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
(1492, 1492, '<p>Tigecycline is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions listed below:<br />\r\n<br />\r\n<strong>Complicated Skin and Skin structure Infections</strong>: Complicated skin and skin structure infections caused by Escherichia coli, Enterococcus faecalis (vancomycin-susceptible isolates only), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus agalactiae, Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Streptococcus pyogenes, Enterobacter cloacae, Klebsiella pneumoniae and Bacteroides fragilis.<br />\r\n<br />\r\n<strong>Complicated Intra-Abdominal Infections</strong>: Complicated intra-abdominal infections caused by Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus faecalis (vancomycin-susceptible isolates only), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatus, Clostridium perfringens, and Peptostreptococcus micros.<br />\r\n<br />\r\n<strong>Community-Acquired Bacterial Pneumonia</strong>: Community-acquired bacterial pneumonia caused by Streptococcus pneumoniae (penicillin-susceptible isolates), including cases with concurrent bacteremia, Haemophilus influenzae (beta-lactamase negative isolates), and Legionella pneumophila.</p>', '<p>Tigecycline, a glycylcycline, inhibits protein translation in bacteria by binding to the 30S ribosomal subunit and blocking entry of amino-acyl tRNA molecules into the A site of the ribosome. This prevents incorporation of amino acid residues into elongating peptide chains. Tigecycline carries a glycylamido moiety attached to the 9-position of minocycline. The substitution pattern is not present in any naturally occurring or semisynthetic tetracycline and imparts certain microbiologic properties to tigecycline. Tigecycline is not affected by the two major tetracycline resistance mechanisms, ribosomal protection and efflux. Accordingly, tigecycline has demonstrated in vitro and in vivo activity against a broad spectrum of bacterial pathogens. There has been no cross resistance observed between tigecycline and other antibiotics. Tigecycline is not affected by resistance mechanisms such as beta-lactamases (including extended spectrum beta-lactamases), target site modifications, macrolide efflux pumps or enzyme target changes (e.g. gyrase/topoisomerase). In vitro studies have not demonstrated antagonism between tigecycline and other commonly used antibacterial drugs. In general, tigecycline is considered bacteriostatic.</p>', '<p>The duration of therapy should be guided by the severity and site of the infection and the patient&#39;s clinical and bacteriological progress. The recommended duration of treatment with Tigecycline for complicated skin and skin structure infections or for complicated intra-abdominal infections is 5 to 14 days and for community-acquired bacterial pneumonia is 7 to 14 days. The recommended daily dose is as follows:<br />\r\n<br />\r\n<strong>Adults</strong>: The recommended dosage regimen for Tigecycline is an initial dose of 100 mg, followed by 50 mg every 12 hours. Intravenous (IV) infusions of Tigecycline should be administered over approximately 30 to 60 minutes every 12 hours.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: Safety and effectiveness in pediatric patients below the age of 18 years have not been established.&nbsp;<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No unexpected overall differences in safety or effectiveness were observed between these subjects and younger subjects.</p>', '<p>Drug interaction of Tigecycline with Digoxin and Warfarin is observed.</p>', '<p>Tigecycline is contraindicated for use in patients who have known hypersensitivity to Tigecycline.</p>', '<p>The most common treatment-emergent adverse events are nausea and vomiting which generally occurre during the first 1-2 days of therapy.<br />\r\n<br />\r\nThe following drug-related adverse events are reported infrequently in patients receiving Tigecycline: Injection site inflammation &amp; pain, septic shock, allergic reaction, chills, thrombophlebitis, bradycardia, tachycardia, vasodilatation, anorexia, dry mouth, hypoglycemia, hyponatremia, prolonged prothrombin time, eosinophilia, thrombocytopenia, vaginal moniliasis, vaginitis, leukorrhea.</p>', '<p><strong>Pregnancy</strong>: Tigecycline 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>: Caution should be exercised when Tigecycline is administered to a nursing woman.</p>', '<p>Tigecycline is structurally similar to Tetracycline-class antibiotics and should be administered with caution in patients with known hypersensitivity to Tetracycline-class antibiotics</p>', '<p>No specific information is available on the treatment of overdosage with Tigecycline. Intravenous administration of Tigecycline at a single dose of 300 mg over 60 minutes in healthy volunteers resulted in an increased incidence of nausea and vomiting.</p>', '<p>Tetracycline group of drugs</p>', '<p>Prior to reconstitution, Tigecycline should be stored at 20&deg;C to 25&deg;C. Once reconstituted, Tigecycline may be stored at room temperature for up to 24 hours (up to 6 hours in the vial and the remaining time in the intravenous bag). Reconstituted solution may be stored refrigerated at 2&deg;C to 8&deg;C for up to 48 hours following immediate transfer of reconstituted solution into the intravenous bag.</p>', NULL, '2022-03-21 20:25:06', '2022-03-21 20:25:06'),
(1493, 1493, '<p>Timolol Maleate Ophthalmic Solution is indicated in the treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma.</p>', '<p>Timolol is a non-selective &beta;-adrenergic receptor blocker. It does not have significant intrinsic sympathomimetic activity, direct myocardial depressant activity or local anaesth activity. Exact mechanism of ocular hypotensive effect is unclear, but it is thought to be related to reduction of aqueous humour formation. &beta;-blockade also causes lowering of BP.</p>', '<p><strong>Eye drops Solution</strong>: Initially, instill 1 drop of 0.25% solution bid into the affected eye(s), may increase to 1 drop of 0.5% solution bid if there is inadequate response; decrease to 1 drop once daily if controlled. Do not exceed 1 drop bid of 0.5% solution.<br />\r\n<br />\r\n<strong>Gel-forming eye drop</strong>s:&nbsp;0.25% or 0.5% Gel-forming eye drops: Instill 1 drop into the affected eye(s) once daily.</p>', '<p>Although Timolol used alone has little or no effect on pupil size, mydriasis resulting from concomitant therapy with Timolol Maleate and epinephrine has been reported occasionally. Drug interactions of Timolol Maleate have been noticed with concomitant administration of beta-adrenergic blocking agents (both oral and topical), calcium antagonists, catecholamine-depleting drugs, digitalis, quinidin, clonidine, injectable epinephrine.</p>', '<p>Timolol is contraindicated in patients with bronchial asthma, a history of bronchial asthma, severe chronic obstructive pulmonary disease, sinus bradycardia, second or third degree atrioventricular block, overt cardiac failure, cardiogenic shock, hypersensitivity to any component of this product.</p>', '<p>Burning and stinging sensation of the eyes, bradycardia, hypotension, arrhythmia and AV or SA nodal block, CHF, pulmonary oedema, Raynaud&#39;s phenomenon, headache, dizziness, fatigue, asthenia, abdominal discomfort, nausea, constipation, hypoglycaemia.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. Timolol 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>: Timolol has been detected in breast milk following oral and ophthalmic drug administration. Because of the potential for serious adverse reactions from Timolol 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>Patients with inadequate cardiac function, DM, myasthenia gravis, cerebrovascular insufficiency, history of atopy. Avoid abrupt withdrawal as it may exacerbate angina symptoms or precipitate MI in patients with coronary artery disease, or precipitate thyroid crisis in patients with thyrotoxicosis. Patients undergoing major surgery. May mask signs of hyperthyroidism and hypoglycaemia. Ophth soln should not be used as monotherapy for angle-closure glaucoma. Renal and hepatic impairment. Pregnancy and lactation.</p>', '<p>There have been reports of inadvertent overdosage with Timolol Ophthalmic Solution resulting in systemic effects similar to those seen with systemic beta-adrenergic blocking agents such as dizziness, headache, shortness of breath, bradycardia, bronchospasm, and cardiac arrest.</p>', '<p>Drugs for miotics and glaucoma.</p>', '<p>Store between 15-30&deg; C. Avoid freezing and protect from light.</p>', NULL, '2022-03-21 20:26:46', '2022-03-21 20:26:46'),
(1494, 1494, '<p><strong>Trichomoniasis</strong>: Tinidazole is indicated for the treatment of trichomoniasis caused by&nbsp;Trichomonas vaginalis. The organism should be identified by appropriate diagnostic procedures. Because trichomoniasis is a sexually transmitted disease with potentially serious sequelae, partners of infected patients should be treated simultaneously in order to prevent re-infection.<br />\r\n<br />\r\n<strong>Giardiasis</strong>: Tinidazole is indicated for the treatment of giardiasis caused by&nbsp;Giardia&nbsp;duodenalis in both adults and pediatric patients older than three years of age. Sections or subsections omitted from the full prescribing information are not listed.<br />\r\n<br />\r\n<strong>Amebiasis</strong>: Tinidazole is indicated for the treatment of intestinal amebiasis and amebic liver&nbsp;abscess&nbsp;caused by&nbsp;Entamoeba histolytica&nbsp;in both adults and pediatric patients older than three years of age. It is not indicated in the treatment of&nbsp;asymptomatic&nbsp;cystpassage.<br />\r\n<br />\r\n<strong>Bacterial Vaginosis</strong>: Tinidazole is indicated for the treatment of bacterial vaginosis (formerly referred to as&nbsp;Haemophilus&nbsp;vaginitis, Gardnerella vaginitis, nonspecific&nbsp;vaginitis, or&nbsp;anaerobic&nbsp;vaginosis) in non-pregnant women.<br />\r\n<br />\r\nOther pathogens commonly associated with vulvovaginitis such as Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans&nbsp;and&nbsp;Herpes&nbsp;simplex&nbsp;virus should be ruled out.<br />\r\n<br />\r\nTo reduce the development of drug-resistant bacteria and maintain the effectiveness of Tinidazole and other&nbsp;antibacterialdrugs, Tinidazole should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.</p>', '<p>Tinidazole, a 5-nitroimidazole derivative with antimicrobial actions similar to metronidazole, is active against both protozoa (e.g. Trichomonas vaginalis, Entamoeba histolytica and Giardia lamblia) and obligate anaerobic bacteria. It damages DNA strands or inhibits DNA synthesis in microorganism.</p>', '<p>Prevention of Postoperative Infections :</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: A single oral dose of 2g approximately 12 hours before surgery.</li>\r\n	<li><strong>Children less than 12 years</strong>: Data are not available to allow dosage recommendations for children below the age of 12 years in the prophylaxis of anaerobic infections.</li>\r\n</ul>\r\n\r\n<p><strong>Trichomoniasis</strong>: a single 2 g oral dose taken with food. Treat sexual partners with the same dose and at the same time<br />\r\n<br />\r\nGiardiasis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: a single 2 g dose taken with food.</li>\r\n	<li><strong>Pediatric patients older than three years of age</strong>: a single dose of 50 mg/kg (up to 2 g) with food</li>\r\n</ul>\r\n\r\n<p>Amebiasis, Intestinal:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 g per day for 3 days with food.</li>\r\n	<li><strong>Pediatric patients older than three years of age</strong>: 50 mg/kg/day (up to 2 g per day) for 3 days with food</li>\r\n</ul>\r\n\r\n<p>Amebic liver abscess:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 2 g per day for 3-5 days with food.</li>\r\n	<li><strong>Pediatric patients older than three years of age</strong>: 50 mg/kg/day (up to 2 g per day) for 3-5 days with food</li>\r\n</ul>\r\n\r\n<p><strong>Bacterial vaginosis</strong>: Non-pregnant, adult women: 2 g once daily for 2 days taken with food, or 1 g once daily for 5 days taken with food.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken with food. Take during or immediately after meals.</p>', '<p>The following interactions were reported with metronidazole, which is chemically-related to tinidazole.<br />\r\n<br />\r\n<strong>Alcohol, disulfiram</strong>: Avoid during tinidazole use and for 3 days afterward because cramps, nausea, vomiting, headaches, and flushing may occur.<br />\r\n<br />\r\n<strong>Anticoagulants, oral (eg, warfarin)</strong>: Anticoagulant effects may be increased. Anticoagulant dose may need to be adjusted during coadministration and for up to 8 days after discontinuation. Cholestyramine: Bioavailability of tinidazole may be decreased.<br />\r\n<br />\r\n<strong>Cyclosporine, lithium, tacrolimus</strong>: Levels may be elevated by tinidazole, increasing the risk of toxicity.<br />\r\n<br />\r\n<strong>Drugs that induce CYP3A4 (eg, fosphenytoin, phenobarbital, phenytoin, rifampin)</strong>: May increase metabolism of tinidazole, decreasing plasma levels and therapeutic effect.<br />\r\n<br />\r\n<strong>Drugs that inhibit CYP3A4 (eg, cimetidine, ketoconazole)</strong>: May prolong t&frac12; and decrease tinidazole Cl, increasing plasma levels and risk of adverse reactions.<br />\r\n<br />\r\n<strong>Fluorouracil</strong>: Cl may be decreased by tinidazole, increasing the risk of adverse reactions<br />\r\n<br />\r\n<strong>Fosphenytoin, phenytoin</strong>: The t&frac12; may be prolonged and Cl reduced by tinidazole, increasing the risk of adverse reactions.<br />\r\n<br />\r\n<strong>Oxytetracycline</strong>: Therapeutic effect of tinidazole may be decreased.</p>', '<p>As with other compounds of similar structure, tinidazole, is contraindicated in patients having, or with a history of, blood dyscrasias although no persistent haematological abnormalities have been noted in clinical or animal studies. Tinidazole should be avoided in patients with organic neurological disorders. Tinidazole should not be administered to patients with known hypersensitivity to the compound.</p>', '<p>Reported side effects have generally been infrequent, mild and self-limiting. Side effects from the gastrointestinal tract include nausea, vomiting, anorexia, diarrhoea and metallic taste. Hypersensitivity reactions, occasionally severe, may occur in rare cases in the form of skin rash, pruritis, urticaria and angioneurotic oedema. As with related compounds, tinidazole may produce transient leukopenia. Other rarely reported side-effects are headache, tiredness, furry tongue and dark urine.</p>', '<p>Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Compounds of similar chemical structure have produced various neurological disturbances such as dizziness, vertigo, uncoordination, and ataxia. If, during therapy with tinidazole, abnormal neurological signs develop, therapy should be discontinued. Use in Pregnancy &amp; Lactation: Tinidazole is contraindicated during the first trimester of pregnancy. While there is no evidence that tinidazole is harmful during the late stages of pregnancy, its use during the last two trimesters requires that the potential benefits outweigh the possible risk to mother and foetus. Tinidazole is excreted in breast milk in concentrations similar to those seen in serum. Tinidazole can be detected in breast milk for up to 72 hours following administration. Interruption of breast-feeding is recommended during tinidazole therapy and for 3 days following the last dose.</p>', NULL, '<p>Amoebicides.</p>', '<p>Store at room temperature &amp; protected from light.</p>', '<p>Renal Impairment: Haemodialysis: Additional dose equal to half the usual dose at the end of haemodialysis.</p>', '2022-03-21 20:28:34', '2022-03-21 20:28:34'),
(1495, 1495, '<p>Tioconazole is indicated for the&nbsp;local treatment&nbsp;of vulvovaginal&nbsp;candidiasis&nbsp;(moniliasis). As Tioconazole has been shown to be effective only for candidal vulvovaginitis, the&nbsp;diagnosis&nbsp;should be confirmed by KOH smears and/or cultures. Other pathogens commonly associated with vulvovaginitis should be ruled out by appropriate methods.<br />\r\n<br />\r\nStudies have shown that women taking oral contraceptives have a&nbsp;cure&nbsp;rate similar to those not taking such agents when treated with Tioconazole.</p>', '<p>Tioconazole interacts with 14-&alpha; demethylase, a cytochrome P-450 enzyme that converts lanosterol to ergosterol, an essential component of the yeast membrane. In this way, tioconazole inhibits ergosterol synthesis, resulting in increased cellular permeability. Tioconazole may also inhibit endogenous respiration, interact with membrane phospholipids, inhibit the transformation of yeasts to mycelial forms and the uptake of purine, impair triglyceride and/or phospholipid biosynthesis, and inhibit the movement of calcium and potassium ions across the cell membrane by blocking the ion transport pathway known as the Gardos channel.</p>', '<p><strong>Topical:&nbsp;</strong>Apply &amp; massage gently into the affected &amp; surrounding skin area once or twice a day. In intertriginous areas, apply sparingly &amp; smoothed in well to avoid macerating effects. Duration: 1-6 weeks.<br />\r\n<br />\r\n<strong>Vaginal candidiasis:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: As 6.5% ointment: Admin intravaginally at bedtime as a single dose.</li>\r\n	<li><strong>Child</strong>: &ge;12 yr Admin at bedtime as a single dose.</li>\r\n</ul>', NULL, '<p>Tioconazole is contraindicated in individuals who have been shown to be sensitive to imidazole&nbsp;antifungal&nbsp;agents or to other components of the&nbsp;ointment.</p>', '<p>Occasional local transient &amp; mild irritation; if hypersensitivity reaction develop, treatment should be discontinued &amp; appropriate therapy should be instituted.</p>', '<p>Pregnancy Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Not for ophthalmic use.</p>', NULL, '<p>Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations.</p>', NULL, '<p>Safety and effectiveness in&nbsp;pregnant&nbsp;and diabetic patients have not been established.</p>', '2022-03-21 20:30:05', '2022-03-21 20:30:05'),
(1496, 1496, '<p>Tiotropium is indicated for the long-term treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.</p>', '<p>Tiotropium&nbsp;is a long-acting, antimuscarinic agent, which is often referred to as an anticholinergic. It has similar affinity to the subtypes of muscarinic receptors, M1 to M5. In the airways, it exhibits pharmacological effects through inhibition of M3-receptors at the smooth muscle leading to bronchodilation. The competitive and reversible nature of antagonism was shown with human and animal origin receptors and isolated organ preparations. In preclinical in vitro as well as in vivo studies, prevention of methacholine-induced bronchoconstriction effects was dose-dependent and lasted longer than 24 hours. The bronchodilation following inhalation of Tiotropium is predominantly a site-specific effect.</p>', '<p><strong>Adult over 18 years</strong>: The recommended dose of Tiotropium Dry Powder Inhaler capsule is 18 mcg (1 capsule) once-daily, with the device.<br />\r\n<br />\r\nThe contents of the Tiotropium Dry Powder Inhaler capsules are only for oral inhalation and should only be used with the device.<br />\r\n<br />\r\nNo dosage adjustment is required for geriatric, hepatically-impaired, or renally-impaired patients. However, patients with moderate to severe renal impairment given Tiotropium capsule should be monitored closely for anticholinergic effects.</p>', '<p>An interaction study with Tiotroplum (14.4 mcg intravenous infusion over 15 minutes) and cimetidine 400 mg three times daily or ranitidine 300 mg once daily was conducted. Concomitant administration of cimetidine with Tiotroplum resulted in a 20% increase in the AUC 0-4 hour, a 28% decrease in the renal clearance of Tiotroplum and no significant change in the Cmax and amount excreted in urine over 96 hours. Co-administration of Tiotroplum with ranitidine did not affect the pharmacokinetics of Tiotroplum.</p>', '<p>Tiotropium is contraindicated in patients with a history of hypersensitivity to atropine or its derivatives, including ipratropium, or to any component of this product.</p>', '<p>The most commonly reported adverse drug reaction was dry mouth. Dry mouth was usually mild and often resolved during continued treatment. Other reactions reported in individual patients and consistent with possible anticholinergic effects included constipation, increased heart rate, blurred&nbsp;vision, glaucoma, urinary difficulty, and urinary retention.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women with Tiotropium. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. The safety and effectiveness of Tiotropium has not been studied during labor and delivery.</p>', '<p>As an anticholinergic drug, Tiotropium may potentially worsen symptoms and signs associated with narrow-angle glaucoma, prostatic hyperplasia or bladder-neck obstruction and should be used with caution in patients with any of these conditions.</p>', '<p>High doses of Tiotropium may lead to anticholinergic signs and symptoms. However, there were no systemic anticholinergic adverse effects following a single inhaled dose of up to 282 mcg Tiotropium in 6 healthy volunteers. In a study of 12 healthy volunteers, bilateral conjunctivitis and dry mouth were seen following repeated once-daily inhalation of 141 mcg of Tiotropium</p>', '<p>Anticholinergic bronchodilators</p>', '<p>Tiotropium Dry Powder Inhaler capsules must not be swallowed. Avoid storage in direct sunlight or heat. Store below 30&deg;C. Keep away from children.</p>', NULL, '2022-03-21 20:31:43', '2022-03-21 20:31:43'),
(1497, 1497, '<p>This Lotion&nbsp;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>Sunburn</li>\r\n	<li>Premature aging</li>\r\n	<li>Risk of skin cancer</li>\r\n	<li>Uv rays protection</li>\r\n	<li>Dryness and chapping of the lips</li>\r\n	<li>Cold sores</li>\r\n	<li>Sun and fever blisters</li>\r\n</ul>', '<p>This Lotion&nbsp;improves the patient&#39;s condition by performing the following functions:</p>\r\n\r\n<ul>\r\n	<li>Absorbing the sun&#39;s ultraviolet radiations.</li>\r\n	<li>Absorbing sun&#39;s ultraviolet radiations.</li>\r\n	<li>Moisturizing the dry skin area.</li>\r\n	<li>Diminishing the penetration of UV light through the epidermis</li>\r\n</ul>', '<p>Apply on the area exposed to sunlight (such as face, neck &amp; body) at least 30 min before exposure and whenever necessary. Massage on to skin until absorbed.<br />\r\n<br />\r\nTo ensure maximum protection, we recommend repeating the application every two hours after continuous exposure to the sun and after swimming, physical exercise (sweat or dry with towel).</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity to&nbsp;Spectraban this lotion&nbsp;is a contraindication. In addition,&nbsp;Spectraban Ultra 28 Lotion&nbsp;should not be used if you have the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Allergic reaction</li>\r\n	<li>Allergic reactions</li>\r\n	<li>Contact with eyes</li>\r\n	<li>Hypersensitivity</li>\r\n</ul>', '<p>The following is a list of possible&nbsp;side-effects&nbsp;that may occur from all constituting ingredients of this&nbsp;lotion. 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>Rash</li>\r\n	<li>Itching</li>\r\n	<li>Severe dizziness</li>\r\n	<li>Trouble breathing</li>\r\n	<li>Skin irritation</li>\r\n	<li>Skin redness</li>\r\n	<li>Acne</li>\r\n	<li>Burning or itching of the skin</li>\r\n	<li>Dark red spots on the skin</li>\r\n	<li>Painful, red and pus-filled blisters in hair follicles</li>\r\n</ul>', '<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>Before using&nbsp;this lotion, 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>Apply it 30 minutes before going in the sun exposure</li>\r\n	<li>Breastfeeding</li>\r\n	<li>Herpes infection</li>\r\n	<li>Infants</li>\r\n	<li>Planning to have baby</li>\r\n	<li>Pregnancy</li>\r\n	<li>Pregnant, planning to become pregnant or breastfeeding</li>\r\n	<li>Pregnant, planning to get pregnant or breastfeeding</li>\r\n	<li>Skin disease</li>\r\n	<li>Do not take by mouth. Consult with your doctor before using this medicine on open wounds, dry, chapped, irritated, or sun-burned skin.</li>\r\n	<li>Wash your hands before and after applying&nbsp;this lotion. Clean and dry the skin area to be treated.</li>\r\n	<li>Do not wash the treated area after immediately applying&nbsp;this lotion. Also avoid the use of other products on the treated area unless directed by your doctor.</li>\r\n	<li>Applying an excessive amount may result in pilling. Use a thinner layer or lesser quantity of medicine to avoid pilling.</li>\r\n	<li>Avoid getting this medication in your eyes or nose or mouth.</li>\r\n</ul>', NULL, '<p>Sunblock Preparation</p>', '<p>Store&nbsp;medicines&nbsp;at room temperature, away from heat and direct light. Do not freeze&nbsp;medicines&nbsp;unless required by package insert. Keep&nbsp;medicines&nbsp;away from children and pets.</p>', NULL, '2022-03-21 20:33:20', '2022-03-21 20:33:20'),
(1498, 1498, '<p>Treatment of painful muscle spasms:</p>\r\n\r\n<ul>\r\n	<li>Associated with static and functional disorders of the spine (cervical and lumbar syndromes).</li>\r\n	<li>Following surgery, e.g. for herniated intervertebral disc or osteoarthritis of the hip.</li>\r\n</ul>\r\n\r\n<p>Treatment of spasticity due to neurological disorders:</p>\r\n\r\n<ul>\r\n	<li>Multiple sclerosis, chronic myelopathy, degenerative spinal cord diseases, cerebrovascular accidents, and cerebral palsy.</li>\r\n</ul>', '<p>Tizanidine is a centrally acting skeletal muscle relaxant. Its principal site of action is the spinal cord, where the evidence suggests that, by stimulating presynaptic alpha2 receptors, it inhibits the release of excitatory amino acids that stimulate N-methyl-D aspartate (NMDA) receptors.<br />\r\n<br />\r\nPolysynaptic signal transmission at spinal interneuron level, which is responsible for excessive muscle tone, is thus inhibited and muscle tone reduced. In addition to its muscle-relaxant properties, tizanidine also exerts a moderate central analgesic effect.<br />\r\n<br />\r\nPharmacodynamic: Tizanidine is effective in both acute painful muscle spasms and chronic spasticity of spinal and cerebral origin. It reduces resistance to passive movements, alleviates spasms and clonus, and may improve voluntary strength. The antispastic activity (measured by the Ashworth score and pendulum test) and adverse effects (heart rate and blood pressure) of Tizanidine are related to plasma tizanidine concentrations.</p>', '<p>Tizanidine has a narrow therapeutic index and high inter-patient variability in tizanidine plasma concentrations which requires individualized dose adjustment. A low starting dose of 2 mg three times daily can minimize the risk for adverse effects. The dose should be carefully adjusted upward according to the needs of the individual patient.<br />\r\n<br />\r\n<strong>Relief of painful muscle spasms</strong>: The usual dose is 2 to 4 mg three times daily in tablet form. In severe cases, an extra dose of 2 or 4 mg may be taken, preferably at night to minimize sedation.<br />\r\n<br />\r\n<strong>Spasticity due to neurological disorders</strong>: The initial daily dose should not exceed 6 mg given in 3 divided doses. It may be increased stepwise at half-weekly or weekly intervals by 2 to 4 mg. The optimum therapeutic response is generally achieved with a daily dose of between 12 and 24 mg, administered in 3 or 4 equally spaced doses. The daily dose of 36 mg should not be exceeded.<br />\r\n<br />\r\n<strong>Pediatrics patients</strong>: Experience in patients below 18 years of age is limited and the use of Tizanidine in this population is not recommended.<br />\r\n<br />\r\n<strong>Geriatric patients</strong>&nbsp;(65 years of age or older): Experience with the use of Tizanidine in the elderly is limited. Therefore, it is recommended to start treatment at the lowest dose and increases should be done in small steps according to tolerability and efficacy.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: In patients with renal impairment (creatinine clearance &lt;25 mL/min), it is recommended to start treatment at 2 mg once daily. An increase in dosage should be done in small steps according to tolerability and efficacy. If efficacy has to be improved, it is advisable to first increase the strength of the daily dose before increasing the frequency of administration.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Use of Tizanidine in patients with severe hepatic impairment is contraindicated. While Tizanidine is extensively metabolized in the liver, limited data are available in this population. Its use has been associated with a reversible abnormality in liver function tests. Tizanidine should be used with caution in patients with moderate hepatic impairment and treatment should be started with the lowest dose. Afterward, an increase in dosage should be done carefully and according to patient tolerability.<br />\r\n<br />\r\n<strong>Discontinuation of treatment</strong>: If Tizanidine has to be discontinued, the dosage should be slowly down titrated, particularly in patients who have received high doses for a longer period of time to avoid or minimize the risk of rebound hypertension and tachycardia.</p>', '<p>Concomitant administration of drugs known to inhibit the activity of CYP1A2 may increase the plasma levels of tizanidine. The increased plasma levels of tizanidine may result in overdose symptoms such as QT(c) prolongation. Concomitant administration of drugs known to induce the activity of CYP1A2 may decrease the plasma levels of tizanidine. The decreased plasma levels of tizanidine may reduce the therapeutic effect of Tizanidine.<br />\r\n<br />\r\n<strong>Observed interactions resulting in a contraindication</strong>: Concomitant use of Tizanidine with fluvoxamine or ciprofloxacin, both CYP1A2 inhibitors is contraindicated. Concomitant use of Tizanidine with fluvoxamine or ciprofloxacin resulted in a 33-fold and 10-fold increase in tizanldine AUC, respectively. Clinically significant and prolonged hypotension may result along with somnolence, dizziness and decreased psychomotor performance. The increased plasma levels of tizanidine may result in overdose symptoms such as QT(c) prolongation.<br />\r\n<br />\r\n<strong>Observed interactions resulting in concomitant use not recommended</strong>: Co administration of Tizanidine with other inhibitors of CYP1A2 such as antiarrhythmics (amiodarone, mexiletine, propafenone), cimetidine, fluoroquinolones (enoxacin, pefloxacin, norfloxacin), rofecoxib, oral contraceptives, and ticlopidine is not recommended.