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
(367, 367, '<p>Clomipramine Hydrochloride is used to treat depression, obsessions and phobias (irrational fears). It is also used to treat muscular weakness (cataplexy) associated with repeat attacks of extreme sleepiness (narcolepsy) in adults.</p>', '<p>Clomipramine hydrochloride belongs to a group of medicines called &quot;tricyclic antidepressants&quot;. This is thought to work either by increasing the amount of chemical &quot;messengers&quot; in the brain or by making their effects last longer. Clomipramine is a potent inhibitor of serotonin re-uptake in the brain. Significant antagonism at cholinergic and &alpha;1-receptors. Weak antagonism at dopamine receptors. It has also antidepressant, sedative and anticholinergic effects.</p>', '<p>The usual dosages for adults are as follows:</p>\r\n\r\n<ul>\r\n	<li>For depression: 10 mg to 150 mg daily. Severe cases may need even higher doses.</li>\r\n	<li>For obsessions and phobias: 10 mg to 150 mg daily.</li>\r\n	<li>For cataplexy: 10 mg to 75 mg daily.</li>\r\n</ul>\r\n\r\n<p>The elderly: Elderly patients often need a lower dose because they are more likely to experience side effects.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Swallow this capsules whole with a drink of water. Keep taking your medicine until your doctor tells you to stop. Do not stop because you do not feel any better. This medicine may take up to 4 weeks to work. The medicine may be taken as one dose at night or as smaller doses at intervals during the day.</p>', '<p>In particular, do not take this if you are taking the following: medicines for depression called monoamine oxidase inhibitors (MAOIs), or have taken them within the last 3 weeks.</p>', '<ul>\r\n	<li>Known hypersensitivity to clomipramine and any of the excipients in the tablets.</li>\r\n	<li>Cross-hypersensitivity to tricyclic antidepressants of the dibenzazepine group.</li>\r\n	<li>Concomitant use with a monoamine oxidase (MAO) inhibitor, or within 14 days before or after treatment with an irreversible MAO inhibitor, or within 14 days before moclobemide, a reversible MAO inhibitor.</li>\r\n	<li>Acute and recovery stages of myocardial infarction.</li>\r\n	<li>Congenital long QT syndrome.</li>\r\n</ul>', '<p>Very common side effects are increase in appetite and weight gain, headaches, dizziness, nausea, constipation, dry mouth, increased sweating, shaking hands, tremor, difficulty in passing urine, problems with their eyes, feeling tired or sleepy, sexual disturbances, restlessness.</p>', '<p>Pregnancy category C. As clomipramine passes into human milk, babies should be weaned or clomipramine gradually withdrawn.</p>', '<p>Check with your doctor or pharmacist before taking your medicine if:</p>\r\n\r\n<ul>\r\n	<li>you have epilepsy (fits)</li>\r\n	<li>you have an overactive thyroid gland</li>\r\n	<li>you have a tumour (cancer) of the adrenal gland (such as phaeochromocytoma or neuroblastoma)</li>\r\n	<li>you have low blood pressure</li>\r\n	<li>you wear contact lenses</li>\r\n	<li>you have had severe constipation for a long time</li>\r\n	<li>you find yourself thinking about suicide</li>\r\n	<li>you have had a head injury and suffered brain damage</li>\r\n	<li>you are going to have ECT (electroconvulsive therapy)</li>\r\n	<li>you have an irregular heart beat or other problems with your heart</li>\r\n	<li>you have been diagnosed as having a low level of potassium in your blood (hypokalemia)</li>\r\n	<li>you have schizophrenia or any other mental disorder</li>\r\n	<li>you are elderly</li>\r\n	<li>you have glaucoma(increased pressure in the eye)</li>\r\n	<li>you have liver or kidney disease</li>\r\n	<li>you have any blood disorder</li>\r\n	<li>you have difficulties in passing urine (e.g. due to diseases of the prostate)</li>\r\n</ul>', NULL, '<p>Tricyclic &amp; related anti-depressant drugs</p>', '<p>Keep out of the reach and sight of children. The capsules should be protected from heat and moisture.</p>', '<p><strong>Older people</strong>: Elderly patients generally need lower doses than young and middle-aged patients. Side effects are more likely to occur in older patients.<br />\r\n<br />\r\n<strong>Use in Children and Adolescents (&lt;18 years)</strong>: The safety and efficacy of clomipramine for the treatment of depression or other psychiatric disorders in children and adolescents aged less than 18 years has not been satisfactorily established. Clomipramine should not be used in this age group for the treatment of depression or other psychiatric disorders</p>', '2022-02-18 21:03:12', '2022-04-10 20:27:46'),
(368, 368, '<p>It is indicated for the treatment of panic disorder, with or without agoraphobia. Panic disorder is characterized by the occurrence of unexpected panic attacks and associated concern about having additional attacks, worry about the implications or consequences of the attacks.<br />\r\n<br />\r\nIt is also indicated alone or as an adjunct in the treatment of the Lennox-Gastaut Syndrome (petit mal variant), akinetic and myoclonic seizures. It may be indicated in patients with absence seizures (petit mal) who have failed to respond to succinimides.<br />\r\n<br />\r\nThe effectiveness of Clonazepam in long-term use, that is, for more than 9 weeks, has not been systematically studied in controlled clinical trials. The physician who elects to use Clonazepam for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.</p>', '<p>Clonazepam exhibits pharmacological properties which are common to benzodiazepines and include anticonvulsive, sedative, muscle relaxing and anxiolytic effects. The central actions of benzodiazepines are mediated through an enhancement of the GABAergic neurotransmission at inhibitory synapses. In the presence of benzodiazepines the affinity of the GABA receptor for the neurotransmitter is enhanced through positive allosteric modulation resulting in an increased action of released GABA on the postsynaptic transmembrane chloride ion flux.<br />\r\n<br />\r\nThere are also animal data showing an effect of clonazepam on serotonin. Animal data and electroencephalographic investigations in man have shown that clonazepam rapidly suppresses many types of paroxysmal activity including the spike and wave discharge in absences seizures (petit mal), slow spike wave, generalized spike wave, spikes with temporal or other locations as well as irregular spikes and waves. Generalized EEG abnormalities are more regularly suppressed than focal abnormalities. According to these findings clonazepam has beneficial effects in generalized and focal epilepsies.</p>', '<p>Oral:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses. Dosage may be increased in increments of 0.5 to 1 mg every 3 days until seizures are adequately controlled or until side effects preclude any further increase. Maintenance dosage must be individualized for each patient depending upon response. Maximum recommended daily dose is 20 mg.</li>\r\n</ul>\r\n\r\n<ul>\r\n	<li>The initial dose for adults with panic disorder is 0.25 mg given in two divided dose. An increase to the target dose for most patients of 1 mg/day may be made after 3 days.</li>\r\n	<li><strong>Pediatric Patients</strong>: In order to minimize drowsiness, the initial dose for infants and children (up to 10 years of age or 30 kg of body weight) should be between 0.01 and 0.03 mg/kg/day but not to exceed 0.05 mg/kg/day given in two or three divided doses.</li>\r\n</ul>\r\n\r\n<p><br />\r\nInjection:</p>\r\n\r\n<ul>\r\n	<li><strong>Infants and children</strong>: half of a vial (0.5 mg) by slow IV injection or by IV infusion.</li>\r\n</ul>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 1 vial (1 mg) by slow IV injection or by IV infusion. This dose can be repeated as required (1-4 mg are usually sufficient to reverse the status). In adults, the rate of injection must not exceed 0.25 - 0.5 mg per minute (0.5-1.0 ml of the prepared solution) and a total dose of 10 mg should not be exceeded.</li>\r\n</ul>', '<p>Clonazepam does not appear to alter the pharmacokinetics of phenytoin, carbamazepine or phenobarbital. The effect of Clonazepam on the metabolism of other drugs has not been investigated.</p>', '<p>It should not be used in patients with a history of hypersensitivity to benzodiazepines, nor in patients with clinical or biochemical evidence of significant liver disease. It may be used in patients with open angle glaucoma who are receiving appropriate therapy but is contraindicated in acute narrow angle glaucoma.</p>', '<p>The most frequently occurring side effects of Clonazepam are referable to CNS depression. Experience in treatment of seizures has shown that drowsiness has occurred in approximately 50% of patients and ataxia in approximately 30%. In some cases, these may diminish with time; behavior problems have been noted in approximately 25% of patients. Abnormal eye movements, aphonia, coma, tremor, vertigo, confusion, depression, amnesia, hallucinations, hysteria, increased libido, insomnia, psychosis &amp; palpitations may also occur.</p>', '<p><strong>Pregnancy</strong>: From preclinical studies it cannot be excluded that clonazepam possesses the possibility of producing congenital malformations. From epidemiological evaluations there is evidence that anticonvulsant drugs act as teratogens. However, it is difficult to determine from published epidemiological reports which drug or combination of drugs is responsible for defects in the newborn. The possibility also exists that other factors e.g. genetic factors or the epileptic condition itself may be more important than drug therapy in leading to birth defects. Under these circumstances, the drug should only be administered to pregnant women if the potential benefits outweigh the risk to the foetus. During pregnancy, Clonazepam may be administered only if there is a compelling indication. Administration of high doses in the last trimester of pregnancy or during labour can cause irregularities in the heartbeat of the unborn child and hypothermia, hypotonia, mild respiratory depression and poor feeding in the neonate. It should be borne in mind that both pregnancy itself and abrupt discontinuation of the medication can cause exacerbation of epilepsy. Withdrawal symptoms in newborn infants have occasionally been reported with benzodiazepines.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Although the active ingredient of Clonazepam has been found to pass into the maternal milk in small amounts only, mothers undergoing treatment with this drug should not breastfeed. If there is a compelling indication for Clonazepam, breastfeeding should be discontinued.</p>', '<p>When used in patients in whom several different types of seizure disorders coexist, Clonazepam may increase the incidence or precipitate the onset of generalized tonic-clonic seizures. This may require the addition of appropriate anticonvulsants or an increase in their dosages. The concomitant use of valproic acid and Clonazepam may produce absence status.</p>', '<p><strong>Symptoms</strong>: Benzodiazepines commonly cause drowsiness, ataxia, dysarthria and nystagmus. Overdose of Clonazepam is seldom life-threatening if the drug is taken alone, but may lead to areflexia, apnoea, hypotension, cardiorespiratory depression and coma. Coma, if it occurs, usually lasts a few hours but it may be more protracted and cyclical, particularly in elderly patients. Increased frequency of seizures may occur in patients at supratherapeutic plasma concentrations. Benzodiazepine respiratory depressant effects are more serious in patients with respiratory disease. Benzodiazepines increase the effects of other central nervous system depressants, including alcohol.<br />\r\n<br />\r\n<strong>Treatment</strong>: Monitor the patient&rsquo;s vital signs and institute supportive measures as indicated by the patient&rsquo;s clinical state. In particular, patients may require symptomatic treatment for cardiorespiratory effects or central nervous system effects. Further absorption should be prevented using an appropriate method e.g. treatment within 1-2 hours with activated charcoal. If activated charcoal is used airway protection is imperative for drowsy patients. In case of mixed ingestion gastric lavage may be considered, however not as a routine measure. If CNS depression is severe consider the use of flumazenil, a benzodiazepine antagonist. This should only be administered under closely monitored conditions. It has a short half-life (about an hour), therefore patients administered flumazenil will require monitoring after its effects have worn off. Flumazenil is to be used with extreme caution in the presence of drugs that reduce seizure threshold (e.g. tricyclic antidepressants). Refer to the prescribing information for flumazenil, for further information on the correct use of this drug.</p>', '<p>Adjunct anti-epileptic drugs, Benzodiazepine hypnotics</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: In infants and small children Rivotril may cause increased production of saliva and bronchial secretion. Therefore special attention must be paid to maintaining patency of the airways.&nbsp;<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Benzodiazepine pharmacologic effects appear to be greater in elderly patients than in younger patients even at similar plasma benzodiazepine concentrations, possibly because of age-related changes in drug&ndash;receptor interactions, post-receptor mechanisms and organ function.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Renal impairment does not affect the pharmacokinetics of clonazepam. Based on pharmacokinetic criteria, no dose adjustment is required in patients with renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairmen</strong>t: Plasma protein binding of clonazepam in cirrhotic patients is significantly different from that in healthy subjects (free fraction 17.1&plusmn;1.0% vs 13.9&plusmn;0.2%). Although the influence of hepatic impairment on clonazepam pharmacokinetics has not been further investigated, experience with another closely related nitrobenzodiazepine (nitrazepam) indicates that clearance of unbound clonazepam might be reduced in liver cirrhosis.</p>', '2022-02-18 21:03:25', '2022-04-10 20:30:12'),
(369, 369, '<p>Clonidine is indicated in Anxiety, Cancer pain, Generalized anxiety disorder, Hypertension, Hypertensive crisis, Menopausal flushing, Migraine, Panic disorder, Severe anxiety disorders, Social anxiety disorder</p>', '<p>Clonidine stimulates &alpha;2-adrenoceptors in the brain stem which results in reduced sympathetic outflow from the CNS, and a decrease in peripheral resistance, heart rate, BP and renal vascular resistance.</p>', '<p><strong>Adults</strong>: The dose of Clonidine tablets must be adjusted according to the patient&#39;s individual blood pressure response. The following is a general guide to its administration.<br />\r\n<br />\r\n<strong>Initial Dose</strong>: 0.1 mg tablet twice daily (morning and bedtime). Elderly patients may benefit from a lower initial dose.<br />\r\n<br />\r\n<strong>Maintenance Dose</strong>: Further increments of 0.1 mg per day may be made at weekly intervals if necessary until the desired response is achieved. Taking the larger portion of the oral daily dose at bedtime may minimize transient adjustment effects of&nbsp;dry mouth&nbsp;and drowsiness. The therapeutic doses most commonly employed have ranged from 0.2 mg to 0.6 mg per day given in divided doses. Studies have indicated that 2.4 mg is the maximum effective daily dose, but doses as high as this have rarely been employed.</p>', '<p>Increased hypotensive effect with other antihypertensives e.g. diuretics, &beta;-blockers, vasodilators, Ca antagonists, ACE inhibitors. Reduced antihypertensive effect and induced orthostatic hypotension with TCAs or neuroleptics with &alpha;-receptor blocking properties. Reduced therapeutic effect with NSAIDs.</p>', '<p>Severe bradyarrhythmia secondary to 2nd- or 3rd-degree AV block or sick sinus syndrome</p>', '<p>Headache, dizziness, drowsiness, dry mouth, constipation, depression, anxiety, nausea, fatigue, anorexia, parotid pain, paraesthesia, delusional perception, sleep disturbances, vivid dreams, impotence and loss of libido, urinary retention or incontinence, orthostatic hypotension, itching or burning sensations in the eye, accommodation disorder, decreased lacrimation, fluid retention, pruritus and rashes (transdermal), bradycardia, other ECG disturbances, heart failure, hallucinations, cramp, Raynaud&#39;s syndrome, gynaecomastia, transient abnormalities in LFTs.</p>', '<p><strong>Category C:</strong>&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Patient with cerebrovascular disease, ischaemic heart disease including MI, occlusive peripheral vascular disorders (e.g. Raynaud&#39;s disease), or those w/ history of depression. Avoid abrupt withdrawal. Renal impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Lethargy, pupillary constriction, hypotension, hypothermia, bradycardia, decreased or absent reflexes, irritability, miosis, weakness, somnolence (including coma) and resp depression (including apnoea). Paradoxical HTN may occur.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Perform gastric lavage following recent ingestion or admin activated charcoal and/or a cathartic. Supportive treatment may include admin of atropine sulfate for symptomatic bradycardia; IV fluids and/or inotropic sympathomimetic agents for hypotension; vasodilators for HTN. Naloxone may be used as adjunct for clonidine-induced resp depression, hypotension and/or coma.</p>', '<p>Centrally acting antihypertensive drugs (central sympatholytic)</p>', '<p>Store between 20-25&deg;C.</p>', '<p><strong>Renal Impairment</strong>: Patients with renal impairment may benefit from a lower initial dose. Patients should be carefully monitored. Since only a minimal amount of clonidine is removed during routine&nbsp;hemodialysis, there is no need to give supplemental clonidine following&nbsp;dialysis.</p>', '2022-02-18 21:03:54', '2022-04-10 20:33:11'),
(370, 370, '<p><strong>Acute Coronary Syndrome (ACS)</strong>: It is indicated to reduce the rate of Myocardial Infarction (MI) and Stroke in patients with non-ST-segment elevation ACS [unstable angina (UA)/non-ST-elevation Myocardial Infarction (NSTEMI)] and acute ST-segment elevation ACS [ST-elevation Myocardial Infarction (STEMI)].<br />\r\n<br />\r\n<strong>Recent MI, recent Stroke, or established Peripheral Arterial Disease</strong>: In patients with established peripheral arterial disease or with a history of recent Myocardial Infarction (MI) or recent Stroke it is indicated to reduce the rate of MI and Stroke.</p>', '<p>Clopidogrel is a prodrug. It inhibits platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. Dose-dependent inhibition of platelet aggregation can be seen at 2 hours after single oral doses. Repeated doses of 75 mg per day inhibit ADP-induced platelet aggregation on the first day, and inhibition reaches steady state between Day 3 and Day 7.<br />\r\n<br />\r\nAspirin inhibits platelet aggregation by irreversible inhibition of platelet cyclooxygenase and thus inhibiting the generation of thromboxane A2 a powerful inducer of platelet aggregation and vasoconstriction.</p>', '<p>The recommended oral dose is one tablet daily.</p>', '<p>Oral anticoagulants, NSAIDs, Metamizole, SSRIs, CYP2C19 inhibitors increase the risk of bleeding. It shows interaction with Tonofovir, Valproic acid, Varicella vaccine, Acetazolamide and Nicorandil.</p>', '<p>This combination is contraindicated in the following conditions: Hypersensitivity to the drug substance or any component of the product. Active pathological bleeding such as peptic ulcer or intracranial hemorrhage.</p>\r\n\r\n<p>&nbsp;</p>', '<p>This combination is generally well tolerated.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. It should be used during first and second trimesters of pregnancy only if clearly needed. It is contraindicated during the third trimester of pregnancy. It is unknown whether Clopidogrel is excreted in human breast milk but Aspirin is known to be excreted in human milk. This Drug should be discontinued during the breast feeding.</p>', '<ul>\r\n	<li>This combination may prolongs the bleeding time.</li>\r\n	<li><strong>Thrombotic thrombocytopenic purpura (TTP)</strong>: TTP has been reported rarely following use of this combination.</li>\r\n	<li><strong>Reye&#39;s syndrome</strong>: Reye&#39;s syndrome may develop in individuals who have chicken pox, influenza or flu symptoms. Hypersensitivity including rash, angioedema or hematologic reaction has been reported in patients receiving this combination or history of hypersensitivity to other thienopyridines</li>\r\n</ul>', '<p>Clopidogrel overdose may lead to bleeding complications. Based on biological plausibility, platelet transfusion may restore clotting ability. In moderate aspirin intoxication dizziness, headache, tinnitus, confusion, and gastrointestinal symptoms may occur which can be treated by inducing vomiting followed by gastric lavage if needed. In severe Aspirin intoxication respiratory alkalosis respiratory acidosis, metabolic acidosis, hyperthermia, perspiration, dehydration can occur. It can be treated with haemodialysis and other symptomatic treatment.</p>', '<p>Anti-platelet drugs</p>', '<p>Keep in a cool &amp; dry place (below 30o C), protected from light &amp; moisture. Keep out of the reach of children.</p>', '<p>It should not be given to children, particularly those under 12 years, unless the expected benefits outweight the possible risks. Aspirin may be a contributory factor in the causation of Reye&rsquo;s syndrome in some children.</p>', '2022-02-18 21:04:12', '2022-04-10 20:35:35'),
(371, 371, '<p><strong>Acute Coronary Syndrome (ACS)</strong>: It is indicated to reduce the rate of myocardial infarction (MI) and stroke in patients with non-ST-segment elevation ACS [unstable angina (UA)/non-ST-elevation myocardial infarction (NSTEMI)]. It is indicated to reduce the rate of myocardial infarction and stroke in patients with acute ST-elevation myocardial infarction (STEMI).<br />\r\n<br />\r\n<strong>Recent MI, recent Stroke, or established Peripheral Arterial Disease</strong>: In patients with established peripheral arterial disease or with a history of recent myocardial infarction (MI) or recent stroke it is indicated to reduce the rate of MI and stroke.</p>', '<p>Clopidogrel is a prodrug. It inhibits platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. Dose-dependent inhibition of platelet aggregation can be seen 2 hours after single oral doses. Repeated doses of 75 mg per day inhibit ADP-induced platelet aggregation on the first day, and inhibition reaches steady state between Day 3 and Day 7.</p>', '<p><strong>Acute Coronary Syndrome</strong>: In patients who need an antiplatelet effect within hours, initiate clopidogrel with a single 300 mg (4 tablets) oral loading dose and then continue at 75 mg once daily. Initiating it without a loading dose will delay establishment of an antiplatelet effect by several days.<br />\r\n<br />\r\n<strong>Recent MI, Recent Stroke, or Established Peripheral Arterial Disease</strong>: 75 mg once daily orally without a loading dose.<br />\r\n<br />\r\nIt is given orally with or without food.</p>', '<ul>\r\n	<li>NSAIDs, warfarin, selective serotonin and serotonin norepinephrine reuptake inhibitors (SSRIs, SNRIs): Increases risk of bleeding</li>\r\n	<li>CYP2C19 inhibitors (omeprazole or esomeprazole): Avoid concomitant use of omeprazole or esomeprazole</li>\r\n	<li>Repaglinide (CYP2C8 substrates): Avoid concomitant use of Clopidogrel with Repaglinide as it increases plasma concentrations of Repaglinide</li>\r\n</ul>', '<p>Clopidogrel is contraindicated in the following conditions: Hypersensitivity to the drug substance or any component of the product. Active pathological bleeding such as peptic ulcer or intracranial hemorrhage.</p>', '<p>Clopidogrel is generally well tolerated drug.</p>\r\n\r\n<ul>\r\n	<li><strong>Common side effects</strong>: Bleeding, Diarrhoea, gastrointestinal discomfort, haemorrhage, Skin reactions.</li>\r\n	<li><strong>Rare side effects</strong>: Acquired haemophilia, anaemia, angioedema, arthralgia, arthritis, bone marrow disorders.</li>\r\n</ul>', '<p>There are no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only if clearly needed. It is unknown whether clopidogrel is excreted in human breast milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<ul>\r\n	<li>As it is a prodrug, so metabolism to its active metabolite is impaired by genetic variations in CYP2C19 (poor metabolizer) and by the drugs that inhibit CYP2C19 such as Omeprazole and Esomeprazole. Concomitant use with these drugs and in CYP2C19 poor metaboliser may reduce the antiplatelet activity of Clopidogrel.</li>\r\n	<li>As it inhibits platelet aggregation for the lifetime of the platelet (7-10 days), risk of bleeding may increase. To restore hemostasis, platelet transfusions within 4 hours of the loading dose or 2 hours of the maintenance dose may be less effective.</li>\r\n	<li>Discontinuation of Clopidogrel increases the risk of cardiovascular events. Discontinue 5 days prior to elective surgery that has a major risk of bleeding. Resume Clopidogrel as soon as hemostasis is achieved.</li>\r\n	<li>Thrombotic Thrombocytopenic Purpura (TTP) has been reported that requires urgent treatment including plasmapheresis (plasma exchange).</li>\r\n	<li>Hypersensitivity including rash, angioedema or hematologic reaction has been reported in patients receiving clopidogrel or history of hypersensitivity to other thienopyridines.</li>\r\n</ul>', '<p>Overdose following clopidogrel administration may lead to bleeding complications. Based on biological plausibility, platelet transfusion may restore clotting ability.</p>', '<p>Anti-platelet drugs</p>', '<p>Keep below 30&deg;C temperature in a dry place. Protected from light. Do not freeze. Keep out of the reach of children.</p>', '<p>Safety and effectiveness in pediatric populations have not been established. No dosage adjustment is necessary in elderly patients.</p>', '2022-02-18 21:04:58', '2022-04-10 20:38:48'),
(372, 372, '<p>Clotrimazole Ear Drop is indicated for the treatment of fungal infections of the ear.</p>', '<p>Clotrimazole kills fungi and yeasts by interfering with their cell membranes. It works by stopping the production of ergosterol, which is an essential component of fungal cell membranes resulting in increased membrane permeability and leakage of essential constituents of the fungal cells.</p>', '<p>Instill 2-3 drops of Clotrimazole Ear Drops in the affected ear two or three times daily. The treatment should be continued for at least two weeks after the disappearance of all signs of infection to prevent re-infection.</p>', '<p>There have been reports of a heat reaction when this medication used concomitantly with Sofradex drops in the ear.</p>', '<p>Individuals who have hypersensitivity to any of its components.</p>', '<p>Clotrimazole is generally well tolerated after local application but the few side effects have been reported infrequently like erythema, stinging, edema, pruritus and general irritation.</p>', '<p>Clotrimazole is recommended during pregnancy only after first consulting a doctor.<strong>&nbsp;</strong>Because systemic absorption of clotrimazole following topical application is marginal, there should be no risk for the infant during lactation.</p>', '<p>If local intolerance develops, consider withdrawal of the medicine and institution of appropriate therapy. Clotrimazole ear drop is not intended for ophthalmic use.</p>', '<p>In case of accidental oral ingestion, supportive measures should be taken.</p>', '<p>Aural Anti-fungal preparations</p>', '<p>Protect from light, store in cool &amp; dry place. Keep out of the reach of children. Protect from freezing. Do not use more than 4 weeks after opening.</p>', NULL, '2022-02-18 21:12:11', '2022-04-10 20:41:40'),
(373, 373, '<p>Clotrimazole Sterile Eye Ointment is indicated for the treatment of fungal keratitis due to filamentous fungi and Candida species.</p>', '<p>Clotrimazole kills fungi and yeasts by interfering with their cell membranes. It works by stopping the production of ergosterol, which is an essential component of fungal cell membranes resulting in increased membrane permeability and leakage of essential constituents of the fungal cells.</p>', '<p><strong>Eye ointment</strong>: It should be applied thinly and evenly to the conjunctival sac every 4 hours daily or as advised by a physician.</p>', NULL, '<p>Clotrimazole ointment is contraindicated in individuals sensitive to its components.</p>', '<p>Rarely patients may experience burning or irritation immediately after applying the ointment.</p>', '<p>Pregnancy category B. There are no adequate and well-controlled studies in pregnant women during the first trimester of pregnancy. Clotrimazole should be used only if clearly indicated during the first trimester of pregnancy.<br />\r\n<br />\r\nIt is not known whether this drug is excreted in human milk, caution should be exercised when Clotrimazole is used by a nursing woman.</p>', '<p>If irritation or sensitivity develops with the use of Clotrimazole ointment, treatment should be discontinued.</p>', NULL, '<p>Ophthalmic Anti-fungal Products</p>', NULL, '<p><strong>Une in children</strong>: Safety and effectiveness in children have been established for Clotrimazole when used as indicated and in the recommended dosage.</p>', '2022-02-18 21:12:42', '2022-04-10 20:43:55'),
(374, 374, '<ul>\r\n	<li>All dermatomycoses due to dermatophytes (e.g.Trichophyton species).</li>\r\n	<li>All dermatomycoses due to yeasts (Candida species).</li>\r\n	<li>Dermatomycoses due to moulds and other fungi.</li>\r\n	<li>Skin diseases showing superinfections with these fungi.</li>\r\n</ul>\r\n\r\n<p>Some examples of skin infections included in above points are interdigital mycoses (e.g. athlete&#39;s foot), paronychias (associated with nail mycoses), mycoses in skin folds, Candida vulvitis, Candida balanitis, Pityriasis versicolor, erythrasma.</p>', '<p>Clotrimazole acts primarily by damaging the permeability barrier in the cell membrane of fungi. Clotrimazole causes inhibition of ergosterol biosynthesis, an essential constituent of fungal cell membranes. If ergosterol synthesis is either completely or partially inhibited, the cell is no longer able to construct an intact and functional cell membrane. Because ergosterol directly promotes the growth of fungal cells in a hormone‐like fashion, rapid onset of the above events leads to dose-dependent inhibition of fungal growth.<br />\r\n<br />\r\nThough decreased ergosterol, due to the inhibition of lanosterol 14-demethylase (also known as CYP51) is accepted to be primarily responsible for the antimycotic properties of clotrimazole, this drug also shows other pharmacological effects. These include the inhibition of sarcoplasmic reticulum Ca2+&nbsp;ATPase, depletion of intracellular calcium, and blocking of calcium‐dependent potassium channels and voltage‐dependent calcium channels. The action of clotrimazole on these targets accounts for other effects of this drug that are separate from its antimycotic activities.</p>', '<p><strong>Clotrimazole Cream</strong>: This should be thinly applied 2-3 times daily to the infected sites and rubbed in. On account of the excellent efficacy, a small amount of cream is usually sufficient for an area about the size of the palm. For the treatment to become a complete success, reliable and sufficiently long-time application of Clotrimazole Cream is important. The duration of treatment varies; it depends among other factors on the extent and localization of the disease.<br />\r\n<br />\r\nRecommended duration of treatment-</p>\r\n\r\n<ul>\r\n	<li>Dermatomycoses: 3-4 weeks</li>\r\n	<li>Candida vulvitis and Candida balanitis: 1-2 weeks</li>\r\n	<li>Erythrasma and Pityriasis Versicolor: 3 weeks (approximately)</li>\r\n</ul>\r\n\r\n<p>In fungal infection of the feet, to prevent relapse, treatment should be continued for about 2 weeks beyond the disappearance of all signs of disease. After washing, the feet should be thoroughly dried (particularly spaces between the toes). Clotrimazole Cream is odorless, can be washed off and does not stain clothing.<br />\r\n<br />\r\n<strong>Clotrimazole topical solution</strong>: Apply this&nbsp;sparingly to the affected areas and rub in gently, two or three times daily.</p>', '<p>No information is available.</p>', '<p>Hypersensitivity to Clotrimazole.</p>', '<p>When applied topically, Clotrimazole is well tolerated.With external application, systemic effects are not observed. Local irritation or burning sensation may occur in a very few cases but these symptoms are not considered harmful.</p>', '<p>It is recommended that Clotrimazole should be used in pregnancy only when considered necessary by the physician.</p>', NULL, NULL, '<p>Drugs for subcutaneous and mycoses, Topical Antifungal preparations</p>', '<p>Keep below 25&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 21:13:48', '2022-04-10 20:45:55'),
(375, 375, '<p>Clotrimazole vaginal suppository is used in candidal vaginitis.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Clotrimazole is a broad-spectrum antifungal agent that is used for the treatment of dermal infections caused by various species of pathogenic dermatophytes, yeasts, moulds and bacteroids. Clotrimazole is also active against certain gram-positive bacteria especially Staphylococci and Tricomonas. Like other imidazoles, Clotrimazole alters the permeability of fungal cell walls by interfering with cell wall lipids. At fungi static levels the main effect is inhibition of ergosterol synthesis but at higher concentrations there is an additional mechanism of membrane damage unrelated to sterol synthesis.</p>', '<p>One suppository should be inserted intravaginally daily (preferably at night) for three consecutive days. The suppository should be inserted into the vagina, as high as possible. This is best achieved when lying back with legs bent up. Or as directed by the physicians.</p>', NULL, '<p>Clotrimazole is contraindicated for patients who are hypersensitive to Clotrimazole.</p>', '<p>Occasional skin irritation or burning sensation may occur in a very few cases which are not considered harmful.</p>', '<p>Clotrimazole is very poorly absorbed into the blood and the body after application to the skin or the vagina. Studies in women in their second or third trimesters have demonstrated no ill effects. It is not known if Clotrimazole is secreted in breast milk. Clotrimazole suppository can be used during pregnancy, but only under the supervision of a Physician.</p>', '<p>Constituents of the vaginal suppository may be incompatible with rubber in both contraceptive condoms and diaphragms. During period this treatment won&#39;t have good result. Avoid oral or ophthalmic use.</p>', NULL, '<p>Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations</p>', '<p>Keep all medicines out of reach of children. Store in a cool &amp; dry place, protected from light.</p>', '<p>Clotrimazole vaginal suppository is not recommended for paediatric use.</p>', '2022-02-18 21:15:34', '2022-04-10 20:48:45'),
(376, 376, '<p>Clotrimazole rectal preparation is indicated in vaginal itching, burning and discharge associated with recurrent vaginal yeast infections (Vaginal candidiasis) and also in viginitis due to Candida species as well as Mycotic infections complicated by other microorganisms sensitive to the drug.</p>', '<p>Clotrimazole is a broad-spectrum antifungal agent that is used for the treatment of dermal infections caused by various species of pathogenic dermatophytes, yeasts, moulds and bacteroids. Clotrimazole is also active against certain gram-positive bacteria especially Staphylococci and Tricomonas. Like other imidazoles, Clotrimazole alters the permeability of fungal cell walls by interfering with cell wall lipids. At fungi static levels the main effect is inhibition of ergosterol synthesis but at higher concentrations there is an additional mechanism of membrane damage unrelated to sterol synthesis.</p>', '<p>Clotrimazole 100 mg &amp; 200 mg vaginal preparation-</p>\r\n\r\n<ul>\r\n	<li><strong>First infections</strong>: In general, a 3-day treatment is sufficient for Candida vaginitis. On 3 consecutive nights, Clotrimazole 200 mg vaginal preparation is inserted as deeply as possible into the vagina. This is best achieved when lying on one&#39;s back with the knees slightly bent.</li>\r\n	<li><strong>Re-infections</strong>: In general, a 6-day treatment is sufficient. This applies also to mixed infections with the above-mentioned causative organisms. On six consecutive nights, 1 Clotrimazole 100 mg&nbsp;vaginal preparation is inserted as deeply as possible into the vagina. If necessary, 2 Clotrimazole 100 mg&nbsp;(1 in the morning and 1 in the evening) or 1 Clotrimazole 200 mg daily can be used for 6-12 days. Treatment should be timed so as to avoid the menstrual period and be finished before the onset of menstruation. To avoid re-infection, the partner should undergo local treatment with Clotrimazole cream at the same time.</li>\r\n</ul>\r\n\r\n<p><strong>Clotrimazole 500 mg vaginal preparation</strong>: Single dose, complete treatment with one vaginal tablet. The tablet should be inserted as deeply as possible into the vagina. This is best achieved when lying on one&#39;s back with the knees slightly bent. It is recommended that the treatment should be timed so as to avoid the menstrual period. For prevention of re-infection the partner should be treated locally with Clotrimazole cream at the same time.<br />\r\n<br />\r\nClotrimazole&nbsp;vaginal preparation are colorless and do not stain the underwear.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Pull out plunger until it stops. Place a vaginal tablet into the applicator</li>\r\n	<li>Insert applicator containing the tablet carefully as deeply as possible into the vagina (best lying on your back)</li>\r\n	<li>Push plunger until it stops, there by depositing the tablet into the vagina. Remove the applicator</li>\r\n	<li>After use, remove plunger completely by pulling it out of the applicator</li>\r\n	<li>Then wash it in warm (not boiling) soapy water, rinse and dry carefully</li>\r\n</ul>\r\n\r\n<p>Note: Pregnant women must follow physician&#39;s instructions</p>', '<p>No information is available.</p>', '<p>It is contraindicated in patients with known hypersensitivity to any of the components of this product.</p>', '<p>Since there is practically no Clotrimazole absorption through the vaginal skin, no systemic effect is expected. The local tolerance of Clotrimazole vaginal tablet is generally good. Local irritation or burning sensation may occur in a very few cases but these symptoms are not considered harmful.</p>', '<p>It is recommended that Clotrimazole should be used in pregnancy only when considered necessary by the physician. Clotrimazole is very poorly absorbed into the blood and the body after application to the skin or the vagina. Studies in women in their second or third trimesters have demonstrated no ill effects. It is not known if Clotrimazole is secreted in breast milk. Clotrimazole suppository can be used during pregnancy, but only under the supervision of Physician.</p>', NULL, NULL, '<p>Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations</p>', '<p>Keep below 25&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-18 21:16:03', '2022-04-10 20:52:43'),
(377, 377, '<p>The treatment of fungal infections where co-existing symptoms of inflammation e.g. itching, require rapid relief.</p>\r\n\r\n<ul>\r\n	<li>All dermatomycoses due to dermatophytes (e.g. Trichophyton species), moulds and other fungi.</li>\r\n	<li>All dermatomycoses due to yeasts (Candida species).</li>\r\n	<li>Skin diseases showing secondary infection with these fungi</li>\r\n	<li>The treatment of nappy rash where infection due to Candida albicans is present.</li>\r\n</ul>', '<p>Clotrimazole is a broad-spectrum antifungal agent active on dermatophytes, yeasts and other fungi. Hydrocortisone is a glucocorticoid with both glucocorticoid and to a lesser extent mineralocorticoid activity. Hydrocortisone is used for replacement therapy in adrenocortical insufficiency.</p>', '<p>Apply thinly and evenly to the affected area twice daily.</p>', NULL, '<p>It is contraindicated in patients with known hypersensitivity to any of the components of this preparation.</p>', '<p>Rarely local mild burning or irritation may be experienced. Hypersensitivity reactions may occur.</p>', NULL, '<p>In infants, the napkins may act as an occlusive dressing and increase absorption. Treatment should be for a maximum period of seven days.</p>', NULL, '<p>Hydrocortisone &amp; Combined preparations</p>', '<p>Keep in a cool and dry place. Keep out of the reach of children.</p>', NULL, '2022-02-18 21:17:01', '2022-04-11 05:03:16'),
(378, 378, '<p>Clove oil is indicated in Bad breath (Halitosis), Tooth decay, Oral thrush, Dental pain, Inflammation of the mouth and pharynx.</p>', '<p>Clove oil is a herbal medicine which main ingredient is clove oil. It contains a large amount of eugenol that is commonly used in the treatment of oral infections and inflammation of the mucous membranes of the mouth and throat. Clove oil is effective, safe and well tolerated for all age groups</p>', '<p><strong>Adult</strong>: Should be taken 5 ml Clove oil with 10 ml-15 ml water and gurgle for 30 seconds of morning &amp; bedtime daily.<br />\r\n<br />\r\n<strong>Children</strong>: Should be taken 2.5 ml Clove oil with 10 ml water and gurgle for 30 seconds of morning &amp; bedtime daily. Also undiluted clove oil is used in temporary relief of toothache due to dental cavity. Repeat administration after 20 minutes, then every 2 hours thereafter if necessary.</p>', NULL, NULL, '<p>In concentrated form oil of clove may be irritating to mucosal tissues.</p>', '<p>There are no known problems with the use of Clove oil during pregnancy and lactation.</p>', NULL, NULL, '<p>Oral preparations</p>', '<p>Store below 30&deg;C. temperature &amp; dry place, protected from light. Keep all medicines out of reach of children.</p>', NULL, '2022-02-18 21:17:16', '2022-04-11 05:06:15'),
(379, 379, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-18 21:17:48', '2022-02-18 21:17:48');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(380, 380, '<p>Clozapine is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Schizophrenia in patients unresponsive to, or intolerant of, conventional antipsychotic drugs.</li>\r\n	<li>Psychosis in Parkinson&#39;s disease.</li>\r\n</ul>', '<p>Clozapine is classified as an &#39;atypical&#39; antipsychotic drug because of its profile of binding to dopamine receptors and its effects on various dopamine-mediated behaviors differ from those exhibited by other typical antipsychotic drug products. In particular, although Clozapine does interfere with the binding of dopamine at D1, D2, D3 and D5 receptors, and has a high affinity for the D4 receptor. This evidence, consistent with the view that Clozapine is preferentially more active at limbic than at striatal dopamine receptors. This may explain the relative freedom of Clozapine from extrapyramidal side effects. Clozapine also acts as an antagonist at adrenergic, cholinergic, histaminergic and serotonergic receptors.</p>', '<p><strong>Schizophrenia</strong>: Adult over 16 years, 12.5 mg once or twice (elderly 12.5 mg once) on first day then 25-50 mg (elderly 25-37.5 mg) on second day then increased gradually (if well tolerated) in steps of 25-50 mg daily (elderly max. increment 25 mg daily) over 14-21 days up to 300 mg daily in divided doses (larger dose at night, up to 200 mg daily may be taken as a single dose at bedtime); if necessary may be further increased in steps of 50-100 mg once (preferably) or twice weekly; usual dose 200-450 mg daily (max. 900 mg daily)<br />\r\n<br />\r\n<strong>Psychosis in Parkinson&#39;s disease</strong>: Adult over 16 years, 12.5 mg at bedtime then increased according to response in steps of 12.5 mg up to twice weekly; usual dose range 25-37.5 mg at bedtime, usual maximum 50 mg daily; exceptionally, dose may be increased further in steps of 12.5 mg weekly to maximum 100 mg daily in 1-2 divided doses.</p>', '<p>Myelosuppression may be aggravated with concomitant use of myelosuppressants. Clozapine may interact with other CNS active drugs or alcohol. Orthostatic hypotension may occur with benzodiazepine usage or other psychotropics. Since Clozapine is highly bound to proteins. It may be displaced by other drugs, which are also highly protein bound. Conversely, Clozapine may also displace protein bound drugs (e.g. warfarin, digoxin). Cimetidine may decrease plasma Clozapine levels.<br />\r\n<br />\r\nAlthough concomitant administration of Carbamazepine and Clozapine is not recommended, it should be noted that discontinuation of concomitant Carbamazepine may result in an increase in plasma Clozapine levels. A reduced Clozapine dosage should be used when it is combined with drugs like fluvoxamine, paroxetine and sertraline. The action of hypotensive drugs may be potentiated. Other anticholinergic drug action may also be increased. Administration of adrenaline should generally be avoided due to possibility of reversal of adrenaline effect due to alpha adrenergic blockade by Clozapine. Concomitant use of Clozapine with other drugs metabolized by cytochrome P450 2D6 (such as phenothiazines, antidepressants, propafenone, flecainide and encainide) or those that inhibit this enzyme such as quinidine; require lower doses of either Clozapine or the other drugs.</p>', '<p>Severe cardiac disorders (e.g. myocarditis); renal impairment (avoid if creatinine clearance less than 10 ml/minute); history of neutropenia or agranulocytosis; bone-marrow disorders; paralytic ileus; alcoholic and toxic psychoses; history of circulatory collapse; drug intoxication; coma or severe CNS depression; uncontrolled epilepsy; breast-feeding.</p>', '<p>Common side effects are constipation, dizziness or lightheadedness (mild), drowsiness, headache (mild), increased watering of mouth, nausea or vomiting, unusual weight gain. Less common side effects include abdominal discomfort or heartburn, dryness of mouth.</p>', '<p>There are no adequate studies of Clozapine in pregnant women. Studies in animals suggest no important effects on the fetus. Clozapine can be used in pregnancy if the physician feels that it is necessary. Animal studies suggest that Clozapine is secreted in breast milk. Therefore, women taking Clozapine should not nurse their infants.</p>', '<p>Medication should not be stopped abruptly; should be tapered off over 1-2 weeks. If conditions warrant abrupt discontinuation (leukopenia, myocarditis, cardiomyopathy), monitor patient for psychosis and cholinergic rebound (headache, nausea, vomiting, diarrhea). Elderly patients are more susceptible to adverse effects&nbsp; (including agranulocytosis, cardiovascular, anticholinergic, and tardive dyskinesia). Significant risk of agranulocytosis, potentially life-threatening. WBC testing should occur weekly for the first 6 months of therapy; thereafter, if acceptable WBC counts are maintained (WBC 3000/mm3, ANC 1500/mm3) then WBC counts can be monitored every other week. WBCs must be monitored weekly for the first 4 weeks after therapy discontinuation. Use with caution in patients receiving other marrow suppressive agents. Eosinophilia has been reported to occur with Clozapine and may require temporary or permanent interruption of therapy.<br />\r\n<br />\r\nCognitive and/or motor impairment (sedation) is common with Clozapine, resulting in impaired performance of tasks requiring alertness (eg, operating machinery or driving). Use with caution in patients at risk of seizures, including those with a history of seizures, head trauma, brain damage, alcoholism, or concurrent therapy with medications which may lower seizure threshold. Has been associated with benign, self-limiting fever (&lt;100.4&deg;F, usually within first 3 weeks). However, dozapine may also be associated with severe febrile reactions, including neuroleptic malignant syndrome (NMS). Clozapine&#39;s potential for extrapyramidal symptoms appear to be extremely low.<br />\r\n<br />\r\nMay cause anticholinergic effects; should be used with caution in patients with urinary retention, benign prostatic hyperplasia, narrow-angle glaucoma, xerostomia, visual problems, constipation, or history of bowel obstruction. May cause hyperglycemia; in some cases may be extreme and associated with ketoacidosis, hyperosmolar coma, or death. Use with caution in patients with diabetes or other disorders of glucose regulation; monitor for worsening of glucose control. Use with caution in patients with hepatic disease or impairment; hepatitis has been reported as a consequence of therapy.<br />\r\n<br />\r\nMay cause orthostatic hypotension and tachycardia; should be used with caution in patients at risk of hypotension or in patients where transient hypotensive episodes would be poorly tolerated (cardiovascular disease or cerebrovascular disease). Concurrent use of psychotropics and benzodiazepines may increase the risk of severe cardiopulmonary reactions.<br />\r\n<br />\r\nMyocarditis, pericarditis, pericardial effusion, cardiomyopathy, and CHF have also been associated with clozapine. Fatalities due to myocarditis have been reported; highest risk in the first month of therapy, however, later cases also reported. Myocarditis or cardiomyopathy should be considered in patients who present with signs/symptoms of heart failure (dyspnea, fatigue, orthopnea, paroxysmal nocturnal dyspnea, peripheral edema), chest pain, palpitations, new electrocardiographic abnormalities (arrhythmias, ST-T wave abnormalities), or unexplained fever. Patients with tachycardia during the first month of therapy should be closely monitored for other signs of myocarditis. Discontinue clozapine if myocarditis is suspected; do not rechallenge in patients with clozapine-related myocarditis. The reported rate of cardiomyopathy in clozapine treated patients is similar to that in the general population. The majority of patients were over 50 years of age and were taking clozapine for &gt;6 months. Clozapine should be discontinued in patients with confirmed cardiomyopathy unless benefit clearly outweighs risk. Rare cases of thromboembolism, including pulmonary embolism and stroke resulting in fatalities, have been associated with clozapine.</p>', '<p>The most commonly reported signs and symptoms associated with Clozapine overdose are: altered states of consciousness, including drowsiness, delirium and coma; tachycardia; hypotension; respiratory depression or failure; hypersalivation. Aspiration pneumonia and cardiac arrhythmias have also been reported. Seizures have occurred in a minority of reported cases. Fatal overdoses have been reported with Clozapine, generally at doses above 2500 mg. There have also been reports of patients recovering from overdoses well in excess of 4 gm.<br />\r\n<br />\r\nManagement of Overdose: Should be established and maintained an airway; should be ensured adequate oxygenation and ventilation. Activated charcoal, which may be used with sorbitol, may be as or more effective than emesis or lavage, and should be considered in treating overdosage. Cardiac and vital signs monitoring is recommended along with general symptomatic and supportive measures. Additional surveillance should be continued for several days because of the risk of delayed effects. Avoid epinephrine and derivatives when treating hypotension, and quinidine and procainamide when treating cardiac arrhythmia. There are no specific antidotes for Clozapine. Forced diuresis, dialysis, hemoperfusion and exchange transfusion are unlikely to be of benefit. ln managing overdosage, the physician should consider the possibility of multiple drug involvement.</p>', '<p>Atypical neuroleptic drugs</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-02-18 21:18:02', '2022-04-11 05:32:19'),
