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
(972, 972, '<p>This inhaler is used for asthma as follows:</p>\r\n\r\n<ul>\r\n	<li>This inhaler is a prescription medicine used to control symptoms of asthma and prevent symptoms such as wheezing in people 12 years of age and older.</li>\r\n	<li>This inhaler contains Formoterol which is a Long Acting &beta;2 Agonist (LABA). When it is used alone increase the risk of hospitalizations and death from asthma problems. This contains an ICS and a LABA. When an ICS and LABA are used together, there is not a significant increased risk in hospitalizations and death from asthma problems.</li>\r\n	<li>This inhaler is not for adults and adolescent patients with asthma who are well controlled with an asthma control medicine, such as a low to medium dose ICS medicine. This inhaler is for adults and adolescent patients with asthma who need both an ICS and LABA medicine.</li>\r\n</ul>', '<p>Mometasone furoate is an inhaled corticosteroid- ICS for short. Inhaled corticosteroids help to decrease inflammation in the lungs. Infammation in the lungs can lead to breathing problems. Formoterol fumarate is a long-acting beta-2 agonist- LABA for short. LABA medicines help the muscles around the airways of the lungs stay relaxed to prevent asthma symptoms, such as wheezing, cough, chest tightness, and shortness of breath. These symptoms can happen when the muscles around the airways tighten. This makes it hard to breathe.</p>', '<p><strong>Adult and adolescent patients aged 12 Years and older</strong>: Dosage is either 2 inhalations twice daily of 200 HFA inhaler or 100 HFA inhaler. When choosing the starting dosage strength of this inhaler, consider the patients&#39; disease severity, based on their previous asthma therapy, including the inhaled corticosteroid dosage, as well as the patients&#39; current control of asthma symptoms and risk of future exacerbation. The maximum recommended dosage is two inhalations of 200 HFA inhaler twice daily (maximum daily dosage 800 mcg/20 mcg). After each dose of 2 puffs, rinse your mouth with water. Spit out the water. Do not swallow it. This will help to prevent thrush in your mouth or throat.</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>Remove the cap and shake the inhaler vigorously before each use.</li>\r\n	<li>Holding the inhaler well away from your mouth, breathe out gently (but not fully).</li>\r\n	<li>Place the mouthpiece in your mouth and close your lips around it.</li>\r\n	<li>After starting to breathe in slowly and deeply through your mouth, press the metal canister firmly to release the powder, and continue to breathe in.</li>\r\n	<li>Remove the inhaler from your mouth and hold your breath for 10 seconds, or as long as it is comfortable, then breathe out slowly.</li>\r\n	<li>If you take a second inhalation, you should wait for at least one minute before repeating steps 2, 3 and 4. After use replace the cap on the mouthpiece.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 2 carefully.</li>\r\n	<li>It is very important that the plastic mouthpiece is to be cleaned regularly to prevent build-up of spare powder. Remove the metal canister and wash the plastic mouthpiece in warm water at least twice a week. Leave to dry in a warm place overnight. No harm will come with from washing the mouthpiece every day. For further assistance / information please consult with your physician.</li>\r\n</ul>', '<ul>\r\n	<li>Strong cytochrome P450 3A4 inhibitors: Use with caution. May cause increased systemic corticosteroid effects.</li>\r\n	<li>Adrenergic agents: Use with caution. Additional adrenergic drugs may potentiate sympathetic effects</li>\r\n	<li>Xanthine derivatives and diuretics: Use with caution. May potentiate ECG changes and/or hypokalemia.</li>\r\n	<li>MAO inhibitors, tricyclic antidepressants, macrolides, and drugs that prolong QTc interval: Use with extreme caution. May potentiate effect on the cardiovascular system.</li>\r\n	<li>Beta-blockers: Use with caution and only when medically necessary. May decrease effectiveness and produce severe bronchospasm.</li>\r\n	<li>Halogenated hydrocarbons: There is an elevated risk of arrhythmias in patients receiving concomitant anesthesia with halogenated hydrocarbons.</li>\r\n</ul>', '<p>This combination is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. This combination is contraindicated in patients with known hypersensitivity to Mometasone Furoate, Formoterol Fumarate, or any of the ingredients in this combination.</p>', '<p>The most common side effects of this combination include inflammation of the nose and throat, inflammation of the sinuses, headache, flu, and upper respiratory infection. Other less common side-effects include: serious allergic reactions, thrush in the mouth &amp; throat, reduces adrenal function, increase in wheezing, lower bone mineral density in osteoporosis patient, slowed growth in children, glaucoma, blurred vision &amp; hypokalemia.</p>', '<p>The use of this combination during pregnancy and lactation should be restricted to those patients in whom the benefits clearly outweigh the risk.</p>', NULL, NULL, NULL, '<p>Keep out of the reach of children. Store below 30&deg;C protected from direct sunlight and heat. Keep away from contact of eyes. The container should not be punctured, broken or burnt even when apparently empty.</p>', '<p>Hepatic/Renal Impairment: There are no data regarding the specific use of this combination in patients with hepatic or renal impairment.<br />\r\n<br />\r\nGeriatrics: The pharmacokinetics of this combination have not been specifically studied in the elderly population.</p>', '2022-03-10 17:21:20', '2022-03-10 17:21:20'),
(973, 973, '<p>This is used for relief of occasional constipation. This product usually produces a bowel movement in 1 to 5 minutes.</p>', NULL, '<p><strong>Adults and children, 12 years and over</strong>: One Bottle per day.<br />\r\n<strong>Children between 2 and 11 years</strong>: Use this laxative preparation.<br />\r\n<strong>Children under 2 years</strong>: Do not use.<br />\r\n<br />\r\nIf no urge is felt after 5 minutes of using, try to empty bowel. Call a doctor promptly if no liquid comes out of the rectum after 30 minutes because dehydration could occur.</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>Remove the orange protective shield from this&nbsp;before inserting.</li>\r\n	<li>With steady pressure, gently insert this bottle tip into the rectum with a slight side-to-side movement, with the tip pointing toward the navel. Insertion may be easier if the person receiving this bears down as if having a bowel movement. This helps relax the muscles around the anus.</li>\r\n	<li>Stop using if the tip is hard to insert. Forcing the tip into the rectum can cause injury (especially if you have hemorrhoids). If this bottle tip causes rectal bleeding or pain, get immediate medical care.</li>\r\n	<li>Squeeze bottle until nearly all liquid is gone. It is not necessary to empty the bottle completely, as it contains more liquid than needed.</li>\r\n	<li>Remove the tip from the rectum and maintain position until the urge to evacuate is strong (usually 1 to 5 minutes).</li>\r\n</ul>\r\n\r\n<p>Positions for using this:</p>\r\n\r\n<ul>\r\n	<li>Left-side position: Lie on left side with knee bent, and arms resting comfortably.</li>\r\n	<li>Knee-chest position: kneel, then lower head and chest forward until left side of face is&nbsp;resting on surface with left arm folded comfortably.</li>\r\n</ul>\r\n\r\n<p>If no urge is felt after 5 minutes of using, try to empty bowel. Call a doctor promptly if no liquid comes out of the rectum after 30 minutes because dehydration could occur.</p>', NULL, '<p>Using more than one bottle in 24 hours can be harmful. Do not use without asking a doctor:</p>\r\n\r\n<ul>\r\n	<li>For more than 3 days</li>\r\n	<li>If you have kidney disease</li>\r\n	<li>If you have heart problems</li>\r\n	<li>If you are dehydrated</li>\r\n	<li>When abdominal pain, nausea, or vomiting are present.</li>\r\n</ul>', NULL, '<p>If pregnant or breastfeeding, ask a health professional before use.</p>', '<p>Ask a doctor before using this product if you:</p>\r\n\r\n<ul>\r\n	<li>Are 55 years old or older</li>\r\n	<li>Are on a sodium-restricted diet</li>\r\n	<li>Have a sudden change in bowel habits lasting more than 2 weeks</li>\r\n	<li>Already used a laxative for more than 1 week</li>\r\n</ul>\r\n\r\n<p>Stop use and ask a doctor if you have:</p>\r\n\r\n<ul>\r\n	<li>Rectal bleeding</li>\r\n	<li>No bowel movement or no liquid comes out of the rectum after 30 minutes</li>\r\n	<li>Symptoms of dehydration (feeling thirsty, dizziness, vomiting, urinating less often than normal)</li>\r\n</ul>', NULL, '<p>Other laxative preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children. If swallowed, get medical help or contact a Poison Control Center right away.</p>', NULL, '2022-03-10 17:23:13', '2022-03-10 17:23:13'),
(974, 974, '<p>Monosemicarbazone Adrenochrome is indicated in the prevention and treatment of surgical and non-surgical capillary bleedings.</p>', '<p>Adrenochrome Monosemicarbazone is a haemostatic with a rapid onset of action. It contains a water soluble form of adrenochrome monosemicarbazone, a stable derivative of adrenochrome as the active substance. Adrenochrome is an oxidation product of adrenaline; it reduces normal and pathologic bleeding time by decreasing capillary permeability. It produces capillary haemostatis without exerting any of the adrenergic actions on respiration or cardiovascular system. Thus, despite its adrenaline like action on small blood vessels, does not give rise to the general systemic effects of sympathomimetic drugs.</p>', '<p>For the prevention and treatment of capillary bleedings, accordingly to the severity of the case, 4-12 tablets divided over the day, preferably one hour before meals. Prior to surgery, medication is started on the preceding evening, either orally or by intramuscular or subcutaneous injection of usually 1.5-5 mg. In addition, an injection is given about half an hour before the surgical intervention.<br />\r\n<br />\r\nInjection solution should be administered by intramuscular or subcutaneous route; in emergency cases the injections may be given intravenously. The tablets should be taken orally.</p>', '<p>No specific drug interaction has been demonstrated.</p>', '<p>There are no known contraindications.</p>', '<p>No adverse reactions have been reported at the recommended dosages.</p>', '<p>During pregnancy, the benefits of the use of Monosemicarbazone Adrenochrome should be weighed against the possible hazards of the foetus.</p>', '<p>Because of the content of diprophylline (90 mg/ml), the dosage of the 5 mg/ml injection preparation to premature babies, infants and young children should not exceed 0.3 ml.</p>', NULL, '<p>Anti-fibrinolytic drugs.</p>', '<p>Store in a cool (in between 2&deg;-25&deg;C), dry place &amp; protect from light. Keep out of the reach of children.</p>', NULL, '2022-03-10 17:25:19', '2022-03-10 17:25:19'),
(975, 975, '<p>Monosulfiram solution is a parasiticide, active against the burrowing mite Sarcoptes scabiei. It is indicated for the treatment and prophylaxis of scabies.</p>', '<p>Monosulfiram, is an ectoparasiticide used in the treatment and prevention of scabies.</p>', '<p>Before application Monosulfiram Solution should be diluted with two to three parts of water. The patient&#39;s body should be liberally washed with soap and water and thoroughly dried. Apart from face and scalp, the entire body should be painted with the dilute solution, which is rubbed well in and left to dry. About ten minutes is allowed for the skin to dry naturally and the patient then dresses. Application is suitable for use in clinics dealing with children. In difficult cases this routine may be repeated successively for two or three days. These instructions are applicable to adults and children.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Known idiosyncratic response to its application. The solution should not be applied near a naked flame. Because of the close chemical relationship between monosulfiram and disulfiram, it is advisable to abstain from alcohol before and for at least 48 hours after the application of Monosulfiram.</p>', '<p>Very few side-effects occur with Monosulfiram Solution even in cases of undiluted application. A few cases of erythematous rash considered as idiosyncratic response have been reported.</p>', '<p>Pregnancy Category is not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', NULL, '<p>The solution contains alcohol and monosulfiram, and if ingested this combination will produce a severe reaction with flushing, dyspnoea, headache, dizziness, nausea, vomiting, drowsiness or sleep. Tachycardia and hypotension may also occur and the resultant myocardial ischaemia may be fatal. Symptomatic measures are required supply of oxygen, if dysponea is excessive, and control of the blood pressure. Other treatment which has been found useful includes application of cardiac stimulants, intravenous iron, ascorbic acid and nicotinamide, adenine and intravenous sodium thiosulphate.</p>', '<p>Parasiticidal preparations</p>', '<p>Store at room temperature (below 35&deg; C). Monosulfiram Solution should not be stored in a cold place as this causes deposition of crystals. These can be redissolved by immersing the bottle in warm water. The solution is flammable and should not be kept near naked flame. Water is a suitable diluents for Monosulfiram.</p>', NULL, '2022-03-10 17:27:39', '2022-03-10 17:27:39'),
(976, 976, '<p>Montelukast Sodium is indicated for:</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis and chronic treatment of asthma</li>\r\n	<li>Acute prevention of Exercise-Induced Bronchoconstriction (EIB)</li>\r\n	<li>Relief of symptoms of Allergic Rhinitis (AR): Seasonal &amp; Perennial Allergic Rhinitis</li>\r\n</ul>', '<p>Montelukast is a selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor (CysLT1). The cysteinyl leukotrienes (LTC4, LTD4, LTE4) are products of arachidonic acid metabolism and are released from various cells, including mast cells and eosinophils. Cysteinyl leukotrienes and leukotriene receptor occupation have been correlated with the pathophysiology of asthma &amp; allergic rhinitis, including airway edema, smooth muscle contraction, and altered cellular activity associated with the inflammatory process, which contribute to the signs and symptoms of asthma.</p>', '<p>Adults &amp; adolescents (15 years &amp; older)-</p>\r\n\r\n<ul>\r\n	<li><strong>Asthma &amp; Allergic Rhinitis</strong>: 10 mg/day&nbsp;</li>\r\n	<li><strong>Exercise-Induced Bronchoconstriction</strong>: 10 mg/day</li>\r\n</ul>\r\n\r\n<p>Pediatric patients (6 to 14 years)-</p>\r\n\r\n<ul>\r\n	<li><strong>Asthma &amp; Allergic Rhinitis</strong>: 5 mg/day&nbsp;</li>\r\n	<li><strong>Exercise-Induced Bronchoconstriction</strong>: 5 mg/day</li>\r\n</ul>\r\n\r\n<p>Pediatric patients (6 months to 5 years)-</p>\r\n\r\n<ul>\r\n	<li><strong>Asthma &amp; Allergic Rhinitis</strong>: 4 mg/day&nbsp;</li>\r\n	<li><strong>Exercise-Induced Bronchoconstriction</strong>: Not recommended</li>\r\n</ul>\r\n\r\n<p>Patients with both asthma and allergic rhinitis should take only one dose daily in the evening. For prevention of Acute prevention of Exercise-Induced Bronchoconstriction, a single dose should be taken at least 2 hours before exercise.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Route of administration: Oral. Montelukast may be taken with or without food or as directed by the physician.</p>', '<p><strong>With medicine</strong>: No dose adjustment is needed when montelukast is co-administered with theophylline, prednisone, prednisolone, terfenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative-hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, oral contraceptives, and Cytochrome P450 (CYP) enzyme inducers.<br />\r\n<br />\r\n<strong>With food and others</strong>: Bioavailability and other conditions were not significantly observed with food &amp; other conditions.</p>', '<p>Montelukast is contraindicated in patients who are hypersensitive to any component of this product.</p>', '<p><strong>Common</strong>: Diarrhoea, fever, gastrointestinal discomfort, headache, nausea, vomiting, skin reactions, upper respiratory tract infection.<br />\r\n<br />\r\n<strong>Uncommon</strong>: Akathisia, anxiety, arthralgia, asthenia, abnormal behavior, depression, dizziness, drowsiness, dry mouth, haemorrhage, irritability, malaise, muscle complaints, oedema, seizure, abnormal sensation, sleep disorders.<br />\r\n<br />\r\n<strong>Rare</strong>: Angioedema, concentration impaired, disorientation, eosinophilic granulomatosis with polyangiitis, erythema nodosum, hallucination, hepatic disorders, memory loss, palpitations, pulmonary eosinophilia, suicidal tendencies, tremor.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Montelukast should be used during pregnancy only if clearly needed. Montelukast is excreted in breast milk. So caution should be exercised when Montelukast is given to a nursing mother.</p>', '<p>Montelukast is not indicated for use in the reversal of bronchospasm in acute asthma attacks, including status asthmatic. Neuropsychiatric events including agitation, hostility, anxiousness, depression, disorientation, disturbance in attention, dream abnormalities, hallucinations, insomnia, irritability, memory impairment, restlessness, somnambulism, suicidal thinking and behavior (including suicide) and tremor.</p>', '<p>There were no adverse experiences in the majority of overdosage reports. The most frequently occurring adverse experiences were consistent with the safety profile of Montelukast and included abdominal pain, somnolence, thirst, headache, vomiting and psychomotor hyperactivity. In the event of overdose, it is reasonable to employ the usual supportive measures; e.g., remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring, and institute supportive therapy, if required.</p>', '<p>Leukotriene receptor antagonists.</p>', '<p>Store in cool &amp; dry place below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-03-10 17:30:07', '2022-03-10 17:30:07'),
(977, 977, '<p>This&nbsp;medication&nbsp;is used to help relieve moderate to severe pain.&nbsp;Morphine&nbsp;belongs to a class of drugs known as&nbsp;opioid&nbsp;(narcotic) analgesics. It works in the&nbsp;brain&nbsp;to change how your body feels and responds to pain.</p>', '<p>Morphine is a phenanthrene derivative which acts mainly on the CNS and smooth muscles. It binds to opiate receptors in the CNS altering pain perception and response. Analgesia, euphoria and dependence are thought to be due to its action at the mu-1 receptors while resp depression and inhibition of intestinal movements are due to action at the mu-2 receptors. Spinal analgesia is mediated by morphine agonist action at the K receptor.</p>', '<p><strong>Oral-&nbsp;</strong>Moderate to severe pain:&nbsp;5-20 mg 4 hrly. Extended-release: 5-20 mg 12 hrly. Dosage is dependent on the severity of pain.<br />\r\n<br />\r\n<strong>Intraspinal-&nbsp;</strong>Moderate to severe pain:&nbsp;Initially, 5 mg epidural inj; after 1 hr, additional doses of 1-2 mg may be given up to a total dose of 10 mg/24 hr if pain relief is unsatisfactory. A dose of 20-30 mg daily may be required in some patients. Liposomal inj: 10-20 mg depending on the type of surgery.<br />\r\n<br />\r\n<strong>Intrathecal-&nbsp;</strong>Moderate to severe pain: 0.2-1 mg once daily or 1-10 mg daily for patients with opioid tolerance. Some patients may require a dose of up to 20 mg daily.<br />\r\n<br />\r\n<strong>Intravenous-&nbsp;</strong>Acute pulmonary oedema:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;5-10 mg via slow inj at 2 mg/min.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Half of the usual adult dose.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-&nbsp;</strong>Pain associated with myocardial infarction:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;5-10 mg at 1-2 mg/min followed by a further 5-10 mg as necessary.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;Half of the usual adult dose.</li>\r\n</ul>\r\n\r\n<p><strong>Parenteral-&nbsp;</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Moderate to severe pain</strong>:&nbsp;5-20 mg; 2.5-10 mg via slow IV inj over 4-5 min with patient in recumbent position or a starting dose of 1-2 mg/hr via continuous IV infusion (max: 100 mg/day; 4 g/day in cancer patients). Doses may be adjusted according to severity of pain and patient&#39;s response.</li>\r\n	<li><strong>Premedication in surgery</strong>:&nbsp;Up to 10 mg, given 60-90 min before operation.</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>May be taken with or without food. May be taken with meals to reduce GI discomfort.</p>', '<p>Additive depressant effects with other CNS depressants (e.g. sedatives, hypnotics, general anaesth, phenothiazines, other tranquilisers). May enhance the neuromuscular blocking action of skeletal muscle relaxants. Reduced analgesic effect with mixed agonist/antagonist opioid analgesics (e.g. pentazocine, nalbuphine, buprenorphine). Increased plasma concentrations with cimetidine. May reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. May delay the absorption of mexiletine. May antagonise the GI effect of cisapride, domperidone and metoclopramide. May produce hyperpyrexia and CNS toxicity with dopaminergics.</p>', '<p>Resp depression, obstructive airway disease, delayed gastric emptying, acute abdomen, heart failure secondary to chronic lung disease, known or suspected paralytic ileus, phaeochromocytoma. Concurrent admin with MAOIs or within 2 wk after treatment.</p>', '<p>Nausea, vomiting, constipation, abdominal pain, dry mouth, anorexia, taste disturbance, dyspepsia, resp depression, sedation, dizziness, confusion, insomnia, headache, somnolence, involuntary muscle contractions, hyperhidrosis, rash, pruritus, asthenic conditions, HTN, bronchospasm, seizures, amenorrhoea, rhabdomyolysis, nystagmus.</p>', '<p>Parenteral or oral: C, D (if prolonged use/high doses at term)</p>', '<p>Patient with impaired resp function, severe bronchial asthma, convulsive disorders, acute alcoholism, delirium tremens, raised intracranial pressure, hypotension with hypovolaemia, cardiac arrhythmias, severe cor pulmonale, history of substance abuse, diseases of the biliary tract, pancreatitis, inflammatory bowel disorders, prostatic hypertrophy, adrenocortical insufficiency, toxic psychoses. Opioid dependent patients. Renal and hepatic impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Resp depression, pinpoint pupils, extreme somnolence progressing to stupor and coma, skeletal muscle flaccidity, cold and clammy skin and sometimes bradycardia and hypotension. Apnoea, circulatory collapse, and cardiac arrest may occur in severe cases.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Re-establish adequate resp exchange through provision of a patent airway and institution of assisted or controlled ventilation. Oxygen, IV fluid, vasopressors and other supportive measures may be employed as necessary. Naloxone may be given as antidote.</p>', '<p>Opioid analgesics</p>', '<p>Inj/oral preparations: Store between 15-30&deg;C. Liposomal inj: Store between 2-8&deg;C. Supp: Store below 25&deg;C. Protect from light.</p>', '<p>Renal Impairment: Dosage may need to be reduced.<br />\r\nHepatic Impairment: Dosage may need to be reduced.</p>', '2022-03-10 17:32:28', '2022-03-10 17:32:28'),
(978, 978, '<p>Moxifloxacin infusion is indicated for treating following infections in adults &gt;18 years of age caused by designated, susceptible bacteria.</p>\r\n\r\n<ul>\r\n	<li>Acute Bacterial Sinusitis</li>\r\n	<li>Acute Bacterial Exacerbation of Chronic Bronchitis</li>\r\n	<li>Community Acquired Pneumonia</li>\r\n	<li>Skin and Skin Structure Infections: Uncomplicated and Complicated</li>\r\n	<li>Complicated Intra-Abdominal Infections.</li>\r\n</ul>', NULL, '<p>The dose of Moxifloxacin is 400 mg once daily. The duration of therapy depends on the type of infection as described in following:</p>\r\n\r\n<ul>\r\n	<li>Acute Bacterial Sinusitis: 400 mg once daily for 10 days.</li>\r\n	<li>Acute Bacterial Exacerbation of Chronic Bronchitis: 400 mg once daily for 5 days.</li>\r\n	<li>Community Acquired Pneumonia: 400 mg once daily for 7-14 days.</li>\r\n	<li>Uncomplicated Skin and Skin Structure Infections: 400 mg once daily for 7 days.</li>\r\n	<li>Complicated Skin and Skin Structure Infections: 400 mg once daily for 7-21 days.</li>\r\n	<li>Complicated Intra-Abdominal Infections: 400 mg once daily for 5-14 days.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Moxifloxacin injection should be administered by intravenous infusion over a period of 60 minutes. Avoid bolus or rapid infusion.</p>\r\n\r\n<ul>\r\n	<li>Check the bag for minute leaks by squeezing the inner bag firmly. If leaks are found, or if seal is not intact, discard the solution.</li>\r\n	<li>Do not use if the solution is cloudy or a precipitate is present.</li>\r\n	<li>Do not use flexible bags in series connections.</li>\r\n	<li>Close flow control clamp of administration set.</li>\r\n	<li>Remove cover from port at bottom of bag.</li>\r\n	<li>Insert piercing pin of administration set into port with a twisting motion until the pin is firmly seated.</li>\r\n	<li>Suspend bag from hanger.</li>\r\n	<li>Squeeze and release drip chamber to establish proper fluid level in chamber during infusion of Moxifloxacin 400 mg intravenous infusion.</li>\r\n	<li>Open flow control clamp to expel air from set. Close clamp.</li>\r\n	<li>Regulate the rate of administration with flow control clamp.</li>\r\n</ul>', '<p>There are no data concerning an interaction of intravenous fluoroquinolones with oral antacids, sucralfate, multivitamins, didanosine, or metal cations. However, no fluoroquinolone should be co-administered with any solution containing multivalent cations, e.g., magnesium, through the same intravenous line. Quinolones, including Moxifloxacin, have been reported to enhance the anticoagulant effects of warfarin or its derivatives in the patient population. Although not observed with Moxifloxacin in predinical and clinical trials, the concomitant administration of a nonsteroidal anti-inflammatory drug with a quinolone may increase the risks of CNS stimulation and convulsions. There is limited information available on the potential for a pharmacodynamic interaction in humans between Moxifloxacin and other drugs that prolong the QTc interval of the electrocardiogram. Sotalol, a Class III antiarrhythmic, has been shown to further increase the QTc interval when combined with high doses of intravenous (IV) Moxifloxacin in dogs. Therefore, Moxifloxacin should be avoided with Class IA and Class III antiarrhythmics.</p>', '<p>Moxifloxacin is contraindicated in persons with known hypersensitivity to Moxifloxacin or other quinolone antibacterials .</p>', '<p>Treatment with Moxifloxacin (oral, IV or sequential therapy) may cause some side effects. Common (&gt;1%) side effects include headache, nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, dizziness, pyrexia and insomnia etc. Less common (0.1 to &lt;1%) side effects include neutropenia, palpitations, tachycardia, bradycardia, vertigo, tinnitus, dry mouth, gastritis, edema, fatigue, malaise, hyperglycemia, anorexia, hyperlipidemia, hypoglycemia, dehydration, back pain and arthralgia etc.</p>', '<p>Pregnancy Category C. Because no adequate or well controlled studies have been conducted in pregnant women, Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Moxifloxacin is excreted in the breast milk of rats. Moxifloxacin may also be excreted in human milk. Because of the potential for serious adverse reactions in infants who are nursing from mothers taking Moxifloxacin, 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>Fluoroquinolones, including Moxifloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants. Fluoroquinolones have neuromuscular blocking activity and may exacerbate muscle weakness in persons with myasthenia gravis. Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Moxifloxacin, and may range in severity from mild diarrhea to fatal colitis.</p>', NULL, '<p>4-Quinolone preparations</p>', '<p>Store below 25&deg;C and protect from light. Avoid extreme heat and freezing. Keep out of reach of children.</p>', '<p><strong>Pediatric patients</strong>: Safety and effectiveness in pediatric patients and adolescents less than 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric patients</strong>: These patients are at increased risk for developing severe tendon disorders including tendon rupture when being treated with a fluoroquinolone such as Moxifloxacin. This risk is further increased in patients receiving concomitant corticosteroid therapy.</p>', '2022-03-10 17:34:38', '2022-03-10 17:34:38'),
(979, 979, '<p>The ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms:</p>\r\n\r\n<ul>\r\n	<li><strong>Aerobic Gram-positive microorganisms</strong>: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumoniae, Streptococcus viridans group.</li>\r\n	<li><strong>Aerobic Gram-negative microorganisms</strong>: Acinetobacterlwoffii, Haemophilusinfluenzae, Haemophilus parainfluenzae.</li>\r\n	<li><strong>Other microorganisms</strong>: Chlamydia trachomatis.</li>\r\n</ul>', '<p>The antimicrobial action of Moxifloxacin results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.</p>', '<p><strong>Eye Drops</strong>: One drop in the affected eye 3 times per day for 7 days.<br />\r\n<br />\r\n<strong>Eye Ointment</strong>: It should be applied thinly and evenly to the affected eye three times a day for the first two days and for the next five days apply two times a day or as advised by the registered physician.</p>', '<p>Drug-drug interaction studies have not been conducted with Moxifloxacin Hydrochloride ophthalmic solution. In vitro studies indicate that Moxifloxacin does not inhibit CYP3A4, CYP2D6, CYP2C9, CYP2C19, or CYP1A2 indicating that Moxifloxacin is unlikely to alter the pharmacokinetics of drugs metabolized by these cytochrome P450 isozymes.</p>', '<p>Moxifloxacin Hydrochloride ophthalmic solution is contraindicated in patients with a history of hypersensitivity to Moxifloxacin, to other quinolones, or to any of the components in this medication.</p>', '<p>The most frequently reported ocular adverse events were conjunctivitis, decreased visual acuity, dry eye, keratitis, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage, and tearing. These events occurred in approximately 1-6% of patients. Nonocular adverse events reported at a rate of 1-4% were fever, increased cough, infection, otitis media, pharyngitis, rash, and rhinitis.</p>', '<p>Since there are no adequate and well-controlled studies in pregnant women, Moxifloxacin Hydrochloride ophthalmic solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Moxifloxacin has not been measured in human milk, although it can be presumed to be excreted in human milk. Caution should be exercised when Moxifloxacin hydrochloride ophthalmic solution is administered to a nursing mother.</p>', '<p>As with other anti-infectives, prolonged use may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, discontinue use and institute alternative therapy. Whenever clinical judgment dictates, the patient should be examined with the aid of magnification, such as slit lamp biomicroscopy, and, where appropriate, fluorescein staining. Patients should be advised not to wear contact lenses if they have signs and symptoms of bacterial conjunctivitis.</p>', NULL, '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store bellow 25&deg;C. Do not freeze. Store in cool and dry place, protected from light. Keep out of the reach of children. Do not touch dropper tip to any surface as this may contaminate this preparation. Do not use after one month of first opening.</p>', NULL, '2022-03-10 17:36:28', '2022-03-10 17:36:28'),
(980, 980, '<p>Moxifloxacin is indicated for the treatment of acute bacterial sinusitis, acute exacerbation of chronic bronchitis, community acquired pneumonia, uncomplicated &amp; complicated skin and skin structure infections, complicated intra-abdominal infections and pelvic inflammatory disease.</p>', '<p>Moxifloxacin is a 4th generation synthetic broad spectrum, fluoroquinolone class of antibacterial drug. It has activity against a wide range of gram-positive, gram-negative, anaerobic and atypical bacteria including Mycoplasma pneumoniae. It acts by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV which are necessary for bacterial DNA replication, transcription &amp; repair.</p>', '<p><strong>Acute bacterial sinusitis</strong>: 400 mg once daily 7-10 days.<br />\r\n<strong>Acute bacterial exacerbation of chronic bronchitis</strong>: 400 mg once daily 5-10 days.<br />\r\n<strong>Community-acquired pneumonia</strong>: 400 mg once daily 7-14 days.<br />\r\n<strong>Uncomplicated skin and skin structure infections</strong>: 400 mg once daily 7 days.<br />\r\n<strong>Complicated skin and skin structure infections</strong>: 400 mg once daily 7-21 days.<br />\r\n<strong>Complicated intra-abdominal infections</strong>: 400 mg once daily 5-14 days.<br />\r\n<strong>Pelvic inflammatory disease</strong>: 400 mg once daily 14 days.</p>', '<p>Moxifloxacin absorption is decreased when administered with antacids, sucralfate, multivitamins, and multivalent cations (e.g. iron or zinc). Moxifloxacin may enhance the risk of convulsions with NSAIDs and bleeding with warfarin. So concomitant use of Moxifloxacin with them should be avoided.</p>', '<p>It is contraindicated in patients with a history of hypersensitivity to Moxifloxacin or other quinolones.</p>', '<p>Common side effects of Moxifloxacin include nausea, vomiting, diarrhea, headache and dizziness.</p>', '<p>US FDA pregnancy category C. Moxifloxacin is not recommended during pregnancy &amp; lactation.</p>', '<p>Moxifloxacin may cause an increased risk of tendinitis and tendon rupture. It should be discontinued if pain or inflammation in a tendon occurs. It should not be used in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia, and patients with receiving Class IA or Class III antiarrhythmic agents.</p>', NULL, '<p>4-Quinolone preparations.</p>', '<p>Keep in a dry place, away from light and heat. Keep out of the reach of children.</p>', '<p><strong>Renal or hepatic impaired patients</strong>: No dose adjustment is necessary for patients with renal or hepatic impairment.<br />\r\n<br />\r\n<strong>Pediatric patients</strong>: Safety and effectiveness of Moxifloxacin in pediatric patients and adolescent less than 18 years of age have not been established.</p>', '2022-03-10 17:38:29', '2022-03-10 17:38:29'),
(981, 981, '<p>Moxifloxacin &amp; Dexamethasone eye drop is indicated in the treatment of eye infections caused by susceptible microorganisms and in the prevention of inflammation and bacterial infection that may occur after eye surgery.</p>', '<p>This Eye Drops is a combination of a fourth generation fluoroquinolone Moxifloxacin and a potent corticosteroid Dexmethasone. Moxifloxacin controls infection by inhibitting the DNA gyrase &amp; Topoisomerase IV. Dexamethasone effectively controls the inflammation by inhibiting the release inflammatory mediators.</p>', '<p><strong>In the prevention of infection and post-surgical ocular inflammation</strong>: Instill 1 drop, 4 times a day, in the eye to be operated, from 1 day before surgery until 15 days after surgery.<br />\r\n<br />\r\n<strong>In patients undergoing cataract surgery</strong>: The day of surgery instill the medication immediately after eye surgery.<br />\r\n<br />\r\n<strong>In patients undergoing LASIK refractive surgery</strong>: On the day of surgery instill the medication at least 15 minutes after ocular surgery.<br />\r\n<br />\r\n<strong>In eye infections caused by susceptible microorganisms</strong>: Instill 1 drop, 4 times a day, for up to 7 days.</p>', NULL, '<p>Hypersensitivity to quinolones. Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella &amp; other viral diseases of cornea &amp; conjunctiva. Mycobacterial infection of the eye. Fungal diseases of ocular structures. Glaucoma &amp; diseases causing thinning of cornea or sclera.</p>', '<p>Moxifloxacin: Conjunctivitis decreased visual acuity, dry eye, keratitis, Ocular discomfort, hyperemia, pain, Subconjunctival hemorrhage and tearing.<br />\r\n<br />\r\nDexamethasone: Visual acuity &amp; field defects, cataract formation, secondary ocular infection following suppression of host response &amp; perforation of the globe.</p>', '<p>There are no adequate and well-controlled studies in pregnant women. Moxifloxacin &amp; Dexamethasone combination eye drops should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution is advised when Moxifloxacin &amp; Dexamethasone combination eye drops is given to nursing women.</p>', '<p>For ophthalmic use only. The solution&nbsp;should not be injected under the conjunctiva, nor introduced directly into the anterior chamber of the eye. Prolonged use of steroids may result in ocular hypertension.</p>', '<p>No information is available on overdosage with this product in humans.</p>', '<p>Ophthalmic Steroid preparations.</p>', '<p>Store in a cool place, below 30&deg;C, protected from light. Once the container is opened the contents must be used within 28 days and may be stored at room temperature up to 30&deg;C. Discard after the 28 days. Keep out of reach of children.</p>', '<p><strong>Use in the elderly</strong>: No change in dosage is required when the product is administered in elderly patients.<br />\r\n<br />\r\n<strong>Use in Children</strong>: The efficacy and safety of Moxifloxacin &amp; Dexamethasone combination eye drops in pediatric patients have not been established.</p>', '2022-03-10 17:41:50', '2022-03-10 17:41:50'),