<br />\r\n<br />\r\n<strong>Observed interactions to be considered</strong>: Caution should be exercised when Tizanidine is given with drugs known to prolong the QT interval (including but not limited to cisapride, amytriptyline and azithromycin).<br />\r\n<br />\r\n<strong>Antihypertensives</strong>: Concomitant use of Tizanidine with antihypertensives, including diuretics, may occasionally cause hypotension and bradycardia. In some patients rebound hypertension and tachycardia have been observed upon abrupt discontinuation of Tizanidine when concomitantly used with antihypertensive drugs. In extreme cases, rebound hypertension might lead to cerebrovascular accident.<br />\r\n<br />\r\n<strong>Rifampicin</strong>: Concomitant administration of Tizanidine with rifampicin results in 50% decrease in tizanidine concentrations. Therefore, the therapeutic effects of Tizanidine may be reduced during treatment with rifampicin, which may be of clinical significance in some patients. Long term coadministration should be avoided and if co- administration is considered a careful dose adjustment (increase) may be required.&nbsp;<br />\r\n<br />\r\n<strong>Cigarette smoke</strong>: Administration of Tizanidine in smokers (&gt;10 cigarettes per day) results in about 30% decrease in tizanidine systemic exposure. Long-term therapy with Tizanidine in heavy smokers may require higher doses than the average doses.<br />\r\n<br />\r\n<strong>Alcohol</strong>: While on Tizanidine therapy, alcohol consumption should be minimized or avoided as it may increase the potential for adverse events (e.g. sedation and hypotension). The central nervous system depressant effects of alcohol may be enhanced by Tizanidine.<br />\r\n<br />\r\n<strong>Anticipated interactions to be considered</strong>: Sedatives, hypnotics (e.g. benzodiazepine or baclofen), and another drug such as antihistamines may enhance the sedative action of tizanidine. Tizanidine should be avoided when using with other alpha-2 adrenergic agonists (such as clonidine) because of their potential additive hypotensive effect.</p>', '<ul>\r\n	<li>Known hypersensitivity to tizanidine or to any of the excipients.</li>\r\n	<li>Severely impaired hepatic function.</li>\r\n	<li>Concomitant use of tizanidine with strong inhibitors of CYP1A2 such as fluvoxamine or ciprofloxacin is contraindicated.</li>\r\n</ul>', '<p>With low doses, such as those recommended for the relief of painful muscle spasms, somnolence, fatigue, dizziness, dry mouth, blood pressure decrease, nausea, gastrointestinal disorder and transaminase increase have been reported, usually as mild and transient adverse reactions.<br />\r\n<br />\r\nWith the higher doses recommended for the treatment of spasticity, the adverse reactions reported with low doses are more frequent and more pronounced, but seldom severe enough to require discontinuation of treatment. In addition, the following adverse reactions may occur: hypotension, bradycardia, muscular weakness, insomnia, sleep disorder, hallucination &amp; hepatitis.</p>\r\n\r\n<ul>\r\n	<li>Psychiatric disorders: Common- Insomnia, sleep disorder.</li>\r\n	<li>Nervous system disorders: Very common- Somnolence, dizziness</li>\r\n	<li>Cardiac disorders: Uncommon- Bradycardia</li>\r\n	<li>Vascular disorders: Common- Hypotension</li>\r\n	<li>Gastrointestinal disorders: Very common- Gastrointestinal disorder, dry mouth; Common- Nausea.</li>\r\n	<li>Musculoskeletal and connective tissue disorders: Very common- Muscular weakness</li>\r\n	<li>General disorders and administration site conditions: Very common- Fatigue</li>\r\n	<li>Investigations: Common- Blood pressure decreased, transaminases increased.</li>\r\n</ul>', '<p>As there is limited experience with the use of Tizanidine in pregnant women, it should not be used during pregnancy unless the benefit clearly outweighs the risk.<br />\r\n<br />\r\n<strong>Animal data</strong>: Reproduction studies performed in rats and rabbits did not show evidence of teratogenicity. In rats, dose levels of 10 and 30 mg/kg/day increased gestation duration. Prenatal and postnatal pup loss was increased and development retardation occurred. At these doses, dams showed marked signs of muscle relaxation and sedation. Based on body surface area, these doses were 2.2 and 6.7 times the maximum recommended human dose of 0.72 mg/kg/day.<br />\r\n<br />\r\n<strong>Lactation</strong>: Small amounts of tizanidine are excreted in rat milk. Since no human (fata are available Tizanidine should not be given to women who are breast-feeding.<br />\r\n<br />\r\n<strong>Females and males of reproductive potential</strong>: Pregnancy testing:&nbsp; Sexually-active females of reproductive potential are recommended to have a pregnancy test prior to starting treatment with Tizanidine.<br />\r\n<br />\r\n<strong>Contraception</strong>: Females of reproductive potential should be advised that animal studies have been performed showing Tizanidine to be harmful to the developing fetus. Sexually-active females of reproductive potential are recommended to use effective contraception (methods that result in less than 1 % pregnancy rates) when using Tizanidine during treatment and for 1 day after stopping treatment with Tizanidine.<br />\r\n<br />\r\n<strong>Fertility</strong>: Animal data: No impairment of fertility was observed in male rats at a dose of 10 mg/kg/day, and in female rats at a dose of 3 mg/kg/day. Fertility was reduced in male rats receiving 30 mg/kg/day and in female rats receiving 10 mg/kg/day. Based on body surface area, these doses were 6.7 and 2.2 times the maximum recommended human dose of 0.72 mg/kg. At these doses, maternal behavioral effects and clinical signs were observed including marked sedation, weight loss and ataxia.</p>', '<p><strong>CYP inhibitors</strong>: The concomitant use of Tizanidine with moderate CYP1A2 inhibitors is not recommended. Caution should be exercised when Tizanidine is given with drugs known to increase the QT interval.<br />\r\n<br />\r\n<strong>Hypotension</strong>: Hypotension may occur during treatment with Tizanidine and also as a result of drug interactions with CYP1A2 inhibitors and/or antihypertensive drugs. Severe manifestations of hypotension such as loss of consciousness and circulatory collapse have also been observed.<br />\r\n<br />\r\n<strong>Withdrawal syndrome</strong>: Rebound hypertension and tachycardia have been observed after sudden withdrawal of Tizanidine, when it had been used chronically, and/or in high daily dosages, and/or concomitantly with antihypertensive drugs. In extreme cases, rebound hypertension might lead to cerebrovascular accident. Tizanidine should not be stopped abruptly, but rather gradually down titrated.<br />\r\n<br />\r\n<strong>Hepatic dysfunction</strong>: Since hepatic dysfunction has been reported in association with tizanidine, but rarely at daily doses up to 12 mg, it is recommended that liver function tests should be monitored monthly for the first four months in patients receiving doses of 12 mg and higher and in patients who develop clinical symptoms suggestive of hepatic dysfunction, such as unexplained nausea, anorexia or tiredness. Treatment with Tizanidine should be discontinued if serum levels of SGPT or SGOT are persistently above three times the upper limit of the normal range.<br />\r\n<br />\r\n<strong>Patients with renal impairment</strong>: In patients with renal impairment (creatinine clearance &lt;25 mL/min) systemic exposure to tizanidine may increase up to 6 times compared to patient with normal renal function. Therefore, it is recommended to start treatment at 2 mg once daily.<br />\r\n<br />\r\n<strong>Hypersensitivity reactions</strong>: Hypersensitivity reactions including anaphylaxis, angioedema, dermatitis, rash, urticarial, pruritis and erythema have been reported in association with tizanidine. Careful observation of the patient is recommended for one to two days after the first dose is administered. If anaphylaxis or angioedema with anaphylactic shock or difficulty of breathing is observed treatment with Tizanidine should be discontinued immediately and appropriate medical treatment should be instituted.<br />\r\n<br />\r\n<strong>Driving and using machines</strong>: Patients experiencing somnolence, dizziness or any signs or symptoms of hypotension should refrain from activities requiring a high degree of alertness, e.g. driving a vehicle or operating machines.</p>', '<p>In the few reports of Tizanidine overdosage received, recovery was uneventful, including by a patient who ingested 400 mg Tizanidine. Nausea, vomiting, hypotension, QT(c) prolongation, dizziness, somnolence, miosis, restlessness, respiratory distress, coma. It is recommended to eliminate the ingested drug by repeated administration of high doses of activated charcoal. Forced diuresis is expected to accelerate the elimination of Tizanidine. Further treatment should be symptomatic.</p>', '<p>Centrally acting Skeletal Muscle Relaxants.</p>', '<p>Store in a dry place below 30&deg;C. Tizanidine must be kept out of the reach and sight of children.</p>', '<p><strong>Renal impairment</strong>&nbsp;(creatinine clearance &lt;25 mL/min): Maximal mean plasma levels were found to be twice as high as in normal volunteers, and the terminal half-life was prolonged to approximately 14 hours, resulting in much higher (approximately 6-fold on average) AUC values.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: No specific studies were conducted in this population. As tizanidine is extensively metabolized in the liver by the CYP1A2 enzyme, hepatic impairment may increase its systemic exposure. Tizanidine is contraindicated in patients with severe hepatic impairment.<br />\r\n<br />\r\n<strong>Geriatrics</strong>&nbsp;(65 years of age and older): Pharmacokinetic data in this population are limited.<br />\r\n<br />\r\n<strong>Gender</strong>: Gender has no clinically significant effect on the pharmacokinetics of tizanidine.<br />\r\n<br />\r\n<strong>Ethnicity</strong>: The impact&nbsp;of ethnic sensitivity and race on the pharmacokinetics of tizanidine has not been studied.</p>', '2022-03-21 20:40:12', '2022-03-21 20:40:12'),
(1499, 1499, '<p>Tobramycin Respirator Solution is indicated for the management of cystic fibrosis patients with Pseudomonas aeruginosa. Also indicated for severe COPD patients colonized with Pseudomonas aeruginosa. Safety and efficacy have not been demonstrated in patients below the age of 6 years, patients with a forced expiratory volume &lt;25% or &gt;75% predicted, or patients colonized with Burkholderia cepacia.</p>', '<p>Tobramycin interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal subunits, resulting in a defective bacterial cell membrane.</p>', '<p>The recommended dosage for, both adult and paediatric patients, 6 years of age and older, is one single-use ampoule (300 mg) administered b.i.d for 28 days. Dosage is not adjusted by weight.<br />\r\n<br />\r\nThe doses should be taken as close to 12 hours apart as possible; they should not be taken less than 6 hours apart.<br />\r\n<br />\r\nIf you are taking several medications, the recommended order is as follows: bronchodilator first, followed by chest physiotherapy, then other inhaled medications and finally Tobramycin.<br />\r\n<br />\r\nYou should take Tobramycin in repeated cycles of 28 days on drug, followed by 28 days off drug. You should take Tobramycin twice a day during the 28 day period on drug.</p>', '<p>Patients taking Tobramycin&nbsp;concomitantly with beta agonists, inhaled corticosteroids, other anti pseudomonal antibiotics or parenteral aminoglycosides demonstrated adverse experience profiles.</p>', '<p>Tobramycin is contraindicated in patients with a known hypersensitivity to any aminoglycoside.</p>', '<p>Inhaled Tobramycin is generally well-tolerated. Voice alterations and tinnitus are more common in the on-drug periods. However all the episodes are transient and resolved without discontinuation of the regimen. Others like dizziness and increase in serum creatinine were similar to those occurring with placebo.</p>', '<p>If you are a nursing mother, pregnant or want to become pregnant, ask your doctor about the possibility of Tobramycin causing any harm.</p>', '<p>It should be used with care in patients with known or suspected renal, auditory, vestibular, or neuromuscular dysfunction. Patients receiving concomitant aminoglycoside therapy should be monitored as clinically appropriate. It must be used with caution in patients with ototoxicity and nephrotoxicity. Discuss the use of Tobramycin with your doctor if you have kidney problems or changes in hearing.&nbsp;Respirator Solution must only be used by inhalation from a nebulizer and must not be injected or swallowed.</p>', '<p><strong>Symptoms</strong>: Nephrotoxicity, auditory and vestibular toxicity (e.g. dizziness, tinnitus, vertigo, loss of high-tone hearing acuity), neuromuscular blockade or resp failure.<br />\r\n<br />\r\n<strong>Management</strong>: Initiate resuscitative measures if resp paralysis occurs. Ca salts may be given to reverse neuromuscular blockade. Haemodialysis or peritoneal dialysis will help remove drug serum levels.</p>', '<p>Aminoglycosides.</p>', '<p>Store under refrigeration at 2-8&deg; C, and protected from light. Slight color change when unrefrigerated do not indicate any change in the quality of the product. The preparation must not be used if it is cloudy, particles appear in the solution or has been stored at room temperature for over 28 dyas. For use only under the prescription of a registered physician. Do not use Tobasol&reg; beyond the expiration date stamped on the ampoule.</p>', '<p><strong>Renal Impairment</strong>: Inhalation: Dosage adjustment needed.</p>', '2022-03-21 20:42:05', '2022-03-21 20:42:05');
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
(1500, 1500, '<p>Tobramycin is a topical antibiotic indicated in the treatment of external bacterial infections of the eye caused by susceptible organisms. Such as,<br />\r\n<br />\r\n<strong>Gram-positive bacteria</strong>: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus spp. of group A beta-hemolytic and some nonhemolytic species.<br />\r\n<br />\r\n<strong>Gram-negative bacteria</strong>: E.coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella spp., Proteusmirabillis, Proteus vulgaris, Haemophilus influenzae, Morganella morganii, Acinetobacter calcoaceticus, Providentia, Serratia, Salmonella spp and some strains of Neisseria.</p>', '<p>Like other aminoglycosides, the bactericidal activity of Tobramycin is taken up into sensitive bacterial cells by an active transport process. Within the cell Tobramycin bind to the 30s, and to some extent to the 50s subunits of the bacterial ribosome, inhibiting protein synthesis and generating errors in the transcription of the genetic code. The manner in which cell death is brought about is imperfectly understood, and other mechanisms may contribute, including effects on membrane permeability.</p>', '<p><strong>Ophthalmic ointment</strong>:</p>\r\n\r\n<ul>\r\n	<li>In mild to moderate infection, apply a small amount 2-3 times daily into the conjunctival sac(s).</li>\r\n	<li>In severe cases of infection, apply a small amount 3-4 times daily into the conjunctival sac(s) until improvement is obtained, then reduce the dose gradually.</li>\r\n</ul>\r\n\r\n<p><strong>Ophthalmic solution</strong>:</p>\r\n\r\n<ul>\r\n	<li>In mild to moderate infections: Instill 1or 2 drops into the affected eye(s) every 4 hours.</li>\r\n	<li>In severe infections: Instill 2 drops into the affected eye(s) every hour until improvement is observed.</li>\r\n</ul>\r\n\r\n<p><strong>Pediatric use</strong>: Safety and effectiveness in children below the age of 1 year have not been established.</p>', '<p>Care should be exercised when tobramycin is given to patients receiving other drugs with neuromauscular blocking agents or ototoxic.</p>', '<p>It is contraindicated in patients who are hypersensitive to Tobramycin or any of the ingredients of the preparation.</p>', '<p>The most frequent side effect of Tobramycin ophthalmic solution is localized ocular toxicity, conjunctival erythema, hypersensitivity including lid itching and swelling.</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should only be used during pregnancy, if the potential benefits outweigh the possible risk to the fetus. Drug may excreted into human milk. A decision should be made whether to discontinue nursing or to taking the drug.</p>', '<p>Minor sensitivity may occur to topically applied aminoglycosides in some patients. If a sensitivity reaction occurs, discontinue use. Prolonged use may result in overgrowth of nonsusceptible organisms and fungi.</p>', '<p>Sign and symptoms of overdose may be similar to side effects as described above.</p>', '<p>Ophthalmic antibacterial drugs</p>', '<p>Protect from light, store in cool (below 25&deg;C) &amp; dry place. Keep out of reach of children. Used within 4 weeks after first opening.</p>', NULL, '2022-03-21 20:43:59', '2022-03-21 20:43:59'),
(1501, 1501, '<p>Tocilizumab is an interleukin-6 (IL-6) receptor antagonist indicated for treatment of:</p>\r\n\r\n<ul>\r\n	<li><strong>Rheumatoid Arthritis (RA)</strong>: Adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more Disease-Modifying Anti-Rheumatic Drugs (DMARDs).</li>\r\n	<li><strong>Giant Cell Arteritis (GCA)</strong>:&nbsp;Adult patients with giant cell arteritis.</li>\r\n	<li><strong>Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)</strong>: Slowing the rate of decline in pulmonary function in adult patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD)</li>\r\n	<li><strong>Polyarticular Juvenile Idiopathic Arthritis (PJIA)</strong>: Patients 2 years of age and older with active polyarticular juvenile idiopathic arthritis.</li>\r\n	<li><strong>Systemic Juvenile Idiopathic Arthritis (SJIA)</strong>: Patients 2 years of age and older with active systemic juvenile idiopathic arthritis.</li>\r\n	<li><strong>Cytokine Release Syndrome (CRS)</strong>: Adults and pediatric patients 2 years of age and older with chimeric antigen receptor (CAR) T cell-induced severe or life-threatening cytokine release syndrome.</li>\r\n</ul>', '<p>Tocilizumab binds to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and has been shown to inhibit IL-6-mediated signaling through these receptors. IL-6 is a pleiotropic pro-inflammatory cytokine produced by a variety of cell types including T- and B-cells, lymphocytes, monocytes and fibroblasts. IL-6 has been shown to be involved in diverse physiological processes such as T-cell activation, induction of immunoglobulin secretion, initiation of hepatic acute phase protein synthesis, and stimulation of hematopoietic precursor cell proliferation and differentiation. IL-6 is also produced by synovial and endothelial cells leading to local production of IL-6 in joints affected by inflammatory processes such as rheumatoid arthritis.</p>', '<p><strong>Rheumatoid Arthritis</strong>: Recommended Adult Intravenous Dosage: When used in combination with DMARDs or as monotherapy the recommended starting dose is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response.</p>\r\n\r\n<ul>\r\n	<li><strong>Patients less than 100 kg weight</strong>: 162 mg administered subcutaneously every other week, followed by an increase to every week based on clinical response</li>\r\n	<li><strong>Patients at or above 100 kg weight</strong>: 162 mg administered subcutaneously every week.</li>\r\n</ul>\r\n\r\n<p><strong>Giant Cell Arteritis</strong>: Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with GCA is 162 mg given once every week as a subcutaneous injection, in combination with a tapering course of glucocorticoids. A dose of 162 mg given once every other week as a subcutaneous injection, in combination with a tapering course of glucocorticoids, may be prescribed based on clinical considerations. tocilizumab can be used alone following discontinuation of glucocorticoids. tocilizumab subcutaneous formulation is not intended for intravenous administration.<br />\r\n<br />\r\n<strong>Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)</strong>: Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with SSc-ILD is 162 mg given once every week as a subcutaneous injection.<br />\r\n<br />\r\n<strong>Polyarticular Juvenile Idiopathic Arthritis</strong><br />\r\nRecommended Intravenous PJIA Dosage Every 4 Weeks-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 10 mg per kg</li>\r\n	<li>Patients at or above 30 kg weight: 8 mg per kg</li>\r\n</ul>\r\n\r\n<p>Recommended Subcutaneous PJIA Dosage-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 162 mg once every three weeks</li>\r\n	<li>Patients at or above 30 kg weight: 162 mg once every two weeks</li>\r\n</ul>\r\n\r\n<p><strong>Systemic Juvenile Idiopathic Arthritis</strong><br />\r\nRecommended Intravenous SJIA Dosage Every 2 Weeks-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 12 mg per kg</li>\r\n	<li>Patients at or above 30 kg weight: 8 mg per kg</li>\r\n</ul>\r\n\r\n<p>Recommended Subcutaneous SJIA Dosage-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight 162 mg every two weeks</li>\r\n	<li>Patients at or above 30 kg weight 162 mg every week</li>\r\n</ul>\r\n\r\n<p><strong>Cytokine Release Syndrome</strong><br />\r\nRecommended Intravenous CRS Dosage-</p>\r\n\r\n<ul>\r\n	<li>Patients less than 30 kg weight: 12 mg per kg</li>\r\n	<li>Patients at or above 30 kg weight: 8 mg per kg</li>\r\n</ul>\r\n\r\n<p>Alone or in combination with corticosteroids.<br />\r\n<br />\r\n<strong>General Dosing Information</strong>:</p>\r\n\r\n<ul>\r\n	<li>It is recommended that tocilizumab not be initiated in patients with an absolute neutrophil count (ANC) below 2000 per mm3, platelet count below 100,000 per mm3, or who have ALT or AST above 1.5 times the upper limit of normal (ULN).</li>\r\n	<li>tocilizumab doses exceeding 800 mg per infusion are not recommended in RA or CRS patients.</li>\r\n</ul>', '<p><strong>Interactions with CYP450 Substrates</strong>: Cytochrome P450s in the liver are down-regulated by infection and inflammation stimuli including cytokines such as IL-6. Inhibition of IL-6 signaling in RA patients treated with tocilizumab may restore CYP450 activities to higher levels than those in the absence of tocilizumab leading to increased metabolism of drugs that are CYP450 substrates. In vitro studies showed that tocilizumab has the potential to affect expression of multiple CYP enzymes including CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6 and CYP3A4. Its effect on CYP2C8 or transporters is unknown. In vivo studies with omeprazole, metabolized by CYP2C19 and CYP3A4, and simvastatin, metabolized by CYP3A4, showed up to a 28% and 57% decrease in exposure one week following a single dose of tocilizumab, respectively. The effect of tocilizumab on CYP enzymes may be clinically relevant for CYP450 substrates with narrow therapeutic index, where the dose is individually adjusted. Upon initiation or discontinuation of tocilizumab, in patients being treated with these types of medicinal products, perform therapeutic monitoring of effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) and the individual dose of the medicinal product adjusted as needed. Exercise caution when coadministering tocilizumab with CYP3A4 substrate drugs where decrease in effectiveness is undesirable, e.g., oral contraceptives, lovastatin, atorvastatin, etc. The effect of tocilizumab on CYP450 enzyme activity may persist for several weeks after stopping therapy.</p>', '<p>Hypersensitivity to tocilizumab or to any of the excipients.</p>', '<p>Most common adverse reactions (incidence of at least 5%): upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions.</p>', '<p>Based on animal data, may cause fetal harm. Discontinue drug or nursing taking into consideration importance of drug to mother.</p>', '<ul>\r\n	<li>Serious Infections- do not administer tocilizumab during an active infection, including localized infections. If a serious infection develops, interrupt tocilizumab until the infection is controlled.</li>\r\n	<li>Gastrointestinal (GI) perforation- use with caution in patients who may be at increased risk.</li>\r\n	<li>Hepatotoxicity- Monitor patients for signs and symptoms of hepatic injury. Modify or discontinue tocilizumab if abnormal liver tests persist or worsen or if clinical signs and symptoms of liver disease develop.</li>\r\n	<li>Laboratory monitoring- recommended due to potential consequences of treatment-related changes in neutrophils, platelets, lipids, and liver function tests.</li>\r\n	<li>Hypersensitivity reactions, including anaphylaxis and death have occurred.</li>\r\n	<li>Live vaccines- Avoid use with tocilizumab.</li>\r\n</ul>', '<p>There are limited data available on overdoses with tocilizumab. One case of accidental overdose was reported with intravenous tocilizumab in which a patient with multiple myeloma received a dose of 40 mg per kg. No adverse drug reactions were observed. No serious adverse drug reactions were observed in healthy volunteers who received single doses of up to 28 mg per kg, although all 5 patients at the highest dose of 28 mg per kg developed dose-limiting neutropenia. In case of an overdose, it is recommended that the patient be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate symptomatic treatment.</p>', '<p>Drugs used for Rheumatoid Arthritis.</p>', '<p>Tocilizumab must be refrigerated at 2&ordm;C to 8&ordm;C. Do not freeze. Protect the vials, syringes, and autoinjectors from light by storage in the original package until time of use, and keep syringes and autoinjectors dry.</p>', NULL, '2022-03-21 20:46:05', '2022-03-21 20:46:05'),
(1502, 1502, '<p><strong>Rheumatoid Arthritis</strong>: Tofacitinib is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate. It may be used as monotherapy or in combination with methotrexate or other nonbiologic disease-modifying antirheumatic drugs (DMARDs).<br />\r\n<br />\r\n<strong>Psoriatic Arthritis</strong>: Tofacitinib is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).<br />\r\n<br />\r\n<strong>Ulcerative Colitis</strong>: Tofacitinib is indicated for the treatment of adult patients with moderately to severely active ulcerative colitis (UC).</p>', '<p>Rheumatoid arthritis is an autoimmune disease characterized by a dysregulation of pro-inflammatory cytokines including IL7, IL15, IL21, IL6, IFN-alpha, and IFN-beta. (3) Cytokines signalling results in tissue inflammation and joint damage by stimulating the recruitment and activation of immune cells via the janus kinase signalling pathway.<br />\r\n<br />\r\nTofacitinib is a partial and reversible janus kinase (JAK) inihibitor that will prevent the body from responding to cytokine signals. By inhibiting JAKs, tofacitinib prevents the phosphorylation and activation of STATs. The JAK-STAT signalling pathway is involved in the transcription of cells involved in hematopoiesis, and immune cell function. Tofacitinib works therapeutically by inhibiting the JAK-STAT pathway to decrease the inflammatory response. However, there is evidence to suggest that it may also achieve efficacy via other pathways as well.</p>', '<p><strong>Rheumatoid Arthritis</strong>: Tofacitinib 5 mg twice daily or Tofacitinib 11 mg once daily.&nbsp;Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacitinib 5 mg once daily.<br />\r\n<br />\r\n<strong>Psoriatic Arthritis&nbsp;</strong>(in combination with nonbiologic DMARDs): Tofacitinib 5 mg twice daily or Tofacitinib 11 mg once daily.&nbsp; Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment is Tofacitinib 5 mg once daily.<br />\r\n<br />\r\n<strong>Ulcerative Colitis</strong>: Tofacitinib 10 mg twice daily for at least 8 weeks; then 5 or 10 mg twice daily. Discontinue after 16 weeks of 10 mg twice daily, if adequate therapeutic benefit is not achieved. Use the lowest effective dose to maintain response.</p>', '<ul>\r\n	<li>Potent inhibitors of Cytochrome P450 3A4 (CYP3A4) (e.g., Ketoconazole)</li>\r\n	<li>Recommended dose is Tofacitinib 5 mg once daily: One or more concomitant medications that result in both moderate inhibition of CYP3A4 and potent inhibition of CYP2C19 (e.g., fluconazole)</li>\r\n	<li>Recommended dose is Tofacitinib 5 mg once daily Potent CYP inducers (e.g.Rifampin): May result in loss of or reduced clinical response.</li>\r\n</ul>', NULL, '<p>The most commonly reported adverse reactions during the first 3 months in controlled clinical trials (occurring in greater than or equal to 2% of patients treated with Tofacitinib monotherapy or in combination with DMARDs) were upper respiratory tract infections, headache, diarrhea and nasopharyngitis.</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Tofacitinib 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 Tofacitinib 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 from Tofacitinib, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug for the mother</p>', '<ul>\r\n	<li>Serious Infections: Avoid use of Tofacitinib during an active serious infection, including localized infections.&nbsp;</li>\r\n	<li>Gastrointestinal Perforations: Use with caution in patients that may be at increased risk.</li>\r\n	<li>Laboratory Monitoring: Recommended due to potential changes in lymphocytes, neutrophils, hemoglobin, liver enzymes and lipids.</li>\r\n	<li>Immunizations: Live vaccines: Avoid use with Tofacitinib.</li>\r\n	<li>Do not initiate Tofacitinib&nbsp;if absolute lymphocyte count &lt;500 cells/mm3, an absolute neutrophil count (ANC) &lt;1000 cells/mm3 or hemoglobin &lt;9 gm/dL.</li>\r\n</ul>', NULL, '<p>Immunosuppressant</p>', '<p>Store below 30&deg;C. Protect from light &amp; moisture. Keep all medicines out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Tofacitinib in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: The frequency of serious infection among Tofacitinib-treated subjects 65 years of age and older was higher than among those under the age of 65. As there is a higher incidence of infections in the elderly population in general, caution should be used when treating the elderly.<br />\r\n<br />\r\n<strong>Moderate and severe renal impairment or moderate hepatic impairment</strong>: half the total daily dosage recommended for patients with normal renal and hepatic function.</p>', '2022-03-21 23:33:13', '2022-03-21 23:33:13'),
