasma and serum Calcium level should be monitored in mild to moderate renal impairment and also in case of long-term use. Patients with renal stones or with such previous history should also take precautions.</p>', '<p>At high doses it may result in nausea, vomiting, dizziness, anorexia, abdominal cramps, headache, constipation, irritability etc. Treatment includes cessation of therapy and adequate rehydration.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Store at temperature of below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-02-18 18:43:59', '2022-03-22 02:45:48'),
(242, 242, '<p>Calcium and Vitamin D3 is used for the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Bone loss (osteoporosis)</li>\r\n	<li>Weak bones (osteomalacia, osteopenia)</li>\r\n	<li>Rickets</li>\r\n	<li>Decreased activity of the parathyroid gland (hypoparathyroidism)</li>\r\n	<li>Latent tetany (certain muscle disease)</li>\r\n</ul>\r\n\r\n<p>To ensure adequate Calcium and Vitamin D3, it may also be used in certain conditions such as:</p>\r\n\r\n<ul>\r\n	<li>Pregnancy and lactation</li>\r\n	<li>Post-menopausal osteoporosis</li>\r\n	<li>Senile osteoporosis</li>\r\n	<li>Drug like- Phenytoin, Phenobarbital or Prednisolone type drug may induce osteoporosis</li>\r\n</ul>', '<p>Calcium plays a very important role in the body. It is necessary for normal functioning of bone, nerve cells, muscle, and other vital organs and the regulatory system of the body. If there is not enough calcium in the blood, then the body will take Calcium from bones, thereby weakening bones and triggers different types of bone disorder. Vitamin D3 helps the body to absorb Calcium. Having the right amounts of Calcium and Vitamin D3 is important for building and keeping strong bones and healthy muscles.</p>', '<p>Route of Administration: Oral. One tablet in the morning and one tablet at night or as directed by the physician. Use in children and adolescents should be directed by the physician.</p>', '<p><strong>With Medicine</strong>: It has possible interaction with digoxin, antacids containing Calcium, aluminum or magnesium, other Calcium supplements, calcitriol, tetracycline, doxycycline, aminocycline or oxytetracycline etc. So while taking Calcium tablet with any of these drugs consultations of the physicians is needed.<br />\r\n<br />\r\n<strong>With food &amp; others</strong>: The intestinal uptake of Calcium may be reduced by concomitant ingestion of certain foods (e.g. spinach, milk and milk products).</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 insufficiencies</li>\r\n	<li>Concomitant digoxin therapy (requires careful monitoring of serum Calcium level</li>\r\n</ul>', '<p>Common Side Effects: Generally orally administered Calcium Carbonate may be irritating to the Gl tract and it may also cause constipation but eggshell Calcium is safe for long-term use without causing any Gl discomfort or constipation. Rare Side Effects: Kidney stone, hypercalcemia, alkalosis, loss of appetite.</p>', '<p>It should be used as directed by the physician during Pregnancy and Lactation.</p>', '<p>When hypercalcemia occurs, discontinuation of the drug is required. Patients with a history of kidney stone formation should also be recommended to increase their fluid intake.</p>', '<p>Symptoms of overdose may include nausea and vomiting, dry mouth, loss of appetite, metallic taste, diarrhea, weakness, headache, irritability or dizziness etc.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Store in a cool (below 30&deg;C) and dry place, away from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 18:44:20', '2022-03-22 02:50:04'),
(243, 243, '<p>This combination is used for treatment of osteoporosis, osteomalacia, rickets, tetany and in parathyroid disease. Calcium supplements are often used to ensure adequate dietary intake in conditions such as pregnancy &amp; lactation, osteogenesis and tooth formation (adjunct with definite treatment) and therapy with anti-seizure medications. It is also used as routine supplement and phosphate binder in chronic renal failure.</p>', '<p>This is the preparation of Calcium Carbonate and Vitamin D3 (Cholecalciferol). Calcium is necessary for many normal functions of our body, especially bone formation and maintenance. Vitamin D3 helps for the absorption &amp; reabsorption of Calcium. Vitamin D3 also stimulates bone formation. Clinical studies showed that Calcium and Vitamin D3 all together helps in bone growth, and in prevention of osteoporosis &amp; bone fracture.</p>', '<p><strong>Calcium 500 mg and Vitamin D3 200 IU Tablet</strong>: 2 tablets daily or 1 tablet twice daily. It is best taken with or just after a meal to improve absorption.<br />\r\n<br />\r\n<strong>Calcium 500 mg and Vitamin D3 400 IU Tablet</strong>: 1 tablet twice daily. It is best taken with or just after a meal to improve absorption.</p>', '<p>It has possible interaction with calcium, aluminium or magnesium containing antacids &amp;&nbsp; other calcium supplements, calcitriol &amp; other vitamin D3 supplements; digoxin, tetracycline, doxycycline, minocycline or oxytetracycline.</p>', '<p>It is contraindicated in case of hypercalcaemia, hyperthyroidism, renal calculi &amp; nephrolithiasis and Zollinger-Ellison Syndrome.</p>', '<p>It is generally well tolerated. If there is experience like nausea, vomiting, stomach cramps, dry mouth, increased thirst, increased urination while taking, noticed to physicians. Constipation may occur.</p>', '<p>This combination should be used as directed by physician during pregnancy or while breast-feeding.</p>', '<p>If there is any pre-existing heart disease or kidney disease, precautions should be taken.</p>', '<p>Symptoms of overdosage may include nausea and vomiting, severe drowsiness, dry mouth, loss of appetite, metallic taste, stomach cramps, diarrhea, headache, constipation.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-18 18:44:49', '2022-03-22 02:54:55'),
(244, 244, '<p>This preparation is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Prevention and treatment of osteoporosis</li>\r\n	<li>To maintain strong bone growth</li>\r\n	<li>For proper functioning of heart, muscle and nerves</li>\r\n	<li>As nutritional supplement</li>\r\n	<li>For bone development and regeneration of bone</li>\r\n	<li>Pregnancy &amp; lactation</li>\r\n	<li>Deficiency state of Calcium, Vitamin D3, Magnesium, Zinc, Copper, Manganese &amp; Boron</li>\r\n</ul>', '<p>Nutrition is the most important to prevent osteoporosis and other bone related diseases. Calcium, Magnesium &amp; Vitamin D3 are the macronutrients for bone. Without Vitamin D3 very little Calcium is absorbed. Like Calcium, Magnesium increases bone strength and rigidity. Recent epidemiological studies showed that some micronutrients like Copper, Manganese, Zinc &amp; Boron play an important role in bone health. Deficiency of the micronutrients is noticed in patients with osteoporosis.</p>', '<p>2 tablets per day, preferably 1 tablet in the morning and 1 tablet in the evening.</p>', '<p>It has possible interaction with Calcium, Aluminium or Magnesium containing Antacids &amp; other Calcium supplements, Calcitriol &amp; other Vitamin D3 supplements; Digoxin, Tetracycline, Doxycycline, Minocycline or Oxytetracycline.</p>', '<p>It is contraindicated in case of hypercalcaemia, hyperthyroidism, renal calculi &amp; nephrolithiasis and Zollinger-Ellison Syndrome.</p>', '<p>It is generally well tolerated. If there is experience like nausea, vomiting, stomach cramps, dry mouth, increased thirst, increased urination while taking, noticed to physicians. Side effects from micronutrient are rare.</p>', '<p>This combination should be used as directed by physician during pregnancy or while breast-feeding.</p>', '<p>If there is any pre-existing heart disease or kidney disease, precautions should be taken.</p>', '<p>Symptoms of overdosage may include nausea and vomiting, severe drowsiness, dry mouth, loss of appetite, metallic taste, stomach cramps, diarrhea, headache &amp; constipation.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-18 18:45:10', '2022-03-22 02:57:46'),
(245, 245, '<p>Calcium Dobesilate is indicated for the treatment of hemorrhoidal syndrome, microcirculation disorders of arteovenous origin, clinical signs of chronic venous insufficiency in the lower limbs (pain, cramps, paresthesia, edema, stasis, dermotosis) and in the particular microangiopathy like diabetic retinopathy. It is also indicated in superficial thrombophlebitis as adjuvant therapy.</p>', '<p>Calcium dobesilate acts selectively on the capillary walls regulating their physiological functions of resistance and permeability. It lowers blood viscosity and restores normal blood flow. This action is beneficial in all cases of capillary fragility due to metabolic disturbances (constitutional or acquired), and surgical stress or induced by certain medicines.</p>', '<p>Calcium Dobesilate capsule once or twice daily should be taken with the main meal. Treatment duration, which generally between a few weeks to several months, depends on the disease and its evolution. Dosage should be adapted individually according to the severity of the disease.Hypersensitivity. Pregnancy and lactation.</p>', NULL, '<p>Hypersensitivity. Pregnancy and lactation.</p>', '<p>Rarely gastrointestinal disorders including nausea and diarrhea, skin reactions, fever, articular pain and in very rare cases agranulocytosis have been reported. These reactions are generally spontaneously reversible after treatment withdrawal.</p>', '<p>The safety of Calcium Dobesilate during pregnancy and lactation has not been established. As it is not known whether calcium dobesilate crosses the placental barrier in humans, the drug should be administered during pregnancy only if the benefit to the mother outweighs the potential risk to the fetus. Avoid breastfeeding while using this medicine.</p>', '<p>Dosage should be reduced in case of severe renal insufficiency requiring dialysis. In patient with agranulocytosis, this medication can decrease the number of white blood cells which affect the body&rsquo;s ability to fight against various infections. If patients experience flu-like symptoms such as cough, sore throat, fever and others, they are advised to seek medical care as soon as possible.</p>', '<p>The clinical signs of a possible overdose are not known. If overdose occurs, seek medical advice immediately.</p>', '<p>Vaso Protective</p>', '<p>Store in a cool and dry place, away from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 18:45:39', '2022-03-22 03:01:00'),
(246, 246, '<p>This rectal ointment is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Internal and external hemorrhoids,</li>\r\n	<li>Anal pruritus</li>\r\n	<li>Anal eczema</li>\r\n	<li>Anitis</li>\r\n	<li>Perianitis</li>\r\n	<li>Acute hemorrhoidal thrombosis&nbsp;</li>\r\n	<li>Anal fissure</li>\r\n	<li>Pre and postoperative treatment in cases of hemorrhoidectomy</li>\r\n</ul>\r\n\r\n<p>A long-lasting treatment is not indicated.</p>', '<p>Calcium Dobesilate acts on the capillary walls by regulating their impaired physiological functions- i.e. increased permeability and decreased resistance and on different signs of inflammation. It also has an antithrombotic activity. Lidocaine hydrochloride, a local anesthetic, contributes to relieve pain. Dexamethasone Acetate, a Corticosteroid for topical use, possesses anti-inflammatory and antipruritic actions.</p>', '<p>2-3 times daily. Apply in the morning and bedtime and if possible after defecation. If the ointment is preferred, use the applicator by screwing it to the tube. Insert the applicator as deep as possible in the anus then press the tube gently while withdrawing it. In this case, the tube is sufficient for 8 applications. In case of external hemorrhoids or anal pruritus, apply a thin layer of the ointment several times a day. The duration of the treatment is generally of some days. The doctor must be informed if, after 1 to 2 weeks of treatment, the symptomatology has not improved or has worsened.<br />\r\n<br />\r\nCalcium Dobesilate, Lidocaine HCI &amp; Dexamethasone Acetate Ointment should be applied 2-3 times daily preferably in the morning and at bedtime, if possible apply after defecation. In the case of internal hemorrhoids apply the ointment by the applicator. In cases of external hemorrhoids and anal pruritus, apply a thin layer of the ointment several times a day. The duration of the treatment is generally of some days. The physician must be informed if, after 1 to 2 weeks of treatment the symptomatology has not improved or has worsened.<br />\r\n<br />\r\nMethod of use of this ointment:<br />\r\n<strong>For internal use</strong>-</p>\r\n\r\n<ul>\r\n	<li>Before use remove the cap from the tube.</li>\r\n	<li>Pierce the tube membrane by inverting the cap.</li>\r\n	<li>Attach the applicator (supplied) to the tube.</li>\r\n	<li>Squeeze the tube to fill the applicator and lubricate the tip with ointment for smooth insertion.</li>\r\n	<li>Insert the applicator gently and to full extend into the anus and squeeze once again from the end of the tube to force the required amount of ointment into the anal canal.</li>\r\n	<li>Remove the applicator after application and discard it.</li>\r\n	<li>Try not to have defecation for a couple of hours after an internal application.</li>\r\n</ul>\r\n\r\n<p><strong>For external use</strong>-</p>\r\n\r\n<ul>\r\n	<li>Squeeze the tube of ointment and apply a small amount to the finger.</li>\r\n	<li>Apply the ointment around the outside of the anus with a finger.</li>\r\n	<li>Wash the hands thoroughly with warm water and soap after each application.</li>\r\n	<li>Reattach the cap to tube.</li>\r\n</ul>', NULL, '<p>Hypersensitivity towards the components of this preparation.</p>', '<p>Very rare cases have been reported: Modifications of the intestinal transit, temporary burning sensation and local pain. Hypersensitivity reactions together with skin reactions and/or fever can occur. These reactions can be of allergic origin and in this case, the treatment must be discontinued.</p>', '<p>Pregnancy category C. Studies in pregnant women or animals are not available and in humans, it is not known whether Calcium Dobesilate crosses the placental barrier. On the other hand, after topical administration, Lidocaine Hydrochloride and Dexamethasone Acetate are resorbed in variable quantities and can have systemic effects. Moreover, both substances cross the placental barrier. In these conditions, this rectal ointment&nbsp;should be administered during pregnancy only if the potential benefit justifies the potential risk to the fetus. After oral administration, Calcium Dobesilate is excreted in the maternal milk in low amounts but it is not known whether this is the case with local use. After topical administration, Lidocaine Hydrochloride and Dexamethasone Acetate are excreted in the maternal milk. As a precaution, it should be decided between discontinuating the treatment or the breast-feeding.</p>', '<p>In case of renal insufficiency, this rectal ointment should not be used during longer periods. Avoid long-lasting treatments.</p>', '<p>No overdosage information found yet.</p>', '<p>Drugs used in Ano-rectal region</p>', '<p>The ointment must be stored protected from heat. Store it below 30&deg;C.</p>', NULL, '2022-02-18 18:45:55', '2022-03-22 03:03:29'),