(982, 982, '<p>This ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms-<br />\r\n<br />\r\n<strong>Aerobic Gram-positive microorganisms</strong>: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumonia, Streptococcus viridans group.<br />\r\n<br />\r\n<strong>Aerobic Gram-negative microorganisms</strong>: Acinetobacter iwoffii, Haemophilus influenza, Haemophilus parainfluenzae.</p>', '<p>The antimicrobial action of Moxifloxacin results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.</p>', '<p>One drop in the affected eye(s) 2 times daily for 7 days.</p>', '<p>Drug-drug interaction studies have not been conducted with Moxifloxacin Hydrochloride.</p>', NULL, '<p>In 1-6% patients the most frequently reported ocular adverse events are eye irritation, pyrexia, conjunctivitis, decreased visual acuity, dry eye, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage and tearing.</p>', '<p>Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus as there are no adequate and well-documented studies in pregnant women. Moxifloxacin has not been measured in human milk, although it can be presumed to be excreted in human milk. Caution should be exercised when Moxifloxacin is administered to a breast feeding mother.</p>', '<p>Prolonged use may result in overgrowth of non-susceptible organisms, including fungi with other anti-infective.</p>', '<p>There is practically no risk of adverse effects due to accidental ingestion, since a bottle of 5 ml eye drops solution contains only 25 mg Moxifloxacin that is much lower than recommended daily oral dose.</p>', '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store in a cool and dry place away from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. After one month of the first opening do not use the medicine of dropper.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Moxifloxacin in infants below four months of age was not proven. However, several clinical studies show that the drug may be used safely in children even younger than one month of age.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety and effectiveness have been observed between elderly and younger patients.</p>', '2022-03-10 17:44:12', '2022-03-10 17:44:12'),
(983, 983, '<p>Moxonidine belongs to a group of drugs called anti-hypertensives that lower blood pressure. Moxonidine is used to treat high blood pressure.</p>', '<p>Stimulation of central alpha 2-adrenergic receptors is associated with sympathoadrenal suppression and subsequent reduction of blood pressure. As this class was further explored it was discovered that sympathoadrenal activity can also be suppressed by a second pathway with a newly discovered drug target specific to imidazolines. Specifically, moxonidine binds the imidazoline receptor subtype 1 (I1) and to a lesser extent &alpha;lpha-2-adrenoreceptors in the RSV causing a reduction of sympathetic activity, reducing systemic vascular resistance and thus arterial blood pressure<br />\r\n<br />\r\nMoreover, since alpha-2-adrenergic receptors are considered the primary molecular target that facilitates the most common side effects of sedation and dry mouth that are elicited by most centrally acting antihypertensives, moxonidine differs from these other centrally acting antihypertensives by demonstrating only low affinity for central alpha-2-adrenoceptors compared to the aforementioned I1-imidazoline receptors.</p>', '<p><strong>Adults (including the elderly)</strong>: Your treatment will normally start with one 200 microgram tablet, taken in the morning. After three weeks, your doctor may increase this dose to 400 micrograms daily, given in a single dose in the morning, or in divided doses in the morning and evening. After another three weeks, your doctor may need to increase this dose to 600 micrograms daily, given in divided doses (morning and evening). You should not take more than 400 micrograms as a single dose, or more than 600 micrograms in any one day.<br />\r\n<br />\r\nIf you forget to take a dose, take one as soon as you remember, unless it is nearly time to take the next one. Do not take a double dose to make up for a forgotten dose.<br />\r\n<br />\r\nIf you forget to take a dose, take one as soon as you remember, unless it is nearly time to take the next one. Do not take a double dose to make up for a forgotten dose.</p>', '<p>Talk to your doctor if you are taking any of the following:</p>\r\n\r\n<ul>\r\n	<li>beta-blockers, such as propranolol or atenolol, used to treat heart problems</li>\r\n	<li>other medicines used to reduce blood pressure such as furosemide a diuretic, or captopril an angiotensin-converting enzyme inhibitor</li>\r\n	<li>antidepressants such as amitriptyline</li>\r\n	<li>sleeping tablets such as zopiclone, tranquilizers such as nitrazepam, lorazepam or phenobarbital</li>\r\n	<li>Moxonidine is removed from body by kidneys through the process called &quot;tubular excretion&quot;. Other medicines removed from the kidneys in the same way could affect how moxonidine works.</li>\r\n</ul>\r\n\r\n<p>Do not drink alcohol whilst taking Moxonidine.</p>', '<p>Do NOT take Moxonidine if you:</p>\r\n\r\n<ul>\r\n	<li>Are allergic (hypersensitive) to moxonidine or any of the other ingredients of this medicine</li>\r\n	<li>Have a slow heart rate or suffer from an abnormal heart rhythm or a change in the rate of the heart beat (called &ldquo;sick sinus syndrome&rdquo; or &ldquo;2nd or 3rd degree AV-block&rdquo;</li>\r\n	<li>Have, or have had, heart failure or other heart problems</li>\r\n</ul>', '<p>The following side effects have been reported at the approximate frequencies shown:</p>\r\n\r\n<ul>\r\n	<li><strong>Very common</strong>: dry mouth, drowsiness</li>\r\n	<li><strong>Common</strong>: headache, dizziness (vertigo), flushing (vasodilation), weakness or loss of strength, confusion, sleep disturbances, nausea (feeling sick), being sick (vomiting), stomach upsets (dyspepsia), diarrhoea, rash or itching (pruritus), back pain</li>\r\n</ul>', '<p>Moxonidine is not recommended if you are pregnant, planning on becoming pregnant or are breastfeeding. Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breastfeeding.</p>', '<p>Tell your doctor before you start to take this medicine if you:</p>\r\n\r\n<ul>\r\n	<li>have a heart problem called &quot;1st-degree AV-block&quot;</li>\r\n	<li>have a severe coronary heart disease, or have angina (chest pain at rest)</li>\r\n	<li>have poor circulation</li>\r\n	<li>have kidney disease</li>\r\n	<li>have been told you have cerebrovascular insufficiency (poor blood supply to the brain which means you are at a greater risk of stroke)</li>\r\n	<li>are below 16 years of age</li>\r\n	<li>have a rare hereditary problem of galactose intolerance, Lapp lactase deficiency or glucosegalactose malabsorption as you should not take this medicine</li>\r\n</ul>\r\n\r\n<p>Patients who are intolerant to lactose should note that Moxonidine tablets contain a small amount of lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.</p>', '<p>If you (or someone else) swallow a lot of the tablets all together, or if you think a child has swallowed any of the tablets, contact your nearest hospital casualty department or your doctor immediately. An overdose is likely to cause headache, sleepiness, dry mouth, loss of balance, dizziness, low blood pressure, slowing of the pulse, vomiting, feeling tired, weakness and pain in your stomach. Please take this leaflet, any remaining tablets and the container with you to the hospital or doctor so that they know which tablets were consumed.</p>', '<p>Anti-hypertensive</p>', '<p>Do not store above 30&deg; C. Keep blister in the outer carton in order to protect from light.</p>', '<p><strong>Patients with kidney problems</strong>:&nbsp;If you have moderate problems with your kidneys, you should not take more than one 200 microgram tablet as a single dose or more than 400 micrograms in total, a day.<br />\r\n<br />\r\n<strong>Children under 16 years of age</strong>: Moxonidine is not recommended for use in children.</p>', '2022-03-10 17:46:24', '2022-03-10 17:46:24');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(984, 984, '<p>This preparation is indicated for the treatment and prevention of vitamin deficiencies.</p>', '<p><strong>Vitamin A</strong>&nbsp;plays an essential role in the function of retina and is essential for growth and differentiation of epithelial tissue.<br />\r\n<br />\r\n<strong>Vitamin B</strong>: Plays a role in the synthesis and maintenance of coenzyme A. Necessary for lipid metabolism, carbohydrate metabolism, tissue respiration, glycogenolysis, inhibition of very low-density lipoprotein (VLDL) synthesis. May increaase chylomicron triglyceride removal from plasma.<br />\r\n<br />\r\n<strong>Vitamin E</strong>&nbsp;is an antioxidant which preserves essential cellular constituents.<br />\r\n<br />\r\n<strong>Vitamin C</strong>: Necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid.<br />\r\n<br />\r\n<strong>Vitamin D3</strong>&nbsp;is a fat-soluble sterol. It is necessary for the regulation and regulation of calcium and phosphate homoeostasis and bone mineralisation. Vitamin D is also essential for healthy bones as it aids in Calcium absorption from the Gl tract. In addition to this it stimulates bone formation. Clinical studies also show that Calcium and Vitamin D has synergistic effects on bone growth as well as in Osteoporosis and fracture prevention.</p>', '<p>One capsule daily for adults and children over 5 years of age or as directed by the physician.</p>', NULL, '<p>This preparation is contraindicated in patients hypersensitive to any component of the drug.</p>', '<p>No side-effect has been reported with such low dose of the vitamin.</p>', '<p>Pregnancy Category is not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Should not use in over dosage. Patients with mild to moderate renal failure. Diabetes, patients prone to recurrent renal calculi.</p>', NULL, '<p>Specific combined vitamin preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 17:48:14', '2022-03-10 17:48:14'),
(985, 985, '<p>This IV preparation is intended as a supplement for intravenous nutrition in order to meet the daily requirements of the water-soluble vitamins in infants, children and adults.</p>', '<p>This IV preparation is a sterile, lyophilized powder of water soluble vitamins for infusion. It contains balanced amount of all the important water soluble vitamins which act as coenzymes of vital enzymes associated with crucial physiological processes, energy metabolism, cell growth and replenishment especially in brain and nerve cells. Vitamin C acts as an antioxidant and helps in collagen formation. Intravenous administration of this combination gives prompt action.</p>', '<p><strong>Adults and children weighing 10 kg or more</strong>: 1 vial (10 ml) daily.<br />\r\n<strong>Children weighing less than 10 kg</strong>: should be given 1 ml of the dissolved mixture per kg body weight/day.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The contents of one vial are dissolved by the aseptic addition of 10 ml of one of the following:</p>\r\n\r\n<ul>\r\n	<li>Water for injection</li>\r\n	<li>Fat emulsion 10%</li>\r\n	<li>Glucose solution for infusion (5% to 60%)</li>\r\n	<li>Normal saline (0.9% Sodium Chloride)</li>\r\n</ul>\r\n\r\n<p>This IV preparation may be added to parenteral nutrition admixtures containing carbohydrates, lipids, amino acids, electrolytes, and trace elements provided that compatibility and stability have been confirmed.</p>', '<p>Vitamin B6 can reduce the effect of levodopa. Folic acid may lower the serum concentration of phenytoin.</p>', '<p>Known hypersensitivity to any of the components, e.g. Thiamine.</p>', '<p>Allergic reactions may occur in patients hypersensitive to any component of the preparation, e.g. Thiamine.</p>', '<p>Animal reproduction studies or clinical investigations during pregnancy have not been carried out with this preparation. However, there are published reports on safe administration of water soluble vitamins in this patient group.</p>', '<p>This IV preparation is diluted with water-based solutions, the admixture should be protected from light. This is not necessary if this IV preparation is diluted with intralipid because of the protective effect of the fat emulsion.</p>', '<p>No adverse effects of an overdose of water soluble multivitamin have been reported, with exception of cases of extremely high parenteral doses. The possibility of hypervitaminosis A and D should be considered if the content of This IV preparation&nbsp;is dissolved in another multivitamin injection.</p>', '<p>Specific combined vitamin preparations</p>', '<p>Before reconstitution: Store below 25&deg; C. Protect from light. After reconstitution: The reconstituted IV preparation should be added to the infusion solution aseptically immediately before the start of the infusion &amp; used within 24 hours.</p>', NULL, '2022-03-10 17:50:53', '2022-03-10 17:50:53'),
(986, 986, '<p>For prevention and treatment of vitamin deficiency in children and infants.</p>', '<p><strong>Vitamin A</strong>&nbsp;plays an essential role in the function of retina and is essential for growh and differentiation of epithelial tissue.<br />\r\n<br />\r\n<strong>Vitamin B</strong>: Plays a role in the synthesis and maintenance of coenzyme A. Necessary for lipid metabolism, carbohydrate metabolism, tissue respiration, glycogenolysis, inhibition of very low-density lipoprotein (VLDL) synthesis. May increaase chylomicron triglyceride removal from plasma.<br />\r\n<br />\r\n<strong>Vitamin B12 (cyanocobalamin)</strong>: Required for the maintenance of normal erthropoiesis, nucleprotein and myelin synthesis, cell reproduction and normal growth; intrinsic factor, a glycoprotein secreted by the gastric mucosa, is required for active absorption of Vitamin B12 from the Gl tract. Necessary for normal tissue respiration; plays a role in activation of pyridoxine and conversion of tryptophan to niacin.<br />\r\n<br />\r\n<strong>Vitamin E</strong>&nbsp;is an antioxidant which preserves essential cellular constituents.<br />\r\n<br />\r\n<strong>Vitamin C</strong>: Necessary for collagen formation and tissue repair; plays a role in oxidation/reduction reactions as well as other metabolic pathways including synthesis of catecholamines, carnitine, and steroids; also plays a role in conversion of folic acid to folinic acid.<br />\r\n<br />\r\n<strong>Vitamin D3</strong>&nbsp;is a fat-soluble sterol. It is necessary for the regulation and regulation of calcium and phosphate homoeostasis and bone mineralisation. Vitamin D is also essential for healthy bones as it aids in Calcium absorption from the Gl tract. In addition to this it stimulates bone formation. Clinical studies also show that Calcium and Vitamin D has synergistic effects on bone growth as well as in Osteoporosis and fracture prevention.</p>', '<p><strong>Below 1 year</strong>: 9-10 drops (0.3 ml)<br />\r\n<strong>1 year and above</strong>: 23-25 drops (1.0 ml) once daily or as advised by the physicians.</p>', NULL, '<p>Supplemental vitamins should not be prescribed for patients with haemochromatosis or Wilson&rsquo;s disease. Hypersensitivity to any of the ingredients is contraindicated. Excessive doses of vitamin A and D can lead to hypervitaminosis. When multivitamin preparations are prescribed allowance must be made for vitamins from other sources.</p>', '<p>Multivitamin preparation with ordinary doses of component are usually nontoxic.</p>', NULL, NULL, NULL, '<p>Specific combined vitamin preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 17:52:19', '2022-03-10 17:52:19'),
(987, 987, '<p>This is intended as a supplement for intravenous nutrition in order to meet the daily requirements of the water soluble vitamins of NPO (nothing by mouth) or surgery patients.</p>', '<p>This is a sterile, lyophilized powder of water-soluble vitamins for infusion. It contains balanced amount of all the important water soluble vitamins which act as coenzymes of vital enzymes associated with crucial physiological processes, energy metabolism, cell growth and replenishment especially in brain and nerve cells. Vitamin C acts as an antioxidant and helps in collagen formation. Intravenous administration of this combination gives prompt action.</p>', '<p><strong>Adults and children weighing 10 kg or more</strong>: 1 vial (10 ml) daily.<br />\r\n<strong>Children weighing less than 10 kg</strong>: should be given 1 ml of the dissolved mixture per kg body weight/day.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The contents of one vial are dissolved by the aseptic addition of 10 ml of one of the following:</p>\r\n\r\n<ul>\r\n	<li>Water for injection</li>\r\n	<li>Fat emulsion 10%</li>\r\n	<li>Glucose solution for infusion (5% to 60%)</li>\r\n	<li>Normal saline (0.9% Sodium Chloride)</li>\r\n</ul>\r\n\r\n<p>Vidalin D IV may be added to parenteral nutrition admixtures containing carbohydrates, lipids, amino acids, electrolytes and trace elements provided that compatibility and stability have been confirmed.</p>', '<p>Vitamin B6 can reduce the effect of Levodopa. Folic Acid may lower the serum concentration of Phenytoin.</p>', '<p>Known hypersensitivity to any of the components, e.g. Thiamine.</p>', '<p>Allergic reactions may occur in patients hypersensitive to any component of the preparation, e.g. Thiamine.</p>', '<p>Animal reproduction studies or clinical investigations during pregnancy have not been carried out with this preparation. However, there are published reports on safe administration of water soluble vitamins in this patient group.</p>', '<p>When Lyophilized Powder for Infusion is diluted with water-based solutions, the admixture sould be protected from light. This is not necessary if lyophilized powder for infusion is diluted with intralipid because of the protective effect of the fat emulsion.</p>', '<p>No adverse effects of an overdose of water soluble multivitamin have been reported, with exception of cases of extremely high parenteral doses. The possibility of hypervitaminosis A and D should be considered if lyophilized powder for infusion is dissolved in another multivitamin injection.</p>', '<p>Multi-vitamin &amp; Multi-mineral combined preparations</p>', '<p>Before reconstitution: Store at below 25&deg;C in a dry place, protected from light. Keep out of reach of children. After reconstitution: The reconstituted preparation should be added to the infusion solution aseptically immediately before the start of the infusion &amp; used within 24 hours.</p>', NULL, '2022-03-10 17:54:28', '2022-03-10 17:54:28'),
(988, 988, '<p>Multivitamin syrup with cod-liver oil is indicated for growing children-</p>\r\n\r\n<ul>\r\n	<li>It helps in the development and proper functioning of their vital organs.</li>\r\n	<li>It helps to prevent vitamin deficiency and restore lost vitality after illness, in case of lack of appetite or tiredness of growing children.</li>\r\n	<li>It also increases immunity and helps to maintain healthy skin, hair, nail, teeth, bone, eye and nervous system.</li>\r\n	<li>Increases the resistance against cough, cold, chest and bronchial troubles.</li>\r\n	<li>Helps to optimize brain development.</li>\r\n	<li>In adults it helps to treat and prevent chronic diseases like heart diseases, rheumatoid arthritis, COPD, cancer etc.</li>\r\n	<li>In pregnant and nursing mother it helps in proper development of the baby.</li>\r\n</ul>', '<p>This preparation contains 8 essential vitamins with Cod Liver Oil. This provides extra protection for the children. It ensures for getting enough vitamins for children that help them to be grown up strong &amp; stay healthy. Cod Liver Oil contains Vitamin A, Vitamin D, EPA &amp; DHA. Vitamin A is essential for the immune system, bone growth, night vision, cellular growth, testicular and ovarian function, Vitamin D is essential for the absorption and utilization of calcium, which is also required for skeletal growth. EPA and DHA; omega-3 fatty acids, which are converted in the body to produce prostaglandins that affect a wide variety of physiological processes due to their modulating effect on the action of hormones. Omega-3 fatty acids relieve the symptoms of osteoarthritis, rheumatoid arthritis which also enhances immune function and promotes healthy blood circulation. It is thought that EPA and DHA may reduce the risk of coronary heart disease. DHA seems essential for normal brain development in unborn babies.</p>', '<p><strong>1-12 Months</strong>: 2.5 ml (&frac12; teaspoon) daily<br />\r\n<strong>1-4 Years</strong>: 5 ml (1 teaspoon) daily<br />\r\n<strong>4 years up</strong>: 7.5 ml (1&frac12; teaspoon) daily<br />\r\n<strong>Adult</strong>: 10 ml (2 teaspoons) daily.<br />\r\n<br />\r\nThis syrup can be taken with water or milk.</p>', '<p>Some drug interaction may occur with- Erythromycin, Conjugated estrogens, Sodium bicarbonate, Chloramphenicol etc.</p>', '<p>This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.</p>', '<p>Generally well tolerated. However, a few allergic reactions may be seen.</p>', '<p>Should be taken on physician&#39;s advice.</p>', '<p>This medicine may accumulate in the body. So, should not be taken in overdose.</p>', NULL, '<p>Specific combined vitamin preparations.</p>', '<p>Keep in cool and dry place and away from light. Keep away from children.</p>', NULL, '2022-03-10 17:56:40', '2022-03-10 17:56:40'),
(989, 989, '<p>This is indicated for the treatment and/or prevention of vitamin and mineral deficiencies associated with restricted diets, improper food intake, alcoholism and decreased absorption. It is also indicated in patients with increased requirements for vitamins and minerals due to acute and chronic diseases, pregnancy, lactation, menopause, infections, during treatment with antibiotics, convalescence etc. To prevent the occurrence of serious birth defects periconceptional (from three months before conception up to the first trimester of pregnancy) supplementation with this tablet is required.</p>', '<p>Vitamins and minerals are essential for normal metabolic functions including hematopoiesis. The members of vitamin B-group are components of enzyme system that regulate various stages of carbohydrate, fat and protein metabolism, each of the components playing a specific biological role. Vitamin C is involved in tissue repair and collagen formation. Vitamin A plays an essential role in the function of retina and is essential for growth and differentiation of epithelial tissue. Vitamin E is an antioxidant which preserves essential cellular constituents. Vitamin D is supplemented for prevention and cure of nutritional and metabolic rickets and for treatment of hypoparathyroidism. Iron, Copper, Manganese, Zinc serve as catalysts in enzyme systems which perform vital cellular functions.</p>', '<p>Orally one tablet daily for adult and children over 5 years of age or as directed by the physicians.</p>', NULL, '<p>This is contraindicated in patients hypersensitive to any of its components. This is not intended for treatment of severe specific deficiencies of vitamins or minerals. It is not recommended for patients undergoing treatment with levodopa as pyridoxine decreases the efficacy of levodopa. During the first trimester of pregnancy, larger doses of vitamin A (more than 10 tablets per day) may be teratogenic.</p>', '<p>Side effects have been reported with specific vitamins &amp; minerals, but at level substantially higher than those in this tablet. Iron has been associated with gastrointestinal intolerance in some patients.</p>', '<p>During the first trimester of pregnancy, recommended daily dose should not be exceeded. Because larger doses of Vitamin-A (multiple tablets per day) may be teratogenic.</p>', '<p>Not intended for treatment of pernicious anemia or other megaloblastic anemia where vitamin B12 is deficient.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations, Specific mineral &amp; vitamin combined preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 17:58:30', '2022-03-10 17:58:30'),
(990, 990, '<p>This preparation is mainly for the malnourished infants of 6 months and children up to 5 years of age to correct anemia, vitamin &amp; mineral deficiency.</p>', '<p>This is a special formulation comprisng of 15 necessary vitamins, minerals &amp; trace elements from vitamin A to zinc.</p>', '<p>This multivitamin &amp; multimineral preparation should be given infants &amp; children after completion of 6 months of age upto 5 years, 1 gm sachat to be given daily mixed with usual foods. After mixing the powder, feeding should be completed within half an hour. To correct anemia, vitamin &amp; mineral deficiency 60 sachets should be giver every child within 120 days. At a minimum interval of 6 months 60 sachets can be given repeatedly upto 5 years of age.</p>', NULL, '<p>This preparation must not be given in the first 6 months of age. The children severely malnourished or sick and admitted in the hospital also should not be given in the first week of treatment.</p>', '<p>No significant side-effects.</p>', '<p>No data found</p>', '<p>No more than 1 sachet to be given daily.&nbsp;This preparation should not be mixed with too hot (60&deg;C) or too liquid food.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', NULL, NULL, '2022-03-10 18:00:17', '2022-03-10 18:00:17'),
(991, 991, '<p>This is indicated for the prevention and treatment of vitamins &amp; minerals deficiencies. As a complete daily nutritional supplement, it is also indicated to meet the increased demand for vitamins and minerals in the conditions like physical and emotional stress, chronic diseases, infection illness, osteoporosis, injuries or wound, surgery, poor digestion, old age, pregnancy and lactation, poor appetite, excess dieting, exposure to environmental pollution, heavy exercise etc.</p>', '<p>This is a film coated tablet, which combines 32 high potency vitamins and minerals. This preparation maintains a healthy body and active life-style.</p>', '<p>One tablet daily or as recommended by the physician.</p>', '<p>No drug interactions have been reported.</p>', '<p>This product is contraindicated in patients with known hypersensitivity to any of the ingredients.</p>', '<p>Generally, this preparation is well tolerated. Diarrhoea may occasionally occur during treatment with beta carotene and the skin may assume a slightly yellow discoloration. Vitamin C and vitamin E may cause diarrhoea and other gastrointestinal disturbances.</p>', '<p>Recommended by the consultation with physician.</p>', '<p>Long term intake of high level of vitamin A (excluding that sourced from beta carotene) may increase the risk of osteoporosis in postmenopausal women.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations</p>', '<p>Keep in a dry place, away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-10 18:02:06', '2022-03-10 18:02:06'),
(992, 992, '<p>This IV is indicated as a daily multivitamin maintenance dosage for infants and children aged up to 11 years receiving parenteral nutrition. It is also indicated in other situations where administration by the intravenous route is required. Such situations include surgery, extensive burns, fractures and other trauma, severe infectious diseases and comatose states, which may provoke a stress situation with profound alterations in the body&#39;s metabolic demands and consequent tissue depletion of nutrients.</p>', '<p>This IV is a sterile, lyophilized powder/cake for infusion which contains nine water-soluble and four fat soluble vitamins. Mixed micelles is used as a solubilizing agent. It is presented as a lyophilized, orange-yellow, sterile powder cake that is to be reconstituted with 5 ml of Water for injections or other parenteral fluids, (e.g. as 0.9% Sodium chloride or 5% Dextrose solution), prior to administration by parenteral route.</p>', '<p><strong>Infants weighing less than 1 kg</strong>: The daily dose is 30% (1.5 ml) of a single full dose (5 ml). Do not exceed this daily dose.<br />\r\n<strong>Infants weighing 1 to 3 kg</strong>: The daily dose is 65% (3.25 ml) of a single full dose (5 ml). A supplemental Vitamin A may be required for low birth weight infants.<br />\r\n<br />\r\n<strong>Infants and children weighing 3 kg or more up to 11 years of age</strong>: The daily dose is 5 ml.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The single dose vial of This IV is reconstituted by adding 5 ml of sterile Water for injection or other intravenous fluids like 0.9% Sodium Chloride injection or 5% dextrose injection. 5 ml of diluent should be added by means of sterile syringe into the vial and gently mixed to dissolve the lyophilized powder/cake. The product will form a clear and yellow color solution after reconstitution. The reconstituted solution is ready within three minutes for immediate use. After This IV is reconstituted it should be immediately diluted into the intravenous solution. The resulting solution should be administered immediately. Some of the vitamins in this product, particularly vitamins A, D and riboflavin are light-sensitive and exposure to light should be minimized. The reconstituted This IV should not be given as a direct, undiluted intravenous injection as it may give rise to dizziness, faintness and possible tissue irritation. For a single dose, 5 ml of reconstituted This IV should be added directly to not less than 100 ml of intravenous dextrose, saline or similar infusion solutions.</p>', '<p>This IV is not physically compatible with alkaline solutions or moderately alkaline drugs such as Acetazolamide, Chlorothiazide sodium, Aminophylline, sodium bicarbonate, Tetracycline HCl. It has also been reported that folic acid is unstable in the presence of calcium salts such as calcium gluconate. Direct addition of This IV to intravenous fat emulsions is not recommended. Thiamine, riboflavin, pyridoxine, niacinamide, and ascorbic acid have been reported to decrease the antibiotic activity of erythromycin, doxycycline and lincomycin. Folic acid may lower the serum concentration of phenytoin resulting in increased seizure frequency. Folic acid may decrease the patient&#39;s response to methotrexate therapy.</p>', NULL, '<p>There have been rare reports of anaphylactic reactions following parenteral multivitamin administration. Rare reports of anaphylactic reactions have also been reported after large intravenous doses of thiamine. The risk is negligible if thiamine is co-administered with other vitamins in the B group. There have been rare reports of the following types of reactions:- rash, erythema, pruritus, headache, dizziness, agitation, anxiety, diplopia, urticaria, shortness of breath, wheezing, and angioedema.</p>', '<p>Not recommended</p>', '<p>Caution should be exercised when administering this multivitamin formulation to patients on warfarin sodium-type anticoagulant therapy as it contains Vitamin K. Larger doses or supplementation with oral or parenteral vitamin E are not recommended because elevated blood levels of vitamin E may result. Additional vitamin A supplementation may be required, especially in low birth weight infants. Polysorbates have been associated with the E-Ferol syndrome (thrombocytopenia, renal dysfunction, hepatomegaly, cholestasis, ascites, hypotension, and metabolic acidosis) in low birth weight infants. This product contains aluminum. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature.</p>', '<p>The possibility of hypervitaminosis A or D should be borne in mind. Clinical manifestations of hypervitaminosis A have been reported in patients with renal failure receiving 1.5 mg/day retinol.</p>', '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', '<p>Before reconstitution: Keep in a cool and dry place away from light. After reconstitution: The reconstituted product should be used immediately or it should be stored at 2&deg;C to 8&deg;C for no more than 24 hours. Discard any unused portion of the reconstituted solution.</p>', NULL, '2022-03-10 18:04:21', '2022-03-10 18:04:21'),
(993, 993, '<p>This Syrup is indicated for the treatment and prevention of vitamin and minerals deficiencies.</p>', '<p>This syrup contains balanced amounts of all the important vitamins, essential minerals and trace elements. Vitamins are essential substances that are supplied to the body in food. Minerals are indispensable for the metabolism and for growth and regeneration of the body. Finally, trace elements are vital substances which are required by the body in minute quantities but which are not always supplied in the daily food in adequate amounts.<br />\r\n<br />\r\nThis syrup is used for the prevention and rapid elimination of general vitamin deficiencies. This syrup is used when there is an increased need for vitamins and minerals, particularly during illness, at times of particular exertion and when increased performance is required.<br />\r\n<br />\r\nThe spectrum of essential nutrients supports healthy development, strong immune function, and emotional and mental vitality. Supplementing a child&#39;s diet is the only way to ensure that all nutritional needs are fulfilled.<br />\r\n<br />\r\nThis syrup provides the optimal dosage of the essential vitamins and minerals with trace elements for infants and children . The great taste makes taking supplements an easy part of a child&#39;s daily routine.</p>', '<p><strong>For infants up to 1 year</strong>: 1 teaspoon syrup daily<br />\r\n<strong>For children 1-4 years</strong>: 1-2 teaspoon syrup daily<br />\r\n<strong>For children 4-12 years</strong>: 2-3 teaspoon syrup daily<br />\r\n<strong>For adults</strong>: 3-4 teaspoon syrup daily</p>', '<p>No such interactions have been reported.</p>', '<p>Contraindicated in patients who are hypersensitive to any of its components.</p>', '<p>This syrup is generally well tolerated.</p>', '<p>Specific information is not available.</p>', '<p>Supplement should not be used in over dosage or continuously except recommended by physicians.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', '<p>Keep in cool, dry place and away from light.</p>', NULL, '2022-03-10 18:06:50', '2022-03-10 18:06:50'),
(994, 994, '<p>This is specially formulated for the prevention and treatment of vitamin and mineral deficiencies for adults over 45 years of age.&nbsp;This Silver is also indicated to meet the increase demands of vitamin and minerals for adults over 45 years of age.</p>', '<p>This preparation is a comprehensive well-balanced multivitamin and multimineral preparation scientifically adjusted and designed to serve as the complete nutritional program for the elderly people. This preparation maintains a healthy body and active lifestyle and keeps proper nutrition covered for elderly people.</p>', '<p>One tablet once daily with food or as indicated by the physician.</p>', '<p>No drug interactions have been reported.</p>', '<p>This product is contraindicated in patients with known hypersensitivity to any of the ingredients. Do not take this product if taking other vitamin A supplements.</p>', '<p>Generally, this preparation is well tolerated. Allergic sensitization has been reported following oral administration of folic acid. Vitamin C and vitamin E may cause diarrhea and other gastrointestinal disturbances.</p>', '<p>Recommended by the consultation with physician.</p>', '<p>Long term intake of high levels of vitamin A (excluding that sourced from beta carotene) may increase the risk of osteoporosis in postmenopausal women.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 18:09:05', '2022-03-10 18:09:05'),