(1503, 1503, '<p>Tolfenamic acid is used specifically for relieving the pain of migraine headache and also recommended for use as an analgesic in post-operative pain and fever.</p>', '<p>Tolfenamic acid (N-(2-methyl-3-chlorophenyl) anthranilic acid) belongs to the fenamate group and is a potent inhibitor of cyclooxygenase enzyme, thus it inhibits the synthesis of important inflammatory mediators such as thromboxane (TX) B2 and prostaglandin (PG) E2. Prostaglandins are responsible for causing swelling pain and inflammation associated with these conditions. It acts not only by inhibiting prostaglandin synthesis, but it also has direct antagonistic action on its receptors.<br />\r\n<br />\r\nPharmacokinetic properties: Absorption Readily absorbed from GI tract. Peak plasma concentration: 60-90 min. Bioavailability 85%. Distribution: Protein-binding: 99% Plasma half-life 2 hours. Metabolism: Metabolised in the liver. Tolfenamic acid undergoes enterohepatic circulation. Excretion: Excreted in urine (90%) and faces.</p>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>Acute migraine attacks</strong>: 200 mg when symptoms appear may be repeated once after 1-2 hour.</li>\r\n	<li><strong>Mild to moderate pain</strong>: 100-200 mg tid</li>\r\n	<li><strong>Renal impairment</strong>: Dose adjustments may be needed.</li>\r\n	<li><strong>Severe renal impairment</strong>: Avoid.</li>\r\n</ul>\r\n\r\n<p>Children: A pediatric dosage regimen has not yet been established.<br />\r\n<br />\r\nTolfenamic acid should be taken with food. Take water during or immediately after meals.</p>', '<p>The rate of absorption of Tolfenamic acid increases with Metoclopramide and Magnesium hydroxide but decreases with Aluminium hydroxide. Risk of bleeding with anticoagulants and other NSAIDS increases when use with Tolfenamic acid. It decreases antihypertensive response to loop diuretics, B-blockers and ACE Inhibitors. Co-administration increases plasma concentration of Lithium Methotrexate and cardiac glycosides. It also increases the risk of nephrotoxicity with ACE inhibitors, Ciclosporin, Tacrolimus or diuretics</p>', '<p>Active peptic ulcer or bleeding in the gut. Severe heart, kidney or liver failure.</p>', '<p>Dysuria especially in males, diarrhoea, nausea epigastric pain, vomiting, dyspepsia, erythema, headache, tremor, euphoria, fatigue, pulmonary infiltration &amp; haematuria. Potentially fatal: Blood dyscrasias and hepatitis.</p>', '<p>This medicine is not recommended for using during pregnancy unless considered essential by doctor Not to be given during the third trimester of pregnancy. NSAID&#39;s can appear in breast milk in very low concentrations NSAID&#39;s should, if possible, be avoided when breastfeeding.</p>', '<p>Precaution should be needed for patients with asthma bronchospasm, bleeding disorders, cardiovascular diseases, peptic ulceration, hypertension, liver infection, cardiac or renal function impairment and elderly. Increase water intake or dose reduction to reduce dysuria.</p>', '<p>Symptoms include headache, nausea, vomiting, epigastric pain. gastrointestinal bleeding, diarrhoea excitation, coma, drowsiness dizziness, tinnitus, fainting and convulsions. In cases of significant poisoning, acute renal failure and liver damage are possible. Patients should be treated symptomatically as required.</p>', '<p>Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs), Other drugs for migraine.</p>', '<p>Store in a cool and dry place, away from light Keep out of the reach of children.</p>', NULL, '2022-03-21 23:34:42', '2022-03-21 23:34:42'),
(1504, 1504, '<p>Tolnaftate is used to treat&nbsp;skin&nbsp;infections such as&nbsp;athlete&#39;s foot,&nbsp;jock itch, and&nbsp;ringworm. It is an&nbsp;antifungal&nbsp;that works by preventing the growth of&nbsp;fungus.</p>', '<p>Tolnaftate is an antifungal which inhibits growth of dermatophytes e.g. Epidermophyton, Microsporum, trichophyton spp, and Malassezia furfur by distorting the hyphae and stopping mycelial growth. It is inactive against Candida spp or bacteria.</p>', '<p>Use this&nbsp;medication&nbsp;on the&nbsp;skin&nbsp;only. Clean and thoroughly dry the area to be treated. Apply this medication to the affected skin, usually twice a day or as directed on the product package or by your doctor. Dosage and length of treatment depends on the type of infection being treated.<br />\r\n<br />\r\nSome forms of tolnaftate (e.g., powder) need to be shaken before applying. Check your product package to see if your form of this medication needs to be shaken. Apply enough medication to cover the affected area and some of the surrounding skin. After applying this medication,&nbsp;wash your hands. Do not wrap, cover, or bandage the area unless directed to do so by your doctor.<br />\r\n<br />\r\nUse this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day.<br />\r\n<br />\r\nContinue to use this medication until the full prescribed amount is finished, even if symptoms disappear after starting tolnaftate. Stopping the medication too early may allow the&nbsp;fungus&nbsp;to continue to grow, which may result in a relapse of the infection.<br />\r\n<br />\r\nInform your doctor if your condition persists after 2 weeks of treatment for&nbsp;jock itch, after 4 weeks of treatment for&nbsp;athlete&#39;s foot&nbsp;or&nbsp;ringworm, or if your condition worsens at any time.</p>', NULL, '<p>Hypersensitivity. Nail and scalp infections.&nbsp;Do not apply this medication in the&nbsp;eyes, nose,&nbsp;mouth, or&nbsp;vagina.</p>', '<p>Irritation of the treated&nbsp;skin&nbsp;may occur. If this effect persists or worsens, notify your doctor or&nbsp;pharmacist&nbsp;promptly.<br />\r\n<br />\r\nIf your doctor has directed you to use this&nbsp;medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.<br />\r\n<br />\r\nA very serious&nbsp;allergic reaction&nbsp;to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious&nbsp;allergic reaction&nbsp;may include:&nbsp;rash,&nbsp;itching/swelling (especially of the face/tongue/throat), severe&nbsp;dizziness,&nbsp;trouble breathing.<br />\r\n<br />\r\nThis is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.</p>', '<p>Tolnaftate topical has not been formally assigned to a pregnancy category by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancy. Tolnaftate topical is only recommended for use during pregnancy when benefit outweighs risk.&nbsp;There are no data on the excretion of tolnaftate topical into human milk.</p>', '<p>Before using tolnaftate, tell your doctor or&nbsp;pharmacist&nbsp;if you are allergic to it; or if you have any other&nbsp;allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.<br />\r\n<br />\r\nBefore using this&nbsp;medication, tell your doctor or pharmacist your medical history, especially of:&nbsp;immune system&nbsp;problems (e.g.,&nbsp;organ transplant,&nbsp;HIV&nbsp;disease),&nbsp;diabetes.<br />\r\n<br />\r\nThis medication should be used only if clearly needed during&nbsp;pregnancy. Discuss the risks and benefits with your doctor.<br />\r\n<br />\r\nIt is not known whether this drug passes into&nbsp;breast&nbsp;milk. Consult your doctor before&nbsp;breast-feeding.</p>', NULL, '<p>Other Antifungal preparations</p>', '<p>Store at 15-30&deg; C.</p>', NULL, '2022-03-21 23:36:14', '2022-03-21 23:36:14'),
(1505, 1505, '<p>Increased tone of skeletal muscles due to organic neurological disorders (e.g. injury of the pyramidal tract, multiple sclerosis, myelopathy, encephalomyelitis etc.), muscular hypertension, muscular spasm, muscular contracture, rigidity, spinal automatism and discopathy, obliterative vascular diseases (obliterative arteriosclerosis, diabetic angiopathy, obliterative thromboangitis, Raynaud&#39;s disease, diffuse scleroderma) and disorders due to injured innervation of the vessels (acrocyanosis, intermittent angioneurotic dysbasia). In individual cases, post-thrombotic venous and lymphatic circulation disorders, crural ulcer.</p>', '<p>Tolperisone Hydrochloride is a centrally acting muscle relaxant. It effectively reduces muscular hypertonicity, improves peripheral blood flow by vasodilatation and reduces pain. Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action.</p>', '<p>The usual dose is one ampoule twice daily by intramuscularly. Injection should be given slowly. Accordingly to age and symptom, the dosage may be changed.</p>', NULL, '<p>Hypersensitivity to any component of the product, Myasthenia gravis, Nursing mother.</p>', '<p>Sometimes, muscular weakness, headache, nausea, vomiting and rarely hypersensitivity reactions may occur as side effects.</p>', '<p>Tolperisone hydrochloride should be used in pregnancy according to physician&#39;s advice. Tolperisone hydrochloride should not be used during breast feeding.</p>', '<p>In case of children, the prescribed dose and duration of treatment should closely be observed.</p>', '<p>In the event of over dosage, supportive therapy may be substituted.</p>', '<p>Centrally acting Skeletal Muscle Relaxants, Locally acting Skeletal Muscle Relaxants.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 23:37:44', '2022-03-21 23:37:44'),
(1506, 1506, '<p>Tolperisone Hydrochloride is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Treatment of increased tone of skeletal muscles due to organic neurological disorders (injury of the pyramidal tract, multiple sclerosis, myelopathy, encephalomyelitis).</li>\r\n	<li>Treatment of muscular spasm, muscular contracture, rigidity, spinal automatism.</li>\r\n	<li>In the treatment of vascular diseases (Obliterative arteriosclerosis, diabetic angiopathy, obliterative thromboangitis, Raynaud&#39;s disease, diffuse scleroderma).</li>\r\n	<li>In individual cases, post-thrombotic venous and lymphatic circulation disorders and crural ulcer.</li>\r\n</ul>', '<p>Tolperisone Hydrochloride is a centrally acting muscle relaxant, which acts on the central nervous system and used mainly for the treatment of elevated muscle tone and tension as well as for certain circulation problems in the extremities.</p>', '<p>The recommended dose is as follows:</p>\r\n\r\n<ul>\r\n	<li>Adult: 50-150 mg three times daily according to the individual requirement and tolerance of the patient.</li>\r\n	<li>Children (from 3 months to 6 years): 5 mg/kg/day in three divided doses.</li>\r\n	<li>Children (from 6 to 14 years): 2-4 mg/kg/day in three divided doses. or, as directed by the registered physician.</li>\r\n</ul>', '<p>Concomitant use of methocarbamol with Tolperisone Hydrochloride has been reported to cause disturbance of visual accommodation.</p>', '<p>It is contraindicated in patients with a history of hypersensitivity to any component of the product, myasthenia gravis and nursing mother.</p>', '<p>Possible side-effects include sometimes muscular weakness, headache, nausea, vomiting and rarely hypersensitivity reactions (itching, redness of the skin, skin rash) may occur.</p>', '<p>Tolperisone Hydrochloride should be used in pregnancy according to the physician&#39;s advice. It should not be used during breast feeding.</p>', '<p>In case of children, the prescribed dose and duration of treatment should closely be observed.</p>', NULL, '<p>Central Depolarizing muscle relaxants, Centrally acting Skeletal Muscle Relaxants.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-21 23:42:29', '2022-03-21 23:42:29'),
(1507, 1507, '<p>Tolterodine Tartrate is indicated for the treatment of overactive bladder with symptoms of urinary urgency, frequency, and/or urge incontinence.</p>', '<p>Tolterodine is a competitive, specific muscarinic receptor antagonist which exhibits a selectivity for the urinary bladder over salivary glands, which have been demonstrated in non clinical pharmacological in vivo studies. Tolterodine has a high specificity for muscarinic receptors. A major active metabolite (5-hydroxymethyl derivative) of tolterodine exhibits a pharmacological profile which is similar to that of the parent compound. In extensive metabolisers this metabolite contributes significantly to the therapeutic effect of tolterodine. The effect of treatment can be expected within 4 weeks.</p>', '<p>The recommended dose for tolterodine is 2 mg twice daily. In case of troublesome side effects the dose may be reduced from 2 mg to 1 mg twice daily.<br />\r\n<br />\r\nThe recommended total daily dose of tolterodine is 2 mg (1 mg b.i.d.) for patients with impaired renal function, impaired liver function, or receiving concomitant medication with potent CYP3A inhibitors, such as macrolide antibiotics (e.g. erythromycin and clarithromycin) or azole antifungal agents (e.g. ketoconazole, itraconazole and miconazole). After six months the need for further treatment should be considered.</p>', '<p>Pharmacokinetic interactions are possible with other drugs metabolised by or inhibiting cytochrome P450 2D6 (CYP2D6) or CYP3A4. Concomitant treatment with fluoxetine does not result in a clinically significant interaction.<br />\r\n<br />\r\nKetoconazole, a potent inhibitor of CYP3A, significantly increased plasma concentrations of tolterodine when coadministered to poor metabolisers (i.e. persons devoid of CYP2D6 metabolic pathway).<br />\r\n<br />\r\nClinical studies have shown no interactions with warfarin or combined oral contraceptives (ethinyloestradiol or levonorgestrel).</p>', '<p>Tolterodine is contraindicated in those patients with urinary retention, uncontrolled narrow angle glaucoma, known hypersensitivity to tolterodine or any other component of the drug.</p>', '<p>Tolterodine may cause mild to moderate antimuscarinic effects, like dryness of mouth, dyspepsia and/or reduced lacrimation.</p>', '<p>There are no studies in pregnant women. Therefore, tolterodine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nUse of tolterodine during lactation should be avoided since no data on excretion of the drug into breast milk in humans is available.</p>', '<p>Tolterodine should be used with caution in the following patients:</p>\r\n\r\n<ul>\r\n	<li>at risk for urinary retention</li>\r\n	<li>at risk for decreased gastrointestinal motility</li>\r\n	<li>with impaired renal function</li>\r\n	<li>with impaired hepatic function</li>\r\n</ul>\r\n\r\n<p>Organic reasons for urge and frequency should be considered before treatment.</p>', '<p>Overdosage with Tolterodine Tartrate capsules can potentially result in severe central anticholinergic effects and should be treated accordingly. ECG monitoring is recommended in the event of overdosage.</p>', '<p>BPH/ Urinary retention/ Urinary incontinence.</p>', '<p>Store in a cool and dry place. Protect from light. Keep out of the reach of children.</p>', '<p><strong>Pediatric use:</strong>&nbsp;Safety and effectiveness of tolterodine in children have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences in safety were observed between the older and younger&nbsp;patients treated with Tolterodine.</p>', '2022-03-21 23:44:15', '2022-03-21 23:44:15'),
(1508, 1508, '<p>Tolvaptan is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Hypervolemic or euvolemic hyponatremia.</li>\r\n	<li>Autosomal dominant polycystic kidney disease.</li>\r\n</ul>', '<p>Tolvaptan is a selective vasopressin V2-receptor antagonist. Tolvaptan affinity for the V2-receptor is 29 times greater than for the V1a-receptor. When taken orally, 15 to 60 mg doses of Tolvaptan antagonize the effect of vasopressin and cause an increase in urine water excretion that results in an increase in free water clearance (aquaresis), a decrease in urine osmolality, and a resulting increase in serum sodium concentrations. Urinary excretion of sodium and potassium and plasma potassium concentrations are not significantly changed.</p>', '<p><strong>Hypervolemic or euvolemic hyponatremia</strong>: The usual starting dose for Tolvaptan is 15 mg administered once daily without regard to meals. Increase the dose to 30 mg once daily, after at least 24 hours, to a maximum of 60 mg once daily, as needed to achieve the desired level of serum sodium. Do not use for more than 30 days due to the risk of hepatotoxicity.<br />\r\n<br />\r\n<strong>Autosomal dominant polycystic kidney disease (ADPKD)</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initially: 60 mg/day in divided doses (given as 45 mg upon wakening and 15 mg 8 hours later);</li>\r\n	<li>Titrate per response and tolerability at intervals of at least 7 days between titrations to 90 mg/day in divided doses (given as 60 mg upon wakening and 30 mg 8 hours later) followed by 120 mg/day in divided doses (given as 90 mg upon wakening and 30 mg 8 hours later).</li>\r\n	<li>Maintain urine osmolality of &lt;300 mOsm/kg if possible; if the maximum dose is not tolerated, administration of a lower dose with the goal of achieving urine osmolality of 250 to 300 mOsm/kg is reasonable.</li>\r\n</ul>', '<p>Other Drugs Affecting Exposure to Tolvaptan:</p>\r\n\r\n<ul>\r\n	<li><strong>CYP 3A Inhibitors</strong>: Tolvaptan is a substrate of CYP 3A. CYP 3A inhibitors can lead to a marked increase in Tolvaptan concentrations. Do not use Tolvaptan with strong inhibitors of CYP 3A and avoid concomitant use with moderate CYP 3A inhibitors.</li>\r\n	<li><strong>CYP 3A Inducers</strong>: Avoid co-administration of CYP 3A inducers (e.g., Rifampin, Rifabutin, Rifapentin, Barbiturates, Phenytoin, Carbamazepine) with Tolvaptan, as this can lead to a reduction in the plasma concentration of Tolvaptan and decreased effectiveness of Tolvaptan treatment. If co-administered with CYP 3A inducers, the dose of Tolvaptan may need to be increased.</li>\r\n	<li><strong>P-gp Inhibitors</strong>: The dose of Tolvaptan may have to be reduced when Tolvaptan is co-administered with P-gp inhibitors, e.g., Cyclosporine.</li>\r\n</ul>', '<p>Hypersensitivity to the active substance or to any of the excipients, anuria, volume depletion, hypovolemic hyponatremia, hypernatremia, Patients who cannot perceive thirst, pregnancy, breast-feeding.</p>', '<p>The most common side effects of Tolvaptan are: thirst, dry mouth, weakness, constipation, making large amounts of urine and urinating often &amp; increased blood sugar levels.</p>', '<p>There are no or limited amount of data from the use of Tolvaptan in pregnant women. Studies in animals have shown reproductive toxicity. The potential risk for humans is unknown. Tolvaptan is contraindicated during pregnancy. Women of childbearing potential have to use effective contraception during Tolvaptan treatment. It is unknown whether Tolvaptan is excreted in human milk.</p>', '<p>Too rapid correction of serum sodium can cause serious neurologic sequelae.</p>', '<p>Single doses up to 480 mg and multiple doses up to 300 mg per day for 5 days have been well tolerated in clinical trials in healthy volunteers. There is no specific antidote for Tolvaptan intoxication. The signs and symptoms of an acute overdose can be anticipated to be those of excessive pharmacologic effect: a rise in serum sodium concentration, polyuria, thirst and dehydration/ hypovolemia (profuse and prolonged aquaresis). In patients with suspected Tolvaptan overdose, assessment of vital signs, electrolyte concentrations, ECG and fluid status is recommended. Appropriate replacement of water and/or electrolytes must continue until aquaresis abates. Dialysis may not be effective in removing Tolvaptan because of its high binding affinity for human plasma protein (&gt;98%).</p>', '<p>Selective vasopressin V2-receptor antagonist.</p>', '<p>Store at below 25&deg;C in a dry place, protected from light. Keep out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Tolvaptan in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total number of hyponatremic subjects treated with Tolvaptan in clinical studies, 42% were 65 and over, while 19% were 75 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Increasing age has no effect on Tolvaptan plasma concentrations.<br />\r\n<br />\r\n<strong>Use in Patients with Hepatic Impairment</strong>: Moderate and severe hepatic impairment do not affect exposure to Tolvaptan to a clinically relevant extent. Avoid use of Tolvaptan in patients with underlying liver disease.<br />\r\n<br />\r\n<strong>Use in Patients with Renal Impairment</strong>: No dose adjustment is necessary based on renal function. There are no clinical trial data in patients with CrCl&lt;10 ml/min, and, because drug effects on serum sodium levels are likely lost at very low levels of renal function, use in patients with a CrCl&lt;10 ml/min is not recommended. No benefit can be expected in patients who are anuric.<br />\r\n<br />\r\n<strong>Use in Patients with Congestive Heart Failure</strong>: The exposure to Tolvaptan in patients with congestive heart failure is not clinically relevantly increased. No dose adjustment is necessary.</p>', '2022-03-21 23:46:25', '2022-03-21 23:46:25');
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
(1509, 1509, '<p><strong>Epilepsy</strong>: Topiramate is indicated as monotherapy in adults and children aged 6 years and above with newly diagnosed epilepsy who have generalised tonic-clonic seizures or partial seizures with or without secondarily generalised seizures. Topiramate is indicated as adjunctive therapy for adults and children over 2 years of age who are inadequately controlled on conventional first line antiepileptic drugs for partial seizures with or without secondarily generalised seizures; seizures associated with Lennox Gastaut Syndrome and primary generalised tonic-clonic seizures.<br />\r\n<br />\r\n<strong>Migraine</strong>: Topiramate is indicated in adults for the prophylaxis of migraine headache. Prophylactic treatment of migraine may be considered in situations such as: adults experiencing three or more migraine attacks per month; frequent migraine attacks that significantly interfere with the patient&#39;s daily routine. Continuing therapy should be reviewed every six months.</p>', '<p>A seizure is an abnormal and unregulated electrical discharge occurring in the brain. This leads to a transient interruption in brain function, manifested by reduced alertness, abnormal sensations, and focal involuntary movements or convulsions. Several types of seizures exist, with common types including tonic-clonic seizures and partial onset seizures.<br />\r\n<br />\r\nThe exact mechanisms by which topiramate exerts pharmacological actions on seizures and migraines are currently not fully characterized. Several properties of this drug, however, are likely to contribute to its therapeutic effects. Topiramate has been observed to exert actions on voltage-dependent sodium channels, GABA receptors, and glutamate receptors.<br />\r\n<br />\r\nTopiramate stimulates GABA-A receptor activity at brain non-benzodiazepine receptor sites and reduces glutamate activity at both AMPA and kainate receptors. Normally, GABA-A receptors are inhibitory and glutaminergic receptors are stimulatory for neuronal activity. By increasing GABA activity and inhibiting glutamate activity, topiramate blocks neuronal excitability, preventing seizures and migraines. Additionally, it blocks the voltage-dependent sodium channels, further blocking seizure activity. Topiramate has been shown to inhibit various carbonic anhydrase isozymes, but the clinical significance of this is unknown at this time.</p>', '<p>Epilepsy: Monotherapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 16 year</strong>s: Titration should begin at 25 mg nightly for 1 week. The dosage should then be increased at 1- or 2-week intervals by increments of 25 or 59 mg/day, administered in two divided doses. The recommended initial target dose for topiramate monotherapy in adults with newly diagnosed epilepsy is 100 mg/day and the maximum recommended daily dose is 400 mg.</li>\r\n	<li><strong>Children aged 6-16 years</strong>: Treatment of children aged 6 years and above should begin at 0.5 to 1 mg/kg nightly for the first week. The dosage should then be increased at 1- or 2-week intervals by increments of 0.5 to 1 mg/kg/day, administered in two divided doses. The recommended initial target dose range for topiramate monotherapy in children with newly diagnosed epilepsy aged 6 years and above is 3 to 6 mg/kg/day. Higher doses have been tolerated and rarely doses up to 16 mg/kg/day have been given.</li>\r\n</ul>\r\n\r\n<p>Epilepsy: Adjunctive therapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 16 years</strong>: The minimal effective dose as adjunctive therapy is 200 mg per day. The usual total daily dose is 200 mg to 400 mg in two divided doses. Some patients may require doses up to 800 mg per day, which is the maximum recommended dose.</li>\r\n	<li><strong>Children aged 2-16 years</strong>: The recommended total daily dose of Topiramate as adjunctive therapy is approximately 5 to 9 mg/kg/day in two divided doses. Titration should begin at 25 mg nightly for the first week. The dosage should then be increased at 1- or 2-week intervals by increments of 1 to 3 mg/kg/day (administered in two divided doses), to achieve optimal clinical response. Dose titration should be guided by clinical outcome. Daily doses up to 30 mg/kg/day have been studied and were generally well tolerated.</li>\r\n</ul>\r\n\r\n<p>Migraine:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children over 16 years</strong>: Titration should begin at 25 mg nightly for 1-week. The dosage should then be increased in increments of 25 mg/day administered at 1-week intervals. The recommended total daily dose of topiramate as treatment for the prophylaxis of migraine headache is 100 mg/day administered in two divided doses. Some patients may experience a benefit at a total daily dose of 50 mg/day.</li>\r\n	<li><strong>Children</strong>: Topiramate in migraine prophylaxis has not been studied in children under 16 years.</li>\r\n</ul>', '<p>The addition of topiramate to other antiepileptic drugs (phenytoin, carbamazepine, valproic add, phenobarbitai, primidone) has no clinically significant effect on their steady-state plasma concentrations, except in some patients where the addition of topiramate to phenytoin may result in an increase of plasma concentrations of phenytoin.<br />\r\n<br />\r\n<strong>CNS Depressants</strong>: Topiramate should be used with caution if used in combination with alcohol and other CNS depressants.<br />\r\n<br />\r\n<strong>Oral Contraceptives</strong>: In an interaction study with a combined oral contraceptive, Topiramate increased plasma clearance of the oestrogenic component significantly. Consequently, and bearing in mind the potential risk of teratogenicity, patients should receive a preparation containing not less than 50 &mu;g of oestrogen or use some alternative non-hormonal method of contraception. Patients taking oral contraceptives should be asked to report any change in their bleeding patterns.<br />\r\n<br />\r\n<strong>Lithium</strong>: In patients with bipolar disorder, the pharmacokinetics of lithium were unaffected during treatment with Topiramate at doses of 200 mg/day; however, there was an observed increase in systemic exposure (26% for AUC) following Topiramate doses of up to 600 mg/day. Lithium levels should be monitored when co-administered with Topiramate.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>&nbsp;(HCTZ): The steady-state pharmacokinetics of HCTZ were not significantly influenced by the concomitant administration of Topiramate. Clinical laboratory results indicated decreases in serum potassium after Topiramate or HCTZ administration, which were greater when HCTZ and Topiramate were administered in combination.<br />\r\n<br />\r\n<strong>Metformin</strong>: Topiramate did not affect metformin tmax. The clinical significance of the effect of topiramate on metformin pharmacokinetics is unclear. Oral plasma clearance of topiramate appears to be reduced when administered with metformin. The clinical significance of the effect of metformin on topiramate pharmacokinetics is unclear. When Topiramate is added or withdrawn in patients on metformin therapy, careful attention should be given to the routine monitoring for adequate control of their diabetic disease state.<br />\r\n<br />\r\n<strong>Pioglitazone</strong>: When Topiramate is added to pioglitazone therapy or pioglitazone is added to Topiramate therapy, careful attention should be given to the routine monitoring of patients for adequate control of their diabetic disease state.<br />\r\n<br />\r\n<strong>Glibenclamide</strong>: The steady-state pharmacokinetics of Topiramate were unaffected by concomitant administration of glibenclamide. When Topiramate is added to glibenclamide therapy or glibenclamide is added to Topiramate therapy, careful attention should be given to the routine monitoring of patients for adequate control of their diabetic disease state.<br />\r\n<br />\r\n<strong>Others</strong>: Topiramate, when used concomitantly with other agents predisposing to nephrolithiasis, may increase the risk of nephrolithiasis. While using Topiramate, agents like these should be avoided since they may create a physiological environment that increases the risk of renal stone formation. The interaction with benzodiazepines has not been studied.&nbsp;<br />\r\n<br />\r\n<strong>Valproic Acid</strong>: Concomitant administration of Topiramate and valproic acid has been associated with hyperammonemia with or without encephalopathy in patients who have tolerated either drug alone. An association of hyperammonemia with Topiramate monotherapy or concomitant treatment with other anti epileptics has not been established.</p>', '<p>Hypersensitivity to any component of this product.</p>', '<p>Nausea, abdominal pain, dyspepsia, diarrhoea, dry mouth, taste disturbance, weight loss, anorexia, paraesthesia, hypoaesthesia, headache, fatigue, dizziness, speech disorder, drowsiness, insomnia, impaired memory &amp; concentration, anxiety, depression, visual disturbance, lesscommonly: sucidal ideation, rarely: reduced sweetening mainly children, metabolic acidosis and alopecia, very rarely: Leucopenia, thrombocytopenia and serious skin reaction.</p>', '<p>Topiramate should not be used during pregnancy unless, in the opinion of the physician, the potential benefit outweighs the potential risk to the foetus. Topiramate should not be used during breastfeeding.</p>', '<p>In patients with or without a history of seizures or epilepsy, antiepileptic drugs, including topiramate, should be gradually withdrawn to minimize the potential for seizures or increased seizure frequency. Topiramate can produce central nervous system-related adverse events and may be more sedative than other antiepileptic drugs. Drowsiness is a likelihood. In addition, there have been reports of visual disturbances/blurred vision. Patients should be warned of these and advised that if affected, they should not drive, operate machinery and/or take part in activities where such reactions could put themselves or others at risk.</p>', '<p>Topiramate overdose can result in severe metabolic acidosis. In acute topiramate overdose, if the ingestion is recent, the stomach should be emptied immediately by lavage or by induction of emesis. Activated charcoal has been shown to adsorb topiramate in vitro. Treatment should be appropriately supportive. Haemodialysis has been shown to be an effective means of removing topiramate from the body. The patient should be well hydrated.</p>', '<p>Adjunct 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, '2022-03-21 23:48:30', '2022-03-21 23:48:30'),