(381, 381, '<p>Coagulation Factor VIIa is indicated in Bleeding episodes in patients with haemophilia,&nbsp;Bleeding episodes due to surgery or invasive procedures in patients with factor VII deficiency,&nbsp;Bleeding episodes due to surgery or invasive procedures in Glanzmann&#39;s thrombasthenia</p>', '<p>Recombinant factor VIIa is a biosynthetic preparation of activated factor VII produced by recombinant DNA technology. It is a vitamin K-dependent glycoprotein. It promotes haemostasis by activating the extrinsic pathway of the coagulation cascade. It replaces deficient activated coagulation factor VII, which complexes with tissue factor and may activate coagulation factor X and factor IX. Factor VIIa is given as the recombinant form, eptacog alfa (activated).</p>', '<p>Bleeding episodes in patients with haemophilia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;As activated eptacog alfa: Initially, 90 mcg/kg given via IV bolus over 2-5 min. Additional dose may be given as needed to achieve or maintain haemostasis, initially 2-3 hrly. May adjust dose or dosing interval according to response. May continue therapy for up to 3 wk or more in cases of serious bleeding episodes.</li>\r\n</ul>\r\n\r\n<p>Bleeding episodes due to surgery or invasive procedures in patients with factor VII deficiency:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;As activated eptacog alfa: 15-30 mcg/kg 4-6 hrly via IV bolus over 2-5 min until haemostasis is achieved.</li>\r\n</ul>\r\n\r\n<p>Bleeding episodes due to surgery or invasive procedures in Glanzmann&#39;s thrombasthenia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;As activated eptacog alfa: 90 mcg/kg 2 hrly via IV bolus over 2-5 min, give at least 3 doses.</li>\r\n</ul>', '<p>Increased risk of thromboembolism with activated or non-activated prothrombin complex concentrate.</p>', '<p>Hypersensitivity to recombinant coagulation factor VIIa or to mouse, hamster or bovine protein. Rare hereditary problems of fructose intolerance, glucose malabsorption or sucrose-isomaltase insufficiency.</p>', '<p>Nausea, vomiting, skin reactions, fever, headache and changes in BP. Rarely, anaphylaxis.</p>', '<p>It is preferable to avoid use during pregnancy. 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.<br />\r\n<br />\r\nIt is unknown whether eptacog alfa is excreted in human breast milk. The excretion of eptacog alfa in milk has<br />\r\nnot been studied in animals.</p>', '<p>Advanced atherosclerotic disease, crush injury, septicemia or disseminated intravascular coagulation. Patients w/ history of CHD, liver disease, undergoing major surgery, at risk of thromboembolic phenomena or disseminated intravascular coagulation. Remote possibility of hypersensitivity to mouse IgG, bovine IgG &amp; other residual culture proteins. Monitor prothrombin time &amp; factor VII coagulant activity in factor VII deficient patients. Pregnancy &amp; lactation. Neonates.</p>', NULL, '<p>Anti-fibrinolytic drugs</p>', '<p>Store between 2-25&deg; C prior to reconstitution. Do not freeze. Protect from light.</p>', NULL, '2022-02-18 21:20:27', '2022-04-11 05:35:36'),
(382, 382, '<p>Coal Tar Cream is indicated for psoriasis. Soritar Cream has a keratoplastic and antipruritic effect in psoriasis.</p>', '<p>Coal tar has antipruritic, keratoplastic and keratolytic properties. It slows down excessive epidermal cell turnover and is often used topically either alone or in combination with other drugs (e.g. salicyclic acid, sulfur) in conditions such as dandruff, seborrheic dermatitis or psoriasis.</p>', '<p><strong>Adults and children over 12 years of age</strong>: Ensure that the lesions are clean. Apply a thin layer of Coal Tar Cream two or three times a day on to the affected areas massage in gently and leave to dry.<br />\r\n<br />\r\n<strong>For young children under 12 years of age and the elderly</strong>: The emulsion may be diluted by mixing it with a few drops of cooled freshly boiled in the palm of the hand.</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>For topical application only.</p>', NULL, '<p>Coal Tar should not be used when a patient has known sensitivity to Coal Tar or any of the other ingredients. If you have folliculitis and acne vulgaris. Coal Tar Cream should not be used on patients who have disease characterised by photosensitivity such as lupus erythematosus or allergy to sunlight. Coal Tar Cream should not be applied to inflamed or broken skin. Warnings and precautions: For topical administration only. Coal Tar Cream may cause skin irritation, should this occur the treatment should be reviewed and if necessary discontinued. Coal Tar enhances photosensitivity of the skin after applying Coal Tar Cream exposure to direct sunlight should be avoided. Use with care near the eyes and mucous membranes. If any emulsion should accidentally enter the eye, flush with normal saline solution or water. Do not apply to genital and rectal areas. Apply with caution to the face do not get in the eyes. Hydrogenated polyoxyl castor oil may cause skin reactions. Methyl and propyl hydroxybenzoates may cause allergic reactions that might be cause a delayed reaction.</p>', '<p>Skin and subcutaneous tissue disorders: Skin irritation, photosensitivity of the skin, Coal Tar Cream may cause acne-like eruptions of the skin. There is an increased risk of skin cancer in psoriatic patients treated with a combination of Coal Tar Cream and UVB radiation has been reported. However epidemiological studies of patients treated with Coal Tar Cream on its own are inconclusive. The risk of toxicity should be taken into account when considering the prescribing this product for the patient.</p>', '<p>There is no direct evidence of the safety in pregnant and lactating mother. Coal tar preparations have been in use for many years without apparent ill-consequence. No harmful effects on the health of the child is anticipated with the proper use of coal tar. However it is recommended that the use of coal tar in pregnancy and lactation is restricted to intermittent use in low concentrations on a small percentage of body&rsquo;s surface, use during the first trimester be avoided.</p>', NULL, '<p>There is no evidence that an overdose of topical Coal Tar Cream would be harmful other than a hypersensitivity to coal tar. Ingestion of Coal Tar Cream may require gastric lavage depending on the quantity taken and should be treated symptomatically.</p>', '<p>Coal-tar preparations</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-18 21:20:39', '2022-04-11 03:09:35'),
(383, 383, '<p>Malignant Diseases:</p>\r\n\r\n<p>Cyclophosphamide is indicated for the treatment of:</p>\r\n\r\n<ul>\r\n	<li>Malignant&nbsp;lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin&#39;s disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma,&nbsp;Burkitt&#39;s lymphoma</li>\r\n	<li>Multiple myeloma</li>\r\n	<li>Leukemias: chronic lymphocytic&nbsp;leukemia,&nbsp;chronic granulocytic leukemia&nbsp;(it is usually ineffective in acute blastic crisis), acute&nbsp;myelogenousand monocytic leukemia, acute lymphoblastic (stem-cell) leukemia (cyclophosphamide given during&nbsp;remission&nbsp;is effective in prolonging its duration)</li>\r\n	<li>Mycosis fungoides&nbsp;(advanced disease)</li>\r\n	<li>Neuroblastoma&nbsp;(disseminated disease)</li>\r\n	<li>Adenocarcinoma&nbsp;of the ovary</li>\r\n	<li>Retinoblastoma</li>\r\n	<li>Carcinoma&nbsp;of the breast</li>\r\n</ul>\r\n\r\n<p>Cyclophosphamide, although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other&nbsp;antineoplastic&nbsp;drugs.</p>\r\n\r\n<p>Minimal Change Nephrotic Syndrome in Pediatric Patients:</p>\r\n\r\n<p>Cyclophosphamide is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatrics patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy.</p>', '<p>Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle. It prevents cell division by cross-linking deoxyribonucleic acid (DNA) strands and reducing DNA synthesis. It also exerts a potent immunosuppressive effect.</p>', '<p>Intravenous (Adult)-</p>\r\n\r\n<p>Malignancies:&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Low dose regimen: 2-6 mg/kg wkly as a single dose;</li>\r\n	<li>Moderate dose regimen: 10-15 mg/kg wkly as a single dose;</li>\r\n	<li>High dose regimen: 20-40 mg/kg as a single dose every 10-20 days.</li>\r\n</ul>\r\n\r\n<p>Alternatively,</p>\r\n\r\n<ul>\r\n	<li>80-300 mg/m2&nbsp;daily as a single dose, or</li>\r\n	<li>300-600 mg/m2&nbsp;wkly as a single dose, or</li>\r\n	<li>600-1,500 mg/m2&nbsp;as a single dose or</li>\r\n	<li>Short infusion at 10- to 20-day intervals.</li>\r\n</ul>\r\n\r\n<p>Oral&nbsp;(Child)-</p>\r\n\r\n<p>Nephrotic syndrome:&nbsp;</p>\r\n\r\n<ul>\r\n	<li>2 mg/kg daily for 8-12 wk.</li>\r\n	<li>Max cumulative dose: 168 mg/kg.</li>\r\n	<li>Max duration: 90 days.</li>\r\n</ul>\r\n\r\n<p>Oral&nbsp;(Adult)-</p>\r\n\r\n<p>Malignancies:&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Low dose regimen: 2-6 mg/kg wkly in divided dose.</li>\r\n	<li>Alternatively, 100-300 mg daily in divided doses, or</li>\r\n	<li>50-250 mg/m2&nbsp;daily or 80-300 mg/m2&nbsp;daily in divided doses.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Preferably taken on an empty stomach, but may be taken with meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole.</p>', '<p>Increased risk of cardiotoxicity with doxorubicin or other cardiotoxic drugs. May increase incidence of mucositis with protease inhibitors. May increase haematotoxicity and/or immunosuppression with ACE inhibitors, natalizumab, paclitaxel, thiazide diuretics, zidovudine. May increase pulmonary toxicity with amiodarone. May increase nephrotoxicity with amphotericin B. May result to acute water intoxication with indometacin. May increase risk of hepatotoxicity with azathioprine. May increase incidence of hepatic veno-occlusive disease and mucositis with busulfan. May increase risk of haemorrhagic cystitis with previous or concomitant radiotherapy. May result to acute encephalopathy with metronidazole. May increase risk of thromboembolic complications. May alter the effect of warfarin. May increase immunosuppressive effect of ciclosporin. May result to prolonged apnoea with depolarising muscle relaxants (e.g. suxamethonium).</p>', '<p>Patient with bone marrow aplasia, urinary outflow obstruction, UTI, acute infection, drug- or radiation-induced urothelial toxicity. Pregnancy.</p>', '<p>Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis.</p>', '<p>Pregnancy&nbsp;Category D.&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Patient with DM, severe immunosuppression, acute porphyria, pre-existing CV disease or those at risk for cardiotoxicity. Renal and hepatic impairment. Lactation.</p>', '<p>Symptoms: Urotoxicity, myelosuppression, cardiotoxicity (including cardiac failure), stomatitis, veno-occlusive hepatic disease.<br />\r\n<br />\r\nManagement: Supportive treatment. May consider haemodialysis. Cystitis prophylaxis with mesna may be useful for urotoxicity.</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>Store at or below 25&deg;C.</p>', NULL, '2022-02-18 21:22:21', '2022-04-11 05:42:14'),
(384, 384, '<p><strong>Transplantation indications</strong>:&nbsp;Solid organ transplantation, Bone marrow transplantation<br />\r\n<br />\r\n<strong>Non-transplantation indications</strong>: Endogenous uveitis, Nephrotic syndrome, Rheumatoid arthritis, Psoriasis, Atopic dermatitis.</p>', '<p>Cyclosporine binds to cyclophilin. The complex then inhibits calcineurin which is normally responsible for activating transcription of interleukin 2. Cyclosporine also inhibits lymphokine production and interleukin release. In ophthalmic applications, the precise mechanism of action is not known. Cyclosporine emulsion is thought to act as a partial immunomodulator in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca.</p>', '<p><strong>Solid organ transplantation:</strong>&nbsp;Initially 10 to 15 mg/kg given in 2 divided doses starting 12 hours before surgery and to continue for 1 to 2 weeks post-operatively. Maintenance dose should be gradually reached to 2 to 6 mg/kg given in 2 divided doses.</p>\r\n\r\n<p><br />\r\n<strong>Bone marrow transplantation:</strong>&nbsp;Initially 12.5 to 15 mg/kg given in 2 divided doses, starting on the day before transplantation. Maintenance treatment of 12.5 mg/Kg in 2 divided doses should be continued for at least 3 months (and preferably for 6 months) before the dose is gradually decreased to zero by 1 year after transplantation.<br />\r\n<br />\r\n<strong>Endogenous uveitis:</strong>&nbsp;Initially 5 mg/kg per day orally given in 2 divided doses are recommended. For maintenance treatment, the dose should be slowly reduced to the lowest effective level.<br />\r\n<br />\r\n<strong>Nephrotic syndrome:</strong>&nbsp;Initially 5 mg/kg for adults and 6 mg/kg for children given in 2 divided doses. In case of renal impairement, the initial dose should not exceed 2.5 mg/kg per day. For maintenance treatment, the dose should be slowly reduced to the lowest effective level.<br />\r\n<br />\r\n<strong>Rheumatoid arthritis:</strong>&nbsp;For the first 6 weeks, the recommended dose is 3 mg/kg per day in 2 divided doses. To achieve full effectiveness, up to 12 weeks of Cyclosporine therapy may be required. For maintenance treatment, the dose has to be titrated individually according to tolerability.<br />\r\n<br />\r\n<strong>Psoriasis &amp; Atopic dermatitis:</strong>&nbsp;Initially 2.5 mg/kg per day orally given in 2 divided doses and 5 mg/kg per day for patients whose condition requires rapid improvement. For maintenance treatment, doses have to be titrated individually to the lowest effective level.</p>', '<p>Drugs that decrease Cyclosporine levels: Barbiturates, carbamazepine, oxcarbazepine, phenytoin, nafcillin, sulfadimidine i.v., rifampicin, octreotide, probucol, orlistat, hypericum perforatum, ticlopidine, sulfinpyrazone, terbinafine, bosentan.<br />\r\n<br />\r\nDrugs that increase Cyclosporine levels: Macrolide antibiotics (e.g., erythromycin, azithromycin and clarithromycin), ketoconazole, fluconazole, itraconazole, voriconazole, diltiazem, nicardipine, verapamil, lercanidipine, metoclopramide, oral contraceptives, danazol, methylprednisolone (high dose), allopurinol, amiodarone, cholic acid and derivatives, protease inhibitors, imatinib, colchicine.<br />\r\n<br />\r\nOther relevant drug interactions: Cyclosporine may reduce the clearance of digoxin, colchicine, prednisolone and HMG-CoA reductase inhibitors (statins).</p>', '<p>Hypersensitivity to Cyclosporine or to any of the excipients of Cyclosporine.</p>', '<p>Renal dysfunction; Hypertension;&nbsp;Tremor, headache, paraesthesia;&nbsp;Anorexia, nausea, vomiting, abdominal pain, diarrhoea, gingival hyperplasia and hepatic dysfunction; Hyperlipidaemia, hyperuricaemia, hyperkalaemia, hypomagnesaemia;&nbsp;Muscle cramps, myalgia and rarely muscle weakness, myopathy;&nbsp;Usually uncommon but anaemia, thrombocytopenia can occur;&nbsp;Hypertrichosis and allergic rashes.</p>', '<p>Pregnancy: There are no adequate and well-controlled studies in pregnant women and, therefore, Cyclosporine should not be used during pregnancy unless the potential benefit to the mother justifies the potential risk to the foetus.<br />\r\n<br />\r\nLactation: Cyclosporine passes into breast milk. Mothers receiving treatment with Cyclosporine should not breast-feed.</p>', '<p>Cyclosporine increases the risk of developing lymphomas and other malignancies, particularly those of the skin. So patients should be warned to avoid excess ultraviolet light exposure.<br />\r\n<br />\r\nCyclosporine may develop bacterial, fungal, parasitic and viral infections. So therapeutic strategies should be employed for long-term immunosuppressive therapy.<br />\r\n<br />\r\nA reversible increase in serum creatinine and urea may occur during the first few weeks of Cyclosporine therapy and usually responding to dose reduction. In elderly patients, renal function should be monitored with particular care.<br />\r\n<br />\r\nRegular monitoring of blood pressure is required during Cyclosporine therapy; if hypertension develops, appropriate antihypertensive treatment must be instituted.<br />\r\n<br />\r\nCyclosporine enhances the risk of hyperkalaemia, especially in patients with renal dysfunction. Caution is also required when Cyclosporine is co-administered with potassium sparing drugs. Cyclosporine enhances the clearance of magnesium. If considered necessary, magnesium supplementation should be given. Caution should be observed in treating patients with hyperuricaemia. During treatment with Cyclosporine, vaccination may be less effective; the use of live-attenuated vaccines should be avoided.<br />\r\n<br />\r\nNon-transplant patients with impaired renal function, uncontrolled hypertension, uncontrolled infections, or any kind of malignancy should not receive Cyclosporine.</p>', '<p>Renal dysfunction, which resolve following drug withdrawal, may occur. Elimination can be achieved only by nonspecific measures, including gastric lavage, as Cyclosporine is not dialyzable to any great extent, nor is it cleared well by charcoal hemoperfusion.</p>', '<p>Immunosuppressant, Vaccines, Anti-sera &amp; Immunoglobulin</p>', '<p>Sporium oral solution should be used within 2 months of opening the bottle and be stored between 15 to 30&deg; C, preferably not below 20&deg; C for prolonged periods, as it contains oily components which tend to solidify at low temperatures. A jelly-like formation may occur below 20&deg; C, which is reversible at temperatures up to 30&deg; C. Slight sediment may still be observed which does not affect the efficacy and safety of the product.</p>', NULL, '2022-02-18 21:22:34', '2022-04-11 05:44:58'),
(385, 385, '<p>Cyclosporine Ophthalmic Emulsion is indicated to increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with dry eye syndrome (keratoconjunctivitis sicca).<br />\r\n<br />\r\nIn addition to this, several clinical studies have showed that cyclosporine is effective in the management of different eye diseases like vernal keratoconjunctivitis, posterior blepharitis, non-infectious uveitis, superior limbic keratoconjunctivitis, phlyctenular keratoconjunctivitis and meibomian gland diseases.</p>', '<p>Cyclosporine is an immunosuppressive agent when administered systemically. In patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca, topical Cyclosporine is thought to act as a partial immunomodulator.</p>', '<p>One drop of Cyclosporine eye drop should be instilled twice a day in each eye approximately 12 hours apart. Cyclosporine eye drop can be used concomitantly with artificial tears, allowing a 15-minute interval between products.</p>', NULL, '<p>Cyclosporine is contraindicated in patients with active ocular infections and in patients with known or suspected hypersensitivity to any of the ingredients in the formulation.</p>', '<p>The most common adverse event was ocular burning. Other events reported included conjunctival hyperemia, discharge, epiphora, eye pain, foreign body sensation, pruritus, stinging, and visual disturbance (most often blurring).</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies of Cyclosporine Ophthalmic Emulsion in pregnant women. It should be administered to pregnant women if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: Cyclosporine is known to be excreted in human milk following systemic administration but excretion in human milk after topical treatment has not been investigated. Although blood concentrations are undetectable after topical administration of Cyclosporine eye drop, caution should be exercised when Cyclosporine is administered to a nursing woman.</p>', '<p>Cyclosporine eye drop should not be administered while wearing contact lenses. Patients with decreased tear production typically should not wear contact lenses. If contact lenses are worn, they should be removed prior to the administration of this formulation. Lenses may be reinserted 15 minutes following administration of Cyclosporine eye drop.</p>', NULL, '<p>Drugs for Dry eyes</p>', NULL, NULL, '2022-02-18 21:26:25', '2022-04-11 05:46:47'),
(386, 386, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-18 21:26:49', '2022-02-18 21:26:49'),
(387, 387, '<p>For the treatment of women with severe acne, unresponsive to oral antibiotic and other available treatments, with associated symptoms of androgenization, including seborrhea and mild hirsutism.</p>', '<p>Cyproterone is a steroid compound with potent antiandrogenic, progestogenic and antigonadotrophic activity. It exerts its antiandrogenic effect by blocking androgen receptors. It also reduces androgen synthesis by a negative feedback effect on the hypothalamo-pituitary-ovarian systems. The estrogen component (Ethinylestradiol) increases levels of sex hormone binding globulin (SHBG) and thus reduces the free circulating plasma levels of androgens. Cyproterone has no tendency to reduce SHBG levels.<br />\r\n<br />\r\nIf used alone in women,Cyproterone leads to menstrual cycle disturbances which are avoided when combined with Ethinylestradiol. When this tablet is administered in a cyclic manner, it has the added effect of preventing ovulation and possible conception.<br />\r\n<br />\r\nThe components of this tablet are rapidly absorbed after oral administration. Due to the long terminal half-life of Cyproterone, a 4-fold increase in plasma levels occurs after 6 to 12 days of daily dosing. Long-term therapy (36 months) with this product did not have a significant influence on lipid metabolism. A trend to increase plasma cholesterol and triglyceride levels was observed. There was a slight decrease in low density lipoprotein (LDL) with a simultaneous increase in high density lipoprotein (HDL).</p>', '<p>This tablet should not be prescribed solely for its contraceptive properties. If patient compliance is uncertain and contraception is necessary, then a supplementary nonhormonal contraceptive method should be considered.<br />\r\n<br />\r\n<strong>First Treatment Course</strong>: The patient is instructed to take 1 tablet daily for 21 consecutive days beginning on day 1 of her menstrual cycle. (For the first cycle only the first day of menstrual flow is considered Day 1). The tablets are then discontinued for 7 days (1 week). Withdrawal bleeding should usually occur during the period that the patient is off the tablets.The first cycle will be somewhat shorter than usual, whereas all following cycles will last 4 weeks. The patient should be instructed to take the first tablet from the blister pack out of the section marked with the corresponding day (for example &quot;Mon&quot; for Monday) of the week and swallow it with some liquid. The patient should be instructed to take the tablet at the same time each day.<br />\r\n<br />\r\n<strong>Subsequent Courses</strong>: The patient begins her next and all subsequent 21-day course of tablets (following the same 21 days on, 7 days off) on the same day of the week that she began her first course. She begins taking her tablets 7 days after discontinuation,regardless of whether or not withdrawal bleeding is still in progress.<br />\r\n<br />\r\nTreatment should be continued for several months,since improvement may not be observed for at least 3 months. The need to continue treatment with This tablet should be evaluated periodically by the treating physician. This drug should be discontinued 3 to 4 cycles after signs have completely resolved.<br />\r\n<br />\r\nPregnancy should be ruled out before continuing treatment with This tablet in patients who have missed a menstrual period, if pregnancy is suspected, medication should be discontinued.<br />\r\n<br />\r\n<strong>Missed dose</strong>: If the patient forgets to take a tablet at the usual time, the tablet may be taken within the next 12 hours. If more than 12 hours have elapsed from the time of usual administration, the patient must discard the missed tablet and continue to take the remaining tablets in the pack at the usual time in order to avoid premature withdrawal bleeding during this cycle. A supplementary nonhormonal method of contraception must be employed until the pack is empty to prevent pregnancy which would necessitate immediate discontinuation of this treatment.</p>', '<p>Concurrent use of the following drugs may result in reduced efficacy of this tablet and increased incidence of breakthrough bleeding: Ampicillin, Analgesics, Antihistamines, Antimigraine preparations, Chloramphenicol, Griseofulvin, Isoniazid, Neomycin, Nitrofurantain, Penicillin V, Phenylbutazone, Sulfonamides and Tetracycline.<br />\r\n<br />\r\nConcurrent use of anticoagulants with estrogen/progestogen combinations may reduce the anticoagulant effect. Effectiveness of the following drugs may be altered when used concurrently: Antihypertensive, Benzodiazepines (those that undergo oxidative degradation), Beta-adrenergic blockers,Caffeine, Corticosteroids, Hypoglycemic, Phenothiazine, Theophylline, Tricyclic antidepressants and Vitamins.<br />\r\n<br />\r\nConcurrent use of the following drugs may reduce the efficacy of this tablet because of accelerated estrogen metabolism caused by the induction of hepatic enzymes: Carbamazepine, Phenobarbital, Phenytoin, Pyrimidine and Rifampicin.<br />\r\n<br />\r\nDiabetics using estrogen/progestogen combinations may require adjustment of their antidiabetic medication. Concurrent administration of vitamin C (ascorbic acid) with estrogen/ progestogen combinations has been reported to result in a significant rise in plasma Ethinylestradiol levels.<br />\r\n<br />\r\nRule out pregnancy before treatment is begun. Because of the antiandrogenic action of this tablet,feminization of male fetuses has occurred in animal studies and may possibly occur in humans.</p>', '<ul>\r\n	<li>Thrombophlebitis, thromboembolic disorders, or a history of these conditions</li>\r\n	<li>Cerebrovascular disorders</li>\r\n	<li>Myocardial infarction or coronary artery diseases</li>\r\n	<li>Active liver disease or hepatic adenomas or carcinomas</li>\r\n	<li>History of cholestatic jaundice</li>\r\n	<li>Known or suspected carcinoma of the breast</li>\r\n	<li>Known or suspected estrogen-dependent neoplasia</li>\r\n	<li>Undiagnosed abnormal vaginal bleeding</li>\r\n	<li>Any ocular lesion arising from ophthalmic vascular disease, such as partial or complete loss of vision or defect in visual fields</li>\r\n	<li>When pregnancy is suspected or diagnosed</li>\r\n	<li>Previous or existing liver tumors</li>\r\n	<li>Severe diabetes with vascular changes</li>\r\n	<li>A history of otosclerosis with deterioration during pregnancy.</li>\r\n</ul>', '<p>Common side effects are Bleeding, Dizziness, Depression, Weight gain, Headache, Edema, Breast pain, Lactation, Blood clot, Gallstones.<br />\r\n.</p>', '<p>Fetal abnormalities have been reported to occur in the offspring of women who have taken estrogen/progestogen combinations in early pregnancy. Rule out pregnancy as soon as it is suspected. The use of estrogen/progestogen combinations during the period a mother is breast-feeding her infant may not be advisable. The hormonal components are excreted in breast milk and may reduce its quantity and quality. The long-term effects on the developing child are not known. This drug may cause fluid retention, conditions such as epilepsy.</p>', '<p><strong>Predisposing Factors for Coronary Artery Diseases</strong>: In women with predisposing factors for coronary artery disease (such as cigarette smoking, hypertension; hypercholesterolemia, obesity, diabetes and increasing age), the use of estrogen or progestogen combinations have been reported as an additional risk factor. After the age of 35 years, estrogen or progestogen combinations should be considered only in exceptional circumstances and when the risk/benefit ratio has been carefully weighed by both the patient and the physician. Cigarette smoking increases the risk of serious adverse effects on the heart and blood vessels from the use of this class of medication. This risk increases with age and heavy smoking (15 or more cigarettes per day) and is more marked in women over 35 years of age. Women who use such medication should not smoke. Estrogen/progestogen combinations may cause an increase in plasma lipoproteins and should be administered with caution to women known to have pre-existent hyperlipoproteinemia. Lipid profiles should be determined regularly in these patients. The combination of obesity, hypertension and diabetes is particularly hazardous to women who are taking this class of medication. To avoid this triad of conditions develop, the patient should be placed on an alternate form of therapy.<br />\r\n<br />\r\n<strong>Discontinue medication at the earliest manifestation of</strong>: Thromboembolic and cardiovascular disorders such as: thrombophlebitis, pulmonary embolism, cerebrovascular disorders, myocardial ischemia, mesenteric thrombosis and retinal thrombosis. The use of estrogen/progestogen-combination products should be avoided in conditions which predispose to venous stasis and to vascular thrombosis, e.g. immobilization after accidents or confinement to bed during long-term illness. Under such conditions other nonhormonal methods of treatment should be considered. For use when surgery is contemplated, see Precautions.</p>\r\n\r\n<ul>\r\n	<li>Visual defects, partial or complete.</li>\r\n	<li>Papilledema, or ophthalmic vascular lesions.</li>\r\n	<li>Severe headache of unknown etiology, or worsening of pre-existing migraine headache.</li>\r\n	<li>Onset of jaundice or hepatitis.</li>\r\n	<li>Itching of the whole body.</li>\r\n</ul>\r\n\r\n<p><strong>Hypertension</strong>: Patients with essential hypertension whose blood pressure is wellcontrolled may be given the drug but only under close supervision. If a significant elevation of blood pressure in previously normotensive or hypertensive subjects occurs at any time during the administration of the drug, cessation of medication is necessary.<br />\r\n<br />\r\n<strong>Migraine and Headache</strong>: The onset or exacerbation of migraine or the development of headache of a new pattern which is recurrent persistent or severe, requires discontinuation of medication and evaluation of the cause.<br />\r\n<br />\r\n<strong>Diabetes</strong>: Diabetic patients, or those with a family history of diabetes, should be observed closely to detect any alterations in carbohydrate metabolism. Patients predisposed to diabetes who can be kept under close supervision may be given estrogen/progestogen combinations under strict medical supervision. Young diabetic patients whose disease is of recent origin, well-controlled, and not associated with hypertension or other signs of vascular disease such as ocular fundal changes should be closely observed.</p>', '<p>Symptoms and Treatment:There have been no reports of overdose with this tablet. There are no specific antidotes and treatment should be symptomatic, based on the knowledge of the pharmacological action of the constituents.</p>', '<p>Oral Contraceptive preparations, Oral Hormonal preparations for Acne</p>', '<p>Store below 30&deg;C and in dry place. Protect from light. Keep out of the reach of children.</p>', NULL, '2022-02-18 21:27:30', '2022-04-11 05:53:40'),
(388, 388, '<p>Cytarabine is indicated in Leukaemic meningitis,&nbsp;Induction and maintenance of remission in acute leukaemias</p>', '<p>Cytarabine inhibits deoxyribonucleic acid (DNA) synthesis specifically at the S-phase of the cell cycle. It also has an antiviral and immunosuppressant activity.</p>', '<p>Intrathecal (Adult)-</p>\r\n\r\n<ul>\r\n	<li><strong>Leukaemic meningitis</strong>:&nbsp;5-75 mg/m2&nbsp;or 30-100 mg once every 2-7 days to once daily for 4 or 5 days.</li>\r\n	<li>For lymphomatous meningitis: 50 mg every 2 wk for 5 doses, then every 4 wk for 5 doses.</li>\r\n</ul>\r\n\r\n<p>Parenteral (Adult)-<br />\r\nInduction and maintenance of remission in acute leukaemias:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>As monotherapy</strong>: 200 mg/m2&nbsp;daily by continuous IV infusion for 5 days, at intervals of approx 2 wk.</li>\r\n	<li><strong>In combination therapy</strong>: 100 mg/m2&nbsp;bid by rapid IV inj or 100 mg/m2&nbsp;daily by continuous IV infusion both for 7 days. Maintenance: 1-1.5 mg/kg once or twice wkly via IV or SC.</li>\r\n</ul>', '<p>May reduce efficacy of 5-fluorocytosine, digoxin, gentamicin. May increase risk of neurotoxicity with other cytotoxic agents (intrathecal).</p>', '<p>Patient with active meningeal infection.</p>', '<p>Nausea, vomiting, fever, rash, diarrhoea, anorexia, oral and anal inflammation or ulceration, hepatic dysfunction, headache, weakness, confusion, thrombocytopenia, fatigue.</p>', '<p>Pregnancy&nbsp;Category D.&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Patient with previous drug-induced bone marrow suppression. Renal or hepatic impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Irreversible CNS toxicity and death. Severe arachnoiditis including encephalopathy.<br />\r\n<br />\r\n<strong>Management</strong>: Therapy cessation followed by treatment of ensuing bone marrow depression including whole blood or platelet transfusion and antibiotics. Maintain vital functions.</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>IV/SC: Store between 15-25&deg;C.&nbsp;Intrathecal: Store between 2-8&deg;C. Avoid freezing.</p>', NULL, '2022-02-18 21:27:44', '2022-04-11 05:56:29'),
(389, 389, '<p>D-chiro-inositol capsule is indicated for the treatment and prevention of-</p>\r\n\r\n<ul>\r\n	<li>Polycystic ovary syndrome (PCOS)</li>\r\n	<li>Anovulation</li>\r\n	<li>Menstrual disorders such as amenorrhea</li>\r\n	<li>Hyperandrogenism complaints such as hirsutism,</li>\r\n	<li>Alopecia, acanthosis nigricans, acne</li>\r\n	<li>Ovarian hyperthecosis.</li>\r\n</ul>', '<p>D-chiro-inositol is extracted by a patented process from Carob (Ceratonia siliqua) pod that mostly found in Southern Europe. Deficiency of D-chiro-inositol in peripheral tissue causes insulin resistance that leads to hyperandrogenism in ovaries which results polycystic ovary syndrome (PCOS). D-chiro-inositol helps to regulate the balance between androgen and estrogen by decreasing luteinizing hormone and serum testosterone level. It improves glucose tolerance and reduces circulating insulin. It reduces oxidative stress on follicle and decreases total cholesterol and triglyceride levels. D-chiro-inositol has been clinically proven as an effective treatment of ovarian cyst and PCOS associated metabolic disorders. It helps to improve and regulate normal ovulation after two weeks of administration. It also reduces hyperandrogenism related skin disorders like hirsutism, alopecia, acanthosis nigricans and acne. It lowers cardiovascular risk in women who are suffering from PCOS by controlling arterial pressure.</p>', '<p>Orally 1-2 capsules daily or as advised by the physician. Duration of the treatment should be minimum 2 months.</p>', '<p>Concurrent use with digoxin may result in increased digoxin toxicity.</p>', '<p>Contraindicated in patient with known hypersensitivity to D-chiro-inositol.</p>', '<p>Well tolerated in recommended dose.</p>', '<p>Several human studies have been conducted with inositol has no clinically relevant adverse effects.</p>', NULL, NULL, '<p>Trophic Hormones &amp; Related Synthetic Drugs</p>', '<p>Store at temperature of below 30˚C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-02-19 05:30:27', '2022-04-11 05:58:51');
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
(390, 390, '<p><strong>Reduction of Risk of Stroke and Systemic Embolism in Non-valvular Atrial Fibrillation</strong>: Dabigatran Etexilate Mesylate is indicated to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation.<br />\r\n<br />\r\n<strong>Treatment of Deep Venous Thrombosis and Pulmonary Embolism</strong>: Dabigatran Etexilate Mesylate is indicated for the treatment of deep venous thrombosis and pulmonary embolism in patients who have been treated with a parenteral anticoagulant for 5-10 days.<br />\r\n<br />\r\n<strong>Reduction in the Risk of Recurrence of Deep Venous Thrombosis and Pulmonary Embolism</strong>: Dabigatran Etexilate Mesylate is indicated to reduce the risk of recurrence of deep venous thrombosis and pulmonary embolism in patients who have been previously treated.<br />\r\n<br />\r\n<strong>Prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism Following Hip Replacement Surgery</strong>: Dabigatran Etexilate Mesylate is indicated for the prophylaxis of deep vein thrombosis and pulmonary embolism, in patients who have undergone hip replacement surgery.</p>', '<p>Dabigatran and its acyl glucuronides are competitive, direct thrombin inhibitors. Because thrombin (serine protease) enables the conversion of fibrinogen into fibrin during the coagulation cascade, its inhibition prevents the development of a thrombus. Both free and clot-bound thrombin, and thrombin-induced platelet aggregation are inhibited by the active moieties.<br />\r\n<br />\r\nAt recommended therapeutic doses, dabigatran etexilate prolongs the coagulation markers such as aPTT, ECT, and TT. INR is relatively insensitive to the exposure to dabigatran and cannot be interpreted the same way as used for warfarin monitoring. The aPTT test provides an approximation of Dabigatran Etexilate&rsquo;s anticoagulant effect. The average time course for effects on aPTT, following approved dosing regimens in patients with various degrees of renal impairment is shown in Figure 2. The curves represent mean levels without confidence intervals; variations should be expected when measuring aPTT. While advice cannot be provided on the level of recovery of aPTT needed in any particular clinical setting, the curves can be used to estimate the time to get to a particular level of recovery, even when the time since the last dose of Dabigatran Etexilate is not precisely known. In the RE-LY trial, the median (10 th to 90 th percentile) trough aPTT in patients receiving the 150 mg dose was 52 (40 to 76) seconds.</p>', '<p>Reduction in Risk of Stroke and Systemic Embolism in Non-valvular AF-</p>\r\n\r\n<ul>\r\n	<li>CrCl &gt;30 mL/min: 150 mg twice daily</li>\r\n	<li>CrCl 15 to 30 mL/min: 75 mg twice daily</li>\r\n	<li>CrCl &lt;15 mL/min or on dialysis: Dosing recommendations cannot be provided</li>\r\n	<li>CrCl 30 to 50 mL/min with concomitant use of P-gp inhibitors: Reduce dose to 75 mg twice daily if given with P-gp inhibitors dronedarone or systemic ketoconazole.</li>\r\n	<li>CrCl &lt;30 mL/min with concomitant use of P-gp inhibitors: Avoid co-administration</li>\r\n</ul>\r\n\r\n<p>Treatment of DVT and PE, Reduction in the Risk of Recurrence of DVT and PE-</p>\r\n\r\n<ul>\r\n	<li>CrCl &gt;30 mL/min: 150 mg twice daily</li>\r\n	<li>CrCl &le;30 mL/min or on dialysis: Dosing recommendations cannot be provided</li>\r\n	<li>CrCl &lt;50 mL/min with concomitant use of P-gp inhibitors: Avoid co-administration</li>\r\n</ul>\r\n\r\n<p>Prophylaxis of DVT and PE Following Hip Replacement Surgery-</p>\r\n\r\n<ul>\r\n	<li>CrCl &gt;30 mL/min: 110 mg for first day, then 220 mg once daily</li>\r\n	<li>CrCl &le;30 mL/min or on dialysis: Dosing recommendations cannot be provided</li>\r\n	<li>CrCl &lt;50 mL/min with concomitant use of P-gp inhibitors: Avoid co-administration.</li>\r\n</ul>\r\n\r\n<p><br />\r\n<strong>Reduction of Risk of Stroke and Systemic Embolism in Non-valvular Atrial Fibrillation</strong>: For patients with creatinine clearance (CrCl) &gt;30 mL/min, the recommended dose of Dabigatran Etexilate is 150 mg taken orally, twice daily. For patients with severe renal impairment (CrCl 15-30 mL/min), the recommended dose of Dabigatran Etexilate is 75 mg twice daily. Dosing recommendations for patients with a CrCl &lt;15 mL/min or on dialysis cannot be provided.<br />\r\n<br />\r\n<strong>Treatment of Deep Venous Thrombosis and Pulmonary Embolism</strong>: For patients with CrCl &gt;30 mL/min, the recommended dose of Dabigatran Etexilate is 150 mg taken orally, twice daily, after 5-10 days of parenteral anticoagulation. Dosing recommendations for patients with a CrCl &le;30 mL/min or on dialysis cannot be provided.<br />\r\n<br />\r\n<strong>Reduction in the Risk of Recurrence of Deep Venous Thrombosis and Pulmonary Embolism</strong>: For patients with CrCl &gt;30 mL/min, the recommended dose of Dabigatran Etexilate is 150 mg taken orally, twice daily after previous treatment. Dosing recommendations for patients with a CrCl &le;30 mL/min or on dialysis cannot be provided.<br />\r\n<br />\r\n<strong>Prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism Following Hip Replacement Surgery</strong>: For patients with CrCl &gt;30 mL/min, the recommended dose of Dabigatran Etexilate is 110 mg taken orally 1-4 hours after surgery and after hemostasis has been achieved, then 220 mg taken once daily for 28-35 days. If Dabigatran Etexilate is not started on the day of surgery, after hemostasis has been achieved initiate treatment with 220 mg once daily. Dosing recommendations for patients with a CrCl &le;30 mL/min or on dialysis cannot be provided</p>', '<p><strong>Reduction of Risk of Stroke and Systemic Embolism in Non-valvular Atrial Fibrillation</strong>: The concomitant use of Dabigatran Etexilate with P-gp inducers (e.g., rifampin) reduces exposure to dabigatran and should generally be avoided. P-gp inhibition and impaired renal function are the major independent factors that result in increased exposure to dabigatran. Concomitant use of P-gp inhibitors in patients with renal impairment is expected to produce increased exposure of dabigatran compared to that seen with either factor alone. In patients with moderate renal impairment (CrCl 30-50 mL/min), reduce the dose of Dabigatran Etexilate to 75 mg twice daily when administered concomitantly with the P-gp inhibitors dronedarone or systemic ketoconazole. The use of the P-gp inhibitors verapamil, amiodarone, quinidine, clarithromycin, and ticagrelor does not require a dose adjustment of Dabigatran Etexilate. These results should not be extrapolated to other P-gp inhibitors. The concomitant use of Dabigatran Etexilate and P-gp inhibitors in patients with severe renal impairment (CrCl 15-30 mL/min) should be avoided.<br />\r\n<br />\r\n<strong>Treatment and Reduction in the Risk of Recurrence of Deep Venous Thrombosis and Pulmonary Embolism</strong>: Avoid use of Dabigatran Etexilate and P-gp inhibitors in patients with CrCl &lt;50 mL/min.<br />\r\n<br />\r\n<strong>Prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism Following Hip Replacement Surgery</strong>: In patients with CrCl &ge;50 mL/min who have concomitant administration of P-gp inhibitors such as dronedarone or systemic ketoconazole, it may be helpful to separate the timing of administration of dabigatran and the P-gp inhibitor by several hours. The concomitant use of Dabigatran Etexilate and P-gp inhibitors in patients with CrCl &lt;50 mL/min should be avoided.</p>', '<p>Dabigatran Etexilate is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Active pathological bleeding.</li>\r\n	<li>History of a serious hypersensitivity reaction to Dabigatran Etexilate (e.g., anaphylactic reaction or anaphylactic shock).</li>\r\n	<li>Mechanical prosthetic heart valve.</li>\r\n</ul>', '<p>The following clinically significant adverse reactions are described elsewhere in the labeling:</p>\r\n\r\n<ul>\r\n	<li>Increased Risk of Thrombotic Events after Premature Discontinuation</li>\r\n	<li>Risk of Bleeding</li>\r\n	<li>Spinal/Epidural Anesthesia or Puncture</li>\r\n	<li>Thromboembolic and Bleeding Events in Patients with Prosthetic Heart Valves</li>\r\n	<li>Increased Risk of Thrombosis in Patients with Triple-Positive Antiphospholipid Syndrome</li>\r\n</ul>', '<p>Pregnancy: The limited available data on Dabigatran Etexilate use in pregnant women are insufficient to determine drug-associated risks for adverse developmental outcomes. There are risks to the mother associated with untreated venous thromboembolism in pregnancy and a risk of hemorrhage in the mother and fetus associated with the use of anticoagulant<br />\r\n<br />\r\nLactation: There are no data on the presence of dabigatran in human milk, the effects on the breastfed child, or on milk production. Dabigatran and/or its metabolites were present in rat milk. Breastfeeding is not recommended during treatment with Dabigatran Etexilate.</p>', '<p><strong>Bleeding</strong>: Dabigatran Etexilate can cause serious and fatal bleeding<br />\r\n<br />\r\n<strong>Bioprosthetic heart valves</strong>: Dabigatran Etexilate use not recommended<br />\r\n<br />\r\n<strong>Increased Risk of Thrombosis in Patients with Triple-Positive Antiphospholipid Syndrome</strong>: Dabigatran Etexilate use not recommended</p>', '<p>Accidental overdose may lead to hemorrhagic complications. In the event of hemorrhagic complications, initiate appropriate clinical support, discontinue treatment with Dabigatran Etexilate, and investigate the source of bleeding. A specific reversal agent (idarucizumab) is available. Dabigatran is primarily eliminated by the kidneys with a low plasma protein binding of approximately 35%. Hemodialysis can remove dabigatran; however, data supporting this approach are limited. Using a high-flux dialyzer, blood flow rate of 200 mL/min, and dialysate flow rate of 700 mL/min, approximately 49% of total dabigatran can be cleared from plasma over 4 hours. At the same dialysate flow rate, approximately 57% can be cleared using a dialyzer blood flow rate of 300 mL/min, with no appreciable increase in clearance observed at higher blood flow rates. Upon cessation of hemodialysis, a redistribution effect of approximately 7% to 15% is seen. The effect of dialysis on dabigatran&rsquo;s plasma concentration would be expected to vary based on patient specific characteristics. Measurement of aPTT or ECT may help guide therapy</p>', '<p>Anti-coagulants, Anti-platelet drugs, Fibrinolytics (Thrombolytics)</p>', '<p>Store Dabigatran Etexilate at room temperature 20&deg;C to 25&deg;C. After opening the bottle, use Dabigatran Etexilate within 4 months. Safely throw away any unused Dabigatran Etexilate after 4 months. Keep Dabigatran Etexilate in the original bottle or blister package to keep it dry (protect the capsules from moisture). Do not put Dabigatran Etexilate in pill boxes or pill organizers. Tightly close your bottle of Dabigatran Etexilate right away after you take your dose. Keep Dabigatran Etexilate and all medicines out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Dabigatran Etexilate in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total number of patients in the RE-LY study, 82% were 65 and over, while 40% were 75 and over. The risk of stroke and bleeding increases with age, but the risk-benefit profile is favorable in all age groups.</p>', '2022-02-19 05:30:57', '2022-04-11 06:01:29'),