(995, 995, '<p>This Syrup is indicated in multivitamin &amp; multimineral deficiencies in:</p>\r\n\r\n<ul>\r\n	<li>Adults (especially who cannot intake supplements in solid dosage forms e.g. tablet and who suffer gastrointestinal side effects after taking solid dosage forms).</li>\r\n	<li>Children of all ages &amp; infants.</li>\r\n</ul>', '<p>This Syrup is a well balanced supplement containing 24 nutritional elements which include vitamins, minerals &amp; trace elements for the adults &amp; for the all ages of children. This Syrup keeps oneself sharp and physically and mentally active. Stresses and strains of today&#39;s life are causing hypertension, diabetes, heart disorders, depression, memory loss and arthritis to the elderly. Some of the declines seniors experience may not be totally age related, but may be caused by poor nutrition, unhealthy eating habits. Research has shown that many times adults fail to get the balanced nutrition that is necessary for proper and healthy bodily functions. As a result, the vital organs of the body begin to break down and illnesses are the result. This Syrup provides optimum nutrition to the senior citizens who cannot intake or tolerate supplements in solid dosage forms like tablet or capsule. Moreover, This Syrup provides the optimal dosage of the essential vitamins and minerals with trace elements for infants and children of all ages. Its essential nutrients support healthy developments, strong immune function and emotional and mental vitality of children. This Syrup contains the primary antioxidant vitamins-C, E &amp; A and minerals - Zn, Se &amp; Mn. All of these elements support immune function, and protect the body from harmful free radicals by neutralizing toxins, helping the body detoxify and eliminating these chemicals; thereby allowing the immune system be more effective and vital on other fonts. The B vitamins are all actively involved helping nervous system functions (learning, memory, managing stress) correctly. Folic acid helps the body digest, assimilate protein and produce RBCs and DNA. Biotin is also involved in DNA/RNA production and fats and oils metabolism which is why it can affect the hair and skin so well. PABA is used to improve the protein used in the body, it relates to red blood cell formation as well as it assists the manufacture of folic acid in the intestines. PABA is an antioxidant nutrient that inhibits the formation of the damaging free radicals. Choline is an essential component of acetylcholine, a neurotransmitter that is involved in regulating sleep, muscle movement, learning and memory.</p>', '<p><strong>For adults</strong>: 3-4 teaspoonfuls daily<br />\r\n<strong>For children of 4-12 years</strong>: 2 - 3 teaspoonfuls daily<br />\r\n<strong>For children of 1-4 years</strong>: 1-2 teaspoonfuls daily<br />\r\n<strong>For infants up to 1 year</strong>: 1 teaspoonful daily, or as directed by the physician.</p>', '<p>Generally no interactions have been observed.</p>', '<p>The product is contraindicated in patients with a known hypersensitivity to any of the ingredients of this product.</p>', '<p>Generally the product is well tolerated.</p>', '<p>The specific information is not available in this respect.</p>', '<p>Supplement should not be used in over dosage or should not be used long time without the recommendation by a physician.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 18:15:46', '2022-03-10 18:15:46'),
(996, 996, '<p>Complete Multivitamin for Teen Boys to Support: Healthy muscle function with magnesium; Healthy immune system with vitamins C and E, beta-carotene, zinc, iron and selenium; Bone strength with calcium, vitamin D, and magnesium; Energy through the conversion of food to fuel with vitamins B6 and B12, thiamin, riboflavin, and niacin.</p>', '<p>This preparation is a comprehensive multivitamin and mineral supplement designed to help teen boys to meet their increased nutritional needs.</p>', '<p><strong>Teens:</strong>&nbsp;One tablet daily, with food.</p>', NULL, '<p>This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.</p>', '<p>Allergic sensitization has been reported following oral administration of folic acid.</p>', '<p>No data available</p>', '<p>Folic acid alone is improper therapy in the treatment of pernicious anaemia and other megaloblastic anaemia where Vitamin B12 is deficient.</p>', '<p>Accidental overdose if an iron-containing product is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately. Do not use this product if safety seal bearing &quot;Sealed for your protection&quot; under cap is torn or missing.</p>', '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', '<p>Tablets should be stored below 25˚ C and protected from light &amp; moisture.</p>', NULL, '2022-03-10 18:18:14', '2022-03-10 18:18:14'),
(997, 997, '<p>Complete Multivitamin for teen girls to Support: Healthy skin function with Vitamin A, C, Copper &amp; Iron; Healthy immune system with vitamins A, C and E, zinc, iron and selenium; Bone strength with calcium, vitamin D, and magnesium; Energy through the conversion of food to fuel with vitamins B6 and B12, thiamin, riboflavin, and niacin.</p>', '<p>This preparation is a comprehensive multivitamin and mineral supplement designed to help teen girls to meet their increased nutritional needs.</p>', '<p>For teen girls, one tablet daily with food.</p>', NULL, '<p>This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.</p>', '<p>Allergic sensitization has been reported following oral administration of folic acid.</p>', '<p>No data available</p>', '<p>Accidental overdose if an iron-containing product is a leading cause of fatal poisoning in children less than 6 years. Keep this product out of reach of children. In case of accidental overdose, call a doctor immediately. Keep out of reach of children.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations</p>', '<p>Store in cool dry place &amp; away from children.</p>', NULL, '2022-03-10 18:20:33', '2022-03-10 18:20:33'),
(998, 998, '<p>This&nbsp;is an advanced formula of 16 essential vitamins &amp; minerals indicated for women while planning conception, throughout pregnancy and when breast feeding. As a complete daily nutritional supplement this&nbsp;is also indicated to meet the increased demands for necessary vitamins and minerals.</p>', '<p>This tablet is specially formulated with 16 essential nutrients to provide multivitamin &amp; multimineral support when planning conception, throughout pregnancy and while breast feeding. It is carefully developed by experts so that all ingredients are within safe levels for pregnancy and are moderate rather than excessive. It provides iodine to promote healthy development of baby&#39;s brain, eyesight &amp; hearing; provides folic acid that may reduce the risk of brain and/or spinal cord birth defects such as spina bifida if taken daily for 1 month prior to conception and throughout pregnancy. It also provides vitamin D to support calcium absorption to assist with healthy development of baby&#39;s bones.</p>', '<p>Two tablets daily with a meal or as prescribed by the physician.</p>', NULL, '<p>This product is contraindicated in patients with a known hypersensitivity to any of the ingredients of this preparation.</p>', '<p>Generally well tolerated.</p>', '<p>Recommended to use in pregnancy and lactation.</p>', '<p>If any pregnant woman has a baby with neural tube defect she is advised to consult with her physician.&nbsp;To be dispensed only on the prescription of a registered<br />\r\nphysician.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', '<p>Keep in a cool and dry place, protect from light. Keep out of the reach of children.</p>', NULL, '2022-03-10 18:22:21', '2022-03-10 18:22:21'),
(999, 999, '<p>For lactating mother to ensure balanced intake of essential vitamins and minerals necessary for child&rsquo;s development.</p>', '<p>This is a special vitamins and minerals preparation comprising of important vitamins and minerals for nursing mother.</p>', '<p>One tablet daily or as directed by a physician. This preparation is indicated for use in improving the nutritional status of mothers throughout lactation period so that the child can get the essential vitamins and minerals for proper growth and development during breast feeding.</p>', NULL, '<p>This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.</p>', '<p>No clinically significant side effects or toxicity are reported with such kind of preparation.</p>', '<p>Recommended to use in pregnancy and lactation.</p>', '<p>Excess vitamin A intake may be toxic and may increase the risk of birth defects. Women who are (or may become) pregnant are advised not to take this supplement except on the advice of a doctor or antenatal clinic.</p>', NULL, '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', NULL, NULL, '2022-03-10 18:24:11', '2022-03-10 18:24:11'),
(1000, 1000, '<p>This is intended as a supplement for intravenous nutrition in order to meet the daily requirements of the water-soluble vitamins of dehydrated patients.</p>', '<p>This is a sterile, lyophilized powder of water-soluble vitamins for infusion. It contains balanced amount of all the important water soluble vitamins which act as coenzymes of vital enzymes associated with crucial physiological processes, energy metabolism, cell growth and replenishment especially in brain and nerve cells. Vitamin C acts as an antioxidant and helps in collagen formation. Intravenous administration of this combination gives prompt action.</p>', '<p><strong>Adults and children weighing 10 kg or more</strong>: 1 vial (10 ml) daily.<br />\r\n<strong>Children weighing less than 10 kg</strong>: should be given 1 ml of the dissolved mixture per kg body weight/day.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>The contents of one vial are dissolved by the aseptic addition of 10 ml of one of the following:</p>\r\n\r\n<ul>\r\n	<li>Water for injection</li>\r\n	<li>Fat emulsion 10%</li>\r\n	<li>Glucose solution for infusion (5% to 60%)</li>\r\n	<li>Normal saline (0.9% Sodium Chloride)</li>\r\n</ul>\r\n\r\n<p>This IV preparataion may be added to parenteral nutrition admixtures containing carbohydrates, lipids, amino acids, electrolytes, and trace elements provided that compatibility and stability have been confirmed.</p>', '<p>Vitamin B6 can reduce the effect of Levodopa. Folic Acid may lower the serum concentration of Phenytoin.</p>', '<p>Known hypersensitivity to any of the components, e.g. Thiamine.</p>', '<p>Allergic reactions may occur in patients hypersensitive to any component of the preparation, e.g. Thiamine.</p>', '<p>Animal reproduction studies or clinical investigations during pregnancy have not been carried out with this preparation. However, there are published reports on safe administration of water-soluble vitamins in this patient group.</p>', '<p>When Lyophilized Powder for Infusion is diluted with water based solutions, the admixture sould be protected from light. This is not necessary if lyophilized powder for infusion is diluted with intralipid because of the protective effect of the fat emulsion.</p>', '<p>No adverse effects of an overdose of water-soluble multivitamin have been reported, with exception of cases of extremely high parenteral doses. The possibility of hypervitaminosis A and D should be considered if lyophilized powder for infusion is dissolved in another multivitamin injection.</p>', '<p>Multi-vitamin &amp; Multi-mineral combined preparations.</p>', '<p>Before reconstitution: Store at below 25&deg;C in a dry place, protected from light. Keep out of reach of children. After reconstitution: The reconstituted this IV preparation should be added to the infusion solution aseptically immediately before the start of the infusion &amp; used within 24 hours.</p>', NULL, '2022-03-10 18:26:14', '2022-03-10 18:26:14'),
(1001, 1001, '<p>Multivitamin with L-Lysine is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Improves appetite</li>\r\n	<li>Promotes growth in height &amp; weight</li>\r\n	<li>Helps in building of muscle protein</li>\r\n	<li>Helps to absorb Calcium</li>\r\n	<li>Ensures energy production</li>\r\n</ul>', NULL, '<p><strong>Adult</strong>: 03 Tablets daily<br />\r\n<strong>Children</strong>&nbsp;(from 01 year of age): 1-3 Tablets daily depending on the age &amp; physical condition</p>', NULL, '<p>The product is contraindicated in patients with a known hypersensitivity to any of the active ingredients of the product.</p>', '<p>The product is usually well tolerated and exerts no untoward effects if taken in the dosage recommended.</p>', '<p>The specific information is not available in this respect.</p>', NULL, NULL, '<p>Specific combined vitamin preparations.</p>', '<p>Keep container well closed after taking medicine. Store below 25&deg;C. Protect from light &amp; moisture. Keep out of reach of children.</p>', NULL, '2022-03-10 18:28:07', '2022-03-10 18:28:07'),
(1002, 1002, '<p>This&nbsp;is indicated for use in improving the nutritional status of women throughout the pregnancy and in the postnatal period for both lactating and non-lactating mothers. This&nbsp;is also indicated in improving the nutritional status of women prior to conception.</p>', '<p>This Multivitamins &amp; Multiminerals is a preparation of comprehensive multiple vitamin and mineral supplement designed to meet the increased nutritional needs of pregnant or lactating women. Since pregnancy and lactation impose an increased demand for certain nutrients, added insurance of a complete multiple vitamin and nutrient supplement is recommended.<br />\r\n<br />\r\nThe special formulation of This Multivitamins &amp; Multiminerals provides a wide spectrum of the essential nutrients needed for pregnant women, in a form that is gentle to the sensitive stomach. is a preparation of comprehensive multiple vitamin and mineral supplement designed to meet the increased nutritional needs of pregnant or lactating women. Since pregnancy and lactation impose an increased demand for certain nutrients, added insurance of a complete multiple vitamin and nutrient supplement is recommended. The special formulation of This Multivitamins &amp; Multiminerals provides a wide spectrum of the essential nutrients needed for pregnant women, in a form that is gentle to the sensitive stomach.</p>', '<p>One tablet daily or as directed by the physician.</p>', NULL, '<p>This Multivitamins &amp; Multiminerals is contraindicated in patients with a known hypersensitivity to any of the ingredients.</p>', '<p>Allergic sensitization has been reported following oral administration of folic acid.</p>', '<p>Recommended.</p>', '<p>Folic acid in doses above 0.1 mg daily may obscure pernicious anemia in that hematological remission can occur while neurological manifestations remain progressive.</p>', '<p>Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. In case of accidental overdose, call a doctor or poison control center immediately.</p>', '<p>Iron, Vitamin &amp; Mineral Combined preparation, Multi-vitamin &amp; Multi-mineral combined preparations.</p>', NULL, NULL, '2022-03-10 18:30:04', '2022-03-10 18:30:04'),
(1003, 1003, '<p>Mupirocin ointment is indicated for the topical treatment of impetigo (skin diseases) due to Staphylococcus aureus and Streptococcus pyogenes. It is also indicated in folliculitis, furunculosis.</p>', '<p>Mupirocin is a naturally occurring antibiotic. This antibacterial agent is produced by fermentation using the organism Pseudomonas fluorescens. It is active against a wide range of bacteria (e.g. Staphylococcus aureus including methicillin-resistant strains and Streptococcus pyogenes) those responsible for the majority of skin infections. It is also active against gram-negative pathogens, such as Escherichia coli and Haemophilus influenzae. Mupirocin inhibits bacterial protein synthesis by reversibly and specifically binding to bacterial isoleucyl transfer-RNA synthetase.</p>', '<p>A small amount of Bactropen ointment should be applied to the affected area 3 times daily for up to 10 days. The safety and effectiveness of Mupirocin ointment have been established in the age range of 2 months to 16 years.</p>', '<p>No drug interaction has been identified with Mupirocin ointment.</p>', '<p>The drug is contraindicated in individuals with a history of hypersensitivity reactions to Mupirocin or any of the components of the preparation.</p>', '<p>Reported side effects are burning, stinging or pain, itching and some patient may be suffered rash, nausea, erythema, dry skin, tenderness, swelling, contact dermatitis and increased exudate.</p>', '<p>Reproduction studies on Mupirocin ointment in animals have revealed no evidence of harm to the foetus. As there is no clinical experience on it&rsquo;s use during pregnancy, Mupirocin ointment should only be used in pregnancy when the potential benefits outweigh the possible risks of treatment.<br />\r\n<br />\r\nIt is unknown whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Mupirocin ointment is administered to a nursing woman.</p>', '<p>Mupirocin ointment is not for ophthalmic or intra-nasal use. As with other antibacterial products, prolonged use may result in overgrowth of non-susceptible organisms, including fungi. When Mupirocin is used on the face care should be taken to avoid the eyes. This is not suitable in conjunction with cannulae and at the site of central venous cannulation. In the event of a sensitization or severe local irritation from Mupirocin ointment, usage should be discontinued and appropriate alternative therapy for the infection instituted. Mixing of Mupirocin ointment with other preparations causes risk of dilution, resulting in a reduction of the antibacterial activity and potential loss of stability of the Mupirocin in the ointment.</p>', '<p>There is currently limited data with overdose of Mupirocin ointment. In the event of overdose, the patient should be treated supportively with appropriate monitoring as necessary.</p>', '<p>Topical Antibiotic preparations.</p>', '<p>Keep below 25&deg; C temperature, protected from light and moisture. Do not keep in freeze. Keep out of the reach of children.</p>', NULL, '2022-03-10 18:32:25', '2022-03-10 18:32:25');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1004, 1004, '<p>Mycophenolate Mofetil in combination with corticosteroids and either ciclosporin or tacrolimus is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Prophylaxis of acute organ rejection and treatment of first or refractory organ rejection in patients receiving allogeneic renal transplants.</li>\r\n	<li>Prophylaxis of acute organ rejection in patients receiving allogeneic cardiac transplants.</li>\r\n	<li>Prophylaxis of acute organ rejection in patients receiving allogeneic hepatic transplants.</li>\r\n	<li>Mycophenolate Mofetil is indicated for induction and maintenance therapy of patients with Class III-V lupus nephritis (diagnosed according to International Society of Nephrology/Renal Pathology Society classification.</li>\r\n</ul>', '<p><strong>Mechanism of Action</strong>: Mycophenolate mofetil is the 2-morpholinoethyl ester of mycophenolic acid (MPA). MPA is a potent, selective, uncompetitive and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), and therefore inhibits the de novo pathway of guanosine nucleotide synthesis. The mechanism by which MPA inhibits the enzymatic activity of IMPDH appears to be related to the ability of MPA to structurally mimic both nicotinamide adenine dinucleotide cofactor and a catalytic water molecule. This prevents the oxidation of IMP to xanthose-5&rsquo;-monophosphate which is the committed step in de novo guanosine nucleotide biosynthesis. MPA has more potent cytostatic effects on lymphocytes than on other cells because T- and B lymphocytes are critically dependent for their proliferation on de novo synthesis of purines whereas other cell types can utilize salvage pathways.<br />\r\n<br />\r\n<strong>Pharmacodynamics</strong>: Mycophenolic acid, the active metabolite of mycophenolate mofetil, is a non-competitive, reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). Inhibition of IMPDH blocks the de novo synthesis of guanosine nucleotides which are necessary substrates for DNA and RNA synthesis. Unlike other cell types which can use the salvage pathway, B and T lymphocytes are dependent upon the de novo pathway for the generation of guanosine. Data from in vitro studies indicate that mycophenolic acid and/or mycophenolate mofetil inhibit mixed lymphocyte responses and human peripheral blood lymphocyte proliferation induced by a variety of mitogens and antigens. Mycophenolic acid decreases intracellular pools of guanosine triphosphate (GTP) and deoxyguanosine triphosphate (dGTP) in mitogen-stimulated human peripheral blood monocytes or T lymphocytic cell lines but has no effect on GTP concentrations in human neutrophils.</p>', '<p><strong>Transplant patients:</strong><br />\r\nStandard dosage for prophylaxis of renal rejection</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: A dose of 1 g administered orally twice a day (daily dose of 2 g) is recommended for use in renal transplant patients.</li>\r\n	<li><strong>Children (aged 3 months to 18 years)</strong>: Patients with a body surface area of 1.25 to 1.5 m2&nbsp;may be prescribed Mycophenolate Mofetil Tablets at a dose of 750 mg twice daily (1.5 g daily dose). Patients with a body surface area &gt;1.5 m2&nbsp;may be prescribed Mycophenolate Mofetil tablets at a dose of 1 gm twice daily (2 g daily dose).</li>\r\n</ul>\r\n\r\n<p>Standard dosage for prophylaxis of cardiac rejection-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: A dose of 1.5 g administered orally (over not less than 2 hour) twice a day (daily dose of 3 g) is recommended for use in cardiac transplant patients.</li>\r\n	<li><strong>Children</strong>: no data are available for pediatric cardiac transplant patients.</li>\r\n</ul>\r\n\r\n<p>Standard dosage for prophylaxis of hepatic rejection-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: A dose of 1.5 g orally twice a day (daily dose of 3 g) is recommended for use in hepatic transplant patients</li>\r\n	<li><strong>Children</strong>: no data are available for pediatric hepatic transplant patients.</li>\r\n</ul>\r\n\r\n<p>Standard dosage for treatment of first or refractory renal rejection-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: A dose of 1.5 g administered orally twice a day (daily dose of 3 g) is recommended for management of first or refractory rejection.</li>\r\n	<li><strong>Children</strong>: no data are available for the treatment of first or refractory renal rejection in pediatric renal transplant patients.</li>\r\n</ul>\r\n\r\n<p><br />\r\n<strong>Lupus nephritis patients:</strong><br />\r\nStandard Dosage for Induction Therapy-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: A dose of 750 mg-1.5 g administered orally twice a day (daily dose of up to 3 g) is recommended</li>\r\n	<li><strong>Children</strong>: A dose of 600 mg/m2&nbsp;administered orally twice a day (up to a maximum of 2 g daily) is recommended</li>\r\n</ul>\r\n\r\n<p>Standard Dosage for Maintenance Therapy-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: A dose of 500 mg-1 g administered orally twice a day is recommended</li>\r\n	<li><strong>Children</strong>: A dose of 300 mg/m2&nbsp;administered orally twice a day is recommended</li>\r\n</ul>\r\n\r\n<p>Mycophenolate Mofetil should be used in combination with corticosteroids. Doses should be introduced gradually and adjusted according to clinical response. Therapeutic drug monitoring could help prevent sub-therapeutic exposure (Cmin&ge;3.0 mg/L or inter-dose AUC &ge;35 h*mg/L).</p>', '<p>Caution should be exercised with concomitant administration of Antacids, Azathioprine, Cyclosporin, Rifampin, Sevelamer, Cholestyramine, Acyclovir, Metronidazole, Hormonal contraceptives as these medicines may decrease Mycophenolic acid concentration.</p>', '<p>Mycophenolic acid is contraindicated in patients with a hypersensitivity to mycophenolic acid, or to any of its excipients. Mycophenolic acid is contraindicated during pregnancy due to its mutagenic and teratogenic potential. Mycophenolic acid is contraindicated in women who are breastfeeding.</p>', '<p>The principal adverse reactions associated with the administration of Mycophenolate Mofetil includes diarrhea, leukopenia, sepsis, gastrointestinal candidiasis, urinary tract infection, herpes simplex, vomiting and there is evidence of a higher frequency of certain types of infections eg. opportunistic infections.</p>', '<p>Mycophenolate Mofetil is contraindicated in pregnancy and during breastfeeding. The safe use of Mycophenolate Mofetil during labor and delivery has not been established.</p>', '<p>Mycophenolic acid tablets are used with caution because it-</p>\r\n\r\n<ul>\r\n	<li>Can increase new or reactive viral infections. Such infections include latent viral reactivation, such as hepatitis B or hepatitis C reactivation, or infections caused by polyomaviruses.</li>\r\n	<li>Can cause blood dyscrasias including pure red cell aplasia (PRCA).</li>\r\n	<li>Can cause serious GI tract complications (gastrointestinal bleeding, perforations and ulcers).</li>\r\n	<li>May increase the risk of developing lymphomas and other malignancies, particularly of the skin.</li>\r\n	<li>Use of live vaccines should be avoided during treatment with Mycophenolic acid.</li>\r\n	<li>Patients should not donate blood during therapy.</li>\r\n</ul>', '<p>In many of these cases no adverse events were reported. It is expected that an overdose of mycophenolate mofetil could possibly result in over suppression of the immune system and increase susceptibility to infections and bone marrow suppression. If neutropenia develops, dosing with Mycophenolate Mofetil should be interrupted or the dose reduced.</p>', '<p>Immunological Chemotherapy, Immunosuppressant.</p>', '<p>Store in a cool (below 30&deg;C), dry place and away from light. Keep out of the reach of children.</p>', '<p><strong>Geriatric population</strong>: Geriatric patients may be at an increased risk of adverse events such as certain infections (including cytomegalovirus tissue invasive disease) and possibly gastrointestinal hemorrhage and pulmonary edema, compared with younger individuals.</p>', '2022-03-10 18:34:57', '2022-03-10 18:34:57'),
(1005, 1005, '<p><strong>Prophylaxis of organ rejection in kidney transplant</strong>: Mycophenolic acid is indicated for the prophylaxis of organ rejection in adult patients receiving a kidney transplant. It is indicated for the prophylaxis of organ rejection in pediatric patients 5 years of age and older who are at least 6 months post kidney transplant.</p>', '<p>Mycophenolic acid delayed-release tablets are enteric coated formulation of mycophenolate sodium that delivers the active moiety mycophenolic acid. It is an immunosuppressive agent. It is an uncompetitive and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). Therefore, it inhibits the de novo pathway of guanosine nucleotide synthesis without incorporation to DNA. Mycophenolic acid has cytostatic effects on lymphocytes. It has been shown to prevent the occurrence of acute rejection of kidney and heart allotransplantation. It also decreases antibody production.</p>', '<p><strong>Dosage in adult kidney transplant patients</strong>: The recommended dose of Mycophenolic acid is 720 mg administered twice daily (1440 mg total daily dose).<br />\r\n<br />\r\n<strong>Dosage in pediatric kidney transplant patients</strong>: The recommended dose of Mycophenolic acid in conversion (at least 6 months post-transplant) pediatric patients age 5 years and older is 400 mg/m2 body surface area (BSA) administered twice daily (up to a maximum dose of 720 mg administered twice daily). Pediatric patients with a BSA of 1.19 to 1.58 m2 may be dosed either with three Mycophenolic acid 180 mg tablets, or one 180 mg tablet plus one 360 mg tablet twice daily (1080 mg daily dose). Patients with a BSA of &gt;1.58 m2 may be dosed either with four Mycophenolic acid 180 mg tablets, or two Mycophenolic acid 360 mg tablets twice daily (1440 mg daily dose).<br />\r\n<br />\r\nMycophenolic acid tablets should be taken on an empty stomach, 1 hour before or 2 hours after food intake. Tablets should not be crushed, chewed, or cut prior to ingesting. The tablets should be swallowed whole in order to maintain the integrity of the enteric coating.</p>', '<p>Caution should be exercised with concomitant administration of Antacids, Azathioprine, Cyclosporin, Rifampin, Sevelamer, Cholestyramine, Acyclovir, Metronidazole, Hormonal contraceptives as these medicines may decrease Mycophenolic acid concentration.</p>', '<p>Mycophenolic acid delayed-release tablets and Mycophenolate mofetil tablets and capsules should not be used interchangeably without physician supervision because the rate of absorption following the administration of these two products is not equivalent.</p>', '<p>The most common adverse reactions (&ge;20%) associated with the administration of Mycophenolic acid are anemia, leukopenia, constipation, diarrhea, vomiting, dyspepsia, urinary tract infection, CMV infection, insomnia, and postoperative pain.</p>', '<p>Pregnancy Category D. Can cause fetal harm.<br />\r\n<br />\r\nLactation: Discontinue Mycophenolic acid or discontinue nursing while on treatment or within 6 weeks after stopping therapy. Take into consideration the importance of the drug to the mother.</p>', '<p>Mycophenolic acid tablets are used with caution because it-</p>\r\n\r\n<ul>\r\n	<li>Can cause embryofetal toxicity</li>\r\n	<li>Can increase new or reactive viral infections</li>\r\n	<li>Can cause blood dyscrasias including pure red cell aplasia</li>\r\n	<li>Can cause serious GI tract complications (gastrointestinal bleeding, perforations and ulcers)</li>\r\n	<li>May increase the risk of developing lymphomas and other malignancies, particularly of the skin</li>\r\n	<li>Use of live vaccine should be avoided during treatment with Mycophenolic acid</li>\r\n</ul>', '<p>No data are available with regard to overdose.</p>', '<p>Immunosuppressant</p>', '<p>Store at 25&deg; C and Keep out of reach of children.</p>', NULL, '2022-03-10 18:36:48', '2022-03-10 18:36:48'),
(1006, 1006, '<p>Allylestrenol is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Intra Uterine Growth Retardation (IUGR)</li>\r\n	<li>Threatened abortion</li>\r\n	<li>Habitual abortion</li>\r\n	<li>Threatened premature delivery</li>\r\n</ul>', '<p>Allylestrenol is a synthetic progesterone derivative that is used to treat threatened pregnancies. It can stop occurring premature labor and can help women give birth to a healthy newborn. It stimulates the secretory phase in myometrium, creates conditions for development of fertilized ovum. It has a tocolytic effect; reduces sensitivity of myometrium to oxytocin. It stimulates the development of acinus of mammary glands, secretory activity of trophoblasts, and development of aldosterone by adrenal glands. Allylestrenol also has a selection of &amp;beta;-adrenergic effect. In this way, it stimulates the synthesis of the body&#39;s placental progesterone, therefore increasing the secretion of placental hormones.</p>', '<p><strong>Intra Uterine Growth Retardation</strong>: 1 tablet three times a day at least two months. Dose to be reduced if symptoms improve.<br />\r\n<strong>Threatened abortion</strong>: 1 tablet three times daily until symptoms disappear.<br />\r\n<strong>Habitual abortion</strong>: 1-2 tablets daily as soon as pregnancy is diagnosed. The administration should be continued for at least one month after the end of the critical period.<br />\r\n<strong>Threatened premature delivery</strong>: Dosage must be determined individually. High dosages (up to 40 mg daily) have been used.<br />\r\n<br />\r\nIn case of a missed dose, it should be taken as soon as the patient remembers &amp; she should continue the regular dosing schedule. A double dose is not recommended.</p>', NULL, '<p>Hypersensitivity; thrombophlebitis; undiagnosed vaginal bleeding, incomplete abortion, hormone-dependent carcinoma, cerebral apoplexy, as a diagnostic test for pregnancy; severe hepatic impairment.</p>', '<p>Treatment with Allylestrenol (especially a long term treatment) is known to cause some gastrointestinal complaints such as vomiting, nausea, and sometimes epigastric discomfort.</p>', '<p>Patients with the following conditions should be cautious: Heart disease, congestive heart failure, sick sinus syndrome, coronary artery disease, seizures, epilepsy, renal dysfunction, migraine headaches, or breathing diseases including asthma, emphysema, chronic bronchitis, or COPD, breast-feeding.</p>', NULL, '<p>Symptoms of overdose may include unusual drowsiness; rapid pulse; fainting; unusual muscle movement or rigidity of the face, neck, or limbs; seizures; and loss of consciousness.</p>', '<p>Female Sex hormones</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>It should not be used for children younger than 16 years old.</p>', '2022-03-10 20:12:52', '2022-03-10 20:12:52'),