(1510, 1510, '<p><strong>Ovarian Cancer</strong>: Topotecan for injection, as a single agent, is indicated for the treatment of patients with metastatic&nbsp;carcinoma&nbsp;of the ovary after disease progression on or after initial or subsequent&nbsp;chemotherapy.<br />\r\n<br />\r\n<strong>Small Cell Lung Cancer</strong>: Topotecan for injection, as a single agent, is indicated for the treatment of patients with small cell&nbsp;lung cancer&nbsp;with platinum-sensitive disease who progressed at least 60 days after initiation of first-line chemotherapy.<br />\r\n<br />\r\n<strong>Cervical Cancer</strong>: Topotecan for injection in combination with&nbsp;cisplatin&nbsp;is indicated for the treatment of patients with Stage IV-B,&nbsp;recurrent, or persistent carcinoma of the&nbsp;cervix&nbsp;not amenable to curative treatment.</p>', '<p>Topotecan has the same mechanism of action as irinotecan and is believed to exert its cytotoxic effects during the S-phase of DNA synthesis. Topoisomerase I relieves torsional strain in DNA by inducing reversible single strand breaks. Topotecan binds to the topoisomerase I-DNA complex and prevents religation of these single strand breaks. This ternary complex interferes with the moving replication fork, which leads to the induction of replication arrest and lethal double-stranded breaks in DNA. As mammalian cells cannot efficiently repair these double strand breaks, the formation of this ternary complex eventually leads to apoptosis (programmed cell death).<br />\r\n<br />\r\nTopotecan mimics a DNA base pair and binds at the site of DNA cleavage by intercalating between the upstream (-1) and downstream (+1) base pairs. Intercalation displaces the downstream DNA, thus preventing religation of the cleaved strand. By specifically binding to the enzyme&ndash;substrate complex, Topotecan acts as an uncompetitive inhibitor.</p>', '<p>Verify dose using&nbsp;body surface area&nbsp;prior to dispensing. Recommended dosage should generally not exceed 4 mg intravenously&nbsp;<br />\r\n<br />\r\n<strong>Ovarian Cancer</strong>: The recommended dose of Topotecan is 1.5 mg/m&sup2; by intravenous infusion over 30 minutes daily for 5 consecutive days, starting on Day 1 of a 21-day course.<br />\r\n<br />\r\n<strong>Small Cell Lung Cancer</strong>: The recommended dose of Topotecan is 1.5 mg/m&sup2; by intravenous infusion over 30 minutes daily for 5 consecutive days, starting on Day 1 of a 21-day course.<br />\r\n<br />\r\n<strong>Cervical Cancer</strong>: The recommended dose of Topotecan is 0.75 mg/m&sup2; by intravenous infusion over 30 minutes daily on Days 1, 2, and 3 in combination with cisplatin 50 mg/m&sup2; on Day 1, repeated every 21 days.</p>', '<p>Increased clearance with phenytoin. G-CGF to be given 24 hr after completion of treatment with topotecan as concurrent admin may prolong duration of neutropenia. Increased bone marrow supression with other cytotoxic drugs (e.g. cisplatin) so dose reduction may be needed.</p>', '<p>Severe bone marrow depression (e.g. baseline neutrophil count of &lt;1500 cells/mm3&nbsp;and platelet count &lt;100,000/mm3). Pregnancy, lactation, severe renal or hepatic impairment.</p>', '<p>Neutropenia (nadir of white cell count occurs about 9-12 days after admin), thrombocytopenia and anaemia. GI upset, total alopecia, headache, dyspnoea. Fatigue, weakness, malaise, pruritus and hyperbilirubinaemia.</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>Preexisting bone marrow depression. Frequent monitoring of peripheral blood cell counts during treatment. Do not continue subsequent courses until neutrophils recover to &gt;1000 cells/mm3, platelets recover to &gt;100,000 cells/mm3&nbsp;and haemoglobin levels recover to 9.0 g/dl (with transfusion if needed). May impair ability to drive or operate machinery.</p>', '<p>Symptoms: Bone marrow supression.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Unopened vial: Store at 20-25&deg;C; protect from light. Reconstituted solution: Stable for 24 hr at 20-25&deg;C in ambient light.</p>', '<p><strong>Renal Impairment:</strong></p>\r\n\r\n<ul>\r\n	<li>Ovarian carcinoma, Small cell lung cancer: CrCl 20-30: Initial dose 0.75 mg/m2.</li>\r\n	<li>Cervical cancer:&nbsp;Treatment to be initiated only if serum creatinine &le;1.5 mg/dl.</li>\r\n</ul>\r\n\r\n<p><strong>Hepatic Impairment</strong>: Avoid</p>', '2022-03-21 23:50:52', '2022-03-21 23:50:52'),
(1511, 1511, '<p>Torasemide is indicated for the management of edema of cardiac, renal and hepatic origin.The management of hypertension, as a sole therapeutic agent or in combination with other classes of antihypertensive agents.</p>', '<p>Torasemide inhibits the Na+/K+/2CI-&nbsp;carrier system (via interference of the chloride binding site) in the lumen of the thick ascending portion of the loop of Henle, resulting in a decrease in reabsorption of sodium and chloride. This results in an increase in the rate of delivery of tubular fluid and electrolytes to the distal sites of hydrogen and potassium ion secretion, while plasma volume contraction increases aldosterone production. The increased delivery and high aldosterone levels promote sodium reabsorption at the distal tubules, and By increasing the delivery of sodium to the distal renal tubule, torasemide indirectly increases potassium excretion via the sodium-potassium exchange mechanism. Torasemide&#39;s effects in other segments of the nephron have not been demonstrated. Thus torasemide increases the urinary excretion of sodium, chloride, and water, but it does not significantly alter glomerular filtration rate, renal plasma flow, or acid-base balance. Torasemide&#39;s effects as a antihypertensive are due to its diuretic actions. By reducing extracellular and plasma fluid volume, blood pressure is reduced temporarily, and cardiac output also decreases.</p>', '<p><strong>Congestive heart failure:</strong>&nbsp;The usual initial oral dose is 10 mg or 20 mg once daily. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200 mg have not been adequately studied.<br />\r\n<br />\r\n<strong>Chronic renal failure</strong>: The usual initial oral dose is 20 mg once daily. lf the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 200mg have not been adequately studied.<br />\r\n<br />\r\n<strong>Hepatic cirrhosis</strong>: The usual initial oral dose is 5 mg or 10 mg once daily, administered together with an aldosterone antagonist or a potassium sparing diuretic. If the diuretic response is inadequate, the dose should be titrated upward by approximately doubling until the desired diuretic response is obtained. Single doses higher than 40 mg have not been adequately studied. Chronic use of any diuretic in hepatic disease has not been studied in adequate and well-controlled trials.<br />\r\n<br />\r\n<strong>Hypertension</strong>: The usual initial oral dose is 2.5-5 mg once daily. If the 5 mg dose does not provide adequate reduction of blood pressure within 4 to 6 weeks, the dose may be increased to 10 mg once daily. If the response to 10 mg is insufficient, an additional antihypertensive should be added to the treatment regimen.</p>', '<p>Increased risk of severe hypokalaemia with amphotercin B, corticosteroids, carbenoxolone, hypokalaemia-causing medications. Increased risk of lithium toxicity. Increased potential for ototoxicity and nephrotoxicity with nephrotoxic or ototoxic medications e.g. aminoglycosides. High dose salicylates may increase the risk of salicylate toxicity. Increased risk of toxicity with digoxin. Reduced diuretic effect with NSAIDs. Increased risk of hypotension with antihypertensives.</p>', '<p>Torasemide is contraindicated in patients with known hypersensitivity to torasemide and other sulfonyl ureas. It is also contraindicated in patients who are anuric.</p>', '<p>Usually torasemide is well tolerated. However, a few side effects like dry mouth, dizziness, tiredness, skin rash, diarrhea, constipation, nausea, vomiting, orthostatic hypotention and muscle cramp may occur. All side effects usually are mild and transient.</p>', '<p><strong>Pregnancy</strong>: Adequate and well controlled studies of torasemide have not been carried out in pregnant woman. Because animal reproduction studies are not always predictive of human response, torasemide can be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mother:</strong>&nbsp;lt is not known whether torasemide is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when torasemide is administered to a nursing mother.</p>', '<p>Precautions should be taken while torasemide is administered in the conditions like diabetes, gout, hypotension and liver failure.</p>', '<p>There is no human experience of overdoses of torasemide, but the signs and symptoms of overdosage can be anticipated to be those of excessive pharmacological effect: dehydration, hypovolemia, hypotension and hypokalemia. Treatment of overdose should consist of fluid and electrolyte supplement.</p>', '<p>Loop diuretics</p>', '<p>Store Torasemide at room temperature less than 30&deg; C and keep in cool and dry place, away from moisture and sunlight. Keep the medicine out of the reach of children.</p>', '<p><strong>Use in children</strong>: Safety and efficacy of torasemide in children have not been established.</p>', '2022-03-21 23:52:35', '2022-03-21 23:52:35'),
(1512, 1512, '<p>Torsemide is indicated for the treatment of edema associated with congestive heart failure, renal disease, or hepatic disease. Torsemide is indicated for the treatment of hypertension alone or in combination with other antihypertensive agents.</p>', '<p>Torsemide acts within the lumen of the thick ascending portion of the loop of Henle, where it inhibits the Na+/K+/2CI carrier system. Torsemide increases the urinary excretion of sodium, chloride and water, but it does not significantly alter glomerular filtration rate, renal plasma flow or acid-base balance.</p>', '<p><strong>Edema associated with heart failure</strong>: The recommended initial dose is Torsemide 10 mg or 20 mg once daily. If the diuretic response is inadequate, titrate upward by approximately doubling until the desired diuretic response is obtained.<br />\r\n<br />\r\n<strong>Edema associated with chronic renal failure</strong>: The recommended initial dose is Torsemide 20 mg once daily. If the diuretic response is inadequate, titrate upward by approximately doubling until the desired diuretic response is obtained.<br />\r\n<br />\r\n<strong>Edema associated with hepatic cirrhosis</strong>: The recommended initial dose is Torsemide 5 mg or 10 mg once daily, administered together with an aldosterone antagonist or a potassium-sparing diuretic. If the diuretic response is inadequate, titrate upward by approximately doubling until<br />\r\nthe desired diuretic response is obtained.<br />\r\n<br />\r\n<strong>Treatment of Hypertension</strong>: The recommended initial dose is 5 mg once daily. If the 5 mg dose does not provide adequate reduction in blood pressure within 4 to 6 weeks, increase to 10 mg once daily. If the response to 10 mg is insufficient, add another antihypertensive agent to the treatment regimen.</p>', '<p>Patients receiving high doses of salicylates may experience salicylate toxicity when Torsemide is concomitantly administered. If Torsemide and cholestyramine should be co-administered, administer Torsemide at least one hour before or 4 to 6 h after cholestyramine administration. Also, coadministration of Torsemide with ACE inhibitors or Angiotensin receptor blockers can increase the risk of hypotension and renal impairment.</p>', '<p>Torsemide is contraindicated in patients with known hypersensitivity to Torsemide. It is contraindicated in patients who are anuric or with hepatic coma.</p>', NULL, '<p>Pregnancy Category: B<br />\r\n<br />\r\nUse in Lactation: It is not known whether Torsemide is excreted in human milk. Caution should be exercised when Torsemide is administered to a nursing woman.</p>', '<p><strong>Hypotension</strong>: Excessive diuresis may cause potentially symptomatic dehydration, blood volume reduction and hypotension.<br />\r\n<br />\r\n<strong>Electrolyte and Metabolic Abnormalities</strong>: Torsemide can cause symptomatic hypokalemia, hyponatremia and hypochloremic alkalosis.</p>', NULL, '<p>Loop diuretics</p>', '<p>Protect from light and moisture. Store below 30&deg;C. Keep the medicine out of reach of children.</p>', NULL, '2022-03-21 23:54:05', '2022-03-21 23:54:05'),
(1513, 1513, '<p>Tramadol is used for the treatment of moderate to severe painful conditions. These include:</p>\r\n\r\n<ul>\r\n	<li>Postoperative pain</li>\r\n	<li>Colic and spastic pain</li>\r\n	<li>Cancer pain</li>\r\n	<li>Joint pain</li>\r\n	<li>Neck and back pain</li>\r\n	<li>Pain associated with osteoporosis.</li>\r\n</ul>', '<p>Tramadol is a centrally acting synthetic analgesic compound. It inhibits the re uptake of neurotransmitters- serotonin and noradrenaline. Thus it modifies the transmission of pain impulses by activating both descending serotonergic pathways and noradrenergic pathways involved in analgesia. The analgesic effects of Tramadol are mediated via stimulation of mu-opioid receptors and indirect modulation of central monoaminergic inhibitory pathways.</p>', '<p><strong>Capsule or Tablet</strong>: Usual doses are 50 to 100 mg every four to six hours. For acute pain an initial dose of 100 mg is required. For chronic painful conditions an initial dose of 50 mg is recommended. Subsequent doses should be 50 to 100 mg administered 4-6 hourly. The dose level and frequency of dosing will depend on the severity of the pain.The total daily dosage by mouth should not exceed 400 mg.<br />\r\n<br />\r\n<strong>Sustained Release Capsule&nbsp;or Tablet</strong>: One SR capsule&nbsp;or tablet every 12 hours, for example first one in the morning and then at the same time in the evening. The number of capsules taken at a time will depend upon severity of pain, but it should not be taken more frequently than every 12 hours.The total daily dosage by mouth should not exceed 400 mg.<br />\r\n<br />\r\n<strong>Injection</strong>: A dose of 50-100 mg may be given every 4 to 6 hours by intramuscular or by intravenous infusion. For the treatment of postoperative pain,the initial dose is 100 mg followed by 50 mg every 10 to 20 minutes if necessary to a maximum of 250 mg in the first hour. Thereafter, doses are 50 to 100 mg every 4 to 6 hours up to a total daily dose of 600 mg.<br />\r\n<br />\r\n<strong>Suppository</strong>: Tramadol suppository should be administered rectally. For adults usual dose is 100 mg Tramadol Hydrochloride 6 hourly. In general, 400 mg Tramadol Hydrochloride (4 Tramadol suppository) per day sufficient. However, for the treatment of Cancer pain and severe pain after operations much higher daily doses can be used.</p>', '<p>In general, physician need not be concerned about drugs interacting with Tramadol. The monoamine oxidase (MAO) inhibitors represent the only drug class not recommended for combination with Tramadol. Concomitant administration of carbamazepine with Tramadol causes a significant increase in Tramadol metabolism and it requires to increase the dose of Tramadol.</p>', '<p>Tramadol is contraindicated in persons having hypersensitivity to this drug. It is also contraindicated in acute intoxication with alcohol, hypnotics, centrally acting analgesics, opioids or psychotropic drugs.</p>', '<p>Commonly occurring side-effects are dizziness/vertigo, nausea, constipation, headache, somnolence, vomiting, pruritus, CNS stimulation, asthenia, sweating, dyspepsia, dry mouth, diarrhoea. Less commonly occurring side-effects include malaise, allergic reaction, weight loss, vasodilatation, palpitations, abdominal pain, anorexia, flatulence, GI bleeding, hepatitis, stomatitis etc.</p>', '<p>Safe use of Tramadol in pregnancy has not been established. Tramadol has been shown to cross the placenta. There are no adequate and well-controlled studies in pregnant women. Therefore, Tramadol should be used during pregnancy only if the potential benefit justifies the risk to the foetus. Tramadol Hydrochloride should not be administered during breast feeding as Tramadol and its metabolites have been detected in breast milk.</p>', '<p><strong>Respiratory depression:</strong>&nbsp;When large doses of tramadol are administered with anaesthetic with anaesthetic medications or alcohol, respiratory depression may result. Therefore, tramadol should be administered cautiously in patients at risk for respiratory depression.<br />\r\n<br />\r\n<strong>Opioid dependence</strong>: Tramadol is not recommended for patients who are dependent on opioids.<br />\r\n<br />\r\n<strong>Concomitant CNS depressants:</strong>&nbsp;Tramadol should be used with caution and in reduced dosages when administering to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, phenothiazines, tranquilizers or sedative hypnotics.<br />\r\n<br />\r\n<strong>Concomitant MAO inhibitors</strong>: Tramadol should be used with great caution in patients taking MAO inhibitors, since tramadol inhibits the uptake of norepinephrine and serotonin.<br />\r\n<br />\r\nTramadol should be used with caution in patients with increased intracranial pressure or head injury and patients with acute abdominal conditions.</p>', NULL, '<p>Opioid analgesics</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>In children from the age of 1 year Tramadol Hydrochloride can be given in a dose of 1-2 mg/kg body weight. However,suppository (100 mg Tramadol Hydrochloride) should not be administered in children and adolescents below the age of 14 years. Tramadol Hydrochloride 100 mg SR Capsules have not been studied in children. Therefore, safety and efficacy have not been established and the product should not be used in children.</p>', '2022-03-21 23:55:44', '2022-03-21 23:55:44'),
(1514, 1514, '<p><strong>In medicine</strong>: Prophylaxis and therapy of hemophtoes, digestive hemorrhages, hemorrhagic syndromes in leukaemia, cirrhosis and hemophilia, thrombocytopenic purpura, accidents during thrombolytic therapy and transfusion.<br />\r\n<br />\r\n<strong>In surgery</strong>: Prophylaxis and antihemorrhagic therapy during operations of any type and nature and particularly in pulmonary, cardiovascular and abdominal surgery and post-operative and traumatic shock.<br />\r\n<br />\r\n<strong>In urology</strong>: Prophylaxis and antihemorrhagic therapy of prostatic, vesical and renal surgery. Hematurias.<br />\r\n<br />\r\n<strong>In obstetrics</strong>: Prophylaxis and therapy of post-partum and puerperium hemorrhages, hemorrhagic metrophathies, functional menometrorrhagias, idiopathic or IUD(lntra uterine Device) induced menorrhagias, primitive hyperfibrinolysis (abruptio placentae, premature placenta detachment) and in cervical conization.<br />\r\n<br />\r\n<strong>In otorhinolaryngology</strong>: Prophylaxis and antihemorrhagic therapy during a tonsillectomy, specialist surgery generally, epistaxis.<br />\r\n<br />\r\n<strong>In stomatology</strong>: Prophylaxis and antihemorrhagic therapy during maxillofacial operations, tooth extractions.<br />\r\n<br />\r\n<strong>In oncology (as supportive therapy)</strong>: To promote the formation of a fibrin capsule to wall off and thereby inhibit the growth of ovarian tumors. To cause regression of ascites secondary to carcinoma. To reduce bleeding during surgical interventions.</p>', '<p>This is a preparation of tranexamic acid (trans-4 aminomethyl-cyclohexanecarboxylic acid). Tranexamic acid is a substance endowed with a strong antifibrinolytic action and both in vivo and in vitro it has proved to be 10 times more active than conventional hemostatics, depending on the test. The antihemorrhagic action of tranexamic acid is essentially due to an inhibition of the plasminogen activation of both exogenous activators like streptokinase and endogenous ones like urokinase and the plasminogen tissue activator. This fact is particularly important for the clinical use of Tranexamic Acid, because it ensures an antihemorrhagic activity with an antifibrinolytic mechanism under a variety of conditions.<br />\r\n<br />\r\nThe acute toxicity of Tranexamic Acid is extremely low and chronic toxicity almost non-existent. Tranexamic Acid is well absorbed by oral route and the effect is already seen 15-30 minutes after administration. It is excreted mainly by renal route but more slowly than conventional hemostatics. These features make the Tranexamic Acid effect more lasting than those conventional hemostatics. Considerably lower single doses of Tranexamic Acid can thus be administered at greater intervals without the drug plasma levels dropping to inefficient levels of antifibrinolytic activity between one dose and the other.<br />\r\n<br />\r\nTranexamic Acid at therapeutic doses does not interfere with clotting processes and even a prolonged administration has not been seen to be accompanied by any tendency to thrombophilia.</p>', '<p>Adults-</p>\r\n\r\n<ul>\r\n	<li><strong>The usual dose</strong>: 500-1000 mg 3 times daily.</li>\r\n	<li><strong>For prophylaxis</strong>: The mean recommended daily doses are 0.5-1 gm orally, 500 mg by the parenteral (intravenous or intramuscular) route.</li>\r\n	<li><strong>For therapy of hemorrhagic manifestations</strong>: the oral dose increases to 1-3 gm given in divided doses: in cases of particular seriousness and urgency, begin by injecting an ampoule (500 mg) slowly by intravenous route and administer the necessary subsequent oral doses.</li>\r\n</ul>\r\n\r\n<p>Children-</p>\r\n\r\n<ul>\r\n	<li><strong>For prophylaxis</strong>: For every kg of body weight from 5-10 mg are orally administered daily in divided doses.</li>\r\n	<li><strong>For therapeutic purposes</strong>: The oral doses are doubled (from 10 to 20 mg/kg), while the intravenous and intramuscular treatment is begun with 10 mg/kg (=0.5 ml every 5 kg) by the slow intravenous route, continuing the oral administration up to the required dose. Where it is more convenient (e.g. in small babies) the ampoules, diluted in a little sweetened water, maybe orally administered instead of the Capsules.</li>\r\n</ul>\r\n\r\n<p>Elderly patients: No reduction in dosage is necessary unless there is evidence of renal failure.</p>', '<p>Tranexamic Acid is a synthetic Amino Acid that is incompatible with solutions containing penicillins (eg: Benzyl penicillin). Thrombolytic drugs like Streptokinase &amp; Urokinase antagonise the antifibrinolytic action of Tranexamic Acid. The potential for thrombus formation may be increased by concomitant administration of estrogen containing drugs, like oral contraceptives. Direct admixture of Tranexamic Acid with whole blood should be avoided during Transfusion.</p>', '<p>Known individual hypersensitivity to the product. Thromboembolic disease, arterial and venous thrombosis, endocavitary hemorrhages, serious kidney failure.</p>', '<ul>\r\n	<li>Tranexamic Acid is generally well tolerated; there may be infrequent cases of sense of fatigue, conjunctival irritation, nasal blockage, itching, skin reddening, exanthems.</li>\r\n	<li>After oral administration there may be sign of nausea, diarrhea, gastric pyrosis.</li>\r\n	<li>There are rare cases of postural hypotension.</li>\r\n	<li>In the case of hypersensitivity to tranexamic acid, avoid or suspend treatment and start a suitable therapy.</li>\r\n</ul>', '<p>Since the transplacental passage of the drug and its possible effects on the fetus are unknown, Tranexamic Acid should not be administered during known and presumed pregnancy. Tranexamic Acid passes into breast milk to a concentration of approximately one hundredth of the concentration in the maternal blood. An antifibrinolytic effect in the infant is unlikely.</p>', '<ul>\r\n	<li>Tranexamic Acid should be used in cases where there is hyperfibrinolysis. The prophylactic treatment must begin 24 hours before the operation and continue until 3-4 days after it.</li>\r\n	<li>The therapy of hemorrhages must be prolonged for at least 24 hours after manifestations have disappeared.</li>\r\n	<li>In hematuria, especially when this is not accompanied by any other hemorrhagic manifestations, reduce the doses to prevent formation of clots in the urinary tract.</li>\r\n	<li>Tranexamic Acid must not be used in serious renal insufficiency or anuric syndromes and must only be used with caution in less serious renal dysfunctions.</li>\r\n	<li>The administration of product requires particular care in cardiopathic and hepatopathic subjects.</li>\r\n</ul>', NULL, '<p>Anti-fibrinolytic drugs, Haemostatic drugs.</p>', '<p>Store in a dry place at 15-30&deg;C, away from light and keep out of children&#39;s reach.</p>', NULL, '2022-03-21 23:57:30', '2022-03-21 23:57:30'),
(1515, 1515, '<p><strong>Adjuvant Breast Cancer</strong>: Trastuzumab is indicated for adjuvant treatment of HER2 overexpressing node-positive or node-negative ER/PR negative or with one high-risk feature breast cancer</p>\r\n\r\n<ul>\r\n	<li>as part of a treatment regimen consisting of doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel</li>\r\n	<li>as part of a treatment regimen with docetaxel and carboplatin</li>\r\n	<li>as a single agent following multi-modality anthracycline-based therapy.</li>\r\n</ul>\r\n\r\n<p><strong>Metastatic Breast Cancer</strong>: Trastuzumab is indicated:</p>\r\n\r\n<ul>\r\n	<li>In combination with paclitaxel for first-line treatment of HER2-overexpressing metastatic breast cancer</li>\r\n	<li>As a single agent for treatment of HER2-overexpressing breast cancer in a patient who has received one or more chemotherapy regimens for metastatic disease. overexpressing breast cancer in patient.</li>\r\n</ul>\r\n\r\n<p><strong>Metastatic Gastric Cancer</strong>: Trastuzumab is indicated, in combination with cisplatin and<br />\r\ncapecitabine or 5-fluorouracil, for the treatment of patients with HER2-overexpressing<br />\r\nmetastatic gastric or gastroesophageal junction adenocarcinoma who have not received<br />\r\nprior treatment for metastatic disease.</p>', '<p>The HER2 (or c-erbB2) proto-oncogene encodes a transmembrane receptor protein of 185 kDa, which is structurally related to the epidermal growth factor receptor. Trastuzumab has been shown, in both in vitro assays and in animals, to inhibit the proliferation of human tumor cells that overexpress HER2. Trastuzumab is a mediator of antibody-dependent cellular cytotoxicity (ADCC). In vitro, Trastuzumab-mediated ADCC has been shown to be preferentially exerted on HER2 overexpressing cancer cells compared with cancer cells that do not overexpress HER2.</p>', '<p><strong>Recommended Doses and Schedules</strong>: Do not administer as an intravenous push or bolus. Do not mix Trastuzumab with other drugs.<br />\r\n<br />\r\n<strong>Adjuvant Treatment, Breast Cancer</strong>: Administer according to one of the following doses and schedules for a total of 52 weeks of Trastuzumab therapy:<br />\r\n<br />\r\n<strong>During and following paclitaxel, docetaxel, or docetaxel/carboplatin</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initial dose of 4 mg/kg as an intravenous infusion over 90 minutes then at 2 mg/kg as an intravenous infusion over 30 minutes weekly during chemotherapy for the first 12 weeks (paclitaxel or docetaxel) or 18 weeks (docetaxel/carboplatin).</li>\r\n	<li>One week following the last weekly dose of Trastuzumab, administer Trastuzumab at 6 mg/kg as an intravenous infusion over 30&minus;90 minutes every three weeks.</li>\r\n</ul>\r\n\r\n<p><strong>As a single agent within three weeks following completion of multi-modality, anthracycline-based chemotherapy regimens</strong>:</p>\r\n\r\n<ul>\r\n	<li>Initial dose at 8 mg/kg as an intravenous infusion over 90 minutes</li>\r\n	<li>Subsequent doses at 6 mg/kg as an intravenous infusion over 30&minus;90 minutes every three weeks.</li>\r\n	<li>Extending adjuvant treatment beyond one year is not recommended</li>\r\n</ul>\r\n\r\n<p><strong>Metastatic Treatment, Breast Cancer</strong>: Administer Trastuzumab, alone or in combination with paclitaxel, at an initial dose of 4 mg/kg as a 90 minute intravenous infusion followed by subsequent once-weekly doses of 2 mg/kg as 30-minute intravenous infusions until disease progression.<br />\r\n<br />\r\n<strong>Metastatic Gastric Cancer</strong>: Administer Trastuzumab at an initial dose of 8 mg/kg as a 90-minute intravenous infusion followed by subsequent doses of 6 mg/kg as an intravenous infusion over 30&ndash;90 minutes every three weeks until disease progression. Or, as directed by the registered physician.</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<ul>\r\n	<li>Using a sterile syringe, slowly inject the 20 ml of diluent into the vial containing the lyophilized powder of Trastuzumab, which has a cake-like appearance. The stream of diluent should be directed into the cake. The reconstituted vial yields a solution for multiple-dose use, containing 21 mg/ml Trastuzumab.</li>\r\n	<li>Swirl the vial gently to aid reconstitution. DO NOT SHAKE.</li>\r\n	<li>Slight foaming of the product may be present upon reconstitution. Allow the vial to stand undisturbed for approximately 5 minutes.</li>\r\n	<li>Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Inspect visually for particulates and discoloration. The solution should be free of visible particulates, clear to slightly opalescent and colorless to pale yellow.</li>\r\n	<li>Store reconstituted Trastuzumab in the refrigerator at 2&deg;C to 8&deg;C, discard unused Trastuzumab after 28 days. If Trastuzumab is reconstituted with SWFI without preservative, use immediately and discard any unused portion.</li>\r\n</ul>', '<p>Patients who receive anthracycline after stopping Trastuzumab may be at increased risk of cardiac dysfunction because of Trastuzumab&rsquo;s long washout period based on population PK analysis. If possible, physicians should avoid anthracycline-based therapy for up to 7 months after stopping Trastuzumab. If anthracyclines are used, the patient&rsquo;s cardiac function should be monitored carefully.</p>', NULL, '<p>The most serious adverse reactions caused by Trastuzumab includes Cardiomyopathy, Infusion Reactions, Embryo-Fetal Toxicity, Pulmonary Toxicity, Exacerbation of Chemotherapy-Induced Neutropenia. The most common adverse reactions in patients receiving Trastuzumab in the adjuvant and metastatic breast cancer setting are fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, and myalgia.</p>', '<p>It can cause fetal harm when administered to a pregnant woman. Verify the pregnancy status of females of reproductive potential prior to the initiation of Trastuzumab. Advise pregnant women and females of reproductive potential that exposure to Trastuzumab during pregnancy or within 7 months prior to conception can result in fetal harm. Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of Trastuzumab. There is no information regarding the presence of Trastuzumab in human milk, the effects on the breastfed infant, or the effects on milk production.