(391, 391, '<p>Dacarbazine is indicated in the treatment of metastatic malignant melanoma. In addition, Dacarbazine is also indicated for Hodgkin&rsquo;s disease as a second-line therapy when used in combination with other effective agents</p>', '<p>Dacarbazine is a non-cell cycle specific antineoplastic agent. The exact mechanism of action by which it exerts cytotoxic effects is still unclear. However, three possible mechanisms have been postulated, including inhibition of DNA synthesis by acting as a purine analog, action as an alkylating agent, and interaction with sulfydryl group in the inhibition of bacterial cell growth.</p>', '<p><strong>Malignant Melanoma</strong>: The recommended dosage is 2 to 4.5 mg/kg/day for 10 days. Treatment may be repeated at 4 week intervals. An alternate recommended dosage is 250 mg/m2/day IV for 5 days. Treatment may be repeated every 3 weeks.<br />\r\n<br />\r\n<strong>Hodgkin&rsquo;s Disease</strong>: The recommended dosage of Dacarbazine in the treatment of Hodgkin&rsquo;s disease is 150 mg/m2/day for 5 days, in combination with other effective drugs. Treatment may be repeated every 4 weeks. An alternative recommended dosage is 375 mg/m2&nbsp;on day 1, in combination with other effective drugs, to be repeated every 15 days.</p>', '<p>Increased metabolism when used with enzyme inducers (e.g. barbiturates, rifampicin, phenytoin). May potentiate the effect of mercaptopurine, azathioprine, allopurinol. May impair immune response to vaccines. May enhance the effects of methoxsalen due to photosensitisation.</p>', '<p>Dacarbazine is contraindicated in patients who&nbsp; have demonstrated a hypersensitivity to it in the past.</p>', '<p>Symptoms of anorexia, nausea and vomiting are the most frequently noted of all toxic reactions. Over 90% of patients are affected with the initial few doses. The vomiting lasts 1 to 12 hours and is incompletely and unpredictably palliated with phenobarbital and/or prochlorperazine. Rarely, intractable nausea and vomiting have necessitated discontinuance of therapy with Dacarbazine for Injection. Rarely, Dacarbazine for Injection has caused diarrhea. Some helpful suggestions include restricting the patient&rsquo;s oral intake of food for 4 to 6 hours prior to treatment. The rapid toleration of these symptoms suggests that a central nervous system mechanism may be involved, and usually these symptoms subside after the first 1 or 2 days.</p>', '<p>Pregnancy Category C. Dacarbazine for Injection has been shown to be teratogenic in rats when given in doses 20 times the human daily dose on day 12 of gestation. Dacarbazine when administered in 10 times the human daily dose to male rats (twice weekly for 9 weeks) did not affect the male libido, although female rats mated to male rats had higher incidence of resorptions than controls. In rabbits, dacarbazine daily dose 7 times the human daily dose given on Days 6 to 15 of gestation resulted in fetal&nbsp;skeletal anomalies. There are no adequate and well controlled studies in pregnant women. Dacarbazine for Injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. 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 tumorigenicity shown for Dacarbazine for Injection in animal studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Hospitalization is not always necessary but adequate laboratory study capability must be available. Extravasation of the drug subcutaneously during intravenous administration may result in tissue damage and severe pain. Local pain, burning sensation and irritation at the site of injection may be relieved by locally applied hot packs. Carcinogenicity of dacarbazine was studied in rats and mice. Proliferative endocardial lesions, including fibrosarcomas and sarcomas were induced by dacarbazine in rats. In mice, administration of dacarbazine resulted in the induction of angiosarcomas of the spleen.</p>', '<p>Give supportive treatment and monitor blood cell counts.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Cytotoxic Chemotherapy</p>', '<p>Store in a refrigerator 2&deg;C to 8&deg;C</p>', NULL, '2022-02-19 05:31:20', '2022-04-11 06:03:55'),
(392, 392, '<p>Sofosbuvir directly targets the Hepatitis C virus to stop it from making copies of itself in the liver. Sofosbuvir attaches itself to the genetic information, called RNA, to block the virus from multiplying. And Daclatasvir is a direct-acting&nbsp;&nbsp; antiviral agent (DAA) against the hepatitis C virus.</p>', '<p><strong>Sofosbuvir</strong>&nbsp;is an inhibitor of the hepatitis C virus (HCV) NS5B ribonucleic acid (RNA)-dependent RNA polymerase, which is essential for viral replication. Sofosbuvir is a nucleotide prodrug that undergoes intracellular metabolism to form the pharmacologically active uridine analog triphosphate (GS-461203), which can be incorporated into HCV RNA by the NS5B polymerase and acts as a chain terminator. In a biochemical assay, GS-461203 inhibited the polymerase activity of the recombinant NS5B from HCV genotype 1b, 2a, 3a and 4a with a 50% inhibitory concentration (IC50) value ranging from 0.7-2.6 micrometer. GS-461203 (the active metabolite of sofosbuvir) is not an inhibitor of human deoxyribonucleic acid (DNA) and RNA polymerases, nor an inhibitor of mitochondrial RNA polymerase.<br />\r\n<br />\r\n<strong>Daclatasvir</strong>&nbsp;stops HCV viral RNA replication and protein translation by directly inhibiting HCV protein NS5A. NS5A is critical for HCV viral transcription and translation.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, '<p>Hepatic viral infections (Hepatitis C)</p>', NULL, NULL, '2022-02-19 05:31:49', '2022-04-11 06:06:26'),
(393, 393, '<p>Danazol is indicated for the following treatment-</p>\r\n\r\n<ul>\r\n	<li>Endometriosis</li>\r\n	<li>Benign breast disease</li>\r\n	<li>Menorrhagia</li>\r\n	<li>Gynecomastia</li>\r\n	<li>Preoperative thinning of the endometrium before hysteroscopic endometrial ablation.</li>\r\n</ul>', '<p>As a gonadotropin inhibitor, danazol suppresses the pituitary-ovarian axis possibly by inhibiting the output of pituitary gonadotropins. Danazol also depresses the preovulatory surge in output of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), thereby reducing ovarian estrogen production. Danazol may also directly inhibits ovarian steroidogenesis; bind to androgen, progesterone, and glucocorticoid receptors; bind to sex-hormone-binding globulin and corticosteroid-binding globulin; and increases the metabolic clearance rate of progesterone. Another mechanism of action by which danazol may use to facilitate regression of endometriosis is by decreasing IgG, IgM, and IgA concentrations, as well as phospholipid and IgG isotope autoantibodies. In the treatment of endometriosis, as a consequence of suppression of ovarian function, danazol causes both normal and ectopic endometrial tissues to become inactive and atrophic. This leads to anovulation and associated amenorrhea. In fibrocystic breast disease, the exact mechanism of action of danazol is unknown, but may be related to suppressed estrogenic stimulation as a result of decreased ovarian production of estrogen. A direct effect on steroid receptor sites in breast tissue is also possible. This leads to a disappearance of nodularity, relief of pain and tenderness, and possibly changes in the menstrual pattern. In terms of hereditary angioedema, danazol corrects the underlying biochemical deficiency by increasing serum concentrations of the deficient C1 esterase inhibitor, resulting in increased serum concentrations of the C4 component of the complement system.</p>', '<p>Preoperative thinning of the endometrium:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;400-800 mg daily, in up to 4 divided doses for 3-6 week.</li>\r\n</ul>\r\n\r\n<p>Benign breast disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 100-400 mg daily in 2 divided doses adjusted according to response and continued for 3-6 month.</li>\r\n</ul>\r\n\r\n<p>Hereditary angioedema:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 200 mg bid-tid reduced thereafter according to patient&#39;s response.</li>\r\n</ul>\r\n\r\n<p>Endometriosis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;200-800 mg daily in 2 divided doses adjusted according to response, for 3-6 month or if necessary, up to 9 month.</li>\r\n</ul>\r\n\r\n<p>Menorrhagia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;200 mg once daily. Review treatment 3 month later.</li>\r\n</ul>\r\n\r\n<p>Gynaecomastia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Male adolescents: Initially, 200 mg daily, may increase to 400 mg daily after 2 month if no response occurs; adult men: Initial: 400 mg daily in up to 4 divided doses. Usual treatment duration: 6 month.</li>\r\n	<li><strong>Child:</strong>&nbsp;Male adolescents: Initially, 200 mg daily increased to 400 mg after 2 month if no response occurs. Treatment usually up to 6 months.</li>\r\n</ul>', '<p><strong>Insulin</strong>: Patients taking danazol may show increased insulin resistance. The significance of this is not known but such patients should be carefully monitored.<br />\r\n<br />\r\n<strong>Estrogens and progestogens</strong>: Theoretically danazol may interact with exogenous estrogens and/or progestogens. It has been suggested that danazol acts by binding to estrogen, progesterone or androgen receptors at various levels in the hypothalamic pituitary-ovarian axis. Therefore, women of child bearing age should use effective, non hormonal methods of contraception.<br />\r\n<br />\r\n<strong>Anticonvulsant therapy</strong>: Danazol may affect the plasma concentration of carbamazepin and possibly the patient&#39;s response to this agent and to phenytoin. A similar interaction is possible for phenobarbital.<br />\r\n<br />\r\n<strong>Antihypertensive therapy</strong>: Danazol can oppose the action of antihypertensive agents, possibly through effects on fluid retention.<br />\r\n<br />\r\n<strong>Cyclosporine</strong>: Danazol can increase the plasma concentration of cyclosporine.<br />\r\n<br />\r\n<strong>Migraine therapy</strong>: Danazol itself may provoke migraine and it may possibly reduce the effectiveness of medication to prevent the condition.</p>', '<ul>\r\n	<li>Pregnancy and breast-feeding</li>\r\n	<li>Impaired hepatic, renal, or cardiac function</li>\r\n	<li>Porphyria</li>\r\n	<li>Thromboembolic disease</li>\r\n	<li>Androgen-dependent tumor</li>\r\n	<li>Abnormal vaginal bleeding that has not been fully investigated.</li>\r\n	<li>Hypersensitivity to danazol.</li>\r\n</ul>', '<p>Oedema, weight gain, sweating, acne, hirsutism, flushing, oily skin or hair, deepening of the voice, clitoral hypertrophy, amenorrhoea, hepatic dysfunction, CNS or GI disturbances, benign intracranial hypertension, reduction in breast size, visual disturbances, elevated LFT values.</p>', '<p><strong>Category X:</strong>&nbsp;Studies in animals or human beings have demonstrated fetal abnormalities or there is evidence of fetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.</p>', '<p>Epilepsy, migraine; cardiac, hepatic, renal disorders. Severe hypertension, diabetes, polycythaemia, history of thrombosis; children.</p>', '<p>There have been no incidents of acute overdosage with Danazol and it is unlikely that any immediate serious reaction will be seen from a single excessive dose. In case of the acute overdosage, the drug should be removed by gastric lavage and the patient should be kept under observation.</p>', '<p>Drugs affecting (inhibiting) gonadotrophin</p>', '<p>Store at 15-30&deg;C.</p>', NULL, '2022-02-19 05:32:01', '2022-04-11 06:09:01'),
(394, 394, '<p><strong>In Chronic Spasticity</strong>: Dantrolene is indicated in controlling the manifestations of clinical spasticity resulting from upper motor neuronal disorders (e.g., spinal cord injury, stroke, cerebral palsy, or multiple sclerosis). It is of particular benefit to the patients whose functional rehabilitation has been retarded by the sequelae of spasticity. Such patients must have presumably reversible spasticity where relief of spasticity will aid in restoring residual function. Dantrolene is not indicated in the treatment of skeletal muscle spasm resulting from rheumatic disorders. Occasionally, subtle but meaningful improvement in spasticity may occur with Dantrolene therapy. In such instances, information regarding improvement should be solicited from the patient. Brief withdrawal of Dantrolene for a period of 2 to 4 days will frequently demonstrate exacerbation of the manifestations of spasticity and may serve to confirm a clinical impression.<br />\r\n<br />\r\nA decision to continue the administration of Dantrolene on a long-term basis is justified if introduction of the drug into the patient&#39;s regimen:</p>\r\n\r\n<ul>\r\n	<li>produces a significant reduction in painful and/or disabling spasticity such as clonus, or</li>\r\n	<li>permits a significant reduction in the intensity and/or degree of nursing care required, or</li>\r\n	<li>rids the patient of any annoying manifestation of spasticity considered important by the patient himself.</li>\r\n</ul>\r\n\r\n<p><strong>In Malignant Hyperthermia</strong>: Oral Dantrolene is also indicated preoperatively to prevent or attenuate the development of signs of malignant hyperthermia in known, or strongly suspect, malignant hyperthermia susceptible patients who require anesthesia and/or surgery. Oral Dantrolene should be administered following a malignant hyperthermic crisis to prevent recurrence of the signs of malignant hyperthermia.</p>', '<p>Dantrolene produces relaxation by affecting the contractile response of the skeletal muscle at a site beyond the myoneural junction, directly on the muscle itself. In skeletal muscle, Dantrolene dissociates the excitation-contraction coupling, probably by interfering with the release of Ca++&nbsp;from the sarcoplasmic reticulum.</p>', '<p>For Use in Chronic Spasticity:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: The following gradual titration schedule is suggested. Some patients will not respond until higher daily dosage is achieved. Each dosage level should be maintained for seven days to determine the patient&#39;s response. If no further benefit is observed at the next higher dose, dosage should be decreased to the previous lower dose.</li>\r\n	<li>Starting dose is 25 mg twice per day and it can be increased to 25-50 mg per day per week. Maximum accepted dosage is 400 mg per day.</li>\r\n	<li><strong>Paediatric Patients</strong>: The following gradual titration schedule is suggested. Some patients will not respond until higher daily dosage is achieved. Each dosage level should be maintained for seven days to determine the patient&#39;s response. If no further benefit is observed at the next higher dose, dosage should be decreased to the previous lower dose.</li>\r\n	<li>0.5 mg/kg once daily for seven days, then 0.5 mg/kg 3 times for 7 days, 1 mg/kg 3 times for 7 days, 2 mg/kg 3 times a day, Therapy with a dose 4 times daily may be necessary for some individuals.</li>\r\n</ul>\r\n\r\n<p>For Malignant Hyperthermia</p>\r\n\r\n<ul>\r\n	<li><strong>Preoperatively</strong>: Administer 4 to 8 mg/kg/day of oral Dantrolene in 3 or 4 divided doses for one or two days prior to surgery, with the last dose being given approximately 3 to 4 hours before scheduled surgery with a minimum of water.</li>\r\n	<li><strong>Post Crisis Follow-up</strong>: Oral Dantrolene should also be administered following a malignant hyperthermia crisis, in doses of 4 to 8 mg/kg per day in four divided doses, for a one to three day period to prevent recurrence of the manifestations of malignant hyperthermia.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>', '<p>Drowsiness may occur with Dantrolene&nbsp;therapy, and the concomitant administration of CNS depressants such as sedatives and tranquilizing agents may result in further drowsiness. Hepatotoxicity has occurred more often in women over 35 years of age receiving concomitant estrogen therapy.</p>', '<p>Active hepatic disease, such as hepatitis and cirrhosis.</p>', '<p>The most frequently occurring side effects of Dantrolene have been drowsiness, dizziness, weakness, general malaise, fatigue, and diarrhea. These are generally transient, occurring early in treatment, and can often be obviated by beginning with a low dose and increasing dosage gradually until an optimal regimen is established. Diarrhea may be severe and may necessitate temporary withdrawal of Dantrolene therapy. If diarrhea recurs upon readministration of Dantrolene, therapy should probably be withdrawn permanently</p>', '<p>Pregnancy Category C. Dantrolene capsules should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Dantrolene should not be used in nursing mothers.</p>', '<p>In view of the potential for liver damage in long-term Dantrolene use, therapy should be stopped if benefits are not evident within 45 days. Patients should be cautioned against driving a motor vehicle or participating in hazardous occupations while taking Dantrolene. Caution should be exercised in the concomitant administration of tranquilizing agents. Dantrolene might possibly evoke a photosensitivity reaction; patients should be cautioned about exposure to sunlight while taking it. It is important to recognize that fatal and non-fatal liver disorders of an idiosyncratic or hypersensitivity type may occur with Dantrolene therapy. At the start of Dantrolene therapy, it is desirable to do liver function studies (SGOT, SGPT, alkaline phosphatase, total bilirubin) for a baseline or to establish whether there is preexisting liver disease. Liver function studies (e.g., SGOT or SGPT) should be performed at appropriate intervals during Dantrolene therapy. Some patients have revealed a return to normal laboratory values in the face of continued therapy while others have not. If symptoms compatible with hepatitis, accompanied by abnormalities in liver function tests or jaundice appear, Dantrolene should be discontinued. If caused by Dantrolene and detected early, the abnormalities in liver function characteristically have reverted to normal when the drug was discontinued. Dantrolene therapy has been reinstituted in a few patients who have developed clinical and/ or laboratory evidence of hepatocellular injury. If such reinstitution of therapy is done, it should be attempted only in patients who clearly need Dantrolene and only after previous symptoms and laboratory abnormalities have cleared. The patient should be hospitalized and the drug should be restarted in very small and gradually increasing doses. Laboratory monitoring should be frequent and the drug should be withdrawn immediately if there is any indication of recurrent liver involvement. Dantrolene should be used with particular caution in females and in patients over 35 years of age in view of apparent greater likelihood of drug-induced, potentially fatal, hepatocellular disease in these groups.<br />\r\n<br />\r\nDantrolene should be used with caution in patients with impaired pulmonary function, and in patients with severely impaired cardiac function due to myocardial disease. It should be used with caution in patients with a history of previous liver disease or dysfunction.</p>', NULL, '<p>Centrally acting Skeletal Muscle Relaxants</p>', '<p>Store in a cool &amp; dry place, protected from light.</p>', '<p>Usage in Paediatric Patients: The long-term safety of Dantrolene in paediatric patients under the age of 5 years has not been established. Because of the possibility that adverse effects of the drug could become apparent only after many years, a benefit-risk consideration of the long-term use of Dantrolene&nbsp;is particularly important in pediatric patients.</p>', '2022-02-19 05:32:22', '2022-04-11 06:11:36'),
(395, 395, '<p>Dapagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with&nbsp;type 2 diabetes&nbsp;mellitus</p>', '<p>Dapagliflozin is a highly potent, selective, and reversible inhibitor of sodium-glucose cotransporter 2 (SGLT2) that improves glycemic control in patients with type 2 diabetes mellitus by reducing renal glucose reabsorption leading to urinary excretion of excess glucose (glucuresis).</p>', '<p>5 mg orally once a day.&nbsp;May increase to 10 mg orally once a day in patients tolerating therapy with 5 mg and requiring additional glycemic control</p>', '<p>Hypoglycemia may occur with concomitant use with insulin &amp; insulin secretagogues eg sulfonylureas. Decrease in Cmax &amp; AUC with rifampin. Increase in Cmax &amp; AUC with mefenamic acid. Increased thiazide &amp; loop diuretic effects; may increase risk of dehydration &amp; hypotension. Pioglitazone.</p>', '<p>Hypersensitivity to dapagliflozin propanediol or to any of the excipients. Moderate to severe renal impairment; end-stage renal disease; active bladder cancer. Pregnancy (2nd &amp; 3rd trimester) &amp; lactation.</p>', '<p>Renal impairment, Female genital mycotic infections, Urinary tract infection, Increased urination, Male genital mycotic infections, Dyslipidemia, Constipation, Discomfort with urination, Extremity pain, Volume depletion, Hypersensitivity</p>', '<p>Pregnancy Category-C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks</p>', '<p>CV disease, history of hypotension, UTI, Children, Elderly. Unknown whether distributed in human breast milk; breastfeeding women should discontinue dapagliflozin or nursing taking into account the importance of the drug to the mother</p>', NULL, '<p>Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors</p>', NULL, '<p>Renal Impairment: No dosage adjustment is indicated based on renal function. The efficacy is dependent on renal function. lt is not recommended for use in patients with moderate to severe renal impairment (patients with CrCI &lt;60 mL/min or eGFR &lt;60 mL/min/1.73 m2).</p>', '2022-02-19 05:32:49', '2022-04-11 06:14:40'),
(396, 396, '<p>Indicated for the treatment of premature ejaculation (PE) in men 18 to 64 years of age, who have all of the following:</p>\r\n\r\n<ul>\r\n	<li>Persistent or recurrent ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the patient wishes.</li>\r\n	<li>Marked personal distress or interpersonal difficulty as a consequence of PE and poor control over ejaculation.</li>\r\n</ul>', '<p>The mechanism of action is thought to be related to inhibition of neuronal reuptake of serotonin and subsequent potentiation of serotonin activity. The central ejaculatory neural circuit comprises spinal and cerebral areas that form a highly interconnected network. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation. To date, three 5-HT receptor subtypes 5-HT(1A), 5-HT(1B), and 5-HT(2C) have been postulated to mediate 5-HT&#39;s modulating activity on ejaculation.</p>', '<p><strong>Adult (18 to 64 years of age)</strong>: The recommended starting dose for all patients is 30 mg, taken as needed approximately 1 to 3 hours prior to sexual activity. If the effect of 30 mg is insufficient and the side effects are acceptable, the dose may be increased to the maximum recommended dose of 60 mg. The maximum recommended dosing frequency is one dose every 24 hours.</p>', '<p><strong>CNS active medicinal products</strong>: The use of Dapoxetine in combination with CNS active medicinal products has not been systematically evaluated in patients with premature ejaculation. Consequently, caution is advised if the concomitant administration of Dapoxetine and such medicinal products is required.<br />\r\n<br />\r\n<strong>PDE5 inhibitors</strong>: Tadalafil did not affect the pharmacokinetics of Dapoxetine. Sildenafil caused slight changes in Dapoxetine pharmacokinetics, which are not expected to be clinically significant. However, Dapoxetine should be prescribed with caution in patients who use PDE5 inhibitors due to possible reduced orthostatic tolerance.<br />\r\n<br />\r\n<strong>Tamsulosin</strong>: Concomitant administration of single or multiple doses of 30 mg or 60 mg Dapoxetine to patients receiving daily doses of Tamsulosin did not result in changes in the pharmacokinetics of Tamsulosin. However, Dapoxetine should be prescribed with caution in patients who use alpha adrenergic receptor antagonists due to possible reduced orthostatic tolerance.<br />\r\n<br />\r\n<strong>Warfarin</strong>: There are no data evaluating the effect of chronic use of Warfarin with Dapoxetine; therefore, caution is advised when Dapoxetine is used in patients taking Warfarin chronically.<br />\r\n<br />\r\n<strong>Ethanol</strong>: Concomitant use of alcohol and Dapoxetine could increase the chance or severity of adverse reactions such as dizziness, drowsiness, slow reflexes, or altered judgment. Combining alcohol with Dapoxetine may increase these alcohol-related effects and may also enhance neurocardiogenic adverse events such as syncope, thereby increasing the risk of accidental injury; therefore, patients should be advised to avoid alcohol while taking Dapoxetine.</p>', '<ul>\r\n	<li>Patients with known hypersensitivity to Dapoxetine Hydrochloride.</li>\r\n	<li>Patients with significant pathological cardiac conditions such as heart failure (NYHA class II-IV), conduction abnormalities (second or third degree AV block or sick sinus syndrome) not treated with a permanent pacemaker, significant ischemic heart disease of significant valvular disease.</li>\r\n	<li>Concomitant treatment with monoamine oxidase inhibitors (MAOIs), thioridazine. Similarly, MAOIs or thioridazine should not be administered within 7 days after Dapoxetine has been discontinued.</li>\r\n	<li>Concomitant treatment with serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs) or other medicinal/herbal products with serotonergic effects or within 14 days of discontinuing treatment with these medicinal/herbal products.</li>\r\n</ul>', '<p>Dizziness, Headache, Somnolence, Tremor, Blurred vision, Tinnitus, Sinus congestion, Nausea, Diarrhea, Abdominal pain, Dry mouth, Fatigue, Insomnia, Hypertension.</p>', '<p>Dapoxetine is not indicated for use by women. It is not known either dapoxetine or its metabolites are excreted through human breast milk.</p>', '<p>Patient with bleeding disorders, epilepsy, susceptibility to angle-closure glaucoma or raised intraocular pressure. Not intended for use in women. Known CYP2D6 poor metabolisers.</p>', '<p>There were no unexpected adverse events in a clinical pharmacology study of Dapoxetine with daily doses up to 240 mg. In general, symptoms of overdose with SSRIs include serotonin-mediated adverse reactions such as somnolence, gastrointestinal disturbances such as nausea and vomiting, tachycardia, tremor, agitation and dizziness. In cases of overdose, standard supportive measures should be adopted as required.</p>', '<p>Drugs for Erectile Dysfunction</p>', '<p>Store below 30&deg;C. Protect from light and moisture. Keep out of reach of children</p>', NULL, '2022-02-19 05:39:50', '2022-04-11 06:17:17'),
(397, 397, '<p>Dapsone is indicated in Primary and secondary prophylaxis of Pneumocystis (carinii) jirovecii pneumonia,&nbsp;Multibacillary leprosy,&nbsp;Paucibacillary leprosy,&nbsp;Dermatitis herpetiformis,&nbsp;Acne</p>', '<p>Dapsone inhibits folic acid synthesis by preventing normal bacterial utilization of PABA (Para-aminobenzoic acid).</p>', '<p>Primary and secondary prophylaxis of Pneumocystis (carinii) jirovecii pneumonia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 50 mg daily, with pyrimethamine 50 mg once wkly. Alternatively, 100 mg with pyrimethamine 50 mg twice wkly.</li>\r\n	<li><strong>Child</strong>: 1 mth-18 yr: 2 mg/kg daily (max: 100 mg daily) or 4 mg/kg wkly (max: 200 mg wkly).</li>\r\n</ul>\r\n\r\n<p>Multibacillary leprosy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 100 mg daily with clofazimine 50 mg daily, together with rifampicin 600 mg and clofazimine 300 mg once a mth for 12 mth.</li>\r\n	<li><strong>Child</strong>: and child 10-14 yr old: daily doses of dapsone 50 mg, or 1 to 2 mg/kg if their body-weight is low</li>\r\n</ul>\r\n\r\n<p>Paucibacillary leprosy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 100 mg daily with 600 mg rifampicin once a mth, both given for 6 mth.</li>\r\n	<li><strong>Child</strong>: Reduce dose as for multibacillary leprosy.</li>\r\n</ul>\r\n\r\n<p>Dermatitis herpetiformis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Initially, 50 mg daily increased gradually to 300 mg daily if required.</li>\r\n</ul>', '<p>Decreased serum conc of dapsone when used with rifampicin. Increased plasma conc with probenecid, trimethoprim. Antagonize clofazimine.</p>', '<p>Hypersensitivity. Severe anaemia, porphyria.</p>', '<p>Anaemia, peripheral neuropathy, haemolysis and methaemoglobinaemia (dose-related), nephrotic syndrome, psychological changes, hepatitis. Others: Nausea, vomiting, anorexia, headache, maculopapular rash, toxic epidermal necrolysis, Stevens-Johnson syndrome. Topical: Dryness, redness, oiliness and peeling at application site.</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>G6PD deficiency, methaemoglobin or Hb M. Perform regular blood counts and monitor liver function regularly. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: nausea, vomiting, hyperexcitability (within a few min to up to 24 hr later), methemoglobin-induced depression, haemolysis (7-14 days after ingestion), seizures and severe cyanosis.<br />\r\n<br />\r\n<strong>Treatment</strong>: activated charcoal (20g four times daily) and haemolysis may enhance elimination of dapsone and its monoacetyl derivative. For patients without G6PD deficiency, methemoglobinemia may be treated with methylene blue 1-2 mg/kg given by slow IV injection (repeated if methemoglobin reaccumulates) or in less severe cases, 3-5 mg/kg every 4-6 hr orally.</p>', '<p>Anti-Leprotic drugs</p>', '<p>Tablet: Store between 15-30&deg;C. Protect from light. Topical Gel: Store between 20-25&deg;C. Do not freeze.</p>', NULL, '2022-02-19 05:40:30', '2022-04-11 06:20:05'),
(398, 398, '<p>Dapsone is indicated for the topical treatment of acne vulgaris in patients 12 years of age and older.</p>', '<p>Dapsone has both anti-infammatory and antimicrobial properties. A combination of these activities may account for its efcacy in acne. Anti-infammatory efects include inhibition of neutrophil myeloperoxidase and eosinophil peroxidase activity, suppression of hypochlorous acid production, scavenging of reactive oxygen species, suppression of neutrophil activity, and inhibition of chemoattractant-induced signal transduction. Antimicrobial activity, similar to that of sulfones and sulfonamides, is by inhibition of bacterial dihydropteroate synthase in the folic acid metabolic pathway. This mechanism is efective against microorganisms synthesizing their own folic acid. In vitro susceptibility testing has demonstrated some activity for Dapsone against Propionibacterium species, including Propionibacterium acnes (P. acnes).</p>', '<p>After the skin is gently washed and patted dry, apply approximately a pea-sized amount of Dapsone in a thin layer to the entire face once daily. In addition, a thin layer may be applied to other afected areas once daily. Rub in Dapsone, gently and completely. If there is no improvement after 12 weeks, treatment with Dapsone should be reassessed. Not for oral, ophthalmic or intravaginal use.</p>', '<p>Trimethoprim/ sulfamethoxazole (TMP/ SMX) increases the systemic level of Dapsone and its metabolites.<br />\r\n<br />\r\nTopical benzoyl peroxide used at the same time as Dapsone may result in temporary local yellow or orange skin discoloration.</p>', '<p>Those who are hypersensitive to Dapsone.</p>', '<p>Most common (incidence &ge; 0.9%) effects are application site dryness and pruritus.</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Dapsone should be used during pregnancy only if the potential beneft justifes the potential risk to the fetus.<br />\r\n<br />\r\nAlthough systemic absorption of Dapsone following topical application of Dapsone is minimal relative to oral Dapsone administration, it is known that Dapsone is excreted in human milk. Because of the potential for oral Dapsone to cause adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue Dapsone, taking into account the importance of the drug to the mother.</p>', '<p><strong>Methemoglobinemia</strong>: Cases of methemoglobinemia have been reported. Discontinue Dapsone if signs of methemoglobinemia occur.<br />\r\n<br />\r\n<strong>Hemolysis</strong>: Some patients with Glucose-6-Phosphate Dehydrogenase (G6PD) defciency using topical Dapsone developed laboratory changes suggestive of hemolysis.</p>', NULL, '<p>Acne treatment preparations</p>', '<p>Store in a cool &amp; dry place. Keep out of reach of children. Do not freeze.</p>', '<p><strong>Pediatric Use</strong>: Safety and efectiveness of Dapsone have not been established in pediatric patients below the age of 12 years.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Dapsone did not include sufcient numbers of subjects aged 65 years and over to determine whether they respond diferently from younger subjects.</p>', '2022-02-19 05:41:02', '2022-04-11 06:22:46');
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
(399, 399, '<p><strong>Anemia Due To Chronic Kidney Disease</strong>: Darbepoetin Alfa is indicated for the treatment of&nbsp;anemia&nbsp;due to chronic kidney disease (CKD), including patients on&nbsp;dialysis&nbsp;and patients not on dialysis.<br />\r\n<br />\r\n<strong>Anemia Due To Chemotherapy In Patients With Cancer</strong>: Darbepoetin Alfa is indicated for the treatment of anemia in patients with non-myeloid&nbsp;malignancies where anemia is due to the effect of concomitant myelosuppressive&nbsp;chemotherapy, and upon initiation, there is a minimum of two additional months of planned chemotherapy.</p>', '<p>Darbepoetin alfa stimulates erythropoiesis by the same mechanism as endogenous erythropoietin. Erythropoietin interacts with progenitor stem cells to increase red cell production. Binding of erythropoietin to the erythropoietin receptor leads to receptor dimerization, which facilitates activation of JAK-STAT signaling pathways within the cytosol. Activated STAT (signal transducers and activators of transcription) proteins are then translocated to the nucleus where they serve as transcription factors which regulate the activation of specific genes involved in cell division or differentiation.</p>', '<p><strong>Usual Adult Dose for Anemia Associated with Chronic Renal Failure:</strong></p>\r\n\r\n<p>Chronic Kidney Disease (CKD) Patients Not on Dialysis:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 0.45 mcg/kg IV or subcutaneously once every 4 weeks as appropriate</li>\r\n	<li><strong>Comments</strong>: Initiate treatment only when hemoglobin is less than 10 g/dL, rate of hemoglobin decline indicates likelihood of requiring RBC transfusion, and reducing risk of alloimmunization and/or other RBC transfusion-related risks is a goal.</li>\r\n</ul>\r\n\r\n<p>CKD Patients on Dialysis:</p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 0.45 mcg/kg IV or subcutaneously once a week or 0.75 mcg/kg once every 2 weeks as appropriate</li>\r\n	<li><strong>Comments</strong>: Initiate treatment when hemoglobin is less than 10 g/dL. IV route is recommended for patients on hemodialysis.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Usual Adult Dose for Anemia Associated with Chemotherapy:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Initial dose</strong>: 2.25 mcg/kg subcutaneously once a week or 500 mcg subcutaneously once every 3 weeks</li>\r\n	<li><strong>Duration of therapy</strong>: Until completion of chemotherapy course</li>\r\n	<li><strong>Comments</strong>: Initiate treatment if hemoglobin is less than 10 g/dL and a minimum of 2 additional months of chemotherapy is planned. Use the lowest dose necessary to avoid RBC transfusions.</li>\r\n	<li><strong>Use</strong>: Treatment of anemia in patients with non-myeloid malignancies where anemia is due to the effect of concomitant myelosuppressive chemotherapy.</li>\r\n</ul>', '<p>Antagonism of hypotensive effect and increased risk of hyperkalemia with ACE inhibitors and angiotensin II receptor antagonists. Ethanol.</p>', '<p>Darbepoetin is contraindicated in patients with:</p>\r\n\r\n<ul>\r\n	<li>Uncontrolled hypertension</li>\r\n	<li>Pure red cell&nbsp;aplasia&nbsp;(PRCA) that begins after treatment with Darbepoetin or other&nbsp;erythropoietin&nbsp;protein drugs&nbsp;</li>\r\n	<li>Serious allergic reactions to Darbepoetin&nbsp;</li>\r\n</ul>', '<p>Increased Mortality,&nbsp;Myocardial Infarction,&nbsp;Stroke, and&nbsp;Thromboembolism; Increased Mortality and/or Increased Risk of Tumor Progression or Recurrence in Patients with cancer; Hypertension; Seizures; Serious allergic reaction; Severe&nbsp;Cutaneous&nbsp;Reactions</p>', '<p>Pregnancy Category C.&nbsp;It is not known whether Darbepoetin Alfa is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Darbepoetin Alfa is administered to a nursing woman.</p>', '<p>Pregnancy and lactation, children. Hypertension; history of seizures; hepatic impairment; sickle cell anaemia; sudden stabing migraine-like pain (warning sign of hypotensive crisis); exclude other causes of anaemia; ischaemic vascular disease; thrombocytosis; epilepsy; malignant disease; increase in heparin dose may be needed; increased risk of thrombosis when used for anaemia before orthopedic surgery; CV disease including recent MI/cerebrovascular accident. Monitor haemoglobin, BP and electrolytes; platelet count for 1st 8 wk.</p>', '<p>Darbepoetin overdosage can cause&nbsp;hemoglobin&nbsp;levels above the desired level, which should be managed with discontinuation or reduction of Darbepoetin dosage and/or with&nbsp;phlebotomy, as clinically indicated. Cases of severe&nbsp;hypertension&nbsp;have been observed following overdose with ESAs</p>', '<p>Haematopoietic Agents</p>', '<p>Store at 2&deg;C to 8&deg;C. Do not freeze.&nbsp;Do not shake. Protect from light; store Darbepoetin Alfa in the carton until use. Do not use Darbepoetin Alfa that has been shaken or frozen.</p>', '<p><strong>Pediatric Use:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Pediatric Patients With CKD</strong>: Darbepoetin safety and efficacy were similar between adults and pediatric patients with CKD when Darbepoetin was used for initial treatment of anemia or patients were transitioned from treatment with epoetin alfa to Darbepoetin</li>\r\n	<li><strong>Pediatric Patients With Cancer</strong>: The safety and efficacy of Darbepoetin in pediatric patients with cancer have not been established.</li>\r\n</ul>\r\n\r\n<p><strong>Geriatric Use</strong>: Of the 1801 patients with CKD in clinical studies of Darbepoetin, 44% were age 65 and over, while 17% were age 75 and over. Of the 873 patients in clinical studies receiving Darbepoetin and concomitant cancer chemotherapy, 45% were age 65 and over, while 14% were age 75 and over. No differences in safety or efficacy were observed between older and younger patients.</p>', '2022-02-19 05:41:25', '2022-04-11 06:25:22'),
(400, 400, '<p>Darifenacin is indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency and frequency.</p>', '<p>Darifenacin is a potent, competitive and selective muscarinic receptor antagonist which has greater binding affinity for muscarinic M3 receptors. M3 receptors are involved in the contraction of the detrusor muscle of the bladder, GI smooth muscle, saliva production, and iris sphincter function. Darifenacin may increase volume threshold in patients with involuntary detrusor contraction, thus increase bladder capacity.</p>', '<p>Darifenacin 7.5 mg once daily; may increase dose to 15 mg once daily if no adequate response after 2 wk of therapy. Darifenacin should be taken with liquid. It can be taken with or without food, and should be swallowed whole and not chewed, divided or crushed.<br />\r\n<br />\r\nFor patients with moderate hepatic impairment or when co-administered with potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin and nefazadone), the daily dose of Darifenacin should not exceed 7.5 mg.</p>', '<p>Darifenacin has known drug-drug interaction with CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, ritonavir, nelfinavir etc.). The concomitant use of Darifenacin with other anticholinergic agents may increase the frequency and/or severity of dry mouth, constipation, blurred vision and other anticholinergic pharmacological effects.</p>', '<p>Patient with urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, and in patients who are at risk for these conditions.</p>', '<p>The most common side effects are dry mouth &amp; constipation. Other less commonly reported side effects include- abnormal vision, back pain, dry skin, hypertension, vomiting, peripheral edema, weight gain, arthralgia, bronchitis, pharyngitis, rhinitis, sinusitis, rash, pruritus, urinary tract disorder and vaginitis.</p>', '<p>Pregnancy&nbsp;Category C. Darifenacin should be used during pregnancy only if the benefit to the mother outweighs the potential risk to the fetus.<br />\r\n<br />\r\nLactation: It is not known whether Darifenacin is excreted into human milk and therefore caution should be exercised before Darifenacin is administered to a nursing woman.</p>', '<p>Darifenacin should be used with caution in the patient at risk for urinary retention &amp; decreased gastrointestinal motility, with impaired renal &amp; hepatic impairment.</p>', '<p>Overdosage with antimuscarinic agents can result in severe antimuscarinic effects. ECG monitoring is recommended when event of overdosage is occurred. Darifenacin has been administered in clinical trials at doses up to 75 mg (five times the maximum therapeutic dose) and signs of overdose were limited to abnormal vision.</p>', '<p>BPH/ Urinary retention/ Urinary incontinence</p>', '<p>Store at 25&deg; C.&nbsp;Protect from light.</p>', NULL, '2022-02-19 05:41:44', '2022-04-11 06:28:02'),
(401, 401, '<p>Dasatinib is indicated for the treatment of adults with:</p>\r\n\r\n<ul>\r\n	<li>Newly diagnosed Philadelphia chromosome-positive (Ph+)&nbsp;chronic myeloid leukemia&nbsp;(CML) in&nbsp;chronic phase.</li>\r\n	<li>Chronic, accelerated, or&nbsp;myeloid&nbsp;or&nbsp;lymphoid&nbsp;blast phase&nbsp;Ph+ CML with resistance or intolerance to prior therapy including imatinib.</li>\r\n	<li>Philadelphia chromosome-positive&nbsp;acute lymphoblastic leukemia&nbsp;(Ph+ ALL) with resistance or intolerance to prior therapy.</li>\r\n</ul>', '<p>Dasatinib, at nanomolar concentrations, inhibits the following kinases: BCR-ABL, SRC family (SRC, LCK, YES, FYN), c-KIT, EPHA2, and PDGFR&beta;. Based on modeling studies, dasatinib is predicted to bind to multiple conformations of the ABL kinase. In vitro, dasatinib was active in leukemic cell lines representing variants of imatinib mesylate sensitive and resistant disease. Dasatinib inhibited the growth of chronic myeloid leukemia (CML) and acute lymphoblastic leukemia (ALL) cell lines overexpressing BCR-ABL. Under the conditions of the assays, dasatinib was able to overcome imatinib resistance resulting from BCR-ABL kinase domain mutations, activation of alternate signaling pathways involving the SRC family kinases (LYN, HCK), and multi-drug resistance gene overexpression.</p>', '<p><strong>The recommended starting dosage of Dasatinib for</strong>:</p>\r\n\r\n<ul>\r\n	<li>Chronic phase CML is 100 mg administered orally once daily.</li>\r\n	<li>Accelerated phase CML, myeloid or lymphoid blast phase CML, or Ph+ ALL is 140 mg administered orally once daily.</li>\r\n</ul>\r\n\r\n<p>Tablets should not be crushed or cut; they should be swallowed whole. Dasatinib can be taken with or without a meal, either in the morning or in the evening.<br />\r\n<br />\r\nIn clinical studies, treatment with Dasatinib was continued until disease progression or until no longer tolerated by the patient. The effect of stopping treatment on long-term disease outcome after the achievement of a cytogenetic response (including complete cytogenetic response [CCyR]) or major molecular response (MMR) is not known.</p>', '<p>Concomitant use with drugs that have narrow therapeutic index (e.g. alfentanil, cisapride, ciclosporin, fentanyl, pimozide, quinidine, simvastatin, sirolimus, tacrolimus, ergot alkaloids) as it may increase the serum levels of these drugs. Increased risk of bleeding and thrombocytopenia with antiplatelet drugs, anticoagulants, and NSAIDs.</p>', '<p>Concomitant use with CYP3A4 inhibitors (e.g. atazanavir, clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, &nbsp;voriconazole or grapefruit juice); CYP3A4 inducers (e.g. carbamazepine, dexamethasone, phenytoin, phenobarbital, rifampicin or St John&#39;s wort); antacid. Pregnancy.</p>', '<p>Reversible myelosuppression, neutropenia, anaemia, thrombocytopenia, fluid retention, pulmonary arterial HTN, QT prolongation, cardiac failure, arrhythmias, HTN, musculoskeletal pain, GI disturbances, headache, chills, fatigue, asthenia, myalgia, chest pain, arthralgia, pyrexia, mucositis, flushing, colitis, electrolyte disturbances, appetite and wt disturbances, rash, dermatitis, hyperhidrosis, pruritus, acne.</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>Patients with predisposing factors for QT prolongation (e.g. congenital long QT syndrome, hypokalaemia, hypomagnesaemia, on antiarrhythmic therapy, or receiving cumulative high doses of anthracyclines). Hepatic impairment. Lactation.</p>', '<p>Symptoms: Significant platelet count reduction. Management: Closely monitor for myelosuppression. Supportive and symptomatic treatment.</p>', '<p>Targeted Cancer Therapy</p>', '<p>Dasatinib tablets should be stored at 20&deg;C to 25&deg;C</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Dasatinib in patients less than 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No differences in confirmed Complete Cytogenetic Response (cCCyR) and&nbsp;MMR&nbsp;were observed between older and younger patients. Of the 2712 patients in clinical studies of Dasatinib, 617 (23%) were 65 years of age and older, and 123 (5%) were 75 years of age and older. While the safety profile of Dasatinib in the geriatric population was similar to that in the younger population, patients aged 65 years and older are more likely to experience the commonly reported adverse reactions of fatigue, pleural effusion, diarrhea, dyspnea, cough, lower gastrointestinal hemorrhage, and appetite disturbance, and more likely to experience the less frequently reported adverse reactions of abdominal&nbsp;distention, dizziness,&nbsp;pericardial effusion, congestive heart failure,&nbsp;hypertension,&nbsp;pulmonary edema, and weight decrease, and should be monitored closely.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment is necessary in patients with hepatic impairment. Caution is recommended when administering Dasatinib to patients with hepatic impairment.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: There are currently no clinical studies with Dasatinib in patients with impaired renal function. Less than 4% of dasatinib and its metabolites are excreted via the kidney.</p>', '2022-02-19 05:42:06', '2022-04-11 06:31:27'),
(402, 402, '<p>Daunorubicin in combination with other approved anticancer drugs is indicated for remission induction in acute nonlymphocytic leukemia (myelogenous, monocytic, erythroid) of adults and for remission induction in acute lymphocytic leukemia of children and adults.</p>', '<p>Daunorubicin has antimitotic and cytotoxic activity through a number of proposed mechanisms of action. It forms complexes with DNA by intercalation between base pairs. It inhibits topoisomerase II activity by stabilizing the DNA- topoisomerase II complex, preventing the religation portion of the ligation- religation reaction that topoisomerase II catalyzes. Single strand and double-strand DNA breaks result. It may also inhibit polymerase activity, affect the regulation of gene expression, and produce free radical damage to DNA. It possesses an antitumor effect against a wide spectrum of animal tumors, either grafted or spontaneous.<br />\r\n<br />\r\n<strong>Distribution</strong>: Daunorubicin is rapidly and widely distributed in tissues, with the highest levels in the spleen, kidneys, liver, lungs and heart. The drug binds to many cellular components, particularly nucleic acids. There is no evidence that it crosses the blood-brain barrier, but the drug apparently crosses the placenta.<br />\r\n<br />\r\n<strong>Metabolism and Elimination</strong>: Daunorubicin is extensively metabolized in the liver and other tissues, mainly by cytoplasmic aldo-keto reductases, producing daunorubicinol, the major metabolite which has antineoplastic activity. Approximately 40% of the drug in the plasma is present as daunorubicinol within 30 minutes and 60% in 4 hours after a dose of Daunorubicin. Further metabolism via reduction cleavage of the glycosidic bond, 4-O demethylation, and conjugation with both sulfate and glucuronide have been demonstrated. Simple glycosidic cleavage of Daunorubicin or Daunorubicinol is not a significant metabolic pathway in man. Twenty-five percent of an administered dose of Daunorubicin is eliminated in an active form by urinary excretion and an estimated 40% by biliary excretion.</p>', '<p>Parenteral drug products should be inspected visually for particulate matter prior to administration.<br />\r\n<br />\r\n<strong>Representative Dose Schedules and Combination for the Approved Indication of Remission Induction in Adult Acute Nonlymphocytic Leukemia</strong>: In Combination: For patients under age 60, Daunorubicin 45 mg/m2/day IV on days 1, 2, and 3 of the first course and on days 1, 2 of subsequent courses AND cytosine arabinoside 100 mg/m2/day IV infusion daily for 7 days for the first course and for 5 days for subsequent courses. For patients 60 years of age and above, Daunorubicin 30 mg/m2/day IV on days 1, 2, and 3 of the first course and on days 1, 2 of subsequent courses AND cytosine arabinoside 100 mg/m2/day IV infusion daily for 7 days for the first course and for 5 days for subsequent courses. This Daunorubicin dose-reduction is based on a single study and may not be appropriate if optimal supportive care is available.<br />\r\n<br />\r\n<strong>Representative Dose Schedule and Combination for the Approved Indication of Remission Induction in Pediatric Acute Lymphocytic Leukemia</strong>: In Combination: Daunorubicin 25 mg/m2 IV on day 1 every week, Vincristine 1.5 mg/m2 IV on day 1 every week, prednisone 40 mg/m2 PO daily. Generally, a complete remission will be obtained within four such courses of therapy; however, if after four courses the patient is in partial remission, an additional one or, if necessary, two courses may be given in an effort to obtain a complete remission. In children less than 2 years of age or below 0.5 m2 body surface area, it has been recommended that the Daunorubicin dosage calculation should be based on weight (1 mg/kg) instead of body surface area.<br />\r\n<br />\r\n<strong>Representative Dose Schedules and Combination for the Approved Indication of Remission Induction in Adult Acute Lymphocytic Leukemia</strong>: In Combination: Daunorubicin 45 mg/m2/day IV on days 1, 2, and 3 and Vincristine 2 mg IV on days 1, 8, and 15; prednisone 40 mg/m2/day PO on days 1 through 22, then tapered between days 22 to 29; L-asparaginase 500 IU/kg/day x 10 days IV on days 22 through 32. Or, as directed by the registered physicians.</p>', '<p>The use of Daunorubicin in a patient who has previously received Doxorubicin increases the risk of cardiotoxicity. Daunorubicin should not be used in patients who have previously received the recommended maximum cumulative doses of Doxorubicin or Daunorubicin. Cyclophosphamide used concurrently with Daunorubicin may also result in increased cardiotoxicity. Dosage reduction of Daunorubicin may be required when used concurrently with other myelosuppressive agents. Hepatotoxic medications, such as high-dose Methotrexate, may impair liver function and increase the risk of toxicity.</p>', '<p>It is contraindicated in patients with known hypersensitivity to Daunorubicin or any other components of this product.</p>', '<p>Dose-limiting toxicity includes myelosuppression and cardiotoxicity. Other reactions include:</p>\r\n\r\n<ul>\r\n	<li><strong>Cutaneous</strong>: Reversible alopecia occurs in most patients. Rash, contact dermatitis and urticaria have occurred rarely.</li>\r\n	<li><strong>Gastrointestinal</strong>: Acute nausea and vomiting occur but are usually mild. Antiemetic therapy may be of some help. Mucositis may occur 3 to 7 days after administration. Diarrhea and abdominal pain have occasionally been reported.</li>\r\n	<li><strong>Local</strong>: If extravasation occurs during administration, severe local tissue necrosis, severe cellulitis, thrombophlebitis or painful induration can result.</li>\r\n	<li><strong>Acute Reactions</strong>: Rarely, anaphylactoid reaction, fever, and chills can occur. Hyperuricemia may occur, especially in patients with leukemia, and serum uric acid levels should be monitored.</li>\r\n</ul>', '<p>Pregnancy Category D. 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 in nursing infants from Daunorubicin, mothers should be advised to discontinue nursing during Daunorubicin therapy.</p>', '<p>Therapy with Daunorubicin requires close patient observation and frequent complete blood-count determinations. Cardiac, renal, and hepatic function should be evaluated prior to each course of treatment. Appropriate measures must be taken to control any systemic infection before beginning therapy with Daunorubicin. It may transiently impart a red coloration to the urine after administration, and patients should be advised to expect this.<br />\r\n<br />\r\nDaunorubicin Hydrochloride Injection must be given into a rapidly flowing intravenous infusion. It must never be given by the intramuscular or subcutaneous route. Severe local tissue necrosis will occur if there is extravasation during administration.<br />\r\n<br />\r\nMyocardial toxicity manifested in its most severe form by potentially fatal congestive heart failure may occur either during therapy or months to years after termination of therapy. The incidence of myocardial toxicity increases after a total cumulative dose exceeding 400 to 550 mg/m2 in adults, 300 mg/m2 in children more than 2 years of age, or 10 mg/kg in children less than 2 years of age.<br />\r\n<br />\r\nSevere myelosuppression occurs when used in therapeutic doses; this may lead to infection or hemorrhage.<br />\r\n<br />\r\nIt is recommended that Daunorubicin Hydrochloride be administered only by physicians who are experienced in leukemia chemotherapy and in facilities with laboratory and supportive resources adequate to monitor drug tolerance and protect and maintain a patient compromised by drug toxicity. The physician and institution must be capable of responding rapidly and completely to severe hemorrhagic conditions and/or overwhelming infection.<br />\r\n<br />\r\nDosage should be reduced in patients with impaired hepatic or renal function.</p>', NULL, '<p>Cytotoxic Chemotherapy</p>', '<p>Store unopened vials in the refrigerator, 2&deg;-8&deg;C. Contains no preservatives. Discard unused portions. Protect from light. If Daunorubicin contacts the skin or mucosae, the area should be washed thoroughly with soap and water. Procedures for proper handling and disposal of anticancer drugs should be considered.</p>', NULL, '2022-02-19 05:42:23', '2022-04-11 06:34:22'),