(247, 247, '<p>Calcium Folinate is indicated in:</p>\r\n\r\n<ul>\r\n	<li>To diminish the toxicity and counteract the effect of impaired Methotrexate elimination.</li>\r\n	<li>To treat the Megaloblastic anemia due to folate deficiency, as in sprue, nutritional deficiency.</li>\r\n	<li>To treat the Megaloblastic anemia of pregnancy and infancy.</li>\r\n</ul>', '<p>Calcium Folinate is a Calcium salt of Folinic acid (citrovorum factor), is a mixture of the diastereoisomers of the 5-formyl derivative of Tetrahydrofolic acid. It is a metabolite of Folic acid and an essential co-enzyme for nucleic acid synthesis used in cytotoxic therapy.</p>', '<p>Oral-</p>\r\n\r\n<ul>\r\n	<li><strong>Reduction of harmful effects of folic acid antagonists</strong>: The dose is usually one 5-15 mg tablet every 6 hours for 2 to 3 days.</li>\r\n	<li><strong>Megaloblastic anemia</strong>: In the treatment of Megaloblastic anemia, the dose is one 5-15 mg tablet daily.</li>\r\n</ul>\r\n\r\n<p>Intravenous-</p>\r\n\r\n<ul>\r\n	<li><strong>Advanced Colorectal Cancer</strong>: Folinic Acid is administered at 200 mg/m2&nbsp;by slow intravenous injection followed by 5-fluorouracil at 370 mg/m2&nbsp;by intravenous injection. Or 20 mg/m&nbsp; 2 by slow intravenous injection followed by 5-fluorouracil at 425 mg/m2&nbsp;by intravenous injection. Treatment is repeated daily for 5 days. This 5 day treatment course may be repeated at 4 weeks interval, for 2 courses and then may repeated at 4-5 weekly intervals if the patient has recovered completely from the toxic effects of the prior treatment course.</li>\r\n	<li><strong>Folinic acid rescue after high dose Methotrexate Therapy</strong>: Calcium Folinate starts 24 hours after the beginning of the methotrexate infusion at dose of 15mg (10 mg/m2&nbsp;) every 6 hours for 10 doses.</li>\r\n</ul>\r\n\r\n<p>Intramuscular-</p>\r\n\r\n<ul>\r\n	<li><strong>Folate deficient megaloboastic anaemia</strong>: Up to 1 mg/day. Or, as directed by the registered physician.</li>\r\n</ul>', NULL, '<p>Calcium Folinate therapy is contraindicated for the following:</p>\r\n\r\n<ul>\r\n	<li>Known hypersensitivity to Calcium Folinate, or to any components of the product formulation.</li>\r\n	<li>Pernicious anemia or other Megaloblastic anemia where Vitamin B12&nbsp;is deficient.</li>\r\n</ul>', '<ul>\r\n	<li>Allergic reaction: one may experience a sudden itchy rash (hives), swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing).</li>\r\n	<li>Fits and fainting.</li>\r\n</ul>', '<p>There are no adequate and well-controlled clinical studies conducted in pregnant or breastfeeding women. 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 Calcium Folinate is administered to a nursing mother.</p>', '<p>Calcium Folinate treatment may mask pernicious anemia and other Megaloblastic anemia resulting from Vitamin B12 deficiency.<br />\r\n<br />\r\nCalcium Folinate should only be used with 5-fluorouracil or Methotrexate under the direct supervision of a clinician experienced in the use of cancer chemotherapeutic agents.<br />\r\n<br />\r\nMany cytotoxic medicinal products- direct or indirect DNA synthesis inhibitors- lead to macrocytosis (hydroxycarbamide, cytarabine, mercaptopurine, thioguanine). Such macrocytosis should not be treated with Folinic acid.<br />\r\n<br />\r\nIn epileptic patients treated with Phenobarbital, Phenytoin, Primidone, and Succinimides, there is a risk to increase the frequency of seizures due to a decrease of plasma concentrations of anti-epileptic drug.</p>', '<p>There have been no reported sequelae in patients who have received significantly more Calcium Folinate than the recommended dosage. However, excessive amounts of Calcium Folinate may nullify the chemotherapeutic effect of folic acid antagonists.</p>', '<p>Supportive Care Therapy</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-02-18 18:46:38', '2022-03-22 03:06:23'),
(248, 248, '<p>Calcium Gluconate is indicated for Antidote in severe hypermagnesaemia, Severe hyperkalaemia, Hypocalcaemic tetany, Severe acute hypocalcaemia, Hypocalcaemia and calcium deficiency states</p>', '<p>Calcium gluconate is used to prevent or treat negative calcium balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function.</p>', '<p><strong>Intravenous</strong>: Antidote in severe hypermagnesaemia, Severe hyperkalaemia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 10 ml of 10% calcium gluconate solution over 2 minutes, repeated every 10 minutes if needed.</li>\r\n	<li><strong>Child</strong>: Neonate and 1 mth-18 yr: 0.5 ml/kg of 10% calcium gluconate solution as a single dose. Max: 20 ml of 10% calcium gluconate solution.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous</strong>: Hypocalcaemic tetany, Severe acute hypocalcaemia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 2.25 mmol by slow IV inj over 10 minutes, followed by 58-77 ml of 10% calcium gluconate solution in 0.5-1 L of 5% dextrose solution as continuous IV infusion.</li>\r\n	<li><strong>Child</strong>: Neonate and 1 mth-18 yr: 0.5 ml/kg of 10% calcium gluconate solution as a single dose. Max: 20 ml of 10% calcium gluconate solution.</li>\r\n</ul>', '<p>Co-administration of high calcium doses with thiazide diuretics may result in milk-alkali syndrome and hypercalcaemia. May potentiate digoxin toxicity. Decreases effects of calcium-channel blockers. Enhanced absorption with calcitriol (a vitamin D metabolite).</p>', '<p>Patients with calcium renal calculi or history of renal calculi. Conditions associated with hypercalcaemia and hypercalciuria.</p>', '<p>GI irritation; soft-tissue calcification, skin sloughing or necrosis after IM/SC inj. Hypercalcaemia characterised by anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness, mental disturbances, polydipsia, polyuria, nephrocalcinosis, renal calculi; chalky taste, hot flushes and peripheral vasodilation.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the fetus (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 fetus.</p>', '<p>Impaired renal function; cardiac disease; hypercalcaemia-associated diseases, e.g. sarcoidosis; other malignancies. Pregnancy.</p>', NULL, '<p>Minerals in bone formation, Specific mineral preparations</p>', NULL, NULL, '2022-02-18 18:46:55', '2022-03-23 17:21:38'),
(249, 249, '<p>Calcium Lactate is indicated for heartburn, calcium supplement, calcium deficiencies.</p>', '<p>Calcium is used to prevent or treat negative calcium balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function. Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways.</p>', '<p><strong>19-50 year</strong>: 1,000 mg elemental Calcium Lactate per day.<br />\r\n<strong>&gt;50 year</strong>: 1,200 mg elemental Calcium Lactate per day.</p>', '<p>May reduce the efficacy of calcium-channel blockers. Concurrent admin of IV calcium salt with cardiac glycosides may lead to serious adverse events. Increased risk of hypercalcaemia when used with thiazide diuretics. May reduce absorption of tetracycline, alendronate, atenolol, iron, quinolone antibiotics, sodium fluoride and zinc.</p>', '<p>Conditions associated with hypercalcaemia and hypercalciuria.</p>', '<p>Gl discomfort e.g. nausea, vomiting, constipation; bradycardia, arrhythmias. Dry mouth, increased thirst or increased urination. Mental confusion, milk-alkali syndrome.</p>', '<p>Pregnancy Category-C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks</p>', '<p>Sarcoidosis; history of nephrolithiasis. Avoid IV admin of calcium in patients on cardiac glycosides. Increased risk of hypercalcaemia and hypercalciuria in hypoparathyroid patients receiving high doses of vitamin D. Caution when used in patients with history of kidney stones. Patients should be advised to administer vitamin D concurrently to optimise calcium absorption. Pregnancy.</p>', NULL, '<p>Minerals in bone formation, Specific mineral preparations</p>', NULL, NULL, '2022-02-18 18:47:38', '2022-03-23 17:30:00'),
(250, 250, '<p>This&nbsp;is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Increased demand for Calcium and Vitamin-C, e.g. pregnancy, lactation, periods of rapid growth (childhood, adolescence), in old age</li>\r\n	<li>During infectious disease and convalescence</li>\r\n	<li>Treatment of calcium and vitamin-C deficiency</li>\r\n	<li>Osteoporosis</li>\r\n	<li>Premenstrual syndrome</li>\r\n	<li>Postmenopausal problems</li>\r\n	<li>Adjuvant in colds and influenza.</li>\r\n</ul>', '<p>Calcium is used as a pharmacological agent in humans almost entirely to remedy deficiency. Adequate calcium in the blood is so vital to a wide variety of bodily functions that our internal biochemistry will not tolerate a deficiency even for short periods.<br />\r\n<br />\r\nVitamin-C is an essential component of the diet as man can not synthesize vitamin-C. It is a very powerful reducing agent. Vitamin-C plays an important part in the response of the body to stress. It is important in the defense against infection.</p>', '<p><strong>Adults and children above 7 years</strong>: 1 effervescent tablet daily<br />\r\n<strong>Children 3 to 7 years</strong>:&nbsp;&frac12; effervescent tablet daily<br />\r\n<strong>Infants</strong>: As prescribed by the physician<br />\r\n<br />\r\nDissolve one tablet in half glass (100 ml) of water.</p>', '<p>Calcium Gluconate: Co-admin of high calcium doses with thiazide diuretics may result in milk-alkali syndrome and hypercalcaemia. May potentiate digoxin toxicity. Decreases effects of calcium channel blockers. Enhanced absorption with calcitriol (a vitamin D metabolite).<br />\r\n<br />\r\nCalcium Carbonate: Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn and calcium-channel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication.<br />\r\n<br />\r\nVitamin C: Deferroxamine, hormonal contraceptives, flufenazine, warfarin, elemental iron, salicylates, warfarin, fluphenazine, disulfiram, mexiletine, vitamin B12.</p>', '<p>Hypercalcemia (e.g. in hyperparathyroidism, vitamin-D overdosage, decalcifying tumors such as plasmocytoma, bone metastases); severe hypercalciuria; severe renal failure.<br />\r\n<br />\r\nPatients with hyperoxalauria, glucose-6- phosphate dehydrogenase deficiency, or iron overload. Larger doses may lead to gastrointestinal tract upset.</p>', '<p>In rare cases, mild gastrointestinal disturbances (bloating, diarrhoea) can occur. In predisposed patients prolonged treatment with high doses may promote the formation of calculi in the urinary tract.</p>', '<p>Calcium containing drugs have been widely used in pregnancy by way of oral calcium supplementation or antacid therapy. Calcium Carbonate can be safely used inlactating women. Vitamin-C may be taken safely during pregnancy and lactation</p>', '<p>For patients with mild hypercalciuria (exceeding 300 mg = 7.5 mmol/24 hours), with mild or moderate impairment of renal function or with a history of urinary concrements, monitoring of calcium excretion in the urine is required. If necessary, the dosage should be reduced or therapy should be discontinued. High doses of vitamin-D and derivatives should be avoided during treatment with this preparation unless especially indicated.<br />\r\n<br />\r\nSince citrate salts have been reported to increase aluminium absorption, this medicine&nbsp;&nbsp;should be used with caution in patients with severely impaired renal function, especially those receiving aluminium-containing preparations. The sugar content should be taken into account by diabetic patients.</p>', '<p>Acute overdosage has not been reported. It would be expected to cause gastrointestinal disturbances but not to result in hypercalcemia, except in patients treated with a very high dosage of vitamin-D and derivatives.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Store at a cool and dry place and protected from light and moisture.</p>', NULL, '2022-02-18 18:47:47', '2022-03-23 17:32:25');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(251, 251, '<p>This combination is indicated for-</p>\r\n\r\n<ul>\r\n	<li>As an adjunct to specific therapy for osteoporosis</li>\r\n	<li>Increased demand for Calcium, Vitamin-C and Vitamin-D such as pregnancy, lactation, period of rapid growing (in childhood, addoloscence) and in old age</li>\r\n	<li>In osteomalacia</li>\r\n	<li>The prevention and treatment of Calcium deficiency/ Vitamin-D deficiency especially in the housebound and hospitalized elderly subjects</li>\r\n	<li>As adjuvant in cold and influenza</li>\r\n	<li>Postmenopausal syndromes</li>\r\n	<li>Premenstrual symptoms</li>\r\n	<li>In high body temperatures</li>\r\n	<li>As alkalizing agent in conditions with systemic acidosis.</li>\r\n</ul>', '<p><strong>Calcium Gluconate</strong>&nbsp;is the gluconate salt of calcium. An element or mineral necessary for normal nerve, muscle, and cardiac function, calcium as the gluconate salt helps to maintain calcium balance and prevent bone loss when taken orally. This agent may also be chemopreventive for colon and other cancers.<br />\r\n<br />\r\n<strong>Calcium carbonate</strong>&nbsp;is a basic inorganic salt that acts by neutralizing hydrochloric acid in gastric secretions. It also inhibits the action of pepsin by increasing the pH and via adsorption. Cytoprotective effects may occur through increases in bicarbonate ion (HCO3-) and prostaglandins. Neutralization of hydrochloric acid results in the formation of calcium chloride, carbon dioxide and water. Approximately 90% of calcium chloride is converted to insoluble calcium salts (e.g. calcium carbonate and calcium phosphate).