(1007, 1007, '<p><strong>Metastatic Breast Cancer</strong>: Nab-Paclitaxel is indicated for the treatment of&nbsp;breast cancer&nbsp;after failure of combination chemotherapy for metastatic disease or relapse within 6 months of&nbsp;adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated.<br />\r\n<br />\r\n<strong>Non-Small Cell Lung Cancer</strong>: Nab-Paclitaxel is indicated for the first-line treatment of locally advanced or metastatic&nbsp;non-small cell lung cancer, in combination with carboplatin, in patients who are not candidates for curative surgery or&nbsp;radiation therapy.<br />\r\n<br />\r\n<strong>Adenocarcinoma Of The Pancreas</strong>: Nab-Paclitaxel is indicated for the first-line treatment of patients with metastatic&nbsp;adenocarcinoma&nbsp;of the pancreas, in combination with gemcitabine.</p>', '<p>Nab-Paclitaxelis a microtubule inhibitor that promotes the assembly of microtubules from tubulin dimers and stabilizes microtubules by preventing depolymerization. This stability results in the inhibition of the normal dynamic reorganization of the microtubule network that is essential for vital&nbsp;interphase&nbsp;and&nbsp;mitotic&nbsp;cellular functions. Paclitaxel induces abnormal arrays or &quot;bundles&quot; of microtubules throughout the&nbsp;cell cycle&nbsp;and multiple asters of microtubules during&nbsp;mitosis.</p>', '<p><strong>Metastatic Breast Cancer</strong>: After failure of combination chemotherapy for metastatic breast cancer or relapse within 6 months of&nbsp;adjuvant&nbsp;chemotherapy, the recommended regimen for Nab-Paclitaxel is 260 mg/m&sup2; administered intravenously over 30 minutes every 3 weeks.<br />\r\n<br />\r\n<strong>Non-Small Cell Lung Cancer</strong>: The recommended dose of Nab-Paclitaxel is 100 mg/m&sup2; administered as an intravenous infusion over 30 minutes on Days 1, 8, and 15 of each 21-day cycle. Administer carboplatin on Day 1 of each 21 day cycle immediately after Nab-Paclitaxel.<br />\r\n<br />\r\n<strong>Adenocarcinoma Of The Pancreas</strong>: The recommended dose of Nab-Paclitaxel is 125 mg/m&sup2; administered as an intravenous infusion over 30-40 minutes on Days 1, 8 and 15 of each 28-day cycle. Administer gemcitabine immediately after Nab-Paclitaxel on Days 1, 8 and 15 of each 28-day cycle.<br />\r\n<br />\r\n<strong>Dosage In Patients With Hepatic Impairment</strong>: For patients with mild hepatic impairment (total bilirubin greater than ULN and less than or equal to 1.5 x ULN and&nbsp;aspartate aminotransferase&nbsp;[AST] less than or equal to 10 x ULN), no dose adjustments are required, regardless of indication.<br />\r\n<br />\r\nDo not administer Nab-Paclitaxel to patients with metastatic adenocarcinoma of the pancreas who have moderate to severe hepatic impairment. Do not administer Nab-Paclitaxel to patients with total bilirubin greater than 5 x ULN or AST greater than 10 x ULN regardless of indication as these patients have not been studied.</p>', '<p>The metabolism of paclitaxel is catalyzed by CYP2C8 and CYP3A4. Caution should be exercised when administering Nab-Paclitaxel concomitantly with medicines known to inhibit (e.g., ketoconazole and other imidazole antifungals,&nbsp;erythromycin, fluoxetine, gemfibrozil, cimetidine, ritonavir, saquinavir, indinavir, and nelfinavir) or induce (e.g., rifampicin, carbamazepine, phenytoin, efavirenz, and nevirapine) either CYP2C8 or CYP3A4.</p>', '<p>Nab-Paclitaxel should not be used in patients who have baseline neutrophil&nbsp;counts of &lt;1,500 cells/mm&sup3;. Patients who experience a severe hypersensitivity reaction to Nab-Paclitaxel should not be rechallenged with the drug.</p>', '<p>The most common adverse reactions ( &ge;20%) with single-agent use of Nab-Paclitaxel in metastatic&nbsp;breast cancer&nbsp;are&nbsp;alopecia,&nbsp;neutropenia, sensory&nbsp;neuropathy, abnormal&nbsp;ECG, fatigue/asthenia, myalgia/arthralgia, AST elevation, alkaline phosphatase elevation,&nbsp;anemia, nausea, infections, and diarrhea.<br />\r\n<br />\r\nThe most common adverse reactions ( &ge;20%) of Nab-Paclitaxel in combination with carboplatin for&nbsp;non-small cell lung cancer&nbsp;are anemia, neutropenia,&nbsp;thrombocytopenia, alopecia,&nbsp;peripheral neuropathy, nausea, and fatigue.<br />\r\n<br />\r\nThe most common serious adverse reactions of Nab-Paclitaxel in combination with carboplatin for non-small cell lung cancer are anemia (4%) and&nbsp;pneumonia&nbsp;(3%).<br />\r\n<br />\r\nThe most common adverse reactions resulting in permanent discontinuation of Nab-Paclitaxel are neutropenia (3%), thrombocytopenia (3%), and peripheral neuropathy (1%).<br />\r\n<br />\r\nThe most common adverse reactions resulting in dose reduction of Nab-Paclitaxel are neutropenia (24%), thrombocytopenia (13%), and anemia (6%).<br />\r\n<br />\r\nThe most common adverse reactions leading to withholding or delay in Nab-Paclitaxel dosing are neutropenia (41%), thrombocytopenia (30%), and anemia (16%).</p>', '<p>Pregnancy Category D. Nab-Paclitaxel can cause fetal harm when administered to a pregnant woman. Administration of paclitaxel formulated as albumin-bound particles to rats during pregnancy at doses lower than the maximum recommended human dose, based on&nbsp;body surface area, caused embryo-fetal toxicities, including&nbsp;intrauterinemortality, increased resorptions, reduced numbers of live fetuses, and malformations.<br />\r\n<br />\r\nThere are no adequate and well-controlled studies in pregnant women receiving Nab-Paclitaxel. If this drug is used during pregnancy, or if the patient becomes pregnant while receiving this drug, the patient should be apprised of the potential hazard to the fetus. Women of childbearing potential should be advised to avoid becoming pregnant while receiving Nab-Paclitaxel<br />\r\n<br />\r\nIt is not known whether paclitaxel is excreted in human milk. Paclitaxel and/or its metabolites were excreted into the milk of lactating rats. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', NULL, '<p>There is no known&nbsp;antidote&nbsp;for Nab-Paclitaxel overdosage. The primary anticipated complications of overdosage would consist of&nbsp;bone marrow&nbsp;suppression, sensory neurotoxicity, and&nbsp;mucositis.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store the vials in original cartons at 20&deg;C to 25&deg;C. Retain in the original package to protect from bright light.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Nab-Paclitaxel in pediatric patients have not been evaluated.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the 229 patients in the randomized study who received Nab-Paclitaxel for the treatment of metastatic breast cancer, 13% were at least 65 years of age and &lt; 2% were 75 years or older. No toxicities occurred notably more frequently among patients who received Nab-Paclitaxel.<br />\r\n<br />\r\nA subsequent pooled analysis was conducted in 981 patients receiving Nab-Paclitaxel monotherapy for metastatic breast cancer, of which 15% were 65 years of age or older and 2% were 75 years of age or older. A higher incidence of&nbsp;epistaxis, diarrhea, dehydration, fatigue and peripheral edema was found in patients 65 years of age or older.<br />\r\n<br />\r\nOf the 514 patients in the randomized study who received Nab-Paclitaxel and carboplatin for the first-line treatment of non-small cell lung cancer, 31% were 65 years or older and 3.5% were 75 years or older. Myelosuppression,&nbsp;peripheral neuropathy, and arthralgia were more frequent in patients 65 years or older compared to patients younger than 65 years old. No overall difference in effectiveness, as measured by response rates, was observed between patients 65 years or older compared to patients younger than 65 years old.<br />\r\n<br />\r\nOf the 431 patients in the randomized study who received Nab-Paclitaxel and gemcitabine for the first-line treatment of pancreatic adenocarcinoma, 41% were 65 years or older and 10% were 75 years or older. No overall differences in effectiveness were observed between patients who were 65 years of age or older and younger patients. Diarrhea, decreased appetite, dehydration and epistaxis were more frequent in patients 65 years or older compared with patients younger than 65 years old. Clinical studies of Nab-Paclitaxel did not include sufficient number of patients with pancreatic cancer who were 75 years and older to determine whether they respond differently from younger patients.<br />\r\n<br />\r\n<strong>Patients With Hepatic Impairment</strong>: The exposure to paclitaxel may be higher in patients with hepatic impairment than in patients with normal hepatic function. Reduce &nbsp;Nab-Paclitaxel starting dose in patients with moderate to severe hepatic impairment. Do not administer Nab-Paclitaxel to patients with total bilirubin &gt; 5 x ULN or AST&gt; 10 x ULN. Do not administer to patients with metastatic adenocarcinoma of the pancreas who have moderate to severe hepatic impairment.<br />\r\n<br />\r\n<strong>Patients With Renal Impairment</strong>: Adjustment of the starting Nab-Paclitaxel dose is not required for patients with mild to moderate renal impairment (estimated creatinine clearance &ge; 30 to &lt; 90 mL/min). There are insufficient data to permit dosage recommendations in patients with severe renal impairment or end stage renal disease (estimated creatinine clearance &lt; 30 mL/min).</p>', '2022-03-10 20:31:59', '2022-03-10 20:31:59'),
(1008, 1008, '<p>Nabumetone is indicated for relief of signs and symptoms of osteoarthritis and rheumatoid arthritis. Carefully consider the potential benefits and risks of Nabumetone and other treatment options before deciding to use Nabumetone. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.</p>', '<p>Nabumetone is a naphthylalkanone. Is is a non-selective prostaglandin G/H synthase (a.k.a. cyclooxygenase or COX) inhibitor that acts on both prostaglandin G/H synthase 1 and 2 (COX-1 and -2). Prostaglandin G/H synthase catalyzes the conversion of arachidonic acid to prostaglandin G2 and prostaglandin G2 to prostaglandin H2. Prostaglandin H2 is the precursor to a number of prostaglandins involved in fever, pain, swelling, inflammation, and platelet aggregation. The parent compound is a prodrug that undergoes hepatic biotransformation to the active compound, 6-methoxy-2-naphthylacetic acid (6MNA). The analgesic, antipyretic and anti-inflammatory effects of NSAIDs occur as a result of decreased prostaglandin synthesis.<br />\r\n<br />\r\nThe parent compound is a prodrug, which undergoes hepatic biotransformation to the active component, 6-methoxy-2-naphthylacetic acid (6MNA), that is a potent inhibitor of prostaglandin synthesis, most likely through binding to the COX-2 and COX-1 receptors.</p>', '<p><strong>Osteoarthritis and Rheumatoid Arthritis</strong>: The recommended starting dose is 1,000 mg taken as a single dose with or without food. Some patients may obtain more symptomatic relief from 1,500 mg to 2,000 mg per day. Nabumetone can be given in either a single or twice-daily dose. Dosages greater than 2,000 mg per day have not been studied. The lowest effective dose should be used for chronic treatment.&nbsp; Patients weighing under 50 kg may be less likely to require dosages beyond 1,000 mg; therefore, after observing the response to initial therapy, the dose should be adjusted to meet individual patients&rsquo; requirements.</p>', '<p>Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE-inhibitors.</p>', '<p>Nabumetone is contraindicated in patients with known hypersensitivity to nabumetone or its excipients. Nabumetone should not be given to patients who have experienced asthma, urticaria, or allergictype reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients. Nabumetone is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.</p>', '<p><strong>Gastrointestinal</strong>: Diarrhea (14%), dyspepsia (13%), abdominal pain (12%), constipation, flatulence, nausea, positive stool guaiac, dry mouth, gastritis, stomatitis, vomiting.<br />\r\n<br />\r\n<strong>Central Nervous System</strong>: Dizziness, headache, fatigue, increased sweating, insomnia, nervousness, somnolence.<br />\r\n<br />\r\n<strong>Dermatologic</strong>: Pruritus, rash<br />\r\n<br />\r\n<strong>Special Senses</strong>: Tinnitus<br />\r\n<br />\r\n<strong>Miscellaneous</strong>: Edema</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Reproductive studies conducted in rats and rabbits have not demonstrated evidence of developmental abnormalities. However, animal reproduction studies are not always predictive of human response. There are no adequate, well-controlled studies in pregnant women. Nabumetone should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk, however 6MNA is excreted in the milk of lactating rats. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Nabumetone, 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.<br />\r\n<br />\r\n<strong>Labor and Delivery</strong>: In rat studies with NSAIDs, as with other drugs known to inhibit prostaglandin synthesis, an increased incidence of dystocia, delayed parturition, and decreased pup survival occurred. The effects of Nabumetone on labor and delivery in pregnant women are unknown.</p>', '<p>Nabumetone cannot be expected to substitute for corticosteroids or to treat corticosteroid insufficiency. Abrupt discontinuation of corticosteroids may lead to disease exacerbation. Patients on prolonged corticosteroid therapy should have their therapy tapered slowly if a decision is made to discontinue corticosteroids. The pharmacological activity of Nabumetone in reducing fever and inflammation may diminish the utility of these diagnostic signs in detecting complications of presumed noninfectious, painful conditions</p>', '<p>Symptoms following acute NSAIDs overdoses are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur. Hypertension, acute renal failure, respiratory depression, and coma may occur, but are rare. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following an overdose.<br />\r\n<br />\r\nPatients should be managed by symptomatic and supportive care following a NSAIDs overdose. There are no specific antidotes. Emesis and/or activated charcoal (60 to 100 grams in adults, 1 to 2 g/kg in children), and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose (5 to 10 times the usual dose). Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.<br />\r\n<br />\r\nThere have been overdoses of up to 25 grams of Nabumetone reported with no long-term sequelae following standard emergency treatment (i.e., activated charcoal, gastric lavage, IV H2-blockers, etc.).</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis.</p>', '<p>Store at 25&deg;C; excursions permitted to 15-30&deg;C in well-closed container; dispense in light-resistant container.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: As with any NSAIDs, caution should be exercised in treating the elderly (65 years and older).</p>', '2022-03-10 20:34:15', '2022-03-10 20:34:15'),
(1009, 1009, '<p>Naftidrofuryl oxalate is used to treat peripheral vascular disorders (blood circulation problems outside the brain and heart). It is used to treat the following symptoms of these disorders:</p>\r\n\r\n<ul>\r\n	<li>Intermittent claudication</li>\r\n	<li>Cramps in legs at night</li>\r\n	<li>Severe pain in legs while resting (rest pain)</li>\r\n	<li>Pale or blue fngers or toes which get worse when it is cold</li>\r\n	<li>Numbness, tingling or burning feelings in fngers or toes (Raynaud&rsquo;s syndrome or acrocyanosis)</li>\r\n	<li>Open sores on the legs or feet (trophic ulcers)</li>\r\n	<li>Poor circulation caused by diabetes (diabetic arteriopathy)</li>\r\n	<li>To treat gangrene</li>\r\n</ul>', '<p>Naftidrofuryl oxalate possesses a 5HT2-blocking activity and counteracts both the vasoconstrictor effect and the effect promoting platelet aggregation due to serotonin. Naftidrofuryl oxalate has a direct effect on intracellular metabolism. Thus it increases ATP level, decreases lactic acid level in ischemic conditions and enhances the cellular oxidative capacity. Also, Naftidrofuryl oxalate is a powerful spasmolytic agent.</p>', '<p>One or two Naftidrofuryl oxalate capsules three times daily during meals for a minimum of three months or at the discretion of the physician.</p>', NULL, '<p>Hypersensitivity to the active substance or to any of the excipients. Patients with a history of hyperoxaluria or recurrent calcium-containing kidney stones.</p>', '<ul>\r\n	<li>Gastrointestinal disorders (uncommon): Diarrhoea, nausea, vomiting and epigastric pain.</li>\r\n	<li>Renal and urinary disorders (very rare): Calcium oxalate kidney stones.</li>\r\n	<li>Skin and subcutaneous tissue disorders (uncommon): Skin rash.</li>\r\n	<li>Hepatobiliary disorders (rare): Liver damage.</li>\r\n</ul>', '<p>In the absence of any relevant clinical data, the use of Naftidrofuryl Oxalate is not advisable during pregnancy. In the absence of specific data concerning the excretion of the drug in human milk, Naftidrofuryl Oxalate should not be used by breastfeeding women.</p>', '<p>The administration of Naftidrofuryl Oxalate may modify the composition of the urine, promoting the formation of calcium oxalate kidney stones. The administration of Naftidrofuryl Oxalate without liquid before going to bed may cause local oesophagitis. Therefore, it is essential to always take the capsule with a sufficient amount of water. Cases of liver damage have been reported.</p>', '<p>Depression of cardiac conduction and convulsions may occur.</p>', '<p>5-HT Agonists.</p>', '<p>Store below 25&deg;C. Protect from light &amp; moisture. Keep the medicine out of reach of children.</p>', NULL, '2022-03-10 20:36:03', '2022-03-10 20:36:03'),
(1010, 1010, '<p>Naftifine cream is an allylamine antifungal indicated for the treatment of interdigital tinea pedis, tinea cruris, and tinea corporis caused by the organism Trichophyton rubrum.</p>', '<p>Although the exact mechanism of action against fungi is not known, naftifine appears to interfere with sterol biosynthesis by inhibiting the enzyme squalene 2,3-epoxidase. This inhibition of enzyme activity results in decreased amounts of sterols, especially ergosterol, and a corresponding accumulation of squalene in the cells.</p>', '<p>For topical use only. Naftifine Cream is not for ophthalmic, oral, or intravaginal use.&nbsp;Apply a thin layer of Naftifine Cream once-daily to the affected areas plus a &frac12; inch margin of healthy surrounding skin for 2 weeks</p>', NULL, NULL, '<p>The most common adverse reaction (&ge;1%) is pruritus.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. There are no adequate and well-controlled studies of Naftifine&nbsp;Cream in pregnant women. Because animal reproduction studies are not always predictive of human response, Naftifine&nbsp;Cream should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Naftifine&nbsp;Cream is administered to a nursing woman.</p>', '<p>If redness or irritation develops with the use of Naftifine Cream treatment should be discontinued.</p>', NULL, '<p>Topical Antifungal preparations.</p>', '<p>Store at 25&deg;C; excursions permitted to 15-30&deg;C</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Naftifine&nbsp;Cream have been established in the age group 12-17 with interdigital tinea pedis and tinea cruris.&nbsp;Safety and effectiveness in pediatric patients &lt;12 years of age have not been established.&nbsp;<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Naftifine&nbsp;Cream did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.</p>', '2022-03-10 20:37:51', '2022-03-10 20:37:51'),
(1011, 1011, '<p>Nalbuphine Hydrochloride is indicated for the relief of moderate to severe pain. It is used for relief of moderate to severe pain associated with myocardial infarction (MI). Nalbuphine Hydrochloride can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery.</p>', '<p>Nalbuphine Hydrochloride is a synthetic potent analgesic. Its analgesic potency is essentially equivalent to that of morphine on a milligram basis. Receptor studies show that Nalbuphine binds to mu, kappa, and delta receptors, but not to sigma receptors. Nalbuphine is primarily a kappa agonist/partial mu antagonist analgesic.</p>', '<p>The usual recommended adult dose is 10 mg for a 70 kg individual, administered subcutaneously, intramuscularly or intravenously; this dose may be repeated every 3 to 6 hours as necessary. Dosage should be adjusted according to the severity of the pain, physical status of the patient, and other medications which the patient may be<br />\r\nreceiving.<br />\r\n<br />\r\n<strong>Moderate to severe pain</strong>: by intravenous or intramuscular injection 10-20 mg for 70 kg patient, adjusted as required; child up to 0.3 mg/kg repeated once or twice as necessary.<br />\r\n<br />\r\n<strong>Preoperative anesthesia</strong>: by intravenous or intramuscular injection 0.1-0.2 mg/kg.<br />\r\n<br />\r\n<strong>Obstetrical analgesia during labor &amp; delivery</strong>: by intravenous injection 0.3-1 mg/kg over 10-15 minutes with maintenance doses of 0.25-0.5 mg/kg in single intravenous administration as required.<br />\r\n<br />\r\n<strong>Intraoperative analgesia</strong>: by intravenous injection 0.25-0.5 mg/kg at 30 minutes intervals.<br />\r\n<br />\r\n<strong>Myocardial infarction</strong>: By slow intravenous injection 10-20 mg, repeated after 30 minutes if necessary. Larger dose is required when used as supplement of anesthesia than that required for analgesia.<br />\r\n<br />\r\n<strong>Children from 18 months to 15 years old</strong>: usually 0.2 mg/ kg body-weight, given preferably by intravenous or intramuscular injection. Maintenance doses may be given at intervals of 4 to 6 hours or the dose must be determined by the physician.</p>', '<p>No hazardous interactions have been identified with Nalbuphine; however, interactions described with other opioids may be anticipated. Patient receiving a narcotic analgesic, general anesthesia, phenothiazines or other tranquilizers, sedatives, hypnotics, or other CNS depressants (including alcohol) concomitantly with Nalbuphine may exhibit an additive effect.</p>', '<p>Known hypersensitivity to Nalbuphine Hydrochloride.</p>', '<p>Generally Nalbuphine is well tolerated. However few side-effects like sedation, sweating, nausea, vomiting, dizziness, vertigo, dry mouth, headache, respiratory depression, dyspnea and asthma may be seen.</p>', '<p>Pregnancy category B. The placental transfer of Nalbuphine is high and rapid. There are no well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Limited data suggest that Nalbuphine is excreted in maternal milk but only in a small amount (less than 1% of the administered dose) and with a clinically insignificant effect. Caution should be exercised when Nalbuphine is administered to a nursing woman.</p>', '<p>Caution should be taken in the following conditions: impaired respiration, impaired renal or hepatic function, billiary tract surgery, myocardial infarction and hypotension.</p>', '<p>Sleepiness &amp; mild dyspnea may occur due to overdose. The immediate intravenous administration of an opiate antagonist such as Naloxone or Nalmefene is a specific antidote. Oxygen, intravenous fluids, vasopressors and other supportive measures should be used as indicated.</p>', '<p>Opioid analgesics</p>', '<p>Keep it in a cool and dry place, protected from light and moisture.</p>', NULL, '2022-03-10 20:40:05', '2022-03-10 20:40:05'),
(1012, 1012, '<p>Nalidixic acid is indicated in the treatment of urinary tract infection caused by susceptible Gram-negative organisms, including Proteus species, Klebsiella species, Enterobacter species and Escherichia coli.</p>', '<p>Nalidixic acid is a synthetic narrow spectrum antibacterial. It is bacteriostatic or bactericidal depending on the concentration. Nalidixic acid appears to act by inhibiting bacterial DNA synthesis, possibly by interfering with DNA polymerization. It is rapidly and completely absorbed from the G.I. Tract. Parent drug and active metabolites are distributed to most tissues specially to the kidney and to the urine. During normal renal function, half-life is 1.1 to 2.5 hours and when renal function is impaired, half-life is up to 21 hours. It is rapidly and almost completely excreted within 24 hours.</p>', '<p><strong>Adult</strong>: initially is 1 g every 6 hours for 7 days reducing to 500 mg every 6 hours.<br />\r\n<br />\r\n<strong>Children</strong>: Infants and children 3 month of age and over Initial: Oral 13.75 mg per kg body weight every six hours for one or two weeks. Maintenance: Oral 8.25 mg per kg body weight every six hours or as prescribed by the physician.</p>', '<p>Concomitant use of Nalidixic acid with melphalan there have been reports of death froms severe blood containing diarrhoea caused by hemorrhagic ulcerative colitis. Probenecids inhibits tubular secretion of nalidixic acid and may therefore elevate serum concentration, possibly enhancing toxicity. Chlorpromazine and Perphenazine have been shown to potentiate the effect of Nalidixic Acid in vitro.</p>', '<p>Nalidixic acid is contraindicated in the following cases- Infants under 3 months, epilepsy, CNS lesions.</p>', '<p>Gastro-intestinal disturbances including nausea, vomiting, diarrhoea, haemolysis in G6PD deficiency, allergic reaction including urticaria, rashes, fever, arthralgia, eosinophilia, also myalgia, muscle weakness, phototoxicity, jaundice, visual disturbances and convulsions.</p>', '<p>There is the possibility that it may cause cartilage damage and as it is a DNA-gyrase inhibitor there is a possibility of causing DNA damage too. Nalidixic acid is excreted in breast milk and there is a report of hemolytic anaemia in a breast feed child of an azotemic mother.</p>', '<p>Risk-benefit must be considered during the first trimester of pregnancy and during breast feeding, impaired renal or hepatic function.</p>', NULL, '<p>Anti-diarrhoeal Antimicrobial drugs, Other Anti-protozoals, Systemic Urinary Anti- infective</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 20:42:02', '2022-03-10 20:42:02'),
(1013, 1013, '<p>Naloxone is indicated for the complete or partial reversal of opioid depression, including&nbsp;respiratory&nbsp;depression, induced by natural and synthetic opioids, including propoxyphene,&nbsp;methadone&nbsp;and certain mixed agonist-antagonist analgesics: nalbuphine, pentazocine, butorphanol, and cyclazocine. Naloxone is also indicated for diagnosis of suspected or known&nbsp;acute&nbsp;opioid overdosage. Naloxone may be useful as an adjunctive agent to increase&nbsp;blood pressure in the management of&nbsp;septic&nbsp;shock.</p>', '<p>Naloxone is a pure opioid antagonist that acts competitively at opioid receptors.&nbsp;While the mechanism of action of naloxone is not fully understood, the preponderance of evidence suggests that naloxone antagonizes the opioid effects by competing for the same receptor sites, especially the opioid mu receptor. Recently, naloxone has been shown to bind all three opioid receptors (mu, kappa and gamma) but the strongest binding is to the mu receptor.</p>', '<p>Reversal of central depression from opioid use during surgery:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:&nbsp;</strong>100-200 mcg at intervals of 2-3 minute, titrate dose according to response while maintaining analgesia.</li>\r\n	<li><strong>Child:</strong>&nbsp;5-10 mcg IV at 2-3 min intervals.</li>\r\n</ul>\r\n\r\n<p>Opioid overdosage:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;0.4-2 mg repeated if necessary at 2-3 min intervals. If there is no response after a total of 10 mg has been given, consider the possibility of overdosage with other drugs. Reduce dose for opioid-dependent patients: 0.1-0.2 mg. IM/SC routes may be used (at IV doses) if IV admin is not feasible.</li>\r\n	<li><strong>Child:&nbsp;</strong>Initially 10 mcg/kg IV followed by 100 mcg/kg IV if necessary. Alternatively, 0.4-0.8 mg IM or SC, repeated as necessary, if IV admin is not feasible.</li>\r\n</ul>\r\n\r\n<p>Opioid-induced depression in neonates due to obstetric analgesia:</p>\r\n\r\n<ul>\r\n	<li><strong>Child:&nbsp;</strong>10 mcg/kg IV, IM or SC repeated at 2-3 min intervals if necessary or 60 mcg/kg as a single IM dose.</li>\r\n</ul>', '<p>Decreased effect of opioid analgesics.</p>', NULL, '<p>Occur secondarily to reversal (withdrawal) of narcotic analgesia and sedation. Mental depression, apathy, inability to concentrate, sleepiness, irritability, anorexia, nausea, and vomiting in high oral doses during initial treatment of opiate addiction.</p>', '<p>Pregnancy 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>Patients physically dependent on opioids, or who have received large doses of opioids (acute withdrawal syndrome may be precipitated). Pregnancy and lactation.</p>', NULL, '<p>Antidote preparations</p>', '<p>Store at 25&deg; C. Protect from light.</p>', NULL, '2022-03-10 20:44:17', '2022-03-10 20:44:17'),
(1014, 1014, '<p>Naltrexone is indicated in the treatment of alcohol dependence and for the blockade of the effects of exogenously administered opioids. Naltrexone has not been shown to provide any therapeutic benefit except as part of an appropriate plan of management for the addictions.</p>', '<p>Naltrexone acts as a competitive antagonist at opioid receptor sites. It blocks the action of opioids and precipitates withdrawal symptoms in opioid-dependent individuals.</p>', '<p>Opioid dependence:</p>\r\n\r\n<ul>\r\n	<li><strong>Initially</strong>:&nbsp;25 mg; increase to 50 mg daily if no withdrawal signs occur.</li>\r\n	<li><strong>Maintenance</strong>: 350 mg wkly given as 50 mg daily or divided in 3 doses (given on 3 days of the wk) for improved compliance.</li>\r\n</ul>\r\n\r\n<p>Adjunct in alcohol dependence: 50 mg daily.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food.</p>', '<p>May reduce effects of opiate-containing preparations e.g. those used for cough and cold, diarrhoea and pain. Increased or decreased serum levels with drugs that alter hepatic metabolism. Potentially increased hepatotoxic effects with disulfiram. Increased risk of naltrexone-induced lethargy and somnolence with thioridazine. May increase insulin requirements.</p>', '<p>Patients concurrently dependent on opioids; acute hepatitis or hepatic failure; acute opioid withdrawal; patients on therapeutic opioid analgesics.</p>', '<p>Abdominal pain, nausea, vomiting; anxiety, insomnia, lethargy, headache, musculoskeletal pain; anorexia, diarrhoea, constipation; increased thirst; chest pain; chills, dizziness; sexual dysfunction; rash, liver function abnormalities and reversible idiopathic thrombocytopenia. Inj-site reactions.</p>', '<p><strong>Pregnancy</strong>&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>Hepatic or renal impairment. Monitor LFTs regularly. Patients should be opioid-free for at least 7-10 days prior to initiating naltrexone therapy. Strictly warn patients against the use of opioids while on naltrexone. Monitor for inj-site reactions. Pregnancy, lactation. History of bleeding disorders (including thrombocytopenia).</p>', '<p><strong>Symptoms</strong>: Clonic-tonic convulsions and respiratory failure.<br />\r\n<strong>Management</strong>: Supportive and symptomatic.</p>', '<p>Antidote preparations</p>', '<p>Store at 20-25&deg; C.</p>', NULL, '2022-03-10 20:46:23', '2022-03-10 20:46:23');
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
(1015, 1015, '<p>Nandrolone Decanoate is indicated in Established Osteoporosis, Disseminated breast cancer in women (palliative therapy), Protein deficiency states occurring after major surgery or trauma, Anemia due to chronic renal failure, Aplastic anemia, Anemia due to cytotoxic therapy, Chronic debilitating disease in elderly, Postsurgical and post traumatic catabolism, During glucocorticosteroid therap.</p>', '<p>Nandrolone Decanoate is an injectable anabolic preparation. The pharmacologically active substance is nandrolone. The decanoate ester gives the preparation duration of action of about three weeks after injection. Nandrolone Decanoate is chemically related to the male hormone. Compared to testosterone, it has an enhanced anabolic and a reduced androgenic activity. This has been demonstrated in animal bioassays and explained by receptor binding studies. The low androgenicity of nandrolone Decanoate is confirmed in clinical use.<br />\r\n<br />\r\nIn the human, Nandrolone has been shown to positively influence calcium metabolism and to increase bone mass in osteoporosis. In women with disseminated mammary carcinoma Nandrolone Decanoate has been reported to produce objective regressions for many months. Furthermore, Nandrolone Decanoate has a nitrogen-saving action. This effect on protein metabolism has been established by metabolic studies and is utilized therapeutically in conditions where a protein deficiency exists such as during chronic debilitating diseases and after major surgery and severe trauma. In these conditions, Nandrolone Decanoate serves as a supportive adjunct to specific therapies and dietary measures as well as parenteral nutrition.<br />\r\n<br />\r\nAndrogenic effects (e.g. virilisation) are relatively uncommon at the recommended dosages. Nandrolone Decanoate lacks the C 17 alpha-alkyl group which is associated with the occurrence of liver dysfunction and cholestasis.</p>', '<ul>\r\n	<li>Established Osteoporosis: 50 mg every 3 weeks</li>\r\n	<li>Disseminated breast cancer in women (palliative therapy): 50 mg every 3 weeks</li>\r\n	<li>Protein deficiency states occurring after major surgery or trauma: 50 mg every 2-3 weeks</li>\r\n	<li>Anemia due to chronic renal failure: 50-200 mg per week</li>\r\n	<li>Aplastic anemia: 50-150 mg per week</li>\r\n	<li>Anemia due to cytotoxic therapy: 200 mg per week</li>\r\n	<li>Chronic debilitating disease in elderly: 100 mg</li>\r\n	<li>Postsurgical and post-traumatic catabolism: 25-50 mg every 3 weeks</li>\r\n	<li>During glucocorticosteroid therapy: 50 mg every 2-3 week</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 administered by deep intramuscular injection. For an optimal therapeutic effect it is necessary to administer adequate amounts of vitamins, minerals and protein in a calorie-rich diet.</p>', '<p>Due to the nature of the drug, side effects cannot be quickly reversed by discontinuing medication. Injectables in general, may cause a local reaction at the injection site. Depending on the dose, frequency and total period of administration of Nandrolone Decanoate the following undesirable effects may occur: Virilism, Hyperlipidaemia, Increased Libido, Hypertension, Dysphonia, Nausea, Abnormal hepatic function, Peliosis hepatis, Acne, Rash, Pruritus, Hirsutism, Premature fusion of Epiphyses, Decreased urine flow, Benign prostatic hyperplasia, Priapism, Enlarged penis, clitoris, Amenorrhoea, Oligomenorrhoea, Decreased sperm count, Oedema, Injection site reaction, Decreased HDL, increased Haemoglobin.</p>', '<p>Contraindicated in Pregnancy, Male breast carcinoma, Prostatic carcinoma, The patients allergic to peanuts &amp; soya and hypersensitive to the active substance or to any of the excipients including arachis oil.</p>', NULL, '<p>This medicine is contraindicated during pregnancy because of possible masculinization of foetus. There are insufficient data on the use of this medicine in pregnant women, during breast feeding to assess potential harm to the infant or a possible influence on milk production.</p>', '<p>If signs of virilisation develop, discontinuation of the treatment should be considered, preferably in consultation with the patient.<br />\r\n<br />\r\nIt is recommended to monitor patients with any of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>latent or overt cardiac failure, renal dysfunction, hypertension of migraine (or a history of these conditions), since anabolic steroids may occasionally induce fluid retention</li>\r\n	<li>incomplete statural growth, since anabolic steroids in high dosages may accelerate epiphyseal closure skeletal metastases of breast carcinoma. In these patients</li>\r\n	<li>hypercalcaemia may develop both spontaneously and as a result of anabolic steroid therapy. The later can be indicative of a positive tumour response to the hormonal treatment. Nevertheless, the hypercalcaemia should first be treated appropriately and after restoration of normal calcium levels hormone therapy can be resumed</li>\r\n	<li>liver dysfunction</li>\r\n</ul>\r\n\r\n<p>The use of anabolic steroids to enhance athletic ability may carry severe risks to the user&#39;s health and should be discouraged</p>', '<p>The acute toxicity of Nandrolone Decanoate in animals is very low. There are no reports of acute over dosage with Nandrolone Decanoate in the human.</p>', '<p>Anabolic steroid (Androgens), Hormone in bone formation by stimulation</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 20:48:32', '2022-03-10 20:48:32'),
(1016, 1016, '<p>Nandrolone Phenylpropionate is indicated-</p>\r\n\r\n<ul>\r\n	<li>As an adjunct to specific therapies and dietary measures in pathologic conditions characterized by a negative nitrogen balance</li>\r\n	<li>For the palliative treatment of selected cases of disseminated mammary carcinoma in women</li>\r\n	<li>Osteoporosis.</li>\r\n</ul>', '<p>Nandrolone Phenylpropionate is an injectable anabolic preparation. The pharmacologically active substance is nandrolone. The phenylpropionate ester gives the preparation a duration of action of about one week after injection. Nandrolone is chemically related to the male hormone. Compared to testosterone, it has an enhanced anabolic and a reduced androgenic activity. This has been demonstrated in animal bioassays and explained by receptor binding studies. The low androgenicity of nandrolone is confirmed in clinical use.<br />\r\n<br />\r\nIn the human, Nandrolone Phenylpropionate has a nitrogen saving action. This effect on protein metabolism has been established by metabolic studies and is utilized therapeutically in conditions where a protein deficiency exists such as during chronic debilitating diseases and after major surgery and severe trauma. In these conditions, Nandrolone Phenylpropionate serves as a supportive adjunct to specific therapies and dietary measures. In women with disseminated mammary carcinoma, in selected cases Nandrolone Phenylpropionate has been reported to produce objective regressions for many months. Furthermore, Nandrolone Phenylpropionate has been shown to produce relief of bone pain in patients with osteoporosis. The similarly acting nandrolone ester, nandrolone decanoate, has been shown to increase bone mineral content in these patients. Androgenic effects (e.g. virilisation) are relatively uncommon at the recommended dosages. Nandrolone lacks the C17alpha-alkyl group which is associated with the occurrence of liver dysfunction and cholestasis.</p>', '<p>As an adjunct to specific therapies and dietary measures in pathologic conditions characterized by a negative nitrogen balance: Recommended dose is 25-50 mg every week.<br />\r\n<br />\r\nFor the palliative treatment of selected cases of disseminated mammary carcinoma in women: Recommended dose is 50 mg every week.<br />\r\n<br />\r\nOsteoporosis: Recommended dose is 50 mg every week.<br />\r\n<br />\r\nFor an optimal therapeutic effect it is necessary to administer adequate amounts of vitamins, minerals and protein in a calorie-rich diet. Nandrolone Phenylpropionate&nbsp;should be administered by deep intramuscular injection.</p>', '<p>Anabolic steroids may improve glucose tolerance and decrease the need for insulin or other antidiabetic medicines in diabetics.</p>', '<p>Contraindicated in Pregnancy, Known or suspected carcinoma of the prostate or breast in the male.</p>', '<p>High dosages, prolonged treatment and/or too frequent administration may cause:</p>\r\n\r\n<ul>\r\n	<li>Virilisation which appears in sensitive women as hoarseness, acne hirsutism and increase of libido; in prepubertal boys as an increased frequency of erections and phallic enlargement, and in girls as an increase of pubic hair and clitoral hypertrophy. Hoarseness may be the first symptom of vocal change which may end in a long-lasting, sometimes irreversible deepening of the voice.</li>\r\n	<li>Amenorrhoea.</li>\r\n	<li>Inhibition of spermatogenesis.</li>\r\n	<li>Premature epiphyseal closure.</li>\r\n	<li>Fluid retention.</li>\r\n</ul>', '<p>This medicine is contraindicated during pregnancy because of possible masculinization of the foetus. There are insufficient data on the use of this medicine during breast-feeding to assess potential harm to the infant or a possible influence on milk production.</p>', '<p>If signs of virilisation develop, discontinuation of the treatment should be considered, Preferably in consultation with the patient.<br />\r\n<br />\r\nIt is recommended to monitor patients with any of the following conditions:</p>\r\n\r\n<ul>\r\n	<li>latent or overt cardiac failure, renal dysfunction, hypertension or migraine (or a history of these conditions), since anabolic steroids may occasioally induce fluid retention:</li>\r\n	<li>incomplete statural growth, since anabolic steroids in high dosages may accelerate epiphyseal closure;</li>\r\n	<li>skeletal metastases of breast carcinoma. In these patients</li>\r\n	<li>hypercalcaemia may develop both spontaneously and as a result of anabolic steroid therapy. The later can be indicative of a positive tumour response to the hormonal treatment. Nevertheless, the hypercalcaemia should first be treated appropriately and after restoration of normal calcium levels hormone therapy can be resumed;</li>\r\n	<li>liver dysfunction.</li>\r\n</ul>\r\n\r\n<p>The use of anabolic steroids to enhance athletic ability may carry severe risks to the user&#39;s health and should be discouraged.</p>', '<p>The acute toxicity of Nandrolone Phenylpropionate in animals is very low. There are no reports of acute overdosage with Nandrolone Phenylpropionate in the human.</p>', '<p>Anabolic steroid (Androgens), Hormone in bone formation by stimulation.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 20:50:42', '2022-03-10 20:50:42'),