(403, 403, '<p>Deferasirox is indicated for the treatment of chronic iron overload due to blood transfusions in adult and paediatric patients (aged 2 years and over).</p>', '<p>Deferasirox is an orally active chelator that is selective for iron (as Fe3+ ). It is a tridentate ligand that binds iron with high&nbsp;affinity&nbsp;in a 2:1 ratio. Although deferasirox has very low affinity for zinc&nbsp;and copper there are variable decreases in the serum concentration of these trace metals after the administration of deferasirox. The clinical significance of these decreases is uncertain.</p>\r\n\r\n<p>&nbsp;</p>', '<p>2 years children &amp; Adult Dose:<br />\r\n<br />\r\n<strong>Chronic Iron overload:</strong>&nbsp;Initially, 20 mg/kg daily. Adjust dosage every 3-6 months as needed based on trends in serum ferritin concentrations (monitor monthly). Adjust dosage in increments of 5 or 10 mg/kg daily (up to maximum dosage of 30 mg/kg daily) according to the patient&rsquo;s clinical response and therapeutic goals. Consider temporarily interrupting therapy if serum ferritin concentrations are consistently &lt;500 mcg/L.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Deferasirox must be taken once daily on an empty stomach at least 30 minutes before food, preferably at the same time each day. The tablets are dispersed by stirring in a glass of water or apple or orange juice (100 to 200 mL) until a line suspension is obtained. After the suspension has been swallowed, any residue must be resuspended in a small volume of water or juice and swallowed. The tablets must not be chewed or swallowed whole. Dispersion in carbonated drinks or milk is not recommended due to foaming and slow dispersion, respectively.</p>', '<p>May chelate Al when used with Al-containing antacids. Decreased exposure with colestyramine and potent inducers of UGT enzymes (e.g. carbamazepine, rifampicin, phenytoin). May increase serum concentration of CYP1A2 (e.g. duloxetine, theophylline) and CYP2C8 (e.g. repaglinide, paclitaxel) substrates, and decrease serum concentrations of CYP3A4 substrates (e.g. ciclosporin, hormonal contraceptives, simvastatin).</p>', '<p>Creatinine clearance &lt;40 mL/min or serum creatinine &gt;2 times the age-appropriate upper limit of normal. High risk myelodysplastic syndrome (MDS) patients and patients with other hematological and non-hematological malignancies who are not expected to benefit from chelation therapy due to the rapid progression of their disease. Hypersensitivity to the active substance or to any of the excipients.</p>', '<p>Serum creatinine increase, Abdominal pain, Nausea, Vomiting, Diarrhea, Proteinuria, Pyrexia, Headache, Cough , Nasopharyngitis, Pharyngolaryngeal pain, Influenza, Rash, Respiratory tract infection, Bronchitis, ALT increased, Arthralgia, back pain, Acute tonsillitis, Rhinitis, Fatigue, Ear infection, Transaminitis, Urticaria, Anaphylaxis, Angioedema, Cytopenias, including agranulocytosis, neutropenia and thrombocytopenia; leukocytoclastic vasculitis</p>', '<p><strong>Pregnancy</strong>:&nbsp;No clinical data on exposed pregnancies are available for deferasirox. Studies in animals have shown some reproductive toxicity at maternally toxic doses. The potential risk for humans is unknown. As a precaution, it is recommended that Deferasirox not be used during pregnancy unless clearly necessary.<br />\r\n<br />\r\n<strong>Breast-feeding</strong>:&nbsp;In animal studies, Deferasirox was found to be rapidly and extensively secreted into maternal milk. No effect on the offspring was noted. It is not known if Deferasirox is secreted into human milk. Breast-feeding while taking Deferasirox is not recommended.</p>', '<p>Moderate hepatic impairment. Children. Pregnancy and lactation.</p>', '<p>Single doses up to 40 mg/kg in normal subjects have been well tolerated. Acute signs of overdose may include nausea, vomiting, headache, and diarrhea. Overdose may be treated by induction of emesis or by gastric lavage, and by symptomatic treatment.</p>', '<p>Antidote preparations</p>', '<p>Store at 25&deg; C. Protect from moisture.</p>', '<p><strong>Dosage Modification for Adverse Renal Effects</strong>: Interrupt therapy if a progressive increase in SCR (Serum Creatinine Concentration) beyond the ULN occurs. Once SCR returns to within normal limits, reinitiate therapy at a lower dosage followed by gradual dosage escalation if clinical beneht is expected to outweigh potential risks. Reduce dosage by 10 mg/kg daily if SCR at 2 consecutive visits increases to a level &gt;33% above the average pretreatment value and the increase cannot be attributed to other causes.<br />\r\n<br />\r\n<strong>Dosage Modifcation for Adverse Hepatic Effects</strong>: Consider dosage adjustment or interruption of therapy in patients with severe, persistent, progressive, or unexplained elevations of liver function test results.</p>', '2022-02-19 05:42:38', '2022-04-11 06:38:35'),
(404, 404, '<p>Iron overload in patients with thalassaemia.</p>', '<p>Deferiprone is a chelating agent with an&nbsp;affinity&nbsp;for ferric ion (iron III). Deferiprone binds with ferric ions to form neutral 3:1 (deferiprone:iron) complexes that are stable over a wide range of pH values. Deferiprone has a lower binding affinity for other metals such as copper, aluminum and&nbsp;zinc&nbsp;than for iron.</p>', '<p><strong>Adult:</strong>&nbsp;25 mg/kg tid. Doses &gt;100 mg/kg daily are not recommended.<br />\r\n<strong>Child:</strong>&nbsp;&gt;6 yr: 25 mg/kg tid.<br />\r\n<br />\r\nMay be taken with or without food.</p>', '<p>Avoid using deferiprone with aluminium-containing antacids as it can chelates trivalent metal ions.</p>', '<p>Agranulocytosis, pregnancy and lactation.</p>', '<p>Musculoskeletal and joint pain; GI disturbances; red-brown discoloration of urine; transient liver enzyme abnormalities; zinc deficiency; neutropenia and agranulocytosis.</p>', '<p>Pregnancy&nbsp;Category D.&nbsp;There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).</p>', '<p>Hepatic and renal impairment. Neutropenia, monitor neutrophil count wkly and discontinue treatment if neutropenia develops. Limited experience in children 6-10 yr.</p>', NULL, '<p>Antidote preparations</p>', '<p>Store below 30&deg; C.</p>', NULL, '2022-02-19 05:43:11', '2022-04-25 20:12:40'),
(405, 405, '<p>Deferoxamine Mesylate is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Acute iron intoxication.</li>\r\n	<li>Chronic iron overload due to transfusion-dependent anemias.</li>\r\n	<li>Diagnosis of aluminum overload (deferoxamine mesylate) infusion test.</li>\r\n	<li>Chronic aluminum overload in patients with End-Stage Renal Failure (ESRF) under maintenance dialysis.</li>\r\n</ul>', '<p>Deferoxamine works in treating iron toxicity by binding trivalent (ferric) iron (for which it has a strong affinity), forming ferrioxamine, a stable complex which is eliminated via the kidneys. 100 mg of deferoxamine is capable of binding approximately 8.5 mg of trivalent (ferric) iron. Deferoxamine works in treating aluminum toxicity by binding to tissue-bound aluminum to form aluminoxamine, a stable, water-soluble complex. The formation of aluminoxamine increases blood concentrations of aluminum, resulting in an increased concentration gradient between the blood and dialysate, boosting the removal of aluminum during dialysis. 100 mg of deferoxamine is capable of binding approximately 4.1 mg of aluminum.</p>', '<p>Deferoxamine mesylate should only be given parenterally. The dose should not exceed 6.0 grams in a twenty-four hour period. Although Deferoxamine can be given by intramuscular injection, in most cases it exerts a considerably greater effect when administered by continuous infusion either intravenously (especially in cases of acute iron intoxication) or subcutaneously (especially in patients with chronic iron overload).<br />\r\n<br />\r\nRapid intravenous injection of Deferoxamine exceeding 15 mg/kg/h has produced flushing of the skin, urticaria, hypotension and shock</p>', '<p><strong>Concomitant use of Prochlorperazine</strong>: Concurrent treatment with Deferoxamine and prochlorperazine, a phenothiazine derivative, may lead to temporary impairment of consciousness.<br />\r\n<br />\r\n<strong>Concomitant use of Vitamin C</strong>: Where an iron-overload is associated with ascorbic acid deficiency, oral administration of Vitamin C in the standard dosage (150 - 250 mg daily) may serve to enhance excretion of the iron complex in response to Deferoxamine. Larger doses of Vitamin C fail to produce an additional effect.<br />\r\n<br />\r\n<strong>Concomitant use of Erythropoietin</strong>: There is evidence that aluminum intoxication causes reduced erythropoiesis. In dialysis patients with iron and/or aluminum overload receiving Deferoxamine and erythropoietin, it is important to adjust the dosage of the latter when necessary. Regular monitoring of iron stores should also be conducted.</p>', '<p>Patients who are hypersensitive to deferoxamine mesylate or component of the container, except where desensitization is successful.</p>', NULL, '<p><strong>Pregnant Women</strong>: There are no adequate and well-controlled studies conducted in pregnant women.Studies in animals (rabbits) have shown reproductive toxicity. The risk to the fetus/mother is unknown. Women of childbearing potential with chronic iron and/or aluminum overload should not receive deferoxamine unless the use of an effective form of contraception, established before treatment, is continued throughout treatment and for at least the first month after treatment. During pregnancy, particularly in the first trimester, deferoxamine should only be used if the hazard of acute iron intoxication is considered to be greater than the potential teratogenic hazard of deferoxamine.<br />\r\n<br />\r\n<strong>Nursing Women</strong>: It is not known whether deferoxamine mesylate passes into the breast milk. Because many drugs are excreted in human milk, and because of the potential for serious adverse drug reactions in breast-fed newborns/infants, a decision should be made whether to abstain from breast-feeding or to abstain from using the medicinal product, taking into account the importance of the medicinal product to the mother.</p>', '<p>Therapy with Deferoxamine should be initiated and maintained by physician experienced in the treatment of chronic iron overload due to blood transfusions. It should be noted that some of the signs and symptoms reported as adverse effects may in fact be manifestations of the underlying disease (iron and/or aluminum overload). As with all medicines, Deferoxamine should be kept out of reach of children. Rapid intravenous injection of Deferoxamine exceeding 15 mg/kg/h has produced flushing of the skin, urticaria, hypotension and shock&nbsp;<br />\r\n<br />\r\nVitamin C supplements should not be given to patients with cardiac failure because impairment of cardiac function may be experienced in patients with severe chronic iron overload receiving combined treatment of Deferoxamine with high doses of vitamin C (more than 500 mg daily)</p>', '<p>Since Ddeferoxamine mesylate is available only for parenteral administration, acute intoxication is unlikely to occur.</p>', '<p>Carboxylic acids and derivatives</p>', '<p>Store between 15-25 &deg;C. Do not store above 25&deg;C.</p>', NULL, '2022-02-19 05:43:30', '2022-04-25 20:15:12'),
(406, 406, '<p>Deflazacort is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Anaphylaxis, asthma, severe hypersensitivity reactions</li>\r\n	<li>Rheumatoid arthritis, juvenile chronic arthritis, polymyalgia rheumatica</li>\r\n	<li>Systemic lupus erythematosus, dermatomyositis, mixed connective tissue disease (other than systemic sclerosis), polyartritis nodosa, sarcoidosis</li>\r\n	<li>Pemphigus,bullous pemphigoid, pyoderma gangrenosum</li>\r\n	<li>Minimal change nephrotic syndrome, acute interstitial nephritis</li>\r\n	<li>Rheumatic carditis</li>\r\n	<li>Ulcerative colitis, Crohn&#39;s disease</li>\r\n	<li>Uveitis, optic neuritis</li>\r\n	<li>Autoimmune haemolytic anaemia, idiopathic thrombocytopenic purpura</li>\r\n	<li>Acute and lymphatic leukaemia, malignant lymphoma, multiple myeloma</li>\r\n	<li>Immune suppression in transplantation</li>\r\n</ul>', '<p>Deflazacort provides anti-inflammatory action by inhibiting Phospholipase A2 enzyme which is responsible for prostaglandin synthesis. Besides Deflazacort decreases the release of certain chemicals that are important in the immune system. By decreasing the release of these chemicals Deflazacort provides immunosuppressive action.</p>', '<p><strong>Adults</strong>-</p>\r\n\r\n<ul>\r\n	<li><strong>For acute disorders</strong>: Up to 120 mg/day Deflazacort may need to be given initially. Maintenance doses in most conditions are within the range of 3-18 mg/day.</li>\r\n	<li><strong>Rheumatoid arthritis</strong>: The maintenance dose is usually within the range of 3-18 mg/day. The smallest effective dose should be used and increased if necessary.</li>\r\n	<li><strong>Bronchial asthma</strong>: In the treatment of an acute attack, high doses of 48-72 mg/day may be needed depending on severity and gradually reduced once the attack has been controlled. For maintenance in chronic asthma, doses should be titrated to the lowest dose that controls symptoms.</li>\r\n	<li><strong>Other conditions</strong>: The dose of Deflazacort depends on clinical need titrated to the lowest effective dose for maintenance. Starting doses may be estimated on the basis of ratio of 5 mg prednisone or prednisolone to 6 mg.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: There has been limited exposure of children to Deflazacort in clinical trials. In children, the indications for glucocorticoids arethe same as for adults, but it is important that the lowest effective dosage is used. Alternate day administration may be appropriate. Doses of Deflazacort usually lie in the range 0.25-1.5 mg/kg/day.<br />\r\n<br />\r\nThe following ranges provide general guidance:</p>\r\n\r\n<ul>\r\n	<li><strong>Juvenile chronic arthritis</strong>: The usual maintenance dose is between 0.25-1.0 mg/kg/day.</li>\r\n	<li><strong>Nephrotic syndrome</strong>: Initial dose of usually 1.5 mg/kg/day followed by down titration according to clinical need.</li>\r\n	<li><strong>Bronchial asthma</strong>: On the basis of the potency ratio, the initial dose should be between 0.25-1.0 mg/kg on alternate days.</li>\r\n</ul>\r\n\r\n<p><strong>Deflazacort withdrawal</strong>: In patients who have received more than physiological doses of systemic corticosteroids (approximately 9 mg per day or equivalent) for greater than 3 weeks, withdrawal should not be abrupt. How dose reduction should be carried out depends largely on whether the disease is likely to relapse as the dose of systemic corticosteroids is reduced.</p>', '<p>Deflazacort is metabolized in the liver. It is recommended to increase the maintenance dose of Deflazacort if drugs which are liver enzyme inducers are co-administered, e.g. rifampicin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone and aminoglutethimide. For drugs which inhibit liver enzymes, (e.g. ketoconazole) it may be possible to reduce the maintenance dose of Deflazacort.</p>', '<p>Hypersensitivity to or any of the ingredients. Patients receiving live virus immunization.</p>', '<p>GI disturbances, musculoskeletal, endocrine, neuropsychiatric, ophthalmic, fluid and electrolyte disturbances; susceptible to infection, impaired healing, hypersensitivity, skin atrophy, striae, telangiectasia, acne, myocardial rupture following recent Ml, thromboembolism.</p>', '<p><strong>Pregnancy</strong>: Deflazacort does cross the placenta. However, when administered for prolonged periods or repeatedly during pregnancy, corticosteroids may increase the risk of intrauterine growth retardation. As with all drugs, corticosteroids should only be prescribed when the benefits to the mother and child outweigh the risks.<br />\r\n<br />\r\n<strong>Nursing Mother</strong>: Corticosteroids are excreted in breast milk, although no data are available for Deflazacort. Doses of up to 50 mg daily of Deflazacort are unlikely to cause systemic effects in the infant. Infants of mothers taking higher doses than this may have a degree of adrenal suppression but the benefits of breastfeeding are likely to outweigh any theoretical risk.</p>', '<p>The following clinical conditions require special caution and frequent patient monitoring is necessary-</p>\r\n\r\n<ul>\r\n	<li>Cardiac disease or congestive heart failure (except in the presence of active rheumatic carditis), hypertension, thromboembolic disorders. Glucocorticoids can cause salt and water retention and increased excretion of potassium. Dietary salt restriction and potassium supplementation may be necessary.</li>\r\n	<li>Gastritis or oesophagitis, diverticulitis, ulcerative colitis if there is the probability of impending perforation, abscess or pyogenic infections, fresh intestinal anastomosis, active or latent peptic ulcer.</li>\r\n	<li>Diabetes mellitus or family history, osteoporosis, myasthenia gravis, renal insufficiency.</li>\r\n	<li>Emotional instability or psychotic tendency, epilepsy.</li>\r\n	<li>Previous corticosteroid-induced myopathy.</li>\r\n	<li>Liver failure.</li>\r\n	<li>Hypothyroidism and cirrhosis, which may increase the glucocorticoid effect.</li>\r\n	<li>Ocular herpes simplex because of possible corneal perforation.</li>\r\n</ul>', NULL, '<p>Glucocorticoids</p>', '<p>Store in a cool (below 25&deg;C) and dry place, protected from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Hepatic Impairment</strong>: In patients with hepatic impairment, blood levels of may be increased. Therefore the dose of Deflazacort should be carefully monitored and adjusted to the minimum effective dose.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: In renally impaired patients, no special precautions other than those usually adopted in patients receiving glucocorticoid therapy are necessary.<br />\r\n<br />\r\n<strong>Elderly</strong>: In elderly patients, no special precautions other than those usually adopted in patients receiving glucocorticoid therapy are necessary. The common adverse effects of systemic corticosteroids may be associated with more serious consequences in old age.</p>', '2022-02-19 05:43:56', '2022-04-25 20:19:07'),
(407, 407, '<p>Degarelix Acetate is a gonadotrophin releasing hormone (GnRH) antagonist indicated for treatment of adult male patients with advanced hormone-dependent prostate cancer.</p>', '<p>Degarelix is a selective gonadotrophin releasing-hormone (GnRH) antagonist that competitively and reversibly binds to the pituitary GnRH receptors, thereby rapidly reducing the release of the gonadotrophins, luteinizing hormone (LH) and follicle stimulating hormone (FSH), and thereby reducing the secretion of testosterone (T) by the testes. Prostatic carcinoma is known to be androgen sensitive and responds to treatment that removes the source of androgen. Unlike GnRH agonists, GnRH antagonists do not induce a LH surge with subsequent testosterone surge/tumour stimulation and potential symptomatic flare after the initiation of treatment.<br />\r\n<br />\r\nA single dose of 240 mg degarelix, followed by a monthly maintenance dose of 80 mg, rapidly causes a decrease in the concentrations of LH, FSH and subsequently testosterone. The serum concentration of dihydrotestosterone (DHT) decreases in a similar manner to testosterone.<br />\r\n<br />\r\nDegarelix is effective in achieving and maintaining testosterone suppression well below medical castration level of 0.5 ng/ml. Maintenance monthly dosing of 80 mg resulted in sustained testosterone suppression in 97% of patients for at least one year. No testosterone microsurges were observed after re-injection during degarelix treatment. Median testosterone levels after one year of treatment were 0.087 ng/ml (interquartile range 0.06-0.15) N=167.</p>', '<p><strong>Starting dose</strong>: 240 mg administered as two consecutive subcutaneous injections of 120 mg each.<br />\r\n<br />\r\n<strong>Maintenance dose (monthly administration)</strong>: 80 mg administered as one subcutaneous injection.<br />\r\n<br />\r\nThe first maintenance dose should be given one month after the starting dose.<br />\r\n<br />\r\nThe therapeutic effect of degarelix should be monitored by clinical parameters and prostate specific antigen (PSA) serum levels. Clinical studies have shown that testosterone (T) suppression occurs immediately after administration of the starting dose with 96% of the patients having serum testosterone levels corresponding to medical castration (T&le;0.5 ng/ml) after three days and 100% after one month. Long term treatment with the maintenance dose up to 1 year shows that 97% of the patients have sustained suppressed testosterone levels (T&le;0.5 ng/ml).<br />\r\n<br />\r\nIn case the patient&#39;s clinical response appears to be sub-optimal, it should be confirmed that serum testosterone levels are remaining sufficiently suppressed.<br />\r\n<br />\r\nSince degarelix does not induce a testosterone surge it is not necessary to add an anti androgen as surge protection at initiation of therapy.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Degarelix must be reconstituted prior to administration. Degarelix is for subcutaneous use only, not to be administered intravenously. Intramuscular administration is not recommended as it has not been studied. Degarelix is administered as a subcutaneous injection in the abdominal region. The injection site should vary periodically. Injections should be given in areas where the patient will not be exposed to pressure e.g. not close to waistband or belt and not close to the ribs.</p>', '<p>No formal drug-drug interaction studies have been performed. Since androgen deprivation treatment may prolong the QTc interval, the concomitant use of degarelix with medicinal products known to prolong the QTc interval or medicinal products able to induce torsades de pointes such as class IA (e.g. quinidine, disopyramide) or class III (e.g. amiodarone, sotalol, dofetilide, ibutilide) antiarrhythmic medicinal products, methadone, moxifloxacin, antipsychotics, etc. should be carefully evaluated. Degarelix is not a substrate for the human CYP450 system and has not been shown to induce or inhibit CYP1A2, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1, or CYP3A4/5 to any great extent in vitro. Therefore, clinically significant pharmacokinetic drug-drug interactions in metabolism related to these isoenzymes are unlikely.</p>', '<p>Hypersensitivity to the active substance or to any of the excipients of this preparation.</p>', '<p>The most commonly observed adverse reactions during degarelix therapy in the confirmatory phase III study (N=409) were due to the expected physiological effects of testosterone suppression, including hot flushes and weight increase (reported in 25% and 7%, respectively, of patients receiving treatment for one year), or injection site adverse reactions. Transient chills, fever or influenza like illness were reported to occur hours after dosing (in 3%, 2% and 1% of patients, respectively).<br />\r\n<br />\r\nThe injection site adverse reactions reported were mainly pain and erythema, reported in 28% and 17% of patients, respectively, less frequently reported were swelling (6%), induration (4%) and nodule (3%). These events occurred primarily with the starting dose whereas during maintenance therapy with the 80 mg dose, the incidence of these events pr 100 injections was: 3 for pain and &lt;1 for erythema, swelling, nodule and induration. The reported events were mostly transient, of mild to moderate intensity and led to very few discontinuations (&lt;1%). Serious injection site reactions were very rarely reported such as injection site infection, injection site abscess or injection site necrosis that could require surgical treatment/drainage.</p>', '<p>There is no relevant indication for use of Degarelix Acetate in women. Degarelix Acetate may inhibit male fertility as long as the testosterone is suppressed.</p>', NULL, '<p>There is no clinical experience with the effects of an acute overdose with degarelix. In the event of an overdose the patient should be monitored and appropriate supportive treatment should be given, if considered necessary.</p>', '<p>Drugs affecting (inhibiting) gonadotrophin</p>', '<p>This medicinal product does not require any special storage conditions. Chemical and physical in-use stability has been demonstrated for 2 hours at 25&deg;C. From a microbiological point of view, unless the method of reconstitution precludes the risk of microbial contamination, the product should be used immediately. If not used immediately, in-use storage times and conditions are the responsibility of the user.</p>', '<p><strong>Elderly, hepatically or renal impaired patients</strong>: There is no need to adjust the dose for the elderly or in patients with mild or moderate liver or kidney function impairment. Patients with severe liver or kidney impairment have not been studied and caution is therefore warranted.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: There is no relevant use of Degarelix Acetate in children and adolescents in the treatment of adult male patients with advanced hormone-dependent prostate cancer.</p>', '2022-02-19 05:44:22', '2022-04-25 20:25:52');
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
(408, 408, '<p>Adequately powered, long-term clinical trials are lacking to support therapeutic use of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) supplementation (hereafter jointly referred to as DHEA/S). Reviews of clinical trials found no convincing evidence to support a place in therapy for DHEA in improving cognitive function or physical strength in elderly patients, or in treating postmenopausal symptoms in women, hyperlipidemia or insulin resistance, schizophrenia, or cancer. Some evidence exists to support the use of DHEA/S supplementation in women with diminished ovarian reserves, in subpopulations of elderly women with osteoporosis, and in mild systemic lupus erythematosus. DHEA is recommended as third-line monotherapy or adjunctive therapy for treatment of major depressive disorder (MDD) by Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines, and limited data suggest a potential role for DHEA as an anxiolytic.</p>', '<p>The sulfate derivative of DHEA has been shown to act as a noncompetitive antagonist of gamma-aminobutyric acid (GABA) receptors, as well as a positive allosteric modulator of&nbsp;N-methyl-D-aspartate receptors. In humans, neuroprotective, antioxidant, antihypertensive, and anti-inflammatory effects have also been reported. Serum DHEA levels peak in 60 to 480 minutes after administration.</p>', '<p><strong>Adrenal insufficiency</strong>: 50 mg/day for 3 months is considered a replacement dose, while 200 mg/day achieves supraphysiological circulating levels and is considered a pharmacological dose.<br />\r\n<br />\r\n<strong>Anorexia nervosa</strong>: 100 mg/day for 6 months was used in a pilot study.<br />\r\n<br />\r\n<strong>Diminished ovarian reserve</strong>: 50 to 75 mg/day (in divided doses) has been used in clinical studies of assisted reproduction.<br />\r\n<br />\r\n<strong>Exercise training&ndash;induced muscle damage</strong>: 100 mg/day of Dehydroepiandrosterone supplementation was administered over 5 days in a study in young men undergoing exercise training.<br />\r\n<br />\r\n<strong>Major depressive disorder</strong>: Doses ranging from 30 to 450 mg/day for 6 to 8 weeks have been used in clinical studies.<br />\r\n<br />\r\n<strong>Metabolic syndrome</strong>: 100 mg/day for 3 months has been used in a study evaluating effects against metabolic syndrome in pre-and postmenopausal women.<br />\r\n<br />\r\n<strong>Postmenopausal women</strong>: 25 mg/day has been suggested because this dose minimizes androgenic adverse effects; however, only studies in which at least 50 mg/day was used demonstrated positive outcomes as hormonal replacement therapy.</p>', '<p>Supraphysiologic serum DHEAS levels due to DHEA supplementation have been documented to interfere with commercially available progesterone assays, yielding false-positive increases in serum progesterone.</p>', '<p>Use of Dehydroepiandrosterone is not recommended in breast or prostate cancer.</p>', '<p>Studies in adrenal insufficiency suggest DHEA is generally well tolerated. However, data from long-term studies are lacking. Observed adverse effects include mania and hypomania, acne, hirsutism, gynecomastia, testicular changes, increased blood pressure, and decreased high-density lipoprotein (HDL) levels.<br />\r\n<br />\r\nUse caution in individuals with psychiatric disorders; agitation, confusion, anxiety, paranoia, and suicidal thoughts have been reported. Use of hormones like DHEA may cause erythrocytosis. Use caution in individuals with diabetes, as DHEA may increase insulin resistance or sensitivity. Use caution in individuals with liver dysfunction, as DHEA may exacerbate this condition. Use caution in individuals with polycystic ovarian syndrome, as DHEA may worsen this condition.</p>', '<p>Information regarding safety and efficacy in pregnancy and lactation is lacking. Dehydroepiandrosterone supplementation has been evaluated for use in improving oocyte production in infertility.</p>', NULL, NULL, NULL, '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-19 05:44:51', '2022-04-25 20:34:46'),
(409, 409, '<p><strong>Acute Bacterial Skin and Skin Structure Infections</strong>: Delafloxacin is indicated in adults for the treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by the following susceptible microorganisms: Staphylococcus aureus (including methicillin-resistant [MRSA] and methicillin-susceptible [MSSA] isolates), Staphylococcus haemolyticus, Staphylococcus lugdunensis, Streptococcus agalactiae, Streptococcus anginosus Group (including Streptococcus anginosus, Streptococcus intermedius, and Streptococcus constellatus), Streptococcus pyogenes, Enterococcus faecalis, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeruginosa.<br />\r\n<br />\r\n<strong>Community-Acquired Bacterial Pneumonia</strong>: Delafloxacin is indicated in adults for the treatment of community-acquired bacterial pneumonia (CABP) caused by the following susceptible microorganisms: Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible [MSSA] isolates only), Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Haemophilus influenzae, Haemophilus parainfluenzae, Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae.<br />\r\n<br />\r\n<strong>Usage</strong>: To reduce the development of drug-resistant bacteria and maintain the effectiveness of Delafloxacin and other antibacterial drugs, Delafloxacin 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>Delafloxacin inhibits the activity of bacterial DNA topoisomerase IV and DNA gyrase (topoisomerase II). This interferes with bacterial DNA replication by preventing the relaxation of positive supercoils introduced as part of the elongation process. The resultant strain inhibits further elongation. Delafloxacin exerts concentration-dependent bacteriocidal activity.<br />\r\n<br />\r\nThe antibacterial activity of delafloxacin appears to best correlate with the ratio of area under the concentration-time curve of free delafloxacin to minimal inhibitory concentration (<em>f</em>AUC/MIC) for Gram-positive organisms such as Staphylococcus aureus and Gram-negative organisms such as Escherichia coli based on animal models of infection.</p>', '<p><strong>Delafloxacin Tablets</strong>: Administer Delafloxacin at least 2 hours before or 6 hours after antacids containing magnesium, or aluminum, with sucralfate, with metal cations such as iron, or with multivitamin preparations containing zinc or iron, or with didanosine buffered tablets for oral suspension or the pediatric powder for oral solution. Delafloxacin Tablets can be taken with or without food. If patients miss a dose, they should take it as soon as possible anytime up to 8 hours prior to their next scheduled dose. If less than 8 hours remain before the next dose, wait until their next scheduled dose.<br />\r\n<br />\r\n<strong>Delafloxacin Injection</strong>: Do NOT administer Delafloxacin for Injection with any solution containing multivalent cations, e.g., calcium and magnesium, through the same intravenous line. Do NOT co-infuse Delafloxacin for Injection with other medications.&nbsp;<br />\r\n<br />\r\n<strong>Acute bacterial skin and skin structure infections</strong>: 300 mg of Delafloxacin for Injection every 12 hours over 60 minutes by intravenous infusion Or 300 mg of Delafloxacin for Injection every 12 hours over 60 minutes by intravenous infusion, then switch to a 450 mg Delafloxacin tablet orally every 12 hours at the discretion of the physician Or 450 mg Delafloxacin tablet orally every 12 hours for 5 to 14 days.<br />\r\n<br />\r\n<strong>Community-Acquired Bacterial Pneumonia</strong>: 300 mg of Delafloxacin for Injection every 12 hours over 60 minutes by intravenous infusion Or 300 mg of Delafloxacin for Injection every 12 hours over 60 minutes by intravenous infusion, then switch to a 450 mg Delafloxacin tablet orally every 12 hours at the discretion of the physician Or 450 mg Delafloxacin tablet orally every 12 hours for 5 to 10 days.</p>', '<p>Fluoroquinolones form chelates with alkaline earth and transition metal cations. Oral administration of Delafloxacin with antacids containing aluminum or magnesium, with sucralfate, with metal cations such as iron, or with multivitamins containing iron or zinc, or with formulations containing divalent and trivalent cations such as didanosine buffered tablets for oral suspension or the pediatric powder for oral solution, may substantially interfere with the absorption of Delafloxacin, resulting in systemic concentrations considerably lower than desired. Therefore, Delafloxacin should be taken at least 2 hours before or 6 hours after these agents. There are no data concerning an interaction of intravenous Delafloxacin with oral antacids, sucralfate, multivitamins, didanosine, or metal cations. However, Delafloxacin should not be co-administered with any solution containing multivalent cations, e.g., magnesium, through the same intravenous line</p>', '<p>Delafloxacin is contraindicated in patients with known hypersensitivity to delafloxacin or any of the fluoroquinolone class of antibacterial drugs, or any of the components of Delafloxacin.</p>', '<p>Most common adverse reactions (incidence &ge;2%) are nausea, diarrhea, headache, transaminase elevations, and vomiting.</p>', '<p><strong>Pregnancy</strong>: The limited available data with Delafloxacin use in pregnant women are insufficient to inform a drug-associated risk of major birth defects and miscarriages. When delafloxacin (as the N-methyl glucamine salt) was administered orally to rats during the period of organogenesis, no malformations or fetal death were observed at up to 7 times the estimated clinical exposure based on AUC. When rats were dosed intravenously in late pregnancy and through lactation, there were no adverse effects on offspring at exposures approximating the clinical intravenous (IV) exposure based on AUC.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no data available on the presence of delafloxacin in human milk, the effects on the breast-fed infant, or the effects on milk production. Delafloxacin is excreted in the breast milk of rats. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Delafloxacin and any potential adverse effects on the breast-fed child from Delafloxacin or from the underlying maternal condition.</p>', '<p>Hypersensitivity Reactions: May occur after first or subsequent doses of Delafloxacin. Discontinue Delafloxacin at the first sign of a skin rash or any other sign of hypersensitivity. Clostridium difficile-associated diarrhea: Evaluate if diarrhea occurs.</p>', NULL, '<p>4-Quinolone preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use:&nbsp;</strong>Use in patients under 18 years of age is not recommended. Safety and effectiveness in pediatric patients below the age of 18 years have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Geriatric patients are at increased risk for developing severe tendon disorders including tendon rupture when being treated with a fluoroquinolone. This risk is further increased in patients receiving concomitant corticosteroid therapy.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: Closely monitor serum creatinine levels in patients with severe renal impairment (eGFR 15 29 mL/min/1.73 m2 ) receiving intravenous delafloxacin. If serum creatinine level increases occur, consider changing to oral delafloxacin. Discontinue Delafloxacin if eGFR decreases to &lt;15 mL/min/1.73 m2.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment is necessary for Delafloxacin in patients with hepatic impairment</p>', '2022-02-19 05:45:07', '2022-04-25 20:41:59'),
(410, 410, '<p>Prevention of skeletal related events (pathological fracture, radiation to bone, spinal cord compression or bone surgery) in patients with bone metastases from solid tumours.</p>', '<p>Denosumab binds to Receptor activator of nuclear factor kappa-B ligand (RANKL), a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption. Denosumab prevents RANKL from activating its receptor, RANK, on the surface of osteoclasts and their precursors. Prevention of the RANKL/RANK interaction inhibits osteoclast formation, function, and survival, thereby decreasing bone resorption and increasing bone mass and strength in both cortical and trabecular bone.</p>', '<p>Subcutaneous Injection: 120 mg once every 4 wk into thigh, abdomen or upper arm. Ca &amp; vitamin D supplements should be given whilst undergoing treatment.</p>', '<p>In subjects with postmenopausal osteoporosis, Denosumab&nbsp;(60 mg subcutaneous injection) did not affect the pharmacokinetics of midazolam, which is metabolized by cytochrome P450 3A4 (CYP3A4), indicating that it should not affect the pharmacokinetics of drugs metabolized by this enzyme in this population</p>', '<p>Hypersensitivity to denosumab or to any of the excipients.</p>', '<p>Dyspnoea, Hypocalcaemia, hypophosphataemia, Osteonecrosis of the Jaw (ONJ).</p>', '<p>Pregnancy&nbsp;Category D. There is positive evidence of human fetal 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>Correct preexisting hypocalcaemia prior to therapy. Osteonecrosis of the jaw (ONJ). Perform oral &amp; dental exam with preventive dentistry prior to treatment. Avoid invasive dental procedures &amp; maintain good oral hygiene while on treatment. Atypical femoral fractures. Severe renal impairment (CrCl &lt;30 ml/min) or in patients receiving dialysis. Concomitant use with other denosumab-containing prep. Pregnancy &amp; lactation. Children.</p>', '<p>There is no experience with overdose in clinical studies. Denosumab has been administered in clinical studies using doses up to 180 mg every 4 weeks (cumulative doses up to 1,080 mg over 6 months), and no additional adverse reactions were observed.</p>', '<p>Inhibiting bone resorption</p>', '<p>Should be stored in cool and dry place.</p>', NULL, '2022-02-19 05:45:26', '2022-04-25 20:45:31'),
(411, 411, '<p>Dequalinium chloride, the active ingredient in Fluomizin, belongs to the family of anti-infective and antiseptic drugs. Dequalinium chloride is active against the bacteria which cause bacterial vaginosis. Fluomizin is used for the treatment of bacterial vaginosis. It is inserted into the vagina for treatment at the site of infection.</p>', NULL, '<ul>\r\n	<li><strong>Adult</strong>: The recommended dose is 1 vaginal tablet daily for 6 days.</li>\r\n	<li><strong>Children and adolescents</strong>: There is insufficient experience of the use of Fluomizin in children and adolescents under 18 years of age.</li>\r\n	<li><strong>Women above 55 years and elderly</strong>: There is insufficient experience of the use of Fluomizin in women above 55 years.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Use every evening before bed.</li>\r\n	<li>Wash your hands before opening the blister pack.</li>\r\n	<li>Lie down in a reclining position with the legs slightly bent. Insert one vaginal tablet deeply into the vagina.</li>\r\n	<li>You should stop the treatment during the heavy bleeding period of your menstruation and resume afterwards.</li>\r\n	<li>Do not stop treatment early, even if you no longer have any discomfort (e.g. itching, discharge, smell). A treatment of less than 6 days may result in your symptoms returning.</li>\r\n	<li>Dequalinium contains ingredients which do not dissolve completely, and the remains of the tablet are occasionally found in the underwear. This won&rsquo;t affect the effectiveness of the treatment. The tablet will not stain your underwear but for your own comfort you can use a sanitary towel or panty liner.</li>\r\n	<li>If your vagina is dry, the vaginal tablet might not dissolve and be discharged as an intact tablet. As a consequence, the treatment is not optimal. In this case the vaginal tablet can be moistened with a drop of water before insertion.</li>\r\n</ul>', NULL, '<p>Do not use Dequalinium Chloride:</p>\r\n\r\n<ul>\r\n	<li>if you are allergic to the active substance dequalinium chloride or any of the other ingredients of this medicine.</li>\r\n	<li>if you have ulcers on your vagina or cervix.</li>\r\n	<li>if you have not yet had your first period.</li>\r\n</ul>', '<p>Sometimes the symptoms of vaginal infections (such as itching, burning and discharge) can get worse at the beginning of the treatment, before they start to get better. You should continue with the treatment, but if the complaints persist see your doctor for advice as soon as possible. Common side effects are Vaginal discharge; vaginal itching or vaginal burning; Vaginal yeast infection (thrush).</p>', '<p>If you are pregnant, think you may be pregnant or plan to have a baby ask your doctor or pharmacist for advice before using Dequalinium. Tell your doctor or pharmacist if you are breast-feeding or if you plan to breast-feed. Based on previous experience and since Dequalinium acts locally, no harmful effects on pregnancy and/or the unborn and breast fed infant are expected. Dequalinium should only be used during pregnancy and during breast-feeding if medically needed. Ask your doctor or pharmacist for advice before taking any medicine.</p>', '<ul>\r\n	<li>Intravaginal use of soaps, spermicides and vaginal douches (vaginal washes) is not recommended during treatment with Fluomizin.</li>\r\n	<li>As with all vaginal infections, unprotected sexual intercourse during treatment with Fluomizin is not recommended.</li>\r\n	<li>Fluomizin does not reduce the effectiveness of latex condoms.</li>\r\n	<li>This product may reduce the effectiveness of non-latex condoms or diaphragms. Consequently, you should use alternative methods of contraception for at least 12 hours following the treatment.</li>\r\n	<li>Do not use Fluomizin within 12 hours before birth to minimize exposure of the newborn to dequalinium chloride. Please inform your doctor otherwise.</li>\r\n	<li>You should stop the treatment during the heavy bleeding period of your menstruation and resume afterwards.</li>\r\n	<li>You should talk to your doctor if the symptoms persist at the end of the treatment or in case the symptoms return.</li>\r\n</ul>', '<ul>\r\n	<li>Using a higher daily dose or increasing the recommended duration might increase the risk of vaginal ulcerations. If you have accidentally used too many vaginal tablets, tell your doctor.</li>\r\n	<li>Do not use a double dose to make up for a forgotten tablet.</li>\r\n	<li>A treatment of less than 6 days may result in a relapse. Therefore, do not stop treatment early, even when you have no discomfort (e.g. itching, discharge, smell) anymore.</li>\r\n</ul>', '<p>Other antibacterial preparation</p>', '<p>Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and the blister. The expiry date refers to the last day of that month.</p>', NULL, '2022-02-19 05:45:51', '2022-04-25 20:48:16'),
(412, 412, '<p>Desloratadine is indicated for the relief of symptoms associated with seasonal and perennial allergic rhinitis, such as sneezing, nasal discharge &amp; itching, congestion or stuffiness, as well as ocular itching, tearing and redness, itching of palate and coughing. Desloratadine is also indicated for the relief of symptoms associated with chronic idiopathic urticaria such as the relief of itching and the size &amp; number of hives.</p>', '<p>Desloratadine, the major active metabolite of Loratadine, is a non-sedating; long acting tricyclic histamine antagonist with selective H1-receptor histamine antagonist activity. Desloratadine also inhibits histamine release from human mast cell.</p>', '<p>Pediatric drops:</p>\r\n\r\n<ul>\r\n	<li><strong>Child 6-11 months of age</strong>: 2 ml drops once daily.</li>\r\n	<li><strong>Child 1-2 years of age</strong>: 2.5 ml drops once daily.</li>\r\n</ul>\r\n\r\n<p>Syrup:</p>\r\n\r\n<ul>\r\n	<li><strong>Child 6-11 months of age</strong>: 2 ml once daily.</li>\r\n	<li><strong>Child 1-5 years of age</strong>: 2.5 ml once daily.</li>\r\n	<li><strong>Child 6-11 years of age</strong>: 5 ml once daily.</li>\r\n	<li><strong>Adults &amp; &gt;12 years of age</strong>: 10 ml once daily.</li>\r\n</ul>\r\n\r\n<p>Tablet:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and children 12 years of age and over</strong>: 1 tablet daily</li>\r\n</ul>', '<p>No clinically relevant drug interactions have been reported.</p>', '<p>Desloratadine is contraindicated in patients having hypersensitivity to this medication or to any of its ingredients or Loratadine.</p>', '<p>Less common side effects may include headache, nausea, fatigue, dizziness, pharyngitis, dyspepsia and myalgia.</p>', '<p>Pregnancy Category C. The safe use of Desloratadine during pregnancy has not been established. Therefore, Desloratadine is not to be used during pregnancy unless clearly indicated. Desloratadine passes into breast milk, therefore a decision should be made whether to discontinue nursing or to discontinue Desloratadine taking into account the importance of the drug to the mother.</p>', '<p>In adult patients with liver or renal impairment: A starting dose of one 5 mg tablet every other day is recommended based on pharmacokinetic data. If the patient has medical or familial history of seizures.</p>', '<p>No clinically relevant adverse effects have been reported.</p>', '<p>Non-sedating antihistamines</p>', '<p>Store in a cool &amp; dry place, protected from light. Store below 30&deg;C. Keep all medicines out of the reach of children.</p>', NULL, '2022-02-19 05:46:10', '2022-04-25 20:51:16'),