<br />\r\n<br />\r\nCalcium is used as a pharmacological agent in humans almost entirely to remedy deficiency. Adequate calcium in the blood is so vital to a wide variety of bodily functions that our internal biochemistry will not tolerate a deficiency even for short periods.<br />\r\n<br />\r\n<strong>Vitamin-C</strong>&nbsp;is an essential component of the diet as humans cannot synthesize Vitamin-C. It is a very powerful reducing agent and plays an important part in the response of the body to stress. It is important in the defense against infections.<br />\r\n<br />\r\n<strong>Vitamin-D</strong>&nbsp;is also essential for healthy bones as it aids in calcium absorption from the GI tract. In addition to this it stimulates bone formation. Clinical studies show that calcium and vitamin-D has synergistic effects on bone growth as well as in osteoporosis and fracture prevention.</p>', '<p><strong>Adults and children of school age</strong>: 1 effervescent tablet daily<br />\r\n<strong>Children 3 to 7 years</strong>: &frac12; effervescent tablet daily<br />\r\n<strong>Infants</strong>: As prescribed by the physician<br />\r\n<br />\r\nDissolve one tablet in half glass (100 ml) of water.</p>', '<p>The risk of hypercalcemia should be considered in patients taking thiazide diuretics since these drugs can reduce urinary calcium excretion. Hypercalcemia must be avoided in digitalised patients. Certain foods (e.g. those containing oxalic acid, phosphate or phytinic acid) may reduce the absorption of calcium. Concomitant therapy with phenytoin or barbiturates can decrease the effect of vitamin-D because of metabolic activation. The effect of digitalis and other cardiac glycosides may be accentuated with the oral administration of calcium combined with vitamin-D. Calcium salts may reduce the absorption of thyroxine, bisphosphonates, sodium fluoride, quinolone or tetracycline antibiotics or iron. It is advisable to allow a minimum period of 4 hours before taking the<br />\r\ncalcium.</p>', '<p>Absolute contraindications are hypercalcaemia resulting from myeloma, bone metastases or other malignant bone disease, sarcoidosis; primary hyperparathyroidism and Vitamin-D overdosage. It is also contraindicated in severe renal failure and hypersensitivity to any of the tablet ingredients.</p>', '<p>The use of Calcium supplements has rarely given rise to mild gastrointestinal disturbances, such as constipation, flatulence, nausea, gastric pain and diarrhoea. Following administration of Vitamin-D supplements occasional skin rash has been reported. Hypercalciuria, and in rare cases hypercalcaemia have been seen in long-term treatment with Vitamin-D at high doses.</p>', '<p>During pregnancy and lactation treatment with this supplements should always be under the direction of a physician.<br />\r\n<br />\r\nDuring pregnancy and lactation, requirements for calcium and vitamin-D are increased but in deciding on the required supplementation allowances should be made for availability of these agents from other sources.<br />\r\n<br />\r\nOverdoses of vitamin-D have shown teratogenic effects in pregnant animals. Vitamin-D and its metabolites pass into the breast milk.</p>', '<p>Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. Periodic checks of plasma Calcium levels and urinary Calcium excretion should be made in patients with mild to moderate renal failure or mild hypercalciuria. In patients with a history of renal stones urinary Calcium excretion should be measured to exclude hypercalciuria. With long-term treatment it is advisable to monitor serum and urinary Calcium levels and kidney function, and reduce or stop treatment temporarily if urinary Calcium exceeds 7.5 mmol/24 hours. Allowances should be made for Calcium and Vitamin-D supplements from other sources.</p>', '<p>The most serious consequence of acute or chronic overdose is hypercalcaemia due to Vitamin-D toxicity. Symptoms include nausea, vomiting, polyuria, and constipation. Chronic overdoses can lead to vascular and organ calcification as a result of hypercalcaemia. Treatment should consist of stopping all intakes of calcium and Vitamin-D and rehydration.</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Store at a cool and dry place. Protect from light and moisture. Keep out of reach of children. Keep the container tightly closed.</p>', NULL, '2022-02-18 18:48:04', '2022-03-23 17:35:17'),
(252, 252, '<p>Prevention and treatment of calcium and vitamin D deficiency. Calcium and vitamin D supplement as an adjunct to specific therapy in the prevention and treatment of Osteoporosis for patients who are at risk of calcium and vitamin D deficiency</p>', '<p>Adequate Calcium in the blood is so vital to a wide variety of bodily functions that our internal biochemistry will not tolerate a deficiency even for short periods. Clinical evidence suggests that Calcium is useful for the prevention and treatment of Osteoporosis and associated fractures. Vitamin D is also essential for healthy bones as it aids in Calcium absorption from the GI tract. In addition to this it stimulates bone formation. Clinical studies also show that Calcium and Vitamin D has synergistic effects on bone growth as well as in Osteoporosis and fracture prevention.</p>', '<p>1-2 tablets per day, preferably one tablet each morning and evening 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>Pour a tablet in a glass of water. The tablet will be dissolved within 1-2 minutes in the water. Drink the solution immediately.</p>', '<p>It has possible interaction with Digoxin, Antacids containing Calcium, Aluminum or Magnesium, other Calcium supplements, Calcitriol, Tetracycline, Doxycycline, Aminocycline or Oxytetracycline etc. So while taking this suppliment with any of these drugs consultations of the physicians is needed.</p>', '<p>Hypercalcemia and hyperparathyroidism, Hypercalciuria and nephrolithiasis, Hypersensitivity to the component of this preparation, Severe renal insufficiencies</p>', '<p>Orally administered Calcium Carbonate may be irritating to the GI tract. It may also cause constipation. Hypercalcemia is rarely produced by administration of Calcium alone, but may occur when large doses are given to patients with chronic renal failure. Also there may be allergic reactions, irregular heartbeats, nausea, vomiting, decreased appetite dry mouth and drowsiness, skin rash.</p>', '<p>This can be used during pregnancy, in case of a calcium and vitamin D deficiency. However, for supplementation starting during the third trimester of pregnancy, the daily intake should not exceed 1500 mg calcium and 1000 IU vitamin D. This preparation can be used during breast-feeding.</p>', '<p>When hypercalcemia occurs discontinuation of the drug is usually sufficient to return serum calcium concentrations to normal. Calcium salts should be used cautiously in patients with sarcoidosis, renal or cardiac disease and in patients receiving cardiac glycosides. Patients with a history of stone formation should also be recommended to increase their fluid intake.</p>', '<p>Symptoms of over dose may include nausea and vomiting, severe drowsiness, dry mouth, loss of appetite, Metallic taste, stomach cramps, unconsciousness, diarrhea, weakness, headache, constipation, dizziness or irritability. The most serious consequence of acute chronic overdose is hypocalcaemia due to Vitamin D toxicity</p>', '<p>Specific mineral &amp; vitamin combined preparations</p>', '<p>Store at a cool and dry place. Protect from light and moisture. Keep out of reach of children. Keep the container tightly closed.</p>', NULL, '2022-02-18 18:48:21', '2022-03-23 17:38:52'),
(253, 253, '<p>This medication is used to prevent or treat low blood calcium levels in people who do not get enough calcium from their diets. To fulfill the calcium deficiency or meet extra need of calcium, it may be used in conditions like osteoporosis osteomalacia, rickets, latent tetany, postmenopausal osteoporosis, senile osteoporosis, juvenile osteoporosis, drug (phenytoin, phenobarbital, or prednisone) induced osteoporosis, pregnancy and lactation, premenstrual syndrome (PMS), hypoparathyroidism and hip joint plastic surgery.<br />\r\n<br />\r\nCalcium Orotate acts against a number of inflammatory diseases like arthritis, psoriasis, lupus, spondylitis, various cardiovascular ailments, encephalitis, retinitis, phlebitis, colitis, and multiple sclerosis. Calcium Orotate helps in controlling weight by suppressing the habit of frequent appetite of chronic overeaters. It is also beneficial in reducing the effects of mood swings and is proved to be quite effective in cognitive enhancement. Calcium Orotate protects the heart by enhancing the efficiency of cardiac muscles. Recent studies on calcium orotate indicate its potential to minimize the risk of colon cancer.</p>', '<p>This contains Calcium Orotate, a calcium supplement with a functional amino acid chelating ligand- orotic acid. Orotic acid assists the transport of calcium through cellular membrane structures, thus facilitating the intracellular uptake of calcium, particularly in bone. Calcium Orotate also helps in the maintenance of healthy cartilage. Furthermore, Orotate is involved in the synthesis of DNA (deoxyribonucleic acid) and RNA (ribonucleic acid) of the various calcium supplements on the market, Calcium Orotate gets high marks because of the compound&#39;s ability to penetrate complex cell membranes so that it can be metabolized in cartilage.</p>', '<p><strong>Calcium Orotate 400 mg</strong>: As an addition to the daily diet, 2-3 tablets are usually recommended with meal or as directed by a physician.<br />\r\n<br />\r\n<strong>Calcium Orotate 740 mg</strong>: As an addition to the daily diet, 1-2 tablets are usually recommended with meal or as directed by a physician.</p>', '<p>Calcium can decrease absorption of the following drugs when taken together: biphosphonates (e.g., alendronate), quinolone antibiotics (e.g., ciprofloxacin, levofloxacin), and tetracycline antibiotics (e.g., doxycycline, minocycline), levothyroxine, phenytoin (an anticonvulsant), and tiludronate disodium (to treat Paget&#39;s disease). Thiazide-type diuretics can interact with Calcium supplements, increasing the risks of hypercalcemia and hypercalciuria. Both aluminum- and magnesium-containing antacids increase urinary calcium excretion. Mineral oil and stimulant laxatives decrease calcium absorption. Glucocorticoids, such as prednisone, can cause calcium depletion and eventually osteoporosis when they are used for months. Oral contraceptives as well as estrogen compounds reduce calcium. Anti-inflammatories such as NSAIDs, Aspirin, Ibuprofen deplete calcium. Corticosteroids deplete calcium.</p>', '<p>Calcium Orotate is contraindicated in conditions like incomplete or infrequent bowel movements, kidney stone, kidney disease, increased activity of the parathyroid gland, high amount of Calcium in urine, high amount of Calcium in the blood, extreme loss of body water.</p>', '<p>Bloating and swelling in the abdomen are common side effects of Calcium Orotate. Loss of appetite, upset stomach, constipation, nausea, vomiting, unusual weight loss, increased thirst/urination, weakness, unusual tiredness, formation of kidney stones may occur infrequently.</p>', '<p>Women who are pregnant and breast-feeding need more calcium. Pregnancy related high blood pressure is a common and serious risk for women and their babies, and taking supplemental forms of Calcium Orotate can help to reduce this risk.</p>', '<p>Before taking Calcium Orotate, precaution is needed if the patient is allergic to Calcium Orotate. This drug may contain inactive ingredients, which can cause allergic reactions or other problems. Precaution is needed before using this drug in kidney disease, kidney stones, little or no stomach acid (achlorhydria), heart disease, disease of the pancreas, sarcoidosis difficulty absorbing nutrition from food (malabsorption syndrome).</p>', NULL, '<p>Minerals in bone formation, Specific mineral preparations</p>', '<p>Keep out of the reach of children. Keep in a cool &amp; dry place. Protect from light.</p>', NULL, '2022-02-18 18:48:41', '2022-03-23 17:42:03'),
(254, 254, '<p>Calcium Pantothenate is used as a&nbsp;calcium supplement, dietary supplements, burning feet syndrome, greying hair, peripheral neuritis, muscular cramps.</p>', '<p>Calcium is used to prevent or treat negative calcium balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function. Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways.</p>', '<p>Slow intravenous or deep intramuscular&nbsp;as required or as directed by physician.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Contraindicated in patients with hypercalcaemia, hypercalciuria.</p>', '<p>Mild gastrointestinal disturbances, bradicardia, arrythmia and irritation after IV injection</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>Renal impairment, sarcoidosis, concurrent administration of thiazide diuretics may increase the risk of hypercalcaemia.</p>', NULL, '<p>Minerals in bone formation, Specific mineral preparations</p>', NULL, NULL, '2022-02-18 18:49:03', '2022-03-23 17:44:25'),