</p>', '<p><strong>Cardiomyopathy</strong>: Trastuzumab can cause left ventricular cardiac dysfunction, arrhythmias, hypertension, disabling cardiac failure, cardiomyopathy, and cardiac death. Trastuzumab can also cause asymptomatic decline in left ventricular ejection fraction (LVEF). There is a 4-6 fold increase in the incidence of symptomatic myocardial dysfunction among patients receiving Trastuzumab as a single agent or in combination therapy compared with those not receiving Trastuzumab. The highest absolute incidence occurs when Trastuzumab is administered with an anthracycline. Withhold Trastuzumab for &ge; 16% absolute decrease in LVEF from pre treatment values or an LVEF value below institutional limits of normal and &ge; 10% absolute decrease in LVEF from pretreatment values. The safety of continuation or resumption of Trastuzumab in patients with Trastuzumab-induced left ventricular cardiac dysfunction has not been studied.<br />\r\n<br />\r\n<strong>Cardiac Monitoring</strong>: Conduct thorough cardiac assessment, including history, physical examination, and determination of LVEF by echocardiogram or MUGA scan. The following schedule is recommended:</p>\r\n\r\n<ul>\r\n	<li>Baseline LVEF measurement immediately prior to initiation of Trastuzumab</li>\r\n	<li>LVEF measurements every 3 months during and upon completion of Trastuzumab</li>\r\n	<li>Repeat LVEF measurement at 4 week intervals if Trastuzumab is withheld for significant left ventricular cardiac dysfunction.</li>\r\n	<li>LVEF measurements every 6 months for at least 2 years following completion of Trastuzumab as a component of adjuvant therapy.</li>\r\n</ul>\r\n\r\n<p><strong>Infusion Reactions</strong>: Infusion reactions consist of a symptom complex characterized by fever and chills, and on occasion included nausea, vomiting, pain (in some cases at tumor sites), headache, dizziness, dyspnea, hypotension, rash, and asthenia. Serious and fatal infusion reactions have been reported. Severe reactions, which include bronchospasm, anaphylaxis, angioedema, hypoxia, and severe hypotension, were usually reported during or immediately following the initial infusion. However, the onset and clinical course were variable, including progressive worsening, initial improvement followed by clinical deterioration, or delayed post-infusion events with rapid clinical deterioration. For fatal events, death occurred within hours to days following a serious infusion reaction. Interrupt Trastuzumab infusion in all patients experiencing dyspnea, clinically significant hypotension, and intervention of medical therapy administered (which may include epinephrine, corticosteroids, diphenhydramine, bronchodilators, and oxygen). Patients should be evaluated and carefully monitored until complete resolution of signs and symptoms. Permanent discontinuation should be strongly considered in all patients with severe infusion reactions. There are no data regarding the most appropriate method of identification of patients who may safely be retreated with Trastuzumab after experiencing a severe infusion reaction. Prior to resumption of Trastuzumab infusion, the majority of patients who experienced a severe infusion reaction were pre-medicated with antihistamines and/or corticosteroids. While some patients tolerated Trastuzumab infusions, others had recurrent severe infusion reactions despite pre-medications.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Trastuzumab can cause fetal harm when administered to a pregnant woman. Use of Trastuzumab during pregnancy resulted in cases of oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of Trastuzumab.<br />\r\n<br />\r\n<strong>Pulmonary Toxicity</strong>: Trastuzumab use can result in serious and fatal pulmonary toxicity. Pulmonary toxicity includes dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency and hypoxia, acute respiratory distress syndrome, and pulmonary fibrosis. Such events can occur as sequelae of infusion reactions. Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest, appear to have more severe toxicity.<br />\r\n<br />\r\n<strong>Exacerbation of Chemotherapy-Induced Neutropenia</strong>: In randomized, controlled clinical trials, the per-patient incidences of NCI-CTC Grade 3-4 neutropenia and of febrile neutropenia were higher in patients receiving Trastuzumab in combination with myelosuppressive chemotherapy as compared to those who received chemotherapy alone. The incidence of septic death was similar among patients who received Trastuzumab and those who did not.</p>', '<p>Store the vial in original carton at 2 o -8 o C. Protect from light. Keep out of the reach of children. Store reconstituted Trastuzumab in the refrigerator at 2&deg;C to 8&deg;C, discard unused Trastuzumab after 28 days. If Trastuzumab is reconstituted with SWFI without preservative, use immediately and discard any unused portion. Do not freeze. The solution of Trastuzumab for infusion diluted in 0.9% Sodium Chloride Injection, USP, should be stored at 2&deg;C to 8&deg;C for no more than 24 hours prior to use. Do not freeze.</p>', NULL, NULL, '<p>Pediatric Use: The safety and effectiveness in pediatric patients have not been established.</p>', '2022-03-21 23:59:39', '2022-03-21 23:59:39');
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
(1516, 1516, '<p><strong>Metastatic Breast Cancer (MBC)</strong>: Trastuzumab Emtansine, as a single agent, is indicated for the treatment of patients with HER2-positive, unresectable locally advanced or metastatic breast cancer who have received prior treatment with trastuzumab and a taxane.</p>', '<p>Trastuzumab Emtansine is a HER2-targeted antibody-drug conjugate which contains the humanized anti-HER2 IgG1, trastuzumab, covalently linked to the microtubule inhibitory drug DM1 (a maytansine derivative) via the stable thioether linker MCC (4-[N-maleimidomethyl] cyclohexane-1-carboxylate). Emtansine refers to the MCC-DM1 complex. An average of 3.5 DM1 molecules are conjugated to each molecule of trastuzumab.<br />\r\n<br />\r\nConjugation of DM1 to trastuzumab confers selectivity of the cytotoxic agent for HER2-overexpressing tumor cells, thereby increasing intracellular delivery of DM1 directly to malignant cells. Upon binding to HER2, trastuzumab emtansine undergoes receptor-mediated internalization and subsequent lysosomal degradation, resulting in release of DM1-containing cytotoxic catabolites (primarily lysine-MCC-DM1).<br />\r\n<br />\r\nTrastuzumab Emtansine has the mechanisms of action of both trastuzumab and DM1.<br />\r\n<br />\r\nTrastuzumab emtansine, like trastuzumab, binds to domain IV of the HER2 extracellular domain (ECD), as well as to Fc&gamma; receptors and complement C1q. In addition, Trastuzumab Emtansine, like trastuzumab, inhibits shedding of the HER2 ECD, inhibits signaling through the phosphatidylinositol 3-kinase (PI3-K) pathway, and mediates antibody-dependent cell-mediated cytotoxicity (ADCC) in human breast cancer cells that overexpress HER2.<br />\r\n<br />\r\nDM1, the cytotoxic drug component of Trastuzumab Emtansine, binds to tubulin. By inhibiting tubulin polymerization, both DM1 and Trastuzumab Emtansine cause cells to arrest in the G2/M phase of the cell cycle, ultimately leading to apoptotic cell death. Results from in vitro cytotoxicity assays show that DM1 is 20&ndash;200 times more potent than taxanes and vinca alkaloids.<br />\r\n<br />\r\nThe MCC linker is designed to limit systemic release and increase targeted delivery of DM1, as demonstrated by detection of very low levels of free DM1 in plasma.</p>', '<p><strong>Recommended Doses And Schedules</strong>: The recommended dose of Trastuzumab Emtansine is 3.6 mg/kg given as an intravenous infusion every 3 weeks (21-day cycle) until disease progression or unacceptable toxicity.&nbsp;Do not administer Trastuzumab Emtansine at doses greater than 3.6 mg/kg.&nbsp;Do not substitute Trastuzumab Emtansine for or with trastuzumab. Closely monitor the infusion site for possible subcutaneous infiltration during drug administration<br />\r\n<br />\r\n<strong>First Infusion</strong>: Administer infusion over 90 minutes. Patients should be observed during the infusion and for at least 90 minutes following the initial dose for fever, chills, or other infusionrelated reactions&nbsp;<br />\r\n<br />\r\n<strong>Subsequent Infusions</strong>: Administer over 30 minutes if prior infusions were well tolerated. Patients should be observed during the infusion and for at least 30 minutes after infusion.</p>', '<p>No formal drug-drug interaction studies with trastuzumab emtansine in humans have been conducted. In vitro metabolism studies in human liver microsomes suggest that DM1, a component of trastuzumab emtansine, is metabolized mainly by CYP3A4 and, to a lesser extent, by CYP3A5. DM1 does not induce or inhibit P450-mediated metabolism in vitro. Caution should be taken when trastuzumab emtansine is co-administered with potent CYP3A inhibitors.</p>', '<p>Trastuzumab Emtansine is contraindicated in patients with a known hypersensitivity to Trastuzumab Emtansine or any of its excipients.</p>', NULL, '<p><strong>Pregnancy</strong>: There are no clinical studies of trastuzumab emtansine in pregnant women. No reproductive and developmental toxicology studies have been conducted with trastuzumab emtansine.<br />\r\n<br />\r\nTrastuzumab, a component of trastuzumab emtansine, can cause fetal harm or death when administered to a pregnant woman. In the postmarketing setting, cases of oligohydramnios, some associated with fatal pulmonary hypoplasia, have been reported in pregnant women receiving trastuzumab. Animal studies of maytansine, a closely related chemical entity of the same maytansinoid class as DM1, suggest that DM1, the microtubule inhibiting cytotoxic drug component of trastuzumab emtansine, is expected to be teratogenic and potentially embryotoxic.<br />\r\n<br />\r\nAdministration of trastuzumab emtansine to pregnant women is not recommended. Women who become pregnant must contact their doctor and should be advised of the possibility of harm to the fetus. If a pregnant woman is treated with trastuzumab emtansine, close monitoring by a multidisciplinary team is recommended.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether trastuzumab emtansine is excreted in human milk. Since many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Kadcyla, women should discontinue nursing prior to initiating treatment with trastuzumab emtansine. Women may begin nursing 7 months after concluding treatment.</p>', '<p>Patients treated with Trastuzumab Emtansine must have confirmed HER2-positive tumor status as assessed by either HER2 protein overexpression or gene amplification.</p>', NULL, '<p>Anti neoplastic preparations.</p>', '<p>Store vials at 2&deg;C-8&deg;C.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Trastuzumab Emtansine in children below 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: There are insufficient data to establish the safety and efficacy of Trastuzumab Emtansine in patients 75 years of age or older.</p>', '2022-03-22 00:01:35', '2022-03-22 00:01:35'),
(1517, 1517, '<p>Travoprost Eye Drops is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension who are intolerant of or insufficiently responsive to another intraocular pressure lowering medication, as monotherapy or as adjunctive therapy.</p>', '<p>Travoprost, an isopropyl ester prodrug, is a synthetic prostaglandin F2 alpha analogue that is rapidly hydrolyzed by esterases in the cornea to its biologically active free acid. The travoporst free acid is potent and highly selective for the FP prostanoid receptor.<br />\r\n<br />\r\nTravoprost free acid is a selective FP prostanoid receptor agonist and is believed to reduce intraocular pressure by increasing the drainage of aqueous humor, which is done primarily through increased uveoscleral outflow and to a lesser extent, trabecular outflow facility.</p>', '<p><strong>Use in adults</strong>: The recommended dose is one drops of Travoprost in the conjunctival sac of the affected eye (s) once daily in the evening, If more than one topical ophthalmic product is being used, the medicines must be administered at least 5 minutes apart. When substituting another ophthalmic antiglaucoma agent with Travoprost, discontinue the other agent and start the following day with Travoprost.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: The efficacy and safety of travoprost eye drops in patients below the age of 18 years have not been established.</p>', '<p>Reduced therapeutic effect with NSAIDs.</p>', '<p>Travoprost eye drops is contraindicated in patients with hypersensitive to travoprost or any excipients of this preparation.</p>', '<p>The most frequently reported treatment-related side-effect is ocular hyperaemia.</p>', '<p>There are no adequate and well-controlled clinical study En pregnant women. Travoprost 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 the drug or its metabolites are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when travoprost is administered to a lactating woman.</p>', '<p>Travoprost should be used with caution in patients with active intraocular inflammation (iritis/uveitis). Travoprost should not be administered while wearing contact lenses. Contact lenses should be removed prior to the administration of the solution. Lenses may be reinserted 15 minutes following administration of Travoprost.</p>', NULL, '<p>Drugs for miotics and glaucoma</p>', '<p>Store in a cool, dry place and protected from light. Keep out of reach of children. Discard the container 4 weeks after opening.</p>', NULL, '2022-03-22 00:03:58', '2022-03-22 00:03:58'),
(1518, 1518, '<p>This Sterile Ophthalmic Solution is indicated for the treatment of elevated intraocular pressure in patients with open angle glaucoma or ocular hypertension who are insufficiently responsive to single therapy with prostaglandin analogue or topical beta blocker.</p>', '<p>Travoprost and Timolol reduce intraocular pressure (IOP) by complementary mechanisms of action. Travoprost is a prostaglandin analogue which reduces IOP by increasing trabecular outflow &amp; uveoscleral outflow. Timolol is a non-selective beta adrenergic receptor blocker that does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anesthetic (membrane stabilizing) activity. It lowers IOP by decreasing the formation of aqueous humor in the ciliary epithelium.</p>', '<p>Instill one drop in the conjunctival sac of the affected eye(s) once daily at about the same time each day, preferably in the evening.</p>', NULL, '<p>Contraindicated in patients who are hypersensitive to Travoprost, Timolol or any of the components of this preparation.</p>', '<p>No serious adverse reactions are reported. Most frequently reported side effects are ocular hyperemia.</p>', '<p><strong>Use in pregnancy</strong>: There are no adequate and well-controlled studies in pregnant women. It should not be used during pregnancy.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: Caution should be exercised when Travoprost + Timolol Maleate is administered to a nursing mother.</p>', '<p>For ophthalmic use only. Patients should remove their contact lenses prior to instilling this preparation and should not insert their lenses until 15 minutes after instillation of the preparation.</p>', NULL, '<p>Drugs for miotics and glaucoma.</p>', '<p>Store in a cool, dry place, away from heat and direct light. Keep out of the reach of children. Do not use more than 4 weeks after opening the bottle.</p>', '<p><strong>Use in children:</strong>&nbsp;Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients:</strong>&nbsp;No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '2022-03-22 00:06:20', '2022-03-22 00:06:20'),
(1519, 1519, '<p>Trelagliptin&nbsp;is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is a highly selective dipeptidyl peptidase-4 inhibitor that is typically used as an add on treatment when the first line treatment of metformin is not achieving the expected glycemic goals; though it has been approved for use as a first line treatment when metformin cannot be used.</p>', '<p>It controls blood glucose levels by selectively and continually inhibiting DPP-4, an enzyme that causes the inactivation of glucagon-like peptide-1 and glucagon-dependent insulinotropic polypeptide, incretin hormones that play an important role in blood glucose regulation. The inhibition of DPP-4 increases insulin secretion depending on blood glucose concentration, thereby controlling blood glucose levels. It is indicated for the treatment of type 2 diabetes.</p>', '<p>100 mg of Trelagliptin is administered to adults once weekly by mouth. This has lesser hypoglycemic events and 4 and 12-fold more potent than Alogliptin and Sitagliptin.</p>', NULL, '<p>Study subjects meeting any of the following criteria will not be included in this study:</p>\r\n\r\n<ul>\r\n	<li>Patients under treatment with trelagliptin for type 2 diabetes at the start of screening.</li>\r\n	<li>Patients with a diagnosis of type 1 diabetes.</li>\r\n	<li>Patients with severe renal impairment or renal failure (e.g., eGFR&nbsp;&lt;&nbsp;30&nbsp;mL/min/1.73&nbsp;m2&nbsp;or on dialysis).</li>\r\n	<li>Patients with serious heart disease or a cerebrovascular disorder, or a serious pancreatic, blood, or other disease.</li>\r\n	<li>Patients with a history of gastrointestinal resection.</li>\r\n	<li>Patients with a proliferative diabetic retinopathy.</li>\r\n	<li>Patients with malignancy.</li>\r\n	<li>Patients with a history of hypersensitivity or allergy to DPP-4 inhibitors.</li>\r\n	<li>Patients who are pregnant, breast-feeding, possibly pregnant, or planning to become pregnant.</li>\r\n	<li>Patients who may need to add or discontinue concomitant medication or change the dose during the study period.</li>\r\n	<li>Patients who will require treatment with a prohibited concomitant medication during the study period.</li>\r\n	<li>Patients participating in other clinical studies.</li>\r\n	<li>Patients assessed as ineligible for any other reason by the investigators.</li>\r\n</ul>', '<p>Among 901 domestic clinical trial cases up to the time of approval, 103 cases ( 11.4%) showed clinical results that included abnormalities and side effects. These mainly included hypoglycemia, nasopharyngitis, and elevated lipase.<br />\r\n<br />\r\nGiven the appearance of serious side effects such as hypoglycemia (0.1~5%) , administer medication in conjunction with close observation of patient status. Other DPP-4 inhibitors have been reported to present serious hypoglycemia in combination with Sulfonylurea medications as well as some cases of loss of consciousness. Moreover, decreased blood sugar from the use of this medication, once confirmed, can be remedied by giving sucrose. However, hypoglycemia resulting from a combination with glucosidase inhibitors should be treated with fructose.</p>', '<p>No study has performed in patients who are pregnant, breast-feeding, possibly pregnant, or planning to become pregnant.</p>', '<p>(provide cautious dosage to the following patients): The following patients or circumstances</p>\r\n\r\n<ul>\r\n	<li>Patients with moderate kidney function disorder</li>\r\n	<li>Patients undergoing treatment with sulfonylurea drugs or insulin medication [there are reports of severe hypotension with use in combination with other DPP-4 inhibitors]</li>\r\n	<li>Hypopituitarism or hypoadrenalism</li>\r\n	<li>Malnutrition, starvation, irregular eating patterns, insufficient eating, or hyposthenia</li>\r\n	<li>Vigorous exercise</li>\r\n	<li>Patients who consume excessive alcohol</li>\r\n</ul>', NULL, '<p>Dipeptidyl Peptidase-4 (DPP-4) inhibitor.</p>', '<p>Store at 25&deg;C; excursions permitted to 15&deg;-30&deg;C. Dispense medication in the original container to protect from exposure to high humidity and light. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:08:46', '2022-03-22 00:08:46'),
(1520, 1520, '<p>Tretinoin capsules are indicated for the induction of remission in patients with acute promyelocytic leukemia (APL), French-American-British (FAB) classification M3 (including the M3 variant), characterized by the presence of the t(15;17) translocation and/or the presence of the PML/RAR&alpha; gene who are refractory to, or who have relapsed from, anthracycline chemotherapy, or for whom anthracycline-based chemotherapy is contraindicated. Tretinoin is for the induction of remission only. The optimal consolidation or maintenance regimens have not been defined, but all patients should receive an accepted form of remission consolidation and/or maintenance therapy for APL after completion of induction therapy with Tretinoin.</p>', '<p>Tretinoin is not a cytolytic agent but instead induces cytodifferentiation and decreased proliferation of APL cells in culture and in vivo. In APL patients, tretinoin treatment produces an initial maturation of the primitive promyelocytes derived from the leukemic clone, followed by a repopulation of the bone marrow and peripheral blood by normal, polyclonal hematopoietic cells in patients achieving complete remission (CR). The exact mechanism of action of tretinoin in APL is unknown.</p>', '<p>The recommended dose is 45 mg/m2/day administered as two evenly divided doses until complete remission is documented. Therapy should be discontinued 30 days after achievement of complete remission or after 90 days of treatment, whichever occurs first. If after initiation of treatment of Tretinoin the presence of the t(15;17) translocation is not confirmed by cytogenetics and/or by polymerase chain reaction studies and the patient has not responded to Tretinoin, alternative therapy appropriate for acute myelogenous leukemia should be considered. Tretinoin is for the induction of remission only. Optimal consolidation or maintenance regimens have not been determined. All patients should, therefore, receive a standard consolidation and/or maintenance chemotherapy regimen for APL after induction therapy with Tretinoin, unless otherwise contraindicated.</p>', '<p>As Tretinoin is metabolized by the hepatic P450 system, there is a potential for alteration of pharmacokinetics parameters in patients administered concomitant medications that are also inducers or inhibitors of this system. Medications that generally induce hepatic P450 enzymes include rifampicin, glucocorticoids, phenobarbital and pentobarbital. Medications that generally inhibit hepatic P450 enzymes include ketoconazole, cimetidine, erythromycin, verapamil, diltiazem and cyclosporine. To date there are no data to suggest that co-use with these medications increases or decreases either efficacy or toxicity of Tretinoin.</p>', '<p>Tretinoin is contraindicated in patients with a known hypersensitivity to Tretinoin, any of its components, or other retinoids. Tretinoin should not be given to patients who are sensitive to parabens, which are used as preservatives in the gelatin capsule.</p>', '<p>Virtually all patients experience some drug-related toxicity, especially headache, fever, weakness, and fatigue. These adverse effects are seldom permanent or irreversible nor do they usually require interruption of therapy. Some of the adverse events are common in patients with APL, including hemorrhage, infections, gastrointestinal hemorrhage, disseminated intravascular coagulation, pneumonia, septicemia, and cerebral hemorrhage. The following describes the adverse events, regardless of drug relationship, that were observed in patients treated with Tretinoin.</p>', '<p>Pregnancy Category D. Tretinoin has teratogenic and embryotoxic effects in mice, rats, hamsters, rabbits and pigtail monkeys, and may be expected to cause fetal harm when administered to a pregnant woman. Tretinoin causes fetal resorptions and a decrease in live fetuses in all animals studied. Although experience with humans administered Tretinoin is extremely limited, increased spontaneous abortions and major human fetal abnormalities related to the use of other retinoids have been documented in humans.<br />\r\n<br />\r\nNursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, and because of the potential for serious adverse reactions from Tretinoin in nursing infants, mothers should discontinue nursing prior to taking this drug.</p>', '<p>Tretinoin has potentially significant toxic side effects in APL patients. Patients undergoing therapy should be closely observed for signs of respiratory compromise and/or leukocytosis. Supportive care appropriate for APL patients, eg, prophylaxis for bleeding, prompt therapy for infection, should be maintained during therapy with Tretinoin.<br />\r\n<br />\r\nThere is a risk of thrombosis (both venous and arterial) which may involve any organ system, during the first month of treatment. Therefore, caution should be exercised when treating patients with the combination of Tretinoin and anti-fibrinolytic agents, such as tranexamic acid, aminocaproic acid or aprotinin.<br />\r\n<br />\r\nThe ability to drive or operate machinery might be impaired in patients treated with Tretinoin, particularly if they are experiencing dizziness or severe headache. Microdosed progesterone preparations (&quot;minipill&quot;) may be an inadequate method of contraception during treatment with Tretinoin.</p>', '<p>There has been no experience with acute overdosage in humans. The maximal tolerated dose in patients with myelodysplastic syndrome or solid tumors was 195 mg/m2 /day. The maximal tolerated dose in pediatric patients was lower at 60 mg/m2 /day. Overdosage with other retinoids has been associated with transient headache, facial flushing, cheilosis, abdominal pain, dizziness and ataxia. These symptoms have quickly resolved without apparent residual effects. There is no specific treatment in the case of an overdose, however, it is important that the patient be treated in a special hematological unit.</p>', '<p>Oral Retinoid preparations</p>', '<p>Store at 15&deg; to 30&deg;C. Protect from light.</p>', '<p><strong>Pediatric Use</strong>: There are limited clinical data on the pediatric use of Tretinoin. Of 15 pediatric patients (age range: 1 to 16 years) treated with Tretinoin, the incidence of complete remission was 67%. Safety and effectiveness in pediatric patients below the age of 1 year have not been established. Some pediatric patients experience severe headache and pseudotumor cerebri, requiring analgesic treatment and lumbar puncture for relief. Increased caution is recommended in the treatment of pediatric patients. Dose reduction may be considered for pediatric patients experiencing serious and/or intolerable toxicity; however, the efficacy and safety of Tretinoin at doses lower than 45 mg/m2 /day have not been evaluated in the pediatric population.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total number of subjects in clinical studies of Tretinoin, 21.4% were 60 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.</p>', '2022-03-22 00:10:56', '2022-03-22 00:10:56'),
(1521, 1521, '<p>For topical application in the treatment of acne vulgaris in which comedones, papules and pustules predominate.</p>', '<p>Although the exact mode of action of Tretinoin is unknown, current evidence suggests that topical Tretinoin decreases cohesiveness of follicular epithelial cells with decreased microcomedo formation. Additionally Tretinoin stimulates mitotic activity and increases turnover of follicular epithelial cells, causing extrusion of the comedones, papules and pustules.</p>', '<p>This cream should be applied sparingly to the whole affected area once or twice daily. The skin should be thoroughly cleaned and dried before application. Patient should be advised that 6 to 8 weeks of treatment may be required before a therapeutic effect is observed. Moisturizers and cosmetics may be used during treatment with Tretinoin cream but should not be applied to the skin at the same time. Astringent toiletries should be avoided.</p>', '<p>Other topical acne treatments should be used with caution during treatment with Tretinoin. Particular caution should be exercised when using preparation containing a peeling agent for example benzoyl peroxide. It is also possible to apply Tretinoin and benzoyl peroxide alternately. The suggested regimens are either Tretinoin in the morning and benzoyl peroxide in the evening or the preparations should be used on alternate days.</p>', '<p>Tretinoin is contraindicated to those who are highly sensitive to any of the ingredients. This cream should not be used in patients with a personal or family history of cutaneous epithelioma (skin cancer).</p>', '<p>Initial external application of Tretinoin generally may cause burning or slight irritation, erythema and peeling at the site of application may also occur. If irritation becomes severe and persists, discontinue application and consult your physicians, if necessary.</p>', '<p>There is an inadequate evidence of the safety of topically applied Tretinoin in human pregnancy. Tretinoin has been associated with teratogenicity in human when administered systemically. So the cream should not be used during pregnancy and lactation.</p>', '<p>Avoid contact of Tretinoin with lips, mouth, eyes, eyelids, nostrils or another mucous membrane. If contact in these areas occurs, careful washing with water is recommended. Apply the cream to sensitive areas of skin, such as the neck, with caution. Do not use it on broken, eczematous or sun burned skin.</p>', NULL, '<p>Topical retinoid and related preparations.</p>', '<p>Keep out of the reach of children. Keep in a cool &amp; dry place, protect from light.</p>', NULL, '2022-03-22 00:13:54', '2022-03-22 00:13:54'),