(413, 413, '<p>Desmopressin Acetate sublingual tablet is indicated for the treatment of-</p>\r\n\r\n<ul>\r\n	<li>Primary Nocturnal Enuresis</li>\r\n	<li>Nocturia and</li>\r\n	<li>Central Diabetes Insipidus</li>\r\n</ul>', '<p>By mimicking the actions of endogenous ADH, desmopressin acts as a selective agonist of V2 receptors expressed in the renal collecting duct (CD) to increase water re-absorption and reduce urine production. Desmopressin has been shown to be more potent than ADH in increasing plasma levels of factor VIII activity in patients with hemophilia and von Willebrand&#39;s disease Type I. Desmopressin demonstrates markedly diminished pressor activity. Desmopressin administered intranasally has an antidiuretic effect about one-tenth that of an equivalent dose administered by injection.<br />\r\n<br />\r\nUpon binding of desmopressin to V2 receptors in the basolateral membrane of the cells of the distal tubule and collecting ducts of the nephron, adenylyl cyclase is stimulated. The resulting intracellular cascades in the collecting duct lead to increased rate of insertion of water channels, called aquaporins, into the lumenal membrane and enhanced the permeability of the membrane to water.</p>', '<p><strong>Treatment of diabetes insipidus</strong>: Dosage is individual in diabetes insipidus but the total daily sublingual dose normally lies in the range of 120 micrograms to 720 micrograms. A suitable starting dose in adults and children is 60 micrograms three times daily, administered sublingually. This dosage regimen should then be adjusted in accordance with the patient&#39;s response. For the majority of patients, the maintenance dose is 60 micrograms to 120 micrograms sublingually three times daily.<br />\r\n<br />\r\n<strong>Post-hypophysectomy polyuria/polydipsia</strong>: The dose of Desmopressin Acetate Melt should be controlled by measurement of urine osmolality.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Desmopressin Acetate Melt is for sublingual use.</p>', '<p>Substances which are known to induce SIADH e.g. tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine and carbamazepine, may cause an additive antidiuretic effect leading to an increased risk of water retention and/or hyponatraemia. NSAIDs may induce water retention and/or hyponatraemia. Concomitant treatment with loperamide may result in a 3-fold increase of desmopressin plasma concentrations, which may lead to an increased risk of water retention and/or hyponatraemia. Although not investigated, other drugs slowing intestinal transport might have the same effect. A standardised 27% fat meal significantly decreased the absorption (rate and extent) of a 0.4mg dose of oral desmopressin tablets. Although it did not significantly affect the pharmacodynamic effect (urine production and osmolality), there is the potential for this to occur at lower doses. If a diminution of effect is noted, then the effect of food should be considered before increasing the dose.</p>', '<p>Desmopressin Acetate Melt is contraindicated in cases of cardiac insufficiency and other conditions requiring treatment with diuretic agents. Before prescribing Desmopressin Acetate Melt, the diagnoses of psychogenic polydipsia and alcohol abuse should be excluded.</p>', '<p>Side-effects include headache, stomach pain and nausea. Isolated cases of allergic skin reactions and more severe general allergic reactions have been reported. Very rare cases of emotional disorders including aggression in children have been reported. Treatment with desmopressin without concomitant reduction of fluid intake may lead to water retention/hyponatraemia with accompanying symptoms of headache, nausea, vomiting, weight gain, decreased serum sodium and in serious cases, convulsions.</p>', '<p><strong>Pregnancy</strong>: Data on a limited number (n=53) of exposed pregnancies in women with diabetes insipidus indicate rare cases of malformations in children treated during pregnancy. To date, no other relevant epidemiological data are available. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/fetal development, parturition or postnatal development. Caution should be exercised when prescribing to pregnant women. Blood pressure monitoring is recommended due to the increased risk of pre-eclampsia.<br />\r\n<br />\r\n<strong>Lactation</strong>: Results from analyses of milk from nursing mothers receiving high dose desmopressin (300 micrograms intranasally) indicate that the amounts of desmopressin that may be transferred to the child are considerably less than the amounts required to influence diuresis.</p>', '<p>Care should be taken with patients who have reduced renal function and/or cardiovascular disease. In chronic renal disease the antidiuretic effect of Desmopressin Acetate Melt would be less than normal. Precautions to prevent fluid overload must be taken in:</p>\r\n\r\n<ul>\r\n	<li>conditions characterised by fluid and/or electrolyte imbalance.</li>\r\n	<li>patients at risk for increased intracranial pressure.</li>\r\n</ul>', '<p>An overdose of Desmopressin Acetate Melt leads to a prolonged duration of action with an increased risk of water retention and/or hyponatraemia. Although the treatment of hyponatraemia should be individualised, the following general recommendations can be given. Hyponatraemia is treated by discontinuing the desmopressin treatment, fluid restriction and symptomatic treatment if needed</p>', '<p>Synthetic analogue of ADH</p>', '<p>Store in the original package in order to protect from moisture and light.</p>', NULL, '2022-02-19 05:46:29', '2022-04-25 20:55:45'),
(414, 414, '<p>Desogestrel is used to provide contraceptive efficacy in women who want to prevent pregnancy. Desogestrel has proved to be highly efficacious as a contraceptive pill and is an alternative for women who have a weak tolerance levels for the estrogen hormones or who are lactating or breast feeding.</p>', NULL, '<p>One tablet at the same time each day, taken continuously without a break. Tablets should be taken within 3 hours of the same time each day.<br />\r\n<br />\r\n<strong>When and how to take the tablets</strong>: Each strip of Desogestrel contains 28 tablets. Arrows are printed on the front side of the strip, between the tablets. If you turn the strip over, next to each tablet is printed the day of the week each tablet should be taken. Take your tablet at about the same time each day. Swallow each tablet whole with water. Each time you start a new strip of Desogestrel; take a tablet in the top row. For example if you start on Wednesday, you should take the tablet from the top row marked that particular day. You should continue to take one tablet a day until the strip is empty, always follow the direction indicated by the arrows. In this way you can easily check whether you have taken your daily tablet. You may have some bleeding during the use of Desogestrel but you must continue to take your tablets as normal. When a strip is empty, you must start with a new pack of Desogestrel on the next day without interruption and without waiting for a bleed. You can stop taking Desogestrel whenever you want. From the day you stop, you are no longer protected against pregnancy.<br />\r\n<br />\r\n<strong>Starting first pack of Desogestrel</strong>: If you are not using hormonal contraception at present (or in the past month) wait for your period to begin. On the first day of your period take the first Desogestrel tablet. If you take your first tablet on days 2 to 5 of your period use an additional barrier method of contraception for the first 7 days of tablet taking.<br />\r\n<br />\r\n<strong>When change from a combined pill</strong>: Start Desogestrel on the day after the last active tablet of the combined pill; in this case additional contraceptive precautions are not necessary.<br />\r\n<br />\r\n<strong>When change from a mini-pill, injection, implant or hormonal IUD</strong>: Switch on any day from another mini pill. Start Desogestrel the day an implant or IUD is removed or the day your next injection would be due, additional contraceptive precau-tions are not necessary.<br />\r\n<br />\r\n<strong>If you have a baby or abortion</strong>: Start immediately after first trimester abortion, additional contraceptive precautions are not necessary. After delivery or second trimester abortion, start before periods return. If more then 21 days have elapsed, pregnancy must be ruled out and an additional barrier method of contraception should be used for the first 7 days.<br />\r\n<br />\r\nIf you forget to take one or more tablets</p>\r\n\r\n<ul>\r\n	<li><strong>If you are more than 12 hours late</strong>: Take a tablet as soon as you remember and take the next one at the usual time. This may mean taking two tablets in one day. This is not harmful. (If you have forgotten more than one tablet you don&#39;t need to take the earlier missed ones). You are not protected against pregnancy. Continue to take your tablets as usual but you must also use an extra method, such as a condom, for the next seven days. If you are more than 12 hours late taking your tablet and have had sex it is safe to use emergency contraception.</li>\r\n	<li><strong>If you are less than 12 hours late</strong>: Take the tablet as soon as you remember, and take the next tablet at the usual time. The contraceptive action of Desogestrel is maintained. If you missed one or more tablets in the first week of tablet intake and had intercourse in the week before missing the tablets, there is a possibility of becoming pregnant. The more consecutive tablets you have missed, the higher the risk that the contraceptive efficacy is decreased.</li>\r\n</ul>\r\n\r\n<p><strong>If you vomit or use medical charcoal</strong>: If you vomit or use medical charcoal within 3 - 4 hours after taking your Desogestrel tablet, the active ingredient may not have been completely absorbed. Follow the advice for missed tablets.</p>', '<p>Enzyme-inducing drugs may result in increased clearance and lead to breakthrough bleeding and contraceptive failure. This may be seen with hydantoins, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, rifabutin, felbamate, ritonavir, griseofulvin and products containing St John&#39;s Wort. Reduced absorption of etonogestrel may be seen with medical charcoal.</p>', '<p>Known or suspected pregnancy, active venous thromboembolic disorder, presence or history of severe hepatic disease with current abnormal liver function tests, progestogen dependent tumors, undiagnosed vaginal bleeding, hypersensitivity to ingredients.</p>', '<p>Common: irregular bleeding, amenorrhoea, headache, weight gain, breast pain, nausea, acne, mood changes, decreased libido. Less common: Vaginitis, dysmenorrhoea, ovarian cysts, vomiting, alopecia, fatigue, difficulty wearing contact lenses. Rare: Rash, urticaria, erythema nodosum.</p>', '<p>Not recommended for use during pregnancy. Desogestrel&nbsp;does not affect the production or quality of breast milk. Small amounts of the metabolite etonogestrel are excreted with the milk. Long term follow-up data are not available, however 7 month data do not indicate a risk to the nursing infant</p>', '<p>Epidemiological studies have associated the use of combined OCs with an increased incidence of venous thromboembolism (VTE, deep venous thrombosis and pulmonary embolism). It is unclear whether desogestrel used alone carries the same risk. Discontinue in the event of a thrombosis. Consider stopping prior to long term immobilization due to surgery or illness. Benefit/risk assessment should be made in women with liver cancer. Caution patients with a history of thromboembolic disorders. Patients with diabetes should be carefully monitored. Effects on bone density are unknown.</p>', '<p>No serious deleterious effects have been reported from an overdose. Other symptoms may include nausea, vomiting and in young girls, slight vaginal bleeding. Treatment should be symptomatic.</p>', '<p>Oral Contraceptive preparations</p>', '<p>Store at room temperature (below 30&deg;C). Do not use it after the expiry date stated on the package.</p>', NULL, '2022-02-19 05:46:48', '2022-04-25 20:58:59'),
(415, 415, '<p>Desonide gel is indicated for the treatment of mild to moderate atopic dermatitis in patients 3 months of age and older.</p>', '<p>Desonide gel contains Desonide which is a synthetic nonfluorinated corticosteroid for topical dermatologic use. Topical corticosteroids have anti-inflammatory, antipruritic and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. Corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids.</p>', '<p>Desonide gel is for external use only. Gel should be applied as a thin layer to the affected areas two times daily and rubbed in gently. Therapy should be discontinued when control is achieved. If no improvement is seen within 4 weeks, treatment should be discontinued and Desonide gel should not be used with occlusive dressings.<br />\r\n<br />\r\nPediatric use: The safety&nbsp;and effectiveness of Desonide gel in pediatric patients less than 3 months of age have not been evaluated, and therefore its use in this age group is not recommended.</p>', NULL, '<p>Desonide gel is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.</p>', '<p>The most common local side effects are burning, rash and pruritus at the application site. The following additional local side effects have been reported infrequently with topical corticosteroids. They may occur more frequently with the use of occlusive dressings, especially with higher potency corticosteroids: folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, secondary infection, skin atrophy, striae, and miliaria.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Therefore, Desonide gel should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk. Caution should be exercised when Desonide gel is administered to a nursing woman.</p>', '<p>Desonide gel is to be used as directed by the physician. It is for external use only and avoid contact with the eyes. It should not be used on the underarm or groin areas of pediatric patients. If irritation develops, Desonide gel should be discontinued and appropriate therapy instituted. Systemic absorption of topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency after withdrawal of treatment. If a favorable response does not occur promptly, use of Desonide gel should be discontinued until the infection has been adequately controlled.</p>', '<p>Topically applied Desonide gel can be absorbed in sufficient amounts to produce systemic effects</p>', '<p>Other Topical corticosteroids</p>', '<p>Desonide gel is indicated for the treatment of mild to moderate atopic dermatitis in patients 3 months of age and older.</p>', NULL, '2022-02-19 05:47:02', '2022-04-26 16:53:41'),
(416, 416, '<p>Desoximetasone Emollient Cream indicated for the relief of the&nbsp;inflammatory and pruritic manifestations of corticosteroid-inflammatory and pruritic manifestations of corticosteroid</p>', '<p>The precise mechanism of the antiinflammatory activity of topical steroids in the treatment of steroid-responsive dermatoses, in general, is uncertain. However, corticosteroids are thought to act by the induction of phospholipase A2&nbsp;inhibitory proteins, collectively called lipocortins. This is achieved first by the drug binding to the glucocorticoid receptors which then translocates into the nucleus and binds to DNA causing various activations and repressions of genes. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.</p>', '<p>Apply a thin film of Desoximetasone Emollient Cream to the affected skin areas twice daily. Rub in&nbsp;gently</p>', NULL, '<p>Topical corticosteroids are contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.</p>', NULL, '<p>Pregnancy Category C</p>', NULL, '<p>Topically applied corticostero systemic effects</p>', '<p>Other Topical corticosteroids</p>', NULL, NULL, '2022-02-19 05:47:23', '2022-04-26 16:55:40'),
(417, 417, '<p>Desvenlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is indicated for the treatment of major depressive disorder (MDD). The efficacy of Desvenlafaxine has been established in four short-term (8-week, placebo-controlled studies) and two maintenance studies in adult outpatients who met DSM-IV criteria for major depressive disorder.</p>', '<p>Desvenlafaxine is the principal active metabolite of venlafaxine. The exact mechanism is unknown, but is thought to be related to the potentiation of serotonin and norepinephrine in the CNS, through inhibition of their reuptake.</p>', '<p>The recommended dose for Desvenlafaxine&nbsp;is 50 mg once daily, with or without food. The 50 mg dose is both a starting dose and the therapeutic dose. Desvenlafaxine should be taken at approximately the same time each day. Tablets must be swallowed whole with fluid and not divided, crushed, chewed, or dissolved.<br />\r\n<br />\r\nIn clinical studies, doses of 10 mg to 400 mg per day were studied. In clinical studies, doses of 50 mg to 400 mg per day were shown to be effective, although no additional benefit was demonstrated at doses greater than 50 mg per day and adverse reactions and discontinuations were more frequent at higher doses.<br />\r\n<br />\r\nThe 25 mg per day dose is intended for a gradual reduction in dose when discontinuing treatment. When discontinuing therapy, gradual dose reduction is recommended whenever possible to minimize discontinuation symptoms</p>', '<p>Increased risk of bleeding with aspirin or other NSAIDs, warfarin and other anticoagulants.</p>', '<p>Concurrent use or within 14 days of discontinuing MAOIs (e.g. linezolid, IV methylene blue). Initiation of MAOI at least 7 days after discontinuing desvenlafaxine.</p>', '<p>Suicidal thinking/ behaviour, HTN, mydriasis, seizure, hyponatraemia, interstitial lung disease and eosinophilic pneumonia; nausea, dizziness, insomnia, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, sexual function disorders in males (e.g. anorgasmia, decreased libido, abnormal orgasm, delayed ejaculation, erectile dysfunction, ejaculation disorder, ejaculation failure, sexual dysfunction).</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>Patient with pre-existing HTN or other conditions that may be compromised by increased BP, raised intraocular pressure, personal or family history of mania or hypomania; CV, cerebrovascular or lipid metabolism disorders; seizure disorder. Avoid abrupt withdrawal. Renal and moderate to severe hepatic impairment. Pregnancy and lactation.</p>', NULL, '<p>Serotonin-norepinephrine reuptake inhibitor (SNRI)</p>', '<p>Store between 20-25&deg; C.</p>', '<p><strong>Hepatic impairment (Moderate to severe)</strong>: 50 mg daily. Max: 100 mg once daily.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl &lt;30 or ESRD</strong>:&nbsp;25 mg daily or 50 mg every other day. Supplemental doses should not be given after dialysis.</li>\r\n	<li><strong>CrCl (30-50)</strong>: Max 50 mg once daily.</li>\r\n</ul>', '2022-02-19 05:47:45', '2022-04-26 16:58:19'),
(418, 418, '<p><strong>Eye</strong>: Dexamethasone Phosphate is indicated for treatment of steroid responsive inflammatory conditions of the conjunctiva, cornea and anterior segment of the eye such as: anterior uveitis, iritis, cyclitis, allergic and vernal conjunctivitis, herpes zoster keratitis, superficial punctate keratitis and non-specific superficial keratitis.<br />\r\n<br />\r\nAlso indicated for the treatment of corneal injury from chemical, radiation or thermal burns or following penetration by foreign bodies. Indicated for post operative use to reduce inflammatory reactions and suppress graft reaction.<br />\r\n<br />\r\n<strong>Ear</strong>: Indicated in the steroid responsive inflammatory conditions of the external auditory meatus, such as allergic otitis externa, selected purulent and non-purulent infective otitis externa.</p>', '<p>Dexamethasone is a synthetic glucocorticoid which decreases inflammation by inhibiting the migration of leukocytes and reversal of increased capillary permeability. It suppresses normal immune response.</p>', '<p><strong>Eye:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>As 0.1% drop</strong>: The frequency of instillation of drops and the duration of treatment will vary depending upon the severity of the underlying condition and the response to treatment. Severe inflammations require one to two drops instilled into the eye every thirty to sixty minutes until a satisfactory response occurs. Subconjunctival or systemic steroid therapy should be considered if there is no response. When a favourable response has been observed reduce the dosage towards one drop every four hours.</li>\r\n	<li><strong>As 0.05% ointment</strong>: Apply 0.5-1 inch ribbon of ointment into the conjunctival sac(s) up to 4 times daily. Reduce to once daily dosing once conditon has improved.</li>\r\n</ul>\r\n\r\n<p><strong>Ear</strong>: Instill two or three drops to the ear at two or three hour interval. The frequency of dosage and duration of the treatment may vary with the type of lesion and severity.</p>', '<p>None relevant to topical use.</p>', '<p>Epithelial herpes simplex keratitis (dendritic keratitis), acute infections stages of vaccinia, varicella, and many other viral diseases of the cornea and conjunctiva, Mycobacterial infection of the eye, Fungal diseases of ocular or auricular structures, perforation of a drum membrane. Hypersensitivity to any ingredient of this product.</p>', '<p>Glaucoma with optic nerve damage, visual acuity and field defects, posterior subcapsular cataract formation, secondary ocular infection from pathogens including herpes simplex, perforation of the globe. Rarely, stinging and burning may occur.</p>', '<p>Pregnancy&nbsp;category C. There is no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nLactation: Caution should be exercised when Dexamethasone ophthalmic solution is administered to a nursing woman.</p>', '<p>The possibility of persistent fungal infections of the cornea should be considered after prolonged corticosteroid dosing. There have been reports of bacterial keratitis associated with the use of multiple dose containers of topical ophthalmic products. These containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface.</p>', '<p>Long-term intensive topical use may lead to systemic effects. Oral ingestion of the contents of the bottle (up to 10 ml) is unlikely to lead to any serious adverse effects.</p>', NULL, '<p>Store below 30&deg; C in a cool and dry place protected from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. Do not use after 30 days of first opening.</p>', '<p><strong>Pediatric Use:</strong>&nbsp;Safety and efficacy in pediatric patients below the age of 18 have not been established.</p>', '2022-02-19 05:48:07', '2022-04-26 17:01:46');
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
(419, 419, '<p><strong>Eye</strong>: This combination is indicated in acute purulent conjunctivitis, fresh inflammation of the superficial and deeper corneal layers and corneal ulceration. It is also used in keratitis disciformis and the more deep-seated forms of post-herpetic keratitis, allergic conjunctivitis, allergic blepharitis, acute and chronic iritis, chronic anterior uveitis and corneal injury from chemical radiation or thermal burns, or penetration of foreign bodies. The combination is used in steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or arisk of bacterial ocular infection exists. The combination can also be used for post-operative inflammation and any other ocular inflammation associated with infection.<br />\r\n<br />\r\n<strong>Ear</strong>: This combination is indicated in otitis externa, otitis media and chronic suppurative otitis media.</p>', '<p>Dexamethasone is a glucocorticoid. It has an anti-inflammatory and anti-allergic action. It is used topically in the treatment of inflammatory conditions of the anterior segment of the eye. Dexamethasone is absorbed rapidly after oral administration with a half-life of about 190 minutes. Sufficient absorption may occur after topical application to the skin and eye to produce systemic effects.<br />\r\n<br />\r\nChloramphenicol is a broad spectrum bacteriostatic antibiotic active against a wide variety of gram-negative and gram-positive organisms. Chloramphenicol exerts its antibacterial effect by binding to bacterial ribosomes and inhibiting bacterial protein synthesis at an early stage</p>', '<p><strong>Eye</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Bacterial Conjunctivitis</strong>: The recommended dosage regimen for the treatment of bacterial conjunctivitis is 1 to 2 drops instilled into the conjunctival sac (s) every 2 hours for 2 days and 1 or 2 drops every 4 hours for the next 5(five days) while awake.</li>\r\n	<li><strong>Corneal Ulcers</strong>: The recommended dosage regimen for the treatment of comeal ulcer is 2 drops in the affected eye (s) every 15 minutes for the first 6 hours then 2 drops into the affected eye(s) every 30 minutes for the remainder of first day. On the second day, instill 2 drops in the affected eye (s) hourly. On the 3 to 14 days, place 2 drops in the affected eye (s) every 4 hours. Treatment may be continued after 14 days if corneal re-epithelialization has not occurred.</li>\r\n</ul>\r\n\r\n<p><strong>Ear</strong>: For all infections, 2 to 3 drops every 2 to 3 hours initially. Frequency should be decreased gradually as warranted by improvement in clinical signs. Care should be taken not to discontinue therapy prematurely.</p>', '<p>If Chloramphenicol is absorbed from eye when taking anticoagulants e.g. warfarin, there may be an increase in the effect of this medicine. Action of Chloramphenicol will be inhibited if given simultaneously with Phenobarbital. The therapeutic efficacy of Dexamethasone may be reduced with the concomitant administration of phenytoin, phenobarbitone, ephedrine and rifampicin</p>', '<p>The combination is contraindicated in epithelial herpes simplex cornealis, fungal, viral, tuberculous and other infections of the eye and in glaucoma. Myelosuppression during previous exposure to Chloramphenicol. Hypersensitivity to Chloramphenicol &amp; Dexamethasone Phosphate or to any other ingredients of the preparations.</p>', '<p>Adverse reactions seen with Chloramphenicol are transient ocular burning or discomfort and other reported reactions include stinging, redness, itching, conjunctivitis, foreign body sensation, photophobia, blurred vision, dryness and eye pain. Allergic sensitization may occur with the local use of Chloramphenicol. Elevation of intraocular pressure with possible development of glaucoma, infrequent optic nerve damage and posterior subcapsular cataract formation.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution should be exercised when Chloramphenicol and Dexamethasone ophthalmic solution is administered to a nursing mother.</p>', '<p>The possibility of persistent fungal infections of the cornea should be considered after prolonged corticosteroid dosing. Prolonged use of steroids containing products may result in posterior subcapsular cataract formation and glaucoma with optic nerve damage. Intraocular pressure monitoring is needed. Prolonged use of antibiotics may result in the overgrowth of non-susceptible organisms, including fungi. If new infections appear during treatment, the drug should be discontinued and alternative therapy should be instituted.</p>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations</p>', '<p>Keep in a cool and dry place, away from light &amp; keep out of the reach of children. Do not use after 30 days of first opening.</p>', NULL, '2022-02-19 05:48:31', '2022-04-26 17:04:19'),
(420, 420, '<p>This is indicated in ocular inflammation when concurrent use of an antimicrobial is judged necessary.</p>', '<p><strong>Dexamethasone (Corticosteroids)</strong>&nbsp;suppress inflammatory response to a variety of agents and they probably delay or slow healing. Since corticosteroid may inhibit the body&#39;s defense mechanism against infection, a concomitant antimicrobial drug may be used when this inhibition is considered to be clinically significant in a particular case. The anti-infective component in the combination is included to provide action against specific organisms susceptible to it.<br />\r\n<br />\r\n<strong>Neomycin Sulphate</strong>&nbsp;is considered active against the following microorganisms: Staphylococcus aureus, Corynebacterium diphtheriae, Streptococcus Viridans, Escherichia coli,Klebsiella pneumoniae, Proteus vulgaris, Aerobacter aerogenes, and Haemophilus influenzae.<br />\r\n<br />\r\n<strong>Polymyxin B Sulphate</strong>&nbsp;is considered active against the following microorganism: Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Klebsiella pneumoniae and Koch-Weeks bacillus.<br />\r\n<br />\r\nWhen a decision to administer both a corticosteroid and an antimicrobial is made, the administration of such drugs in combination has the advantage of greater patient compliance and convenience, with the added assurance that the appropriate dosage of both drugs is administered, plus assured compatibility of ingredients when both types of drugs are in the same formulation and, particularly, that the correct volume of drug is delivered and retained.</p>', '<p><strong>Eye drops:</strong>&nbsp;One drop topically into the conjunctival sac(s). In severe disease, drops may be used hourly, being tapered to discontinuation as the inflammation subsides. In mild disease, drops may be used up to four to six times daily.<br />\r\n<br />\r\n<strong>Eye ointment:</strong>&nbsp;It should be applied thinly and evenly to the conjunctival sac(s) at night (if eye drops used during the day) or 3-4 times daily (if eye ointment used alone).</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Epithelial herpes simplex keratitis (dentritic keratitis), vaccinia, varicella, and many other viral diseases of the cornea and conjunctiva. Hypersensitivity to a component of the medication (Hypersensitivity to the antibiotic component occurs at a higher rate than other component). The use of these combinations is always contraindicated after uncomplicated removal of a corneal foreign body.</p>', '<p>Adverse reactions have occurred with steroid/anti-infective combination drugs which can be attributed to the steroid component, the anti-infective component, or the combination. Exact incidence figures are not available since no denominator of treated patients is available. Reactions occurring most often from the presence of the anti-infective ingredient are allergic sensitizations. The reactions due to the steroid component in decreasing order of frequency are: elevation of intraocular pressure (IOP) with possible development of glaucoma, and infrequent optic nerve damage, posterior sub-capsular cataract formation and delayed wound healing.</p>', '<p><strong>Pregnancy</strong>&nbsp;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<br />\r\n<br />\r\n<strong>Lactation</strong>: Unknown if excreted in breast milk; minimal systemic absorption with ophthalmic administration</p>', '<p>Prolonged use may cause glaucoma, damage to the optic nerve, defects in visual acuity and fields of vision, posterior subcapsular cataract formation and increased risk of secondary ocular infections. Increased risk of perforations in diseases which can cause thinning of the cornea or sclera. Corticosteroids may mask infection or worsen existing infections in acute purulent conditions of the eye. Regular monitoring of the intraocular pressure is recommended if product is used for 10 days. Long term application of topical corticosteroids may also increase the risk of ocular fungal infections. Neomycin sulfate may cause cutaneous sensitisation. Pregnancy and lactation.</p>', NULL, '<p>Ophthalmic steroid - antibiotic combined preparations</p>', NULL, NULL, '2022-02-19 05:48:50', '2022-04-26 17:06:47'),
(421, 421, '<p>This sterile Eye Suspension is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial ocular infection exists.</p>', '<p>Like other amino-glycosides, the bactericidal activity of Tobramycin is accomplished by specific inhibition of normal protein synthesis in susceptible bacteria, but at the present time, very little is known about this action. It is thought that inhibition of protein synthesis is due to an action on ribosome that causes bacterial misreading of messenger RNA. The action of Dexamethasone is to inhibit the phospholipase A2, the first step in prostaglandin synthesis. Also Dexamethasone inhibits the chemo-tactic infiltration of neutrophils into the site of inflammation. The result is that its anti-inflammatory activity is 25 times greater and its overall therapeutic effectiveness 8-10 times greater than that of hydrocortisone.</p>', '<p>Insert 1 drop into the conjunctival sac 3-5 times per day. During the initial 24 to 48 hours, the dosage may be increased to 1 drop every 2 hours.</p>', '<p>No specific interaction studies were performed with this combination eye drops. In case of concomitant therapy with other topical ophthalmic medicines, an interval of 10 minutes should be allowed between successive applications.</p>', '<p>Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella and other viral disease of the cornea and conjunctiva. Mycobacterial infections of the eye caused by, but not limited to, acid-fast bacilli such as Mycobacterium tuberculosis, Mycobacterium leprae, or Mycobacterium avium. Fungal diseases of ocular structures. Untreated purulent infection of the eye. Hypersensitivity to any component of the medication.</p>', '<p>The most frequent side effects to topical ocular Tobramycin are localized ocular toxicity and hypersensitivity, including lid itching and swelling and conjuntival erythema. The reactions due to the steroid component are elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsule cataract formation.</p>', '<p>Safety for use during pregnancy and lactation in humans has not been established</p>', '<p>Shake the bottle well before use. To prevent contamination do not touch the tip of the bottle to affected eye, eyelid or any surface of of the affected eye. Keep the bottle tightly closed after use.</p>', '<p>Overdose of this eye drops may be flushed from the eye(s) with lukewarm tap water.</p>', '<p>Ophthalmic steroid - antibiotic combined preparations</p>', '<p>Store at room temperature. Close the bottle immediately after use. Do not use for longer than one month after opening the bottle.</p>', '<p><strong>Use in paediatric:</strong>&nbsp;Safety and effectiveness in paediatric patients below 2 years have not been established.</p>', '2022-02-19 05:49:17', '2022-04-26 17:09:15'),
(422, 422, '<p>Dexibuprofen is indicated in-</p>\r\n\r\n<ul>\r\n	<li>The relief of sign and symptoms of osteoarthritis.</li>\r\n	<li>Indicated in rheumatoidal disorders such as osseous rheumatism, ankylosing spondilitis, juvenile arthritis, muscular rheumatism, degenerative joint diseases</li>\r\n	<li>Acute symptomatic treatment of painful menstruation (primary dysmenorrhoea)</li>\r\n	<li>Common headache and fever</li>\r\n	<li>Symptomatic treatment of mild to moderate pain, such as muscle pain, headache and dental pain</li>\r\n	<li>As an adjuvant with common cold and influenza associated with headache.</li>\r\n</ul>', '<p>Dexibuprofen (S (+)-ibuprofen) is considered as the pharmacologically active enantiomer of racemic ibuprofen. Like racemic ibuprofen, Dexibuprofen is a non-steroidal anti-inflammatory drug with analgesic action. Like ibuprofen, Dexibuprofen acts by inhibiting prostaglandin synthesis.<br />\r\n<br />\r\nPharmacokinetics: Dexibuprofen is absorbed primarily from the small intestine. After metabolic transformation in the liver (hydroxylation, carboxylation) the pharmacologically inactive metabolites are completely excreted, mainly by the kidneys (90%), but also in the bile. The elimination half-life is 1.8-3.5 hours; the plasma protein binding is about 99%. Maximum plasma levels are reached about 2 hours after oral administration. The administration of dexibuprofen with a meal delays the time to reach maximum concentrations (from 2.1 hours after fasting conditions to 2.8 hours after non-fasting conditions) and decreases the maximum plasma concentrations (from 20.6 to 18.1 mcg/ml, which is of no clinical relevance), but has no effect on the extent of absorption.</p>', '<p>The dosage must be adjusted to the seriousness of the syndrome and the complaints of the patient. During chronic pain, the dosage must be adapted to the lowest effective dose.<br />\r\n<br />\r\n<strong>The recommended dosage</strong>: 600-900 mg Dexibuprofen per day, at 2-3 divided doses. The dosage can be raised temporarily up to 1200 mg Dexibuprofen per day in patients with acute disorders or exacerbations. The maximum daily dose is 1200 mg.<br />\r\n<br />\r\n<strong>At dysmenorrhea:</strong>&nbsp;A dosage of 600 up to 900 mg Dexibuprofen per day, at a divided dose.</p>', '<p>The reported drug interactions of Dexibuprofen are similar to that of racemic mixture of ibuprofen. Drug interactions is noticed with simultaneous use of anticoagulant, hydantoine and sulfonamide, ticlopidine, lithium, other NSAID&#39;s, ACE inhibitors, beta blockers, cyclosporine, tacrolimus, corticosteroids, digoxin, methotrexate, pentoxyfiline, phenytoine, probenecid, sulfinpyrazon, sulfonylurea, thiazide and thiazide type diuretics, and zidovudine.</p>', '<p>Dexibuprofen is contraindicated in patients with previous history of hypersensitivity to Dexibuprofen, or another NSAID, or any other component of the product. Patients, who experience attack of asthma, arouse bronchospasm, acute rhinitis, urticaria or edema after use of similar drugs (e.g. aspirin or other NSAID&#39;s). It is also contraindicated in patients with active or suspected hemorrhage, Crohn&#39;s disease or ulcerative colitis, patients with serious heart diseases, kidney function impairment (GFR &lt;30ml/min), and liver function impairment.</p>', '<p>Clinical experience has shown that adverse effects of Dexibuprofen are similar to those of racemic ibuprofen. Common side-effects are dyspepsia, diarrhea, fatigue, and headache, nausea, vomiting, abdominal pain, hypersensitivity reactions - bleeding, ulcer.</p>', '<p><strong>Pregnancy</strong>: Although no teratogennic impact has been observed in the animal-experimental research with dexibuprofen or ibuprofen, the use should be avoided during the pregnancy. However, animal reproduction studies are not always predictive of human response. Because of the known effects of nonsteroidal anti-inflammatory drugs on the fetal cardiovascular system (closure of ductus arteriosus), use during late pregnancy should be avoided.<br />\r\n<br />\r\n<strong>Lactation</strong>: Studies at people have shown that racimic ibuprofen proceed in small to negligible degree in mother milk. So, Dexibuprofen should be used with cautions in nursing mothers.</p>', '<p>Dexibuprofen should be used with particular caution in patients with bronchial asthma or other chronic diseases of the pulmonary tract as well as in persons prone to allergy. The drug should be used in patients with hepatic, renal or cardiac insufficiency and with hypertension not responding to any treatment. Consultation with a doctor is recommended for patients with systemic lupus or with other autoimmunological disease before beginning therapy using the drug. Dexibuprofen should be used with extreme cautions in active and suspected hemorrhagic conditions such as gastro-duodenal ulcers, ulcerative colitis, Crohn&#39;s disease, alcoholism. Allergic reactions to the drug may appear even for the first-time user and in such case, it should immediately be stopped.</p>', '<p>Dexibuprofen has low acute toxicities. Symptoms of toxicity occur at doses between 80 and 100 mg/kg body weight. Mild symptoms are abdominal pain, nausea, vomiting, lethargy, headache, tinnitus and ataxia. Moderate to serious symptoms, such as flatulence, hypotension, hypothermia, metabolic acidosis, reduced kidney function, coma, and apnoea. The treatment must be symptomatic: there is no specific antidote. In case of large quantities of Dexibuprofen, activated charcoal should be administered. Vomiting can be induced only when life-threatening quantities of the substance ingested and the procedure can be carried out within 60 minutes after ingestion. Dialysis and hemodialysis are of little value as Dexibuprofen binds strongly to plasma protein.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children</p>', '<p><strong>Hepatic impairment</strong>: Patients with mild to moderate liver function impairments must start with low amounts, and must closely be monitored. Dexibuprofen should not be used in patients with serious liver function impairments.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: The start amount must be reduced at patients with mild to moderate kidney function impairments. Dexibuprofen cannot be used patients with serious kidney function impairments.<br />\r\n<br />\r\n<strong>Children Dose</strong>: Although Dexibuprofen is not licensed for use in children under 18 years of age in the UK, some countries permit such use. For example, in Switzerland, Dexibuprofen has been given to children aged 6 years and over at a dose of 10 to 15 mg/kg daily in 2-4 divided doses.<br />\r\n<br />\r\n<strong>For elderly people</strong>: Lowest effective dose is recommended. The dosage can be raised to adult dosage if well tolerated.</p>', '2022-02-19 05:49:34', '2022-04-26 17:12:14'),
(423, 423, '<p>Symptomatic treatment of pain and inflammation of mild or moderate intensity, such as musculo-skeletal pain, menstrual pain, &amp; dental pain</p>', '<p>Dexketoprofen is the S(+)-enantiomer of Ketoprofen and is responsible for the analgesic and anti-inflammatory activity of Ketoprofen. The inactive R(-)-enantiomer does not contribute to the therapeutic properties of Ketoprofen but adds to the metabolic load. Dexketoprofen has been formulated as a trometamol salt. Its high solubility in water means a rapid absorption through the gut wall which results in a more rapid onset of action than Ketoprofen. Peak plasma concentrations are attained more quickly than other widely used analgesics with an onset of action of 30 minutes. Dexketoprofen trometamol, given as a tablet, is rapidly absorbed, with a time to maximum plasma concentration (tmax) of between 0.25 and 0.75 hours, whereas the tmax&nbsp;for the S-enantiomer after the racemic drug, administered as tablets or capsules prepared with the free acid, is between 0.5 and 3 hours. Peak plasma concentrations of 1.4 and 3.1 mg/L are reached after administration of Dexketoprofen trometamol 12.5 and 25 mg, respectively. From 70 to 80% of the administered dose is recovered in the urine during the first 12 hours, mainly as the acyl-glucuronoconjugated parent drug. No R(-)-Ketoprofen is found in the urine after administration of Dexketoprofen [S(+)-Ketoprofen], confirming the absence of bioinversion of the S(+)-enantiomer in humans. The anti-inflammatory potency of Dexketoprofen was always equivalent to that demonstrated by twice the dose of Ketoprofen.</p>', '<p>The dose of Dexketoprofen 25 mg tablets depends on the type, severity, and duration of pain. The recommended dose is generally 1 tablet every 8 hours, with no more than 3 tablets daily. The elderly and patients with renal or hepatic impairment should start treatment with a total daily dose of no more than 2 tablets. Normally it is recommended to take the tablets with food. In the case of acute pain, it is recommended that tablets be taken at least 30 minutes before meals. Dexketoprofen is not recommended for children.</p>', '<p>Any of the following drugs cannot be used at the same time while taking Dexketoprofen. Other non-steroidal anti-inflammatory drugs, anticoagulant medicines; lithium; methotrexate; hydantoins (a type of medicine used for epilepsy) or some antibiotics of sulphonamide type (e.g. sulfamethoxazole); medications used to treat high blood pressure (ACE inhibitors, diuretics and beta-blockers); pentoxifylline; zidovudine; cyclosporine or tacrolimus; some oral medicines for diabetes (sulphonylureas); thrombolytic medicines; probenecid; cardiac glycosides; mifepristone; and quinolone antibiotics.</p>', '<p>Dexketoprofen tablets are not recommended to use in patients who are allergic to this product or aspirin or other non-steroidal anti-inflammatory medicines; who have suffered attacks of asthma, bronchospasm, acute rhinitis, nasal polyps, urticaria, angioedema (swollen face, eyes, lips, or tongue, or difficulty in breathing) after taking aspirin or other non-steroidal anti-inflammatory medicines; who have or previously suffered from a peptic ulcer or chronic gastro-intestinal disorders; who had previously gastro-intestinal haemorrhage (bleeding); who have suffered bronchial asthma; who have severe heart failure, moderate to severe renal dysfunction or severely impaired hepatic function; who have a bleeding disorder, a blood clotting disorder or are taking an anticoagulant; and who are pregnant or breast-feeding.</p>', '<p>As with all medicines, Dexketoprofen 25 mg tablets may cause some unwanted effects in some patients. These are described below and are characteristic of non-steroidal antiinflammatory drugs:</p>\r\n\r\n<ul>\r\n	<li>Common (1-10%): nausea, vomiting, diarrhoea, stomach pain or heartburn.</li>\r\n	<li>Uncommon (0.1-1%): sleep disorders, nervousness, headache, dizziness, vertigo, palpitations, constipation, dry mouth, flatulence, skin rash, fatigue, hot flushes, shivering, general malaise.</li>\r\n	<li>Rare (0.01 0.1%): stomach ulceration, gastric haemorrhage or perforation; pins and needles, high blood pressure, water retention, slowed breathing rate, hepatic enzymes increased, increased sweating.</li>\r\n	<li>Very rare/isolated cases (&lt;0.01%): blurred vision, ringing in the ear, low blood pressure, haematological reactions, hepatic or renal damage, dermatological and photosensitivity reactions, bronchospasm or anaphylaxis.</li>\r\n	<li>In patients with systemic lupus erythematosus or mixed connective tissue disease, antiinflammatory medicines may rarely cause isolated cases of fever, headache and rigidity of the nape (back of the neck).</li>\r\n</ul>', '<p>The use of Dexketoprofen tablets during pregnancy or breast-feeding is not recommended.</p>', '<p>Precaution should be exercised during using Dexketoprofen tablets in patient who are allergic to any other NSAIDs; who have kidney disease, liver disease, heart disease or fluid retention conditions; and who have blood disorder, systemic lupus erythematosus or mixed connective tissue disease.</p>', NULL, '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Store at a cool &amp; dry place protected from light and moisture. Keep out of reach of children.</p>', '<p>Should not be given to children.</p>', '2022-02-19 05:49:53', '2022-04-26 17:15:13'),
(424, 424, '<p><strong>Healing of Erosive Esophagitis</strong>: Dexlansoprazole is indicated for the healing of all grades of erosive esophagitis (EE) for up to 8 weeks.<br />\r\n<br />\r\n<strong>Maintenance of Healed Erosive Esophagitis</strong>: Dexlansoprazole is indicated to maintain healing of EE and relief of heartburn for up to 6 months.<br />\r\n<br />\r\n<strong>Symptomatic Non-Erosive Gastroesophageal Reflux Disease</strong>: Dexlansoprazole is indicated for the treatment of heartburn associated with symptomatic non-erosive Gastroesophageal Reflux Disease (GERD) for 4 weeks.</p>', '<p>Dexlansoprazole delayed-release capsule is a Proton Pump Inhibitor (PPI) which suppresses gastric acid secretion by specific inhibition of the (H+/K+)-ATPase in the gastric parietal cell. By acting specifically on the proton pump, Dexlansoprazole blocks the final step of acid production. It is the R-enantiomer of lansoprazole (A racemic mixture of the R- and S-enantiomers). Dexlansoprazole is supplied as a Dual Delayed Release (DDR) formulation in a capsule for oral administration. This capsule contains a mixture of two types of enteric coated granules with different pH-dependent dissolution profiles. The dual delayed release formulation in dexlansoprazole, plasma concentration-time profile with two distinct peaks; the first peak occurs 1 to 2 hours after administration, followed by a second peak within 4 to 5 hours. After oral administration, mean Cmax&nbsp;and AUC value of Dexlansoprazole increased approximately dose proportionally. Dexlansoprazole is extensively metabolized in the liver and excreated by urine.</p>', '<p>Dexlansoprazole dosing recommendations-</p>\r\n\r\n<ul>\r\n	<li><strong>Maintenance of Healed erosive esophagitis and relief of heartburn</strong>: 30 mg Once daily</li>\r\n	<li><strong>Symptomatic Non-Erosive GERD</strong>: 30 mg Once daily for 4 weeks</li>\r\n	<li><strong>Healing of erosive esophagitis</strong>: 60 mg Once daily for up to 8 weeks</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Dexlansoprazole can be taken without regard to food. It should be swallowed whole.<br />\r\n<br />\r\nAlternatively, Dexlansoprazole capsules can be administered as follows:</p>\r\n\r\n<ul>\r\n	<li>Open capsule</li>\r\n	<li>Sprinkle intact granules on one tablespoon</li>\r\n	<li>Swallow immediately.</li>\r\n</ul>\r\n\r\n<p>Granules should not be chewed.<br />\r\n<br />\r\nIf a capsule is missed at its usual time, it should be taken as soon as possible. But if it is too close to the time of the next dose, only the prescribed dose should be taken at the appointed time. A double dose should not be taken.</p>', '<p>With medicine: Atazanavir, Warfarin, Tacrolimus, Clopidogrel &amp; Methotrexate. With food &amp; others: No data available.</p>', '<p>Dexlansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.</p>', '<p>Common side effects: Diarrhea, abdominal pain, nausea, vomiting &amp; flatulence.</p>', '<p>Pregnancy Category B. There is no adequate and well-controlled studies with Dexlansoprazole in pregnant women. There is no adequate and well-controlled studies with Dexlansoprazole in Lactating mother.</p>', '<p>Gastric Malignancy,&nbsp;<em>Clostridium difficile</em>&nbsp;Associated Diarrhea, Bone fracture, Hypomagnesemia, and concomitant use of Dexlansoprazole with Methotrexate.</p>', '<p>There have been no reports of a significant overdose of Dexlansoprazole. Multiple doses of Dexlansoprazole 120 mg and a single dose of Dexlansoprazole 300 mg did not result in death or other severe adverse events.</p>', '<p>Proton Pump Inhibitor</p>', '<p>Store below 30&deg;C temperature &amp; in a dry place, protected from light. Keep all medicines out of reach of children.</p>', '<p><strong>Use in children &amp; adolescents</strong>: Safety and effectiveness of Dexlansoprazole in patients below 12 years age have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No dose adjustment is necessary for elderly patients.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: No dose adjustment of Dexlansoprazole is necessary for patients with renal<br />\r\nimpairment.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: No dose adjustment for Dexlansoprazole is necessary for patients with mild hepatic impairment. A maximum daily dose of Dexlansoprazole 30 mg should be considered for patients with moderate hepatic impairment.</p>', '2022-02-19 05:50:08', '2022-04-26 17:17:56'),