(255, 255, '<p>Calcium Polystyrene Sulfonate is indicated in patients with hyperkalemia associated with anuria or severe oliguria. It reduces serum level of potassium and removes excess potassium from the body. Calcium Polystyrene Sulfonate is indicated in all states of hyperkalemia due to acute and chronic renal failure, abortion, complicated labor, incompatible blood transfusion, crush injury, prostectomy, severe burns, surgical shock, cases of severe glomerulonephritis and pyelonephritis. Calcium Polystyrene Sulfonate can also be useful in patients requiring dialysis and can also be used during the period of under dialysis to control blood potassium levels.</p>', '<p>Calcium Polystyrene Sulfonate acts by a cumulative process throughout the gastrointestinal tract, removing potassium ions which are excreted in the feces. Calcium Polystyrene Sulfonate passes through the colon and comes into contact with fluids containing increased amounts of potassium. The result is that potassium is taken up in increasing amounts in exchange for calcium ions. The length of time Calcium Polystyrene Sulfonate remains in the body is a decisive factor in its effectiveness. For this reason oral administration is more effective than rectal administration</p>', '<p>Calcium Polystyrene Sulfonate is for oral or rectal administration only. Treatment with the resin should be given as soon as the serum potassium level rises above 6 mmol/L.<br />\r\n<br />\r\nAdults (Including the Elderly)-</p>\r\n\r\n<ul>\r\n	<li><strong>Oral</strong>: For adults the usual dose is 15 g, 3 or 4 times a day. The resin is given by mouth as a suspension in a little water or for greater palatability, the resin may be made into a paste with some sweetened vehicle but not orange juice or other fruit juices that are known to contain potassium. The amount of fluid usually ranges from 3 to 4 ml for per gram of resin.</li>\r\n	<li><strong>Rectal</strong>: In cases where oral administration is not possible Calcium Polystyrene Sulfonate may be given rectally as a suspension of 30 g resin in 100 ml of 2% methylcellulose and 100 ml of water as a daily retention enema.</li>\r\n</ul>\r\n\r\n<p>Pediatrics-</p>\r\n\r\n<ul>\r\n	<li><strong>Oral</strong>: Children should be given 1 g/kg body weight of Calcium Polystyrene Sulfonate daily in divided doses in acute hyperkalemia. In maintenance therapy the dose may be reduced to 0.5 g/kg body weight daily in divided doses.</li>\r\n	<li><strong>Rectal</strong>: It can be given rectally 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>Oral administration of Calcium Polystyrene Sulfonate is contraindicated in neonates.</li>\r\n	<li>Only rectal administration should be considered. With rectal administration, the minimum effective dosage within the range of 0.5 g/kg to 1 g/kg should be given diluted as for adults and with adequate irrigation to ensure recovery of the resin.</li>\r\n</ul>', '<p>Concomitant use of Calcium Polystyrene Sulfonate is not recommended with Sorbitol, Digitalis drugs, Cation donating agents, Non-absorbable cation-donating antacids and laxatives, Aluminum hydroxide, Lithium, Thyroxine.</p>', '<p>Calcium Polystyrene Sulfonate should not be administered to patients with Serum potassium &lt;5 mmol/L and a conditions associated with hypercalcemia, hyperparathyroidism, multiple myeloma, sarcoidosis or metastic carcinoma, history of hypersensitivity to polystyrene sulfonate resins and obstructive bowel disease. Oral administration of Calcium Polystyrene Sulfonate is contraindicated in neonates.</p>', '<p>Nausea, vomiting, gastric irritation, anorexia, constipation and occasionally diarrhea, fecal impaction, Gastrointestinal stenosis and intestinal obstruction, Gastrointestinal ischemia, ischemic colitis, rectal haemorrhage, gastrointestinal tract ulceration or necrosis, Hypomagnesemia, Hypercalcemia etc. Some cases of acute bronchitis and bronchopneumonia have been reported.</p>', '<p>Calcium Polystyrene Sulfonate is not absorbed from the gastrointestinal tract. No data are available about the use of this&nbsp;in human pregnancy and lactation.</p>', '<p>During treatment with Calcium Polystyrene Sulfonate the possibility of severe potassium depletion should be considered. To prevent serious hypokalemia, administration of the resin should be discontinued as soon as the serum potassium level falls to 5 mmol/L. Hypomagnesemia and hypercalcemia may occur.<br />\r\n<br />\r\nPatients should be monitored for all electrolyte disturbances. In the event of clinically significant constipation, treatment with the resin should be discontinued until normal bowel motions are resumed. Magnesium-containing laxatives should not be used. The patient should be positioned carefully when ingesting the resin to avoid aspiration which may lead to bronchopulmonary complications.</p>', '<p>Clinical signs and symptoms of hypokalemia including irritability, confusion, delayed thought processes, muscle weakness, hyporeflexia and eventually frank paralysis. Apnea may be a serious consequence of this progression. Electrocardiographic changes may be consistent with hypokalemia or hypercalcemia; cardiac arrhythmia may occur.</p>', '<p>Hyperkalaemia Products</p>', '<p>Store at below 30&deg;C in a dry place protected from light. Keep out of reach of children.</p>', NULL, '2022-02-18 18:49:24', '2022-03-23 17:47:13'),
(256, 256, '<p>Stiffness, Congestion, Muscle aches, Sprains, Strains, Back pain, Joint pain, Cold, Flu, Catarrh, Headache</p>', '<p>Camphor acts as a cough suppressant &amp; topical analgesic. Eucalyptus Oil acts as a cough suppressant. Menthol acts as a acts as cough suppressant &amp; topical analgesic</p>', '<p><strong>Topical</strong>: Rub gently 3-4 mintues on the chest and back 2-3 times daily. Cover the rubbed area with warm clothes.<br />\r\n<br />\r\n<strong>Inhalation</strong>: 1 tsf of ointment to be dissolved in boiled water and inhale the steam by mouth or nose as required.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Children under 3 years. History of convulsion.</p>', '<p>Redness, irritation, rash or pruritis may occur with sensitive skin.</p>', '<p>Pregnancy Category-Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Avoid contact with eyes. Should not be applied to wounds or damaged skin. Wash hand thoroughly after applying.</p>', NULL, '<p>Topical Analgesics, Topical anti-inflammatory preparations</p>', NULL, NULL, '2022-02-18 18:50:44', '2022-03-23 17:50:10'),
(257, 257, '<p>Canagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.</p>', '<p>Canagliflozin is an inhibitor of subtype-2 sodium-glucose co-transport protein (SGLT2), which is responsible for at least 90% of the glucose reabsorption in the kidney. Blocking this transporter reduces the reabsorption of glucose from renal tubules, leading to more excretion of glucose in urine.</p>', '<p>The recommended starting dose is 100 mg once daily, taken before the first meal of the day. Dose can be increased to 300 mg once daily who have CrCl&gt;60 ml/min or who requires additional glycemic control. No dose adjustment is required for mild renal impairment. For moderate renal impairment (CrCl 45-60 ml/min) Canagliflozin 100 mg is recommended.</p>', '<p><strong>UGT inducers (e.g. rifampin, phenytoin)</strong>: Canagliflozin exposure is reduced. Consider increasing dose from 100 mg to 300 mg.<br />\r\n<strong>Digoxin</strong>: Canagliflozin may slightly increase the concentration of digoxin in the body when both drugs are being taken.</p>', '<p>History of serious hypersensitivity reaction to Canagliflozin, severe renal impairment, End Stage Renal Disease (ESRD), or on dialysis patients.</p>', '<p>The most common adverse reactions of Canagliflozin are female genital mycotic infections, urinary tract infection and increased urination. Other side effects of Canagliflozin include low blood pressure, increases potassium blood levels (hyperkalemia), low blood glucose and increases Low-Density Lipoprotein (LDL-C).</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. For nursing mother discontinue drug or nursing.</p>', '<p>Not for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis.</p>', NULL, '<p>Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-18 18:51:04', '2022-03-23 17:56:13'),
(258, 258, '<p>Candesartan Cilexetil is indicated for hypertension, heart failure with impaired left ventricular systolic function.</p>', '<p>Candesartan Cilexetil is an ester prodrug that is hydrolysed in the body to the active form Candesartan during absorption from the gastro-intestinal tract. Candesartan is angiotensin II receptor (type AT1) antagonist. Candesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues (eg, vascular smooth muscle, adrenal gland).</p>', '<p><strong>Hypertention</strong>: initially 8 mg (hepatic impairment 2 mg, renal impairment or intravascular volume depletion 4 mg) once daily, increased if necessary at intervals of 4 weeks to max 32 mg once daily; usual maintenance dose 8 mg once daily.<br />\r\n<br />\r\n<strong>Heart failure</strong>: initially 4 mg once daily, increased at intervals of at least 2 weeks to target dose of 32 mg once daily or to max tolerated dose.</p>', '<p>No significant drug interactions have been reported in studies of Candesartan Cilexetil given with other drugs such as glyburide, nifedipine, digoxin, warfarin, hydrochlorothiazide and oral contraceptives in healthy volunteers. Because candesartan is not metabolised by the cytochrome P-450 system and has no effects on P-450 enzymes, interactions with drugs that inhibit, or are metabolised by, those enzymes could not be expected.</p>', '<p>Hypersensitivity to any component of this product. Pregnancy, breast-feeding, cholestasis.</p>', '<p>Side-effects are usually mild. Symptomatic hypotension including dizziness may occur, particularly in patients with intravascular volume depletion (e.g. those taking high dose diuretics). Hyperkalemia occurs occassionally; angioedema has also been reported with some angiotension II receptor antagonist. Also vertigo, headache; rarely hepatitis, blood disorders, hyponatraemia, back pain, arthralgia, myalgia, rash, urticaria, pruritous.</p>', '<p>When pregnancy is detected, Candesartan Cilexetil should be discontinued as soon as possible. It should be used in lactation.</p>', '<p>Candesartan should be used with caution in renal artery stenosis, aortic or mitral valve stenosis and in obstructive hypertropic cardiomyopathy. Monitoring of plasma-potassium concentration is advised, particularly in the elderly and in patients with renal impairment; lower initial doses may be appropriate in these patients.</p>', NULL, '<p>Angiotensin-ll receptor blocker</p>', '<p>Store in a cool &amp; dry place. Protect from light and moisture</p>', '<p>Use in pediatric: Safety and effectiveness in pediatric patients have not been established.</p>', '2022-02-18 18:51:27', '2022-03-23 17:59:02'),
(259, 259, '<p>This is indicated for the treatment of hypertension, congestive heart failure.</p>', '<p>Candesartan Cilexetil-Hydrochlorothiazide combines an angiotensin II receptor blocker, Candesartan Cilexetil and a diuretic, Hydrochlorothiazide.<br />\r\n<br />\r\n<strong>Candesartan Cilexetil</strong>&nbsp;is an ester prodrug that is hydrolysed in the body to the active form Candesartan during absorption from the gastrointestinal tract. Candesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues (eg, vascular smooth muscle, adrenal gland).<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>&nbsp;is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly by increasing sodium excreation. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume with consequent increase in plasma renin activity, aldosterone secretion, urinary potassium loss, and decrease in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so coadministration of Candesartan tends to reverse the potassium loss associated with Hydrochlorothiazide.</p>', '<p>The usual dose is one tablet once daily.</p>', '<p>No significant drug interactions have been reported for Candesartan Cilexetil with other drugs such as glyburide, nifedifine, digoxin, warfarin, hydrochlorothiazide and oral contraceptives. Alcohol, barbiturates, or narcotics- Potentiation of orthostatic hypotension may occur. Antidiabetic drugs (oral agents and insulin)- Dosage adjustment of the antidiabetic drug may be required. Other antihypertensive drugs- Additive effect or potentiation. Skeletal muscle relaxants, tubocurarine- Possible increased responsiveness to the muscle relaxant. NSAID can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.</p>', '<p>Candesartan Cilexetil &amp; Hydrochlorothiazide is contraindicated in patients who are hypersensitive to any component of this product. Because of the hydrochlorothiazide component, this product is contraindicated in patients with anuria or hypersensitivity to other sulfonamide-derived drugs.</p>', '<p>Mild and transient in nature. The overall incidence of adverse events is comparable to placebo. Side effects are headache, upper respiratory tract infection, back pain, influenza-like symptoms.</p>', '<p>Use in pregnancy &amp; lactation is not recommended.</p>', '<p>No patient receiving this combination was discontinued due to increases or decreases in serum potassium. Overall, the combination of candesartan cilexetil and hydrochlorothiazide had no clinically significant effect on serum potassium.</p>', NULL, '<p>Combined antihypertensive preparations</p>', NULL, '<p>Use in pediatric patient: Safety and effectiveness in pediatric patients have not been established.</p>', '2022-02-18 18:52:00', '2022-03-23 18:01:34'),
(260, 260, '<p>Capecitabine is a nucleoside metabolic inhibitor with antineoplastic activity indicated for:</p>\r\n\r\n<ul>\r\n	<li><strong>Adjuvant Colon Cancer</strong>: Patients with Dukes&#39;C colon cancer.</li>\r\n	<li><strong>Metastatic Colorectal Cancer</strong>: First-line as monotherapy when treatment with fluoropyrimidine therapy alone is preferred.</li>\r\n	<li><strong>Metastatic Breast Cancer</strong>: In combination with docetaxel after failure of prior anthracycline containing therapy.</li>\r\n	<li>As monotherapy in patients resistant to both paclitaxel and an anthracycline-containing regimen.</li>\r\n</ul>', '<p>Capecitabine is a preparation of Capecitabine, an orally-administered chemotherapeutic agent used in the treatment of cancers. Capecitabine is a prodrug, that is enzymatically converted to fluorouracil (antimetabolite) in the tumour, where it inhibits DNA synthesis and slows growth of tumour tissue.</p>\r\n\r\n<p>Capecitabine is a prodrug that is selectively tumour-activated to its cytotoxic moiety, fluorouracil, by thymidine phosphorylase, an enzyme found in higher concentrations in many tumours compared to normal tissues or plasma. Fluorouracil is further metabolized to two active metabolites, 5-fluoro-2&#39;-deoxyuridine 5-monophosphate (FdUMP) and 5-fluorouridine triphosphate (FUTP), within normal and tumour cells. These metabolites cause cell injury by two different mechanisms. First, FdUMP and the folate cofactor, N5-10 methylenetetrahydrofolate, bind to thymidylate synthase (TS) to form a covalently bound ternary complex. This binding inhibits the formation of thymidylate from 2-deoxyuridylate. Thymidylate is the necessary precursor of thymidine triphosphate, which is essential for the synthesis of DNA, therefore a deficiency of this compound can inhibit cell division. Secondly, nuclear transcriptional enzymes can mistakenly incorporate FUTP in place of uridine triphosphate (UTP) during the synthesis of RNA. This metabolic error can interfere with RNA processing and protein synthesis through the production of fraudulent RNA.