(1522, 1522, '<p>This medication is a combination&nbsp;antibiotic&nbsp;and steroid used on the skin to treat an infection and relieve associated&nbsp;itching&nbsp;and swelling.</p>', '<p><strong>Triamcinolone</strong>&nbsp;is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions.<br />\r\n<br />\r\n<strong>Nystatin</strong>, a polyene antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi e.g Candida spp.<br />\r\n<br />\r\n<strong>Neomycin</strong>&nbsp;is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms.<br />\r\n<br />\r\n<strong>Gramicidin</strong>, an antibacterial substance extracted from tyrothricin, is active against many Grampositive bacteria. Used together, this combination provides a wide coverage against gram-positive, gram-negative bacteria and yeast which are responsible for most of the skin infections.</p>', '<p>This medication is for use on the skin only. Wash your hands before using. Avoid getting this product in your eyes or inside the mouth. If this occurs, wipe off the medication and rinse thoroughly with water. Do not use inside the nose unless directed by your doctor.<br />\r\n<br />\r\nClean and dry the affected area as directed. Apply a small amount of medication in a thin layer on the skin and rub in gently, usually 2 to 3 times daily or as directed by your doctor. Wash your hands after use.<br />\r\n<br />\r\nDo not bandage, wrap, or cover the treated area unless you are instructed to do so by your doctor. If this medication is applied to the groin area, do not use tight-fitting plastic pants/diapers/garments for incontinence (loss of control of your bladder or bowels). Doing so may increase the absorption of this product through the skin and increase the risk for side effects.<br />\r\n<br />\r\nDo not use large amounts of this medication, apply it more often, or use it for a longer time than directed. Your condition may not improve faster, and the risk for side effects may be increased.<br />\r\n<br />\r\nUse this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.<br />\r\n<br />\r\nTell your doctor if your condition does not improve or if it worsens after 1 week.</p>', '<p>Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.<br />\r\n<br />\r\nBefore using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:</p>\r\n\r\n<ul>\r\n	<li>other products for the skin (e.g., corticosteroids/antiseptics)</li>\r\n	<li>aminoglycoside antibiotics (e.g., gentamicin, tobramycin)</li>\r\n	<li>corticosteroids taken by mouth (e.g., prednisone)</li>\r\n</ul>\r\n\r\n<p>This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.</p>', '<p>Tuberculous, viral lesions of the skin (e.g. herpes simplex and varicella); fungal lesions not susceptible to nystatin, facial rosacea, acne vulgaris or perioral dermatitis. Not to be applied to the external auditory canal in patients with perforated tympanic membranes. Do not use on extensive areas to reduce risk of systemic absorption and neomycin-induced ototoxicity. Not recommended for &lt;1 yr.</p>', '<p>Prolonged use may cause sensitivity reactions, impaired wound healing, thinning of skin, striae, telangiectasia, hirsutism, hypothalamic-pituitary-adrenal axis suppression, Cushing&#39;s syndrome.</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Patients with established hearing loss. Avoid occlusive dressing and prolonged or recurrent use. Avoid contact with eyes or mucous membranes. If there is no clinical improvement after 7 days, discontinue use as the infection may be masked by the steroid. Limit use to 5 days if used on the face or on children &lt;1 yr. Use with caution and sparingly on inflamed or damaged skin (e.g extensive burns, trophic ulceration). Pregnancy.</p>', NULL, '<p>Triamcinolone &amp; Combined preparations.</p>', '<p>Store at room temperature between 15 and 30 degrees C, away from heat. Check the expiration date on the tube and discard any expired medication.</p>', NULL, '2022-03-22 00:17:10', '2022-03-22 00:17:10'),
(1523, 1523, '<p>Post-traumatic osteoarthritis, synovitis of osteoarthritis, rheumatoid arthritis, acute and sub-acute bursitis, epicondylitis, acute non-specific tenosynovitis, acute gouty arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile rheumatoid arthritis, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe psoriasis, bronchial asthma, contact dermatitis, atopic dermatitis, seasonal or perennial allergic rhinitis.</p>', '<p>The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition of arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Firstly, however, these glucocorticoids bind to the glucocorticoid receptors which translocate into the nucleus and bind DNA (GRE) and change genetic expression both positively and negatively. The immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.</p>', '<p><strong>Adults and children over 12 years of age</strong>: Initial dose is 60 mg. Dosage is usually adjusted within the range of 40 to 80 mg. For local areas, dose for adults is up to 10 mg for smaller areas and up to 40 mg for larger areas.<br />\r\n<br />\r\n<strong>Children 6 to 12 years</strong>: Initial dose is 40 mg</p>', '<p><strong>Aminoglutethimide</strong>: Aminoglutethimide may lead to a loss of corticosteroid-induced adrenal suppression.&nbsp;<br />\r\n<br />\r\n<strong>Amphotericin B injection and potassium-depleting agents</strong>: When corticosteroids are administered concomitantly with potassium-depleting agents (ie, amphotericin B, diuretics), patients should be observed closely for development of hypokalemia. There have been cases reported in which concomitant use of amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failure.&nbsp;<br />\r\n<br />\r\n<strong>Antibiotics</strong>: Macrolide antibiotics have been reported to cause a significant decrease in corticosteroid clearance.&nbsp;<br />\r\n<br />\r\n<strong>Anticholinesterases</strong>: Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, anticholinesterase agents should be withdrawn at least 24 hours before initiating corticosteroid therapy.<br />\r\n&nbsp;<br />\r\n<strong>Anticoagulants, oral</strong>: Coadministration of corticosteroids and warfarin usually results in inhibition of response to warfarin, although there have been some conflicting reports. Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect.<br />\r\n&nbsp;<br />\r\n<strong>Antidiabetics</strong>: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required.&nbsp;<br />\r\n<br />\r\n<strong>Antitubercular drugs</strong>: Serum concentrations of isoniazid may be decreased.&nbsp;<br />\r\n<br />\r\n<strong>Cholestyramine</strong>: Cholestyramine may increase the clearance of corticosteroids.&nbsp;<br />\r\n<br />\r\n<strong>Cyclosporine</strong>: Increased activity of both cyclosporine and corticosteroids may occur when the two are used concurrently. Convulsions have been reported with this concurrent use.&nbsp;<br />\r\n<br />\r\n<strong>Digitalis glycosides</strong>: Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia.&nbsp;<br />\r\nEstrogens, including oral contraceptives: Estrogens may decrease the hepatic metabolism of certain corticosteroids, thereby increasing their effect.&nbsp;<br />\r\n<br />\r\n<strong>Hepatic enzyme inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin)</strong>: Drugs which induce hepatic microsomal drug metabolizing enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased.&nbsp;<br />\r\n<br />\r\n<strong>Ketoconazole</strong>: Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60%, leading to an increased risk of corticosteroid side effects.&nbsp;<br />\r\n<br />\r\n<strong>Nonsteroidal anti-inflammatory drugs (NSAIDs)</strong>: Concomitant use of aspirin (or other nonsteroidal anti-inflammatory drugs) and corticosteroids increases the risk of gastrointestinal side effects. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. The clearance of salicylates may be increased with concurrent use of corticosteroids.&nbsp;<br />\r\n<br />\r\n<strong>Skin tests</strong>: Corticosteroids may suppress reactions to skin tests.&nbsp;<br />\r\n<br />\r\n<strong>Vaccines</strong>: Patients on prolonged corticosteroid therapy may exhibit a diminished response to toxoids and live or inactivated vaccines due to inhibition of antibody response. Corticosteroids may also potentiate the replication of some organisms contained in live attenuated vaccines. Routine administration of vaccines or toxoids should be deferred until corticosteroid therapy is discontinued if possible.</p>', '<p>Triamcinolone Acetonide injection is contraindicated in patients with a sensitivity to the active or inactive ingredients.</p>', '<p>Cushingoid syndrome, weakness, bruising or purpura, aggravation of infections, peptic ulcer, activation of latent or aggravation of existing diabetes, altered menstrual cycle, hirsutism.</p>', '<p>Triamcinolone Acetonide injection should be used during pregnancy, nursing mothers if the possible benefits of the medication justify the potential hazards to the fetus or nursing infant.</p>', '<p>Triamcinolone Acetonide injection should be used cautiously in patients with ocular herpes simplex, nonspecific ulcerative colitis, active or latent peptic ulcer, renal insufficiency, hypertension, osteoporosis, Cushing&#39;s syndrome, diabetes mellitus, congestive heart failure, chronic nephritis.</p>', '<p>Treatment of acute overdosage is by supportive and symptomatic therapy. For chronic overdosage in the face of severe disease requiring continuous steroid therapy, the dosage of the corticosteroid may be reduced only temporarily, or alternate day treatment may be introduced.</p>', '<p>Corticosteroid, Glucocorticoids, Triamcinolone &amp; Combined preparations.</p>', '<p>Store at controlled room temperature, 20-25&deg;C, avoid freezing and protect from light.</p>', '<p><strong>Use in the elderly</strong>: The common adverse effects of systemic corticosteroids such as osteoporosis or hypertension may be associated with more serious consequences in old age. Close clinical supervision is recommended.<br />\r\n<br />\r\n<strong>Use in children</strong>: As corticosteroids can suppress growth, the development of infants and children on prolonged corticosteroid therapy should be carefully observed. Caution should be taken in the event of exposure to chicken pox, measles or other communicable diseases. Children should not be vaccinated or immunized while on corticosteroid therapy. Corticosteroids may also affect endogenous steroid production.</p>', '2022-03-22 00:19:19', '2022-03-22 00:19:19'),
(1524, 1524, '<p>Triamcinolone is indicated for the treatment and prophylaxis of the nasal symptoms of seasonal and perennial allergic rhinitis in adults and children 6 years of age and older.</p>', '<p>The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition of arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Firstly, however, these glucocorticoids bind to the glucocorticoid receptors which translocate into the nucleus and bind DNA (GRE) and change genetic expression both positively and negatively. The immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.<br />\r\n<br />\r\nTriamcinolone Acetonide is a more potent derivative of Triamcinolone and is approximately 8 times more potent than prednisone. Corticosteroids are very effective in the treatment of allergic diseases in man. When given by intranasal spray, Triamcinolone Acetonide provides relief from allergy-induced watery nasal discharge (rhinorrhea), nasal congestion, postnasal drip, sneezing, and itching of the back of the throat.</p>', '<p><strong>Adults and children 12 years of age and older</strong>: The recommended dose is 220 &micro;gm as 2 sprays in each nostril once daily. Once symptoms are controlled patients can be maintained on 110 &micro;gm (1 spray in each nostril once daily). The minimum effective dose should be used to ensure continued control of symptoms.<br />\r\n<br />\r\n<strong>Pediatric Patients aged 6 to 12 years</strong>: The recommended dose is 110 &micro;gm as 1 spray in each nostril once daily. Triamcinolone&nbsp;spray is not recommended for children under 6 years of age.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', NULL, '<p>No specific contraindications but caution is required in patients with hypersensitivity to any constituents of the formulation.</p>', '<p>The most commonly reported adverse reactions in clinical trials with Triamcinolone included those involving mucous membranes of the nose &amp; throat. The most prevalent adverse reactions considered are rhinitis, headache, &amp; pharyngitis. The nasopharyngeal adverse effects included epistaxis, nasal irritation, dry mucous membrane,&nbsp;naso-sinus congestion and sneezing although these are seen as frequently with placebo. As with other nasally inhaled corticosteroids, nasal septal perforation has been reported.</p>', '<p>There are no adequate and well controlled studies in pregnant women with Triamcinolone. Because animal studies indicate a teratogenic effect, Triamcinolone should be used during pregnancy if the potential benefit justifies the potential benefit to fetus. It is not known whether Triamcinolone is excreted in human breast milk.</p>', '<p>If there is any reason to suppose that adrenal function is impaired, care must be taken while transferring patients from systemic steroid treatment to Triamcinolone. In clinical studies with Triamcinolone administered intranasally, the development of localized infections, on the nose, and pharynx with Candida albicans, has rarely occurred. When such an infection develops it may require treatment with appropriate local therapy and discontinuance of treatment with Triamcinolone. Because of the inhibitory effect of corticosteroids on wound healing in patients who have experienced recent nasal septal ulcers, nasal surgery of trauma, Triamcinolone should be used with caution until healing has occurred.</p>', '<p>Like any other nasally administered corticosteroid, acute overdosing with Triamcinolone is unlikely in view of the total amount of active ingredient present.</p>', '<p>Corticosteroid, Glucocorticoids, Nasal Steroid Preparations.</p>', '<p>Store at a temperature not exceeding 25˚C. Protect from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:21:18', '2022-03-22 00:21:18'),
(1525, 1525, '<p>is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses including atopic dermatitis, contact dermatitis, eczematous dermatitis, neurodermatitis, seborrheic dermatitis, insect bites, lichen simplex chronicus, exfoliative dermatitis, stasis dermatitis, nummular eczema, psoriasis and pruritus ani and vulvae.</p>', '<p>Triamcinolone Acetonide (a derivative of Triamcinolone) in a compatible base. Topical steroids are primarily effective because of their anti-inflammatory, antipruritic &amp; vasoconstrictive actions.</p>', '<p>A small amount of Triamcinolone is gently rub to the affected area 1-2 times daily. Some cases of eczematised psoriasis may be treated more effectively by the application of Triamcinolone under an occlusive dressing.<br />\r\n<br />\r\n<strong>Occlusive dressing technique</strong>: Gently rub a small amount of Triamcinolone on the lesion until it disappears. Then reapply, leaving a thin coating and cover with a pliable non porous film. For convenience apply Triamcinolone intermittently (12 hour occlusion during the night) followed by reapplication without occlusion, during the day.<br />\r\n<br />\r\n<strong>Pediatric use</strong>: Triamcinolone&nbsp;should not be used in children under 8 years. Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children. As children are more likely to get side effects, they should not normally be treated for longer than 5 days.</p>', NULL, '<p>Triamcinolone Acetonide is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. It is also contraindicated in tuberculosis of the skin, fungus infections and viral diseases of the skin (Herpes simplex, chickenpox and vaccinia), perioral dermatitis, rosacea and ulcerative conditions.</p>', '<p>The following local side effects have been reported with topical corticosteroids, either with or without occlusive dressings: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis and allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae and miliaria.</p>', '<p>There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether topical administration of corticosteroid could result in sufficient systemic absorption to produce detectable quantities in breast milk. Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman.</p>', '<p>If reactions or idiosyncrasies are encountered, Triamcinolone Acetonide should be discontinued. The use of topical steroids on infected areas should be attended with caution and careful observation, bearing in mind the potential spreading of infections by anti-inflammatory steroids and the possible advisability of discontinuing steroid therapy and/or initiating antibacterial measures.<br />\r\n<br />\r\nTriamcinolone Acetonide should not be used on healthy skin or over large areas of skin and not to be used in the eye as there is potential risk of glaucoma and cataract. When steroids are applied for long periods of time (more than 4 weeks) the occurrence of atrophic striae is likely. Prolonged use on flexures and intertriginous areas is undesirable. Children may absorb proportionately larger amounts of topical corticosteroids and thus may be more susceptible to systemic toxicity. In infants, long term continuous topical steroid therapy should be avoided. Adrenal suppression can occur even without occlusion.</p>', '<p>Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects e.g., mild, reversible suppression of adrenal function, ecchymoses of the skin, peptic ulceration, hypertension, aggravation of infection, hirsutism, acne, edema and muscle weakness.</p>', '<p>Corticosteroid, Glucocorticoids, Triamcinolone &amp; Combined preparations.</p>', '<p>Store in a cool &amp; dry place. Protect from light.</p>', NULL, '2022-03-22 00:22:52', '2022-03-22 00:22:52');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1526, 1526, '<p>Trifarotene cream is a retinoid indicated for the topical treatment of acne vulgaris in patients 9 years of age and older.</p>', '<p>Trifarotene is an agonist of retinoic acid receptors (RAR), with particular activity at the gamma subtype of RAR. Stimulation of RAR results in modulation of target genes which are associated with various processes, including cell differentiation and mediation of inflammation. The exact process by which Trifarotene ameliorates acne is unknown.</p>', '<p>Apply a thin layer of Trifarotene cream to the affected areas once daily, in the evening, on clean and dry skin. The use of a moisturizer is recommended as frequently as needed from the initiation of treatment. Avoid contact with the eyes, lips, paranasal creases, mucous membranes. Trifarotene cream is intended for topical use only. Not for oral, ophthalmic or intravaginal use.</p>', '<p>Topical application of Trifarotene cream is not expected to affect the circulating concentrations of oral hormonal contraceptives containing ethinylestradiol and levonorgestrel.</p>', NULL, '<p>Most common adverse reactions (incidence &gt;1%) in patients treated with Trifarotene cream were application site irritation, application site pruritus, and sunburn.</p>', '<p>Pregnancy Category C. Available data from clinical trials with Trifarotene cream use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Trifarotene cream and any potential adverse effects on the breastfed infant from Trifarotene cream or from the underlying maternal condition.</p>', '<p><strong>Skin irritation</strong>: Patients using Trifarotene cream may experience erythema, scaling, dryness and stinging/burning. Maximum severity of these reactions typically occurred within the first 4 weeks of treatment, and severity decreased with continued use of the medication. Depending upon the severity of these adverse reactions, instruct patients to use a moisturizer, reduce the frequency of application of Trifarotene cream, or suspend use temporarily. If severe reactions persist the treatment may be discontinued. Avoid application of Trifarotene cream to cuts, abrasions, or eczematous or sunburned skin. Use of &quot;waxing&quot; as a depilatory method should be avoided on skin treated with Trifarotene cream.<br />\r\n<br />\r\n<strong>Ultraviolet Light and Environmental Exposure</strong>: Minimize unprotected exposure to ultraviolet rays (including sunlight and sunlamps) during treatment with Trifarotene cream. Warn patients who normally experience high levels of sun exposure and those with inherent sensitivity to sun to exercise caution. Use of sunscreen products and protective clothing over treated areas is recommended when exposure cannot be avoided.</p>', NULL, '<p>Topical retinoid and related preparations.</p>', '<p>Do not store above 25&deg;C. Protect from light. Keep out of reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Trifarotene cream have not been established in pediatric patients below the age of 9 years.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Trifarotene cream did not include any subjects aged 65 years and over to determine whether they respond differently than younger subjects</p>', '2022-03-22 00:24:25', '2022-03-22 00:24:25'),
(1527, 1527, '<p><strong>Anxiety states</strong>: It controls excessive anxiety, tension, and agitation seen in neuroses or associated with somatic conditions. The treatment or prevention of nausea and vomiting of various causes. The management of psychotic disorders, such as acute or chronic catatonic, hebephrenic and paranoid schizophrenia; psychosis due to organic brain damage, toxic psychosis, and the manic&nbsp;phase of manic-depressive illness.</p>', '<p>Trifluoperazine is one of the phenothiazine class of compounds and as such has many pharmacodynamic effects which relate to its therapeutic actions and side effects. The most notable action of phenothiazines is antagonism at dopamine receptors in the CNS. It is hypothesised that this action in the limbic system and associated areas of cerebral cortex is the basis of the antipsychotic action of phenothiazines, whilst in the medullary chemoreceptor trigger zone it appears to be responsible for the antiemetic effect of these agents.</p>', '<p>Schizophrenia and other psychoses:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and child over 12 years</strong>: Recommended starting dose is 2-5 mg b.i.d, increased by 5 mg daily after 1 week then at interval of 3 days, according to response.&nbsp;</li>\r\n	<li><strong>Children (6-12 years)</strong>: Dosage should be adjusted to the weight of the child and severity of the symptoms. The starting dosage is 1 mg b.i.d. Dosage may be increased gradually until symptoms are controlled or until side effects become troublesome. While it is usually not necessary to exceed dosages of 15 mg daily.</li>\r\n	<li><strong>Elderly</strong>: Reduce initial dose by at least half</li>\r\n</ul>\r\n\r\n<p>Short-term management of severe anxiety:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult and child over 12 years</strong>: 1-2 mg b.i.d, increased if necessary to 6 mg daily.</li>\r\n	<li><strong>Child (3-5 years)</strong>: 1 mg daily</li>\r\n	<li><strong>Child (6-12 years)</strong>: Up to 4 mg daily in divided dose.</li>\r\n	<li><strong>Elderly</strong>: Reduce initial dose by at least half</li>\r\n</ul>\r\n\r\n<p>Antiemetic:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 2-4 mg daily in divided doses; max. 6 mg daily;</li>\r\n	<li><strong>Child</strong>&nbsp;3-5 years: up to 1 mg daily, 6-12 years up to 4 mg daily.</li>\r\n</ul>', '<p>Trifluoperazine may diminish the effect of oral anticoagulants. Concomitant administration of propranolol with trifluoperazine results in increased plasma levels of both drugs. Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concurrently. Potentiation may occur if antipsychotic drugs are combined with CNS depressants such as alcohol. hypnotics and anticonvulsant.</p>', '<p>Do not use Trifluoperazine in comatose patients, or in those with existing blood dyscrasias or known liver damage, or in those hypersensitive to the active ingredient or related compounds.</p>', '<p>Common side effects are transient restlessness, dystonias or may resemble parkinsonism. Other CNS Reactions are drowsiness, dizziness, fatigue, blurred vision, seizures. Without these Peripheral oedema, blood dyscrasias, jaundice may occasionally occur. Tachycardia, constipation, urinary hesitancy and retention and hyperpyrexia have been reported very rarely.</p>', '<p><strong>Pregnancy</strong>: Safety for the use of trifluoperazine during pregnancy has not been established. Therefore, it is not recommended that the drug be given to pregnant patients except when, in the judgement of the physician, it is essential. The potential benefits should clearly outweigh possible hazards. There are reported instances of prolonged jaundices, extrapyramidal signs, hyperreflexia or hypoflexia in newborn infants whose mother received phenothiazines.<br />\r\n<br />\r\n<strong>Lactation</strong>: Adequate human data are not available in case of lactation.</p>', '<p>Care should be taken when treating elderly patients, and initial dosage should be reduced. Such patients can be specially sensitive, particularly to extra pyramidal and hypotensive effects. Patients with cardiovascular disease including arrhythmias should also be treated with caution. Care should be taken in patients with angina pectoris.</p>', '<p>Signs and symptoms will be predominantly extrapyramidal; hypotension may occur. Treatment consists of gastric lavage together with supportive and symptomatic measures. Do not induce vomiting. Extra pyramidal symptoms may be treated with an anticholinergic, antiparkinsonism drug. Treat hypotension with fluid replacement; if severe or persistent. nor adrenaline may be considered. Adrenaline is contraindicated.</p>', '<p>Phenothiazine drugs.</p>', '<p>It should be store at room temperature between 15-30&deg; C away from light and moisture.</p>', NULL, '2022-03-22 00:26:09', '2022-03-22 00:26:09'),
(1528, 1528, '<p>Trifluridine Sterile Eye Drops is indicated for the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus, type 1 and 2.</p>', '<p>Trifluridine is a fluorinated pyrimidine nucleoside analog which interferes with DNA synthesis of herpes simplex virus, type 1 and 2 and vaccinia virus. It stops replication of herpes viral DNA in 3 ways:</p>\r\n\r\n<ol>\r\n	<li>Competitive inhibition of viral DNA polymerase,</li>\r\n	<li>Incorporation into and termination of the growing viral DNA chain and</li>\r\n	<li>Inactivation of the viral DNA polymerase.</li>\r\n</ol>', '<p><strong>Children above 6 years of age &amp; adults:</strong>&nbsp;Instill 1 drop every 2 hrs while awake; maximum 9 drops/day until the corneal ulcer has completely re-epithelialized.<br />\r\n<br />\r\n<strong>After re-epithelialization:</strong>&nbsp;Instill 1 drop every 4 hrs or at least 5 drops/day for 7 days is recommended. If there are no signs of improvement after 7 days of therapy or complete re-epithelialization has not occurred after 14 days of therapy, other forms of therapy should be considered. Continuous administration of Trifluridine&nbsp;eye drops for periods exceeding 21 days should be avoided because of potential ocular toxicity.</p>', NULL, '<p>Contraindicated in patients who develop hypersensitivity reactions or chemical intolerance to Trifluridine.</p>', '<p>Reported side effects are mild, transient burning or stinging sensation upon instillation. Other side effects are superficial punctate keratopathy, epithelial keratopathy, hypersensitivity reaction, stromal edema, irritation, keratitis sicca, hyperemia and increased intraocular pressure.</p>', '<p><strong>Pregnancy</strong>&nbsp;category C. There are no adequate and well-controlled studies in pregnant women. Trifluridine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation:</strong>&nbsp;It is unlikely that Trifluridine is excreted in human milk after instillation of Trifluridine&nbsp;eye drops because of the relatively small dosage. The drug should not be prescribed for nursing mothers unless the potential benefits outweigh the potential risks.</p>', '<p>Trifluridine should be prescribed only for patients who have a clinical diagnosis of herpetic keratitis.</p>', NULL, '<p>Ophthalmic Anti-viral Products.</p>', NULL, '<p><strong>Use in children</strong>: Safety and effectiveness in pediatric patients below 6 years of age have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall clinical differences in safety or effectiveness have been observed between elderly and other adult patients.</p>', '2022-03-22 00:27:41', '2022-03-22 00:27:41'),
(1529, 1529, '<p>Trihexyphenidyl Hydrochloride is indicated as an adjunct treatment of all forms of parkinsonism (postencephalitic, arteriosclerotic &amp; idiopathic). Additionally, it is indicated for the control of extrapyramidal disorders caused by central nervous system drugs such as dibenzoxazepines, phenothiazines, thioxanthenes &amp; butyrophenones.</p>', '<p>Trihexyphenidyl is a non-selective muscarinic acetylcholine receptor antagonist but binds with higher affinity to the M1 subtype. In vivo studies have shown that trihexyphenidyl demonstrates higher affinity for central muscarinic receptors located in the cerebral cortex and lower affinity for those located peripherally. Other studies suggest that trihexyphenidyl may modify nicotinic acetylcholine receptor neurotransmission, leading indirectly to enhanced dopamine release in the striatum. Although the anticholinergic has proven to be useful in the treatment of symptoms associated with Parkinson&rsquo;s disease or other movement disorders, its mechanism of action has yet to be fully elucidated.</p>', '<p>Dosage should be individualized. The initial dose should be low and then increased gradually, especially in patients over 60 years of age. Whether Trihexyphenidyl may best be given before or after meals should be determined by the way the patient reacts.<br />\r\n<br />\r\n<strong>Idiopathic Parkinsonism</strong>: 1 mg of Trihexyphenidyl may be administered the first day. The dose may then be increased by 2mg increments at intervals of three to five days.<br />\r\n<br />\r\n<strong>Drug-Induced Parkinsonism</strong>: Commence therapy with a single 1 mg dose increase the total daily dosage to 5-15 mg range if the extrapyramidal manifestations are not controlled.<br />\r\n<br />\r\n<strong>Concomitant Use with Levodopa</strong>: When Trihexyphenidyl is used concomitantly with levodopa, the usual dose is 3-6 mg daily.</p>', '<p>Cannabinoids, barbiturates, opiates, and alcohol may have additive effects with Trihexyphenidyl, and thus, an abuse potential exists. Concurrent use of alcohol or other CNS depressants with Trihexyphenidyl may cause increased sedative effects. It may be contraindicated in patients taking monoamine oxidase inhibitors &amp; tricycllic antidepressants.</p>', '<p>Contraindicated in patients with hypersensitivity to Trihexyphenidyl HCI or to any of the tablet or elixir ingredients. Trihexyphenidyl is also contraindicated in patients with narrow angle glaucoma. Blindness after long-term use due to narrow angle glaucoma has been reported.</p>', '<p>Minor side effects such as dryness of the mouth, blurring of vision, dizziness, mild nausea or nervousness. Patients with arteriosclerosis or with a history of idiosyncrasy to other drugs may exhibit reactions of mental confusion, agitation, disturbed behavior, or nausea and vomiting. Potential side effects are constipation, drowsiness, urinary hesitancy or retention, pupil dilation, increased intraocular tension, vomiting and headache.</p>', '<p>Pregnancy Category C. It is not known whether the drug is excreted in human milk and therefore Trihexyphenidyl should only be used if the expected benefit to the mother outweighs the potential risk to the infant.</p>', '<p>Patients with cardiac, liver, or kidney disorders, or with hypertensioon, should closely be monitored. Since Trihexyphenidyl HCI has parasympatholytic activity, it should be used with caution in patients with glaucoma, obstructive disease of the gastrointestinal or genitourinary tracts, and in elderly males with possible prostatic hypertrophy. Trihexyphenidyl is not recommended for use in patients with tardive dyskinesia unless they have concomitant Parkinson&rsquo;s disease. Abrupt withdrawal of treatment for parkinsonism may result in acute exacerbation of parkinsonism symptoms; therefore, abrupt withdrawal should be avoided.</p>', '<p>Overdosage with Trihexyphenidyl produces typical central symptoms of atropine intoxication (the central anticholinergic syndrome). Signs &amp; symptoms are: dilated and sluggish pupils, warm, dry skin, facial flushing, decreased secretions of mouth, pharynx, nose and bronchi, foul smelling breath, tachycardia etc. Neuropsychiatric signs such as delirium, disorientation, anxiety, hallucinations etc. The condition can progress to stupor, coma, paralysis, cardiac, respiratory arrest and death.</p>', '<p>Antiparkinson drugs</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-22 00:29:27', '2022-03-22 00:29:27'),