(1017, 1017, '<p>This eye drop is indicated for the symptomatic treatment of allergic conjunctivitis.</p>', '<p>Naphazoline, an imidazoline derivative is a sympathomimetic with &alpha;-adrenergic activity. It produces vasoconstriction. When applied topically to mucous membranes, it reduces swelling and congestion. It is often used in combination with pheniramine, an alkylamine derivative antihistamine, in ophthalmic preparations.</p>', '<p><strong>Adults and children 6 years of age and older</strong>: instill 1 or 2 drops in affected eye(s) up to 4 times daily.<br />\r\n<br />\r\n<strong>Children under 6 years</strong>: ask a doctor.</p>', '<p>Increased pressor effects with maprotiline or TCA. Possibility of severe hypertensive reaction with MAOI.</p>', '<p>Angle closure glaucoma.</p>', '<p>Blurring of vision, mild stinging and/or irritation, mydriasis and increased or decreased intraocular pressure. When used in high doses in elderly, naphazoline may liberate pigment granules from the iris.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.</p>', '<p>Glaucoma, hypertension, CV abnormalities, DM, hyperthyroidism, infection, or injury. Pregnancy and lactation. Avoid in infants and young children &lt;6 yr. Rebound congestion may occur with prolonged use or overuse. Patient to seek medical advice if there is ocular pain, vision changes, worsening of redness or irritation of the eye or symptoms lasts &gt;72 hr. Remove contact lens before use.</p>', NULL, '<p>Ophthalmic Non-Steroid Combined preparations.</p>', '<p>Store at room temperature 20 degrees to 25 degrees C. Protect from light. Use before expiration date marked on the carton or bottle.</p>', NULL, '2022-03-10 20:52:44', '2022-03-10 20:52:44'),
(1018, 1018, '<p>Acute and chronic non-infectious conjunctivitis, nonspecific conjunctival irritation; also after successful treatment of bacterial and viral conjunctivitis. Irrigation of the tear ducts.</p>', '<p>Zinc ions, the active compound of zinc sulphate, have an astringent, i.e. tissue-sealing and slightly anti-septic effect. Naphazoline constricts the blood vessels and reduces the inflammation and swelling of the conjunctiva. This effect of naphazoline, a substance of the benzylimidazoline group, is due to direct binding to a-adrenergic receptor sites on unstriated muscle cells in the blood vessels.</p>', '<p><strong>Adults</strong>: 1 drop in the conjunctival sac, three to 4 times per day.<br />\r\n<br />\r\n<strong>Children</strong>: Naphazoline nitrate and Zinc sulphate drops has not been studied in children. Generally, in children the dosage of vasoconstrictors should be low and selected with caution.</p>', '<p>Naphazoline containing products should not be administered during treatment with MAO-blockers nor during 10 days after discontinuation of such treatment. The effects of Naphazoline may be increased by concomitant use of tricyclic antidepressants.</p>', '<p>Hypersensitivity to zinc sulphate, Naphazoline and other ingredients. Naphazoline &amp; Zinc is contraindicated in patients suffering from narrow-angle glaucoma, dry eye and especially keratoconjunctivits sicca Sjogren&#39;s syndrome. Naphazoline &amp; Zinc must not be used in infants.</p>', '<p>Mydriasis and a slight increase of intraocular pressure in isolated cases. A slight and transient burning sensation may occur after instillation, which does not affect the success of the treatment. Long term use may result in reactive redness of the eye (rebound effect).<br />\r\n<br />\r\nIn very rare cases systemic cardiovascular effects, such as hypertension and arrhythmia, may occur. Nonspecific fatigue has been observed in some patients.</p>', '<p><strong>Use in pregnancy</strong>: There are neither controlled animal studies nor studies in pregnant women available.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: The effects of Naphazoline &amp; Zinc treatment during lactation have not been investigated.</p>', '<p>Uncontrolled use of Naphazoline &amp; Zinc over extended periods of time should be avoided. If no improvement is seen after 2 days, treatment should be discontinued and other therapeutic measures should be considered. If ocular discomfort or visual disturbance occurs during Naphazoline &amp; Zinc treatment, the therapy must be discontinued. Caution is indicated in patients with predisposition to glaucoma and in patients suffering from hypertension, cardiovascular diseases, pheochromocytoma, aneurysm, hyperglycemia, and hyperthyroidism.</p>', NULL, '<p>Ophthalmic Non-Steroid drugs.</p>', NULL, NULL, '2022-03-10 20:54:30', '2022-03-10 20:54:30'),
(1019, 1019, '<p>Naproxen is indicated for the relief of sign and symptoms of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile arthritis, tendonitis, bursitis &amp; acute gout. It is also indicated for the management of primary dysmenorrhea &amp; pain.</p>', '<p>Naproxen is a non steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic &amp; antipyretic properties. It is rapidly absorbed from the gastrointestinal tract and achieves 95% bioavailability.</p>', '<p>Naproxen Tablet-</p>\r\n\r\n<ul>\r\n	<li><strong>Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis</strong>: The usual dose is 500-1000 mg daily in two divided doses after meals.</li>\r\n	<li><strong>Management of pain, primary dysmenorrhea, acute tendonitis &amp; bursitis</strong>: Recommended starting dose is 500 mg followed by 500 mg every 12 hours or 250 mg every 6-8 hours. The initial total daily dose should not exceed 1250 mg and thereafter, the total daily dose should not exceed 1000 mg.</li>\r\n	<li><strong>Acute gout</strong>: Recommended starting dose is 750 mg followed by 250 mg every 8 hours until the attack has subsided.</li>\r\n</ul>\r\n\r\n<p>Naproxen Suspension-</p>\r\n\r\n<ul>\r\n	<li><strong>For Juvenile rheumatoid arthritis</strong>: The usual dose for children over 2 years is 10 mg/kg/day given as two divided doses at 12-hours intervals. Therapy in children under 2 years of age is not recommended.</li>\r\n</ul>\r\n\r\n<p>Naproxen Gel-</p>\r\n\r\n<ul>\r\n	<li>Is to be applied 2-6 times a day as required and is not recommended for use in children.</li>\r\n</ul>', '<p><strong>ACE inhibitors</strong>: diminish the antihypertensive effect of ACE inhibitors.<br />\r\n<strong>Antacids &amp; Sucralfate</strong>: delay the absorption of Naproxen.<br />\r\n<strong>Aspirin</strong>: increase adverse effects.<br />\r\n<strong>Diuretics</strong>: reduce the natriuretic effect of Furosemide and Thiazides.<br />\r\n<strong>Methotrexate</strong>: enhance the toxicity of Methotrexate.<br />\r\n<strong>Warfarin</strong>: increase the risk of GI bleeding.<br />\r\n<strong>Selective Serotonin Reuptake Inhibitors (SSRI)</strong>: increase the risk of GI bleeding.</p>', '<p>Naproxen is contraindicated in patients with known hypersensitivity to Naproxen. It should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. It is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.</p>', '<p>Most frequently reported side effects include following:</p>\r\n\r\n<ul>\r\n	<li><strong>Gastrointestinal</strong>: Heartburn, abdominal pain, nausea, diarrhea, dyspepsia.</li>\r\n	<li><strong>Central Nervous System</strong>: Headache, vertigo, drowsiness.</li>\r\n	<li><strong>Dermatological</strong>: Pruritus (itching), purpura.</li>\r\n	<li><strong>Cardiovascular</strong>: Edema, palpitation.</li>\r\n	<li><strong>Others</strong>: Visual disturbances, hearing disturbances.</li>\r\n</ul>', '<p>US FDA pregnancy category of Naproxen is C. So, Naproxen should be avoided in pregnancy &amp; lactation unless the potential benefits to the other outweigh the possible risks to the fetus.</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, protected from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-03-10 20:56:09', '2022-03-10 20:56:09'),
(1020, 1020, '<p>Naproxen &amp; Esomeprazole is indicated for the relief of signs &amp; symptoms of-</p>\r\n\r\n<ul>\r\n	<li>Osteoarthritis</li>\r\n	<li>Rheumatoid arthritis</li>\r\n	<li>Ankylosing spondylitis &amp;</li>\r\n	<li>To decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.</li>\r\n</ul>', '<p>This consists of an immediate release Esomeprazole Magnesium layer &amp; an enteric-coated Naproxen core. As a result, Esomeprazole is released first into the stomach, prior to the dissolution of Naproxen in the small intestine.<br />\r\n<br />\r\nNaproxen is a NSAID with analgesic &amp; antipyretic properties. The mechanism of action of Naproxen is to inhibit the prostaglandin synthesis. Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H+/k+&nbsp;-ATPase in the gastric parietal cell by acting specifically on the proton pump, Esomeprazole blocks the final step in acid production, thus reducing gastric acidity.</p>', '<p>Carefully consider the potential benefits &amp; risks of this tablet &amp; other treatment options before deciding to use this tablet. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals. If a dose of Esomeprazole lower than a total daily dose of 40 mg is more appropriate, a different treatment should be considered.<br />\r\n<br />\r\nRheumatoid Arthritis, Osteoarthritis and Ankylosing Spondylitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: One tablet twice daily of either: 375 mg naproxen/20 mg of esomeprazole; or 500 mg naproxen/20 mg of esomeprazole</li>\r\n</ul>\r\n\r\n<p>Juvenile Idiopathic Arthritis in Adolescent Patients 12 Years of Age &amp; Older-</p>\r\n\r\n<ul>\r\n	<li><strong>Weight greater than 50 kg</strong>: 375 mg naproxen/20 mg of esomeprazole; or 500 mg naproxen/20 mg of esomeprazole</li>\r\n	<li><strong>Weight 38 kg to less than 50 kg</strong>: One tablet twice daily of 375 mg naproxen/20 mg of esomeprazole.</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>Do not split, chew, crush or dissolve the tablet. This tablet is to be taken at least 30 minutes before meals.</p>', '<p>With medicine:</p>\r\n\r\n<ul>\r\n	<li>Concomitant use of NSAIDs may reduce the antihypertensive effect of ACE inhibitors, diuretics &amp; beta-blockers</li>\r\n	<li>Concomitant use of this tablet and warfarin may result in an increased risk of a bleeding complication.</li>\r\n	<li>Esomeprazole inhibits gastric acid secretion &amp; may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (eg. Ketoconazole, iron salts and digoxin).</li>\r\n</ul>\r\n\r\n<p>With food &amp; others: Administration of Naproxen &amp; Esomeprazole together with high-fat food in healthy volunteers does not affect the extent of absorption of naproxen but significantly prolongs tmax&nbsp;by 10 hours and decreases peak plasma concentration (Cmax) by about 12%</p>', '<ul>\r\n	<li>Known hypersensitivity to any component of this tablet or substituted benzimidazoles.</li>\r\n	<li>History of asthmay urticaria or other allergic-type reactions after taking aspirin or other NSAIDs.</li>\r\n	<li>Use during the peri-operative period in the setting of coronary artery bypass graft (CABG) surgery.</li>\r\n</ul>', '<p>In general, this preparation is well tolerated. The most common adverse reactions in clinical trials (&gt;5%): erosive gastritis, dyspepsia, gastritis, diarrhea, gastric ulcer, upper abdominal pain, nausea etc.</p>', '<p>Pregnancy category C. In late pregnancy, it should be avoided because it may cause premature closure of the ductus arteriosus. This tablet should not be used in nursing mothers due to the Naproxen component.</p>', '<p>Patients with known CV disease/risk factors may be at greater risk. This tablet should be used with caution in patients with fluid retention or heart failure.</p>', '<p>There is no clinical data on overdosage with this tablet.<br />\r\n<br />\r\n<strong>Overdose of Naproxen</strong>: Significant naproxen overdosage may be characterized by lethargy, drowsiness, epigastric pain, abdominal discomfort, heartburn, indigestion, nausea, transient alteration in liver function, hypoprothrombinemia, renal dysfunction, metabolic acidosis, apnea, vomiting etc.<br />\r\n<br />\r\n<strong>Overdose of Esomeprazole</strong>: The major signs of acute toxicity were reduced motor activity, changes in respiratory frequency, tremor and intermittent clonic convulsions etc.</p>', '<p>Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)</p>', '<p>Store at temperature of below 30&deg;C, protect from light &amp; moisture. Keep out of reach of children.</p>', '<p><strong>Elderly patients</strong>: Studies indicate that although the total plasma concentration of naproxen is unchanged, the unbound plasma fraction of naproxen is increased in the elderly. Use caution when high doses are required &amp; some adjustment of dosage may be required in elderly patients. As with other drugs used in the elderly use the lowest effective dose.<br />\r\n<br />\r\n<strong>Patients with Moderate to Severe Renal impairment</strong>: Naproxen-containing&nbsp;products are not recommended for use in patients with moderate to severe or severe renal impairment (creatinine clearance &lt;30 ml/min).<br />\r\n<br />\r\n<strong>Hepatic insufficiency</strong>: Monitor patients with mild to moderate hepatic impairment closely &amp; consider a possible dose reduction based on the Naproxen component of this tablet. This is not recommended in patients with severe hepatic impairment because Esomeprazole dosage should not exceed 20 mg daily in these patients.</p>', '2022-03-10 20:58:26', '2022-03-10 20:58:26'),
(1021, 1021, '<p>Natamycin sterile ophthalmic suspension is indicated for the treatment of fungal blepharitis, conjunctivitis and keratitis caused by susceptible organisms including Fusarium solani.</p>', '<p>Natamycin is a tetraene polyene antibiotic derived from Streptomyces natalensis. Natamycin probably exerts its antifungal effects by binding to sterols in the fungal cell membrane to produce a change in membrane permeability that allows loss of essential cellular constituents. It possesses in vitro activity against a variety of yeast and filamentous fungi, including Candida, Aspergillus, Cephalosporium, Fusarium and Penicillium. Although the activity against fungi is dose-related, Natamycin is predominantly fungicidal. Topical administration appears to produce effective concentration of Natamycin within the corneal stroma but not in intraocular fluid.</p>', '<p><strong>For fungal keratitis</strong>: The preferred initial dosage is 1 drop instilled in the conjuntival sac (s) at 1-2 hours interval. The frequency of application can usually be reduced to 1 drop 6-8 times daily after the first 3-4 days. Therapy should generally be continued for 14 to 21 days or until there is resolution of active fungal keratitis. In many cases, it may be helpful to reduce the dosage gradually at 4 to 7 days intervals to assure the replicating fungus has been eliminated.<br />\r\n<br />\r\n<strong>For fungal blepharitis &amp; conjunctivitis</strong>: Less frequent initial dosage, 1 drop 4-6 times daily may be sufficient.</p>', '<p>May increase spread of fungal eye infection when used with topical corticosteroid.</p>', '<p>Natamycin ophthalmic suspension is contraindicated in individuals with a history of hypersensitivity to any of its component.</p>', '<p>Eye irritation, eye discomfort, eye edema, conjunctival chemosis and hyperemia has been reported.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. Natamycin sterile ophthalmic suspension should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether this drug is excreted in human milk. Caution should be exercised when Natamycin is administered to a nursing mother.</p>', '<p>For topical eye use only. Failure of improvement of keratitis following 7-10 days of administration of the drug suggests that the infection may be caused by a microorganism not susceptible to natamycin.</p>', NULL, '<p>Ophthalmic antibacterial drugs.</p>', '<p>Store in a cool and dry place. Protect from light. Do not freeze. Do not use for longer than one month after first opening of the bottle.</p>', '<p><strong>Pediatric</strong>: Safety and effectiveness in paediatric patients have not been established.</p>', '2022-03-10 21:01:01', '2022-03-10 21:01:01'),
(1022, 1022, '<p>Nateglinide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.</p>', '<p>Nateglinide, a nonsulfonylurea hypoglycaemic agent which stimulates insulin release from the pancreatic &beta;-cells by blocking ATP-dependent K channels, depolarising the membrane and facilitating Ca entry through Ca channels. This action depends on the amount of existing glucose levels.</p>', '<p><strong>Initial dose</strong>: 120 mg orally 3 times a day before meals<br />\r\n<br />\r\n<strong>Maintenance dose</strong>: 60 to 120 mg orally 3 times a day before meals<br />\r\n<br />\r\nFor patients who are near goal HbA1c when therapy is initiated, therapy should be initiated at 60 mg orally 3 times. May be used as monotherapy, or in combination with metformin or a thiazolidinedione. As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Take orally 1 to 30 minutes before a meal. Patients who skip a meal should be instructed to skip the dose for that meal</p>', '<p>CYP2C9 and CYP3A4 inhibitors or inducers may alter metabolism of nateglinide. Increased hypoglycaemic effects with MAOIs, nonselective &beta;-adrenergic blockers, NSAIDs, salicylates. Decreased hypoglycaemic effects with corticosteroids, sympathomimetic agents, thiazide diuretics, thyroid hormones.</p>', '<p>IDDM, diabetic ketoacidosis.</p>', '<p>Hypoglycaemia, upper respiratory tract infection, back pain, flu-like symptoms, dizziness, arthropathy, diarrhoea, accidental trauma, bronchitis, cough.</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 adrenal and/or pituitary impairment. Severe renal and moderate to severe hepatic impairment. Pregnancy and lactation.</p>', '<p>Symptoms: Hypoglycaemia.<br />\r\nManagement: Use IV glucose in severe reaction.</p>', '<p>Meglitinide Analogues</p>', '<p>Store at 25&deg; C.</p>', '<p><strong>Renal Dose Adjustments</strong>: No adjustment recommended<br />\r\n<br />\r\n<strong>Mild hepatic impairment</strong>: No adjustment recommended<br />\r\n<br />\r\n<strong>Moderate to severe hepatic impairment</strong>: Use caution<br />\r\n<br />\r\n<strong>Elderly</strong>: No adjustment recommended; however, some individuals may have a greater sensitivity to therapy.&nbsp;Insulin therapy may be temporarily needed in times of fever, infection, trauma, or surgery.<br />\r\n<br />\r\n<strong>Younger than 18 years</strong>: Safety and efficacy have not been established in patients younger than 18 years.</p>', '2022-03-10 21:03:16', '2022-03-10 21:03:16'),
(1023, 1023, '<p>Essential hypertension</p>', '<p>The Combination of these ingredients has an additive antihypertensive effect, reducing blood pressure to a greater degree than either component alone. This combination has mild vasodilating properties which reduces heart rate and blood pressure in hypertensive patients. Hydrochlorothiazide affects the renal tubular mechanisms of electrolyte reabsorption which directly increase the excretion of sodium and chloride in approximately equivalent amounts. The diuretic action of Hydrochlorothiazide reduces plasma volume, increases plasma renin activity and increases aldosterone secretion.</p>', '<p>Once daily, preferably at the same time every day.</p>', '<p>Nebivolol:</p>\r\n\r\n<ul>\r\n	<li>Class I &amp; III Antiarrhythmics, Calcium channel blocker (Verapamil/Diltiazem)</li>\r\n	<li>Centrally-acting antihypertensives, Anaesthetics</li>\r\n	<li>Antipsychotics, Antidepressants, NSAIDs</li>\r\n</ul>\r\n\r\n<p>Hydrochlorothiazide:</p>\r\n\r\n<ul>\r\n	<li>Drugs affecting Potassium &amp; Calcium level</li>\r\n	<li>Non-steroidal anti-inflammatory drugs (NSAIDs)</li>\r\n	<li>Concomitant administration of this combination with Antipsychotics, Tricyclic Antidepressants &amp; Barbiturates may enhance the hypotensive effect and lead to postural hypotension.</li>\r\n</ul>', '<p>Hypersensitivity to the active substances, Liver function impairment. Severe renal insufficiency (Creatinine clearance &lt; 30 ml/min.), Bradycardia, Hypotension.</p>', '<p><strong>Nebivolol</strong>: Headache, Dizziness, Tiredness, Diarrhoea, Constipation, Nausea etc.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: Vertigo, Itchiness, Rash, Increased sensitivity of skin to sunlight etc.</p>', '<p>This combination is not recommended during pregnancy. It is also not recommended for mothers who are breast-feeding.</p>', '<p><strong>Nebivolol</strong>: Beta-blockers should not be used in patients with untreated Congestive Heart Failure (CHF) &amp; bradycardia. In patients with Chronic Obstructive Pulmonary Diseases (COPD), beta-blockers should be used with caution as airway constriction may be aggravated.<br />\r\n<br />\r\n<strong>Hydrochlorothiazide</strong>: In patients with renal disease, thiazides may increase azotaemia. If progressive renal impairment becomes evident, careful reappraisal of therapy is necessary. Thiazides can cause fluid or electrolyte imbalance. Thiazides may decrease urinary calcium excretion and may cause slight elevation of serum calcium in the absence of known disorders of calcium metabolism.</p>', '<p>No data are available on Overdosage. Overdosage with Hydrochlorothiazide is associated with electrolyte depletion and dehydration resulting from excessive diuresis.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Protect from light &amp; moisture. Store below 30&deg; C. Keep out of reach of children.</p>', '<p>Use in children is not recommended.</p>', '2022-03-10 21:05:27', '2022-03-10 21:05:27'),
(1024, 1024, '<p>Nebivolol is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Hypertension</li>\r\n	<li>Treatment of essential hypertension</li>\r\n	<li>Chronic heart failure (CHF)</li>\r\n	<li>Treatment of stable mild and moderate chronic heart failure in addition to standard therapies in elderly patients.</li>\r\n</ul>', '<p>Nebivolol is a &beta; adrenergic receptor blocking agent. Nebivolol inhibits both &beta;1 and &beta;1 adrenergic receptors. Nebivolol lacks intrinsic sympathomimetic and membrane stabilizing activity at therapeutically relevant concentrations. At clinically relevant doses, Nebivolol does not demonstrate &beta;1-adrenergic receptor blockade activity. Various metabolites, including glucuronides, contribute to beta-blocking activity.<br />\r\n<br />\r\nMode of Action of Nebivolol involved include:</p>\r\n\r\n<ul>\r\n	<li>decreased heart rate</li>\r\n	<li>decreased myocardia contractility</li>\r\n	<li>diminution of tonic sympathetic outflow to the periphery from cerebral vasomotor centers</li>\r\n	<li>suppression of renin activity and</li>\r\n	<li>vasodilation and decreased peripheral vascular resistance</li>\r\n</ul>\r\n\r\n<p><strong>Pharmacokinetics</strong>: Nebivolol is metabolized by a number of routes, including glucuronidation and hydroxylation by CYP2D6. The active isomer (d-nebivolol) has an effective half-life of about 12 hours in CYP2D6 extensive metabolizers (most people), and 19 hours in poor metabolizers and exposure to d-nebivolol is substantially increased in poor metabolizers. This has less importance than usual, however, because the metabolites, including the hydroxyl metabolite and glucuronides (the predominant circulating metabolites), contribute to b blocking activity.<br />\r\n<br />\r\n<strong>Absorption and Distribution</strong>: Absorption of Nebivolol is similar to an oral solution. Mean peak plasma nebivolol concentrations occur approximately 1.5 to 4 hours post-dosing in EMs and PMs. Food does not alter the pharmacokinetics of nebivolol. Nebivolol may be administered without regard to meals. The in vitro human plasma protein binding of nebivolol is approximately 98%, mostly to albumin, and is independent of nebivolol concentrations.<br />\r\n<br />\r\n<strong>Metabolism and Excretion</strong>: Nebivolol is predominantly metabolized via direct glucuronidation of parent and to a lesser extent via N-dealkylation and oxidation via cytochrome P450 2D6. After a single oral administration of 14C-nebivolol, 38% of the dose was recovered in urine and 44% in feces for EMs and 67% in urine and 13% in feces for PMs.<br />\r\n<br />\r\n<strong>Digoxin</strong>: Concomitant administration of Nebivolol (10 mg once daily) and digoxin (0.25 mg once daily) for 10 days in 14 healthy adult individuals resulted in no significant changes in the pharmacokinetics of digoxin or nebivolol.<br />\r\n<br />\r\n<strong>Warfarin</strong>: Administration of Nebivolol (10 mg once daily for 10 days) led to no significant changes in the pharmacokinetics of nebivolol or R- or S-warfarin following a single 10 mg dose of warfarin. Similarly, nebivolol has no significant effects on the anticoagulant activity of warfarin, as assessed by Prothrombin time and INR profiles from 0 to 144 hours after a single 10 mg warfarin dose in 12 healthy adult volunteers. The starting dose should be reduced in patients with moderate hepatic impairment. No formal studies have been performed in patients with severe hepatic impairment and nebivolol should be contraindicated for these patients.</p>', '<p>The dose of Nebivolol should be individualized to the needs of the patient. For most patients, the recommended starting dose is 5 mg once daily, with or without food, as monotherapy or in combination with other agents. For patients requiring further reduction in blood pressure, the dose can be increased at 2-week intervals up to 40 mg. A more frequent dosing regimen is unlikely to be beneficial.</p>', '<p>Nebivolol should be used with care when myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide, are used concurrently. Both digitalis glycosides and &beta;-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.<br />\r\n<br />\r\nNebivolol should not be combined with other &beta;-blockers. Patients receiving catecholamine-depleting drugs, such as reserpine or guanethidine, should be closely monitored, because the added &beta;-blocking action of Nebivolol may produce excessive reduction of sympathetic activity. In patients who are receiving Nebivolol and clonidine, Nebivolol should be discontinued for several days before the gradual tapering of clonidine.<br />\r\n<br />\r\nCYP2D6 Inhibitors: Use caution when Nebivolol is co-administered with CYP2D6 inhibitors (quinidine, propafenone, fluoxetine, paroxetine, etc.)</p>', '<p>Nebivolol is contraindicated in patients with severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome (unless a permanent pacemaker is in place), or severe hepatic impairment (Child-Pugh &gt;B), and in patients who are hypersensitive to any component of this product.</p>', '<p>Headache, nausea and bradycardia.</p>', NULL, '<p><strong>Abrupt Cessation of Therapy</strong>: Patients with coronary artery disease treated with Nebivolol should be advised against abrupt discontinuation of therapy. Severe exacerbation of angina and the occurrence of myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following the abrupt discontinuation of therapy with &beta;-blockers. Myocardial infarction and ventricular arrhythmias may occur with or without preceding exacerbation of the angina pectoris. Even patients without overt coronary artery disease should be cautioned against interruption or abrupt discontinuation of therapy. As with other &beta;-blockers, when discontinuation of Nebivolol is planned, patients should be carefully observed and advised to minimize physical activity. Nebivolol should be tapered over 1 to 2 weeks when possible. If the angina worsens or acute coronary insufficiency develops, it is recommended that Nebivolol be promptly reinstituted, at least temporarily.<br />\r\n<br />\r\n<strong>Cardiac Failure</strong>: Sympathetic stimulation is a vital component supporting circulatory function in the setting of congestive heart failure, and (&beta;-blockade may result in further depression of myocardial contractility and precipitate more severe failure. In patients who have compensated congestive heart failure, Nebivolol should be administered cautiously. If heart failure worsens, discontinuation of Nebivolol should be considered.<br />\r\n<br />\r\n<strong>Angina and Acute Myocardial Infarction</strong>: Nebivolol was not studied in patients with angina pectoris or who had a recent Ml.<br />\r\n<br />\r\n<strong>Bronchospastic Diseases</strong>: In general, patients with bronchospastic diseases should not receive (3-blockers.<br />\r\n<br />\r\n<strong>Anesthesia and Major Surgery</strong>: If Nebivolol is to be continued perioperatively, patients should be closely monitored when anesthetic agents which depress myocardial function, such as ether, cyclopropane, and trichloroethylene, are used. If &beta;-blocking therapy is withdrawn prior to major surgery, the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures. The &beta;-blocking effects of Nebivolol can be reversed by &beta;-agonists, e.g., dobutamine or isoproterenol. However, such patients may be subject to protracted severe hypotension. Additionally, difficulty in restarting and maintaining the heartbeat has been reported with (&beta;-blockers).<br />\r\n<br />\r\n<strong>Diabetes and Hypoglycemia</strong>: &beta;-blockers may mask some of the manifestations of hypoglycemia, particularly tachycardia. Nonselective &beta;-blockers may potentiate insulin-induced hypoglycemia and delay recovery of serum glucose levels. It is not known whether nebivolol has these effects. Patients subject to spontaneous hypoglycemia, or diabetic patients receiving insulin or oral hypoglycemic agents, should be advised about these possibilities and nebivolol should be used with caution.<br />\r\n<br />\r\n<strong>Thyrotoxicosis</strong>: &beta;-blockers may mask clinical signs of hyperthyroidism, such as tachycardia. Abrupt withdrawal of &beta;-blockers may be followed by an exacerbation of the symptoms of hyperthyroidism or may precipitate a thyroid storm.<br />\r\n<br />\r\n<strong>Peripheral Vascular Disease</strong>: &beta;-blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. Caution should be exercised in these patients.<br />\r\n<br />\r\n<strong>Non-dihydropyridine Calcium Channel Blockers</strong>: Because of significant negative inotropic and chronotropic effects in patients treated with &beta;-blockers and calcium channel blockers of the verapamil and diltiazem type, caution should be used in patients treated concomitantly with these agents and ECG and blood pressure should be monitored.</p>', NULL, '<p>Beta-adrenoceptor blocking drugs, Beta-blockers.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Impaired Renal Function</strong>: Nebivolol should be used with caution in patients with severe renal impairment because of decreased renal clearance. Nebivolol has not been studied in patients receiving dialysis.<br />\r\n<br />\r\n<strong>Impaired Hepatic Function</strong>: Nebivolol should be used with caution in patients with moderate hepatic impairment because of decreased metabolism. Since Nebivolol has not been studied in patients with severe hepatic impairment, Nebivolol is contraindicated in this population.&nbsp;<br />\r\n<br />\r\n<strong>Risk of Anaphylactic Reactions</strong>: While taking &beta;-blockers, patients with a history of severe anaphylactic reactions to a variety of allergens may be more reactive to repeated challenges either accidental, diagnostic, or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reactions.</p>', '2022-03-10 21:08:16', '2022-03-10 21:08:16'),
(1025, 1025, '<p>Nedocromil inhaler is indicated for&nbsp;maintenance therapy&nbsp;in the management of adult and&nbsp;pediatric&nbsp;patients 6 years and older with mild to moderate&nbsp;asthma. Nedocromil&nbsp;inhaler is not indicated for the reversal of&nbsp;acute&nbsp;bronchospasm.</p>', '<p>Nedocromil is a mast-cell stabiliser. It inhibits mediator release and bronchoconstriction induced by various stimuli and affects various inflammatory cells.</p>', '<p>The recommended dosage for adult and pediatric patients 6 years of age and older is two inhalations four times a day at regular intervals, which provides a dose of 14 mg per day. In patients whose asthma is well controlled on this dosage (e.g., patients who only need occasional inhaled or oral beta2-agonists and who are not experiencing serious exacerbations), less frequent administration may be effective.<br />\r\n<br />\r\nEach Nedocromil Inhaler canister must be primed with 3 actuations prior to the first use. If a canister remains unused for more than 7 days, then it should be reprimed with 3 actuations. Nedocromil Inhaler may be added to the patient&#39;s existing treatment&nbsp;regimen&nbsp;(e.g., bronchodilators). When a clinical response to Nedocromil Inhaler is evident and if the patient&#39;s asthma is under good control, an attempt may be made to decrease concomitant medication usage gradually. Proper inhalational technique is&nbsp;essential&nbsp;(see&nbsp;Patient Instructions&nbsp;for Use). Patients should be advised that the optimal effect of Nedocromil &nbsp;therapy&nbsp;depends upon its administration at regular intervals, even during symptom-free periods.</p>', '<p>In clinical studies, Nedocromil inhalation aerosol has been co-administered with other anti-asthma medications, including inhaled and oral bronchodilators, and inhaled corticosteroids, with no evidence of increased frequency of adverse events or laboratory abnormalities. No formal drug-drug interaction studies, however, have been conducted.</p>', '<p>Nedocromil inhalation aerosol inhaler is contraindicated in patients who have shown hypersensitivity to nedocromil sodium or other ingredients in this preparation.</p>', '<p>Unpleasant taste, headache, fatigue, nausea, vomiting, dyspepsia, diarrhoea, abdominal pain, conjunctivitis, cough, pharyngitis, rhinitis, upper respiratory infection.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. Reproduction studies performed in mice, rats, and rabbits using a subcutaneous dose of 100 mg/kg/day (approximately 30 times, 60 times, and 116 times, respectively, the maximum recommended human daily inhalation dose on a mg/m2&nbsp;basis) revealed no evidence of teratogenicity or harm to the&nbsp;fetus&nbsp;due to nedocromil sodium. There are, however, no adequate and well-controlled studies in&nbsp;pregnant&nbsp;women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>:&nbsp;It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Nedocromil inhalation aerosol is administered to a nursing woman.</p>', '<p>Pregnancy and lactation. Not for use in acute asthma attacks; acute bronchospasm. Children &lt;6 yr; monitor closely.</p>', NULL, '<p>Cromoglycate &amp; related drugs</p>', '<p>Store at 2-30&deg; C. Do not freeze.</p>', '<p><strong>Pediatric Use</strong>:&nbsp;The safety and effectiveness of Nedocromil inhalation aerosol in patients below the age of 6 years have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>:&nbsp;Clinical studies of Nedocromil inhalation aerosol did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.</p>', '2022-03-10 21:10:54', '2022-03-10 21:10:54');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(1026, 1026, '<p>Nefopam Hydrochloride is indicated for the relief of acute pain, including post-operative, dental, musculo-skeletal and acute traumatic pain. It is also indicated in chronic pain like cancer pain.</p>', '<p>Nefopam is a non-opioid analgesic and though it acts centrally, its mechanism is not defined. It also exerts antimuscarinic and sympathomimetic actions.</p>', '<p>Tablet-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: Dosage may range from 30 to 90 mg three times daily depending on response. The recommended starting dosage is 2 tablets three times daily.&nbsp;</li>\r\n	<li><strong>Elderly</strong>: Elderly patients may require reduced dosage due to slower metabolism. It is strongly recommended that the starting dose does not exceed 1 tablet 3 times daily.</li>\r\n</ul>\r\n\r\n<p>Injection-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 20 mg by IM injection, repeated every 6 hours if necessary. It also be given by slow IV injection in similar dose.</li>\r\n	<li><strong>Children</strong>: Not recommended for children under the age of 12 years.&nbsp;</li>\r\n</ul>', NULL, '<p>Nefopam Hydrochloride is contraindicated in patients with a history of convulsive disorders and should not be given to patients taking monoamine oxidase (MAO) inhibitors. It is also should not be used in the treatment of myocardial infarction.</p>', '<p>Nefopam Hydrochloride is generally well tolerated. However the most common side-effects are nausea, nervousness, dry mouth, lightheadedness and urinary retention.The less common side-effects are vomiting, blurred vision, drowsiness, sweating, insomnia, headache, confusion, hallucinations, tachycardia and aggravation of angina.</p>', '<p><strong>Pregnancy:</strong>&nbsp;Nefopam Hydrochloride is not recommended for pregnant women.<br />\r\n<br />\r\n<strong>Lactation:</strong>&nbsp;Evidence suggests that nefopam is excreted in human milk. A decision should made whether to discontinue nursing or discontinue the medication, taking into account the potential for adverse effects for the foetus and the importance of treatment to the mother.</p>', '<p>Nefopam Hydrochloride should be used with caution in patients with glaucoma and with or at risk of urinary retention. Caution should be exercised when Nefopam is administered concurrently with tricyclic antidepressants. Caution should also be exercised in patients with a history of ischaemic heart disease.</p>', '<p>Nefopam toxicity is manifested by neurological symptoms (convulsions, hallucinations, agitation) and cardiovascular response (tachycardia with hyperdynamic circulation). Supportive treatment is suggested including gastric lavage, forced emesis and diuresis. Oral administration of activated charcoal may help prevent absorption. Convulsions and hallucinations may be controlled with diazepam. Beta-adrenergic blockers may be of use in controlling the cardiovascular complications.</p>', '<p>Non opioid analgesics, Non-Opioid Analgesics</p>', NULL, NULL, '2022-03-10 21:12:46', '2022-03-10 21:12:46'),