</p>', '<p><strong>Monotherapy</strong>: 1250 mg/m2 twice daily orally for 2 weeks followed by a one-week rest period in 3-week cycles<br />\r\n<br />\r\n<strong>Adjuvant treatment</strong>: Is recommended for a total of 6 months (8 cycles)<br />\r\n<br />\r\n<strong>In combination with docetaxel</strong>: The recommended dose of Capecitabine is 1250 mg/m2 twice daily for 2 weeks followed by a 7-day rest period, combined with docetaxel at 75 mg/m2 as a 1-hour IV infusion every 3 weeks. Capecitabine dosage may need to be individualized to optimize patient management. Capecitabine dosage has to be reduced by 25% in patients with moderate renal impairment.<br />\r\n<br />\r\nExample: A person whose body weight is 64 kg and height is 1.64 m has a body surface area of 1.7 m2 and should take 4 tablets of 500 mg and 1 tablet of 150 mg two times daily.<br />\r\n<br />\r\nThe tablets should be taken in morning and evening as prescribed by doctor. The tablets should be taken within 30 minutes after the end of a meal (breakfast and dinner) and swallowed whole with water. Tablets should not be cut or crushed. Capecitabine should only be prescribed by a doctor experienced in the use of anticancer medicines.</p>', '<ul>\r\n	<li><strong>Anticoagulants</strong>: Anticoagulant response (INR or prothrombin time) should be monitored frequently in order to adjust the anticoagulant dose as needed.</li>\r\n	<li><strong>Phenytoin</strong>: Phenytoin levels should be monitored in patients taking Capecitabine concomitantly with phenytoin. The phenytoin dose may need to be reduced.</li>\r\n	<li><strong>Leucovorin</strong>: The concentration of 5-fluorouracil is increased and its toxicity may be enhanced by leucovorin.</li>\r\n	<li><strong>CYP2C9 substrates</strong>: Care should be exercised when Capecitabine is co-administered with CYP2C9 substrates.</li>\r\n	<li><strong>Food</strong>: Reduced both the rate and extent of absorption of Capecitabine.</li>\r\n</ul>', '<ul>\r\n	<li>Severe Renal Impairment</li>\r\n	<li>Hypersensitivity</li>\r\n	<li>leucopenia, neutropenia or thrombocytopenia</li>\r\n	<li>Severe reactions to fluoropyrimidine therapy</li>\r\n	<li>Complete DPD deficiency</li>\r\n	<li>Pregnant or breast-feeding</li>\r\n</ul>', '<p>Abdominal pain, Rash, dry or itchy skin, Tiredness, loss of appetite (anorexia), Diarrhea, Vomiting, Nausea, Stomatitis, Hand-and-foot skin-reaction, Fever, Infection, Chest pain, Steven-Johnson syndrome</p>', '<p>Pregnancy category D. Capecitabine can cause fetal harm. Women are advised of the potential risk to the fetus. It is not known whether Capecitabine is excreted in human breast milk.No studies have been conducted to assess the impact of Capecitabine on milk production or its presence in human breast milk. As the potential for harm to the nursing infant is unknown, breast-feeding should be discontinued while receiving treatment with Capecitabine and for 2 weeks after the final dose.</p>', '<p><strong>Coagulopathy</strong>: Anticoagulant response should be monitored (e.g. INR) and anticoagulant dose must be adjusted accordingly. Otherwise may result in bleeding, death.<br />\r\n<br />\r\n<strong>Diarrhea</strong>: Capecitabine treatment should be stopped immediately until diarrhea resolves or decreases to grade 1. Standard antidiarrheal treatments recommended. Otherwise may get severe.<br />\r\n<br />\r\n<strong>Cardiotoxicity</strong>: Common in patients with a prior history of coronary artery disease.<br />\r\n<br />\r\n<strong>Increased Risk of Severe or Fatal Adverse Reactions in Patients with Low or Absent Dihydropyrimidine Dehydrogenase (DPD) Activity</strong>: Capecitabine should be withhold or permanently discontinued in patients with evidence of acute early-onset or unusually severe toxicity, which may indicate near complete or total absence of DPD activity.<br />\r\n<br />\r\n<strong>Dehydration and Renal Failure</strong>: Capecitabine treatment should be stopped until dehydration is corrected. Potential risk of acute renal failure secondary to dehydration.<br />\r\n<br />\r\n<strong>Mucocutaneous and Dermatologic Toxicity</strong>: Severe mucocutaneous reactions, Steven-Johnson Syndrome. (SJS) and Toxic Epidermal Necrolysis (TEN), have been reported. Capecitabine should be permanently discontinued in patients who experience a severe mucocutaneous reaction during treatment. Capecitabine may induce hand-and-foot syndrome. Capecitabine treatment should be interrupted until the hand-and-foot syndrome event resolves or decreases in intensity.<br />\r\n<br />\r\n<strong>Hyperbilirubinemia</strong>: Capecitabine treatment should be interrupted immediately until the hyperbilirubinemia resolves or decreases in intensity.<br />\r\n<br />\r\n<strong>Hematologic</strong>: Patients should not be treated with neutrophil counts &lt;1.5x109/L or thrombocyte counts &lt;100x109/L.</p>', '<p>The manifestations of acute overdose include nausea, vomiting, diarrhea, mucositis, gastrointestinal irritation and bleeding, and bone marrow depression. Medical management of overdose should include customary therapeutic and supportive medical interventions aimed at correcting the presenting clinical manifestations and preventing their possible complications.</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>Keep in a dry place and store below 30&deg;C. Protect from light and keep out of the reach of children.</p>', NULL, '2022-02-18 18:52:24', '2022-03-23 18:05:04'),
(261, 261, '<p>Repairs, restores &amp; protects dry skin &amp; sensitive skin conditionsRepairs, restores &amp; protects dry skin &amp; sensitive skin conditions</p>', '<p>With physiological lipids to protect &amp; maintain healthy skin.The Derma Membrane Structure (DMS) base, used uniquely in Physiogel products, is made up of natural lipids similar to the skin&#39;s (epidermis) physiologic lipids which are natural and essential components of normal healthy skin, hence, revitalizes very dry, irritated and sensitive skin or helps retain skin moisture and prevents skin dryness, thus, regenerates the skin lipid barrier, reduces water loss and provides protection against environmental triggers.</p>', '<p><strong>Cream:</strong>&nbsp;Apply a thin film once or bd on hands, face &amp; particularly dry areas.<br />\r\n<strong>Lotion</strong>: Apply once or bd. Ideal for the entire body.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity.</p>', '<p>Some possible side effects and reactions include rash, redness and itchiness.</p>', '<p>Pregnancy Category - Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Discontinue use and consult a dermatologist if undue irritation develops or increases. Avoid contact with eyes or mucous membranes. In case of contact, rinse thoroughly with water.</p>', NULL, '<p>Emollients &amp; combined preparations</p>', NULL, NULL, '2022-02-18 18:54:15', '2022-03-23 18:07:27'),
(262, 262, '<p>Capsaicin is indicatd for- Rheumatoid arthritis, Osteoarthritis, Pain due to diabetic neuropathy, Joint pain, Post-herpetic neuralgia, Post-surgical neuropathic pain, Nerve Pain, Back pain, Muscle pain, Fibromyalgia, Bursitis, Pruritis (itching)</p>', '<p>Although the precise mechanism of action of Capsaicin is not fully understood, current evidence suggests that Capsaicin exerts an analgesic effect by depleting and preventing reaccumulation of Substance P in peripheral sensory neurons. Substance P is thought to be the principal chemomediator of pain impulses from the periphery to the central nervous system.</p>', '<p><strong>18 years of age and older</strong>:&nbsp;Apply a thin film of Capsaicin cream to affected area 3 to 4 times daily. A burning sensation may occur upon application, but generally disappears with regular use. Application schedules of 3 to 4 times a day for 2 weeks provides optimum pain relief.</p>', NULL, '<p>Capsaicin cream is contraindicated on broken or irritated skin. It is also contraindicated in patients with known hypersensitivity to capsaicin or any of the excipients used in this product.</p>', '<p>Capsaicin may cause transient burning on application. This burning is observed more frequently when the application schedules are more than 3-4 times daily. The burning can be enhanced if too much cream is used and if it is applied just before or after a bath or shower.</p>', '<p>The safety of Capsaicin during pregnancy or lactation has not been established in either humans or animals.</p>', '<p>Capsaicin cream should not be applied to broken or irritated skin. Applied area should not be tightly bandaged. Do not get on mucous membranes and into eyes or on contact lenses. If this occurs, rinse the affected area thoroughly with water. Do not apply the cream on the heat treated area as this may increase the burning sensation. In case of accidental ingestion, seek physician advice immediately.</p>', '<p>Sufficient information on overdose of Capsaicin is not available.</p>', '<p>Topical Analgesics, Topical anti-inflammatory preparations</p>', '<p>Keep at cool and dry place, away form light. Keep out of the reach of children.</p>', NULL, '2022-02-18 18:54:34', '2022-03-23 18:09:40'),
(263, 263, '<p><strong>Hypertension</strong>: Mild to moderate hypertension as an adjunct to thiazide therapy in patients who have not responded effectively to thiazide treatment alone.<br />\r\n<br />\r\n<strong>Severe hypertension</strong>: Where standard therapy has failed. Cardopril is effective alone or in combination with other antihypertensive agents especially thiazide type of diuretics. The blood pressure lowering effect of Cardopril and thiazides are approximately additive.<br />\r\n<br />\r\n<strong>Congestive heart failure</strong>: It is also used as an adjunct to the treatment of severe congestive heart failure.</p>', '<p>Captopril competitively inhibits the conversion of angiotensin I (ATI) to angiotensin II (ATII), thus resulting in reduced ATII levels and aldosterone secretion. It also increases plasma renin activity and bradykinin levels. Reduction of ATII leads to decreased Na and water retention. This promotes vasodilation and BP reduction.</p>', '<p><strong>Diabetic nephropathy</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Type 1 diabetics: 75-100 mg/day in divided doses.</li>\r\n</ul>\r\n\r\n<p><strong>Post-myocardial infarction</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: May be started 3-16 days after MI. Initially, 6.25 mg/day followed by 12.5 mg tid for 2 days, then 25 mg tid. Maintenance: 75-150 mg/day in 2 or 3 divided doses.</li>\r\n</ul>\r\n\r\n<p><strong>Hypertension</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially, 12.5 mg bid, 1st dose preferably at bedtime to avoid precipitous fall in BP, gradually increased at 2-4-wk intervals according to response. Maintenance: 25-50 mg bid. Max: 50 mg tid. Patients on diuretics: 6.25 mg bid.</li>\r\n	<li><strong>Child</strong>: Neonates and infants: 0.15 mg/kg. Max: 6 mg/kg in 2 or 3 divided doses according to response. Childn and adolescents: 0.3 mg/kg. Max: 6 mg/kg in 2 or 3 divided doses according to response.</li>\r\n	<li><strong>Elderly</strong>: Initially, 6.25 mg bid.</li>\r\n</ul>\r\n\r\n<p><strong>Heart failure</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially, 6.25-12.5 mg bid or tid. Maintenance: 25 mg bid or tid. Max: 50 mg tid.</li>\r\n	<li><strong>Child</strong>: Initially, 0.25 mg/kg/day, increased up to 2.5 or 3.5 mg/kg/day in 3 divided doses.</li>\r\n</ul>', '<p>Concurrent treatment with NSAIDs reduces hypotensive action and increases the risk of nephrotoxicity. Additive hyperkalaemic effect with K supplements, K-sparing diuretics, and other drugs (e.g. heparin). May increase risk of leucopenia with procainamide, allopurinol, cytostatic or immunosuppressants. May increase risk of lithium toxicity. Increased risk of nitritoid reactions with gold (Na aurothiomalate).</p>', '<p>Angioedema related to previous ACE inhibitor treatment, hereditary or idiopathic angioneurotic oedema. Concomitant use with aliskiren in diabetic patients. Pregnancy.</p>', '<p>Neutropenia, anaemia and thrombocytopenia; proteinuria, elevated blood urea and creatinine, elevated serum potassium and acidosis;&nbsp;hypotension, tachycardia;&nbsp;rashes usually pruritic, may occur;&nbsp;Reversible and usually self limiting taste impairment has been reported. Stomatitis resembling aphthous ulcers has also been reported.</p>', '<p>Pregnancy&nbsp;Category D.&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk</p>', '<p>Patients with bilateral renal artery stenosis, collagen vascular disease, aortic or mitral valve stenosis, volume and/or Na depletion. Renal impairment. Lactation.</p>', '<p><strong>Symptoms</strong>: Severe hypotension, shock, stupor, bradycardia, electrolyte disturbances and renal failure.<br />\r\n<br />\r\n<strong>Management</strong>: Perform gastric lavage, administer adsorbent and sodium sulfate with in 30 min of ingestion; NaCl 0.9% IV infusion. Treatment with angiotensin-II may also be considered. Administer atropine in case of extensive vagal reactions or bradycardia. Pacemaker is also an option. Elimination may be enhanced by haemodialysis.</p>', '<p>Angiotensin-converting enzyme (ACE) inhibitors</p>', '<p>Store below 30&deg; C</p>', NULL, '2022-02-18 19:01:15', '2022-03-23 18:12:28');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(264, 264, '<p>Carbamazepine is indicated for-</p>\r\n\r\n<ul>\r\n	<li>partial and secondary generalized tonic-clonic seizures</li>\r\n	<li>Primary generalized tonic-clonic seizures</li>\r\n	<li>Trigeminal neuralgia</li>\r\n	<li>Prophylaxis of bipolar disorder</li>\r\n</ul>', '<p>Carbamazepine depresses activity in the nucleus ventralis of the thalamus, reduces synaptic propagation of excitatory impulses or decreases summation of temporal stimulation leading to neural discharge by limiting influx of Na ions across cell membrane or other unknown mechanisms. It stimulates the release of antidiuretic hormone (ADH) and potentiates its action in promoting reabsorption of water.</p>', '<p>Epilepsy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 12 years of age</strong>- Initial: Either 200 mg b.i.d. for tablets and controlled release tablets, or 1 teaspoon q.i.d. for suspension (400 mg/day). Increase at weekly intervals by adding up to 200 mg/day using a b.i.d or a t.i.d. or q.i.d. regimen of the either formulations until the optimal response is obtained.</li>\r\n	<li><strong>Children 12-15 years of age</strong>- Dosage generally should not exceed 1000 mg daily, and 1200 mg daily in patients above 15 years of age. Doses up to 1600 mg daily have been used in adults in rare instances. Maintenance: usually 800-1200 mg daily.