(1530, 1530, '<p>Treatment and relief of symptoms associated with irritable bowel syndrome (spastic colon). Postoperative paralytic ileus in order to accelerate the resumption of the intestinal transit following abdominal surgery.</p>', '<p>Trimebutine maleate is a noncompetitive spasmolytic agent. It possesses moderate opiate receptor affinity and has marked anti-serotonin activity especially on &#39;mu&#39; receptors. It induces regulation of spontaneous activity and increases synchronization between electrophysiological spikes and contractions in isolated guinea pig strips of colon and ileum. However, it does not alter normal motility, but regulates abnormal intestinal activity.</p>', '<p><strong>For adults</strong>: 100 mg to 200 mg, 3 times per day before meals.</p>', '<p>Trimebutine maleate increases the duration of d-tubocurarine-induced curarization. No other druginteractions have been observed during clinical trial or otherwise reported.</p>', '<p>Patients with known hypersensitivity to trimebutine maleate or any excipient.</p>', '<p>Trimebutine maleate is generally well tolerated. The infrequently reported adverse effects are as follows: dry mouth, foul taste, diarrhea, dyspepsia, epigastric pain, nausea, constipation, drowsiness, fatigue, dizziness, hot/cold sensations, headache etc.</p>', '<p>Although teratological studies have not shown any drug related adverse effects on the course and outcome of pregnancy, the use of trimebutine maleate in pregnant women is not recommended.<br />\r\n<br />\r\nIt is not known if trimebutine maleate passes into breast milk. This medication should be used while breast feeding only if the potential benefits outweigh risks to the nursing infants.</p>', '<p>Elderly, pregnancy and lactation</p>', '<p>No evidence of overdosage have been reported to date. However, if overdosage should occur following oral administration, gastric lavage is recommended. Treatment should be made according to the symptoms observed.</p>', '<p>Anticholinergics.</p>', '<p>Store in a cool and dry place, protected from light and moisture. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:31:13', '2022-03-22 00:31:13'),
(1531, 1531, '<p>Trimetazidine Dihydrochloride is indicated in adults as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled by or intolerant to first-line antianginal therapies.</p>', '<p>Trimetazidine Dihydrochloride is the first 3- keto acyl CoA thiolase inhibitor (KAT), a metabolic anti-ischemic agent with proven benefits for all coronary patients. Trimetazidine Dihydrochloride inhibits fatty acid pathway by inhibiting 3-keto acyl CoA thiolase enzyme and transfers oxygen to glucose pathway. Since glucose pathway is more efficient in producing energy, the same oxygen produces more energy and makes the heart more active. Moreover, the aerobic oxidation of glucose stops production of lactic acid, which prevents angina pectoris.</p>', '<p>The recommended dose of Trimetazidine is 35 mg twice daily or 20 mg tablet thrice daily during meals. The benefit of the treatment should be assessed after three months and Trimetazidine should be discontinued if there is no treatment response.</p>', '<p>No drug interaction so far has been reported. In particular, no interaction has been reported with beta-blockers, calcium antagonists, nitrates, heparin, hypolipidemic agents or digitalis preparation.</p>', '<p>Trimetazidine is contraindicated in patients who have hypersensitivity to the active substance or to any of the excipients. It is also is contraindicated in patients with Parkinson&rsquo;s disease, parkinsonian symptoms, tremors, restless legs movement disorders, severe renal impairment.</p>', '<p>Trimetazidine is safe and well tolerated. The Common side effects associated with Trimetazidine are dizziness, headache, abdominal pain, diarrhoea, dyspepsia, nausea, vomiting, rash, pruritus, urticaria and asthenia</p>', '<p>There is no data on the use of Trimetazidine in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. As a precautionary measure, it is preferable to avoid the use of Trimetazidine during pregnancy. It is unknown whether Trimetazidine is excreted in human milk. A risk to the newborns/infants cannot be excluded. Trimetazidine should not be used during breast-feeding.</p>', '<p>Trimetazidine is not a curative treatment for angina attacks, nor an initial treatment for unstable angina pectoris. It is also not a treatment for myocardial infarction.</p>', NULL, '<p>Other Anti-anginal &amp; Anti-ischaemic drugs.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:32:31', '2022-03-22 00:32:31'),
(1532, 1532, '<p>This&nbsp;medication&nbsp;is used to treat&nbsp;depression. It may help improve your mood and sense of well-being and allow you to enjoy everyday life more.&nbsp;Trimipramine&nbsp;is a tricyclic antidepressant. It works by restoring the balance of certain natural substances (neurotransmitters) in the&nbsp;brain.</p>', '<p>Trimipramine is a tricyclic antidepressant. It was thought that tricyclic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine and serotonin by nerve cells. However, this response occurs immediately, yet mood does not lift for around two weeks. It is now thought that changes occur in receptor sensitivity in the cerebral cortex and hippocampus. The hippocampus is part of the limbic system, a part of the brain involved in emotions. Presynaptic receptors are affected: a1 and b1 receptors are sensitized, a2 receptors are desensitised (leading to increased noradrenaline production). Tricyclics are also known as effective analgesics for different types of pain, especially neuropathic or neuralgic pain. A precise mechanism for their analgesic action is unknown, but it is thought that they modulate anti-pain opioid systems in the CNS via an indirect serotonergic route. They are also effective in migraine prophylaxis, but not in abortion of acute migraine attack. The mechanism of their anti-migraine action is also thought to be serotonergic.</p>', '<p><strong>Adult:&nbsp;</strong>Initially 50-75 mg daily, increased gradually as necessary to 150-300 mg daily. May be given in divided doses during the day or as a single dose at night.<br />\r\n<br />\r\n<strong>Elderly:&nbsp;</strong>Initial 50-75 mg daily, increased gradually if necessary. Max: 100 mg daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food</p>', '<p>Decreased antihypertensive effects of guanethidine, guanfacine, debrisoquine, betanidine and possibly clonidine. Increased CNS depression with CNS depressants such as alcohol, sedatives, hypnotics or barbiturates. Increased trimipramine levels with protease inhibitors, SSRIs, selegiline, tramadol, quinidine, diltiazem and verapamil. Decreased trimipramine levels with barbiturates. Increased risk of arrhythmias with drugs that prolong QT intervals. Increased risk of serotonin syndrome with linezolid. Increased antimuscarinic adverse effects with nefopam. Risk of neurotoxicity and serotonin syndrome with lithium.</p>', '<p>Recent MI, cardiac arrhythmias, heart block; mania; porphyria, severe liver disease. Neonates and children. Lactation.</p>', '<p>Dry mouth, accommodation disturbances, tachycardia, constipation, hesitancy of micturation, drowsiness, sweating, postural hypotension, skin rashes, cholestatic jaundice, hypomania, convulsions, cardiac arrhythmias and peripheral neuropathy. Agitation, confusion (elderly).</p>', '<p>Pregnancy&nbsp;Category C.&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Narrow-angle glaucoma; prostatic hypertrophy; history of epilepsy; hyperthyroidism; patients requiring anaesthesia. Pregnancy. Withdraw gradually to decrease risk of withdrawal symptoms. Monitor liver function in long term treatment. May impair ability to drive or operate machinery.</p>', '<p><strong>Symptoms</strong>: Hypotensive collapse, convulsions, cardiac arrhythmias, acidosis and coma.<br />\r\n<br />\r\n<strong>Management</strong>: Gastric lavage should be carried out as soon as possible. Treatment is supportive and symptomatic with ECG monitoring. Intubate and ventilate the patient before convulsions develop. If convulsions occur, treat with IV diazepam. Treatment should be continued for at least 3 days even if the patient appears to have recovered, due to the long half life of trimipramine.</p>', '<p>Tricyclic &amp; related anti-depressant drugs.</p>', NULL, NULL, '2022-03-22 00:34:05', '2022-03-22 00:34:05'),
(1533, 1533, '<p>For mydriasis and cycloplegia for diagnostic procedure, for the treatment of acute and subacute iridocyclitis, chronic iridocyclitis, Adhesions and disruptions of iris and ciliary body, Sclera and iris operations</p>', '<p>Tropicamide binds to and blocks the receptors in the muscles of the eye (muscarinic receptor M4). Tropicamide acts by blocking the responses of the iris sphincter muscle to the iris and ciliary muscles to cholinergic stimulation, producing dilation of the pupil and paralysis of the ciliary muscle.</p>', '<p><strong>For refraction:</strong>&nbsp;Instill one or two drops of 1% solution in the eye(s), repeated in five minutes. If patient is not seen within 20 to 30 minutes, an additional drop may be instilled to prolong mydriatic effect.<br />\r\n<br />\r\n<strong>For examination of fundus:</strong>&nbsp;Instill one or two drops of 0.5% solution 15 to 20 minutes prior to examination. Individuals with heavily pigmented irides may require higher strength or more doses.</p>', '<p>Tropicamide may interfere with the antihypertensive action of carbachol, pilocarpine, or ophthalmic cholinesterase inhibitors.</p>', '<p>Contraindicated in persons showing hypersensitivity to any component of this preparation.</p>', '<p>Transient stinging, blurred vision, photophobia and superficial punctate keratitis have been reported with the use of tropicamide. Increased intraocular pressure has been reported following the use of mydriatics. Dryness of the mouth, tachycardia, headache, allergic reactions, nausea, vomiting, pallor, central nervous system disturbances and muscle rigidity have been reported with the use of tropicamide.</p>', '<p>Pregnancy Category C. Tropicamide should be given to a pregnant woman only if clearly needed. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when tropicamide is administered to a nursing woman.</p>', '<p>The lacrimal sac should be compressed by digital pressure for 2-3 minutes after instillation to avoid excessive systemic absorption.</p>', NULL, '<p>Mydriatic and Cycloplegic agents.</p>', '<p>Store at 15&deg; to 25&deg;C . Do not refrigerate or store at high temperatures. Keep container tightly closed.</p>', NULL, '2022-03-22 00:35:32', '2022-03-22 00:35:32'),
(1534, 1534, '<p>This is indicated for cataract surgery to obtain mydriasis (dilation of the pupil) and intraocular anesthesia during the surgical procedure.</p>', '<p>Used only in the elderly and adults undergoing cataract surgery. The injection has to be administered by an ophthalmic surgeon, under local anesthesia, at the beginning of cataract surgery. The recommended dose is 0.2 ml of solution, in only one injection. The following procedure should be followed:</p>\r\n\r\n<ul>\r\n	<li>Five minutes before performing the preoperative antiseptic procedure and the first incision, one to two drops of anesthetic eye drops should be instilled in the eye.</li>\r\n	<li>At the beginning of surgery, 0.2 ml of the drop is slowly injected in only one injection via intracameral route, through the side port or principal port.</li>\r\n</ul>', NULL, NULL, NULL, '<p>Most serious well-known complications occurring during or after cataract surgery:<br />\r\nUncommon: may affect up to 1 in 100 people</p>\r\n\r\n<ul>\r\n	<li>Injury to the lens (posterior capsule rupture)</li>\r\n	<li>Swelling of the retina (cystoid macular edema)</li>\r\n</ul>\r\n\r\n<p>Please seek urgent medical advice in this case.<br />\r\nOther side effects:<br />\r\nUncommon: may affect up to 1 in 100 people</p>\r\n\r\n<ul>\r\n	<li>Nervous system disorder: Headache</li>\r\n	<li>Eye Disorder: Swelling of the cornea (keratitis), increased pressure in the eye, redness of the eye (ocular hyperaemia)</li>\r\n	<li>Vascular disorder: High blood pressure (hypertension)</li>\r\n</ul>', '<p>This medicine should not be used during pregnancy and lactation.</p>', '<p>Do not use if the blister is damaged or broken. Open under aseptic conditions only. The product should be used immediately after opening of the ampoule and not be reused for the other eye or any other patient. This is not recommended:</p>\r\n\r\n<ul>\r\n	<li>In combined cataract surgery with a certain type of eye surgery (vitrectomy)</li>\r\n	<li>If the ocular anterior chamber is shallow</li>\r\n	<li>If the patient has a history of acute narrow angle glaucoma</li>\r\n</ul>\r\n\r\n<p>The doctor should consider the patient&rsquo;s medical condition if he is suffering from hypertension, atherosclerosis or any kind of heart disease, hyperthyroidism, prostate gland disorders, epilepsy, any liver disease or kidney problem, breathing problem or myasthenia gravis.</p>', NULL, '<p>Other ophthalmic preparations</p>', '<p>Do not store above 30⁰C. Does not require refrigeration. Keep away from light and out of the reach of children. For single eye use only. This medicine should be used immediately after first opening of the ampoule. After use, discard the remaining solution appropriately. Do not keep it for subsequent use.</p>', NULL, '2022-03-22 00:36:40', '2022-03-22 00:36:40'),
(1535, 1535, '<p>Therapeutic purpose:</p>\r\n\r\n<ul>\r\n	<li>Inflammatory conditions of the uveal tract.</li>\r\n	<li>May be used in temporary lowering of intraocular pressure in glaucoma.</li>\r\n</ul>\r\n\r\n<p>Diagnostic purpose:</p>\r\n\r\n<ul>\r\n	<li>Retinal photography.</li>\r\n	<li>Refractive errors.</li>\r\n	<li>Fundus examination/photography.</li>\r\n	<li>Slit lamp examination.</li>\r\n</ul>\r\n\r\n<p>Pre-operative use: In order to undergo surgical procedure that requires the visualization of structures behind the iris, such as cataract extraction, vitrectomy and retinal detachment surgery.</p>', '<p>Tropicamide binds to and blocks the receptors in the muscles of the eye (muscarinic receptor M4). Tropicamide acts by blocking the responses of the iris sphincter muscle to the iris and ciliary muscles to cholinergic stimulation, producing dilation of the pupil and paralysis of the ciliary muscle.<br />\r\n<br />\r\nPhenylephrine Hydrochloride is a selective alpha-1 agonist, which causes mydriasis without cycloplegia. It tends to reduce intraocular lesion by vasoconstrictor action.</p>', '<p><strong>Uveitis</strong>: 1-2 drops bid-qid or as required.<br />\r\n<br />\r\n<strong>Diagnostic purpose/Pre-operative purpose</strong>: Instill 1-2 drops in the eye(s) 15-20 minutes before examination. If examination is not conducted within 20&ndash;30 minutes, an additional drop may be placed in the eye(s) to prolong the effect.</p>', '<p>Tropicamide may interfere with the antihypertensive action of carbachol, pilocarpine or ophthalmic cholinesterase inhibitors.</p>', '<p>This medication is contraindicated in these following cases</p>\r\n\r\n<ul>\r\n	<li>Patients with hypersensitivity to any of the components and narrow angles or narrow angle glaucoma.</li>\r\n	<li>Low birth weight infants and some elderly adults with severe arteriosclerotic cardiovascular or cerebrovascular disease.</li>\r\n	<li>During intraocular operative procedures when the corneal epithelial barrier has been disturbed.</li>\r\n</ul>', '<p>Elevated IOP (occasionally), stinging, blurred vision, tachycardia, photophobia, headache, parasympathetic stimulation and allergic reactions. Systemic effects include arrhythmias, hypertension and coronary artery spasm.</p>', '<p>The safety of this medication during pregnancy or lactation has not been established.</p>', '<p>Caution should be taken when administered with, or upto 21days after administration of monoamine oxidase (MAO) inhibitors as exaggerated adrenergic effects may result.<br />\r\n<br />\r\nThe possibility of psychotic reactions and behavioral disturbances should be considered in patients who are hypersensitive to anticholinergic drugs.<br />\r\n<br />\r\nUse with extreme caution in infants.</p>', '<p>Excessive use in children and in certain susceptible individuals may produce systemic toxic symptoms.</p>', '<p>Preparations for Ophthalmic diagnosis.</p>', '<p>Keep out of the reach of children. Store in a cool, dry place, away from heat and direct light. Do not use more than 4 weeks after opening.&nbsp;</p>', NULL, '2022-03-22 00:38:16', '2022-03-22 00:38:16'),
(1536, 1536, '<p>Trospium is a muscarinic antagonist indicated for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency.</p>', '<p>Trospium is a muscarinic antagonist. Trospium chloride antagonizes the effect of acetylcholine on muscarinic receptors in cholinergically innervated organs including the bladder. Its parasympatholytic action reduces the tonus of smooth muscle in the bladder. Receptor assays showed that trospium chloride has negligible affinity for nicotinic receptors as compared to muscarinic receptors at concentrations obtained from therapeutic doses.</p>', '<p>The recommended dose is 20 mg twice daily. Trospium should be dosed at least one hour before meals or given on an empty stomach. Dosage modification is recommended in the following patient populations:</p>\r\n\r\n<ul>\r\n	<li>For patients with severe renal impairment (creatinine clearance less than 30 mL/min), the recommended dose is 20 mg once daily at bedtime.</li>\r\n	<li>In geriatric patients greater than or equal to 75 years of age, dose may be titrated down to 20 mg once daily based upon tolerability.</li>\r\n	<li>Pediatric Use: The safety and effectiveness of Trospium in pediatric patients have not been established.</li>\r\n</ul>', '<p><strong>Digoxin</strong>: Concomitant use of Trospium and digoxin did not affect the pharmacokinetics of either drug.<br />\r\n<br />\r\n<strong>Drugs Eliminated by Active Tubular Secretion</strong>: Although demonstrated in a drug-drug interaction study not to affect the pharmacokinetics of digoxin, Trospium has the potential for pharmacokinetic interactions with other drugs that are eliminated by active tubular secretion (e.g., procainamide, pancuronium, morphine, vancomycin, and tenofovir). Coadministration of Trospium with these drugs may increase the serum concentration of Trospium and/or the coadministered drug due to competition for this elimination pathway. Careful patient monitoring is recommended in patients receiving such drugs.<br />\r\n<br />\r\n<strong>Antimuscarinic Agents</strong>: The concomitant use of Trospium with other antimuscarinic agents that produce dry mouth, constipation, and other anticholinergic pharmacological effects may increase the frequency and/or severity of such effects. Trospium may potentially alter the absorption of some concomitantly administered drugs due to anticholinergic effects on gastrointestinal motility.<br />\r\n<br />\r\n<strong>Metformin</strong>: Co-administration of 500 mg metformin immediate release tablets twice daily with Trospium 60 mg extended release reduced the steady-state systemic exposure of trospium by approximately 29% for mean AUC0-24&nbsp;and by 34% for mean Cmax.</p>', '<p>Trospium is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Urinary retention</li>\r\n	<li>Gastric retention</li>\r\n	<li>Uncontrolled narrow-angle glaucoma.</li>\r\n	<li>Known hypersensitivity to the drug or its ingredients. Angioedema, rash and anaphylactic reaction have been reported.</li>\r\n</ul>', '<p>The following adverse reactions have been identified during post-approval use of trospium chloride. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.</p>\r\n\r\n<ul>\r\n	<li>Gastrointestinal: gastritis</li>\r\n	<li>Cardiovascular: palpitations, supraventricular tachycardia, chest pain, syncope,</li>\r\n	<li>hypertensive crisis</li>\r\n	<li>Immunological: Stevens-Johnson syndrome, anaphylactic reaction, angioedema</li>\r\n	<li>Nervous System: dizziness, confusion, vision abnormal, hallucinations, somnolence and delirium</li>\r\n	<li>Musculoskeletal: rhabdomyolysis</li>\r\n	<li>General: rash</li>\r\n</ul>', '<p>Pregnancy Category C: There are no adequate and well-controlled studies of Trospium in pregnant women. Trospium should be used during pregnancy only if the potential benefit to the patient outweighs the risk to the patient and fetus. Women who become pregnant during Trospium treatment are encouraged to contact their physician.<br />\r\n<br />\r\nNursing Mothers: Trospium chloride (2 mg/kg orally and 50 mcg/kg intravenously) was excreted, to a limited extent (less than 1%), into the milk of lactating rats (primarily as parent compound). It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, Trospium should be used during lactation only if the potential benefit justifies the potential risk to the newborn.</p>', '<p><strong>Risk of Urin</strong>ary Retention: Trospium should be administered with caution to patients with clinically significant bladder outflow obstruction because of the risk of urinary retention.<br />\r\n<br />\r\n<strong>Angioedema</strong>: Angioedema of the face, lips, tongue, and/or larynx has been reported with trospium chloride, the active ingredient in Trospium. In one case, angioedema occurred after the first dose of trospium chloride. Angioedema associated with upper airway swelling may be life threatening. If involvement of the tongue, hypopharynx, or larynx occurs, Trospium should be promptly discontinued and appropriate therapy and/or measures necessary to ensure a patent airway should be promptly provided.<br />\r\n<br />\r\n<strong>Decreased Gastrointestinal Motility</strong>: Trospium should be administered with caution to patients with gastrointestinal obstructive disorders because of the risk of gastric retention. Trospium ,like other antimuscarinic agents, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as ulcerative colitis, intestinal atony and myasthenia gravis.<br />\r\n<br />\r\n<strong>Controlled Narrow-angle Glaucoma</strong>: In patients being treated for narrow-angle glaucoma, Trospium should only be used if the potential benefits outweigh the risks and in that circumstance only with careful monitoring.<br />\r\n<br />\r\n<strong>Central Nervous System Effects</strong>: Trospium is associated with anticholinergic central nervous system (CNS) effects. A variety of CNS anticholinergic effects have been reported, including dizziness, confusion, hallucinations and somnolence. Patients should be monitored for signs of anticholinergic CNS effects, particularly after beginning treatment or increasing the dose. Advise patients not to drive or operate heavy machinery until they know how Trospium affects them. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered.<br />\r\n<br />\r\n<strong>Anticholinergic Adverse Reactions in Patients with Moderate Renal Impairment</strong>: Trospium is substantially excreted by the kidney. The effects of moderate renal impairment on systemic exposure are not known but systemic exposure is likely increased. Therefore, anticholinergic adverse reactions (including dry mouth, constipation, dyspepsia, urinary tract infection, and urinary retention) are expected to be greater in patients with moderate renal impairment.</p>', '<p>Overdosage with antimuscarinic agents, including Trospium, can result in severe antimuscarinic effects. Supportive treatment should be provided according to symptoms. In the event of overdosage, electrocardiographic monitoring is recommended. A 7-month-old baby experienced tachycardia and mydriasis after administration of a single dose of trospium 10 mg given by a sibling. The baby&rsquo;s weight was reported as 5 kg. Following admission into the hospital and about 1 hour after ingestion of the trospium, medicinal charcoal was administered for detoxification. While hospitalized, the baby&nbsp; experienced mydriasis and tachycardia up to 230 beats per minute. Therapeutic intervention was not deemed necessary. The baby was discharged as completely recovered the following day.</p>', '<p>Other genito-urinary preparations.</p>', '<p>Store at controlled room temperature 20&deg;-25&deg;C.</p>', NULL, '2022-03-22 00:40:01', '2022-03-22 00:40:01'),
(1537, 1537, '<p>Trypan Blue is indicated for use as an aid in ophthalmic surgery by staining the anterior capsule of the lens.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Trypan Blue is a selective tissue staining agent (dye) which stains anterior lens capsule of the human crystalline lens. The dye does not penetrate the capsule, permitting visualization of the anterior capsule in contrast to the non-stained lens cortex and inner lens material.</p>', '<p>The first step to administer Trypan Blue is to inject an air bubble into the anterior chamber using a 26 gauge needle. It prevents dilution of dye by the aqueous humor. Then Trypan Blue is injected into the anterior lens capsule using a tuberculin syringe. Sufficient staining is achieved as soon as the dye has contracted the capsule. If some area is left unstained, inject one more drop till it gets stained.</p>', NULL, '<p>Trypan Blue is contraindicated when a non-hydrated (dry state), hydrophilic acrylic intraocular lens (IOL) is planned to be inserted into the eye because the dye may be absorbed by the IOL and stain the IOL.</p>', '<ul>\r\n	<li>Discoloration of high water content hydrogen intraocular lenses.</li>\r\n	<li>Inadvertent staining of the posterior lens capsule and vitreous face.</li>\r\n	<li>It is generally self limited, lasting up to one week.</li>\r\n</ul>', '<p><strong>Pregnancy</strong>&nbsp;Category C. There are no adequate and well-controlled studies in pregnant women. Trypan Blue should be given to a pregnant woman 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 this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Trypan Blue is administered to a nursing woman.</p>', '<p>It is recommended that after injection all excess Trypan Blue should be immediately removed from the eye by thorough irrigation of the anterior chamber.</p>', NULL, '<p>Preparations for Ophthalmic diagnosis.</p>', '<p>Store below 30&deg; C and keep away from lig.</p>', '<p><strong>Pediatric use:</strong>&nbsp;The safety and effectiveness of Trypan Blue have been established in pediatric patients. Use of Trypan Blue is supported by evidence from an adequate and well controlled study in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric use:</strong>&nbsp;No overall differences in safety and effectiveness have been observed between elderly and younger patients.</p>', '2022-03-22 00:41:41', '2022-03-22 00:41:41'),
(1538, 1538, '<p>This toothpaste is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Faster relief from dental hypersensitivity.</li>\r\n	<li>Sensitivity repair</li>\r\n	<li>Teeth strengthening</li>\r\n	<li>Gum protection</li>\r\n	<li>Teeth whitening</li>\r\n	<li>Total oral hygiene</li>\r\n	<li>Plaque control</li>\r\n	<li>Enamel protection</li>\r\n	<li>Extra fresh breath</li>\r\n</ul>', '<ul>\r\n	<li>Patent oral hygiene product</li>\r\n	<li>Long lasting protection with twice daily brushing</li>\r\n	<li>Prevent common dental problem</li>\r\n	<li>FDA categorized human OTC drug label</li>\r\n	<li>WHO recommended antiseptic &amp; disinfectant</li>\r\n	<li>European Medicines Agency approved as</li>\r\n	<li>herbal Medicine Product</li>\r\n</ul>', '<p>Take a small amount of toothpaste on the tooth brush and brush the tooth twice daily for at least one minutes.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Miscellaneous topical agents.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-22 00:42:43', '2022-03-22 00:42:43');
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