(425, 425, '<p>Dexmedetomidine Hydrochloride Injection is a central alpha-2 adrenergic agonist indicated for sedation of non-intubated patients prior to and/or during surgical and other procedures</p>', '<p>Dexmedetomidine is a specific and selective alpha-2 adrenoceptor agonist. By binding to the presynaptic alpha-2 adrenoceptors, it inhibits the release if norepinephrine, therefore, terminate the propagation of pain signals. Activation of the postsynaptic alpha-2 adrenoceptors inhibits the sympathetic activity decreases blood pressure and heart rate.</p>', '<p>Dilute in 0.9% Sodium Chloride Injection to concentration of 4 mcg/mL prior to administration.<br />\r\n<br />\r\nTo be administered only by health care providers skilled in the management of patients in the operating room setting.<br />\r\n<br />\r\nAdminister intravenously using a controlled infusion device. Administration duration should not exceed 24 hours.<br />\r\n<br />\r\nContinuously monitor blood pressure, heart rate, and oxygen levels during administration and as clinically appropriate after discontinuation.<br />\r\n<br />\r\nInitiation of Procedural Sedation:</p>\r\n\r\n<ul>\r\n	<li><strong>More invasive procedures or awake fiberoptic intubation</strong>:&nbsp;1 mcg/kg over 10 minutes</li>\r\n	<li><strong>Less invasive procedures such as ophthalmic surgery</strong>:&nbsp;0.5 mcg/kg over 10 minutes</li>\r\n</ul>\r\n\r\n<p>Maintenance of Procedural Sedation</p>\r\n\r\n<ul>\r\n	<li><strong>All procedures except awake fiberoptic intubation</strong>:&nbsp;Generally, initiate at 0.6 mcg/kg/hour and titrate to achieve desired clinical effect with dosages ranging from 0.2 to 1 mcg/kg/hour.&nbsp;</li>\r\n	<li><strong>Awake fiberoptic intubation</strong>:&nbsp;Administer 0.7 mcg/kg/hour until the endotracheal tube is secured&nbsp;</li>\r\n</ul>', '<p><strong>Anesthetics, sedatives/hypnotics, opioids</strong>: Can potentiate sedating effects. Consider reducing dosage of dexmedetomidine HCl or co-administered drug.</p>', '<p>None</p>', '<p>The most common adverse reactions (incidence greater than 10%) were hypotension, respiratory depression, and bradycardia.</p>', '<p><strong>Pregnancy</strong>: There are no studies conducted with dexmedetomidine hydrochloride in pregnant women to inform any drug-associated risks.<br />\r\n<br />\r\n<strong>Lactation</strong>: There is no information regarding the presence of dexmedetomidine hydrochloride in human milk, the effects of the drug on the breastfed infant, or the effects of the drug on milk production.</p>', '<p><strong>Bradycardia and Sinus Arrest</strong>: Consider decreasing or stopping dexmedetomidine HCl infusion; decreasing or stopping other medications that depress sinus node function; administering anticholinergic agents (e.g., glycopyrrolate, atropine); and/or administering pressor agents.&nbsp;&nbsp;<br />\r\n<br />\r\n<strong>Hypotension</strong>: Consider decreasing or stopping dexmedetomidine HCl infusion; increasing rate of intravenous fluid administration; elevating lower extremities, and/or administering pressor agents.<br />\r\n<br />\r\n<strong>Transient Hypertension</strong>: Observed primarily during administration of loading dose. Consider reducing loading infusion rate.<br />\r\n<br />\r\n<strong>Arousability</strong>: Patients can become aroused/alert with stimulation; this alone should not be considered as lack of efficacy.<br />\r\n<br />\r\nProlonged exposure to dexmedetomidine beyond 24 hours may be associated with tolerance and tachyphylaxis and a dose-related increase in adverse events.</p>', NULL, '<p>Miscellaneous sedatives &amp; hypnotics</p>', NULL, '<p><strong>Geriatric patients (age greater than 65 years)</strong>: Recommended loading infusion dosage for initiation of procedural sedation is 0.5 mcg/kg over 10 minutes. Consider dosage reduction for maintenance<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Consider dosage reduction for initiation and maintenance of procedural sedation.</p>', '2022-02-19 05:50:32', '2022-04-26 17:20:28'),
(426, 426, '<p>Dexpanthenol is indicated in-</p>\r\n\r\n<ul>\r\n	<li>For prevention and treatment of diaper rash in infants.</li>\r\n	<li>For prevention and treatment of cracked or sore nipples in nursing women.</li>\r\n	<li>For prevention and treatment of chafed, cracked or split skin.</li>\r\n	<li>For treatment of light skin wounds and dry skin</li>\r\n</ul>', '<p>Dexpanthenol is an alcohol derivative of pantothenic acid, a component of the B complex vitamins and an essential component of a normally functioning epithelium. Dexpanthenol is enzymatically cleaved to form pantothenic acid, which is an essential component of Coenzyme A, which acts as a cofactor in many enzymatic reactions that are important for protein metabolism in the epithelium.<br />\r\n<br />\r\nDermatological effects of the topical use of dexpanthenol include increased fibroblast proliferation and accelerated re-epithelialization in wound healing. Furthermore, it acts as a topical protectant, moisturizer, and has demonstrated anti-inflammatory properties</p>', '<p>Check with the doctor or pharmacist if you are unsure how to use Dexpanthenol.<br />\r\n<br />\r\nThe usual dosage is generally:</p>\r\n\r\n<ul>\r\n	<li><strong>Diaper rash</strong>: Apply a thin layer on the baby&rsquo;s bottom at every diaper change.</li>\r\n	<li><strong>Nipples</strong>: Apply a thin layer on the nipples after each nursing session. Wash the nipples thoroughly before the next nursing session.</li>\r\n	<li><strong>Dry/cracked skin or light wounds and chafed skin</strong>: Apply to the dry areas and/or to the wound up to 3 times a day.</li>\r\n</ul>\r\n\r\n<p>Do not exceed the recommended dose, Do not swallow. This medicine is intended for external use only.</p>', NULL, NULL, '<p>As with any medicine, use of Dexpanthenol may cause side effects in some users. Do not be alarmed by the list of side effects. You may not suffer from any of them. Discontinue use and refer to a doctor immediately in the event of: Allergic reaction and/or allergic skin reaction such as: atopic dermatitis, allergic dermatitis, pruritus, redness, rash, eczema, urticaria, local irritation or blistering. If a side effect occurs, worsens, or if you suffer from a side effect not mentioned in this leaflet, consult with the doctor.</p>', NULL, NULL, NULL, '<p>Miscellaneous topical agents</p>', '<p>Do not store above 30 degree Celsius. Keep away from light and out of the reach of children.</p>', NULL, '2022-02-19 05:50:57', '2022-04-27 15:51:04'),
(427, 427, '<p>This is indicated in thromboembolic disorders, hypovolaemic shock, pulmonary embolism, venous thrombosis</p>', '<p><strong>Dextrans</strong>&nbsp;produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.<br />\r\n<br />\r\n<strong>Dextrose</strong>&nbsp;is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.</p>', '<p><strong>Adult:</strong>&nbsp;IV Hypovolaemic shock As dextran 40 (10% soln): 10 mL/kg/day for up to 5 days.<br />\r\n<br />\r\n<strong>Thromboembolic disorders:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>As dextran 40 (10% soln)</strong>: Initial: 500 ml on day 1, followed by 500 ml on day 2 and subsequently on alternate days up to 10 days. Prophylaxis of post-op thromboembolic disorders. 500 ml during or at the end of surgery. May repeat dose next day and continue treatment on alternate days for up to 10 days in high-risk patients.</li>\r\n</ul>\r\n\r\n<p><strong>Child:</strong>&nbsp;As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy.</p>', '<p><strong>Dextran:</strong></p>\r\n\r\n<ul>\r\n	<li>Enzyme inducers e.g. phenytoin or carbamazepine</li>\r\n	<li>enzyme inhibitors e.g. cimetidine.</li>\r\n</ul>', NULL, '<p>Congestive heart failure, Mild hypotension, Tightness of chest, Thrombocytopenia, Anaphylaxis, Injection site infection/phlebitis, Acute renal failure, Acidosis (if NaCI soln used), Pulmonary edema, Wheezing</p>', '<p>Pregnancy Category - C<br />\r\n<br />\r\nAnimal 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>Caution should be taken during pregnency</p>', NULL, '<p>Plasma expanders</p>', NULL, NULL, '2022-02-19 05:51:19', '2022-04-27 15:53:34'),
(428, 428, '<p>As a lubricant and artificial tear in dry eye and other ocular irritation syndromes associated with deficient tear or mucous secretion. This combination also prevents cornea to damage in patients with keratoconjunctivitis and for ocular lubrication. It is also used for the temporary relief of burning and irritation due to dryness of the eye and for use as the protectant against further irritation.</p>', '<p>Dextran &amp; Hypromellose combination Eye drops acts like natural tears, which provides smoothing relief to dry, itchy, burning and irritated eyes. It helps eyes to stay moist<br />\r\nhealthy and protects against further irritation. This unique combination of ingredients works together to retain moisture on the eye and slow evaporation of the tear film.<br />\r\n<br />\r\nHypromellose promotes corneal wetting by stabilizing and thickening the precorneal tear film and prolonging the tear film breakup time, which is usually shortened in dry eye conditions. Also acts to lubricate and protect the eye. Dextran is a complex branched glucan composed of chains of varying lengths. It is used medicinally as an antithrombotic, to reduce blood viscosity, and as a volume expander in hypovolaemia.</p>', '<p><strong>Adults and children</strong>: One or two drops three times daily or as directed by the physician.</p>', NULL, '<p>This product contains Benzalkonium Chloride and should not be used when soft contact lenses are being worn.</p>', '<p>There are no known side effects with the use of it, however, if the patient experiences any reaction in eye or other part of the body after using this medication then consult with doctor</p>', '<p>There is insufficient evidence as to the safety in pregnancy and lactation. Therefore, this product should only be used in pregnancy and lactation if it is considered essential by the physician.</p>', '<p>If irritation persists or if the condition does not improve, patient should seek further advice from doctor.</p>', NULL, '<p>Drugs for Dry eyes</p>', '<p>Store below 25&deg;C and do not freeze. Do not use after 30 days of first opening. Keep the container closed tightly after each opening. Keep out of the reach of children.</p>', NULL, '2022-02-19 05:51:41', '2022-04-27 15:55:51'),
(429, 429, '<p>This is indicated in Aid in Hysteroscopy,&nbsp;Thromboembolic disorders,&nbsp;Prophylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery,&nbsp;Prophylaxis of postoperative thromboembolic disorders,&nbsp;Hypovolaemic shock.</p>', '<p><strong>Dextran</strong>&nbsp;produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.<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.</p>', '<p><strong>Intrauterine-</strong><br />\r\nAid in hysteroscopy:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;<strong>As dextran 70:</strong>&nbsp;50-100 mL of a 32% solution instilled into the uterus as a rinsing and dilatation fluid.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-</strong><br />\r\nThromboembolic disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult: As dextran 40:</strong>&nbsp;Initially, 500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr, followed by 500 ml infused over 4-6 hr on the next and subsequent alternate days for not more than 10 days.</li>\r\n	<li><strong>Child:</strong>&nbsp;As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-</strong><br />\r\nProphylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;<strong>As dextran 70:</strong>&nbsp;Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or immediately after surgery, followed by 500 mL on the next day and on subsequent alternate days for up to 2 wk after surgery in high-risk patients.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-</strong><br />\r\nProphylaxis of postoperative thromboembolic disorders:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;<strong>As dextran 40:</strong>&nbsp;500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or at the end of the surgery. Dose may be repeated the following day and treatment may be continued on alternate days for up to 10 days in high-risk patient.</li>\r\n	<li><strong>Child:</strong>&nbsp;As dextran 40: Up to 10 ml/kg in children.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-</strong><br />\r\nHypovolaemic shock:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;<strong>As dextran 40:</strong>&nbsp;Initially, 10 ml/kg given by rapid infusion as a 10% solution in sodium chloride 0.9% or glucose 5%. Doses may be given daily for up to 5 days. As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused at a rate of 20-40 mL/min. Maintenance: 10 ml/kg/day for3 days (Dextran 70).</li>\r\n</ul>', '<p><strong>Dextran:</strong>&nbsp;Enzyme inducers e.g. phenytoin or carbamazepine and enzyme inhibitors e.g. cimetidine.<br />\r\n<br />\r\n<strong>Sodium Chloride:</strong>&nbsp;May affect serum concentrations of lithium.</p>', '<p>Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy.</p>', '<p>GI disturbances; headache, dizziness; allergic reactions; raised liver enzyme values; alopecia; bone marrow suppression.</p>', '<p><strong>Category C:</strong>&nbsp;Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Lactation.</p>', NULL, '<p>Plasma expanders</p>', '<p>Store at 25&deg;C.</p>', NULL, '2022-02-19 05:52:00', '2022-04-27 15:58:18');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(430, 430, '<p>Temporarily relieves these symptoms due to common cold, hay fever (allergic rhinitis) or other upper respiratory allergies:</p>\r\n\r\n<ul>\r\n	<li>cough due to minor throat or bronchial irritation</li>\r\n	<li>runny nose</li>\r\n	<li>sneezing</li>\r\n	<li>itching of the nose or throat</li>\r\n	<li>itchy, watery eyes</li>\r\n	<li>nasal congestion</li>\r\n	<li>reduces swelling of nasal passages</li>\r\n</ul>', '<p>This preparation is a mixture of antitussive, decongestant and antihistamine agent. Dextromethorphan is a safe, effective, non-narcotic antitussive agent which has a central action on the cough centre in the medulla. Although structurally related to Morphine, it has no analgesic and habit forming properties and in general it has little sedative activity. Phenylephrine is a decongestant that shrinks blood vessels in the nasal passage. It is used to treat nasal and sinus congestion of the tubes that drain fluid from inner ear. Triprolidine provides symptomatic relief in conditions believed to depend wholly or partly upon the triggered release of histamine. It is a potent competitive histamine H1-receptor antagonist of the pyrrolidine class with mild central nervous system depressant properties which may cause drowsiness.</p>', '<p><strong>Adults &amp; Children 12 years of age and older</strong>: 1 teaspoonful (5 ml) every 4 hours, or as directed by a doctor.<br />\r\n<br />\r\n<strong>Children 6 to under 12 years of age</strong>: &frac12; teaspoonful (2.5 ml) every 4 hours, or as directed by a doctor.<br />\r\n<br />\r\n<strong>Children below 2 years old</strong>: Not to be used in children below 2 years old. To be used with caution, and as advised by the physician for children age 2 to 6 years.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Take with or without food. Take with food if it causes an upset stomach.&nbsp;Measure liquid doses carefully. Use the measuring device that comes with this medicine.</p>', '<p>Taking certain MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking isocarboxazid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, or tranylcypromine during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Caution should be excercised while taking this drug with antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray), antispasmodics (e.g. atropine, belladonna alkaloids), beta blockers (e.g. metoprolol, atenolol), drugs for Parkinson&rsquo;s disease (e.g. anticholinergics such as benztropine, trihexyphenidyl), guanethidine, certain inhaled anesthetics (e.g. halothane), methyldopa, reserpine, scopolamine, tricyclic antidepressants (e.g. amitriptyline, desipramine), anti seizure drugs (e.g. carbamazepine), medicine for sleep or anxiety (e.g. alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g. codeine), psychiatric medicines (e.g. chlorpromazine, risperidone, amitriptyline, trazodone).</p>', '<p>It should be avoided in patients with liver disease or asthmatic patients and is contraindicated in patients taking monoamine oxidase inhibitors or within 2 weeks from stopping such treatment, known hypersensitivity to phenylephrine hydrochloride, dextromethorphan hydrobromide and during acute attacks of asthma. It is contraindicated in patients with severe hypertension or severe coronary artery disease.</p>', '<p>It may cause drowsiness, dottiness and constipation. Other side effects that may occur include GIT discomfort. No apparent evidence of physical dependence of the morphine type. Other less common side effects may include transient hypertension, dry mouth, restlessness, palpitations, allergic reactions such as rashes, tightness of chest, thickening of bronchial secretions, toxic psychosis and blood dyscrasia.</p>', '<p>As with any other drugs, use in pregnancy and lactation is best avoided.</p>', '<p>This preparation may cause drowsiness. If affected, do not drive motor vehicle or operate machinery. Avoid alcoholic drink while on this medication. Use with caution in patients with epilepsy, prostatic hypertrophy, glaucoma, hepatic disease, hypertension, heart disease, diabetes, hyperthyroidism, patients with stenosing peptic ulcer, pyloro-duodenal obstruction or bladder neck obstruction, unless under the medical advice and supervision. If symptoms do not improve within one week or accompanied with high fever, consult a physician before continuing use.</p>', '<p>In cases of over dosage, hospital admission is strongly advised. Over dosage may produce respiratory depression, paranoid psychosis, delusions, hallucinations, and convulsion. Treatment should include emptying the stomach by aspiration or gastric lavage. Nervous stimulation and convulsions should be treated with a sedative such as diazepam intramuscularly. If marked excitation is present, a sedative such as diazepam or a short-acting barbiturate may be given.<br />\r\n<br />\r\nSevere over dosage of phenylephrine hydrochloride may produce hypertension and associated reflex bradycardia. Treatment measures include early gastric lavage and symptomatic and supportive measures. The hypertensive effects may be treated with an alpha-receptor blocking agent (such as phentolamine mesilate 6-10 mg) given intravenously, and the bradycardia treated with atropine, preferable only after the pressure has been controlled.</p>', '<p>Combined cough suppressants</p>', '<p>Keep out of the reach of children. Keep in a cool &amp; dry place. Protect from light.</p>', NULL, '2022-02-19 05:52:16', '2022-04-27 16:02:11'),
(431, 431, '<p>This preparation temporarily relieves these symptoms due to common cold, hay fever (allergic rhinitis) or other upper respiratory allergies:</p>\r\n\r\n<ul>\r\n	<li>Non-productive cough due to minor throat or bronchial irritation</li>\r\n	<li>Runny Nose</li>\r\n	<li>Sneezing</li>\r\n	<li>Itching of the nose or throat</li>\r\n	<li>Itchy &amp; watery eyes</li>\r\n	<li>Nasal congestion</li>\r\n</ul>', '<p>This preparation is a mixture of antitussive, decongestant and antihistamine agent. Dextromethorphan is a safe, effective, non-narcotic antitussive agent which has a central action on the cough centre in the medulla. Although structurally related to Morphine, it has no analgesic and habit forming properties and in general it has little sedative activity. Phenylephrine is a decongestant that shrinks blood vessels in the nasal passage. Phenylephrine is used for the temporary relief of stuffy nose, sinus, and ear symptoms caused by the common cold, flu, allergies, sinusitis &amp; bronchitis. This medication works by decreasing swelling in the nose and ears, thereby lessening discomfort and making it easier to breathe. Triprolidine is an antihistamine used to relieve symptoms of allergy, hay fever, and the common cold. These symptoms include rash, watery eyes, itchy eyes/nose/throat/skin, cough, runny nose, and sneezing. It is a potent competitive histamine H1-receptor antagonist of the pyrrolidine class with mild central nervous system depressant properties which may cause drowsiness. By antagonizing another natural substance acetylcholine, it helps dry up some body fluids to relieve symptoms such as watery eyes and runny nose.</p>', '<p><strong>Adults &amp; Children over 12 years</strong>: 1 teaspoonful (5 ml) 4 times a day every 4 hours interval.<br />\r\n<br />\r\n<strong>6-12 years</strong>: 1/2 teaspoonful 4 times a day every 4 hours interval.<br />\r\n<br />\r\n<strong>Use in children and adolescents</strong>: A physician&#39;s advice should be obtained before administering this combination to children less than 6 years.</p>', '<p>Taking certain MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking isocarboxazid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, or tranylcypromine during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication.</p>', '<p>It should be avoided in patients with liver disease or asthmatic patients and is contraindicated in patients taking monoamine oxidase inhibitors or within 2 weeks from stopping such treatment</p>', '<p>It may cause drowsiness and constipation. Other side effects that may occur include GIT discomfort. No apparent evidence of physical dependence of the morphine type.</p>', '<p>There are no specific data on use of this combination during pregnancy &amp; lactation.</p>', '<p>This preparation may cause drowsiness. If affected, do not drive motor vehicle or operate machinery. Avoid alcoholic drink while on this medication. Use with caution in patients with epilepsy, prostatic hypertrophy, glaucoma, hepatic disease, hypertension, heart disease, diabetes, hyperthyroidism. If symptoms do not improve within one week or accompanied with high fever, consult a physician before continuing use.</p>', '<p>In cases of over dosage, hospital admission is strongly advised. Over dosage may produce respiratory depression, paranoid psychosis, delusions, hallucinations and convulsion.</p>', '<p>Combined cough suppressants</p>', '<p>Store in a cool and dry place (below 30&deg;C temperature), away from light. Keep out of the reach of children.</p>', NULL, '2022-02-19 05:52:58', '2022-04-27 16:05:17'),
(432, 432, '<p>Dextromethorphan is indicated in Chronic dry cough or unproductive cough; Acute dry cough which is interfering with normal function or sleep.</p>', '<p>Dextromethorphan suppresses the cough reflex by a direct action on the cough center in the medulla of the brain. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity.</p>', '<p><strong>Adults and Children over 12 years:</strong>&nbsp;15 to 30 mg three to four times per day. However, 60 mg doses up to four times per day have been used without increased side effects.<br />\r\n<strong>Children between 6 and 12 years:</strong>&nbsp;5-15 mg up to four times per day.<br />\r\n<strong>Children between 2 and 6 years:</strong>&nbsp;2.5-5 mg up to four times per day.</p>', '<p>The following medicines should be taken carefully while concomitantly use with Dextromethorphan: Amiodarone, Fluoexetine, Quinidine, CNS depressants and Monoamine oxidase (MAO) inhibitors.</p>', '<p>Hypersensitivity to Dextromethorphan or any other component.</p>', '<p>Adverse effects with Dextromethorphan are rare, but nausea and dizziness sometimes occur. The drug produces no analgesia or addiction and little or no CNS depression. Excitation, confusion and respiratory depression may occur after overdosage.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Adequate and well-controlled studies in human have not been done. However, Dextromethorphan has not been reported to cause birth defects.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;It is not known whether dextromethorphan passes into breast milk. However, Dextromethorphan has not been reported to cause problems in nursing babies.</p>', '<p>Do not use Dextromethorphan to control a cough that is associated with smoking, asthma, or emphysema, or a cough that is productive (produces sputum or phlegm).</p>', '<p><strong>Symptoms:</strong>&nbsp;In mild overdose, tachycardia, hypertension, vomiting, mydriasis, diaphoresis, nystagmus, euphoria, loss of motor coordination, and giggling; in moderate intoxication, in addition to those listed above, hallucinations and a plodding ataxic gait; in severely intoxication, agitation or somnolence.<br />\r\n<br />\r\n<strong>Management</strong>: treatment is symptomatic and supportive. Naloxone may be useful in reversing toxicity.</p>', '<p>Cough suppressant</p>', '<p>Store at 15-30&deg; C</p>', NULL, '2022-02-19 05:53:28', '2022-04-27 16:13:39'),
(433, 433, '<p>This preparation provides relief from all the symptoms associated with common cold such as dry cough, chest congestion etc.</p>', '<p>This tablet is a combination of Guaifenesin and Dextromethorphan HBr. Dextromethorphan is a cough suppressant and gives relief from cough by blocking the cough centre in the brain. Guaifenesin is an expectorant. It reduces the viscosity of cough by increasing the flow of fluids in the bronchial secretion thereby facilitating the expectoration of cough.</p>', '<p><strong>Adults and children 12 years and older</strong>: 1 or 2 tablets every 12 hours and not more than 4 tablets daily.</p>\r\n\r\n<ul>\r\n	<li>Do not crush, chew, or break tablet</li>\r\n	<li>Take with a full glass of water</li>\r\n	<li>This product can be administered without regard for the timing of meals.</li>\r\n</ul>', NULL, '<p>This tablet is contraindicated in patients with known hypersensitivity to Dextromethorphan and Guaifenesin. Moreover, the patients who are taking monoamine oxidase inhibitor (MAOI) certain drugs or for 2 weeks after stopping the MAOI drug cannot take this preparation.</p>', '<p>Common side effects are hypersensitivity, rash, nausea &amp; vomiting.</p>', '<p>There is no information regarding safety in pregnancy and lactation. So consultation with physician is must before use in this case.</p>', NULL, NULL, '<p>Combined cough expectorants, Cough expectorants &amp; mucolytics</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', '<p>Usage in children: This tablet is not indicated for the children under 12 years of age.</p>', '2022-02-19 05:53:55', '2022-04-27 16:16:02'),
(434, 434, '<p>Dextrose is administered in the treatment of carbohydrate and fluid depletions. It is mainly used to replace water deficiency and should be given alone when there is no significant loss of electrolytes. Water depletion (dehydration) tends to occur when these losses are not matched by a comparable intake, as for example may occur in coma or dysphagia or in the aged person who may not drink water in sufficient amount on their own initiative. It provides a readily metabolizable nutrient. One litre of 5% solution provides about 170 calories. Glucose solutions are also given in regimens with calcium bicarbonate, and insulin for the emergency management of hyperkalaemia. They are also given, after correction of hyperglycaemia, during treatment of diabetic ketoacidosis, when they must be accompanied by continuing insulin infusion. Dextrose also may act as a suitable vehicle for the slow intravenous infusion of numerous drugs.</p>', '<p>Dextrose is a form of glucose (sugar). Dextrose 5% in water is injected into a vein through an IV to replace lost fluids and provide carbohydrates to the body. Dextrose 5% in water is used to treat low blood sugar (hypoglycemia), insulin shock, or dehydration (fluid loss). Dextrose 5% in water is also given for nutritional support to patients who are unable to eat because of illness, injury, or other medical condition.</p>', '<p><strong>5% dextrose solution</strong>: The dose of Dextrose infusion is variable. It is dependent on individual patient requirements. For 5% dextrose solution, the dose frequently ranges from 500 to 1000 ml. The maximum rate of infusion that will not cause glycosuria is 0.5 g/kg/hour. About 95% is retained when the rate is 0.8 g/kg/hr. the maximum rate of glucose utilization is about 800 mg per kg body weight per hour.<br />\r\n<br />\r\n<strong>25% dextrose solution</strong>: The volume and rate of infusion of dextrose solution will depend upon the requirements of the individual patient and the judgment of the physician. The maximum rate at which dextrose can be infused without producing glycosuria is 0.5 g/kg/hr. The usual recommended flow rate for adult is 10-35 drops per minute infused intravenously. It should not be administered by SC or IM route. 25% dextrose solution should be infused through the largest available peripheral vein.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<ul>\r\n	<li>Check infusion set and infusion solution prior to use.</li>\r\n	<li>Pull moderately to tear off the protective cover of the Eurocap.</li>\r\n	<li>Hold lightly the Eurocap but not the bottle body.</li>\r\n	<li>Open the flow regulator fully and hold the giving set on the top white area, but not the memorane venting region.</li>\r\n	<li>Insert the spike of the administration set to the Eurocap and fit the connector of the administration set firmly to the needle.</li>\r\n	<li>Gradually allow the fluid to flow down to the needletip and close.</li>\r\n	<li>Remove the protective cover of the needle.</li>\r\n	<li>Locate the venpuncture site and clean the site with an antiseptic solution, and then insert the needle.</li>\r\n	<li>Securely tape the puncture site.</li>\r\n	<li>Securely tape the wings and tubing</li>\r\n	<li>Start infusion while adjusting drip speed.</li>\r\n</ul>', NULL, '<p>Do not take this medicine and tell your doctor if: You should not use this medication if you are allergic to dextrose. Before using dextrose 5% in water, tell your doctor if you have diabetes, breathing problems, an electrolyte imbalance, kidney or liver disease, a food or drug allergy, or if you receive regular blood transfusions.</p>', '<ul>\r\n	<li>severe burning, pain, or swelling around the IV needle;</li>\r\n	<li>warmth, redness, oozing, or bleeding where the IV was placed;</li>\r\n	<li>fever, ongoing cough;</li>\r\n	<li>high blood sugar, headache, trouble concentrating, memory problems, weakness, feeling unsteady, hallucinations, fainting, seizure, shallow breathing or breathing that stops;</li>\r\n	<li>low potassium or anxiety, sweating, pale skin, severe shortness of breath, wheezing, pain, fast or uneven heart rate.</li>\r\n</ul>', '<p>FDA pregnancy category C. It is not known whether dextrose 5% in water will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether dextrose 5% in water passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.</p>', '<p>Serum glucose concentration should be carefully monitored. Concurrent use of insulin may be needed in case of diabetic patients. Dextrose solution should not be mixed with whole blood as haemolysis and clumping may occur. Infusion of fluid should be immediately discontinued if rigor arises for any reasons during the process. Do not use if the solution is cloudy, contains particles, or after expiry date.<br />\r\n<br />\r\nTake special care with dextrose. Check with your doctor before taking this medicine if: You should not use this medication if you are allergic to dextrose.<br />\r\n<br />\r\nTo make sure you can safely use dextrose 5% in water, tell your doctor if you have any of these other conditions:</p>\r\n\r\n<ul>\r\n	<li>diabetes;</li>\r\n	<li>breathing problems;</li>\r\n	<li>an electrolyte imbalance (such as low levels of potassium in your blood);</li>\r\n	<li>kidney or liver disease;</li>\r\n	<li>any allergy to foods or medicines; or</li>\r\n	<li>if you receive regular blood transfusions.</li>\r\n</ul>', NULL, '<p>Intravenous fluid preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-19 05:54:11', '2022-04-27 16:18:57'),
(435, 435, '<p>This solution&nbsp;is indicated as a source of water, electrolytes and calories or as an alkalinizing agent.</p>', '<p>This&nbsp;is a sterile, nonpyrogenic solution for fluid and electrolyte replenishment and caloric supply in a single dose container for intravenous administration.</p>', '<p>As directed by a physician. Dosage is dependent upon the age, weight and clinical condition of the patient as well as laboratory determinations. The dosage and constant infusion rate of intravenous dextrose must be selected with caution in pediatric patients, particularly neonates and low weight infants, because of the increased risk of hyperglycemia/ hypoglycemia. Additives may be incompatible. Administration Procedure:</p>\r\n\r\n<ul>\r\n	<li>Check infusion set and infusion solution prior to use</li>\r\n	<li>Pull moderately to tear off the protective cover of the Eurohead</li>\r\n	<li>Hold lightly the Eurohead but not the bag</li>\r\n	<li>Open the flow regulator fully and hold the giving set on the top white area, but not the membrane venting region</li>\r\n	<li>Insert the spike of the administration set to the Eurohead and fit the connector of the administration set firmly to the needle</li>\r\n	<li>Gradually allow the fluid to flow down to the needle tip and close</li>\r\n	<li>Remove the protective cover of the needle</li>\r\n	<li>Locate the veinpuncture site and clean the site with an antiseptic solution, and then insert the needle</li>\r\n	<li>Securely tape the puncture site</li>\r\n	<li>Securely tape the wings and tubing</li>\r\n	<li>Start infusion while adjusting drip speed.</li>\r\n</ul>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.</p>', '<p>Allergic reactions or anaphylactoid symptoms such as localized or generalized urticaria and pruritus; periorbital, facial, and/or laryngeal edema, coughing, sneezing, and/or difficulty with breathing have been reported during administration. The reporting frequency of these signs and symptoms is higher in women during pregnancy.</p>', '<p>Teratogenic effect and pregnancy category C. This solution&nbsp;should be given to a pregnant woman only if clearly needed.&nbsp;It is not known whether this drug is excreted in human milk.</p>', '<p>Do not uses if the solution is cloudy contain particles or date expired. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process.</p>', NULL, '<p>Intravenous fluid preparations</p>', '<p>Should be stored at controlled room temperature.</p>', '<p>Pediatric Use: Safety and effectiveness of this solution&nbsp;in pediatric patients have not been established by adequate and well controlled trials.<br />\r\n<br />\r\nGeriatric Use: Clinical studies of this solution did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.</p>', '2022-02-19 05:54:36', '2022-04-27 16:28:55'),
(436, 436, '<p>For the relief of occasional constipation. For use where bowel cleansing is required, such as before and after lower bowel surgery, delivery and post-partum, before proctoscopy, sigmoidoscopy or colonoscopy and before radiological examinations of the lower bowel.</p>', '<p>It acts as a saline laxative when administered by the rectal route. Fluid accumulation in the lower bowel produces distension and promotes peristalsis and bowel movement on the rectum, sigmoid and descending colon. These phenomena results in rapid evacuation.</p>', '<p><strong>Adults, Elderly and Children over 12 years old</strong>: 118 ml delivered dose, not more than once daily or as directed by a physician. Additional liquids by mouth are recommended. Encourage patients to drink large amounts of clear liquids to prevent dehydration.</p>', '<p>Use with caution in patients taking calcium channel blockers, diuretics, lithium treatment or other medications that might affect electrolyte levels as hyperphosphataemia, hypocalcaemia, hypokalae- mia, hypernatraemic dehydration and acidosis may occur. No other sodium phosphate preparations including sodium phosphate oral solution or tablets should be given concomitantly. As hypernatraemia is associated with lower lithium levels, concomitant use of this medicine and lithium therapy could lead to a fall in serum lithium levels with a lessening of effectiveness.</p>', '<p>Do not use in patients with, Congestive heart failure, impairment of renal function, gastrointestinal obstruction, Megacolon, Paralytic ileus, Perforation, Active inflammatory bowel disease, Imperforate anus, Dehydration, Children under 2 years of age, Hypersensitivity to active ingredients or to any of the excipients of the product.</p>', '<p>Phosphate Enema is well tolerated when used as indicated. However, adverse events possibly associated with the use of phosphate enema have been infrequently reported. In some cases, adverse events may occur, especially if the enema is misused.</p>', '<p>As there is no relevant data available to evaluate the potential for fetal malformation or other feto-toxic effects when administered during pregnancy it should only be used as directed by a physician at the time of delivery or postpartum. As sodium phosphate may pass into the breast milk, it is advised that breast milk is expressed and discarded for at least 24 hours after receiving this medicine.</p>', '<p>Use with caution in patients, with impaired renal function, with pre-existing electrolyte disturbances or who are taking diuretics which may affect electrolyte levels, Who are taking medications known to prolong the QT interval, Ascites, With a colostomy.</p>', '<p>Using more than 133 ml&nbsp;in 24 hours can be harmful. In case of excessive dose, recovery from the toxic effects can normally be achieved by rehydration. Treatment of electrolyte imbalance may require immediate medical intervention with appropriate electrolyte and fluid replacement therapy.</p>', '<p>Enema &amp; bowel cleansing solution</p>', '<p>Store below 25&deg; C. Protect from light. Do not refrigerate. Keep out of the reach of children.</p>', NULL, '2022-02-19 05:55:08', '2022-04-27 16:31:32'),
(437, 438, '<p>Diazepam is indicated for the short-term treatment of mild to moderate anxiety, excitation, agitation, fear, aggressiveness, etc. Anxiety reactions caused by stressed conditions, anxiety states with somatic expression, acute alcohol withdrawal, status epilepticus, premedication for surgical procedures, febrile convulsions, insomnia of hospitalized patients.</p>', '<p>Diazepam attaches to the specific site on the GABA receptor and potentiates the effect of GABA, which acts by opening chloride ion channels into cells.<br />\r\n<br />\r\nDiazepam is absorbed rapidly and completely after oral administration. Peak Plasma concentration reaches within 15-90 minutes. Mean plasma half-life is 30 hours. Plasma protein binding is 98-99%. Diazepam is metabolized in the liver with only traces of the unchanged drug excreted in urine. A very small proportion of the metabolites is excreted through the bile into the intestine and eliminated with the feces. After rectal administration in suppository form diazepam is significantly absorbed and peak concentration reaches within 1.5-2 hours.</p>', '<p>Oral:</p>\r\n\r\n<ul>\r\n	<li><strong>Anxiety</strong>: 2 mg thrice daily, increased if necessary to 15-30 mg daily in divided doses. Elderly (or debilitated), half of the adult dose.</li>\r\n	<li><strong>Insomnia associated with anxiety</strong>: 5-15 mg at bedtime.</li>\r\n	<li><strong>Night terrors and somnambulism in Child</strong>: 1-5 mg at bedtime.</li>\r\n</ul>\r\n\r\n<p>IM/slow IV injection (large vein, a rate below 5 mg/minute):</p>\r\n\r\n<ul>\r\n	<li><strong>For severe acute anxiety, control of acute panic attacks, and acute alcohol withdrawal</strong>: 10 mg repeated if necessary after not less than 4 hours.</li>\r\n	<li><strong>Febrile convulsion in children</strong>: Slow IV in a dose of 250 mcg/kg.</li>\r\n</ul>\r\n\r\n<p>Rectal:</p>\r\n\r\n<ul>\r\n	<li><strong>In case of children</strong>- A dose of 500 mcg/kg (maximum 10 mg), repeated if necessary.</li>\r\n</ul>', '<p>Concomitant intake with alcohol is not recommended. Sedation may be increased due to concomitant use of neuroleptics (antipsychotics), hypnotics, sedative antihistamines and CNS depressants e.g., general anesthetics, narcotic analgesics or antidepressants. Diazepam clearance is increased by concomitant administration of phonobarbitone and is decreased by administration of cimetidine. Omeprazole and isoniazide inhibit diazepam metabolism.</p>', '<p>Diazepam is contraindicated in myasthenia gravis, pulmonary insufficiency, respiratory depression and hypersensitivity to bezodiazepine.</p>', '<p>Diazepam is generally well tolerated. Higher doses may cause somnolence, dizziness, light headedness, confusion and ataxia.</p>', '<p>Diazepam and its active metabolites cross the placental barrier and also pass into breast milk. So, it should be avoided if possible during pregnancy and lactation. US FDA pregnancy category D.</p>', '<p>Prolonged use and abrupt withdrawal should be avoided. Diazepam should be used with caution in respiratory disease, muscle weakness, history of drug or alcohol abuse, in hepatic or renal impairment.</p>', '<p>Sedation, muscle weakness, profound sleep or paradoxical excitation. In more severe cases symptoms may include ataxia, hypotonia, hypotension, respiratory depression and rarely coma and death.</p>', '<p>Benzodiazepine sedatives, Centrally acting Skeletal Muscle Relaxants, Primary anti-epileptic drugs</p>', '<p>Store in a cool (below 25˚C temperature) and dry place protected from light.</p>', NULL, '2022-02-19 06:18:40', '2022-04-27 16:39:14'),
(438, 437, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-02-19 06:18:40', '2022-02-19 06:18:40'),
(439, 439, '<p>Diazoxide tablets are used orally in the treatment of intractable hypoglycemia.<br />\r\n<br />\r\nHypoglycaemia: Diazoxide administered orally is indicated for the treatment of intractable hypoglycaemia with severe symptoms from a variety of causes including idiopathic hypoglycaemia in infancy, leucine-sensitive or unclassified; functional islet cell tumours both malignant and benign if inoperable, extra-pancreatic neoplasms producing hypoglycaemia; glycogen storage disease; hypoglycaemia of unknown origin. Diazoxide also causes salt and water retention.</p>', '<p>As a diuretic, Diazoxide inhibits active chloride reabsorption at the early distal tubule via the Na-CI cotransporter, resulting in an increase in the excretion of sodium, chloride, and water. Thiazides like Diazoxide also inhibit sodium ion transport across the renal tubular epithelium through binding to the thiazide sensitive sodium-chloride transporter. This results in an increase in potassium excretion via the sodium-potassium exchange mechanism. The antihypertensive mechanism of Diazoxide is less well understood although it may be mediated through its action on carbonic anhydrases in the smooth muscle or through its action on the large-conductance calcium-activated potassium (KCa) channel, also found in the smooth muscle. As a antihypoglycemic, Diazoxide inhibits insulin release from the pancreas, probably by opening potassium channels in the beta cell membrane.<br />\r\n<br />\r\nPharmacodynamics: Diazoxide is a potassium channel activator. Its mechanism of action revolves around enhancing cell membrane permeability to potassium ions. This action consequently elicits the relaxation of local smooth muscles. This switches off voltage-gated calcium ion channels which inhibits the generation of an action potential.</p>', '<p><strong>For both adults and children</strong>: a starting oral dose of 5mg/kg body weight divided into 2 or 3 equal doses per 24 hours will establish the patient&#39;s response and thereafter the dose can be increased until the symptoms and blood glucose level respond satisfactorily. Regular determinations of the blood glucose in the initial days of treatment are essential. The usual maintenance dose is 3-8mg/kg/day given in two or three divided doses.<br />\r\n<br />\r\n<strong>Patients with renal impairment</strong>: Reduced doses may be required in patients with impaired renal function.<br />\r\n<br />\r\n<strong>In children with leucine-sensitive hypoglycaemia</strong>: A dosage range of 15- 20mg/kg/day is suggested.<br />\r\n<br />\r\n<strong>In adults with benign or malignant islet-cell tumours producing large quantities of insulin</strong>: High dosages of up to 1,000mg per day have been used.</p>', '<p>Drugs potentiated by Diazoxide therapy include: oral diuretics, antihypertensive agents and anticoagulants. Phenytoin levels should be monitored as increased dosage may be needed if administered concurrently with diazoxide. The risk of hyperglycaemia may be increased by concurrent administration of corticosteroids or oestrogen-progestogen combinations.</p>', '<p>In the treatment of hypoglycaemia, Diazoxide is contraindicated in all cases which are amenable to surgery or other specific therapy. Hypersensitivity to any component of the preparation or other thiazides</p>', '<p>The adverse reactions are thrombocytopenia, pancreatitis, hypotension, diarrhea, heart failure etc.</p>', '<p><strong>Pregnancy</strong>: Reproduction studies using the oral preparation in rats have revealed increased fetal resorptions and delayed parturition, as well as fetal skeletal anomalies; evidence of skeletal and cardiac teratogenic effects in rabbits has been noted with intravenous administration. The drug has also been demonstrated to cross the placental barrier in animals and to cause degeneration of the fetal pancreatic beta cells. Since there are no adequate data on fetal effects of this drug when given to pregnant women, safety in pregnancy has not been established. When the use of Diazoxide is considered, the indications should be limited to those specified above for adults, and the potential benefits to the mother must be weighed against possible harmful effects to the fetus. Diazoxide Tablets are only to be used in pregnant women when the indicated condition is deemed to put the mother&#39;s life at risk. Prolonged oral therapy of Diazoxide during pregnancy has been reported to cause alopecia in the newborn.<br />\r\n<br />\r\n<strong>Nursing mothers</strong>: Information is not available concerning the passage of Diazoxide in breast milk. Because many drugs are excreted in human milk and because of the potential for adverse reactions from Diazoxide 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>In the treatment of hypoglycaemia it is necessary that the blood pressure be monitored regularly. Retention of sodium and water is likely to necessitate therapy with an oral diuretic such as frusemide or ethacrynic acid The dosage of either of the diuretics mentioned may be up to 1g daily. It must be appreciated that if diuretics are employed then both the hypotensive and hyperglycaemic activities of Diazoxide will be potentiated and it is likely that the dosage of Diazoxide will require adjustment downwards. In patients with severe renal failure it is desirable to maintain, with diuretic therapy, urinary volumes in excess of 1 litre daily. Hypokalaemia should be avoided by adequate potassium replacement.<br />\r\n<br />\r\nDiazoxide should be used with caution in patients with cardiac failure or impaired cardiac reserve in whom sodium and water retention may worsen or precipitate congestive heart failure. A direct effect on myocardium and cardiac function cannot be excluded.<br />\r\n<br />\r\nDiazoxide should be used with care in patients with impaired cardiac or cerebral circulation and in patients with aortic coarctation, aortic stenosis, arteriovenous shunt, heart failure or other cardiovascular disorders in which an increase in cardiac output could be detrimental.<br />\r\n<br />\r\nDiazoxide should be administered with caution to patients with hyperuricaemia or a history of gout, and it is advisable to monitor serum uric acid concentration.<br />\r\n<br />\r\nWhenever Diazoxide is given over a prolonged period regular haematological examinations are indicated to exclude changes in white blood cell and platelet counts.<br />\r\n<br />\r\nAlso in children there should be regular assessment of growth, bone and psychological maturation.<br />\r\n<br />\r\nThe very rapid, almost complete protein binding of Diazoxide requires cautious dosage to be used in patients whose plasma proteins may be lower than normal</p>', '<p>Excessive dosage of Diazoxide can result in hyperglycaemia. Severe hyperglycaemia may be corrected by giving insulin and less severe hyperglycaemia may respond to oral hypoglycaemics. Hypotension may be managed with intravenous fluids and in severe cases may require sympathomimetics.</p>', '<p>Combination Oral hypoglycemic preparations</p>', '<p>Store below 30&deg;C. Store in the original container in order to protect from moisture. Keep Diazoxide out of reach and sight of the children.</p>', NULL, '2022-02-19 06:19:11', '2022-04-27 16:44:25'),