</li>\r\n	<li><strong>Children 6-12 years of age</strong>- Initial: Either 100 mg b.i.d. for tablets or controlled release tablets, or 1/2 teaspoon q.i.d. for suspension (200 mg/day). Increase at weekly intervals by adding up to 100 mg/day using a b.i.d. or a t.i.d.or q.i.d. regimen of the either formulations until the optimal response is obtained. Dosage generally should not exceed 1000 mg daily. Maintenance:usually 400-800 mg daily.</li>\r\n	<li><strong>Children under 6 years of age</strong>- Initial: 10-20 mg/kg/day b.i.d.or t.i.d. as tablets, or q.i.d. as suspension. Increase weekly to achieve optimal clinical response administered t.i.d. or q.i.d. Maintenance: Ordinarily, optimal clinical response is achieved at daily doses below 35 mg/kg. If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the therapeutic range. No recommendation regarding the safety of Carbamazepine for use at doses above 35 mg/kg/24 hours can be made.</li>\r\n</ul>\r\n\r\n<p><strong>Combination therapy</strong>: Carbamazepine may be used alone or with other anticonvulsants. When added to existing anticonvulsant therapy, the drug should be added gradually while the other anticonvulsants are maintained or gradually decreased, except phenytoin, which may have to be increased.<br />\r\n<br />\r\n<strong>Trigeminal Neuralgia</strong>: Initial: On the first day,either 100 mg b.i.d. for tablets or controlled release tablets, or 1/2 teaspoon q.i.d. for suspension, for a total daily dose of 200 mg. This daily dose may be increased by up to 200 mg/day using increments of 100 mg every 12 hours for tablets or controlled release tablets, or 50 mg (1/2 teaspoon) q.i.d. for suspension, only as needed to achieve freedom from pain. A total dose of 1200 mg daily shouldn&#39;t be exceeded. Maintenance: Control of pain can be maintained in most patients with 400-800 mg daily. However, some patients may be maintained on as little as 200 mg daily, while others may require as much as 1200 mg daily. At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum effective level or even to discontinue the drug. The tablets or syrup can be taken without regards to meal.</p>', '<p>Galactorrhoea has been reported in few women on oral contraceptives within the first two months of Carbamazepine treatment Hepatic enzyme inducers such as Carbamazepine and Phenytoin may interact with Carbamazepine by increasing its metabolism. So an increase in dosage of Carbamazepine may be required.</p>', '<p>This medicine should not be used if anybody is allergic to one or any of its ingredients. It can not be used also in the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Problems with the electrical message pathways in the heart (atrioventricular block)</li>\r\n	<li>History of decreased blood cell production by the bone marrow (bone marrow depression)</li>\r\n	<li>Hereditary blood disorders called porphyrias</li>\r\n	<li>Allergy to tricyclic antidepressants</li>\r\n	<li>People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days</li>\r\n</ul>', '<p>The common side effects are dizziness, drowsiness, ataxia, dry mouth, abdominal pain, nausea, vomiting, anorexia, leucopenia, proteinuria, bradycardia, heart failure and hypotension. Erythematous skin rash, aplastic anemia may also be observed.<br />\r\n<br />\r\nThe most severe adverse reactions have been observed in the hemopoietic system, the skin and the cardiovascular system.The most frequently observed adverse reactions, particularly during the initial phases of therapy, are dizziness, drowsiness, unsteadiness, nausea, and vomiting. This medicine may cause increased sensitivity to the sun. Exposure to the sun, sunlamps, or tanning booths should be avoided if the increased sensitivity is seen. A sunscreen or protective clothing may be helpful at outside for a prolonged period.</p>', '<p>Pregnancy category D. Carbamazepine and its epoxide metabolite are transferred to breast milk. Because of the potential serious side effects, decision should me made whether to discontinue nursing or discontinue the drug.</p>', '<p>This medicine may cause dizziness and drowsiness.Special care should be taken while performing potentially hazardous activities, such as driving or operating machinery.<br />\r\n<br />\r\nThis medicine may cause skin reactions. If any rash,skin peeling, itching, or other unexplained skin reaction is seen while taking this medicine the concerned doctor should be informed immediately.<br />\r\n<br />\r\nThis medicine may rarely cause liver problems.For this reason, consultation with doctor is needed if unexplained itching, yellowing of the skin or eyes, unusually dark urine, nausea and vomiting, abdominal pains, and loss of appetite or flu-like symptoms.<br />\r\n<br />\r\nCarbamazepine decreases the blood levels of hormonal contraceptives containing estrogen and/or progesterone, which may make the contraceptive ineffective or result in breakthrough bleeding.<br />\r\n<br />\r\nWomen taking this medicine who require contraception should be prescribed a contraceptive containing at least 50 micrograms of oestrogen,or use non-hormonal methods of contraception, such as condoms.<br />\r\n<br />\r\nTaking this medicine should not be stopped suddenly unless the doctor tells. Otherwise, as suddenly stopping treatment is likely to make the symptoms return.If this medicine is stopped, it should normally be done gradually, under the supervision of a specialist.<br />\r\n<br />\r\nCaution should be taken in-</p>\r\n\r\n<ul>\r\n	<li>Mixed seizures including absence seizures</li>\r\n	<li>Elderly people</li>\r\n	<li>History of heart disease</li>\r\n	<li>History of kidney disease</li>\r\n	<li>History of liver disease</li>\r\n	<li>History of psychotic illness</li>\r\n	<li>Raised pressure in the eye (intraocular pressure), eg.glaucoma</li>\r\n	<li>History of blood disorders that were caused by any other medication</li>\r\n	<li>History of previous Carbamazepine therapy that was interrupted due to side effects or allergy</li>\r\n</ul>', NULL, '<p>Primary anti-epileptic drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 19:01:30', '2022-03-23 18:51:01'),
(265, 265, '<p>Carbetocin is indicated for the prevention of uterine atony and postpartum haemorrhage (excessive bleeding) following delivery of the infant by elective caesarean section under epidural or spinal anaesthesia.</p>', '<p>Carbetocin is a drug used to control postpartum hemorrhage, bleeding after giving birth. It is an analogue of oxytocin, and its action is similar to that of oxytocin; it causes contraction of the uterus. Carbetocin binds to oxytocin receptors present on the smooth musculature of the uterus, resulting in rhythmic contractions of the uterus, increased frequency of existing contractions, and increased uterine tone. The oxytocin receptor content of the uterus is very low in the non-pregnant state, and increases during pregnancy, reaching a peak at the time of delivery.</p>', '<p>A single intravenous dose of 100 mcg of carbetocin injection is administered by bolus injection, slowly over 1 minute, only when infant delivery has been completed by caesarean section under epidural or spinal anaesthesia. carbetocin is to be used as a single dose only.</p>', '<p>No specific drug interactions have been reported with carbetocin.</p>', '<p>Because of its long duration of action relative to oxytocin, uterine contractions produced by carbetocin cannot be stopped by simply discontinuing the medication. Therefore, carbetocin should not be administered prior to delivery of the infant for any reason, including elective or medical induction of labour. Inappropriate use of carbetocin during pregnancy could theoretically mimic the symptoms of oxytocin overdosage, including hyperstimulation of the uterus with strong (hypertonic) or prolonged (tetanic) contractions, tumultuous labour, uterine rupture, cervical and vaginal lacerations, postpartum haemorrhage, utero-placental hypoperfusion and variable deceleration of foetal heart, foetal hypoxia, hypercapnia, or death. Carbetocin should not be used in patients with a history of hypersensitivity to oxytocin or carbetocin. Carbetocin should not be used in patients with cardio vascular disease, especially coronary artery disease, valvular heart disease, cardiomyopathy and heart failure. Carbetocin is not intended for use in children.&nbsp;</p>', '<p>10-40% of patients experienced nausea, vomiting, abdominal pain, itching skin, increased body temperature, trembling and weakness. Infrequent adverse events (1-5% of patients) included back pain, dizziness, metallic taste, anaemia, sweating, chest pain, dyspnoea, chills, tachycardia and anxiety.</p>', '<p>Use of carbetocin injection is contraindicated during pregnancy. Small amounts of carbetocin has been shown to cross over from plasma into the breast milk of nursing women. The small amount of carbetocin ingested by infant would not be expected to present a significant safety concern.</p>', '<ul>\r\n	<li>In patients who may not have an adequate uterine contraction after a single injection of carbetocin, more aggressive treatment with additional doses of oxytocin or ergometrine is warranted.</li>\r\n	<li>As carbetocin is closely related in structure to oxytocin, hyponatraemia may occur.</li>\r\n	<li>Carbetocin should be used cautiously in the presence of epilepsy, migraine, asthma or any state in which a rapid addition to extracellular water may produce hazard for an already overburdened system.</li>\r\n	<li>Patients with eclampsia and pre-eclampsia should be monitored for changes in blood pressure.</li>\r\n	<li>Carbetocin is not recommended for use in elderly patients.</li>\r\n</ul>', '<p>Overdosage of carbetocin can be expected to produce enhanced pharmacological effects associated with uterine hyperactivity and pain. Treatment consists of symptomatic and supportive management.</p>', '<p>Drugs acting on the Uterus</p>', '<p>Store at 2-8&deg;C. Do not freeze. Keep away from light. Once the ampoule has been opened, the product should be used immediately.</p>', NULL, '2022-02-18 19:01:48', '2022-03-23 18:53:21'),
(266, 266, '<p>Carbimazole is indicated in the management of hyperthyroidism, thyrotoxicosis (including thyroid storm), and also for the preparation of patients for thyroidectomy. Carbimazole can also be used in combination with radio-active ablative therapy</p>', '<p>Carbimazole is metabolised to thiamazole which is responsible for its antithyroid action. It blocks the production of thyroid hormones through inhibition of the organification of iodide and the coupling of iodothyronine residues.</p>', '<p>10 mg to 60 mg daily according to the severity of the disorder. The dose should be gradually reduced to the smallest amount which will control the disease. Daily dosage should be divided.</p>', '<p>Carbimazole may interact adversely with other medicines. Iodine or iodine excess may decrease the response to Carbimazole, requiring an increase in dosage or longer duration of therapy with antithyroid agents. As thyroid and metabolic status of patient decreases toward normal, response to oral anticoagulants may decrease, however, if thioamide-induced hypoprothrombinemia occurs, anticoagulant effects may be enhanced. Adjustment of oral anticoagulant dosage on the basis of prothrombin time is recommended. Serum concentrations of digoxin and digitoxin have been reported to increase as the thyroid and metabolic status of patients taking antithyroid agents decreased, reduction in dosage of any digitalis glycoside may be necessary as patients become euthyroid.</p>', '<p>Hypersensitivity to carbimazole or other thiourea antithyroid agents</p>', '<p>Nausea, headache, arthralgia, fever, jaundice, malaise, mild gastric distress, skin rashes, pruritus, taste disturbance; bone marrow depression including neutropenia, eosinophilia, leucopenia. Rarely, pancytopenia/aplastic anaemia and isolated thrombocytopenia, haemolytic anaemia.</p>', '<p>Pregnancy&nbsp;Category D.&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk</p>', '<p>Caution should be taken in patients with intrathoracic goitre. Mild to moderate hepatic impairment. Caution also should be taken in children, pregnancy and lactation.</p>', '<p>Overdose or accidental poisoning may result in hypothyroidism and goitre. If blood dyscrasias occur, the drug should be immediately withdrawn. Further treatment is symptomatic and supportive.</p>', '<p>Anti-thyroid drugs</p>', '<p>Store below 25&deg; C.</p>', NULL, '2022-02-18 19:02:15', '2022-03-23 18:59:36'),
(267, 267, '<p>Carbocisteine is indicated for- Acute bronchitis, Chronic bronchitis, Bronchial asthma, Upper respiratory tract inflammation (pharyngitis, laryngitis), Cystic fibrosis Bronchiectasis, Pulmonary tuberculosis, Drainage in chronic sinusitis and pneumonia, Drainage in otitis media in children.</p>', '<p>Carbocisteine reduces goblet cell hyperplasia and therefore plays a role in the management of disorders characterised by abnormal mucous. Carbocisteine loosens thick sputum effectively by reducing its viscosity and thereby helps to expectorate that mucus more easily from the respiratory tract. The mucolytic action happens in several mechanisms. It breaks the disulphide bonds, which cross-link certain glycoprotein molecules in the mucus, the mucus produced under the influence of Carbocisteine has high sialomucin and low fucomucin content. This combined effect ultimately reduces the viscosity of the sputum and increases its volume.</p>', '<p><strong>Adult</strong>: Initially, 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves.<br />\r\n<strong>Child</strong>: 2-5 year: 62.5-125 mg 4 times daily; 6-12 year 250 mg tid.<br />\r\n&nbsp;</p>', '<p>Neither hazardous nor therapeutically useful interactions have been reported.</p>', '<p>Contraindicated in active peptic ulceration and in patients with hypersensitivity to the drug.</p>', '<p>Gastrointestinal discomfort, nausea, diarrhoea, gastrointestinal bleeding, palpitation, dizziness, headache, heartburn and skin rash may occur.</p>', '<p>There is no information on the use of Carbocisteine during lactation. While there are no reports of teratogenic effects, the manufacturers do not recommend the use of Carbocisteine in the first trimester.</p>', '<p>No specific precaution is recommended but Carbocisteine should be used with caution in patients with a recent history of peptic ulcer and recurrent gastrointestinal bleeding.</p>', '<p>Symptoms: GI disturbance.<br />\r\nManagement: May perform gastric lavage, followed by observation.</p>', '<p>Cough expectorants &amp; mucolytics</p>', '<p>Cough expectorants &amp; mucolytics</p>', NULL, '2022-02-18 19:02:41', '2022-03-23 19:01:37'),