(1539, 1539, '<p>Tulobuterol is indicated for prophylaxis and control of bronchospasm in bronchial asthma, chronic bronchitis, asthmatic bronchitis, pulmonary emphysema, bronchiectasis, tracheobronchitis with emphysema and other bronchospastic disorders and conditions characterized by bronchoconstriction. Because oral tulobuterol is long acting, it is ideally suited for routine maintenance therapy in chronic asthma and chronic bronchitis. Tulobuterol has been shown in controlled single and multiple-dose studies to be more effective than terbutaline and fenoterol and at least as effective as salbutamol (albuterol) in relieving bronchospasm associated with reversible obstructive airways disease such as asthma, and also chronic bronchitis and emphysema. Clinically significant improvement in pulmonary function, as demonstrated by an increase in FEV of 15% or more, occurred within 30 minutes after oral dosing with peak improvement occurring within two to three hours. In some patients, a therapeutic response was still apparent at 12 hours. Continued effectiveness was demonstrated over a one-year period.</p>', '<p>The primary pharmacological action of beta-adrenergic drugs is to stimulate adenyl cyclase, the enzyme which catalyzes the formation of cyclic-3&#39;,5&#39; adenosine monophosphate (cyclic AMP) from adenosine triphosphate (ATP). The cyclic AMP thus formed mediates the cellular response that results in bronchodilation. Tulobuterol, due to its highly selective action on beta-2 adrenoceptors, relaxes the bronchial smooth muscle and has been shown to be clinically successful in the symptomatic treatment of reversible obstructive airways disease (ROAD) such as bronchial asthma, and also in bronchitis and emphysema.<br />\r\n<br />\r\nSome bronchodilators stimulate beta-1 (cardiac) receptors in addition to beta-2 receptors and may cause tachycardia, angina, and possibly arrhythmias in susceptible patients. Animal studies and in vitro experiments indicate that tulobuterol is more selective in its beta-2 agonist activity than other agents in this class and, therefore, should produce fewer cardiac side effects.</p>', '<p>As long-term clinical studies have demonstrated, tulobuterol continues to be efficacious and does not result in cumulative or toxic side effects. Due to the variability of the disease and the need for individualized dosage requirements, flexibility in dosing is indispensable.<br />\r\n<br />\r\nThe use of Long-Acting Beta Agonists is contraindicated without the use of an asthma controller medication such as inhaled corticosteroid.<br />\r\n<br />\r\nLong-Acting Beta Agonists should be used for the shortest duration of time required to achieve control of asthma symptoms and discontinued, if possible, once asthma control is achieved. Patient should then be maintained on a long-term asthma controller medication (e.g. Corticosteroids).<br />\r\n<br />\r\n<strong>Tablets</strong>: The usual oral adult dose of tulobuterol is one 2 mg tablet twice a day. A convenient starting dose for children 12 years and over and adults is 1 mg twice a day, particularly for elderly patients and those with a history of sensitivity to beta-adrenergic agents. Unless precluded by drug-related side effects, the patient may have the dose increased after seven to ten days to 2 mg twice a day, if necessary, to achieve a greater therapeutic response.<br />\r\n<br />\r\nAlthough most patients can be maintained on a dose of 1 to 2 mg twice daily, the variability of patient response and severity of symptoms may require further adjustment of the dose, as with any bronchodilator treatment. Therefore, if necessary, the adult dose of tulobuterol may be increased to 6 mg a day in divided doses according to clinical response.<br />\r\n<br />\r\n<strong>Syrup</strong>: Based on dose-ranging studies in children, the usual dose of tulobuterol syrup (1 mg/5 mL) for children is 40 to 80 mcg/kg/day in two divided doses.<br />\r\n<br />\r\nIn clinical studies in children, the effective dose has ranged from 20 to 100 mcg/kg/day.<br />\r\n<br />\r\nThis leads to the following recommendations on the basis of age:</p>\r\n\r\n<ul>\r\n	<li>For children aged one to six years, 0.25 tsp. (1.25 mL) to 0.5 tsp. (2.5 mL) BID</li>\r\n	<li>For children aged six to twelve years, 0.5 tsp. (2.5 mL) to 1 tsp. (5 mL) BID</li>\r\n	<li>For children aged over twelve years, 1 tsp. (5 mL) to 2 tsp. (10 mL) BID</li>\r\n	<li>The above age recommended doses may have to be modified according to patient response.</li>\r\n</ul>', '<p>Increased risk of arrhythmia with digoxin. Hypokalaemia with concomitant admin of xanthines, corticosteroids and diuretics.</p>', '<p>Administration of tulobuterol is contraindicated in patients with known hypersensitivity to sympathomimetic amines or any of the formulation components.</p>', '<p>The adverse reactions of tulobuterol are similar in nature to those of other sympathomimetic agents, however the incidence of certain cardiovascular effects is less with tulobuterol. Dose-related finger tremor is common with these agents, but the effects tend to lessen with continued administration of the drug. Oral formulations of tulobuterol, like other sympathomimetic agents, can also cause less frequent adverse reactions such as hypertension, palpitations, angina, tachycardia, vomiting, vertigo, central nervous system stimulation, insomnia and headache.</p>', '<p>Safety of this product for use during pregnancy has not been established. It is not known whether tulobuterol is excreted in human breast milk nor whether it has a harmful effect on the newborn. Therefore, as with any medication, the use of the drug in pregnancy, lactation, or women of childbearing potential requires that the expected therapeutic benefit of the drug be weighed against its possible hazards to the mother and child.</p>', '<p>Long-Acting Beta Agonists should only be used long-term in patients whose asthma cannot be adequately controlled on asthma controller medications alone.<br />\r\n<br />\r\nTulobuterol should be used with caution in patients with diabetes mellitus, hypertension, hyperthyroidism, and seizure disorders.<br />\r\n<br />\r\nCaution should be observed in patients with renal failure in view of the kidney being the principle route of elimination of the drug. Dosage may also require individualization in patients with impaired liver function as normally tulobuterol is extensively metabolized by the liver.<br />\r\n<br />\r\nAs with other sympathomimetic bronchodilator agents, tulobuterol should be administered cautiously to cardiac patients, especially those with associated arrhythmias, coronary insufficiency, or myocardial ischemia.</p>', NULL, '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants.</p>', NULL, NULL, '2022-03-22 00:44:21', '2022-03-22 00:44:21'),
(1540, 1540, '<p>Typhoid Polysaccharide Vaccine is indicated for active immunization against typhoid fever for adults and children two years of age or older. Selective immunization with typhoid vaccine is recommended for the following:</p>\r\n\r\n<ul>\r\n	<li>Travellers to high endemic areas</li>\r\n	<li>Household contact of carriers</li>\r\n	<li>Healthcare personnel</li>\r\n	<li>Police, Armed forces and such other regimented personnel</li>\r\n	<li>Laboratory workers who work with Salmonella typhi</li>\r\n</ul>', '<p><strong>Dosage</strong>: A single dose of 0.5 ml is recommended for both adults and children 2 years of age or older. Subjects who remain at risk of typhoid fever should be given a single booster dose of the vaccine with an interval of not more than 3 years.<br />\r\n<br />\r\n<strong>Administration</strong>: Typhoid Polysaccharide Vaccine is for intramuscular injection only. Do not inject intravenously. This should be given intramuscularly in the deltoid and children should be injected intramuscularly either in the deltoid or the vastus lateralis. It should not be injected into the gluteal areas where there may be a nerve trunk. Typhoid Polysaccharide Vaccine injection should be administered with caution to subjects with thrombocytopenia or bleeding disorders since bleeding may occur following an intramuscular administration to these subjects. Following injection, firm pressure should be applied to the site (without rubbing) for at least two minutes.<br />\r\n<br />\r\n<strong>Co-administration</strong>: Typhoid vaccine can be co-administered with other vaccines but should not be mixed with other vaccines or medicinal products in the same syringe.</p>', NULL, NULL, '<p>The vaccine protects against typhoid fever caused by Salmonella typhi. Protection is not conferred against paratyphoid fever or illness caused by non-invasive Salmonella. Typhoid vaccine should not be administered to subjects with known hypersensitivity to any component of the vaccine or to subjects having shown signs of hypersensitivity after previous Typhoid vaccine administration or after any other vaccine containing Vi polysaccharide Salmonella typhi antigens. It may be expected that in patients receiving immunosuppressive treatment or patients with immunodeficiency, an adequate response may not be achieved. The administration of Typhoid vaccine should be postponed in subjects suffering from acute severe febrile illness.</p>', '<p>Most recepients of Typhoid vaccine experience some reactions upon vaccination. These are generally moderate and short in duration. They mainly consist of local reactions at the injection site (erythema, induration and tenderness). Systemic reactions (malaise, headache, diarrhea, vomiting, myalgia and elevated temperature) are reported less commonly. In very rare cases allergic type reactions (pruritus, rash, urticaria) may be observed.</p>', '<p>The effect of Typhoid vaccine on foetal development or reproduction capacity has not been evaluated. Typhoid vaccine should only be used during pregnancy when there is a high risk of infection. It is not known if Typhoid vaccine is excreted in human milk. It may be administered to nursing mothers only if clearly needed.</p>', NULL, NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin.</p>', '<p>Keep out of the reach of children. Store at +2&deg;C to +8&deg;C. Transportation should also be at +2&deg;C to +8&deg;C. Do not freeze. Discard vaccine if frozen. Protect from light.</p>', NULL, '2022-03-22 00:45:35', '2022-03-22 00:45:35'),
(1541, 1541, '<p>Abemaciclib is a kinase inhibitor indicated:</p>\r\n\r\n<ul>\r\n	<li>in combination with endocrine therapy (tamoxifen or an aromatase inhibitor) for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive, early breast cancer at high risk of recurrence and a Ki-67 score &ge;20% as determined by an FDA approved test.</li>\r\n	<li>in combination with an aromatase inhibitor as initial endocrine-based&nbsp;therapy for the treatment of postmenopausal women, and men, with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.</li>\r\n	<li>in combination with fulvestrant for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.</li>\r\n	<li>as monotherapy for the treatment of adult patients with HR-positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy and prior chemotherapy in the metastatic setting.</li>\r\n</ul>', '<p>Abemaciclib is an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4 and CDK6). These kinases are activated upon binding to D-cyclins. In estrogen receptor-positive (ER+) breast cancer cell lines, cyclin D1 and CDK4/6 promote phosphorylation of the retinoblastoma protein (Rb), cell cycle progression, and cell proliferation. In vitro, continuous exposure to abemaciclib inhibited Rb phosphorylation and blocked progression from G1 into S phase of the cell cycle, resulting in senescence and apoptosis. In breast cancer xenograft models, abemaciclib dosed daily without interruption as a single agent or in combination with antiestrogens resulted in reduction of tumor size.</p>', '<p>Abemaciclib tablets are taken orally with or without food.</p>\r\n\r\n<ul>\r\n	<li>Recommended starting dose in combination with fulvestrant, tamoxifen, or an aromatase inhibitor: 150 mg twice daily.</li>\r\n	<li>Recommended starting dose as monotherapy: 200 mg twice daily.</li>\r\n	<li>Dosing interruption and/or dose reductions may be required based on individual safety and tolerability.</li>\r\n</ul>', '<p><strong>CYP3A Inhibitors</strong>: Avoid concomitant use of ketoconazole. Reduce the Abemaciclib dose with concomitant use of other strong and moderate CYP3A inhibitors.<br />\r\n<strong>CYP3A Inducers</strong>: Avoid concomitant use of strong and moderate CYP3A inducers.</p>', NULL, '<p>Most common adverse reactions (incidence &ge;20%) were diarrhea, neutropenia, nausea, abdominal pain, infections, fatigue, anemia, leukopenia, decreased appetite, vomiting, headache, alopecia, and thrombocytopenia.</p>', '<p>Based on findings from animal studies and the mechanism of action, Abemaciclib can cause fetal harm when administered to a pregnant woman. In animal reproduction studies, administration of abemaciclib to pregnant rats during the period of organogenesis caused teratogenicity and decreased fetal weight at maternal exposures that were similar to the human clinical exposure based on area under the curve (AUC) at the maximum recommended human dose. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with Abemaciclib and for 3 weeks after the last dose.</p>', '<p><strong>Diarrhea</strong>: Abemaciclib can cause severe cases of diarrhea, associated with dehydration and infection. Instruct patients at the first sign of loose stools to initiate antidiarrheal therapy, increase oral fluids, and notify their healthcare provider.<br />\r\n<br />\r\n<strong>Neutropenia</strong>: Monitor complete blood counts prior to the start of Abemaciclib therapy, every 2 weeks for the first 2 months, monthly for the next 2 months, and as clinically indicated.<br />\r\n<br />\r\n<strong>Interstitial Lung Disease (ILD)/Pneumonitis</strong>: Severe and fatal cases of ILD/pneumonitis have been reported. Monitor for clinical symptoms or radiological changes indicative of ILD/pneumonitis. Permanently discontinue Abemaciclib in all patients with Grade 3 or 4 ILD or pneumonitis.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Increases in serum transaminase levels have been observed. Perform liver function tests (LFTs) before initiating treatment with Abemaciclib. Monitor LFTs every two weeks for the first two months, monthly for the next 2 months, and as clinically indicated.<br />\r\n<br />\r\n<strong>Venous Thromboembolism</strong>: Monitor patients for signs and symptoms of thrombosis and pulmonary embolism and treat as medically appropriate.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Can cause fetal harm. Advise patients of potential</p>', NULL, '<p>Protein kinase inhibitor</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 Abemaciclib have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness of Abemaciclib were observed between these patients and younger patients.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is required for patients with mild or moderate renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustments are necessary in patients with mild or moderate hepatic impairment</p>', '2022-04-03 01:34:23', '2022-04-03 01:34:23'),
(1542, 1542, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-04-03 01:50:47', '2022-04-03 01:50:47'),
(1543, 1543, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-04-03 01:52:56', '2022-04-03 01:52:56'),
(1545, 1545, '<p>This solution is used in Haemodialysis.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>Composition:&nbsp;</p>\r\n\r\n<p>Each 1 liter solution contains-</p>\r\n\r\n<ul>\r\n	<li>Sodium Chloride: 161.43 gm</li>\r\n	<li>Potassium Chloride: 5.49 gm</li>\r\n	<li>Calcium Chloride: 9.75 gm</li>\r\n	<li>Magnessium Chloride: 3.74 gm</li>\r\n	<li>Glacial Acetic Acid: 8.85 gm</li>\r\n	<li>Highly purified water: q.s. to 1 liter</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>', '<p><strong>Calcium chloride</strong>&nbsp;is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.<br />\r\n<br />\r\n<strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;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.<br />\r\n<br />\r\n<strong>Magnessium Chloride</strong>&nbsp;acts as cofactor in numerous enzymatic reactions involving protein synthesis and carbohydrate metabolism; depresses CNS, blocks peripheral neuromuscular transmission, produces anticonvulsant effects.</p>', '<p><strong>Recommended dose</strong>: 5 liters concentrate per dialysis or as required.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Known hypersensitivity to any of the ingredients of this preparation.</p>', '<p>Fluid and electrolyte imbalance, hypovolemia, hypotension or muscle cramping may occur.</p>', '<p>Pregnancy Category is not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>It is used for hemodialysis purposes only. Do not use solution A or B alone. Discard container in case visible solid particles inside.</p>', NULL, '<p>Haemodialysis solutions</p>', NULL, NULL, '2022-04-15 08:19:27', '2022-04-15 08:19:27'),
(1546, 1546, '<p>This is a natural formula meant to promote the quality and quantity of milk. This is 100% safe and effective. It can be used as a tonic for physically weak nursing mothers. Breast milk production may increase within a couple of days. However, in order to ensure the best results, the mother should continue taking this preparation for at least 15 days.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', NULL, NULL, '2022-04-24 04:47:44', '2022-04-24 04:47:44'),
(1547, 1547, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Haemorrhoid</li>\r\n	<li>Bleeding piles</li>\r\n	<li>Constipation</li>\r\n	<li>Indigestion</li>\r\n	<li>Hyperacidity</li>\r\n	<li>Carminative</li>\r\n</ul>', '<p>This is a liquid Ayurvedic medicine. It Is a combination of several medicinal plants that are effective to cure Haemorrhoid Bleeding piles, Constipation and Indigestion. It also acts as Antacid and Carminative. It is aimed to treat male and female patients of all age groups for oral administration.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Terminalia chebula</strong>: It contains chebulinic acid, tannic acid, gallic acid, resin, tannin and glycoside. It prevents haemorrhoid, bleeding, constipation and improve digestive power.<br />\r\n<br />\r\n<strong>Vitis vinifera</strong>: It contains sugar gum, tannin, tartaric, citric, racemic and malic acids, chlondes of potassium and sodium, iron, albumin etc. It is used as demulcent, diuretic, laxative, stomachic and tonic. It is also used in dyspepsia.<br />\r\n<br />\r\n<strong>Madhuca indica</strong>: It contains glycoside saponin, sapogenin, B-sitosterol and sterol glucoside. It is used in haemorrhoids and constipation.<br />\r\n<br />\r\n<strong>Embelia ribes</strong>: It contains hydroquinone embelin alkaloid christembine, tannin, quercifol and volatile oil that have carminative, laxative, stomachic and anthelmintic activities. It is also used to improve digestive power.<br />\r\n<br />\r\n<strong>Tribulus terrestris</strong>: It contains alkaloids, pedalitin, diosmetin and dinatin. It is cooling, tonic, and carminative. It is used in piles and remove inflammation.<br />\r\n<br />\r\n<strong>Piper chaba</strong>: It contains pipperin, pippalartin, pipperleguminin, sterols, glycosides etc. It cures piles, cough and indigestion.<br />\r\n<br />\r\n<strong>Coriandrum sativum</strong>: It contains a-pinene, limonene, B-phellandrene, linalool, geraniol, linalys acetate etc. It has carminative, stomachic, refrigerant and antibacterial activity. It can help to remove dyspepsia.<br />\r\n<br />\r\n<strong>Zingiber officinale</strong>: It contains zingiberenen, zingerfone, terpenes, cineol, borneol, citrol, camphene, phelandrene, gingerol shogaol etc. It is digestive, carminative, stomachic ano stimulant. It also use in dyspepsia, flatulent, colic and constipation.<br />\r\n<br />\r\n<strong>Operculina turpethum</strong>: It contains glycosidium resin, glycoside (turoethin) and volatile oil. If is a good laxative and helpful in other abdominal troubles. It is also helpful in managing the normal body temperature.<br />\r\n<br />\r\n<strong>Salmalia malabarica</strong>: It contains minerals, starch, protein, fatty acid tannic acid and gallic acid. It is cooling, stimulant, tonic and demulcent. It is useful in haemorrhoid.</p>', '<p>Adult: 2-4 teaspoonful 2-3 times daily after meal.<br />\r\nChildren: 1-2 teaspoonful 2-3 times daily after meal.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', NULL, '2022-04-24 04:49:32', '2022-04-24 04:49:32'),
(1548, 1548, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Sexual debility</li>\r\n	<li>Spermatorrhoea</li>\r\n	<li>Oligospermia</li>\r\n	<li>Gonorrhoea</li>\r\n</ul>', '<p>This is a unique formulation of Acacia (Acacia arabica), Dates (Phoenix dactylifera), Asparagus (Asparagus racemosus), Edible Pine (Pinus gerardiana), Hazel nut (Corylus avellana), Levant cotton (Gossypium herbaceum), Clove (Eugenia caryophyllus), Nutmeg (Myristica fragrans) etc. It helps to relives sparmatorrhoea, oligospermia and sexual debility. It is an ideal aphrodisiac and nervine tonic.</p>', '<p>1 teaspoonful twice daily before meal for 2-3 months or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 04:50:37', '2022-04-24 04:50:37'),
(1549, 1549, '<p>This is indicated in</p>\r\n\r\n<ul>\r\n	<li>Spermatorrhoea</li>\r\n	<li>Oligospermia</li>\r\n	<li>Sexual debility</li>\r\n	<li>Nocturnal emission</li>\r\n</ul>', '<p>This is a unique formulation of Almond (Prunus amygdalus), Coconut (Cocos nucifera), Edible Pine (Pinus gerardiana), Salep (Orchis latifolia), Mastic tree (Pistacia lentiscus), which enhances retentive power and relieves oligospermia. It also prevents sparmatorrhoea and premature ejaculation. This preparation enhances viscosity of semen &amp; prolongs the duration of coitus and ensures post coitus freshness.</p>', '<p>1-2 teaspoonful(s) twice daily with or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 04:51:35', '2022-04-24 04:51:35'),
(1550, 1550, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Constipation</li>\r\n	<li>Flatulence</li>\r\n	<li>Anorexia</li>\r\n	<li>Colic</li>\r\n	<li>Obesity</li>\r\n	<li>Hypercholesterolaemia</li>\r\n</ul>', '<p>This is a unique unani medicine prepared with various natural ingredients, such as Aloe (Aloe baradensis), Black pepper (Piper nigrum), Henbane (Hyoscyamus niger) and other natural medicinal ingredients. The synergistic action of these natural ingredients makes this tablet, an effective remedy for flatulence, constipation and colic. It discharges the excessive stool from the bowels and increases appetite. It also helps to reduce obesity.</p>', '<p>1-2 tablet(s) daily with milk at bed time or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 04:52:38', '2022-04-24 04:52:38'),
(1551, 1551, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Acid reflux</li>\r\n	<li>Gastric ulcer</li>\r\n	<li>Obesity</li>\r\n	<li>Constipation</li>\r\n	<li>Piles</li>\r\n</ul>', '<p><strong>Aloe indica royle</strong>: Aloe contains anthrone -10-C-glycosyls, including aloin A, aloin B, 7-hydroxyaloin and 1,8-dihydroxy anthraquinone, including Aloe-emodin. The 2015 study found that aloe effectively reduced the symptoms of acid reflux as well as certain traditional medication without any reported side effects. Researchers concluded that aloe may work by reducing acid production and acting as an anti-inflammatory agent. By taking Aloe regularly, ensures a better sensation of well-being, allowing energy levels to increase and also helps maintain a healthy body weight. Aloe is a best natural aid for detoxification. Aloe is colonic-specific stimulant laxatives that have a direct action on intestinal mucosa, increasing the rate of colonic motility and inhibiting water &amp; electrolyte secretion. Anthraquinones may also have stool softening properties.<br />\r\n<br />\r\n<strong>Hyoscyamus niger</strong>: It contains the alkaloids hyoscyamine and scopolamine. It is used to provide symptomatic relief of spasms caused by various lower abdominal and bladder disorders including peptic ulcers, irritable bowel syndrome, colic &amp; cystitis.<br />\r\n<br />\r\n<strong>Piper nigrum</strong>: It contains 3, 4-dihydroxy phenyl ethanol glycosides, piperine, polysac- charides, fatty oil &amp; volatile oil. It stimulates the thermal receptors and increases secretion of saliva and gastric mucus. It influences liver metabolic functions.</p>', '<p>1-2 tablets daily at bedtime.</p>', '<p>Antiarrhythmic agents, diuretic agents &amp; corticosteroids.</p>', '<p>Intestinal pathological narrow or obstruction &amp; acutely inflamed intestinal diseases, e.g, Crohn&rsquo;s disease, ulcerative colitis &amp; appendicitis.</p>', '<p>Occasionally allergic reaction may occur. Chronic use may cause loss of electrolytes (Potassium) that will reverse upon discontinuation.</p>', '<p>Should not be used during Pregnancy. There is no sufficient information for use in lactation.</p>', NULL, '<p>Overdose may alter electrolyte and water balance.</p>', '<p>Herbal and Nutraceuticals</p>', '<p>Store in a cool &amp; dry place, protected from light. Keep all medicines out of reach of children.</p>', NULL, '2022-04-24 04:58:34', '2022-04-24 04:58:34'),
(1552, 1552, '<p>This in indicated in-</p>\r\n\r\n<ul>\r\n	<li>Hyperacidity</li>\r\n	<li>Indigestion</li>\r\n	<li>Dyspepsia</li>\r\n	<li>Anorexia</li>\r\n	<li>Flatulence</li>\r\n	<li>Anaemia</li>\r\n	<li>Jaundice and</li>\r\n	<li>Increase body immunity</li>\r\n</ul>', '<p>Phyllanthus emblica-</p>\r\n\r\n<ul>\r\n	<li>Active Constituents: Phyllantidine, tannins, phyllenbic acid, gallic acid, ellagic acid and large amount of vitamin-C.</li>\r\n	<li>Actions: It is used as antacid, stomachic, carminative and antioxidant due to gallic acid. It is used in hyperacidity, anorexia, dyspepsia, jaundice, flatulence and gastrointestinal disorders.</li>\r\n</ul>\r\n\r\n<p>Piper longum-</p>\r\n\r\n<ul>\r\n	<li>Active constituents: Piperine, Piplartine, Piperlonguminine, sesamine volatile oil etc.</li>\r\n	<li>Actions: It is used as carminative, digestive, strengthen muscular system and nervine tonic. It can be used in anaemia, ascites, hemorrhoids, colic and splenic disorder.</li>\r\n</ul>', '<p><strong>Adult</strong>: 2-4 teaspoonful 2-3 times daily after meal.<br />\r\n<strong>Children</strong>: 1-2 teaspoonful 2-3 times daily after meal.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store in a cool &amp; dry place, protected from light. Keep all medicines out of reach of children.</p>', NULL, '2022-04-24 04:59:44', '2022-04-24 04:59:44'),
(1553, 1553, '<p>Ambar Momiyaee-</p>\r\n\r\n<ul>\r\n	<li>Combats erectile dysfunction.</li>\r\n	<li>Is an ideal aphrodisiac and nervine tonic.</li>\r\n	<li>Restores sex hormone and depleted sexual power.</li>\r\n	<li>Relieves limpness and weakness after coitus.</li>\r\n	<li>Enhances retentive power.</li>\r\n	<li>Tones up the vital organ of the body.</li>\r\n	<li>Removes mental depression.</li>\r\n	<li>Its continuous use serves as a good general tonic.</li>\r\n</ul>', '<p>Ambar Momiyaee is a research product of Hamdard Laboratories and time tested aphrodisiac. Ambar Momiyaee is being used successfully to treat the patients of erectile dysfunction in different Hamdard clinics of the subcontinent for long time. It acts as nervine tonic and continuous use serves as a good general tonic.</p>', '<p>1 tablet twice daily to be taken with milk or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 05:00:51', '2022-04-24 05:00:51'),
(1554, 1554, '<ul>\r\n	<li>Strengthens vital organs.</li>\r\n	<li>Removes foul smell of mouth.</li>\r\n	<li>Acts as a powerful antioxidant.</li>\r\n	<li>Boosts up immune system.</li>\r\n	<li>Helps in regaining lost vigour &amp; vitality.</li>\r\n	<li>Strengthens the reproductive organs.</li>\r\n	<li>Prevents the symptoms of early aging &amp; senile debility.</li>\r\n</ul>', '<p>This is a versatile polypharmaceutical modern unani medicine with judicious combination of synergistically acting precious natural ingredients which restores physical strength, psychological strength, physiological strength and vital energy. This is being used successfully to treat patient of general debility, senile debility, nervine debility, paralysis, mental depression, sexual debility and foul smell of mouth. It is easily assimilable and more effective.</p>', '<p>1 capsule/tablet twice daily or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store at cool and dry place, protect from light.</p>', NULL, '2022-04-24 05:02:29', '2022-04-24 05:02:29'),
(1555, 1555, '<p>Andrographis paniculata is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Viral fever</li>\r\n	<li>Flu</li>\r\n	<li>Common cold</li>\r\n	<li>Sinusitis</li>\r\n	<li>Upper respiratory tract infection</li>\r\n	<li>Viral hepatitis.</li>\r\n</ul>', '<p>Andrographis compounds have shown antiviral properties which appear to inhibit glycoproteins in the virus. This impedes the ability of viruses to invade cells and replicate. It also has a major effect activating the general defense functions of the immune system by stimulating the production of antibodies as well as non-specific immune responses such as increased macrophage phagocytosis, rather than by any direct antimicrobial activity. Andrographis has flavonoids, which always have an anti-inflammatory effect. In vitro studies have shown that the flavonoid activities suppressed the genetic expression of neutrophils. Similarly, studies have indicated that a variety of inflammatory proteins, including COX-2, are reduced by the presence of Andrographoloid.<br />\r\n<br />\r\nThe aerial parts and their constituent andrographolides have antihepato-toxic activity in vitro and in vivo. In vitro studies have shown that intraperitoneal administration of a methanol extract of the aerial parts to mice reduced hepatotoxicity induced by carbon tetrachloride CCl4, and reversed CCl4 induced histopathological changes in the liver. Intraperitoneal administration of andrographolide to mice inhibited the CCl4 induced increase in the activity of serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, alkaline phosphatase, bilirubin and hepatic triglycerides. Andrographolide, the major antihepatotoxic component of the plant, exerted a pronounced protective effect in rats against hepato-toxicity induced by CCl4, Dgalactosamine, paracetamol and ethanol.<br />\r\n<br />\r\nMoreover, andrographolide and related diterpenes are choleretic, antidiarrheal, immunostimulant, antimalarial, antipyretic and active in urinary tract infections.</p>', '<p><strong>Age 18 and above</strong>: 1 capsule 3 times daily after meal for 5 to 10 days.<br />\r\n<strong>12 to 17 years</strong>: 1 capsule 2 times daily after meal for 5 to 10 days.<br />\r\n<strong>4 to 11 years</strong>: 1 capsule daily after meal for 5 to 10 days or as directed by the physician.</p>', '<p>May have a synergistic effect with isoniazid.</p>', '<p>Andrographis is contraindicated in cases of known allergy to plants of the acanthaceae family</p>', '<p>Large oral doses may cause gastric discomfort, vomiting and loss of appetite. These side-effects appear to be due to the bitter taste of andrographolide.</p>', '<p>Andrographis should not be used during pregnancy or lactation.</p>', NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-04-24 05:04:47', '2022-04-24 05:04:47'),
(1556, 1556, '<p>For digestive disorders and teething troubles, it is a palatable way to fight against griping, flatulence, convulsions, diarrhoea and indigestion, so common among infants and teething children.</p>', '<p>This is specially made for the proper growth and development of infants and children. It is totally free of alcohol and chemical that may be harmful to their delicate systems. This contains curative herbs and natural oils in a modern formulation that relieves stomach pain and gently soothes the digestive system.</p>', '<p>Up to 6 months: 1/2 teaspoonful<br />\r\n6 months to 1 year: 1 teaspoonful<br />\r\n1 year &amp; above: 2 teaspoonfuls 3-4 times daily or as prescribed by the physician.</p>', NULL, NULL, NULL, NULL, NULL, NULL, '<p>Herbal and Nutraceuticals</p>', '<p>Store in cool and dry place, protect from light.</p>', NULL, '2022-04-24 05:06:04', '2022-04-24 05:06:04'),
(1557, 1557, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-05-09 19:44:22', '2022-05-09 19:44:22'),
(1558, 1558, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-05-10 21:35:09', '2022-05-10 21:35:09'),
(1559, 1559, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-02 01:25:57', '2022-06-02 01:25:57'),
(1560, 1560, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-04 04:17:20', '2022-06-04 04:17:20'),
(1561, 1561, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-07 00:08:16', '2022-06-07 00:08:16'),
(1562, 1562, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-08 17:48:10', '2022-06-08 17:48:10'),
(1563, 1563, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-06-08 17:49:22', '2022-06-08 17:49:22');

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