(440, 440, '<p>This topical gel is a Non-steroidal anti-inflammatory (NSAID) drug used to treat pain associated with conditions like gout, migraine, rheumatoid arthritis, sprains of muscles and joints etc.</p>', '<p>Diclofenac Diethylamine, Mephenesin, Menthol, Methyl Salicylate, Turpentine oil works by reducing pain and delayed onset muscle soreness; relieving pruritus; providing relief from painful conditions; providing relief of musculoskeletal aches and pains; reducing the pain.</p>', '<p>Depending on the size of the area to be treated, 2-4 gm of this gel should be applied to the skin 3-4 times daily to the affected area and rubbed in lightly.</p>', NULL, '<p>It is contraindicated in patients who have hypersensitivity to this gel. In addition, This gel should not be used if one has the following conditions:</p>\r\n\r\n<ul>\r\n	<li>children less than 12 years old</li>\r\n	<li>cuts</li>\r\n	<li>infected skin</li>\r\n</ul>', '<p>The most commonly reported side-effects of this gel are itching, blisters, allergic contact dermatitis, anaphylactic reactions, pruritus, and rash.</p>', '<p>Not recommended.</p>', '<p>This gel should not be allowed to come in contact with the eyes or mucous membranes. After application, the hands should be washed unless they are the sites being treated. Not to be taken by mouth.</p>', NULL, '<p>Topical Analgesics</p>', '<p>It should be stored in a cool and dry place, protected from light and moisture.</p>', NULL, '2022-02-19 06:19:26', '2022-04-27 16:46:38'),
(441, 441, '<p>Short-term treatment in the following acute conditions:</p>\r\n\r\n<ul>\r\n	<li>Post-traumatic pain, inflammation and swelling,e.g.due to sprains</li>\r\n	<li>Post-operative pain, inflammation and swelling,e.g.following dental or orthopaedic surgery</li>\r\n	<li>Painful and/or inflammatory conditions in gynaecology, e.g. primary dysmenorrhoea or adnexitis</li>\r\n	<li>Migraine attacks</li>\r\n	<li>Painful syndromes of the vertebral column</li>\r\n	<li>Non-articular rheumatism</li>\r\n	<li>As an adjuvant in severe painful inflammatory infections of the ear, nose, or throat, e.g. pharyngotonsillitis, otitis.</li>\r\n</ul>', '<p>The mechanism of action of Diclofenac Potassium, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2).<br />\r\n<br />\r\nDiclofenac is a potent inhibitor of prostaglandin synthesis in vitro. Diclofenac concentrations reached during therapy have produced in vivo effects. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in inducing pain in animal models. Prostaglandins are mediators of inflammation. Because diclofenac is an inhibitor of prostaglandin synthesis, its mode of action may be due to a decrease of prostaglandins in peripheral tissues.</p>', '<p><strong>Adults</strong>: Following an initial loading dose of 50 mg, 25-50 mg is to be taken every eight hours if necessary.<br />\r\n<br />\r\n<strong>Migraine</strong>: An initial loading dose of 50 mg, then if necessary a further 25-50 mg after 2 hours. The maximum daily dose is 150 mg. The tablets should be swallowed whole with liquid, preferably before meals.<br />\r\n<br />\r\n<strong>Children</strong>: Children over 14 years of age: upto 75 mg daily in divided doses.</p>', '<p>Diclofenac may have the following drug interactions:</p>\r\n\r\n<ul>\r\n	<li>Lithium and Digoxin: Diclofenac may increase plasma concentrations of Lithium and Digoxin.</li>\r\n	<li>Anticoagulant:There are isolated reports of and increased risk of haemorrhage with the combined use of Diclofenac and anticoagulant therapy.</li>\r\n	<li>Cyclosporin: Cases of nephrotoxicity have been reported in patients receiving Cyclosporin and Diclofenac concomitantly.</li>\r\n	<li>Methotrexate: Cases of serious toxicity have been reported when Methotrexate and NSAIDs are given within 24 hours of each other.</li>\r\n	<li>Diuretics: Like other NSAIDs, Diclofenac may inhibit the activity of diuretics.</li>\r\n	<li>Other NSAIDs and steroids; Co-administration of Diclofenac with other systemic NSAIDs and steroids may increase the frequency of unwanted effects.</li>\r\n</ul>', '<p>Diclofenac Potassium tablets are contraindicated in patients with known hypersensitivity to Diclofenac. Diclofenac should not be given to patients who have experienced asthma, urticaria, or allergic type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients. Diclofenac is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.</p>', '<p>Side-effects of Diclofenac are usually mild and transient. However, if serious side-effects occur. Diclofenac should be discontinued. Occasional: epigastric pain, other gastro-intestinal disorders (e.g., nausea, vomiting, diarrhoea, abdominal cramps, dyspepsia,flatulence,anorexia). Rare: gastro-intestinal bleeding, peptic ulcer (with or without bleeding or perforation), bloody diarrhoea.</p>', '<p>Diclofenac should not be prescribed during pregnancy, unless there are compelling reasons for doing so. The lowest effective dosage should be used. This type of drugs are not recommended during the last trimester of pregnancy. Very small quantities of diclofenac may be detected in breast milk, but no undesirable effects on the infant are to be expected.</p>', NULL, NULL, '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-19 06:19:50', '2022-04-27 16:48:49'),
(442, 442, '<p><strong>Rheumatology</strong>: Inflammatory and degenerative forms of rheumatism, chronic involutive, polyarthritis, ankylosing spondylarthritis, osteoarthritis, spondylarthroses, acute gout, peri-articular rheumatic disorders.<br />\r\n<br />\r\n<strong>Surgery and Traumatology</strong>: Sprain, bruises, dislocations, fractures, softtissue injuries, surgical interventions.<br />\r\n<br />\r\n<strong>Obstetrics and Gynecology</strong>: Primary dysmenorrhoea, episiotomy, adnexitis, endometritis, parametritis, salpingitis, and mastitis.<br />\r\n<br />\r\n<strong>Otorhinolaryngology</strong>: As pre-operative medication for the prevention of pain, inflammation, and swelling.<br />\r\n<br />\r\n<strong>Dentistry</strong>: Post-operative and post-traumatic pain, inflammation, and swelling.<br />\r\n<br />\r\n<strong>Other indications</strong>: For the prevention of pain and treatment of inflammation and swelling of patients operated in the urogenital tract, renal and biliary colic.</p>', '<p>Dilofenac Sodium is a potent non-steroidal anti-inflammatory drug (NSAID) with pronounced anti-rheumatic, anti-inflammatory, analgesic and antipyretic properties. It has also some uricosuric effect. Diclofenac exerts its effect by inhibiting prostaglandin biosynthesis which plays a major role in causing inflammation, pain and fever. Diclofenac is rapidly and completely absorbed from the gastro-intestinal tract when taken with or after meal. Peak plasma concentrations are reached within an average of 2 hours after ingestion of it. At therapeutic concentrations, it is 99.7% bound to plasma proteins. Diclofenac is metabolized in the liver and undergoes first pass metabolism.</p>', '<p><strong>Diclofenac FC Tablet</strong>: Adults: 75-150 mg daily in 2 to 3 divided doses, preferably after food. Dose should be reduced in long term use.<br />\r\n<br />\r\n<strong>Diclofenac SR Tablet</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 1 tablet daily, taken whole with liquid, preferably at meal times. If necessary, the daily dose can be increased to 150 mg by supplementation with conventional tablets.</li>\r\n	<li><strong>Children</strong>: 1-3 mg of diclofenac/kg body wt. daily in divided doses.</li>\r\n	<li><strong>Elderly patients</strong>: In elderly or debilitated patients, the lowest effective dosage is recommended, although the pharmacokinetics of diclofenac sodium is not impaired to any clinically relevant extent in elderly patients.</li>\r\n</ul>\r\n\r\n<p><strong>Diclofenac Dispersible Tablet</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: The recommended daily dosage is 2-3 tablets and the maximum daily dose is 150 mg. In milder cases, 2 tablets of Diclofenac DT per day are sufficient. Diclofenac DT should preferably be taken before meals.</li>\r\n	<li><strong>Children</strong>: Diclofenac is not recommended in children for other indications except juvenile rheumatoid arthritis where the recommended dose is 1-3 mg/kg body weight. Diclofenac DT is to be dropped into a half-glass of water and the liquid is to be stirred to aid dispersion before swallowing. There is no information on the use of Diclofenac DT for more than 03 months.</li>\r\n</ul>\r\n\r\n<p><strong>Diclofenac TR Capsule</strong>: One capsule daily. Diclofenac TR should be taken preferably after mealtimes.<br />\r\n<br />\r\n<strong>Diclofenac Suppository</strong>: For adults: 50 mg suppository 2-3 times daily. Maximum daily dose is 150 mg.<br />\r\n<br />\r\n<strong>Diclofenac injection</strong>: For adults the usual dose is 1 ampoule daily. In serious cases this dose may be increased up to 2 ampoules daily.<br />\r\n<br />\r\n<strong>Diclofenac Gel</strong>: For external use only. Depending on the size of area to be treated, 2-4 g of Diclofenac gel should be applied to the skin 3-4 times daily. To the affected area gel should be rubbed in lightly. This gel may also be given in addition to further treatment with other dosage forms of Diclofenac.</p>', NULL, '<p>Contraindicated to the patients hypersensitive to any ingredient of the products. Peptic ulcer, hypersensitivity to Diclofenac like other non-steroid anti-inflammatory agents, Diclofenac is also contra-indicated in asthmatic patient in whom attack with asthma, urticaria or acute rhinitis are precipitated by acetylsalicylic acid or by other drugs with prostaglandin synthetase inhibitor. This Gel should not be used under occlusive airtight dressings.</p>', '<p>Diclofenac Sodium is generally well tolerated. Adverse effects are mild, rare and transient. At the starting of the treatment, however, patients may be sometimes complaining of epigastric pain, eructation, nausea and diarrhea or dizziness or headache. These effects are usually mild in nature. Peripheral edema and skin reactions, such as rash and eczema have also been encountered. Diclofenac Sodium Gel may cause local irritation and reddening of the skin and skin rash.</p>', '<p>During pregnancy, Diclofenac should be employed only for compelling reasons. The lowest effective dose should be used. These types of drugs are not recommended during the first trimester of pregnancy. In view of insufficient clinical data, Diclofenac Sodium Gel is not recommended during pregnancy. A very insignificant quantity of Diclofenac may be detected in breast milk but no undesirable effects on the infant to be expected.</p>', '<p>In rare instances where peptic ulceration or gastrointestinal bleeding occurs in patients under treatment with Diclofenac. In patients with advanced age should be kept under close observation. Diclofenac Sodium Gel should not be allowed to come in contact with the eyes or mucus membranes, after application the hands should be washed properly and not to be taken by mouth.</p>', NULL, '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Store in a cool and dry place, protected from light. Store below 30&deg;C. Keep out of the reach of children.</p>', NULL, '2022-02-19 06:20:07', '2022-04-27 16:51:06');
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
(443, 443, '<p>Diclofenac Sodium ophthalmic preparation is indicated in-&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Inhibition of miosis during cataract surgery.</li>\r\n	<li>Post-operative inflammation after cataract surgery and other ocular surgical procedures.</li>\r\n	<li>Pre-operative and post-operative prevention of cystoid macular edema (CME) associated with lens extraction &amp; intraocular lens implantation.</li>\r\n	<li>Post-traumatic inflammation in penetrating and non- penetrating wounds (as an adjuvant to local anti-infective therapy).</li>\r\n	<li>Non-infected chronic conjunctivitis, keratoconjunctivitis.</li>\r\n</ul>', '<p>Diclofenac Eye Drops contains Diclofenac Sodium, a potent non-steroidal anti-inflammatory drug with analgesic property. Diclofenac Sodium produces anti-inflammatory effect by inhibiting cyclooxygenase activity with a reduction in the tissue prostaglandin ( such as PgE2 and Pg F2&alpha;) .</p>', '<p>Ophthalmic (Adult)-</p>\r\n\r\n<ul>\r\n	<li><strong>Postoperative ocular inflammation</strong>: Instill into the appropriate eye 4 times daily starting 24 hr after surgery for up to 28 days.</li>\r\n	<li><strong>Inflammation and discomfort after strabismus surgery</strong>: Instill 1 drop 4 times daily for the 1st wk; then tid in the 2nd wk, bid in the 3rd wk, and as required for the 4th wk.</li>\r\n	<li><strong>Pain and discomfort after radial keratotomy</strong>: Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.</li>\r\n	<li><strong>Pain after accidental trauma</strong>: Instill 1 drop 4 times daily for up to 2 days.</li>\r\n	<li><strong>Control of inflammation after argon laser trabeculoplasty</strong>:&nbsp;Instill 1 drop 4 times during the 2 hr before procedure followed by 1 drop 4 times daily, up to 7 days after procedure.</li>\r\n	<li><strong>Prophylaxis of intra-operative miosis</strong>: Instill into appropriate eye 4 times w/in 2 hr before surgery.</li>\r\n	<li><strong>Post-photorefractive keratectomy pain</strong>:&nbsp;Instill into the affected eye twice, an hr before surgery, then 1 drop twice at 5-min intervals immediately after surgery, then every 2-5 hr while awake for up to 24 hr.</li>\r\n	<li><strong>Seasonal allergic conjunctivitis:</strong>&nbsp;Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.</li>\r\n</ul>', '<p>No drug interaction is reported. There should be at least 5 minutes interval when another ophthalmic solution (e.g., steroid) is given.</p>', '<p>Hypersensitivity to any of the components Like other non steroidal anti-inflammatory agents, Diclofenac Sodium eye drops is contraindicated in patients in whom attacks of asthma, urticaria or acute rhinitis have been observed following application of acetyl salicylic acid or other cyclo-oxygenase inhibitors</p>', '<p>Mild to moderate burning sensation in 5-15% patients which is transient in nature and almost never necessitated discontinuation of treatment. Other less common side-effects are sensitivity to light, bad taste, feeling of pressure, allergic reactions etc.</p>', '<p>The safety of Diclofenac eye drops in pregnancy &amp; lactation has not been established and its use therefore is not recommended unless the potential benefit to the mother outweighs the possible risk to the child.</p>', '<p>Diclofenac eye drops may mask the signs of infection. So physicians should be alert to the development of infections in patients receiving the drug. During prolonged use, it is recommended that physicians conduct periodic examinations of the eye, including measurement of the intraocular pressure. Contact lenses should not be worn during treatment.</p>', '<p>Accidental ingestion of Diclofenac Sodium presents virtually no risk of unwanted effects, since one 5 ml bottle of eye drop solution contains only 5 mg of Diclofenac Sodium, which is equivalent to about 3% of the recommended maximum oral dose for adults.</p>', '<p>Ophthalmic Non-Steroid drugs</p>', '<p>Close the bottle immediately after use. Do not use for more than four weeks after opening. Store at room temperature.</p>', NULL, '2022-02-19 06:20:25', '2022-04-27 16:54:15'),
(444, 444, '<p>The injection contains Diclofenac Sodium that is used to relief all grades of pain and inflammation in a wide range of conditions including:</p>\r\n\r\n<ul>\r\n	<li>Arthritic conditions such as rheumatoid arthritis, osteoarthritis, juvenile chronic arthritis, ankylosing spondylitis, acute gout.</li>\r\n	<li>Acute musculoskeletal disorders such as periarthritis (e.g., Frozen shoulder), tendinitis, tenosynovitis, bursitis.</li>\r\n	<li>Other painful conditions resulting from trauma including, fracture, low back pain, sprains, strains, dislocations, control of pain and inflammation in orthopaedic, dental and other minor surgeries, postoperative pain, pain of renal colic etc.</li>\r\n</ul>\r\n\r\n<p>The injection also contains Lidocaine which acts as a local anaesthetic. Therefore the possibility of pain at the injection site, which is most likely to occur after intramuscular injection, is minimized if the Lidocaine containing injection is used in the above indications.</p>', '<p>Diclofenac Sodium is a potent nonsteroidal antiinflammatory drug (NSAID) with marked analgesic and antipyretic properties. It also has some uricosuric effects. The action of Diclofenac appeared to be associated with the inhibition of prostaglandin synthesis. Diclofenac may inhibit synthesis of prostaglandins by inhibiting cyclooxygenase, an enzyme that catalyses the formation of prostaglandin precursors from arachidonic acid. Peak plasma concentration is achieved within half an hour following injection. Lidocaine is the most widely used local anaesthetic drug. It acts more rapidly and is more stable than most other local anaesthetics. It is a very useful surface anaesthetic. Like other local anaesthetics, Lidocaine impairs the generation and conduction of nerve impulses by slowing depolarization. The onset of anaesthesia of Lidocaine Hydrochloride is more rapid and the duration is 1-2 hours.</p>', '<p><strong>Adult</strong>: One ampoule once (or in severe cases, twice) daily by intramuscular injection.<br />\r\n<br />\r\n<strong>Renal colic</strong>: One ampoule once daily intramuscularly. A second dose may be administered after 30 minutes if necessary.<br />\r\n<br />\r\n<strong>Children</strong>: In Juvenile chronic arthritis, 1-3 mg of Diclofenac Sodium per kg body weight daily in divided doses.<br />\r\n<br />\r\n<strong>Elderly patients</strong>: In elderly or debilitated patients, the lowest effective dosage is recommended, commensurate with age and physical status, or as prescribed by the physician.</p>', '<p><strong>Lithium and Digoxin:</strong>&nbsp;Diclofenac may increase plasma concentrations of Lithium and Digoxin.<br />\r\n<br />\r\n<strong>Anticoagulants:</strong>&nbsp;There are isolated reports of an increased risk of haemorrhage with the combined use of Diclofenac and anticoagulant therapy, although clinical investigations do not appear to indicate any influence on anticoagulant effect.<br />\r\n<br />\r\n<strong>Antidiabetic agents:&nbsp;</strong>Clinical studies have shown that Diclofenac can be given together with oral antidiabetic agents without influencing their clinical effect.<br />\r\n<br />\r\n<strong>Cyclosporin:&nbsp;</strong>Cases of nephrotoxicity have been reported in patients receiving Cyclosporin and Diclofenac concomitantly.<br />\r\n<br />\r\n<strong>Methotrexate:&nbsp;</strong>Cases of serious toxicity have been reported when Methotrexate and NSAIDs are given within 24 hours of each other.<br />\r\n<br />\r\n<strong>Quinolone antimicrobials:</strong>&nbsp;Convulsions may occur due to an interaction between quinolones and NSAIDs. Therefore, caution should be exercised when considering concomitant therapy of NSAIDs and quinolones.<br />\r\n<br />\r\n<strong>Other NSAIDs and steroids</strong>: Co-administration of Diclofenac with other systemic NSAIDs and steroids may increase the frequency of unwanted effects. With Aspirin, the plasma levels of each are lowered, although no clinical significance is known.<br />\r\n<br />\r\n<strong>Diuretics:</strong>&nbsp;Various NSAIDs are liable to inhibit the activity of diuretics. Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels. So, serum potassium should be monitored.</p>', '<p>It is contraindicated for those patients who are hypersensitive to Diclofenac. In patients with active or suspected peptic ulcer or gastrointestinal bleeding or for those patients in whom attacks of asthma, urticaria or acute rhinitis are precipitated by Aspirin or other NSAIDs possessing prostaglandin synthetase inhibiting activity Diclofenac is also contraindicated. Because of the presence of Lidocaine, this&nbsp;injection is also contraindicated for those patients who are hypersensitive to local anaesthetics of the amide type, although the incidence is very rare. In patients with Adams-Stokes syndrome or with severe degrees of SA, AV, or intraventricular heart block in the absence of an artificial pacemaker, and for those patients who are hypersensitive to any of the excipients used in the formulation (Sodium Metabisulphite, Disodium Edetate, Benzyl Alcohol, Sodium Hydroxide, Propylene Glycol), this injection is also contraindicated.</p>', '<p>Side effects to Diclofenac Sodium and Lidocaine injection are usually mild and transient. However if serious side effects occur the injection should be discontinued. Gastrointestinal discomfort, nausea, diarrhea and occasionally bleeding may occur. In very rare instances, injection site disorder may occur. In isolated cases, abscesses and local necrosis may occur. The adverse effects due to Lidocaine mainly involve the CNS, are usually of short duration, and are dose related. The CNS reactions may be manifested by drowsiness, dizziness, disorientation, confusion, lightheadedness etc.</p>', '<p>It should not be prescribed during pregnancy unless there are compelling reasons for doing so. The lowest effective dosage should be used. These types of drugs are not recommended during the last trimester of pregnancy. Very small quantities of Diclofenac may be detected in breast milk, but no undesirable effects on the infant are to be expected.</p>', '<p><strong>Renal:</strong>&nbsp;Patients with severe hepatic, cardiac or renal insufficiency or the elderly should be kept under close observation, since the use of NSAIDs may result in deterioration of renal function. The lowest effective dose should be used and renal function should be monitored.<br />\r\n<br />\r\n<strong>Hepatic:</strong>&nbsp;If abnormal liver function tests persist or worsen, clinical signs or symptoms consistent with liver disease develop or if other manifestations occur (eosinophilia, rash), Diclofenac should be discontinued. All patients who are receiving long term treatment with NSAIDs should be monitored as a precautionary measure (e.g., renal, hepatic function and blood counts).</p>', NULL, '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Store at temparature not exceeding 30&deg;C in a dry place. Protected from light.</p>', NULL, '2022-02-19 06:20:51', '2022-04-27 16:56:33'),
(445, 445, '<p>Indicated for the quick relief from pain, swelling and inflammation due to musculo-skeletal disorders such as sprains, strains, tendinitis, bursitis, hands, neck &amp; shoulder pain, sciatica, muscle stiffness, joint pain, back ache and lumbago.</p>', '<p>Diclofenac Diethylamine is systemically absorbed through the skin; it inhibits the enzyme cyclooxygenase, thus reducing the formation of PGE2. Moreover, it also increases the uptake of Arachidonic acid into the cellullar pool. Menthol is a vasodilator. It dilates the blood vessels, produces a feeling of coolness and produces analgesia. Methyl salicylate is a known anti-inflammatory agent.</p>', '<p>Approximately one-inch band of gel should be applied to the affected site three to four times daily with rubbing till the film disappears. Safety and effectiveness in pediatric patients have not been established.</p>', NULL, '<p>Known hypersensitivity to any part of the preparation.</p>', '<p>Usually well tolerated. Extremely low frequency of hypersensitivity reactions.</p>', '<p>The safety of this gel has not been established during pregnancy. There are no well-controlled studies of diclofenac in pregnant women.</p>', '<p>For external use only. Avoid contact with the eyes. Stop use and ask a doctor if condition worsens or does not improve within 7 days. Keep out of the reach of children. If swallowed, get medical help or contact a poison control center right away.</p>', NULL, '<p>Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Store below 25&deg;C. Protect from light. Do not freeze. Keep out of reach of children. Close cap tightly after each application.</p>', NULL, '2022-02-19 06:21:07', '2022-06-06 00:49:47'),
(446, 446, '<p>This combination is indicated for treatment of the signs and symptoms of osteoarthritis or rheumatoid arthritis in patients at high risk of developing NSAID-induced gastric and duodenal ulcers and their complications.</p>', '<p>It is a combination product containing Diclofenac Sodium, a nonsteroidal anti-inflammatory drug (NSAID) with analgesic properties and Misoprostol, a gastrointestinal (GI) mucosal protective prostaglandin E 1 analog. The mechanism of action of Diclofenac Sodium, like other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition. NSAIDs inhibit prostaglandin synthesis. A deficiency of prostaglandins within the gastric and duodenal may lead to diminish bicarbonate and mucosal secretion and may contribute to mucosal damage caused by NSAIDs. Misoprostol can increase bicarbonate and mucous production &amp; prevents gastric and duodenal ulcers.</p>', '<p><strong>Osteoarthritis</strong>: The recommended dosage for maximal GI mucosal protection is Diclofenac Sodium 50 mg &amp; Misoprostol 200 &micro;g tid. For patients who experience intolerance, Diclofenac Sodium 75 mg &amp; Misoprostol 200 &micro;g bid or Diclofenac Sodium 50 mg &amp; Misoprostol 200 &micro;g bid can be used.<br />\r\n<br />\r\n<strong>Rheumatoid arthritis</strong>: The recommended dosage is Diclofenac Sodium 50 mg &amp; Misoprostol 200 &micro;g tid or qid. For patients who experience intolerance, Diclofenac Sodium 75 mg &amp; Misoprostol 200 &micro;g bid or Diclofenac Sodium 50 mg &amp; Misoprostol 200 &micro;g bid can be used.</p>', '<p><strong>Aspirin:</strong>&nbsp;Concomitant administration with aspirin is not recommended because Diclofenac Sodium is displaced from its binding sites by aspirin, resulting in lower plasma concentrations, peak plasma levels and AUC values.<br />\r\n<br />\r\n<strong>Digoxin:</strong>&nbsp;Elevated digoxin levels have been reported in patients receiving digoxin and Diclofenac Sodium. Antihypertensives: NSAIDs can inhibit the activity of antihypertensives, including ACE inhibitors.<br />\r\n<br />\r\n<strong>Warfarin</strong>: The effects of warfarin and NSAIDs on GI bleeding are synergistic, such that users of both drugs together have a risk of serious bleeding greater than users of either drug alone.<br />\r\n<br />\r\n<strong>Oral hypoglycaemics:</strong>&nbsp;Diclofenac Sodium does not alter glucose metabolism in healthy people nor it alters the effects of oral hypoglycaemics. Diclofenac Sodium may alter diabetic patient&rsquo;s response to insulin or oral hypoglycaemics.<br />\r\n<br />\r\n<strong>Antacids:</strong>&nbsp;Antacids reduce the bioavailability of Misoprostol. Antacids may also delay absorption of Diclofenac Sodium.<br />\r\n<br />\r\n<strong>Diuretics:</strong>&nbsp;The Diclofenac Sodium component like other NSAIDs, can inhibit the activity of diuretics. Concomitant therapy with potassium-sparing diuretics may be associated with increased serum potassium levels.</p>', '<p>This is contraindicated in patients with hypersensitivity to Diclofenac, Misoprostol or to other prostaglandins. This should not be given to patients who have experienced asthma, urticaria or other allergic-type reactions after taking aspirin or other NSAIDs.</p>', '<p>The most common reported side effects are abdominal pain, diarrhea and other GI symptoms. Diarrhea and abdominal pain developed early in the course of therapy and were usually self-limited (resolved after 2 to 7 days). Rare instances of profound diarrhea leading to &nbsp;severe dehydration have been reported in patients receiving Misoprostol.</p>', '<p>Because of the abortifacient property of the Misoprostol component, this is contraindicated in women who are pregnant. Diclofenac Sodium has been found in the milk of nursing mothers. Diclofenac Sodium plus Misoprostol is not recommended for use by nursing mothers.</p>', '<p>Patients with an underlying condition such as inflammatory bowel disease or those in whom dehydration should be monitored carefully if Diclofenac Sodium plus Misoprostol is prescribed.</p>', '<p><strong>Misoprostol:</strong>&nbsp;Convulsions, sedation, tremor, dyspnoea, diarrhoea, abdominal pain, fever, palpitations, hypotension, bradycardia. Management: Supportive treatment.<br />\r\n<br />\r\n<strong>Diclofenac:</strong>&nbsp;Lethargy, drowsiness, nausea, vomiting, epigastric pain, GI bleeding. HTN, acute renal failure, resp depression, anaphylactoid reactions and coma may occur rarely</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Store in a cool and dry place below 25&ordm; C. Protect from light.</p>', '<p><strong>Paediatric use</strong>: Safety and effectiveness of Diclofenac Sodium and Misoprostol combination in paediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some elderly person cannot be ruled out. As with any NSAID, the elderly are likely to tolerate adverse events less well than younger patients.</p>', '2022-02-19 06:21:41', '2022-06-06 21:59:07'),
(447, 447, '<p>Dicycloverine is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Functional bowel/irritable bowel syndrome</li>\r\n	<li>Urinary incontinence secondary to unstable detrusor muscle</li>\r\n	<li>Infantile colic</li>\r\n	<li>GIT spasm</li>\r\n	<li>Colicky abdominal pain</li>\r\n	<li>Diverticulitis</li>\r\n	<li>Abdominal colic</li>\r\n</ul>', '<p>Dicycloverine hydrochloride is an antispasmodic and anticholinergic (antimuscarinic) agent. Chemically, it is [Bicyclohexyl-]1-carboxylic acid, 2-(diethylammo) ethyl ester, hydrochloride. Dicycloverine relieves smooth muscle spasm of the gastrointestinal tract. Dicycloverine HCl Injection is a sterile, pyrogen-free, aqueous solution for intramuscular injection (Not For Intravenous Use). It works at specific receptors, called cholinergic (or muscarinic) receptors, located on the involuntary muscle in the walls of the gut. By binding to these receptors dicycloverine prevents certain chemicals produced by the body from interacting with these receptors. This causes the gut muscle to relax, relieving the pain of colic produced by gut muscle contraction and spasm.</p>', '<p>For oral dosage forms:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>:10 to 20 mg three times a day.</li>\r\n	<li><strong>Children over 6 months of age</strong>: 5 to 10 mg three times a day.</li>\r\n</ul>\r\n\r\n<p>For injectable dosage form:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: Intramuscular injection. Not for intravenous use. The recommended intramuscular dose is 80 mg daily (in 4 equally divided doses).</li>\r\n</ul>\r\n\r\n<p>Oral dicycloverine Hydrochloride should be started as soon as possible and the intramuscular form should not be used for periods longer than 1 or 2 days.<br />\r\n<br />\r\n<strong>Children</strong>: Dose must be determined by the doctor.</p>', NULL, NULL, '<p>Insomnia, mydriasis, cycloplegia, increased ocular tension, urinary hesitancy, palpitations, dyspnea.</p>', '<p>Pregnancy Category B. Dicycloverine was neither teratogenic nor embryocidal in animal trial. It, like other drugs should be used during pregnancy only if clearly needed. There are no data on the secretion of this drug into breast milk. Dicycloverine should be used cautiously in case of lactating mother.</p>', '<p>Use with caution in patients with autonomic neuropathy, hepatic or renal disease, ulcerative colitis, coronary heart disease, congestive heart failure, cardiac tachyarrhythmia, hiatal hernia, known or suspected prostatic hypertrophy.</p>', '<p>Toxic reaction seldom occurs with dicycloverine. The signs and symptoms of overdosage are headache; nausea; vomiting; blurred vision; dilated pupils; hot, dry skin; dizziness; dryness of the mouth; difficulty in swallowing; and CNS stimulation.</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-19 06:22:16', '2022-06-06 22:02:02'),
(448, 448, '<p>Dienoaest is indicated for the treatment of endometriosis. This is the preparation of Dienogest which belongs to the class of medications called progestins. Progestins reduce the effects of estrogen on tissues such as the endometrium (lining of the uterus) and the breast. By reducing the growth effect of estrogen on the endometrium, Dienogest helps to reduce the pelvic pain experienced by women with endometriosis.</p>', '<p>Dienogest acts as an agonist at the progesterone receptor (PR) with weak affinity that is comparable to that of progesterone but has a very potent progestagenic effect in the endometrium, causing endometrial atrophy after prolonged use. It promotes antiproliferative, immunologic and antiangiogenic effects on endometrial tissue. Dienogest reduces the level of endogenous production of oestradiol and thereby suppressing the trophic effects of oestradiol on both the eutopic and ectopic endometrium. Continous administration of dienogest results in hyperprogestogenic and moderately hypoestrogenic endocrine environment, which causes initial decidualization of endometrial tissue. It is an antagonist at androgen receptors, improve androgenic symptoms such as acne and hirsutism [A16570].</p>', '<p>Tablet-taking can be started on any day of the menstrual cycle. The dosage of Dienogest is 2 mg daily without any break, taken preferably at the same time each day with some liquid as needed. Tablet must be taken continuously without regard to vaginal bleeding. When a pack is finished, the next one should be started without interruption.<br />\r\n<br />\r\nIn the event of missed tablet(s), the woman should take 2 mg only, as soon as she remembers, and should then continue the next day to take the tablet at her usual time. A tablet not absorbed due to vomiting or diarrhea should likewise be replaced by 2 mg.</p>', '<p>Progestogens including Dienogest are metabolized mainly by the cytochrome P450 3A4 system . Therefore, inducers or inhibitors of CYP3A4 may affect the progestogen drug metabolism. Known CYP3A4 inhibitors like azole antifungals (e.g, ketoconazole, itraconazole, fluconazole), cimetidine, verapamil, macrolides (e.g, erythromycin, clarithromycin and roxithromycin), diltiazem, protease inhibitors (e.g, ritonavir, saquinavir, indinavir, nelfinavir), antidepressants (e.g, nefazodone, fluvoxamine, fluoxetine) may increase plasma levels of progestogens and result in adverse reactions.</p>', '<p>Hypersensitivity to dienogest or to any of the excipients of Dienogest. Dienogest should not be used in the presence of any of the&nbsp;conditions such as, Active venous thromboembolic disorder; arterial and cardiovascular disease, (e.g, myocardial infarction, cerebrovascular accident, ischemic heart disease); diabetes mellitus with vascular involvement; presence or history of severe hepatic disease as long as liver function values have not returned to normal; presence or history of liver tumors (benign or malignant); known or suspected sex hormone-dependent malignancies and undiagnosed vaginal bleeding.</p>', '<p>Undesirable effects are more common during the 1st months after start of intake of Dienogest, and subside with duration of treatment. The following undesirable effects have been reported in users of Dienogest. The most frequently reported undesirable effects during treatment that were considered at least possibly related to Dienogest were headache (9%), breast discomfort (5.4%), depressed mood (5.1%) and acne (5.1%).</p>\r\n\r\n<ul>\r\n	<li>Nervous System Disorders: Headache, migraine.</li>\r\n	<li>Cardiac Disorders: Uncommon: Unspecified circulatory system disorder, palpitations.</li>\r\n	<li>Vascular Disorders: Uncommon: Hypotension.</li>\r\n	<li>Gastrointestinal Disorders: Common: Nausea, abdominal pain, flatulence.</li>\r\n	<li>Metabolism and nutrition disorders: Weight increase (3.6%)</li>\r\n	<li>Psychiatric Disorders: Depressed mood, irritability, nervousness, altered mood.</li>\r\n</ul>', '<p>There are limited data from the use of Dienogest in pregnant women. Animal studies and data from women exposed to Dienogest during pregnancy reveal no special risks on pregnancy, embryonic/fetal development, birth or development after birth for humans. However, Dienogest should not be administered to pregnant women because there is no need to treat endometriosis during pregnancy.<br />\r\n<br />\r\nTreatment with Dienogest during lactation is not recommended. Physiochemical properties and animal data indicate excretion of Dienogest in breast milk. A decision must be made whether to discontinue breastfeeding or to abstain from Dienogest therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the woman.</p>', '<p>Before starting Dienogest treatment, pregnancy must be excluded. During treatment, patients are advised to use nonhormonal methods of contraception (e.g, barrier method) if contraception is required.<br />\r\n<br />\r\nAs Dienogest is a progestogen-only preparation, it can be assumed that special warnings and special precautions for use of other progestogen-only preparations are also valid for the use of Dienogest .</p>\r\n\r\n<ul>\r\n	<li>Changes in Bleeding Pattern: Dienogest treatment affects the menstrual bleeding pattern in the majority of women.</li>\r\n	<li>Hepatic Impairment: Dienogest is contraindicated in patients with present or past severe hepatic disease.</li>\r\n	<li>Impairment of Fertility: Based on available data, ovulation is inhibited in the majority of patients during treatment with Dienogest. However, Dienogest is not a contraceptive. If contraception is required, a nonhormonal method should be used.</li>\r\n</ul>', '<p>Acute toxicity studies performed with Dienogest did not indicate a risk of acute adverse effects in case of inadvertent intake of a multiple of the daily therapeutic dose. There is no specific antidote. Dienogest 20-30 mg/day (10-15 times higher dose than in Dienogest) over 24 weeks of use were very well tolerated.</p>', '<p>Female Sex hormones</p>', '<p>Keep in a cool and dry place. Protect from light. Keep out of the reach of children.</p>', '<p>Use in Children: Dienogest is not indicated in children prior to menarche. The safety and efficacy of Dienogest in adolescents (menarche to 18 years) has not yet been established.<br />\r\n<br />\r\nUse in the Elderly: There is no relevant indication for the use of Dienogest in the geriatric population.</p>', '2022-02-19 06:22:32', '2022-06-06 21:54:55'),
(449, 449, '<p>This is an estrogen/progestin COC, indicated for use by women to prevent pregnancy. The efficacy of this tablet&nbsp;in women with a body mass index (BMI) of &gt;30 kg/m 2 has not been evaluated. Treatment of heavy menstrual bleeding in women without organic pathology who choose to use an oral contraceptive as their method of contraception.</p>', '<p>COCs lower the risk of becoming pregnant primarily by suppressing ovulation. Other possible mechanisms may include cervical mucus changes that inhibit sperm penetration and endometrial changes that reduce the likelihood of implantation.</p>', '<p>Take one tablet daily by mouth at the same time every day. Tablets must be taken in the order directed on the blister pack. Do not skip or delay intake by more than 12 hours.&nbsp;</p>', '<p>Drugs or herbal products that induce certain enzymes (for example CYP3A4) may decrease the effectiveness of COCs or increase breakthrough bleeding. Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with COCs.</p>', '<ul>\r\n	<li>A high risk of arterial or venous thrombotic diseases</li>\r\n	<li>Undiagnosed abnormal uterine bleeding</li>\r\n	<li>Breast cancer or other estrogens- or progestin-sensitive cancer</li>\r\n</ul>', '<p>The most common adverse reactions (&ge;2%) in clinical trials for Natazia are headache (including migraines) 13%, breast pain 7%, menstrual disorders 7%, nausea or vomiting 6%, acne 4%, mood changes (3%) and increased weight 3%.</p>', NULL, '<ul>\r\n	<li>Vascular risks: Stop this tablet if a thrombotic event occurs. Stop this tablet at least 4 weeks before and through 2 weeks after major surgery. Start this tablet no earlier than 4 weeks after delivery, in women who are not breastfeeding.</li>\r\n	<li>Liver disease: Discontinue this tablet if jaundice occurs.</li>\r\n	<li>High blood pressure: Do not prescribe this tablet for women with uncontrolled hypertension or hypertension with vascular disease.</li>\r\n	<li>Carbohydrate and lipid metabolic effects: Monitor prediabetic and diabetic women taking this tablet. Consider an alternate contraceptive method for women with uncontrolled dyslipidemia.</li>\r\n	<li>Headache: Evaluate significant change in headaches and discontinue this tablet if indicated.</li>\r\n	<li>Uterine bleeding: Evaluate irregular bleeding or amenorrhea.</li>\r\n	<li>CYP3A4 induction: Women taking strong CYP3A4 inducers (for example, carbamazepine, phenytoin, rifampicin, and St. John&rsquo;s wort) should not choose this tablet as their oral contraceptive due to the possibility of decreased contraceptive efficacy.</li>\r\n</ul>', NULL, '<p>Drugs for menopausal symptoms: Hormone replacement therapy, Female Sex hormones</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-19 06:22:59', '2022-06-06 22:51:52'),
(450, 450, '<p>Diethylcarbamazine is indicated for Filariasis, Lymphatic filariasis, Pulmonary eosinophilia, Loiasis, Toxocariasis.</p>', '<p>The mechanism of action of diethylcarbamazine is thought to involve sensitizing the microfilariae to phagocytosis. One study showed that diethylcarbamazine&#39;s activity against Brugia malayi microfilariae is dependent on inducible nitric-oxide synthase and the cyclooxygenase pathway. It confirmed the important role of the arachidonic acid metabolic pathway in diethylcarbamazine&#39;s mechanism of action in vivo and showes that in addition to its effects on the 5-lipoxygenase pathway, it targets the cyclooxygenase pathway and COX-1.</p>', '<p><strong>Inital</strong>: 1 mg/kg/day, may increase to 6 mg/kg/day over 3 days, then maintain for 3 wk. Prophylaxis of loiasis 300 mg/wk.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Pregnancy, hypersensitivity; lactation; infants, elderly or debilitated patients; impaired renal function; cardiac disease.</p>', '<p>Fever, headache, vomiting, dizziness, drowsiness, nausea, chills.<br />\r\n<br />\r\nPotentially Fatal: Severe hypersensitivity reactions may occur especially in the treatment of onchocerciasis where rare Mazzotti reaction characterised by rash, itching, headache, muscle and joint pains, tachycardia, postural hypotension may start within 2 hr of drug administration. Encephalitis and retinal haemorrhage</p>', '<p><strong>Pregnancy&nbsp;Category- X.&nbsp;</strong>Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.</p>', '<p>Patients with poor health.<br />\r\n<br />\r\nLactation: not known if excreted in breast milk</p>', NULL, '<p>Other Anti-protozoals</p>', NULL, NULL, '2022-02-19 06:23:24', '2022-06-06 22:54:32'),
(451, 451, '<p>Diflorasone Diacetate cream &amp; ointment are indicated for relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.</p>', '<p>Like other topical corticosteroids, Diflorasone Diacetate has anti-inflammatory, anti-pruritic and vasoconstrictive actions. The mechanism of the anti-inflammatory activity of the topical corticosteroids, in general, is unclear. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.</p>', '<p>Apply to the affected areas as a thin film from one to four times daily depending on the severity of the condition. Occlusive dressings may be used for the management of psoriasis or recalcitrant conditions. If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy should be instituted.<br />\r\n<br />\r\nSafety and effectiveness of Diflorasone Diacetate cream &amp; ointment in paediatric patients have not been established. Paediatric patients are at greater risk than adults of HPA axis suppression when they are treated with topical corticosteroids.</p>', NULL, '<p>Diflorasone Diacetate is contraindicated in those patients with a history of hypersensitivity to the preparation.</p>', '<p>The following adverse effects have been reported infrequently with topical corticosteroids. These reactions include burning, itching, irritation, dryness, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infections, skin atrophy, striae and miliaria.</p>', '<p>Topical corticosteroids 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 corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Therefore caution should be exercised when topical corticosteroids are administered to a nursing woman</p>', '<p>Systemic absorption of topical corticosteroids may cause reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of cushing&#39;s syndrome, hyperglycemia, and glucosuria. Patients receiving large dose of a potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests. If HPA axis suppression is noted, an attempt should be made to withdraw the drug, to reduce the frequency of application, or to substitute a less potent steroid.</p>', NULL, '<p>Other Topical corticosteroids</p>', '<p>Store in a cool and dry place, protected from light. Do not freeze. Keep all medicines out of the reach of children.</p>', NULL, '2022-02-19 06:23:52', '2022-06-06 22:56:27'),
(452, 452, '<p>Difluprednate is indicated for the treatment of inflammation and pain associated with ocular surgery. It is also indicated for the treatment of uveitis, pseudophakic cystoid macular edema(CME), ocular surface diseases, e.g. blepharitis &amp; corneal inflammation.</p>', '<p>Corticosteroids inhibit the inflammatory response to a variety of inciting agents and may delay or slow healing. They inhibit edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen, and scar formation associated with inflammation. There is no generally accepted explanation for the mechanism of action of ocular corticosteroids. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Difluprednate is structurally similar to other corticosteroids.</p>', '<p><strong>For the treatment of inflammation and pain associated with ocular surgery:</strong>&nbsp;Instill 1 drop into the conjunctival sac of the affected eye 4 times daily beginning 24 hours after surgery and continuing throughout the first 2 weeks of the post-operative period, followed by 2 times daily for a week and then a taper based on the response.<br />\r\n<br />\r\n<strong>For the treatment of endogenous anterior uveitis:</strong>&nbsp;Instill 1 drop into the conjunctival sac of the affected eye 4 times daily for 14 days followed by tapering as clinically indicated.<br />\r\n<br />\r\n<strong>For blepharitis:</strong>&nbsp;Instill 1 drop into the conjunctival sac of the affected eyes 2 times daily for 1 week &amp; then once daily for 1 week.<br />\r\n<br />\r\n<strong>For pseudophakic cystoid macular edema:</strong>&nbsp;Instill 1 drop into the conjunctival sac of the affected eyes 2 times daily.</p>', '<p>Specific drug interaction studies have not been conducted with Difluprednate 0.05% ophthalmic emulsion.</p>', '<p>Difluprednate is contraindicated in most active viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures.</p>', '<p>Adverse reactions associated with ophthalmic steroids include elevated intraocular pressure, which may be associated with optic nerve damage, visual acuity and field defects; posterior subcapsular cataract formation; secondary ocular infection from pathogens including herpes simplex, and perforation of the globe where there is thinning of the cornea or sclera. Ocular adverse reactions occurring with Difluprednate included corneal edema, ciliary and conjunctival hyperemia, eye pain, photophobia, posterior capsule opacification, anterior chamber cells, anterior chamber flare, conjunctival edema, and blepharitis for patient with ocular surgery.</p>', '<p>Pregnancy Category C. Difluprednate has been shown to be embryotoxic and teratogenic when administered subcutaneously to rabbits. Since use of Difluprednate during human pregnancy has not been evaluated so Difluprednate should be used during pregnancy only if the potential benefit justifies the potential risk to the embryo or fetus. It is not known whether use of Difluprednate passes into breast milk. Caution should be exercised when it is administered to a nursing mothers</p>', '<ul>\r\n	<li>Prolonged use of corticosteroids may result in glaucoma &amp; posterior subcapsular cataract formation. If this product is used for 10 days or longer, IOP should be monitored.</li>\r\n	<li>Use of a corticosteroid medication in the treatment of patients with a history of herpes simplex requires great caution.</li>\r\n	<li>Fungal infections of the cornea are particularly prone to develop coincidentally with long-term local steroid application.</li>\r\n	<li>Do not touch dropper tip to any surface as this may contaminate this preparation.</li>\r\n</ul>', '<p>Overdosage will not ordinarily cause acute problems. If accidentally ingested, drink fluids to dilute.</p>', '<p>Ophthalmic Steroid preparations</p>', '<p>Store at room temperature, protect from light and freezing. It is desirable that the contents should not be used more than 1 month after first opening of the bottle.</p>', '<p><strong>Pediatric Use</strong>: Difluprednate was evaluated in 0 to 3 years of age for the treatment of inflammation following cataract surgery. A similar safety profile was observed in pediatric patients comparing Difluprednate to Prednisolone Acetate ophthalmic suspension 1%.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients</p>', '2022-02-19 06:24:50', '2022-06-06 22:58:36'),