(268, 268, '<p>This capsule is used for the treatment, control, prevention, &amp; improvement of the following diseases, conditions and symptoms:</p>\r\n\r\n<ul>\r\n	<li>Iron deficiency</li>\r\n	<li>Treatment of megaloblastic anemias due to a deficiency of folic acid</li>\r\n	<li>Treatment of anemias of nutritional origin, pregnancy, infancy, or childhood</li>\r\n	<li>This may also be used for purposes not listed here.</li>\r\n</ul>', '<p>This capsule is used for Iron deficiency, Treatment of megaloblastic anemias due to a deficiency of folic acid, Treatment of anemias of nutritional origin, Pregnancy, Infancy, Or childhood and other conditions. This capsule may also be used for purposes not listed in this medication guide.<br />\r\n&nbsp;<br />\r\nThis capsule contains Carbonyl Iron and Folic Acid as active ingredients. It works by producing red blood cells as well as transporting oxygen in the body; acting on megaloblastic bone marrow to produce a normoblastic marrow.</p>', '<p>One capsule daily. In more severe cases, 2 capsules a day may be required or as directed by the physician.</p>', '<p>If you use other drugs or over the counter products at the same time, the effects of this capsule may change. This may increase your risk for side-effects or cause your drug not to work properly. Tell your doctor about all the drugs, vitamins, and herbal supplements you are using, so that you doctor can help you prevent or manage drug interactions. It may interact with the following drugs and products:</p>\r\n\r\n<ul>\r\n	<li>Alcohol</li>\r\n	<li>Antibiotics</li>\r\n	<li>Barbiturates</li>\r\n	<li>Bisphosphonates</li>\r\n	<li>Diphenylhydantoin</li>\r\n	<li>Levodopa</li>\r\n	<li>Levothyroxine</li>\r\n	<li>Methotrexate</li>\r\n	<li>Methyldopa</li>\r\n	<li>Nitrofurantoin</li>\r\n</ul>', '<p>Hypersensitivity to this capsule is a contraindication. In addition, this capsule should not be used if you have the following conditions: Hypersensitivity, Intolerance to the drug.</p>', '<p>The following is a list of possible side-effects that may occur from all constituting ingredients of this capsule. This is not a comprehensive list. These side-effects are possible, but do not always occur. Some of the side-effects may be rare but serious. Consult your doctor if you observe any of the following side-effects, especially if they do not go away.</p>\r\n\r\n<ul>\r\n	<li>Constipation</li>\r\n	<li>Diarrhea</li>\r\n	<li>Stomach cramps</li>\r\n	<li>Upset stomach</li>\r\n	<li>Allergic reactions</li>\r\n	<li>Anorexia</li>\r\n	<li>Nausea</li>\r\n	<li>Abdominal distention</li>\r\n	<li>Flatulence</li>\r\n	<li>Bitter or bad taste</li>\r\n	<li>Altered sleep patterns</li>\r\n	<li>Difficulty in concentrating</li>\r\n	<li>Irritability</li>\r\n</ul>', NULL, '<p>Before using this capsule, inform your doctor about your current list of medications, over the counter products (e.g. vitamins, herbal supplements, etc.), allergies, pre-existing diseases, and current health conditions (e.g. pregnancy, upcoming surgery, etc.). Some health conditions may make you more susceptible to the side-effects of the drug. Take as directed by your doctor or follow the direction printed on the product insert. Dosage is based on your condition. Tell your doctor if your condition persists or worsens. Important counseling points are listed below.</p>\r\n\r\n<ul>\r\n	<li>Administration of folic acid alone is improper therapy for pernicious anemia and other megaloblastic anemias in which vitamin B12 is deficient</li>\r\n	<li>Avoid alcohol consumption, especially if having alcoholic cirrhosis</li>\r\n	<li>Avoid taking antacids within 2 hours while taking this medicine</li>\r\n	<li>Do not take this medicine if you have too much iron builds</li>\r\n	<li>Folic acid in doses above 0.1 mg daily may obscure the diagnosis of pernicious anemia</li>\r\n	<li>Pregnant, planning to become pregnant or breastfeeding</li>\r\n	<li>Risk of obscuring the diagnosis of pernicious anemia</li>\r\n	<li>Take this medicine without meal</li>\r\n	<li>Vitamin B12 is use to treat pernicious anemia</li>\r\n</ul>', NULL, '<p>Iron &amp; Vitamin Combined preparations</p>', '<p>Store medicines at room temperature, away from heat and direct light. Do not freeze medicines unless required by package insert. Keep medicines away from children.</p>', NULL, '2022-02-18 19:03:07', '2022-03-23 19:28:29'),
(269, 269, '<p>It is indicated for the treatment and prophylaxis of Iron, Folic Acid and Zinc deficiency especially during pregnancy and lactation.</p>', '<p>This timed-release capsule is the combined preparation of Carbonyl Iron, Folic Acid and Zinc Sulphate Monohydrate. It contains Carbonyl Iron with not less than 98% Iron content. Carbinyl Iron, having high bioavailability and low toxicity is safer and more effective choice for iron supplementation.</p>', '<p><strong>Adult</strong>: One Capsule daily before food or as directed by the physician.</p>', '<p>Carbonyl Iron decreases the absorption of tetracycline antibiotics, quinolone antibiotics, levodopa, levothyroxine, methyldopa and penecillamine. Folic Acid interacts with antiepileptics, so plasma concentrations of phenobarbital, phenytoin and primidone are possibly reduced.</p>', '<p>It is contraindicated in patients with known hypersensitivity to any of its component or those with Iron overload.</p>', '<p>Gastrointestinal irritations such as nausea, anorexia, vomiting, discomfort, constipation and diarrhoea may occur. Patients may complain of dark stool. Carbonyl Iron pellets incorporated into the capsules to reduce the possibility of gastrointestinal irritations. Rarely there may be allergic reactions.</p>', '<p>Use of any drug during first trimester of pregnancy should be avoided if possible. Thus administration of Iron during the first trimester requires definite evidence of Iron deficiency. Prophylaxis of Iron deficiency where inadequate diet calls for supplementary Zinc and Folic acid is justified during the remainder of pregnancy.</p>', '<p>Special care should be taken in patients with Iron overload states, such as haemochromatosis, haemolytic anaemia or red blood cell aplasia. Failure to response to the treatment requires further investigations to exclude other causes of anaemia. In patients with renal failure there may be the risk of Zinc accumulation.</p>', '<p>Symptoms of Carbonyl Iron include decreased energy, nausea, abdominal pain, tarry stool, weak, rapid pulse, fever, coma, seizures.</p>', '<p>Iron, Vitamin &amp; Mineral Combined preparation</p>', '<p>Store below 30&deg;C. and keep away from light and moisture. Keep all medicines out of the reach of children.</p>', NULL, '2022-02-18 19:05:42', '2022-03-23 19:31:16'),
(270, 270, '<p>This capsule is indicated for the treatment and prophylaxis of iron, folic acid, zinc, vitamin-B complex and vitamin-C deficiency, especially during pregnancy and lactation.</p>', '<ul>\r\n	<li>Carbonyl Iron is more effective and safer choice of Iron supplementation as it has higher bioavailability, low toxicity and better Gl tolerance.</li>\r\n	<li>Folic acid is required to maintain normal healthy development of the neural tube and is vital for cell division from a single cell to a fully developed baby.</li>\r\n	<li>Vitamin B Complex is required for the growth and development of unborn babies.</li>\r\n	<li>Vitamin C plays a role In the structure of collagen in the fetal membrane.</li>\r\n	<li>Zinc is a critical nutrient for fetal growth &amp; development, central nervous system development &amp; function and ensures better maternal &amp; infant health</li>\r\n</ul>', '<p><strong>Adult</strong>: One capsule daily before food or as directed by the physician.<br />\r\n<br />\r\n<strong>Use in Children &amp; Adolescents</strong>: Upon consultation with a doctor, recommended to use in children &amp; adolescents.</p>', '<p>Carbonyl Iron decreases the absorption of tetracycline antibiotics, quinolone antibiotics, levodopa, levothyroxine, methyldopa and penicillamine. Folic Acid interacts with antiepileptics, so plasma concentrations of phenobarbital, phenytoin and primidone are possibly reduced.</p>', '<p>It is contraindicated in patients with a known hypersensitivity to any of the ingredients. Iron therapy is contraindicated in the presence of haemolytic anaemia.</p>', '<p>Allergic sensitization has been reported following oral administration of Folic acid. Oral iron preparation may cause constipation, particularly in older patients.</p>', '<p>Use of any drug during first trimester of pregnancy should be avoided if possible. Thus administration of Iron during the first trimester requires definite evidence of Iron deficiency. Prophylaxis of Iron deficiency where inadequate diet calls for supplementary Zinc and Folic acid is justified during the remainder of the pregnancy.</p>', '<p>Care should be taken in patients who may develop iron overload, such as those with hemochromatosis, hemolytic anemia or red cell aplasia. Iron chelates with tetracycline and absorption may be impaired.</p>', '<p>Symptoms of Carbonyl Iron include decreased energy, nausea, abdominal pain, tarry stool, weak, rapid pulse, fever, coma, seizures.</p>', '<p>Iron, Vitamin &amp; Mineral Combined preparation</p>', '<p>Store at temperature not exceeding 30&deg;C in a dry place. Protect from moisture.</p>', NULL, '2022-02-18 19:11:38', '2022-03-23 19:34:10'),
(271, 271, '<p><strong>Initial Treatment of Advanced Ovarian Carcinoma</strong>: Carboplatin is indicated for the initial treatment of advanced ovarian carcinoma in established combination with other approved chemotherapeutic agents. One established combination regimenconsists of Carboplatin and cyclophosphamide. Two randomizedcontrolled studies conducted by the NCIC and SWOG with carboplatin versus&nbsp;cisplatin, both in combination with cyclophosphamide, have demonstrated equivalent overall survival between the two groups.<br />\r\n<br />\r\nThere is limited statistical power to demonstrate equivalence in overal&nbsp; pathologic complete response rates and long-term survival ( &ge; 3 years) because of the small number of patients with these outcomes: the small number of patients with residual tumor&nbsp;&lt; 2 cm after initial&nbsp;surgery&nbsp;also limits the statistical power to demonstrate equivalence in this subgroup.<br />\r\n<br />\r\n<strong>Secondary Treatment of Advanced Ovarian Carcinoma</strong>: Carboplatin is indicated for the&nbsp;palliative treatment&nbsp;of patients with ovarian carcinoma recurrent after prior&nbsp;chemotherapy, including patients who have been previously treated with cisplatin.<br />\r\n<br />\r\nWithin the group of patients previously treated with cisplatin, those who have developed progressive disease while receiving cisplatin&nbsp;therapy&nbsp;may have a decreased response rate.</p>', '<p>Carboplatin is an alkylating agent which binds covalently to DNA. It modifies the cell cycle by interfering with DNA structure and function.</p>', '<p><strong>Previously untreated patients</strong>: 400 mg/m2&nbsp;as single short term IV infusion over 15-60 min. Therapy should not be repeated until 4 wk after the previous course and/or until the neutrophil count is at least 2,000 cells/mm3&nbsp;and the platelet count is at least 100,000 cells/mm3.<br />\r\n<br />\r\n<strong>Patients previously treated with myelosuppresive therapy or patients with poor performance status</strong>: Reduce initial dosage by 20-25% (300-320 mg/m2).</p>', '<p>Administration of a liver vaccine may be dangerous during treatment with carboplatin. The renal effects of nephrotoxic compounds may be potentiated by carboplatin.</p>', '<p>Carboplatin injection should not be employed in patients with severe bone marrow depression or significant bleeding. It is contraindicated in patients with a history of severe allergic reactions to cisplatin or other platinum containing compounds.</p>', '<p>Bone marrow suppression, gastrointestinal effects, nephrotoxicity, nervous system, ototoxicity, allergic reactions, alopecia, mucositis.</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</p>', '<p>Much less renal toxicity than cisplatin so no need for a vigorousm hydration schedule or forced diuresis. If AUC dosing is not used, dose should be reduced to 250 mg/m2&nbsp;for creatinine clearance of 41 to 59 ml/min and to 200 mg/m2&nbsp;for clearance of 16 to 40 ml/min. Corticosteroids &amp; antihistamines are employed to alleviate symptoms.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', '<p>Store at 25&deg; C. Protect from light.</p>', '<p><strong>Renal Impairment</strong>:</p>\r\n\r\n<ul>\r\n	<li>CrCl (16-40 ml/min)- 200 mg/m2.</li>\r\n	<li>CrCl (41-59 ml/min)-&nbsp;250 mg/m2.</li>\r\n</ul>', '2022-02-18 19:12:16', '2022-03-23 19:36:49'),