(1027, 1027, '<p>Nelfinavir is indicated for the treatment of HIV infection when antiretroviral therapy is warranted.</p>', '<p>Nelfinavir is a selective, competitive, reversible HIV protease inhibitor. It inhibits HIV-1 protease preventing the cleavage of the gag-pol polyprotein resulting in the production of noninfectious virus.</p>', '<p><strong>Adults</strong>: The recommended dose is 1250 mg (five 250 mg tablets) twice daily or 750 mg (three 250 mg tablets) three times daily. Nelfinavir should be taken with a meal. Antiviral activity is enhanced when Nelfinavir is administered in combination with nucleoside analogues. Therefore, it is recommended that Nelfinavir should be used in combination with nucleoside analogues.<br />\r\n<br />\r\n<strong>Paediatric patients (2-13 years)</strong>: The recommended oral dose of Nelfinavir for paediatric patients 2 to 13 years of age is 20-30 mg/kg per dose, three times daily with a meal.</p>', '<p>Reduced levels/effects with antacids, phenobarbital, carbamazepine, aminoglutethimide, phenytoin, rifampicin, nafcillin, nevirapine, omeprazole, nevirapine. Increased serum levels/effects with azole antifungal agents, cimetidine, efavirenz. Increased serum levels/effects of azithromycin, calcium channel blockers, clarithromycin, corticosteroids (e.g. fluticasone), mirtazapine, nateglinide, nefazodone, ciclosporin, sirolimus, tacrolimus, venlafaxine, eplerinone, fentanyl, atorvastatin, phosphodiesterase-5 (PDE-5) inhibitors, rifabutin, trazodone, TCAs. Reduced serum levels/effects of hormonal contraceptives, methadone, theophylline derivatives.</p>', '<p>Nelfinavir is contraindicated in patients with clinically significant hypersensitivity to any of its components. Co-administration of Avifix is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening adverse events.</p>', '<p>The safety of Nelfinavir was studied in over 1500 patients who received drug either alone or in combination with nucleoside analogues. The majority of adverse events were of mild intensity. The most frequently reported adverse event among patients receiving Nelfinavir was diarrhoea, which was generally of mild to moderate intensity. Adverse events occurring in less than 2% of patients receiving Nelfinavir in all phase II/III clinical trials and considered at least possibly related or of unknown relationship to treatment and of at least moderate severity are listed below.<br />\r\n<br />\r\n<strong>General</strong>: Abdominal pain, accidental injury, allergic reaction, asthenia, back pain, fever, headache, malaise, pain and redistribution/accumulation of body fat.<br />\r\n<br />\r\n<strong>Digestive system</strong>: Anorexia, dyspepsia, epigastric pain, gastrointestinal bleeding, hepatitis, mouth ulceration, pancreatitis and vomiting.<br />\r\n<br />\r\n<strong>Haemic/Lymphatic system</strong>: Anaemia, leukopenia and thrombocytopenia.<br />\r\n<br />\r\n<strong>Metabolic/Nutritional</strong>: Increase in alkaline phosphate, amylase, creatinine phosphokinase, lactic dehydrogenase, SGOT, SGPT and g glutamyl transpeptidase, hyperlipaemia, hyperuricaemia, hyperglycaemia, hypoglycaemia, dehydration and liver function tests abnormal.<br />\r\n<br />\r\n<strong>Musculoskeletal system</strong>: Arthralgia, arthritis, cramps, myalgia, myasthenia and myopathy.<br />\r\n<br />\r\n<strong>Nervous system</strong>: Anxiety, depression, dizziness, emotional lability, hyperkinesia, insomnia, migraine, paraesthesia, seizures, sleep disorder, somnolence and suicide ideation.<br />\r\n<br />\r\n<strong>Respiratory system</strong>: Dyspnoea, pharyngitis, rhinitis and sinusitis.<br />\r\n<br />\r\n<strong>Skin/Appendages</strong>: Dermatitis, folliculitis, fungal dermatitis, maculopapular rash, pruitus, sweating, and urticaria.<br />\r\n<br />\r\n<strong>Ophthalmic</strong>: Acute iritis and eye disorder.<br />\r\n<br />\r\n<strong>Urogenital system</strong>: Kidney calculas, sexual dysfunction.</p>', '<p>Pregnancy Category B. There are no adequate and well controlled studies in pregnant women.<br />\r\n<br />\r\nLactation: The US Public Health Service Centers for Disease Control and Prevention advises HIV-infected women not to breast-feed to avoid postnatal transmission of HIV to a child.</p>', '<p>Nelfinavir should not be administered concurrently with Terfenadine, Astemizole, Cisapride, Triazolam, Midazolam, Ergot derivatives, Amiodarone or Quinidine because Nelfinavir may affect the hepatic metabolism of these drugs and create potential for serious and/or life-threatening adverse events. New onset diabetes mellitus, exacerbation of pre-existing diabetes mellitus and hyperglycaemia have been reported during post-marketing surveillance in HIV-infected patients receiving protease inhibitor therapy. Some patients required either initiation or dose adjustments of insulin or oral hypoglycaemic agents for treatment of these events. In some cases diabetic ketoacidosis has occurred. In those patients who discontinued protease inhibitor therapy, hyperglycaemia persisted in some cases.<br />\r\n<br />\r\n<strong>General:</strong>&nbsp;Nelfinavir is principally metabolised by the liver. Therefore, caution should be exercised when administering this drug to patients with hepatic impairment.<br />\r\n<br />\r\n<strong>Haemophilia:</strong>&nbsp;There have been reports of increased bleeding, including spontaneous skin haematomas and haemarthrosis, in patients with haemophilia type A and B treated with protease inhibitors. In some patients, additional factor VIII was given. In more than half of the reported cases, treatment with protease inhibitors was continued or reintroduced. A causal relationship has not been established.</p>', NULL, '<p>Drugs for HIV / Anti-retroviral drugs</p>', '<p>Store at 15-30&deg; C.</p>', '<p><strong>Paediatric use:</strong>&nbsp;The safety, effectiveness and pharmacokinetics of Nelfinavir have not been evaluated in paediatric patients below the age of 2 years.</p>', '2022-03-10 21:23:22', '2022-03-10 21:23:22'),
(1028, 1028, '<p>This is indicated in the treatment of topical bacterial infections. This is particularly effective in atopic, contact stasis and infections, eczematoid dermatitis, neurodermatitis, eczema, anogenital pruritus. It may also be useful as an adjunct in certain pyodermas, such as impetigo, during specific systemic antibiotic therapy for these infections.</p>', '<p><strong>Bacitracin</strong>&nbsp;inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.<br />\r\n<br />\r\n<strong>Neomycin</strong>, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram negative aerobes and against some strains of staphylococci.</p>', '<p><strong>Ointment:</strong>&nbsp;Before use, the area for application should be cleaned gently. Derbis such as pus or crusts should be removed from the affected area. Apply two to three times daily to the affected skin area.<br />\r\n<br />\r\n<strong>Dusting Powder:</strong>&nbsp;Antibiotic powder is a non- sterile dusting powder and used for superficial skin infections. A light dusting of the powder to be applied to the affected skin area upto 4 times daily.</p>', '<p><strong>Bacitracin Zinc:</strong>&nbsp;Increased risk of nephrotoxicity when used with other nephrotoxic drugs. May enhance the action of neuromuscular-blocking agents.<br />\r\n<br />\r\n<strong>Neomycin Sulphate:</strong>&nbsp;Additive nephrotoxic and neurotoxic effect with other aminoglycosides, bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin. Enhanced toxicity with potent diuretics. May impair the absorption of other drugs. May enhance the effect of acarbose. May enhance the effect of non-depolarising muscle relaxants. May antagonise the parasympathomimetic effect of neostigmine and pyridostigmine. May increase the risk of hypocalcaemia in patients receiving bisphosphonates. May alter INR when givenwithanticoagulants. May inactivate oral typhoid vaccine.</p>', '<p>Hypersensitivity to any of its components.</p>', '<p>This preparation&nbsp;is usually well tolerated. In rare cases, allergic reactions may be occurred.</p>', '<p>The safe use of this preparation during pregnancy &amp; lactation has not been established. Therefore it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Bacitracin &amp; Neomycin antibiotic powder should not be used to large open wounds or to severely injured skin or on areas that exude large volumes of fluid as hard crusts may form. Since this&nbsp;skin ointment contains Neomycin, it should not be used for the treatment of otitis external when the eardrum is perforated because of risk of ototoxicity.<br />\r\n<br />\r\nPatients considering self-medication with a topical anti-infective for deep or puncture wounds, animal bites, or serious burns should be advised to first consult a physician. Patients using the preparations for the prevention of infection in minor skin injuries (e.g., cuts, scrapes, burns) should be advised to discontinue the topical anti-infective preparation and consult a physician if the condition persists or worsens; it should not be used for longer than 1 week unless directed by a physician.</p>', NULL, '<p>Ophthalmic and Topical antibacterial products.</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', '<p><strong>Children and Infants</strong>: This ointment is suitable for use in children at the same dose as adults, but the dose should be reduced in infants. This ointment is not recommended for use in neonates.</p>', '2022-03-10 21:25:58', '2022-03-10 21:25:58'),
(1029, 1029, '<p>This is indicated in the treatment of topical bacterial infections. This is particularly effective in atopic, contact stasis and infections, eczematoid dermatitis, neurodermatitis, eczema, anogenital pruritus. It may also be useful as an adjunct in certain pyodermas, such as impetigo, during specific systemic antibiotic therapy for these infections.</p>', '<p><strong>Bacitracin</strong>&nbsp;inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.<br />\r\n<br />\r\n<strong>Neomycin</strong>, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram negative aerobes and against some strains of staphylococci.</p>', '<p><strong>Ointment:</strong>&nbsp;Before use, the area for application should be cleaned gently. Derbis such as pus or crusts should be removed from the affected area. Apply two to three times daily to the affected skin area.<br />\r\n<br />\r\n<strong>Dusting Powder:</strong>&nbsp;Antibiotic powder is a non- sterile dusting powder and used for superficial skin infections. A light dusting of the powder to be applied to the affected skin area upto 4 times daily.</p>', '<p><strong>Bacitracin Zinc:</strong>&nbsp;Increased risk of nephrotoxicity when used with other nephrotoxic drugs. May enhance the action of neuromuscular-blocking agents.<br />\r\n<br />\r\n<strong>Neomycin Sulphate:</strong>&nbsp;Additive nephrotoxic and neurotoxic effect with other aminoglycosides, bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin. Enhanced toxicity with potent diuretics. May impair the absorption of other drugs. May enhance the effect of acarbose. May enhance the effect of non-depolarising muscle relaxants. May antagonise the parasympathomimetic effect of neostigmine and pyridostigmine. May increase the risk of hypocalcaemia in patients receiving bisphosphonates. May alter INR when givenwithanticoagulants. May inactivate oral typhoid vaccine.</p>', '<p>Hypersensitivity to any of its components.</p>', '<p>This preparation&nbsp;is usually well tolerated. In rare cases, allergic reactions may be occurred.</p>', '<p>The safe use of this preparation during pregnancy &amp; lactation has not been established. Therefore it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Bacitracin &amp; Neomycin antibiotic powder should not be used to large open wounds or to severely injured skin or on areas that exude large volumes of fluid as hard crusts may form. Since this&nbsp;skin ointment contains Neomycin, it should not be used for the treatment of otitis external when the eardrum is perforated because of risk of ototoxicity.<br />\r\n<br />\r\nPatients considering self-medication with a topical anti-infective for deep or puncture wounds, animal bites, or serious burns should be advised to first consult a physician. Patients using the preparations for the prevention of infection in minor skin injuries (e.g., cuts, scrapes, burns) should be advised to discontinue the topical anti-infective preparation and consult a physician if the condition persists or worsens; it should not be used for longer than 1 week unless directed by a physician.</p>', NULL, '<p>Ophthalmic and Topical antibacterial products</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', '<p><strong>Children and Infants</strong>: This ointment is suitable for use in children at the same dose as adults, but the dose should be reduced in infants. This ointment is not recommended for use in neonates.</p>', '2022-03-10 21:28:17', '2022-03-10 21:28:17'),
(1030, 1030, '<p>This ophthalmic ointment or drop is indicated for the topical treatment of superficial infections of the external eye and its adnexa caused by susceptible bacteria. Such infections encompass conjunctivitis, keratitis and keratoconjunctivitis, blepharitis and blepharoconjunctivitis.</p>', '<p><strong>Neomycin</strong>, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram-negative aerobes and against some strains of staphylococci.<br />\r\n<br />\r\n<strong>Bacitracin</strong>, on the other hand, inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.<br />\r\n<br />\r\n<strong>Polymyxin B</strong>&nbsp;disrupts the bacterial cytoplasmic membrane of mostly gm-ve organisms allowing leakage of intracellular constituents by binding to membrane phospholipids.</p>', '<p><strong>Eye Drop</strong>: 1-2 drops 3-4 times daily.<br />\r\n<br />\r\n<strong>Eye ointment</strong>: Apply 1/2 inch ribbon of ointment to conjunctival sac of affected eye(s) q3-4hr for 7-10 days for acute infections</p>', NULL, '<p>Hypersensitivity</p>', '<p>Rash, itching, burning, anaphylactic reactions, swelling, conjunctival erythema.</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<br />\r\n<br />\r\nLactation: Excretion in breast milk unknown; caution should be taken</p>', '<p>Excessive use of the topical preparation may lead to substantial systemic absorption which may lead to nephrotoxicity (polymyxin B sulfate) and neurotoxicity (bacitracin). Prolonged use of the antibacterial preparation may cause overgrowth of non-susceptible organisms, including fungi. Pregnancy and lactation.</p>', NULL, '<p>Aural Anti-bacterial preparations, Ophthalmic antibacterial drugs</p>', NULL, '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-03-10 21:31:36', '2022-03-10 21:31:36'),
(1031, 1031, '<p>This is a first aid cream. It prevents infections and provides temporary relief of pain or discomfort in minor cuts, scrapes and burns.</p>', '<p>This cream is a combination of Neomycin, Polymyxin B and Pramoxine HCl.<br />\r\n<br />\r\n<strong>Neomycin</strong>&nbsp;is a bactericidal for many gram positive and gram-negative organisms. It is an aminoglycoside antibiotic which inhibits protein synthesis by binding with ribosomal RNA and causing misreading of the bacterial genetic code.<br />\r\n<br />\r\n<strong>Polymyxin B</strong>&nbsp;is bactericidal for a variety of gram-negative organisms. It increases the permeability of the bacterial cell membrane by interacting with the phospholipids components of the membrane.<br />\r\n<br />\r\n<strong>Pramoxine</strong>&nbsp;is an external analgesic that provides temporary relief of pain or discomfort.</p>', '<p>Clean the affected area. Apply a small amount of product (an amount equal to the surface area of the tip of a finger). May be covered with a sterile bandage.</p>', NULL, '<p>Neomycin, Polymyxin B and Pramoxine HCl cream should not be administered to individuals who are hypersensitive to Neomycin, Polymyxin B, Pramoxine or any other components of this product.</p>', '<p>Topical antibiotics, particularly Neomycin sulphate, may cause cutaneous sensitization. The manifestations of sensitization to topical antibiotics are usually itching and reddening. When used in small doses, no common side effects have been reported with this product.</p>', '<p>Use Neomycin, Polymyxin B and Pramoxine HCl during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in breast milk. Exercise caution when applying Nepranol to a nursing mother.</p>', '<p>Do not use this medication in the eyes or apply to large areas of the body. Do not use longer than one week unless directed by the physician.</p>', NULL, '<p>Anti-infective &amp; Anesthetic combined preparations.</p>', '<p>Store in a dry and cool place protected from light and moisture.</p>', '<p>Safety and effectiveness in children below 2 years of age have not been established.</p>', '2022-03-10 21:42:34', '2022-03-10 21:42:34'),
(1032, 1032, '<p><strong>Neostigmine Methyl Sulphate is indicated for</strong>-</p>\r\n\r\n<ul>\r\n	<li>Reversal of nondepolarising neuromuscular blockade for surgical anesthetic procedures</li>\r\n	<li>The prevention and treatment of post-operative abdominal distention and urinary retention after mechanical obstruction has been excluded.</li>\r\n	<li>Treatment of the systemic control of Myasthenia Gravis when oral therapy is impractical.</li>\r\n</ul>', '<p>Neostigmine is a parasympathomimetic, specifically, a reversible cholinesterase inhibitor. By interfering with the breakdown of acetylcholine, Neostigmine indirectly stimulates both nicotinic and muscarinic receptors. It does cross the blood-brain barrier but only poorly. Neostigmine binds to the anionic site of cholinesterase. The drug blocks the active site of acetylcholinesterase; so the enzyme can no longer break down the acetylcholine molecules before they reach the postsynaptic membrane receptors. This allows for the threshold to be reached so a new impulse can be triggered in the next neuron. In myasthenia gravis there are too few acetylcholine receptors. So with the acetylcholinesterase blocked, acetylcholine can bind to the few receptors and trigger a muscular contraction.</p>', '<p><strong>Reversal of the effects of Non-depolarizing Neurormuscular Blocking Agents</strong>: The usual dose is 0.5 to 2 mg given by slow intravenous injection over 60 seconds; repeated as required. Total dose should not exceed 5 mg (in exceptional cases). When Neostigmine is administered intravenously, it is recommended that Atropine Sulphate (0.6-1.2 mg) also be given intravenously using separate syringe.<br />\r\n<br />\r\n<strong>Prevention of post-operative abdominal distention and urinary retention:</strong>&nbsp;0.25 mg intramuscularly or subcutaneously as soon as possible after operation; repeat every 4 6 hours for 2-3 days.<br />\r\n<br />\r\n<strong>Treatment of post-operative abdominal distention</strong>: 0.5 mg intramuscularly or subcutaneously or as required.<br />\r\n<br />\r\n<strong>Treatment of urinary retention:</strong>&nbsp;0.5 mg intramuscularly or subcutaneously. If urination does not occur within an hour, the patient should be catheterized. After the patient has voided, or the bladder has been emptied, continue the 0.5 mg injection every 3 hours, for at least 5 injections.<br />\r\n<br />\r\n<strong>Symptomatic control of Myasthenia Gravis:</strong>&nbsp;0.5 mg intramuscularly or subcutaneously. Subsequent dose should be based on the individual patient&#39;s response.<br />\r\n<br />\r\n<strong>Neonates:</strong>&nbsp;50-250 micrograms (0.1 to 0.5 ml) every 4 hours.<br />\r\n<br />\r\n<strong>Children:</strong>&nbsp;200-500 micrograms (0.4 ml to 1 ml) as recommended.</p>', '<p>Anti-arrhythmic Procainamide, Quinidine and possibly Propafenone antagonise effect of Neostigmine. Antibacterials, Aminoglycosides, Clindamycin, Lincomycin and Polymyxins antagonise effect of Neostigmine.</p>', '<p>Neostigmine is contraindicated in patients with known hypersensitivity to the drug. It is also contraindicated in patients with peritonitis or mechanical obstruction of the intestinal or urinary tract.</p>', '<p>Nausea, vomiting, increased salivation, diarrhoea and abdominal cramps (more marked with high doses). Signs of overdose are increased gastrointestinal discomfort, bronchial secretions and sweating, involuntary defecation and micturition, miosis, nystagmus, bradycardia, hypotension, agitation, excessive dreaming and weakness eventually leading to fasciculation and paralysis.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category C. There are no adequate or well-controlled studies of Neostigmine in either laboratory animals or in&nbsp;pregnantwomen. It is not known whether Neostigmine can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Neostigmine should be given to a pregnant woman only if clearly needed.<br />\r\n<br />\r\n<strong>Nonteratogenic Effects</strong>: Anticholinesterase drugs may cause uterine irritability and induce premature&nbsp;labor&nbsp;when given intravenously to pregnant women near term.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether Neostigmine is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions from Neostigmine 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>Asthma, bradycardia, recent myocardial infarction, epilepsy, hypotension, parkinsonism, vagotonia, peptic ulceration. Atropine or other antidote to muscarinic effccts may be necessary (particularly when Neostigmine is given by injection), but it should not be given routinely as it may mask signs of overdose.</p>', NULL, '<p>Anti-cholinesterases, Drugs used in Myasthenia Gravis</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-10 21:45:01', '2022-03-10 21:45:01'),
(1033, 1033, '<p><strong>Nepafenac 0.1% Sterile Ophthalmic Suspension</strong>: The treatment of post-operative ocular pain and inflammation including cataract surgery Inhibition of surgery induced miosis and Prevention of post-operative cystoid macular edema (CME).<br />\r\n<br />\r\n<strong>Nepafenac 0.3% Sterile Ophthalmic Suspension</strong>: Post-operative pain and inflammation associated with cataract surgery.</p>', '<p>Nepafenac is a nonsteroidal anti-inflammatory prodrug (NSAID). After instillation in the eye, it penetrates the cornea and is converted by ocular tissue hydrolase to Amfenac, a potent nonsteroidal anti-inflammatory drug. Amfenac is thought to inhibit the action of cyclooxygenase enzyme. This enzyme is required for prostaglandin synthesis.</p>', '<p>Nepafenac 0.1% Sterile Ophthalmic Suspension-</p>\r\n\r\n<ul>\r\n	<li><strong>For post-operative pain &amp; inflammation:</strong>&nbsp;Instill 1 drop 3 times daily 1 day prior to cataract surgery and continued on the day of surgery and through the first 2 weeks of the post-operative period.</li>\r\n	<li><strong>For surgery induced miosis</strong>: Instill 1 drop 3 times daily 1 day before surgery &amp; on the day of surgery.</li>\r\n	<li><strong>For prevention of post-operative CME:</strong>&nbsp;Instill 1 drop 3 times daily 1 day before surgery and continued on the day of surgery and through the first 6 weeks of the post-operative period.</li>\r\n</ul>\r\n\r\n<p>Nepafenac 0.3% Sterile Ophthalmic Suspension-</p>\r\n\r\n<ul>\r\n	<li><strong>For post-operative pain &amp; inflammation:</strong>&nbsp;Instill 1 drop once daily 1 day prior to cataract surgery and continued on the day of surgery and through the first 2 weeks of the post-operative period. An additional drop should be administered 30 to 120 minutes prior to surgery.</li>\r\n</ul>', NULL, '<p>Contraindicated in patients with previously demonstrated hypersensitivity to any of the ingredients in the formulation or to other NSAIDs.</p>', '<p>Reported side effects are foreign body sensation, lid margin crusting, ocular discomfort, ocular hyperemia etc.</p>', '<p><strong>Use in pregnancy:</strong>&nbsp;There are no adequate and well-controlled studies in pregnant women. Nepafenac should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Use in lactation:&nbsp;</strong>It is not known whether this drug is excreted in human milk. So, caution should be exercised when Nepafenac ophthalmic suspension is administered to a nursing mother.</p>', '<p>Nepafenac should be used with caution in patients with known bleeding tendencies or who are receiving medications which may prolong bleeding time.</p>', NULL, '<p>Ophthalmic Non-Steroid drugs.</p>', NULL, '<p><strong>Use in children</strong>: Safety and effectiveness in pediatric patients below 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety or effectiveness have been observed between elderly and younger patients.</p>', '2022-03-10 21:47:09', '2022-03-10 21:47:09'),
(1034, 1034, '<p>Neratinib is a kinase inhibitor indicated for the extended adjuvant treatment of adult patients with early stage HER2-overexpressed/amplified breast cancer, to follow adjuvant trastuzumab-based therapy.</p>', '<p>Neratinib is a kinase inhibitor that irreversibly binds to Epidermal Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor 2 (HER2), and HER4. In vitro, neratinib reduces EGFR and HER2 autophosphorylation, downstream MAPK and AKT signaling pathways, and showed antitumor activity in EGFR and/or HER2 expressing carcinoma cell lines. Neratinib human metabolites M3, M6, M7 and M11 inhibited the activity of EGFR, HER2 and HER4 in vitro. In vivo, oral administration of neratinib inhibited tumor growth in mouse xenograft models with tumor cell lines expressing HER2 and EGFR.</p>', '<p>Antidiarrheal prophylaxis: Initiate loperamide with the first dose of Neratinib and continue during first 2 cycles (56 days) of treatment. Instruct patients to maintain 1-2 bowel movements per day and on how to use antidiarrheal treatment regimens<br />\r\n<br />\r\n<strong>Recommended dose</strong>: 240 mg (6 tablets) given orally once daily with food, continuously for one year. Dose interruptions and/or dose reductions are recommended based on individual safety and tolerability<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Reduce starting dose to 80 mg in patients with severe hepatic impairment.</p>', '<p><strong>Gastric acid reducing agents</strong>: Avoid concomitant use with proton pump inhibitors (PPI) and H2-receptor antagonists. Separate Neratinib by 3 hours after antacid dosing.<br />\r\n<br />\r\n<strong>Strong or moderate CYP3A4 inhibitors</strong>: Avoid concomitant use.<br />\r\n<br />\r\n<strong>Strong or moderate CYP3A4 inducers</strong>: Avoid concomitant use.&nbsp;<br />\r\n<br />\r\n<strong>P-glycoprotein (P-gp) substrates</strong>: Monitor for adverse reactions of narrow therapeutic agents that are P-gp substrates when used concomitantly with Neratinib.</p>', '<p>None</p>', '<p>The most common adverse reactions (&gt; 5%) were diarrhea, nausea, abdominal pain, fatigue, vomiting, rash, stomatitis, decreased appetite, muscle spasms, dyspepsia, AST or ALT increase, nail disorder, dry skin, abdominal distention, weight decreased and urinary tract infection.</p>', '<p>There are no available data in pregnant women to inform the drug-associated risk. No data are available regarding the presence of neratinib or its metabolites in human milk or its<br />\r\neffects on the breastfed infant or on milk production.</p>', '<p><strong>Diarrhea</strong>: Aggressively manage diarrhea occurring despite recommended prophylaxis with additional antidiarrheals, fluids, and electrolytes as clinically indicated. Withhold Meratinib in patients experiencing severe and/or persistent diarrhea. Permanently discontinue Meratinib in patients experiencing Grade 4 diarrhea or Grade &ge; 2 diarrhea that occurs after maximal dose reduction.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Monitor liver function tests monthly for the first 3 months of treatment, then every 3 months while on treatment and as clinically indicated. Withhold Meratinib in patients experiencing Grade 3 liver abnormalities and permanently discontinue Meratinib in patients experiencing Grade 4 liver abnormalities.<br />\r\n<br />\r\n<strong>Embryo-Fetal Toxicity</strong>: Meratinib can cause fetal harm. Advise patients of potential risk to a fetus and to use effective contraception.</p>', '<p>There is no specific antidote, and the benefit of hemodialysis in the treatment of Neratinib overdose is unknown. In the event of an overdose, administration should be withheld and general supportive measures undertaken. In the clinical trial setting, a limited number of patients reported overdose. The adverse reactions experienced by these patients were diarrhea, nausea, vomiting, and dehydration. The frequency and severity of gastrointestinal disorders (diarrhea, abdominal pain, nausea and vomiting) appear to be dose related.</p>', '<p>Tyrosine Kinase Inhibitor.</p>', '<p>Store Neratinib at room temperature between 20&deg; to 25&deg;C. Keep Neratinib and all medicines out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Neratinib in pediatric patients has not been established.</p>', '2022-03-10 21:49:18', '2022-03-10 21:49:18'),
(1035, 1035, '<p>This is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.</p>', '<p>This is a fixed-dose combination of a Rho kinase inhibitor and a Prostaglandin F2 analogue. Netarsudil is a Rho kinase inhibitor, works at the cellular level within the trabecular outflow pathway to relax actin-myosin. This causes relaxation within the trabecular meshwork and the inner wall of Schlemm&#39;s canal, and decrease episcleral venous pressure (EVP).<br />\r\n<br />\r\nLatanoprost is a selective FP receptor agonist which reduces the intraocular pressure (IOP) by increasing the outflow of aqueous humor through uveoscleral outflow.</p>', '<p>The recommended dosage is one drop in the affected eye(s) once daily in the evening.</p>', NULL, '<p>This eye drops is contraindicated in patients who are hypersensitive to any component of this preparation.</p>', '<p>The most common ocular adverse reaction observed in controlled clinical studies with Netarsudil &amp; Latanoprost was conjunctival hyperemia, instillation site pain, corneal verticillata, instillation site discomfort, foreign body sensation and blurred visions were reported in few patients.</p>', '<p>There are no adequate and well-controlled studies of Netarsudil &amp; Latanoprost combination in pregnant women to inform any drug-associated risk. There are no data on the presence of Netarsudil or Latanoprost in human milk, the effects on the breastfed infant, or the effects on milk production.</p>', '<ul>\r\n	<li>For ophthalmic use only</li>\r\n	<li>To avoid possible contamination of the drops, do not touch the dropper tip or to any surface</li>\r\n	<li>Should be used with caution in patients with active intraocular inflammation (e.g., iritis/uveits)</li>\r\n	<li>May cause changes to pigmented tissues, gradually change eyelashes and vellus hair in the treated eye</li>\r\n	<li>Cystoid macular edema, has been reported during treatment with Latanoprost. Reactivation of Herpes Simplex keratitis may occur</li>\r\n	<li>Netarsudil &amp; Latanoprost combination can be used with other topical eye drug products, but they should be administered at least 5 minutes apart from each other.</li>\r\n</ul>', NULL, '<p>Drugs for miotics and glaucoma.</p>', '<p>Store at 2&deg;-8&deg;C in a dry place, protect from light until opened. After opening the product may be kept at 2&deg;-25&deg;C for upto 6 weeks. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '2022-03-10 21:51:03', '2022-03-10 21:51:03'),
(1036, 1036, '<p>Netarsudil ophthalmic solution is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.</p>', '<p>Netarsudil is a Rho kinase inhibitor, works at the cellular level within the trabecular outflow pathway to relax actin-myosin. This causes relaxation within the trabecular meshwork and the inner wall of Schlemm&#39;s canal and decreases episcleral venous pressure (EVP).</p>', '<p>The recommended dosage is one drop in the affected eye(s) once daily in the evening.</p>', '<p>This eye drops is contraindicated in patients who are hypersensitive to any component of this preparation.</p>', NULL, '<p>The most common ocular adverse reaction observed in controlled clinical studies with Netarsudil was conjunctival hyperemia, corneal verticillata, instillation site pain, corneal staining and blurred vision.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies of Netarsudil ophthalmic solution in pregnant women to inform any drug-associated risk. However, systemic exposure to Netarsudil from ocular administration is low.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no data on the presence of Netarsudil in human milk, the effects on the breastfed infant, or the effects on milk production.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients below the age of 18 years have not been established.<br />\r\n<br />\r\n<strong>Use in elderly patients</strong>: No overall differences in safety and effectiveness have been observed between elderly and other adult patients.</p>', '<p>For ophthalmic use only. To avoid possible contamination of the drops, do not touch the dropper tip or to any surface. Netarsudil can be used with other topical eye drug products, but they should be administered at least 5 minutes apart from each other. Contact lenses should be removed prior to instillation of Netarsudil and may be reinserted 15 minutes following its administration.</p>', NULL, '<p>Drugs for miotics and glaucoma.</p>', '<p>Store at 2&deg;-8&deg;C in a dry place, protect from light until opened. After opening the product may be kept at 2&deg;-25&deg;C for upto 6 weeks. Keep out of the reach of children.</p>', NULL, '2022-03-10 21:52:46', '2022-03-10 21:52:46'),