(453, 453, '<p>Digoxin is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Heart failure.</li>\r\n	<li>Atrial fibrillation with an uncontrolled ventricular rate.</li>\r\n	<li>Acute left ventricular failure.</li>\r\n	<li>Chronic left ventricular failure and conjestive heart failure,especially when caused by hypertensive valvular (especially mitral valvular) disease or ischaemic heart disease.</li>\r\n</ul>', '<p>Digoxin is a cardiac glycoside used in the management of particularly atrial fibrillation and in heart failure.The principal actions of digoxin are an increase in the force of myocardial contraction (positive inotropic activity and a reduction in the conductivity of the heart particularly in conduction through the atrioventricular node. Digoxin also has a direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system and particularly by an increase in vagal activity.</p>', '<p>By oral administration:</p>\r\n\r\n<ul>\r\n	<li><strong>Rapid digitalization</strong>: 1-1.5 mg in divided doses over 24 hours</li>\r\n	<li><strong>Less urgent digitalization</strong>: 250-500 micrograms daily (higher dose may be divided)</li>\r\n	<li><strong>Maintenance</strong>: 62.5-500 micrograms daily (higher dose may be divided) according to renal function and in atrial fibrillation on heart rate response.</li>\r\n	<li><strong>Usual range</strong>: 125-250 micrograms daily (lower dose may be divided) according to renal function and in atrial fibrilation on heart rate response.</li>\r\n	<li><strong>Usual range</strong>: 125-250 micrograms daily (lower dose may be appropriate in the elderly)</li>\r\n</ul>', '<p>Potassium-depleting diuretics increase the effects of digitalis. Calcium particularly if administered rapidly by the intravenous route, may produce serious arrhythmia in digitalized patients. Quinidine, verapamil, amiodarone, propafenone, indomethacin, itraconazole, alprazolam, spironolactone, erythromycin, clarithromycin (and possibly other macrolide antibiotics) and tetracycline increase digoxin serum level. Besides antacids, kaolinpectin, sulfasalazine, neomycin, penicillamine, calestipol, metoclopramide, rifampin may interfere with intestinal absorption of digoxin resulting low serum concentrations of the drug.</p>', '<ul>\r\n	<li>Ventricular fibrillation.</li>\r\n	<li>Hypersensitivity to digoxin or other digitalis preparation</li>\r\n</ul>', '<p>Usually associated with excessive dosage include anorexia, nausea, vomiting, diarrhoea, abdominal pain, visual disturbance, headache, fatigue, drowsiness, confusion, delirium, hallucination, depression, arrhythmia, heart block, intestinal ischaemia, gynaecomastia on long term use, thrombocytopenia reported. Digoxin can be safely used in pregnancy</p>', '<p>Digoxin is excreted in breast milk but in concentration below those found in plasma and therefore poses no hazard to the breast-fed infant.</p>', NULL, NULL, '<p>Positive Inotropic drugs</p>', '<p>Store in a cool and dry place.Keep out of the reach of children.</p>', '<p><strong>Neonates</strong>: Digoxin can be used in neonates.<br />\r\n<br />\r\n<strong>Children</strong>: Digoxin can be used in children.<br />\r\n<br />\r\n<strong>The elderly</strong>: Partly because of reduced renal function and partly because their tissues are more sensitive to the effects of digitalis, the elderly require a lower maintenance dose of digoxin than younger adults.</p>', '2022-02-19 06:25:06', '2022-06-06 23:00:26'),
(454, 454, '<p>Diloxanide is indicated for intestinal amoebiasis</p>', '<p>Diloxanide is a luminal amoebicide which is hydrolysed in the gut, thus releasing the free diloxanide which acts as an amoebicide. It is given alone in asymptomatic cyst passers. For patients with active amoebic infections, it can be administered with a 5-nitroimidazole e.g. metronidazole or tinidazole.</p>', '<p><strong>Adult</strong>: The recommended dose is 500 mg 3 times/day for 10 days. May repeat course if needed.<br />\r\n<br />\r\n<strong>Child: &gt;25 kg</strong>: 20 mg/kg daily in 3 divided doses for 10 days, repeated if necessary.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Hypersensitivity.</p>', '<p>The frequency of these side-effects is unknown flatulence, itching, urticaria, vomiting</p>', '<p>Pregnancy Category- Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Caution should be exercised in pregnant and breastfeeding women. Avoid excess dosage.</p>', NULL, '<p>Amoebicides</p>', NULL, NULL, '2022-02-19 06:25:29', '2022-06-06 23:01:54'),
(455, 455, '<p>Diltiazem Hydrochloride film coated tablet is used for the prophylaxis and treatment of chronic stable (classical) and vasopastic angina pectoris and has also been used alone or in combination in the management of hypertension, also, Diltiazem is effective in myocardial infarction, coronary artery spasm, arrhythmias, Raynaud&#39;s phenomenon, oesophageal motility disorder and migraine.</p>', '<p>Diltiazem is a calcium-channel blocker with peripheral and coronary vasodilator properties. It lowers blood pressure and has some effect on cardiac conduction. Diltiazem interferes with the influx of calcium ions through the channels of active cell membranes.</p>', '<p><strong>Adult</strong>: The usual dose of Diltiazem Hydrochloride film coated tablet is 60 mg thrice daily. However patient&#39;s response may vary and dosage requirements can differ significantly between individual patients. If necessary, the divided dose may be increased to 180-300 mg/day. Dosage may be started as 30 mg four times daily and increasing at 1 to 2 days intervals until the optimum response is achieved. Higher doses upto 480 mg/day have been used with benefit in some patients especially in unstable angina. Elderly and patients with impaired hepatic or renal function: The recommended starting dose is 60 mg twice daily. The heart rate should be measured regularly and the dose should not be increased if the heart rate falls below 50 beats per minute.<br />\r\n<br />\r\n<strong>Children</strong>: Not recommended.</p>', '<p>Digoxin, Propranolol, Cyclosporin, Theophylline, Cimetidine, Lithium &amp; Carbamazepine.</p>', '<p>Diltiazem is contraindicated to the patients of severe bradycardia, sick sinus syndrome, pregnancy, second or third degree AV block.</p>', '<p>With Diltiazem headache, ankle oedema, hypertension, dizziness, flushing, rashes (toxic erythema), nausea and Gl disturbances may occur. Transient elevation in liver enzyme values and occasionally hepatitis have been reported. Diltiazem may depress cardiac conduction and has occasionally led to AV block, bradycardia and rarely asystoleor sinus arrest.</p>', NULL, '<p>Diltiazem should be used with care in patients with lesser degrees of AV block or bradycardia; also in patients with impaired left ventricular function. Caution should be required in patients with impaired liver or kidney function.</p>', NULL, '<p>Calcium-channel blockers</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-19 06:26:02', '2022-06-06 23:04:16');
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
(456, 456, '<p>Diltiazem Hydrochloride sustained release tablet is indicated in the prophylaxis and treatment of angina pectoris. It is used in the management of classical and vasospastic angina pectoris. It has also been used in the treatment of essential hypertension. It is used for prophylaxis of some selected supraventricular tachyarrhythmias.</p>', '<p>Diltiazem hydrochloride is a calcium channel antagonist. It is a peripheral and coronary vasodilator with some negative inotropic activity. Diltiazem inhibits cardiac conduction particularly at the sino-atrial and atrioventricular nodes. Diltiazem has the following actions:<br />\r\n<br />\r\n<strong>Antianginal</strong>: A direct dilatation of coronary arteries and arterioles proved oxygen supply to myocardial tissues. In addition dilatation of the peripheral vasculature reduces systemic pressure of cardiac &quot;after load&quot; which results in lessened stress and reduced oxygen requirements of the myocardial tissues.<br />\r\n<br />\r\n<strong>Antiarrhythmic</strong>: The inhibited influx of calcium ions in cardiac tissues result in slowed electrophysiological activity through the S-A and A-V nodes without affecting accessory bypass conduction or altering normal atrial action potential or intraventricular conduction.<br />\r\n<br />\r\n<strong>Antihypertensive</strong>: Reduces peripheral vascular resistance as a result of vasodilatation. More than 90% of an oral dose is rapidly absorbed. Protein binding is very high. Peak plasma concentration reaches within 30-60 minutes. It is metabolised in the liver and excreted (60%) through bile.</p>', '<p><strong>Mild to moderate hypertension</strong>: initially 90 mg or 120 mg twice daily (elderly once daily); up to 360 mg daily may be required (elderly upto 240 mg) daily.<br />\r\n<br />\r\n<strong>Angina</strong>: initially 90 mg or 120 mg twice daily in divided doses may be required (elderly up to 240 mg daily).</p>', '<p>Concomitant prophylactic therapy with short-or long-acting nitrates may be administered safely during diltiazem therapy. Diltiazem recommended caution and careful dosage titration when diltiazem is administered concomitantly with other drugs that can affect cardiac contractility and/ or conduction.</p>', '<p>Diltiazem Hydrochloride sustained release tablet is contraindicated in patients with known hypersensitivity to the drug, sick sinus syndrome, second or third degree AV block, severe hypertension or acute myocardial infarction and rediographically documented pulmonary congestion.</p>', '<p>Bradycardia, sino-atrial block, atrioventricular block, hypertension, malaise, headache, hot flushes, GIT disturbances, oedema, hepatitis and depression reported.</p>', '<p>There are no adequate and controlled studies to date with diltiazem in pregnant women, and the drug should be used during pregnancy only when the potential benefits justify the possible risk to the fetus. Because diltiazem is distributed into milk, women receiving the drug should not breastfeed their infants; an alternative method of infant feeding should be used if diltiazem therapy is considered necessary in nursing women.</p>', NULL, NULL, '<p>Calcium-channel blockers</p>', '<p>Keep medicine out of the reach of children. Store in a cool and dry place.</p>', NULL, '2022-02-19 06:26:18', '2022-06-06 23:08:15'),
(457, 457, '<p>This medicine is used to help relieve dry, irritating coughs. The liquid contains diphenhydramine hydrochloride which is an antihistamine that helps relieve coughing and dry secretions in the nose and chest, dextromethorphan hydrobromide which is an antitussive to help stop coughing and levomenthol which helps you breathe more easily by relieving congestion.</p>', '<p>This medicine is used to help relieve dry, irritating coughs. The liquid contains diphenhydramine hydrochloride which is an antihistamine that helps relieve coughing and dry secretions in the nose and chest, dextromethorphan hydrobromide which is an antitussive to help stop coughing and levomenthol which helps you breathe more easily by relieving congestion.</p>', '<p><strong>Adults and children aged 12 years and over</strong>: Take two 5 ml spoonfuls four times a day.<br />\r\n<br />\r\nDo not take more than 4 doses in 24 hours. &nbsp;If symptoms persist, talk to your doctor</p>', NULL, '<p>Do not use this medicine&hellip;</p>\r\n\r\n<ul>\r\n	<li>If you have ever had a bad reaction to any of the ingredients.</li>\r\n	<li>If you suffer from lung disease.</li>\r\n	<li>If you have prostate problems. (Difficulty with passing water or needing to pass water often).</li>\r\n	<li>If you have narrow-angle glaucoma (increased pressure in the eye).</li>\r\n	<li>If you are taking, or have taken in the last two weeks, drugs for depression known as</li>\r\n	<li>Monoamine Oxidase Inhibitors (MAOIs).</li>\r\n	<li>For children under 12 years old.</li>\r\n</ul>', '<p>Mild effects which may occur include:</p>\r\n\r\n<ul>\r\n	<li>Drowsiness, dizziness, blurred vision.</li>\r\n	<li>Dry mouth, nose and throat.</li>\r\n	<li>Upset stomach.</li>\r\n	<li>Vomiting.</li>\r\n	<li>Nausea.</li>\r\n	<li>Problems with passing water.</li>\r\n</ul>', '<p>Ask your doctor for advice before taking this medicine if you are pregnant or breast-feeding.</p>', '<p>Talk to your doctor&hellip;</p>\r\n\r\n<ul>\r\n	<li>If you suffer from liver or kidney problems.</li>\r\n	<li>If you are taking alcohol.</li>\r\n	<li>If you have been told by your doctor that you have an intolerance to some sugars.</li>\r\n	<li>If you are taking any other medicines, including:</li>\r\n</ul>\r\n\r\n<p>anticholinergic drugs e.g. antihistamines (drugs used to treat allergies), antidepressants (drugs to treat mood disorders), atropine (used to treat some eye conditions and occasionally bowel conditions). minor tranquillisers (drugs used to relax muscles or decrease anxiety). barbiturates (a kind of sleeping tablet)<br />\r\n<br />\r\nThis medicine may cause drowsiness. If affected, do not operate machinery. Avoid alcoholic drink.<br />\r\n<br />\r\nThis medicine can affect your ability to drive. Do not drive whilst taking this medicine until you know how this medicine affects you. It may be an offence to drive when taking this medicine if your ability to drive safely is affected.</p>', NULL, '<p>Combined cough expectorants, Combined cough suppressants</p>', '<p>Do not store this product above 30&ordm;C. Store in the original container. Keep the product out of the reach and sight of children.</p>', NULL, '2022-02-19 06:26:33', '2022-06-06 23:10:57'),
(458, 458, '<p>This preparation is indicated for the relief of cough and associated congestive symptoms. It is also used to relieve runny nose, sneezing, watery eyes, itchy nose/eyes/throat and other allergic symptoms.</p>', '<p>Diphenhydramine possesses antitussive and antihistaminic properties. It relieves cough centrally (brain stem) and treats sneezing, runny nose and allergy (itchy eyes, nose, skin). Levomenthol has decongestant and anti-inflammatory properties which helps soothe cough and reduces congestion and inflammation in the nasal passage and lungs that makes breathing easier.</p>', '<p><strong>Adults and Children over 12 years</strong>: The recommended dose is 10 ml of syrup 4 times a day. Maximum daily dose is 40 ml syrup.</p>', '<p>Diphenhydramine may potentiate the effects of alcohol, codeine, CNS depressants, the effects of anticholinergics (ex- some psychotropic drugs and atropine) and other antihistamines. MAO inhibitors potentiate and intensify the anticholinergic effects of antihistamines.</p>', '<p>This preparation is contraindicated in individuals with known hypersensitivity to the product or any of its constituents and in individuals with chronic or persistent cough, such as occurs with asthma, or where cough is accompanied by excessive secretions, unless directed by the physician. It should not be administered to patients currently receiving monoamine oxidase inhibitors (MAOIs) or those patients who have received treatment with MAOIs within the last two weeks.</p>', '<p>Diphenhydramine may cause drowsiness, dizziness, gastrointestinal disturbance, dry mouth/nose/throat, difficulty in urination or blurred vision</p>', '<p>Diphenhydramine has been in widespread use for many years without ill consequence. However, it is known to cross the placenta and has been detected in breast milk. Therefore, it is only used when the potential benefit of treatment to the mother exceeds any possible hazards to the developing fetus or suckling infant.</p>', '<p>This preparation may cause drowsiness. Caution should be exercised in patients with moderate to severe renal or hepatic dysfunction or urinary retention when using this preparation. Diphenhydramine should not be taken by individuals with narrow-angle glaucoma or symptomatic prostatic hypertrophy.</p>', '<p>The signs and symptoms of overdose may include drowsiness, hyperpyrexia and anticholinergic effects. With higher doses, CNS excitation including hallucinations and coma or cardiovascular collapse may appear. Treatment of overdose should be symptomatic and supportive, rapid gastric emptying (with Syrup of Ipecac-induced emesis or gastric lavage and activated charcoal) may be useful. Seizures may be controlled with Diazepam or Thiopental Sodium and Physostigmine IV may be efficacious to antagonise severe antichlolinergic symptoms.</p>', '<p>Combined cough expectorants</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-19 06:27:10', '2022-06-06 23:13:08'),
(459, 459, '<p>Diphenhydramine is indicated for the treatment of followings:</p>\r\n\r\n<ul>\r\n	<li>Seasonal, perennial, vasomotor rhinitis</li>\r\n	<li>Urticaria, angioneurotic oedema, anaphylaxis</li>\r\n	<li>Pruiritic conditions</li>\r\n	<li>Premedication for emesis and motion sickness</li>\r\n	<li>Miscellaneous like meniere&#39;s disease and parkinsonism</li>\r\n</ul>', '<p>Diphenhydramine is an antihistamine with anticholinergic and sedative effects. It competes with histamine for H1-receptor sites on effector cells in the GI tract, blood vessels and respiratory tract.</p>', '<p>Adult-</p>\r\n\r\n<ul>\r\n	<li><strong>Most allergic conditions:</strong>&nbsp;25-50 mg three times a day with a further 50 mg at night.</li>\r\n</ul>\r\n\r\n<p>Children-</p>\r\n\r\n<ul>\r\n	<li><strong>1 to 5 years of age:</strong>&nbsp;5 mg i.e., 2.5 ml of elixir 4 times a day</li>\r\n	<li><strong>More than 6 years of age:</strong>&nbsp;10 mg i.e. 5 ml of elixir 4 times a day</li>\r\n</ul>', '<p>Diphenhydramine administration significantly reduces the absorption of the antituberculous agent para-aminosalicyclic acid (PAS) from the gastrointestinal tract. CNS depressants may potentiate the sedative action of Diphenhydramine. Anticholinergic drugs may potentiate Diphenhydramine&rsquo;s anticholinergic side effects.</p>', '<p>Known hypersensitivity to Diphenhydramine Hydrochloride, Ammonium chloride is contra-indicated in presence of impaired hepatic or renal function.</p>', '<p>Side effect includes sedation, dizziness, tinnitus, fatigue, ataxia, blurred vision, diplopia, euphoria, and epigastric discomfort.</p>', '<p><strong>Category B</strong>: There are no adequate and well controlled studies in pregnant women using diphenhydramine hydrochloride. Therefore, diphenhydramine hydrochloride should be used in pregnancy only if clearly needed. Diphenhydramine hydrochloride has been reported to be excreted in breast milk and thus, use of diphenhydramine hydrochloride in lactating mother is not recommended.</p>', '<p>Caution should be exercised with patients in whom drowsiness is undesirable e.g., drivers, machine operators. Concomitant consumption of alcohol or central nervous system (CNS) depressants will potentiate drowsiness.</p>', '<p><strong>Symptoms:</strong>&nbsp;Impaired consciousness; psychosis, seizures, antimuscarinic symptoms (e.g. mydriasis, tachycardia, tachyarrhythmias), resp failure, rhabdomyolysis; acute delirium with visual and auditory hallucination (topical).<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Supportive and symptomatic treatment. Convulsions and marked CNS stimulation may be treated with IV diazepam.</p>', '<p>Sedating Anti-histamine</p>', '<p>Store between 15-30&deg; C. Protect from moisture.</p>', NULL, '2022-02-19 06:27:32', '2022-06-06 23:15:31'),
(460, 460, '<p>This cream is used to temporarily relieve pain and itching associated with: insect bites, minor burns, sunburn, minor skin irritations, minor cuts, scrapes, rashes due to poison ivy, poison oak, and poison sumac, dries the oozing and weeping of poison ivy, poison oak, and poison sumac.</p>', '<p>Diphenhydramine is an antihistamine and works as a topical anti-allergic and analgesic by blocking the releases of histamine at its sources. Zinc is used as a skin protectant.</p>', '<p><strong>Adults &amp; children above 2 years</strong>: Apply to the affected area 3 to 4 times daily. Before application of cream, the skin should be clean, cool and dry. Should not have a hot shower or bath before applying. Apply the cream lightly on the skin until the cream disappears. It is important to include all skin surfaces, such as between the fingers and toes, under the nails and on the soles of the feet.<br />\r\n<br />\r\n<strong>For babies under 2 years</strong>: Initially consult with the physician, if it is recommended, apply to the face, neck, ears and scalp as well, only avoiding the area immediately around the eyes and mouth. Leave cream on for at least 8 hours, before washing off. Reapply to any area that may be washed during the 8 hours treatment time (such as after washing the hands).</p>', NULL, '<p>Use of cream is contraindicated in individuals with a known allergy to its components, other pyrethroids or pyrethrins.</p>', '<p>Contact dermatitis with mild erythematous vesicular lesions and papules has occasionally been reported.</p>', '<p>In the absence of specific studies in pregnant women its use in pregnancy should only follow medical advice. However, teratogenic effects would not be anticipated. Although caution should be exercised in administration of diphenhydramine to nursing mothers, levels in breast milk following topical application are likely to be very low.</p>', '<p>For external use only. Flammable, keep away from fire or flame. Do not use on large areas of the body with any other product containing diphenhydramine, even should not be taken by mouth. Consult with the physician before use on chicken pox, on measles. When using this product, avoid contact of eyes.</p>', NULL, '<p>Local Antipruritic, Topical Antihistamines</p>', '<p>Store below 30&deg;C. Protect from light. Do not freeze.</p>', NULL, '2022-02-19 06:27:56', '2022-06-06 23:17:26'),
(461, 461, '<p>Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed is a vaccine indicated for active booster immunization against tetanus, diphtheria and pertussis. This Vaccine Adsorbed is approved for use as a single dose in persons 10 through 64 years of age</p>', '<p>Diphtheria, Tetanus and Pertussis vaccine&shy; prepared from diphtheria formol toxoid, tetanus formol toxoid and pertussis vaccine (killed B pertusis not less than 4 IU from not more than&nbsp;20000 million organism/0.5 ml); 0.5 ml ampoule: Injection.</p>', '<p><strong>Child</strong>: Under 5 yrs, primary immunisation-3 doses of 0.5 ml vaccine by IM or deep SC injection, each dose at an interval of minimum 4 weeks; Over 5 yrs, not recommended.</p>', '<p>When Diphtheria, Pertussis &amp; Tetanus vaccine was administered concomitantly with trivalent inactivated influenza vaccine (TIV) to adults 19-64 years of age, a lower antibody response was observed for pertactin antigen as compared to Diphtheria, Pertussis &amp; Tetanus vaccine administered alone.&nbsp;<br />\r\n<br />\r\nImmunosuppressive therapies may reduce the immune response to Diphtheria, Pertussis &amp; Tetanus vaccine.&nbsp;<br />\r\n<br />\r\nDo not mix this vaccine with any other vaccine in the same syringe or vial</p>', '<ul>\r\n	<li>Severe allergic reaction (eg, anaphylaxis) to any component of Diphtheria, Pertussis &amp; Tetanus vaccine or any other diphtheria toxoid, tetanus toxoid and pertussis antigencontaining vaccine.</li>\r\n	<li>Encephalopathy (eg, coma, decreased level of consciousness, prolonged seizures) within 7 days of administration of a previous pertussis antigen-containing vaccine.</li>\r\n</ul>', '<p>The most common solicited injection site reactions occurring within 0-14 days following vaccination with this were:</p>\r\n\r\n<ul>\r\n	<li>For Adolescents 11-17 years of age: pain (77.8%), swelling (20.9%), erythema (20.8%).</li>\r\n	<li>For Adults 18-64 years of age: pain (65.7%), swelling (21.0%), erythema (24.7%).&nbsp;</li>\r\n</ul>\r\n\r\n<p>The most common solicited systemic reactions occurring within 0-14 days following vaccination with this were:</p>\r\n\r\n<ul>\r\n	<li>For Adolescents 11-17 years of age: headache (43.7%), body ache or muscle weakness (30.4%), tiredness (15.1%).</li>\r\n	<li>For Adults 18-64 years of age: headache (33.9%), body ache or muscle weakness (21.9%).</li>\r\n</ul>', '<p>Safety and effectiveness of this vaccine have not been established in pregnant women.</p>', '<p>For one presentation of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed, the tip caps of the prefilled syringes may contain natural rubber latex, which may cause allergic reactions in latex sensitive individuals.&nbsp;<br />\r\n<br />\r\nIf Guillain-Barr&eacute; syndrome occurred within 6 weeks of receipt of a prior vaccine containing tetanus toxoid, the risk for Guillain-Barr&eacute; syndrome may be increased following a subsequent dose of this vaccine<br />\r\n<br />\r\nProgressive or unstable neurologic conditions are reasons to defer this vaccination.<br />\r\n<br />\r\nPersons who experienced an Arthus-type hypersensitivity reaction following a prior dose of a tetanus toxoid-containing vaccine should not receive Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed unless at least 10 years have elapsed since the last dose of a tetanus toxoid containing vaccine.<br />\r\n<br />\r\nSyncope (fainting) can occur in association with administration of injectable vaccines, including Diphtheria, Pertussis &amp; Tetanus vaccine. Procedures should be in place to prevent falling injury and manage syncopal reactions.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin</p>', NULL, NULL, '2022-02-19 06:28:44', '2022-06-06 23:20:19'),
(462, 462, '<p>DTaP-IPV-HB-Hib is indicated for primary and booster vaccination of infants and toddlers from six weeks of age against diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and invasive diseases caused by Haemophilus influenzae type b (Hib).</p>\r\n\r\n<ul>\r\n</ul>', NULL, '<p><strong>Primary Vaccination</strong>: Three injections at an interval of one to two months (at least four weeks apart).<br />\r\n<br />\r\n<strong>Booster</strong>: At least 6 months after the last dose of first course. This vaccine should be used according to the local vaccination programme.<br />\r\n<br />\r\nThis should be administered intramuscularly. The recommended injection sites are generally the anterolateral aspect of the upper thigh in infants and toddlers and the deltoid muscle in older children. The intradermal or intravascular route must not be used.; ensure that the needle does not penetrate a blood vessel. Separate syringes, separate injection sites and preferably separate limbs must be used in case of the concomitant administration with other vaccines.</p>', NULL, '<p>History of an anaphylactic reaction after a previous administration of this vaccine Encephalopathy within 7 days of administration of a previous dose of any vaccine containing pertussis antigens (whole cell or acellular pertussis vaccines). Uncontrolled neurologic disorder, uncontrolled epilepsy.</p>', '<p>Serious Allergic reactions (anaphylactic reaction): Difficulty in breathing, blueness of tongue/lips, a rash, swelling of face/throat, sudden and dizziness, loss of consciousness, accelerated heart rate with respiratory disorders. Serious allergic reactions are a rare possibility (may up to 1 in 1,000 people) after receiving this vaccine. Other side effects:</p>\r\n\r\n<ul>\r\n	<li>Very common: Anorexia, crying, somnolence, vomiting, pain redness and swelling at injection site, irritability, Fever</li>\r\n	<li>Common side effects: Prolonged crying, diarrhoea, induration</li>\r\n	<li>Uncommon side effects: Allergicreaction, lump at injection site, High fever.</li>\r\n</ul>', NULL, '<p>Vaccination must be postponed in cases of moderate or severe febrile and/or acute disease; the administration of Hexaxim must be carefully considered in individuals who have a history of serious or severe reactions within 48 hours following administration of a vaccine containing similar components. As with all injectable vaccines, the vaccine must be administered with caution to subjects with thrombocytopenia or a bleeding disorder since bleeding may occur following an intramuscular administration. If any of the following events are known to have occurred after receiving any pertussis-containing vaccine, the decision to give further doses of pertussis containing vaccine should be carefully considered:</p>\r\n\r\n<ul>\r\n	<li>The temperature of &ge;40&deg;C within 48 hours not due to another identifiable cause;</li>\r\n	<li>Collapse or shock-like state (hypotonic-hyporesponsive episode) within 48 hours of vaccination;</li>\r\n	<li>Persistent, inconsolable crying lasting &ge; 3 hours, occurring within 48 hours of vaccination;</li>\r\n	<li>Convulsions with or without fever, occurring within 3 days of vaccination. Take special care in case of Guillain Barr&eacute; Syndrome, Brachial neuritis, acute or chronic renal insufficiency, epilepsy.</li>\r\n</ul>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin</p>', '<p>Keep out of the reach and sight 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 solution if frozen. Protect from light.</p>', NULL, '2022-02-19 06:28:57', '2022-06-06 23:23:31'),
(463, 463, '<p>This vaccine is indicated for the prevention of diphtheria, tetanus, pertussis and poliomyelitis:</p>\r\n\r\n<ul>\r\n	<li>for primary vaccination in infants from the age of 2 months, for booster vaccination, one year after primary vaccination during the second year of life,</li>\r\n	<li>for booster vaccination between 5 and 13 years of age, according to official recommendations.</li>\r\n</ul>', NULL, '<p>This vaccine must be administered according to the official recommendations in effect. Primary vaccination: 3 injections given at an interval of one month, i.e. according to the official schedule, at the age of 2, 3, 4 months.<br />\r\n<br />\r\nBooster vaccination: 1 injection one year after primary vaccination, i.e. usually, between 16 and 18 months. Booster vaccination between 5 and 13 years of age: 1 injection. For primary vaccination and for the first booster dose, this vaccine may be administered by reconstituting the Haemophilus influenzae type b conjugate vaccine (Act-HIB) or administered at the same time as this vaccine, but at two separate injection sites.<br />\r\n<br />\r\nAdminister via the intramuscular route. Administration should preferably be performed in the antero-lateral side of the thigh (middle third) in infants and in the deltoid area in children</p>', '<p>This vaccine can be administered simultaneously with the M-M-RVAXPRO vaccine or with the HBVAXPRO vaccine, but in two separate sites This vaccine can be associated or combined with the Haemophilus influenzae type b conjugate vaccine (Act-HIB).</p>', '<p>Hypersensitivity:</p>\r\n\r\n<ul>\r\n	<li>to any of the active substances of this vaccine,</li>\r\n	<li>to any of the excipients listed in section 6.1,</li>\r\n	<li>to glutaraldehyde, neomycin, streptomycin, or polymyxin B (used during the manufacturing process and which may be present as traces)</li>\r\n	<li>to a pertussis vaccine (acellular or whole cell).</li>\r\n</ul>\r\n\r\n<p>Life-threatening reaction after previous administration of the same vaccine or a vaccine containing the same substances. Vaccination must be postponed in case of febrile or acute disease. Evolving encephalopathy. Encephalopathy within 7 days of administration of a previous dose of any vaccine containing pertussis antigens (whole cell or acellular pertussis vaccines).</p>', '<p>The safety profile is described below according to the clinical data generated in France, South Korea, Chile and Thailand. In clinical studies in children who received TETRAXIM as a primary series, stand alone or combined with the Act- HIB vaccine, the most frequently reported reactions are local injection-site reactions, abnormal crying, loss of appetite and irritability. These signs and symptoms usually occur within 48 hours following the vaccination and may continue for 48-72 hours. They resolve spontaneously without requiring specific treatment. The frequency of injection-site reactions tends to increase at booster vaccination compared with the frequency observed for primary series. The safety profile of TETRAXIM does not differ significantly according to age groups. However certain reactions (myalgia, malaise, headache) are specific to children aged 2 years or more.</p>', NULL, '<p>The immunogenicity of this vaccine may be reduced by immunosuppressive treatment or immunodeficiency. It is then recommended to wait until the end of the treatment or disease before vaccinating. Nevertheless, vaccination of subjects with chronic immunodeficiency such as HIV infection is recommended even if the immune response may be limited. If Guillain-Barre syndrome or brachial neuritis has occurred in subjects following receipt of prior vaccine containing tetanus toxoid, the decision to give any vaccine containing tetanus toxoid should be based on careful consideration of the potential benefits and possible risks of vaccination. Vaccination is usually justified for infants whose primary immunization schedules are incomplete (i.e. fewer than three doses administered).<br />\r\n<br />\r\nDo not inject via the intravascular route: make sure the needle does not penetrate a blood vessel. Do not inject via the intradermal route. As with all injectable vaccines, This vaccine must be administered with caution to subjects with thrombocytopenia or a bleeding disorder since bleeding may occur following an intramuscular administration to these subjects.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin</p>', '<p>Keep out of the reach and sight 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 solution if frozen. Protect from light.</p>', NULL, '2022-02-19 06:29:18', '2022-06-06 23:27:22'),
(464, 464, '<p>Dipyridamole is indicated in Prophylaxis of thromboembolism following cardiac valve replacement,&nbsp;Secondary prophylaxis of stroke or transient ischaemic attack</p>', '<p>Dipyridamole causes an accumulation of adenosine, adenine nucleotides and cAMP by inhibiting the activity of adenosine deaminase and phosphodiesterase thus inhibiting platelet aggregation and may cause vasodilation.</p>', '<p>Prophylaxis of thromboembolism following cardiac valve replacement:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 300-600 mg/day in divided doses with an oral anticoagulant.</li>\r\n	<li><strong>Child</strong>: 5 mg/kg/day in divided doses.</li>\r\n</ul>\r\n\r\n<p>Secondary prophylaxis of stroke or transient ischaemic attack:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: As modified-release preparation: 200 mg bid, with or without aspirin.</li>\r\n	<li>Should be taken on an empty stomach. Take 1 hr before meals. May be taken with meals to reduce GI discomfort.</li>\r\n</ul>', '<p>Aminophylline may reverse vasodilatation effect. Useful combination with aspirin in prevention of thromboembolism. Efficacy reduced by concurrent admin of antacids. Concurrent use may increase the cardiotoxic effects of adenosine.</p>', '<p>Hypersensitivity. Peptic ulcer.</p>', '<p>GI disturbances, headache, dizziness, faintness, facial flushing, skin rash, liver dysfunction, angina. Large doses may lower BP.</p>', '<p>Pregnancy&nbsp;Category B.&nbsp;Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>In patients with rapidly worsening angina, subvalvular aortic stenosis, haemodynamic instability associated with recent MI or coagulation disorders esp when given IV during myocardial imaging. Hypotension, unstable angina, aortic stenosis. Pregnancy and lactation. Safety and efficacy are not established in childn &lt; 12 yrs.</p>', '<p><strong>Symptoms</strong>: warm feeling, flushes, sweating, restlessness, weakness, dizziness, hypotension and tachycardia.<br />\r\n<br />\r\n<strong>Management</strong>: treatment is symptomatic. Empty stomach by gastric lavage. Haemodialysis unlikely to be useful.</p>', '<p>Anti-platelet drugs</p>', '<p>Store below 25&deg; C.</p>', NULL, '2022-02-19 06:29:41', '2022-06-06 23:31:46'),
(465, 465, '<p>Disopyramide is indicated for the ventricular arrhythmias, especially after myocardial infarction, supraventricular arrhythmias.</p>', '<p>Disopyramide&rsquo;s Class 1a activity is similar to that of quinidine in that it targets sodium channels to inhibit conduction. Disopyramide depresses the increase in sodium permeability of the cardiac Myocyte during Phase 0 of the cardiac action potential, in turn decreasing the inward sodium current. This results in an increased threshold for excitation and a decreased upstroke velocity.<br />\r\n<br />\r\nDisopyramide prolongs the PR interval by lengthening both the QRS and P wave duration. This effect is particularly well suited in the treatment of ventricular tachycardia as it slows the action potential propagation through the atria to the ventricles.<br />\r\n<br />\r\nDisopyramide does not act as a blocking agent for beta or alpha adrenergic receptors, but does have a significant negative inotropic effect on the ventricular myocardium. As a result, the use of disopyramide may reduce contractile force up to 42% at low doses and up to 100% in higher doses leading to heart failure.<br />\r\n<br />\r\nThis provides a possible treatment for atrial and ventricular fibrillation, as it restores pacemaker control of the tissue to the SA and AV nodes</p>', '<p>The recommended dose of Disopyramide is 400 mg /day in 4 divided doses (100 mg capsule 6 hourly).<br />\r\n<br />\r\nPatients with renal insufficiency should take 100 mg capsule according to the schedule given below:<br />\r\n<br />\r\nCreatinine clearance (ml/min) &gt;15: Approximate dosing q 8 hrq 12 hrq 24 hr<br />\r\n<br />\r\nPatients in whom rapid control of ventricular arrhythmia is essential, an initial loading dose of 300 mg Disopyramide is recommended, followed by the appropriate maintenance dosage.</p>', NULL, '<p>Disopyramide is contraindicated in the pre-existing A-V heart block, shock, glaucoma, urinary retention and known hypersensitivity to the drug</p>', '<p>Usually Disopyramide is well tolerated but occasionally in some cases dry mouth/ nose/ eye, nausea, vomiting, diarrhea, bloating, blurred vision, urinary problems, headache, skin rash, dizziness, nervousness &amp; impotence (1-3%) may occur.</p>', '<p><strong>Pregnancy:</strong>&nbsp;There are no adequate and well-controlled studies in pregnant women. Disopyramide 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>&nbsp;Because of the potential for serious adverse reactions in nursing infants from Disopyramide, 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>Disopyramide should not be administered to patients with cardiomyopathy and associated congestive heart failure unless the patient is digitalized and adequately compensated. Disopyramide should be used with caution in the presence of digitalis intoxication.</p>', '<p>Deliberate or accidental over dosage of oral Disopyramide may be followed by apnea, loss of consciousness &amp; loss of spontaneous respiration. In such a case immediate hospitalization and all life saving measures should be taken.</p>', '<p>Membrane stabilizing agent (Sodium channel blockers)</p>', NULL, NULL, '2022-02-19 06:30:04', '2022-06-07 00:10:40'),
(466, 466, '<p>এই অয়েন্টমেন্ট নিন্মোক্ত উপসর্গে নির্দেশিত-</p>\r\n\r\n<ul>\r\n	<li>দাদ</li>\r\n	<li>কাউর</li>\r\n	<li>সোরাইসিস</li>\r\n</ul>', '<p><strong>ডাইথ্রানল</strong>: ডাইথ্রানল চর্মের এপিডার্মাল কোষে ATP সরবরাহ বন্ধ করে দিতে পারে, ফলে Keratinocytes এ শক্তি সরবরাহ বন্ধ হয়ে যায়। এই প্রক্রিয়া অন্ততঃ পক্ষে আংশিক ভাবে সোরাইসিসের উপর ডাইথ্রানলের আরোগ্যকর কার্যকারিতা ব্যাখ্যা করা যেতে পারে। ইহার ছত্রাক ধ্বংসের ক্ষমতা রয়েছে।<br />\r\n<br />\r\n<strong>স্যালিসাইলিক এসিড</strong>: ইহা একটি Keratolytic agent. স্যালিসাইলিক এসিড desquamation এর গতি বাড়িয়ে দেয়, ফলে এই প্রক্রিয়ার মাধ্যমে আক্রমণকারী ছত্রাক দূরীভূত করে এবং ঔষধ চর্মের ভিতরে প্রবেশে সহায়তা করে। Keratolysis প্রক্রিয়ায় চর্মের এপিডার্মিসের শক্ত অংশ (horny layer) খসে যায়। স্যালিসাইলিক এসিড আন্তঃকোষীয় সংযোজক পদার্থকে (Intercellular cement) দ্রবীভূত করে desquamation প্রক্রিয়া সম্পন্ন করে। উক্ত সংযোজক পদার্থ চর্মের Stratum Corneum এর আঁইশকে Scales সংযুক্ত করে রাখে। স্যালিসাইলিক এসিড প্রধানতঃ খোলস বা আঁইশ খসানো বর্ধিত করে এর কার্যকারিতা প্রদর্শন করে।<br />\r\n<br />\r\n<strong>বোরিক এসিড</strong>: এর ব্যাক্টেরিয়া এবং ছত্রাকের উৎপাদন দমনের (bacteriostatic and fungistatic properties) ক্ষমতা রয়েছে।</p>', '<ul>\r\n	<li>ক্ষতস্থান গরম পানিতে খুব ভাল করে ধুয়ে ফেলুন।</li>\r\n	<li>তারপর শুকনো ক্ষতস্থানে অল্প পরিমাণে মলম লাগিয়ে দিন (ক্ষতের বাইরে লাগাবেন না)।</li>\r\n	<li>মলম দিনে একবার, প্রয়োজনবোধে বা চিকিৎসকের পরামর্শ অনুসারে দুইবার ক্ষত না সারা পর্যন্ত নিয়মিতভাবে ব্যবহার করুন।</li>\r\n	<li>ক্ষত সেরে যাবার পর সম্পূর্ণভাবে আরোগ্য হওয়ার জন্য ৩-৪ দিন পর্যন্ত সামান্য পরিমাণ ব্যবহার করুন।</li>\r\n</ul>', '<p>If you use other drugs or over the counter products at the same time, the effects of this ointment may change. This may increase your risk for side-effects or cause your drug not to work properly. Tell your doctor about all the drugs, vitamins, and herbal supplements you are using, so that you doctor can help you prevent or manage drug interactions. this ointment may interact with the following drugs and products:</p>\r\n\r\n<ul>\r\n	<li>Fluocinolone</li>\r\n	<li>Hydroquinone</li>\r\n	<li>Isotretinoin</li>\r\n	<li>None reported</li>\r\n	<li>Riboflavin</li>\r\n	<li>Tretinoin</li>\r\n</ul>', '<p>Hypersensitivity to this ointment is a contraindication. In addition, this ointment should not be used if you have the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Acute or actively inflamed psoriatic eruptions</li>\r\n	<li>After shaving or bathing</li>\r\n	<li>Avoid use on dentures</li>\r\n	<li>Breastfeeding</li>\r\n	<li>Children</li>\r\n	<li>Do not apply bandage or heating pad</li>\r\n	<li>Facial psoriasis</li>\r\n	<li>Genital warts</li>\r\n	<li>Hypersensitivity</li>\r\n	<li>Hypersensitivity to this drug</li>\r\n</ul>', '<p>The following is a list of possible side-effects that may occur from all constituting ingredients of this ointment. 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>Contact allergic reactions</li>\r\n	<li>Irritation in skin areas surrounding treated lesions</li>\r\n	<li>Soreness</li>\r\n	<li>Temporary discoloration of hair and fingernails</li>\r\n	<li>Mild cold or burning sensation at the site of application</li>\r\n	<li>Severe allergic reaction</li>\r\n	<li>Cardiovascular defects</li>\r\n	<li>Skeletal variations</li>\r\n	<li>Mild kidney lesions</li>\r\n	<li>Infertility</li>\r\n</ul>', '<p>Not recommended during pregnancy. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>ক্ষতস্থানের বাইরে স্বাভাবিক চর্মে এবং চোখ বা চোখের নিকটবর্তী স্থানে এই টপিক্যাল অয়েন্টমেন্ট ব্যবহার নিষেধ। এই মলমের কোন উপাদানের প্রতি সংবেদনশীলতা থাকলে এর ব্যবহার করা যাবে না। মলম ব্যবহারের পর ভাল করে হাত ধুয়ে ফেলতে হবে।</p>', NULL, '<p>Dithranol &amp; combined preparations</p>', '<p>Store medicines at room temperature, away from heat and direct light. Do not freeze medicines unless required by package insert. Keep medicines away from children.</p>', NULL, '2022-02-19 06:30:38', '2022-06-07 00:12:57'),
(467, 467, '<p>Dobutamine Hydrochloride is indicated when inotropic support is necessary for the treatment of patients with hypoperfusion states in whom cardiac output is insufficient to meet circulatory demands. Dobutamine Hydrochloride is also indicated when inotropic support is required for the treatment of patients in whom abnormally increased ventricular filling pressures introduce the risk of pulmonary congestion and oedema.</p>', '<p>Dobutamine exerts positive inotropic effect on the myocardium by stimulating &beta;1-adrenergic receptors, thereby increasing myocardial contractility, stroke vol and cardiac output.</p>', '<p><strong>Recommended Dosage</strong>: The rate of infusion needed to increase cardiac output has ranged from 2.5 to 10 mcg/kg/min in the majority of patients. Frequently, doses up to 20 mcg/kg/min are required for adequate haemodynamic improvement. On rare occasions, infusion rates up to 40 mcg/kg/min have been reported.<br />\r\n<br />\r\nThe rate of administration and the duration of therapy should be adjusted according to the patient&#39;s response, The indicators are: haemodynamic parameters such as heart rate and rhythm, arterial pressure, and, whenever possible, cardiac output and measurements of ventricular filling pressures and signs of pulmonary congestion. Concentrations up to 5,000 mg/L have been administered to humans. The final volume administered should be determined by the fluid requirements of the patient. Rather than abruptly discontinuing therapy with Dobutamine Hydrochloride, it is often advisable to decrease the dosage gradually.<br />\r\n<br />\r\nRates of Infusion Based on Concentration of Dobutamine Hydrochloride. The rates of fluid infusion that are required to deliver specific dosages are a function of the concentration of Dobutamine Hydrochloride in the infusate. The following table provides a guideline of infusion rates (mL/kg/min) required for 3 frequently used concentrations of Dobutamine Hydrochloride (250, 500, and 1000 mg/L).</p>\r\n\r\n<p>Because of its short half-life, Dobutamine Hydrochloride must be administered as a continuous intravenous infusion. Following the initiation of a constant rate infusion, or upon changing the rate, a steady-state dobutamine plasma concentration is achieved within approximately 10 minutes. Thus, loading doses or bolus injections are not necessary and are not recommended.</p>', '<p>The potency of Dobutamine Hydrochloride may be decreased if the patient is given b-adrenergic receptor antagonists. In such a case, the unopposed a-agonist effects of Dobutamine Hydrochloride may become apparent, including peripheral vasoconstriction and hypertension. Conversely, a-adrenergic blockade may make the b-1 and b-2 effects apparent, resulting in tachycardia and vasodilatation.<br />\r\n<br />\r\nThere has been no overt indication of medicine interactions in clinical studies in which Dobutamine Hydrochloride was administered concurrently with other medicines, including digitalis preparations, furosemide, spironolactone, lidocaine, nitroglycerin, nitroprusside, isosorbide dinitrate, morphine, atropine, heparin, protamine, potassium chloride, folic acid, and paracetamol.</p>', '<p>Dobutamine Hydrochloride is contraindicated in patients who have shown previous manifestations of hypersensitivity to Dobutamine Hydrochloride.</p>', '<p><strong>Increased Heart Rate, Blood Pressure, And Ventricular Ectopic Activity</strong>: A 10- to 20-mm increase in&nbsp;systolic&nbsp;blood pressure and an increase in heart rate of 5 to 15 beats/minute have been noted in most patients (see&nbsp;WARNINGS&nbsp;regarding exaggerated chronotropic and pressor effects). Approximately 5% of patients have had increased premature&nbsp;ventricular&nbsp;beats during infusions. These effects are dose related.<br />\r\n<br />\r\n<strong>Hypotension</strong>: Precipitous decreases in blood pressure have occasionally been described in association with&nbsp;dobutamine&nbsp;therapy. Decreasing the dose or discontinuing the infusion typically results in rapid return of blood pressure to baseline values. In rare cases, however, intervention may be required and reversibility may not be immediate.<br />\r\n<br />\r\n<strong>Reactions At Sites Of Intravenous Infusion</strong>: Phlebitis&nbsp;has occasionally been reported. Local inflammatory changes have been described following inadvertent infiltration. Isolated cases of cutaneous necrosis&nbsp;(destruction of skin tissue) have been reported.<br />\r\n<br />\r\n<strong>Miscellaneous Uncommon Effects</strong>: The following adverse effects have been reported in 1% to 3% of patients: nausea, headache, anginal pain, nonspecific chest pain,&nbsp;palpitations, and shortness of breath. Isolated cases of&nbsp;thrombocytopenia&nbsp;have been reported.<br />\r\n<br />\r\nAdministration of dobutamine, like other catecholamines, can produce a mild reduction in serum&nbsp;potassium&nbsp;concentration, rarely to hypokalemic levels.<br />\r\n<br />\r\n<strong>Longer-Term Safety</strong>: Infusions of up to 72 hours have revealed no adverse effects other than those seen with shorter infusions.</p>', '<p>Since there are no adequate and well controlled studies in pregnant women, Dobutamine Hydrochloride should not be used during pregnancy unless the potential benefits outweigh the potential risks to the foetus.<br />\r\n<br />\r\nIt is not known whether this medicine is excreted in human milk. Because many medicines are excreted in human milk, caution should be exercised when Dobutamine Hydrochloride is administered to a nursing woman. If a mother requires dobutamine treatment, breastfeeding should be discontinued for the duration of the treatment.</p>', '<p>During the administration of Dobutamine Hydrochloride, as with any parenteral catecholamine, heart rate and rhythm, arterial blood pressure, and infusion rate should be monitored closely. When initiating therapy, electrocardiographic monitoring is advisable until a stable response is achieved.</p>', '<p><strong>Signs And Symptoms</strong>: Toxicity from dobutamine hydrochloride is usually due to excessive cardiac &beta;- receptor stimulation. The duration of action of dobutamine hydrochloride is generally short (T&frac12;= 2 minutes) because it is rapidly metabolized by catechol-0-methyltransferase. The symptoms of toxicity may include&nbsp;anorexia, nausea, vomiting,&nbsp;tremor, anxiety,&nbsp;palpitations, headache, shortness of breath, and anginal and nonspecific chest pain. The positive&nbsp;inotropicand chronotropic effects of dobutamine on the&nbsp;myocardium&nbsp;may cause&nbsp;hypertension, tachyarrhythmias, myocardial&nbsp;ischemia, and&nbsp;ventricular fibrillation.&nbsp;Hypotension&nbsp;may result from&nbsp;vasodilation.<br />\r\n<br />\r\n<strong>Treatment</strong>: To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physicians&#39; Desk Reference (PDR). In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug&nbsp;kinetics&nbsp;in your patient.<br />\r\n<br />\r\nThe initial actions to be taken in a dobutamine hydrochloride overdose are discontinuing administration, establishing an airway, and ensuring&nbsp;oxygenation&nbsp;and&nbsp;ventilation. Resuscitative measures should be initiated promptly. Severe&nbsp;ventricular&nbsp;tachyarrhythmias may be successfully treated with propranolol or lidocaine. Hypertension usually responds to a reduction in dose or discontinuation of therapy.<br />\r\n<br />\r\nProtect the patient&#39;s airway and support ventilation and&nbsp;perfusion. If needed, meticulously monitor and maintain, within acceptable limits, the patient&#39;s vital signs, blood gases, serum electrolytes, etc. If the product is ingested, unpredictable absorption may occur from the mouth and the&nbsp;gastrointestinal tract. Absorption of drugs from the&nbsp;gastrointestinal&nbsp;tract may be decreased by giving&nbsp;activated charcoal, which, in many cases, is more effective than emisis of lavage; consider charcoal instead of or in addition to&nbsp;gastric&nbsp;emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Safeguard the patient&#39;s airway when employing gastric emptying or charcoal.<br />\r\n<br />\r\nForced&nbsp;diuresis,&nbsp;peritoneal dialysis,&nbsp;hemodialysis, or charcoal hemoperfusion have not been established as beneficial for an overdose of dobutamine hydrochloride</p>', '<p>Inotropic-sympathomimetics</p>', '<p>Store between 15-30&deg; C.</p>', NULL, '2022-02-19 06:30:59', '2022-06-07 00:15:17');