(272, 272, '<p>Carboprost Sterile Solution is indicated for aborting pregnancy between the 13th and 20th weeks of gestation as calculated from the first day of the last normal menstrual period and in the following conditions related to second trimester abortion:</p>\r\n\r\n<ul>\r\n	<li>Failure of expulsion of the fetus during the course of treatment by another method;</li>\r\n	<li>Premature rupture of membranes in intrauterine methods with loss of drug and insufficient or absent uterine activity;</li>\r\n	<li>Requirement of a repeat intrauterine instillation of drug for expulsion of the fetus;</li>\r\n	<li>Inadvertent or spontaneous rupture of membranes in the presence of a previable fetus and absence of adequate activity for expulsion.</li>\r\n</ul>\r\n\r\n<p>Carboprost is indicated for the treatment of postpartum hemorrhage due to uterine atony which has not responded to conventional methods of management. Prior treatment should include the use of intravenously administered oxytocin, manipulative techniques such as uterine massage and, unless contraindicated, intramuscular ergot preparations. Studies have shown that in such cases, the use of Carboprost has resulted in satisfactory control of hemorrhage, although it is unclear whether or not ongoing or delayed effects of previously administered ecbolic agents have contributed to the outcome. In a high proportion of cases, Carboprost used in this manner has resulted in the cessation of life threatening bleeding and the avoidance of emergency surgical intervention.</p>', '<p>Carboprost tromethamine administered intramuscularly stimulates in the gravid uterus myometrial contractions similar to labor contractions at the end of a full term pregnancy. Whether or not these contractions result from a direct effect of carboprost on the myometrium has not been determined. Nonetheless, they evacuate the products of conception from the uterus in most cases.<br />\r\n<br />\r\nPostpartum, the resultant myometrial contractions provide hemostasis at the site of placentation.<br />\r\n<br />\r\nCarboprost tromethamine also stimulates the smooth muscle of the human gastrointestinal tract. This activity may produce the vomiting or diarrhea or both that is common when carboprost tromethamine is used to terminate pregnancy and for use postpartum. In laboratory animals and also in humans carboprost tromethamine can elevate body temperature. With the clinical doses of carboprost tromethamine used for the termination of pregnancy, and for use postpartum, some patients do experience transient temperature increases.<br />\r\n<br />\r\nIn laboratory animals and in humans large doses of carboprost tromethamine can raise blood pressure, probably by contracting the vascular smooth muscle. With the doses of carboprost tromethamine used for terminating pregnancy, this effect has not been clinically significant. In laboratory animals and also in humans carboprost tromethamine can elevate body temperature. With the clinical doses of carboprost tromethamine used for the termination of pregnancy, some patients do experience temperature increases. In some patients, carboprost tromethamine may cause transient bronchoconstriction.</p>', '<p><strong>Abortion and Indications 1-4</strong>: An initial dose of 1 mL of Carboprost Sterile Solution (containing the equivalent of 250 micrograms of carboprost) is to be administered deep in the muscle with a tuberculin syringe. Subsequent doses of 250 micrograms should be administered at 1&frac12; to 3&frac12; hour intervals depending on uterine response.<br />\r\n<br />\r\nAn optional test dose of 100 micrograms (0.4 mL) may be administered initially. The dose may be increased to 500 micrograms (2 mL) if uterine contractility is judged to be inadequate after several doses of 250 micrograms (1 mL).<br />\r\n<br />\r\nThe total dose administered of carboprost tromethamine should not exceed 12 milligrams and continuous administration of the drug for more than two days is not recommended.<br />\r\n&nbsp;<br />\r\n<strong>For Refractory Postpartum Uterine Bleeding</strong>: An initial dose of 250 micrograms of Carboprost Sterile Solution (1 mL of Carboprost) is to be given deep, intramuscularly. In clinical trials it was found that the majority of successful cases (73%) responded to single injections. In some selected cases, however, multiple dosing at intervals of 15 to 90 minutes was carried out with successful outcome. The need for additional injections and the interval at which these should be given can be determined only by the attending physicians as dictated by the course of clinical events. The total dose of Carboprost should not exceed 2 milligrams (8 doses).</p>', '<p>Carboprost may augment the activity of other oxytocic agents. Concomitant use with other oxytocic agents is not recommended.</p>', '<ul>\r\n	<li>Hypersensitivity (including anaphylaxis and angioedema) to Carboprost Sterile Solution</li>\r\n	<li>Acute pelvic inflammatory disease</li>\r\n	<li>Patients with active cardiac, pulmonary, renal or hepatic disease</li>\r\n</ul>', '<p>The most frequent adverse reactions observed are related to its contractile effect on smooth muscle, especially gastrointestinal effects like vomiting, nausea, diarrhea and pyrexia. Endometritis, retained placental fragments, and excessive uterine bleeding occurred as the most common complications after abortion with Carboprost.</p>', '<p>Pregnancy category C. Animal studies do not indicate that Carboprost is teratogenic, however, it has been shown to be embryotoxic in rats and rabbits and any dose which produces increased uterine tone could put the embryo or fetus at risk.</p>', '<ul>\r\n	<li>Use Carboprost by medically trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities.</li>\r\n	<li>Use Carboprost cautiously in patients with a history of asthma, hypo- or hypertension, cardiovascular, renal or hepatic disease, anemia, jaundice, diabetes or epilepsy and compromised (scarred) uteri.</li>\r\n	<li>In few patients with chorioamnionitis, uterus may not respond to Carboprost.</li>\r\n	<li>Cervix should always be carefully examined immediately post-abortion.</li>\r\n</ul>', NULL, '<p>Drugs acting on the Uterus</p>', NULL, NULL, '2022-02-18 19:12:42', '2022-03-23 19:39:04'),
(273, 273, '<p>It is used as a lubricant to relieve irritation and discomfort due to dryness of the eye or due to exposure to wind or sun.</p>', '<p>Carboxymethylcellulose binds to the surface of corneal epithelial cells via its glucopyranose subunits binding to glucose receptors GLUT-1. The residence time of carboxymethylcellulose bound to corneal cells is approximately 2 hours as indicated by a short-term binding assay. Binding of carboxymethylcellulose to the matrix proteins stimulated corneal epithelial cell attachment, migration, and re-epithelialization of corneal wounds.<br />\r\n<br />\r\nThis eye drop contains Carboxymethylcellulose Sodium similar to normal tears which acts as an ocular lubricant. It provides a lubricating and hydrating protective shield on the ocular surface.</p>', '<p>Instill 1 drop in the affected eye(s) 4 times a day or as needed.</p>', '<p>Not known.</p>', '<p>This eye drop is contraindicated in patients with known hypersensitivity to any ingredient of the product.</p>', '<p>Burning, Eye Irritation or Pruritus, Visual disturbance, Ocular discharge were reported with this eye drop.</p>', '<p>Safe use during pregnancy and lactation has not been established.</p>', '<p>Concomitant ocular medication should be administered 15 minutes prior to the instillation of this eye drop.</p>', NULL, NULL, '<p>The drug is to be used within 30 days after the first opening. Store at temperature not exceeding 30&deg;C in a dry place. Protect from light. The bottle is to be closed strongly immediately after use. Keep away from the reach of children.</p>', '<p><strong>Pediatric use</strong>: This eye drop should not be used in infants and small children under 3 years.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences in safety or effectiveness have been observed between elderly and other adult patients.</p>', '2022-02-18 19:13:08', '2022-03-23 19:45:01'),
(274, 274, '<p>This Sterile Eye Drops is indicated for the temporary relief of burning, irritation, and discomfort due to dryness of the eye or exposure to wind or sun.</p>', '<p>The combination of Carboxymethylcellulose Sodium and Glycerin relieves the symptoms of dry eye in two ways. Firstly it provides lubricating and hydrating protective shield on the ocular surface of the eye and then it works below the tear film to provide protection to the cornea.</p>', '<p>Instill 1 drop in the affected eyes as needed.&nbsp;It can be used in children.</p>', NULL, '<p>It is contraindicated in patients with known hypersensitivity to any ingredient of this formulation.</p>', '<p>Vision may be temporarily blurred when this product is first used. Also, minor burning/ stinging/ irritation may temporarily occur.</p>', '<p><strong>Use in pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. Carboxymethylcellulose Sodium and Glycerin should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: Carboxymethylcellulose Sodium or Glycerin has not been measured in human milk. Caution should be exercised when the combination of Carboxymethylcellulose Sodium and Glycerin is administered to a nursing mother.</p>', '<p>Consult doctor if irritation, eye pain or visual changes worsen or persist beyond 72 hours.</p>', NULL, '<p>Drugs for Dry eyes</p>', NULL, NULL, '2022-02-18 19:13:32', '2022-03-23 19:48:47'),
(275, 275, '<p>This medication is used to relieve the dryness and pain associated with reduced or abnormal tear production.</p>', '<p>Carboxymethylcellulose Sodium &amp; Hypromellose both of them are polymer in nature. It is a clear and colorless aqueous solution. This medication lubricates the surface of the eye in the same way as natural tears. It can therefore be used to relieve the dryness and pain associated with reduced or abnormal tear production.</p>', '<p><strong>For Adults and Children</strong>: Instill 1 or 2 drops in the affected eye(s) as needed.</p>', NULL, '<p>Known sensitivity or allergy to any ingredient of the formulation.</p>', '<p>Common side effects are blurred vision, matting or stickiness of eyelashes.</p>', '<p>Carboxymethylcellulose Sodium &amp; Hypromellose have not been shown to cause birth defects or other problems during pregnancy and breastfeeding.</p>', '<p>If you experience eye pain, changes in vision, continued redness or irritation of the eye or if your symptoms continue for more than 3 days or become worse, check with your doctor.</p>', NULL, '<p>Drugs for Dry eyes</p>', '<p>Store in a cool, dry place and protected from light, Keep out of the reach of children, Do not use more than 4 weeks after opening.</p>', '<p>This drug does not cause different side effects or problems in children than it does in adults.</p>', '2022-02-18 19:13:54', '2022-03-23 19:53:20'),
(276, 276, '<p>Carisoprodol is indicated for-</p>\r\n\r\n<ul>\r\n	<li>The relief of discomfort associated with acute, painful musculoskeletal conditions in adults.</li>\r\n	<li>Sedation and decrease anxiety in patients with severe pain.</li>\r\n	<li>Used as an adjunct in physical therapy in injuries.</li>\r\n</ul>', '<p>Carisoprodol is a GABA-A receptor indirect agonist with CNS chloride channel conductance effect. GABA receptor agonists typically produce sedative effect and may also cause other effects such as anxiolytic, anticonvulsant and muscle relaxant. Metabolite of Carisoprodol, Meprobamate, has anxiolytic and sedative properties. Carisoprodol decreases the impulses from brain and spinal cord to the muscle. This causes the muscle to relax and hence decrease the spasm. It has no direct action on muscle itself.</p>', '<p><strong>Adults (18 years and older)</strong>: The recommended dose of Carisoprodol is 250 mg three times daily and at bedtime (4 times daily). The recommended maximum duration of Carisoprodol use is up to two or three weeks. Caution should be taken in patients with renal and hepatic impairment and also with reduced CYP2C19 activity.</p>', '<ul>\r\n	<li>Caution should be exercised with patients who take other CNS depressants (eg. alcohol, benzodiazepines, opioids, tricyclic antidepressants) with Carisoprodol.</li>\r\n	<li>Co-administration of CYP2C19 inhibitors (Omeprazole, Fluvoxamine) with Carisoprodol could result in increased exposure of Carisoprodol. Co-administration of CYP2C19 inducers (Rifampin) with Carisoprodol could result in decreased exposure of arisoprodol.</li>\r\n</ul>', '<p>Carisoprodol is contraindicated in patients with a history of acute intermittent porphyria or a hypersensitivity reaction to a carbamate such as meprobamate.</p>', '<p>Common side effects are drowsiness, dizziness and headache</p>', '<p>Pregnancy category C. Maternal use of Carisoprodol may lead to reduced or less effective infant feeding (due to sedation) and/or decresed milk production. Caution should be exercised when Carisoprodol is administered to a nursing woman.</p>', '<p>Due to sedative properties, may impair ability to perform hazardous tasks such as driving or operating machinery. Additive sedative effects when used with other CNS depressants including alcohol. Cases of Drug Dependence, Withdrawal, and Abuse. Seizures</p>', '<p>Overdosage of Carisoprodol commonly produces CNS depression. Death, coma, respiratory depression, hypotension, seizures have been reported with Carisoprodol overdosage. Basic life support measures should be instituted in Carisoprodol overdose. Induced emesis is not recommended due to the risk of CNS and respiratory depression. Gastric lavage should be considered soon after ingestion (within one hour). Circulatory support should be administered with volume infusion and vasopressor agents if needed. Seizures should be treated with intravenous benzodiazepines and the reoccurrence of seizures may be treated with phenobarbital. In cases of severe CNS depression, airway protective reflexes may be compromised and tracheal intubation should be considered for airway protection and respiratory support.</p>', '<p>Locally acting Skeletal Muscle Relaxants</p>', '<p>Store in cool and dry place at room temperature 20&deg;-25&deg;C, away from direct light. Keep out reach of children.</p>', NULL, '2022-02-18 19:14:20', '2022-03-23 19:56:03'),
(277, 277, '<p>Carmellose Sodium is a substitute for tears, and contains the lubricant called carmellose sodium. It is used for the treatment of the symptoms of dry eye (such as soreness, burning, irritation or dryness) caused by you not producing enough tears to keep the eye wet.</p>', NULL, '<p>The recommended dose is 1-2 drops of Carmellose Sodium in the affected eye/each affected eye, 4 times a day or as often as needed. You do not need to remove contact lenses before using Carmellose Sodium. Make sure that the single-dose container is intact before use. The solution should be used immediately after opening. To avoid contamination or possible eye injury, do not let the open-end of the single-dose container touch your eye or anything else. Wash your hands before use.</p>', '<p>Please tell your doctor or pharmacist if you are using, have recently used or might use any other medicines, including medicines obtained without a prescription. If you are using other eye drops, leave at least 15 minutes between putting in the other drops and Carmellose Sodium.</p>', '<p>If you are hypersensitive (allergic) to carmellose sodium or any of the other ingredients of this medicine.</p>', '<p>Common side effects are eye irritation (including burning and discomfort), eye pain, itchy eyes, visual disturbance.</p>', '<p>You can use Carmellose Sodium if you are pregnant and when you are breast-feeding.</p>', '<p>If irritation, pain, redness or changes in vision occur or if you feel your condition is getting worse, stop taking this medicine and consult your doctor or pharmacist.</p>', NULL, '<p>Drugs for Dry eyes</p>', '<p>Keep this medicine out of the sight and reach of children. Do not store above 25&deg;C.</p>', NULL, '2022-02-18 19:14:38', '2022-03-23 19:58:39');