(1037, 1037, '<p>Nevirapine is indicated for combination&nbsp;antiretroviral&nbsp;treatment of&nbsp;HIV-1 infection in adults and in pediatric patients 15 days and older.<br />\r\n<br />\r\nAdditional important information regarding the use of Nevirapine for the treatment of HIV-1 infection:</p>\r\n\r\n<ul>\r\n	<li>Based on serious and life-threatening hepatotoxicity observed in controlled and uncontrolled trials, Nevirapine should not be initiated in adult females with CD4+&nbsp;cell counts greater than 250 cells/mm&sup3; or in adult males with CD4+&nbsp;cell counts greater than 400 cells/mm&sup3; unless the benefit outweighs the risk.</li>\r\n	<li>The 14-day lead-in period with Nevirapine 200 mg daily dosing must be strictly followed; it has been demonstrated to reduce the frequency of rash.</li>\r\n	<li>If rash persists beyond the 14-day lead-in period, do not dose escalate to 200 mg twice daily. The 200 mg once-daily dosing regimen should not be continued beyond 28 days, at which point an alternative regimen should be sought.</li>\r\n</ul>', '<p>Nevirapine is a non-nucleoside reverse transcriptase inhibitor that acts against HIV-1. It binds directly to reverse transcriptase and thereby blocks the RNA-dependent and DNA-dependent DNA polymerase activities by disrupting the enzyme&#39;s catalytic site.</p>', '<p><strong>Adult Patients</strong>: The recommended dose for Nevirapine is one 200 mg tablet daily for the first 14 days, followed by one 200 mg tablet twice daily, in combination with other antiretroviral agents. The lead-in period has been observed to decrease the incidence of rash. For concomitantly administered&nbsp;antiretroviral therapy, the manufacturer&#39;s recommended dosage and monitoring should be followed.<br />\r\n<br />\r\n<strong>Pediatric Patients</strong>: The recommended oral dose for pediatric patients 15 days and older is 150 mg/m&sup2; once daily for 14 days followed by 150 mg/m&sup2; twice daily thereafter. The total daily dose should not exceed 400 mg for any patient.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food.</p>', '<p>Mutually increased levels effects when used with drugs extensively metabolised by CYP3A. Reduced levels/effects of methadone.</p>', '<p>Hypersensitivity. Lactation. Severe hepatic impairment.</p>', '<p>Skin rash, nausea, vomiting, headache, abnormal LFT, fatigue, diarrhoea, abdominal pain.</p>', '<p><strong>Nursing Mothers</strong>: The Centers for Disease Control and Prevention recommend that HIV-1 infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1. Nevirapine is excreted in breast milk. Because of both the potential for HIV-1 transmission and the potential for serious adverse reactions in nursing infants, mothers should be instructed not to breastfeed if they are receiving Nevirapine.</p>', '<p>Caution should be taken during pregnancy. Interrupt treatment if severe hepatotoxicity or life-threatening skin reactions develop. Renal or hepatic insufficiency. Monitor liver function periodically.</p>', '<p>There is no known&nbsp;antidote&nbsp;for Nevirapine overdosage. Cases of Nevirapine overdose at doses ranging from 800 to 1800 mg per day for up to 15 days have been reported. Patients have experienced events including&nbsp;edema,&nbsp;erythema nodosum, fatigue, fever, headache, insomnia, nausea, pulmonary infiltrates, rash,&nbsp;vertigo, vomiting, and weight decrease. All events subsided following discontinuation of Nevirapine.</p>', '<p>Drugs for HIV / Anti-retroviral drugs.</p>', '<p>Store at 15-30&deg; C.</p>', '<p><strong>Pediatric Use</strong>: The safety, pharmacokinetic profile, and virologic and immunologic responses of Nevirapine have been evaluated in HIV-1 infected pediatric subjects age 3 months to 18 years. The safety and pharmacokinetic profile of Nevirapine has been evaluated in HIV-1 infected pediatric subjects age 15 days to less than 3 months.<br />\r\n<br />\r\nThe most frequently reported adverse events related to Nevirapine in pediatric subjects were similar to those observed in adults, with the exception of granulocytopenia, which was more commonly observed in children receiving both&nbsp;zidovudine&nbsp;and Nevirapine.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical trials of Nevirapine did not include sufficient numbers of subjects aged 65 and older to determine whether elderly subjects respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: In subjects with renal impairment (mild, moderate or severe), there were no significant changes in the pharmacokinetics of nevirapine. Nevirapine is extensively metabolized by the liver and nevirapine metabolites are extensively eliminated by the kidney. Nevirapine metabolites may accumulate in patients receiving&nbsp;dialysis; however, the clinical significance of this accumulation is not known. No adjustment in nevirapine dosing is required in patients with CrCL greater than or equal to 20 mL per min. The pharmacokinetics of nevirapine have not been evaluated in patients with CrCl less than 20 mL per min. In patients undergoing chronic&nbsp;hemodialysis, an additional 200 mg dose following each dialysis treatment is indicated.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Because increased nevirapine levels and nevirapine accumulation may be observed in patients with serious liver disease, do not administer Nevirapine to patients with moderate or severe (Child-Pugh Class B or C, respectively) hepatic impairment.</p>', '2022-03-10 21:55:01', '2022-03-10 21:55:01');
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
(1038, 1038, '<p>Nicorandil is indicated for the prevention and long-term treatment of angina pectoris.</p>', '<p>Nicorandil dilates arterioles and large coronary arteries by opening the potassium channels, and stimulates guanylate cyclase causing venous vasodilatation. It therefore reduces preload and afterload, and improves coronary blood flow.</p>', '<p><strong>Adult</strong>: The usual therapeutic range is 10 to 20 mg twice daily. The usual&nbsp;starting dose is 10 mg twice daily, in the morning and in the evening&nbsp;preferably, and should be titrated upwards in accordance with patients needs, response and&nbsp;tolerance up to 40 mg twice daily, if necessary. An even lower starting dose of 5 mg twice daily may be used in patients particularly prone to headache.<br />\r\n<br />\r\n<strong>Eldery</strong>: There are no&nbsp;special dosage requirements for elderly patients, but as with all medicines the lowest effective&nbsp;dose should be used. Nicorandil should be administered with care, using low starting&nbsp;dosages, in the elderly.<br />\r\n<br />\r\n<strong>Children</strong>: Not recommended. Nicorandil should be used with&nbsp;caution in patients with serious hepatic dysfunction.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: Dose reduction may be necessary.</p>', '<p>Although no pharmacological and/or pharmacokinetic interaction has been obsen/ed in animal and human studies with Nicorandil associated with beta-blockers, calcium antagonists, digoxin, a combination of digoxin/furosemide, rifampicin, and cimetidine, it is not excluded that the drug may nevertheless potentiate the effect of other vasodilators, tricyclic antidepressants and antihypertensive drugs administered concurrently, especially in combination with alcohol.</p>', '<p>Nicorandil tablet is contra-indicated in patients who have shown&nbsp;hypersensitivity to Nicorandil. Use is contra-indicated with cardiogenic shock and acute&nbsp;myocardial infarction with acute left ventricular failure and low filling pressures, in patients with&nbsp;hypotension, and in patients taking phosphodiesterase-5 inhibitors because concurrent use of&nbsp;Nicorandil can lead to a serious drop in blood pressure. Warnings and precautions: Nicorandil&nbsp;should be used with caution in patients who may have blood volume depletion or in those who&nbsp;present with low systolic blood pressure (below 100 mm Hg). The use of the drug in patients with&nbsp;cardiogenic shock, or acute myocardial infarction with acute left ventricular failure and low filling&nbsp;pressures should be avoided. Nicorandil should be discontinued and appropriate measures taken&nbsp;if mouth ulceration, stomatitis or persistent or severe buccal ulcerations, appear. Caution is&nbsp;advised for the use of Nicorandil in patients with glaucoma. The hypotensive effect of other&nbsp;vasodilators, tricyclic antidepressants or alcohol can be increased by administration in&nbsp;combination with Nicorandil. Therapeutic doses of Nicorandil may lower the blood pressure of&nbsp;hypertensive patients and Nicorandil therefore, as with other antianginal agents, should be used&nbsp;with care when prescribed with antihypertensive drugs. Animal mutagenicify and carcinogenicity&nbsp;studies have not revealed any adverse effect of Nicorandil when used under experimental&nbsp;conditions.</p>', '<p>Headache (usually transitory), flushing, dizziness, nausea, vomiting and weakness. Hypotension and reflex tachycardia at high doses.</p>', '<p>Although animal studies have not shown any harmful&nbsp;effect of Nicorandil to the foetus, has not been studied in human pregnancy. Use in pregnant&nbsp;women requires that the anticipated benefit be weighed against possible hazard. It is not known&nbsp;whether the drug is excreted in human milk. Caution should be exercised when Nicorandil is&nbsp;administered to a nursing mother. Drug interactions: Although no pharmacological and/or&nbsp;pharmacokinetic interaction has been obsen/ed in animal and human studies with Nicorandil&nbsp;associated with beta-blockers, calcium antagonists, digoxin, a combination of digoxin/furosemide,&nbsp;rifampicin, and cimetidine, it is not excluded that the drug may nevertheless potentiate the effect&nbsp;of other vasodilators, tricyclic antidepressants and antihypertensive drugs administered&nbsp;concurrently, especially in combination with alcohol.</p>', '<p>Hypovolaemia, low systolic BP, acute pulmonary oedema, pregnancy. May impair ability to drive or operate machinery.</p>', '<p>ln the case of overdosage, the likely symptomatology may be peripheral vasodilation with a fall in blood pressure and reflex tachycardia. In such an event, monitoring of cardiac function and general supportive measures should be used. If not successful, circulating plasma volume should be increased by substitution of fluid. ln life-threatening situations, administration of vasopressors should be considered.</p>', '<p>Potassium-channel activator.</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-03-10 21:57:09', '2022-03-10 21:57:09'),
(1039, 1039, '<p>Niacin is indicated as an adjunct to diet for reduction of elevated TC, LDL-C, Apo B and TG level and to increase HDL-C in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia. when the response to an appropriate diet has been inadequate. In patients with a history of myocardial infarction and hypercholesterolemia, Niacin is indicated to reduce the risk of recurrent nonfatal myocardial infarction. Niacin is also indicated as adjunctive therapy for treatment of adult patients with very high serum triglyceride levels (Type IV and V hyperlipidemia) who present a risk of pancreatitis and who do not respond adequately to a determined dietary effort to control them. Prior to initiating therapy with Niacin, secondary causes for hypercholesterolemia (e.g poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemias, obstructive liver disease, other drug therapy, alcoholism) should be excluded and a lipid profile obtained to measure TC, HDL-C and TG.</p>', '<p>Niacin is a preparation of Nicotinic acid. It is proven effective at lowering VLDL, LDL, total cholesterol and triglyceride levels while raising HDL levels. So Niacin has been prescriped for the treatment of cardiovascular disease particularly the hyperlipidemias.</p>', '<p><strong>Initial Dose</strong>: 500 mg tablet at bedtime from 1 to 4 weeks.<br />\r\n<br />\r\n<strong>Maintenance Dose</strong>: the daily dosage should not be increased by more than 500 mg in any 4 week period. The recommended maintenance dose is 1000 mg (two tablet) to 2000 mg (4 tablets) once daily at bedtime. Dose greater than 2000 mg daily is not recommended. Or, as directed by the registered physician.</p>', '<p>Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. Concomitant aspirin may decrease the metabolic clearance of nicotinic acid. The clinical relevance of this finding is unclear. About 98% of available Niacin was bound to colestipol, with 10 to 30% binding to cholestyramine. These results suggest that 4 to 6 hours, or as great an interval as possible, should elapse between the ingestion of bile acid-binding resins and the administration of Niacin.</p>', '<p>Niacin is contraindicated in patients with a known hypersensitivity to Niacin or any component of this medication, significant or unexplained hepatic dysfunction, active peptic ulcer disease or arterial bleeding.</p>', '<p>Niacin is generally well tolerated; adverse reactions have been mild and transient. The most frequent advers effects were flushing, itching, pruritis, nausea and GI upset, jaundice, hypotension, tachycardia, increased serum blood glucose and uric acid levels, myalgia.</p>', '<p>Niacin cannot be used in pregnancy and lactation because of a lack of information.</p>', '<p>Before instituting therapy with Niacin, an attempt should be made to control hyperlipidemia with appropriate diet, exercise, and weight reduction in obese patients and to treat other underlying medical problems. Patients with a past history of jaundice, hepatobiliary disease, or peptic ulcer should be observed closely during Niacin therapy. Frequent monitoring of liver function tests and blood glucose should be performed to ascertain that the drug is producing no adverse effects on these organ systems. Diabetic patients may experience a dose-related rise in glucose intolerance, the clinical significance of which is unclear. Diabetic or potentially diabetic patients should be observed closely. Adjustment of diet and/or hypoglycemic therapy may be necessary.<br />\r\n<br />\r\nCaution should also be used when Niacin is used in patients with unstable angina or in the acute phase of MI, particularly when such patients are also receiving vasoactive drugs such as nitrates, calcium channel blockers or adrenergic blocking agents. Elevated uric acid levels have occurred with Niacin therapy, therefore use with caution in patients predisposed to gout. Niacin has been associated with small but statistically significant dose-related reductions in platelet count and increases in prothrombin time. Caution should be observed when Niacin is administered concomitantly with anticoagulants; prothrombin time and platelet counts should be monitored closely in such patients. Niacin has been associated with small but statistically significant, dose-related reductions in phosphorus levels (mean of -13% with 2000 mg). So phosphorus levels should be monitored periodically in patients at risk.</p>', '<p>Supportive measures should be undertaken in the event of an overdosage. Symptoms may include nausea, dizziness, itching, vomiting, upset stomach, and flushing.</p>', NULL, '<p>Store in a cool and dry place, protect from light and moisture. Keep all medicines out of the reach of the children.</p>', NULL, '2022-03-10 21:58:55', '2022-03-10 21:58:55'),
(1040, 1040, '<p>Nifedipine is indicated in the management of all types of essential &amp; renal hypertension. Also indicated in the management of hypertension during pregnancy &amp; during coronary by pass surgery.<br />\r\n<br />\r\nNifedipine is also used for prophylaxis and the treatment of unstable &amp; variant angina, myocardial infarction, and silent myocardial ischaemia. Moreover Nifedipine is also used in Raynaud&#39;s phenomenon &amp; heart failure.</p>', '<p>Nifedipine is an inhibitor of Calcium Channel Blocker that blocks the transmembrane influx of Calcium ions into muscle cells. Nifedipine has selective effects as a dilator of arterial vessels. Nifedipine dilates main coronary and systemic arteries. As a result blood pressure falls and this elicits a sympathetic reflex response causing tachycardia and an increased cardiac output. Pulmonary arterial pressure also falls. Nifedipine has direct negative inotropic effects on cardiac muscles and these effects are seen at higher doses than dose which causes arterial vasodilatation.</p>', '<p><strong>Nifedipine 10 mg:</strong></p>\r\n\r\n<ul>\r\n	<li><strong>Angina:</strong>&nbsp;Initially 10 mg 3 times daily with food increased to 20 mg 3 times daily if necessary, in elderly patients, initially 5 mg 3 times daily.</li>\r\n	<li><strong>Raynaud&#39;s Phenomenon:</strong>&nbsp;10 mg 3 times daily; maximum 60 mg daily. In urgent cases, the tablet should be dissolved under the tongue like a sublingual tablet. The effect occurs within some minutes.</li>\r\n</ul>\r\n\r\n<p><strong>Nifedipine 20 mg:&nbsp;</strong>The starting dose for patients, not previously prescribed Nifedipine products is one tablet once daily. The recommended dose in hypertension and angina prophylaxis is 20 mg twice daily during or after food. Dosage may be adjusted within the range 10 mg twice daily to 40 mg twice daily.<br />\r\n<br />\r\nPatients with liver dysfunction should commence therapy with 10 mg twice daily with careful monitoring.<br />\r\n<br />\r\nPatients with renal impairment do not require adjustment of dosage.</p>', '<p>&nbsp;</p>\r\n\r\n<ul>\r\n	<li>ACE inhibitors: Enhanced hypotensive effect.</li>\r\n	<li>Anti-arrythmics: Plasma concentration of quinidine is reduced.</li>\r\n	<li>Anti-bacterials: Rifampicin possibly increases metabolism of Nifedipine.</li>\r\n	<li>Anti-epileptics: Plasma concentration of phenytoin increases.</li>\r\n	<li>Antipsychotics: Enhanced hypotensive effect.</li>\r\n	<li>&beta;-blockers: Occasionally severe hypotension and heart failure may occur.</li>\r\n	<li>Cyclosporin: Plasma concentration of Nifedipine possibly increases.</li>\r\n	<li>Muscle relaxants: Effect of muscle relaxants e.g. tubocurarine increases.</li>\r\n	<li>Ulcer healing drugs: Metabolism of Nifedipine increases.</li>\r\n</ul>', '<p>Cardiogenic shock, advanced aortic stenosis, nursing mothers, GI obstruction, inflammatory bowel disease, hypotension.</p>', '<p>Headache, flushing, lethargy, gravitational oedema rash, nausea, increased frequency of micturation, eye pain, gum hyperplasia, depression, tremor, photosensitivity and few cases of jaundice have been reported. These reactions may regress on discontinuation of therapy. Its introduction may induce attacks of ischaemic pain in some patients with angina pectoris.</p>', '<p>There are no adequate and well controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Tablets should be swallowed whole and should not be bitten, chewed or broken up. It should be used with caution in patient whose cardiac reserve is poor. Should be withdrawn if ischaemic pain occurs or existing pain worsens shortly after initiating treatment. Use in diabetic patients requires adjustment of their control. Since the absorption of the drug could be modified by renal disease, caution should be exercised in treating such patients.</p>', NULL, '<p>Calcium-channel blockers.</p>', '<p>Protect from strong light, store in a cool place in the original pack.</p>', NULL, '2022-03-10 22:00:44', '2022-03-10 22:00:44'),
(1041, 1041, '<p>Nikethamide Injection is used for the treatment, control, prevention, &amp; improvement of the following diseases, conditions and symptoms: Central nervous system stimulant, Barbiturate overdose.</p>', '<p>Nikethamide was formerly used as a respiratory stimulant but its use for this indication is no longer recommended as the effective doses are close to those causing toxic effects (especially convulsions).</p>', '<p>1500 mg as single dose. Frequency: as recommended.</p>', '<p>Additive pressor effects with sympathomimetics or MAOIs. Increased risk of cardiac arrythmias with some anaesthetics (halothane, enflurane, isoflurane). May mask the effects of neuromuscular blockers. Increased risk of convulsions with bupropion.</p>', '<p>Porphyria, epilepsy or other convulsive disorders, cerebral oedema, cerebrovascular accident, head injury, acute severe asthma, physical obstruction of the airway, severe hypertension, ischaemic heart disease, hyperthyroidism, phaeochromocytoma.</p>', '<p>The following is a list of possible side-effects that may occur from all constituting ingredients of Nikethamide Injection: Skin irritation, Eye irritation, Respiratory irritation.</p>', NULL, '<p>Less severe degrees of hypertension or impaired cardiac reserve; liver dysfunction.</p>', NULL, '<p>Respiratory stimulants: analeptics</p>', NULL, NULL, '2022-03-10 22:02:39', '2022-03-10 22:02:39'),
(1042, 1042, '<p>Treatment of newly diagnosed adult patients with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase. The study is ongoing and further data will be required to determine long-term outcome.<br />\r\n<br />\r\nTreatment of chronic phase (CP) and accelerated phase (AP) Ph+ CML in adult patients resistant to or intolerant to prior therapy that included imatinib. Clinical benefit, such as improvement in disease-related symptoms or increased survival, has not been demonstrated.</p>', '<p>Nilotinib is a potent inhibitor of BCR-ABL tyrosine kinase. It binds to and stabilises the inactive conformation of the kinase domain of Abl protein.</p>', '<p><strong>Adult:</strong>&nbsp;400 mg bid. May continue until patient shows unacceptable toxicity or evidence of progression.<br />\r\n<br />\r\n<strong>Patient on strong CYP3A4 inhibitor:</strong>&nbsp;Reduce dose to 300 mg once daily, or to 200 mg once daily in newly-diagnosed chronic phase Philadelphia chronic myelogenous leukaemia. Dose may be adjusted to usual dose after a washout period.<br />\r\n<br />\r\n<strong>Patient on drugs that prolong QT interval</strong>&nbsp;(e.g. antiarrhythmics): Reduce dose and closely monitor for QT interval prolongation.<br />\r\n<br />\r\n<strong>Hepatic Impairment:</strong>&nbsp;Use a lower starting dose.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Avoid food at least 2 hr before &amp; at least 1 hr after a dose. Swallow whole, do not chew/crush. Avoid grapefruit products.</p>', '<p>Drugs that inhibit gastric acid secretion (e.g. PPIs) may reduce solubility and bioavailability of nilotinib.</p>', '<p>Patient with hypokalaemia, hypomagnesaemia or long QT syndrome. Concomitant use with potent CYP3A4 inhibitors or antiarrhythmics and other QT prolonging drugs. Concomitant use with potent CYP3A4 inducers.</p>', '<p>Rash, pruritus, hepatotoxicity, headache, fever, fatigue, GI disturbances (nausea, constipation, diarrhoea), alopecia, asthenia, muscle spasms, arthralgia, myalgia, pain (e.g. musculoskeletal or chest pain), oedema, folliculitis, papilloma, insomnia, dizziness, vertigo, anxiety, paraesthesia, hyperhidrosis, dry skin, urticaria, acne, conjunctivitis, dry eye, flushing, dyspnoea, cough, myelosuppression (e.g. thrombocytopenia, neutropenia, and anaemia), thrombotic disorders or haemorrhage, arrhythmias, heart failure, pericarditis, palpitations, HTN, angina, MI; elevated AST/ALT, serum lipase; electrolyte imbalances.</p>', '<p><strong>Category D:</strong>&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 history of pancreatitis, with total gastrectomy. Hepatic impairment. Maintain adequate hydration and correct uric acid levels, hypomagnesaemia, hypokalaemia and other electrolyte imbalances prior to therapy. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Neutropenia, vomiting and drowsiness.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Monitor patient and give supportive treatment.</p>', '<p>Targeted Cancer Therapy.</p>', '<p>Store below 30&deg; C.</p>', NULL, '2022-03-10 22:04:46', '2022-03-10 22:04:46'),
(1043, 1043, '<p>Nimesulide is indicated in acute pain; extra-articular disorders; osteoarthritis; post-op pain; primary dysmenorrhoea.</p>', '<p>Nimesulide is a nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory, anti-pyretic, and analgesic properties. It inhibits prostaglandin synthetase/cyclooxygenase, which limits prostaglandin production. Its cyclooxygenase inhibiting potency is intermediate, but is relatively selective for the cyclo-oxygenase-2 (COX-2) thus the potential for gastric injury and intolerance is less. It is also a free radical scavenger, and helps protect against the tissue damage that occurs during inflammation.</p>', '<p>100 mg twice daily.&nbsp;Should be taken with food. Take after meals.</p>', '<p>Additive hepatotoxic effects with known hepatotoxins: anti-convulsants (e.g. valproic acid), anti-fungals (e.g. ketoconazole), anti-tuberculous drugs (e.g. isoniazid), tacrine, pemoline, amiodarone, methotrexate, methyldopa, amoxicillin/clavulanic acid. May decrease the oral bioavailability of furosemide and the natriuretic and diuretic response to furosemide. Increased risks of GI and hepatic adverse effects with other NSAIDs, including aspirin. May increase anti-coagulant effect of warfarin. Potentiates the action of phenytoin. May be displaced from binding sites with fenofibrate, salicylic acid, and tolbutamide. Interactions between NSAIDs and lithium, probenecid and ciclosporin, have been documented.</p>', '<p>Hypersensitivity; GI bleeding, active peptic ulcer disease; severe renal and heart failure; hepatic impairment or known liver disease; coagulation disorders; pregnancy; children &lt;12 yr.</p>', '<p>Epigastric discomfort, heartburn or abdominal cramps, nausea, vomiting and diarrhoea; skin rash, pruritus, oedema, headache, dizziness, drowsiness; hypersensitivity reactions (e.g. bronchospasm, rhinitis, angioedema urticaria); GI haemorrhage/perforation; bullous/erosive stomatitis, purpura, thrombocytopenia, toxic epidermal necrolysis, haematuria, oliguria, and renal failure; increases in liver enzymes.</p>', '<p>Category not classified</p>', '<p>History of GI tract disease, infections, oedema, hypertension, elderly, lactation.</p>', '<p>Epigastric pain, nausea, vomiting, drowsiness, lethargy, GI haemorrhage, seizures, hypertension, apnoea, coma, anaphylactic reactions and renal failure. Treatment is supportive.</p>', '<p>Non-steroidal Anti-inflammatory Drugs (NSAIDs).</p>', '<p>Protect from heat and humidity; store at &lt;25&deg;C.</p>', NULL, '2022-03-10 22:06:33', '2022-03-10 22:06:33'),
(1044, 1044, '<p>For the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in patients with subarachnoid hemorrhage from ruptured intracranial berry aneurysms regardless of their post ictus neurological condition.</p>', '<p>Nimodipine inhibits inflow of Calcium ions into cells by blocking Calcium channels or select voltage-sensitive areas resulting in relaxation of vascular smooth muscle and myocardium during depolarisation. Nimodipine has greater action on the cerebral vessels because of its high lipophilicity.</p>', '<p><strong>Adult:</strong>&nbsp;Initial dose is 60 mg in every four hours interval for 21 consecutive days, preferably not less than one hour before or two hours after meals. Oral Nimodipine therapy should be commence within 96 hours of the subarachnoid hemorrhage.<br />\r\n<br />\r\n<strong>Use in Pediatric Patients:</strong>&nbsp;While there is no specific information on use of this medication in pediatric patients.</p>', '<p>Plasma concentration and efficacy may be significantly reduced when administered with strong CYP3A4 inducers (e.g. rifampicin, carbamazepine, phenobarbital, phenytoin). May increase serum levels and toxicity of phenytoin. Increased plasma concentrations with cimetidine or sodium valproate.</p>', '<p>Use within 1 mth of MI or an episode of unstable angina. Concomitant use with potent CYP3A4 inhibitors (e.g. clarithromycin, ritonavir, ketoconazole, nefazodone).</p>', '<p>Although side effects from nimodipine are not common, the following can occur: headache, dizziness, flushing (feeling of warmth), heartburn, fast heartbeat, slow heartbeat, upset stomach, stomach pain, constipation, depression etc.</p>', '<p><strong>Use in Pregnancy:&nbsp;</strong>Large doses of nimodipine have been shown to cause birth defects in animals. Human studies have not been done. Before you take nimodipine, tell your doctor if you are pregnant or plan to become pregnant.<br />\r\n<br />\r\n<strong>Use in Nursing Mothers:&nbsp;</strong>Nimodipine may pass into breast milk but has not been reported to cause problems; caution is advised. Consult your doctor for advice.</p>', '<p>Patients with cerebral oedema or severely raised intracranial pressure. Contents of oral capsules should be given only by mouth or through a feeding tube. It must never be administered IV or by any other parenteral route. Hepatic impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Excessive peripheral vasodilation, systemic hypotension, tachycardia, bradycardia, GI complaints, nausea.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic and supportive treatment. Admin of vasopressor may be necessary if significant hypotension occurs. IV Ca salts have been also used for hypotension.</p>', '<p>Calcium-channel blockers.</p>', '<p>Store between 15-30&deg; C. Protect from light.</p>', NULL, '2022-03-10 22:08:24', '2022-03-10 22:08:24'),
(1045, 1045, '<ul>\r\n	<li>Nintedanib is indicated in adults for the treatment of Idiopathic Pulmonary Fibrosis (IPF).</li>\r\n	<li>Nintedanib is indicated in adults for the treatment of chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype.</li>\r\n	<li>Nintedanib is indicated in adults for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD).</li>\r\n	<li>Nintedanib is indicated in combination with docetaxel for the treatment of adult patients with locally advanced, metastatic or locally recurrent non-small cell lung cancer (NSCLC) of adenocarcinoma tumor histology after first-line chemotherapy.</li>\r\n</ul>', '<p>Nintedanib is a small molecule, competitive, triple angiokinase inhibitor that targets multiple receptor tyrosine kinases (RTKs) and non-receptor tyrosine kinases (nRTKs). Many of these RTKs are implicated in lung fibrosis and tumour angiogenesis, so nintedanib is therefore used in the treatment of proliferative diseases such as idiopathic pulmonary fibrosis, non-small cell lung cancer, and systemic sclerosis-associated interstitial lung disease. The specific RTKs that nintedanib inhibits are platelet-derived growth factor (PDGFR) &alpha; and &beta;, fibroblast growth factor receptor (FGFR) 1-3, vascular endothelial growth factor receptor (VEGFR), and Fns-Like tyrosine kinase-3 (FLT3). Nintedanib binds to the ATP-binding pocket of these receptors and inhibits their activity, thereby blocking signalling cascades that result in the proliferation and migration of lung fibroblasts. Nintedanib also inhibits kinase signalling pathways in various cells within tumour tissues, including endothelial cells, pericytes, smooth muscle cells, and cells contributing to angiogenesis, culminating in an inhibition of cell proliferation and apoptosis of affected tumour cells.<br />\r\n<br />\r\nIn addition to RTK inhibition, nintedanib also prevents the actions of the nRTKs Lck, Lyn, and Src. The contribution of the inhibition of Lck and Lyn towards the therapeutic efficacy of nintedanib is unclear, but inhibition of the Src pathway by nintedanib has been shown to reduce lung fibrosis.</p>', '<p>Treatment with Nintedanib should be initiated by physicians experienced in the diagnosis and treatment of IPF.<br />\r\n<br />\r\nPosology: The recommended dose is 150 mg Nintedanib twice daily administered approximately 12 hours apart. The 100 mg twice daily dose is only recommended to be used in patients who do not tolerate the 150 mg twice daily dose. If a dose is missed, administration should resume at the next scheduled time at the recommended dose. If a dose is missed the patient should not take an additional dose. The recommended maximum daily dose of 300 mg should not be exceeded.<br />\r\n<br />\r\nFor NSCLC:</p>\r\n\r\n<ul>\r\n	<li>The recommended dose of nintedanib is 200 mg twice daily administered approximately 12 hours apart, on days 2 to 21 of a standard 21 day docetaxel treatment cycle.</li>\r\n	<li>Nintedanib must not be taken on the same day of docetaxel chemotherapy administration (= day 1). If a dose of nintedanib is missed, administration should resume at the next scheduled time at the recommended dose. The individual daily doses of nintedanib should not be increased beyond the recommended dose to make up for missed doses. The recommended maximum daily dose of 400 mg should not be exceeded.</li>\r\n	<li>Patients may continue therapy with nintedanib after discontinuation of docetaxel for as long as clinical benefit is observed or until unacceptable toxicity occurs.</li>\r\n	<li>Dose adjustments: In addition to symptomatic treatment if applicable, the management of adverse reactions to Nintedanib could include dose reduction and temporary interruption until the specific adverse reaction has resolved to levels that allow continuation of therapy. Nintedanib treatment may be resumed at the full dose (150 mg twice daily) or a reduced dose (100 mg twice daily). If a patient does not tolerate 100 mg twice daily, treatment with Nintedanib should be discontinued.</li>\r\n	<li>In case of interruptions due to aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevations &gt; 3x upper limit of normal (ULN), once transaminases have returned to baseline values, treatment with Nintedanib may be reintroduced at a reduced dose (100 mg twice daily) which subsequently may be increased to the full dose (150 mg twice daily).</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>Nintedanib is for oral use. The capsules should be taken with food, swallowed whole with water, and should not be chewed or crushed.</p>', '<p><strong>P-glycoprotein (P-gp)</strong>: Nintedanib is a substrate of P-gp. Co-administration with the potent P-gp inhibitor ketoconazole increased exposure to Nintedanib 1.61-fold based on AUC and 1.83-fold based on Cmax in a dedicated drug-drug interaction study. In a drug-drug interaction study with the potent P-gp inducer rifampicin, exposure to Nintedanib decreased to 50.3% based on AUC and to 60.3% based on Cmax upon co-administration with rifampicin compared to administration of Nintedanib alone. If co-administered with Nintedanib, potent P-gp inhibitors (e.g. ketoconazole, erythromycin or cyclosporine) may increase exposure to Nintedanib. In such cases, patients should be monitored closely for tolerability of Nintedanib. Management of side effects may require interruption, dose reduction, or discontinuation of therapy with Nintedanib. Potent P-gp inducers (e.g. rifampicin, carbamazepine, phenytoin, and St. John&rsquo;s Wort) may decrease exposure to Nintedanib. Selection of an alternate concomitant medicinal product with no or minimal P-gp induction potential should be considered.<br />\r\n<br />\r\n<strong>Cytochrome (CYP)-enzymes</strong>: Only a minor extent of the biotransformation of Nintedanib consisted of CYP pathways. Nintedanib and its metabolites, the free acid moiety BIBF 1202 and its glucuronide BIBF 1202 glucuronide, did not inhibit or induce CYP enzymes in preclinical studies. The likelihood of drug-drug interactions with Nintedanib based on CYP metabolism is therefore considered to be low.<br />\r\n<br />\r\n<strong>Co-administration with other medicinal products</strong>: The potential for interactions of Nintedanib with hormonal contraceptives was not explored.</p>', '<p>Hypersensitivity to Nintedanib, to peanut or soya, or to any of the excipients.</p>', '<p>Summary of the safety profile: Nintedanib has been studied in clinical trials of 1,529 patients suffering from IPF. The safety data provided in the following are based on the two Phase III, randomized, double-blind, placebo-controlled studies in 1,061 patients comparing treatment with Nintedanib 150 mg twice daily to placebo for 52 weeks (INPULSIS-1 and INPULSIS-2) and based on data observed during the post-marketing period.<br />\r\n<br />\r\nThe most frequently reported adverse reactions associated with the use of Nintedanib included diarrhea, nausea and vomiting, abdominal pain, decreased appetite, weight decreased and hepatic enzyme increased.<br />\r\n<br />\r\nTabulated list of adverse reactions: The below table provides a summary of the adverse reactions by MedDRA System Organ Class (SOC) and frequency category.<br />\r\n<br />\r\nBelow table summarizes the frequencies of adverse drug reactions (ADRs) that were reported in the Nintedanib group (638 patients) pooled from the two placebo-controlled Phase III clinical trials of 52 weeks duration or from the post-marketing period.<br />\r\n<br />\r\nFrequency categories are defined using the following convention: Very common (&ge; 1/10), common (&ge; 1/100 to &lt; 1/10), uncommon (&ge; 1/1,000 to &lt; 1/100), rare (&ge; 1/10,000 to &lt; 1/1,000), very rare (&lt; 1/10,000), not known (cannot be estimated from the available data).</p>', '<p>Women of childbearing potential/Contraception: Nintedanib may cause foetalharm in humans. Women of childbearing potential should be advised to avoid becoming pregnant while receiving treatment with Nintedanib. They should be advised to use adequate contraception during and at least 3 months after the last dose of Nintedanib. Since the effect of Nintedanib on the metabolism and efficacy of hormonal contraceptives has not been investigated, barrier methods should be applied as a second form of contraception, to avoid pregnancy.<br />\r\n<br />\r\n<strong>Pregnancy</strong>: There is no information on the use of Nintedanib in pregnant women, but pre-clinical studies in animals have shown reproductive toxicity of this active substance. As Nintedanib may cause foetal harm also in humans, it must not be used during pregnancy. Female patients should be advised to notify their doctor or pharmacist if they become pregnant during therapy with Nintedanib. If the patient becomes pregnant while receiving Nintedanib, she should be apprised of the potential hazard to the foetus. Termination of the treatment with Nintedanib should be considered.<br />\r\n<br />\r\n<strong>Lactation</strong>: There is no information on the excretion of Nintedanib and its metabolites in human milk. Pre-clinical studies showed that small amounts of Nintedanib and its metabolites (&le; 0.5% of the administered dose) were secreted into milk of lactating rats. A risk to the newborns/infants cannot be excluded. Breast-feeding should be discontinued during treatment with Nintedanib.<br />\r\n<br />\r\n<strong>Fertility</strong>: Based on preclinical investigations there is no evidence for impairment of male fertility. From subchronic and chronic toxicity studies, there is no evidence that female fertility in rats is impaired at a systemic exposure level comparable with that at the maximum recommended human dose (MRHD) of 150 mg twice daily.</p>', '<p><strong>Diarrhoea</strong>: In the INPULSIS trials, diarrhoea was the most frequent gastro-intestinal adverse reaction reported in 62.4% versus 18.4% of patients treated with Nintedanib and placebo, respectively. In most patients the adverse reaction was of mild to moderate intensity and occurred within the first 3 months of treatment. Diarrhoea led to dose reduction in 10.7% of the patients and to discontinuation of Nintedanib in 4.4% of the patients in clinical trials. Serious cases of diarrhoea leading to dehydration and electrolyte disturbances have been reported in the post-marketing. Patients should be treated at first signs with adequate hydration and anti-diarrhoeal medicinal products, e.g. loperamide, and may require treatment interruption. Nintedanib treatment may be resumed at a reduced dose (100 mg twice daily) or at the full dose (150 mg twice daily). In case of persisting severe diarrhoea despite symptomatic treatment, therapy with Nintedanib should be discontinued.<br />\r\n<br />\r\n<strong>Nausea and vomiting</strong>: Nausea and vomiting were frequently reported gastrointestinal adverse reactions. In most patients with nausea and vomiting, the event was of mild to moderate intensity. Nausea led to discontinuation of Nintedanib in 2.0% of patients. Vomiting led to discontinuation in 0.8% of the patients. If symptoms persist despite appropriate supportive care (including anti-emetic therapy), dose reduction or treatment interruption may be required. The treatment may be resumed at a reduced dose (100 mg twice daily) or at the full dose (150 mg twice daily). In case of persisting severe symptoms therapy with Nintedanib should be discontinued.<br />\r\n<br />\r\n<strong>Hepatic function</strong>: The safety and efficacy of Nintedanib has not been studied&nbsp; in patients with moderate (Child Pugh B) or severe (Child Pugh C) hepatic impairment. Therefore, treatment with Nintedanib is not recommended in such patients. Based on increased exposure, the risk for adverse events may be increased in patients with mild hepatic impairment (Child Pugh A). Patients with mild hepatic impairment (Child Pugh A) should be treated with a reduced dose of Nintedanib. Cases of drug-induced liver injury have been observed with Nintedanib treatment, including severe liver injury with fatal outcome. The majority of hepatic events occur within the first three months of treatment. Therefore, hepatic transaminase and bilirubin levels should be investigated before treatment initiation and during the first month of treatment with Nintedanib. Patients should then be monitored at regular intervals during the subsequent two months of treatment and periodically thereafter, e.g. at each patient visit or as clinically indicated. Elevations of liver enzymes (ALT, AST, ALKP, gamma-glutamyl-transferase (GGT) and bilirubin were reversible upon dose reduction or interruption in the majority of cases. If transaminase (AST or ALT) elevations &gt; 3x ULN are measured, dose reduction or interruption of the therapy with Nintedanib is recommended and the patient should be monitored closely. Once transaminases have returned to baseline values, treatment with Nintedanib may be resumed at the full dose (150 mg twice daily) or reintroduced at a reduced dose (100 mg twice daily) which subsequently may be increased to the full dose. If any liver test elevations are associated with clinical signs or symptoms of liver injury, e.g. jaundice, treatment with Nintedanib should be permanently discontinued. Alternative causes of the liver enzyme elevations should be investigated.<br />\r\n<br />\r\nPatients with low body weight (&lt;65 kg), Asian and female patients have a higher risk of elevations of liver enzymes. Nintedanib exposure increased linearly with patient age, which may also result in a higher risk of developing liver enzyme elevations. Close monitoring is recommended in patients with these risk factors.<br />\r\n<br />\r\n<strong>Renal Function</strong>: Cases of renal impairment/failure, in some cases with fatal outcome, have been reported with Nintedanib use. Patients should be monitored during Nintedanib therapy, with particular attention to those patients exhibiting risk factors for renal impairment/failure. In case of renal impairment/failure, therapy adjustment should be considered.<br />\r\n<br />\r\n<strong>Haemorrhage</strong>: Vascular endothelial growth factor receptor (VEGFR) inhibition might be associated with an increased risk of bleeding. In the INPULSIS trials with Nintedanib, the frequency of patients who experienced bleeding AEs was slightly higher in the Nintedanib arm (10.3%) than in the placebo arm (7.8%). Non-serious epistaxis was the most frequent bleeding event. Serious bleeding events occurred with low and similar frequencies in the 2 treatment groups (placebo: 1.4%; Nintedanib: 1.3%). Patients at known risk for bleeding including patients with inherited predisposition to bleeding or patients receiving a full dose of anti-coagulative treatment were not included in the INPULSIS studies. Non-serious and serious bleeding events, some of which were fatal, have been reported in the post-marketing period (including patients with or without anticoagulant therapy or other drugs that could cause bleeding). Therefore, these patients should only be treated with Nintedanib if the anticipated benefit outweighs the potential risk. Post-marketing bleeding events include but are not limited to gastrointestinal, respiratory and central nervous organ systems, with the most frequent being gastrointestinal.<br />\r\n<br />\r\n<strong>Arterial thromboembolic events</strong>: Patients with a recent history of myocardial infarction or stroke were excluded from the INPULSIS trials. Arterial thromboembolic events were infrequently reported: in 0.7% of patients in the placebo and 2.5% in the Nintedanib treated group. While adverse events reflecting ischemic heart disease were balanced between the Nintedanib and placebo groups, a higher percentage of patients experienced myocardial infarctions in the Nintedanib group (1.6%) compared to the placebo group (0.5%). Caution should be used when treating patients at higher cardiovascular risk including known coronary artery disease. Treatment interruption should be considered in patients who develop signs or symptoms of acute myocardial ischemia.<br />\r\n<br />\r\n<strong>Venous thromboembolism</strong>: In the INPULSIS trials no increased risk of venous thromboembolism was observed in Nintedanib treated patients. Due to the mechanism of action of Nintedanib patients might have an increased risk of thromboembolic events.<br />\r\n<br />\r\n<strong>Gastrointestinal perforations</strong>: In the INPULSIS trials, the frequency of patients with perforation was very low in both treatment groups: 0% placebo, 0.3% Nintedanib (involving two patients). Due to the mechanism of action of Nintedanib patients might have an increased risk of gastrointestinal perforation. Cases of gastrointestinal perforations, some of which were fatal, have been reported in the post-marketing period. Particular caution should be exercised when treating patients with previous abdominal surgery, previous history of peptic ulceration, diverticular disease or receiving concomitant corticosteroids or NSAIDs. Nintedanib should only be initiated at least 4 weeks after abdominal surgery. Therapy with Nintedanib should be permanently discontinued in patients who develop gastrointestinal perforation.<br />\r\n<br />\r\n<strong>Hypertension</strong>: Administration of Nintedanib may increase blood pressure. Systemic blood pressure should be measured periodically and as clinically indicated.<br />\r\n<br />\r\n<strong>Wound healing complication</strong>: No increased frequency of impaired wound healing was observed in the INPULSIS trials. Based on the mechanism of action Nintedanib may impair wound healing. No dedicated studies investigating the effect of Nintedanib on wound healing were performed. Treatment with Nintedanib should therefore only be initiated or &ndash; in case of perioperative interruption &ndash; resumed based on clinical judgement of adequate wound healing.<br />\r\n<br />\r\n<strong>Co-administration with Pirfenidone</strong>: In a dedicated pharmacokinetic study, concomitant treatment of Nintedanib with Pirfenidone was investigated in patients with IPF. Based on these results, there is no evidence of a relevant pharmacokinetic drug-drug interaction between Nintedanib and Pirfenidone when administered in combination. In view of the limited number of patients, this study detected only the most frequent adverse events and showed an increase in gastrointestinal adverse events and a trend toward increased hepatic adverse events. Given the similarity in safety profiles for both medicinal products, additive adverse events, including gastrointestinal and hepatic adverse events, may be expected. The benefit-risk balance of concomitant treatment with Pirfenidone has not been established.<br />\r\n<br />\r\n<strong>Effect on QT interval</strong>: No evidence of QT prolongation was observed for Nintedanib in the clinical trial programme. As some other tyrosine kinase inhibitors are known to exert an effect on QT, caution should be exercised when administered Nintedanib in patients who may develop QTc prolongation.<br />\r\n<br />\r\n<strong>Allergic reaction</strong>: Dietary soya products are known to cause allergic reactions including severe anaphylaxis in persons with soya allergy. Patients with known allergy to peanut protein carry an enhanced risk for severe reactions to soya preparations.</p>', NULL, '<p>Tyrosine Kinase Inhibitor.</p>', '<p>Store in a cool and dry place, protected from light. Do not store above 25&deg;C.</p>', '<p><strong>Elderly patients (&ge;65 years)</strong>: No overall differences in safety and efficacy were observed for elderly patients. No a-priori dose adjustment is required on the basis of a patient&rsquo;s age. Patients &ge;75 years may be more likely to require dose reduction to manage adverse effects.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Less than 1% of a single dose of Nintedanib is excreted via the kidney. Adjustment of the starting dose in patients with mild to moderate renal impairment is not required. The safety, efficacy, and pharmacokinetics of Nintedanib have not been studied in patients with severe renal impairment (&lt;30 ml/min creatinine clearance).<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Nintedanib is predominantly eliminated via biliary/faecal excretion (&gt; 90%). Exposure increased in patients with hepatic impairment (Child Pugh A, Child Pugh B). In patients with mild hepatic impairment (Child Pugh A), the recommended dose of Nintedanib is 100 mg twice daily approximately 12 hours apart. In patients with mild hepatic impairment (Child Pugh A), treatment interruption or discontinuation for management of adverse reactions should be considered. The safety and efficacy of Nintedanib have not been investigated in patients with hepatic impairment classified as Child Pugh B and C. Treatment of patients with moderate (Child Pugh B) and severe (Child Pugh C) hepatic impairment with Nintedanib is not recommended.<br />\r\n<br />\r\n<strong>Paediatric population</strong>:&nbsp;The safety and efficacy of Nintedanib in children aged 0-18 years have not been established. No data are available.</p>', '2022-03-10 22:11:14', '2022-03-10 22:11:14');
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
(1046, 1046, '<p>Niraparib is indicated for the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy.</p>', '<p>Niraparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, PARP-1 and PARP-2, which play a role in DNA repair. In vitro studies have shown that niraparib induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complexes resulting in DNA damage, apoptosis and cell death. Increased Niraparib-induced cytotoxicity was observed in tumor cell lines with or without deficiencies in BRCA1/2. Niraparib decreased tumor growth in mouse xenograft models of human cancer cell lines with deficiencies in BRCA1/2 and in human patient-derived xenograft tumor models with homologous recombination deficiency that had either mutated or wild type BRCA1/2.<br />\r\n<br />\r\n<strong>Absorption</strong>: The absolute bioavailability of niraparib is approximately 73%. Following oral administration of Niraparib, peak plasma concentration, Cmax, is reached within 3 hours. Concomitant administration of a high fat meal (800-1,000 calories with approximately 50% of total caloric content of the meal from fat) did not significantly affect the pharmacokinetics of Niraparib.<br />\r\n<br />\r\n<strong>Distribution</strong>: Niraparib is 83.0% bound to human plasma proteins. The average (&plusmn;SD) apparent volume of distribution (Vd/F) was 1220 (&plusmn;1114) L. In a population pharmacokinetic analysis, the Vd/F of Niraparib was 1074 L in cancer patients.<br />\r\n<br />\r\n<strong>Elimination</strong>: Following multiple daily doses of 300 mg Niraparib, the mean half-life (t1/2) is 36 hours. In a population pharmacokinetic analysis, the apparent total clearance (CL/F) of niraparib was 16.2 L/h in cancer patients.<br />\r\n<br />\r\n<strong>Metabolism</strong>: Niraparib is metabolized primarily by carboxylesterases (CEs) to form a major inactive metabolite, which subsequently undergoes glucuronidation.<br />\r\n<br />\r\n<strong>Excretion</strong>: Following administration of a single oral 300 mg dose of radio-labeled Niraparib, the average percent recovery of the administered dose over 21 days was 47.5% (range 33.4% to 60.2%) in urine and 38.8% (range 28.3% to 47.0%) in feces. In pooled samples collected over 6 days, unchanged Niraparib accounted for 11% and 19% of the administered dose recovered in urine and feces, respectively</p>', '<p>The recommended dose of Niraparib as monotherapy is 300 mg (three 100 mg capsules) taken orally once daily. Instruct patients to take their dose of Niraparib at approximately the same time each day. Each capsule should be swallowed whole. Niraparib may be taken with or without food. Bedtime administration may be a potential method for managing nausea. Patients should start treatment with Niraparib no later than 8 weeks after their most recent platinum-containing regimen. Niraparib treatment should be continued until disease progression or unacceptable toxicity. In the case of a missed dose of Niraparib, instruct patients to take their next dose at its regularly scheduled time. If a patient vomits or misses a dose of Niraparib, an additional dose should not be taken.<br />\r\n<br />\r\nNiraparib is for oral use. The capsules should be swallowed whole with water. The capsules should not be chewed or crushed. Niraparib can be taken without regard to meals.</p>', '<p>Inhibition of CYPs (CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A4). Neither Niraparib nor M1 is an inhibitor of any active ubstance-metabolising CYP enzymes, namely CYP1A1/2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 and CYP3A4/5. Even though inhibition of CYP3A4 in the liver is not expected, the potential to inhibit CYP3A4 at the intestinal level has not been established at relevant Niraparib concentrations. Therefore, caution is recommended when Niraparib is combined with active substances the metabolism of which is CYP3A4-dependent and, notably, those having a narrow therapeutic range (e.g. ciclosporin, tacrolimus, alfentanil, ergotamine, pimozide, quetiapine and halofantrine).<br />\r\n<br />\r\nInduction of CYPs (CYP1A2 and CYP3A4): Neither Niraparib nor M1 is a CYP3A4 inducer in vitro. In vitro, Niraparib weakly induces CYP1A2 at high concentrations and the clinical relevance of this effect would not be completely ruled out. M1 is not a CYP1A2 inducer. Therefore, caution is recommended when niraparib is combined with active substances the metabolism of which is CYP1A2-dependent and, notably, those having a narrow therapeutic range (e.g. clozapine, theophylline and ropinirole).</p>', '<p>Hypersensitivity to the active substance or to any of the excipients &amp; breast-feeding.</p>', '<p>In the pivotal ENGOT-OV16 study, adverse reactions (ADRs) occurring &gt; 10% of patients receiving Niraparib monotherapy were nausea, thrombocytopenia, fatigue/asthenia, anaemia, constipation, vomiting, abdominal pain, neutropenia, insomnia, headache, decreased appetite, nasopharyngitis, diarrhoea, dyspnea, hypertension, dyspepsia, back pain, dizziness, cough, urinary tract infection, arthralgia, palpitations, and dysgeusia. The most common serious adverse reactions &gt;1% (treatment-emergent frequencies) were thrombocytopenia and anaemia.</p>', '<p>Women of childbearing potential/contraception in females Women of childbearing potential should not become pregnant while on treatment and should not be pregnant at the beginning of treatment. A pregnancy test should be performed on all women of childbearing potential prior to treatment. Women of childbearing potential must use effective contraception during therapy and for 1 month after receiving the last dose of Niraparib.<br />\r\n<br />\r\n<strong>Pregnancy</strong>: There are no or limited amount of data from the use of Niraparib in pregnant women. Animal reproductive and developmental toxicity studies have not been conducted. However, based on its mechanism of action, niraparib could cause embryonic or foetal harm, including embryo-lethal and teratogenic effects, when administered to a pregnant woman. Niraparib should not be used during pregnancy.<br />\r\n<br />\r\n<strong>Breast-feeding</strong>: It is unknown whether niraparib or its metabolites are excreted in human milk. Breast-feeding is contraindicated during administration of Niraparib and for 1 month after receiving the last dose.<br />\r\n<br />\r\n<strong>Fertility</strong>: There are no clinical data on fertility. A reversible reduction of spermatogenesis was observed in rats and dogs.</p>', '<p><strong>Myelodysplastic syndrome/acute myeloid leukaemia</strong>: Myelodysplastic syndrome/acute myeloid leukaemia (MDS/AML), including cases with fatal outcome, have been reported in a small number of patients who received Niraparib or placebo. In the pivotal Phase 3 international trial (ENGOT-OV16), the incidence of MDS/AML in patients who received niraparib (1.4%) was similar to that in patients who received placebo (1.1%). Overall, MDS/AML has been reported in 7 out of 751 (0.9%) patients treated with Niraparib in clinical studies. The duration of Niraparib treatment in patients prior to developing MDS/AML varied from 1 month to &gt; 2 years. The cases were typical of secondary, cancer therapy-related MDS/AML. All patients had received multiple platinum-containing chemotherapy regimens and many had also received other DNA damaging agents and radiotherapy. Some of the patients had a history of bone marrow dysplasia. If MDS and/or AML are confirmed while on treatment with Niraparib, treatment should be discontinued and the patient treated appropriately.<br />\r\n<br />\r\n<strong>Hypertension including hypertensive crisis</strong>: Hypertension, including hypertensive crisis, has been reported with the use of Niraparib. Pre-existing hypertension should be adequately controlled before starting Niraparib treatment. Blood pressure should be monitored monthly for the first year and periodically thereafter during treatment with Niraparib. Hypertension should be medically managed with antihypertensive medicinal products as well as adjustment of the Niraparib dose, if necessary. In the clinical programme, blood pressure measurements were obtained on Day 1 of each 28-day cycle while the patient remained on Niraparib. In most cases, hypertension was controlled adequately using standard antihypertensive treatment with or without Niraparib dose adjustment. Niraparib should be discontinued in case of hypertensive crisis or if medically significant hypertension cannot be adequately controlled with antihypertensive therapy.<br />\r\n<br />\r\n<strong>Pregnancy/contraception</strong>: Niraparib should not be used during pregnancy or in women of childbearing potential not willing to use reliable contraception during therapy and for 1 month after receiving the last dose of Niraparib. A pregnancy test should be performed on all women of childbearing potential prior to treatment.<br />\r\n<br />\r\n<strong>Lactose</strong>: Niraparib hard capsules contain lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose galactose malabsorption should not take this medicine.<br />\r\n<br />\r\n<strong>Tartrazine (E102)</strong>: This medicinal product contains tartrazine (E 102), which may cause allergic reactions.</p>', '<p>There is no specific treatment in the event of Niraparib overdose, and symptoms of overdose are not established. In the event of an overdose, physicians should follow general supportive measures and should treat symptomatically.</p>', '<p>Cytotoxic Chemotherapy.</p>', '<p>Store in a cool and dry place. Do not store above 30&deg;C. Do not take Niraparib if it is suspected of having been exposed to temperatures greater than 40&deg;C or 104&deg;F. Keep Niraparib out of the reach and sight of children.</p>', '<p><strong>Elderly</strong>: No dose adjustment is necessary for elderly patients (&gt; 65 years). There are limited clinical data in patients aged 75 or over.<br />\r\n<br />\r\n<strong>Paediatric population</strong>: The safety and efficacy of niraparib in children and adolescents below 18 years of age have not yet been established. No data are available.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: No dose adjustment is necessary for patients with mild to moderate renal impairment. There are no data in patients with severe renal impairment or end-stage renal disease undergoing hemodialysis; use with caution in these patients.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: No dose adjustment is needed in patients with mild to moderate hepatic impairment. There are no data in patients with severe hepatic impairment; use with caution in these patients.</p>', '2022-03-10 22:13:25', '2022-03-10 22:13:25'),
(1047, 1047, '<p>This is indicated in combination with other antiretrovirals or alone for the treatment of human immunodeficiency virus type 1 (HIV-1) infection.</p>', '<p>Abacavir is a carbocyclic synthetic nucleoside analogue and an antiviral agent. Intracellularly, abacavir is converted by cellular enzymes to the active metabolite carbovir triphosphate, an analogue of deoxyguanosine-5&#39;-triphosphate (dGTP). Carbovir triphosphate inhibits the activity of HIV-1 reverse transcriptase (RT) both by competing with the natural substrate dGTP and by its incorporation into viral DNA. Viral DNA growth is terminated because the incorporated nucleotide lacks a 3&#39;-OH group, which is needed to form the 5&prime; to 3&prime; phosphodiester linkage essential for DNA chain elongation.<br />\r\n<br />\r\nLamivudine is a synthetic nucleoside analogue and is phosphorylated intracellularly to its active 5&#39;-triphosphate metabolite, lamivudine triphosphate (L-TP). This nucleoside analogue is incorporated into viral DNA by HIV reverse transcriptase and HBV polymerase, resulting in DNA chain termination.<br />\r\n<br />\r\nZidovudine, a structural analog of thymidine, is a prodrug that must be phosphorylated to its active 5&prime;-triphosphate metabolite, zidovudine triphosphate (ZDV-TP). It inhibits the activity of HIV-1 reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleotide analogue. It competes with the natural substrate dGTP and incorporates itself into viral DNA. It is also a weak inhibitor of cellular DNA polymerase &alpha; and &gamma;.</p>', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '2022-03-11 01:14:16', '2022-03-11 01:14:16'),
(1048, 1048, '<p>Indicated for mild-to-moderate COVID-19 positive adult and pediatric patients (12 years of age and older weighing at least 40 kg), who are at high risk for progression to severe COVID-19, including hospitalization or death.</p>', '<p>This inhibits the main protease (Mpro) of the SARS-CoV-2. This main protease (Mpro) is also referred as 3C-like protease (3CLpro) or nsp5 protease. This inhibition of Mpro hampers the peptidomimetic activity of SARS-CoV-2. Ritonavir is an HIV-1 protease inhibitor but is not active against SARS-CoV-2 Mpro. Ritonavir inhibits the CYP3A mediated metabolism of Nirmatrelvir, resulting in increased plasma concentrations of Nirmatrelvir.</p>', '<p>Nirmatrelvir must be co-administered with Ritonavir. Initiate this treatment as soon as possible after diagnosis of COVID-19 and within 3-5 days of symptom onset. Administer orally with or without food.<br />\r\n<br />\r\n<strong>Dosage</strong>: 300 mg Nirmatrelvir (two 150 mg tablets) with 100 mg Ritonavir (one 100 mg tablet), with all three tablets taken together twice daily for 5 days.<br />\r\n<br />\r\n<strong>Missed Dose</strong>: If the patient misses a dose of this within 8 hours of the time it is usually taken, the patient should take it as soon as possible and resume the normal dosing schedule. If the patient misses a dose by more than 8 hours, the patient should not take the missed dose and instead take the next dose at the regularly scheduled time. The patient should not double the dose to make up for a missed dose.</p>', '<p>Co-administration of this tablet with drugs highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening events is contraindicated. Co-administration with other CYP3A substrates may require a dose adjustment or additional monitoring. Nirmatrelvir and Ritonavir are CYP3A substrates; therefore, drugs that induce CYP3A may decrease Nirmatrelvir and Ritonavir plasma concentrations and reduce this tablet therapeutic effect.</p>', '<ul>\r\n	<li>History of clinically significant hypersensitivity reactions to the active ingredients (Nirmatrelvir or Ritonavir) or any other components.</li>\r\n	<li>Co-administration with drugs highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.</li>\r\n	<li>Co-administration with potent CYP3A inducers where significantly reduced Nirmatrelvir or Ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance.</li>\r\n</ul>', '<p>Adverse events (incidence &gt;1% and subject difference) were dysgeusia, diarrhea, hypertension, and myalgia.</p>', '<p>This is not recommended during pregnancy and in people who can become pregnant and who are not using contraception. Breastfeeding should be interrupted during treatment. These recommendations are because laboratory studies in animals suggest that high doses of this may impact the growth of the fetus. This drug should be used during pregnancy only if clearly needed and the benefit outweighs the risk to the fetus; use of oral solution is not recommended.</p>', '<p>The concomitant use of this tablet and certain other drugs may result in potentially significant drug interactions. Consult the full prescribing information prior to and during treatment for potential drug interactions.<br />\r\n<br />\r\n<strong>Hepatotoxicity</strong>: Hepatic transaminase elevations, clinical hepatitis, and jaundice have occurred in patients receiving Ritonavir.<br />\r\n<br />\r\n<strong>HIV-1 Drug Resistance</strong>: This tablet use may lead to a risk of HIV-1 developing resistance to HIV protease inhibitors in individuals with uncontrolled or undiagnosed HIV-1 infection.</p>', '<p>Treatment of an overdose of this tablet should consist of general supportive measures including monitoring of vital signs and observation of the clinical status of the patient. There is no specific antidote for overdose with this tablet.</p>', NULL, '<p>Do not store above 30&deg;C. Keep in a dry place. Protect from light and keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: This tablet is not authorized for use in pediatric patients younger than 12 years of age or weighing less than 40 kg. The safety and effectiveness of this tablet have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of this tablet include subjects 65 years of age and older and their data contributes to the overall assessment of safety and efficacy.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is needed in patients with mild renal impairment. In patients with moderate renal impairment (eGFR &gt;30 to &lt;60 mL/min), reduce the dose of This tablet to 150 mg Nirmatrelvir and 100 mg Ritonavir twice daily for 5 days. This tablet is not recommended in patients with severe renal impairment (eGFR &lt;30 mL/min).<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment of this tablet is needed for patients with either mild (Child-Pugh Class A) or moderate (Child-Pugh Class B) hepatic impairment. This tablet is not recommended in patients with severe hepatic impairment (Child-Pugh Class C).</p>', '2022-03-11 03:37:39', '2022-03-11 03:37:39'),
(1049, 1049, '<p>Nitazoxanide is indicated for the treatment of diarrhea caused by Cryptosporidium parvum, Giardia lamblia and Entamoeba histolytica.</p>', '<p>Nitazoxanide is a synthetic antiprotozoal agent for oral administration. The antiprotozoal activity of Nitazoxanide is believed to be interference with the Pyruvate Ferredoxin Oxido Reductase (PFOR) enzyme-dependant electron transfer reaction. This reaction is essential for anaerobic energy metabolism of the protozoa. Nitazoxanide and its metabolites, tizoxanid are active in vitro in inhibiting the growth of sporozoites and oocyst of Cryptosporidium parvum and trophozoites of Giardia lamblia.</p>', '<p><strong>Age 1-3 years</strong>: 1 tea-spoonfull or 5 ml suspension every 12 hours for 3 days.<br />\r\n<strong>Age 4-11 years</strong>: 2 tea-spoonfulls or 10 ml suspension every 12 hours for 3 days.<br />\r\n<strong>Age 12 years or above</strong>: 5 tea-spoonfulls (25 ml) suspension or 1 tablet every 12 hours for 3 days.<br />\r\n<br />\r\nIt is recommended to be administered with food.</p>', '<p>It is highly bound to plasma protein. Therefore, caution should be exercised when administering Nitazoxanide concurrently with other highly plasma protein-bound drugs with narrow therapeutic index.</p>', '<p>It is contraindicated in patients with known hypersensitivity to Nitazoxanide or any components of the preparation.</p>', '<p>The most frequent side effects, reported by Nitazoxanide are abdominal pain, vomiting and headache. These side effects are typically mild and transient in nature. Very rare side effects include- nausea, anorexia, flatulence, increased appetite, enlarged salivary glands, increased creatinine &amp; SGPT level, pruritus, rhinitis, sweating, dizziness, discolored urine etc.</p>', '<p>US FDA pregnancy category of Nitazoxanide is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Nitazoxanide have been shown to be excreted in human milk. So, caution should be exercised when Nitazoxanide is administered during lactation.</p>', '<p>Nitazoxanide must be administered with caution to patients with hepatic &amp; biliary disease and to patients with renal disease.</p>', NULL, '<p>Anti-diarrhoeal Antiprotozoal.</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-03-11 03:39:52', '2022-03-11 03:39:52'),
(1050, 1050, '<p>Short-term management of insomnia,&nbsp;Infantile spasms.</p>', '<p>Nitrazepam is a benzodiazepine with a pronounced sleep-inducing activity. It depresses the reticular-activating system in the brainstem by enhancing the inhibitory effect of GABA on brain cells, thus preventing excessive brain activity.</p>', '<p>Short-term management of insomnia:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;5 mg at night; increase to 10 mg if necessary.</li>\r\n	<li><strong>Elderly:</strong>&nbsp;and debilitated patients: &le;normal adult dose.</li>\r\n</ul>\r\n\r\n<p>Infantile spasms:</p>\r\n\r\n<ul>\r\n	<li><strong>Child:</strong>&nbsp;Infants: 125 mcg/kg bid; gradually increase to 250-500 mcg/kg bid.</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>May be taken with or without food</p>', '<p>CNS depressant effect increased with alcohol, barbiturates, TCAs, phenothiazines, morphine derivatives. Effects may be antagonised by theophylline. Increased levels/effects with probenecid. Reduced levels/effects with rifampicin. May reduce effects of levodopa.</p>', '<p>Myasthenia gravis, narrow-angle glaucoma, severe respiratory insufficiency, sleep apnoea syndrome, severe hepatic impairment, porphyria.</p>', '<p>Hypotension, palpitation; agitation, aggressiveness, amnesia, ataxia, confusion, delusions, disorientation, dizziness, fatigue, hallucination, hangover, headache, irritability, nightmares, psychoses, rage, restlessness, sedation; rash; changes in libido; constipation, diarrhoea, excessive salivation, heartburn, nausea, vomiting; granulocytopenia, leukopenia; falling, muscle weakness; blurred or double vision; tinnitus (associated with withdrawal); aspiration, increased bronchial secretion, dyspnoea.</p>', '<p>Category not classified</p>', '<p>May induce anterograde amnesia; caution patients to have uninterrupted sleep of 7-8 hr after ingestion of dose. May impair ability to drive or operate machinery. Depression, especially if suicidal risk may be present. History of drug abuse or acute alcoholism. Hepatic and renal impairment. Respiratory disease. Debilitated patients. Patients who are at risk of falls. Children, elderly. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Somnolence, drowsiness, confusion, ataxia, impaired reflexes, coma, dyspnoea, hypotension, respiratory and cardiovascular depression.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Supportive. Gastric lavage may be beneficial if performed soon after ingestion. Flumazenil may reverse benzodiazepine-induced CNS depression.</p>', '<p>Benzodiazepine hypnotics</p>', '<p>Store at room temperature. Protect from light and moisture.</p>', NULL, '2022-03-11 03:42:06', '2022-03-11 03:42:06'),
(1051, 1051, '<p>Nitrofurantoin is specifically indicated for the treatment &amp; prophylaxis of urinary tract infections caused by susceptible strains of Escherichia coli, Enterococci, Staphylococcus aureus, Staphylococcus saprophyticus and certain susceptible strains of Klebsiella and Enterobacter species.</p>', '<p>Nitrofurantoin is an antibacterial agent specific for urinary tract infections. Nitrofurantoin is highly soluble in urine, to which it may impart a brown color. Nitrofurantoin inactivates or alters bacterial ribosomal proteins and other macromolecules. Nitrofurantoin has been shown to be active against the following bacteria: Gram-Positive Aerobes Staphylococcus saprophyticus, Coagulase-negative staphylococci (including Staphylococcus epidermidis), Enterococcus faecalis, Staphylococcus aureus, Streptococcus agalactiae, Group D streptococci, Viridans group streptococci. Gram-Negative Aerobes- Escherichia coli, Citrobacter amalonaticus, Citrobacter diversus, Citrobacter freundii, Klebsiella oxytoca, Klebsiella ozaenae.</p>', '<p>Nitrofurantoin tablet (In adults):</p>\r\n\r\n<ul>\r\n	<li><strong>Uncomplicated urinary tract infections</strong>: 50-100 mg four times a day- the lower dosage level is recommended. Therapy should be continued for one week or for at least 3 days after sterility of the urine is obtained.</li>\r\n	<li><strong>For long-term suppressive therapy</strong>: In adults, a reduction of dosage to 50-100 mg at bedtime may be adequate.</li>\r\n</ul>\r\n\r\n<p>Nitrofurantoin capsule (In adults):</p>\r\n\r\n<ul>\r\n	<li><strong>Acute Uncomplicated Urinary Tract Infections (UTIs)</strong>: 50 mg four times daily for 7 days.</li>\r\n	<li><strong>Long term suppression</strong>: 50-100 mg once a day.</li>\r\n	<li><strong>Prophylaxis</strong>: 50 mg four times daily for the duration of procedure and for three days thereafter.</li>\r\n</ul>\r\n\r\n<p>Nitrofurantoin SR capsule:</p>\r\n\r\n<ul>\r\n	<li><strong>Adults and Children over 12 years</strong>: One 100 mg capsule every 12 hours for seven days.</li>\r\n	<li><strong>Genito-urinary surgical prophylaxis</strong>: One capsule twice daily on day of procedure and for next 3 days.</li>\r\n</ul>\r\n\r\n<p>Nitrofurantoin suspension: Children: 5-7 mg/kg/day in four divided doses (contraindicated under one month of age). The average dose of Nintoin suspension for pediatric patients are as follows-</p>\r\n\r\n<ul>\r\n	<li>7 to 11 kg: &frac12; (2.5 ml) teaspoonfuls 4 times daily.</li>\r\n	<li>12 to 21 kg: 1 (5 ml) teaspoonfuls 4 times daily.</li>\r\n	<li>22 to 30 kg: 1&frac12; (7.5 ml) teaspoonfuls 4 times daily.</li>\r\n	<li>31 to 41 kg: 2 (10 ml) teaspoonfuls 4 times daily.</li>\r\n</ul>\r\n\r\n<p>Therapy should be continued for one week or for at least 3 days after sterility of the urine is obtained. For long-term suppressive therapy in children, doses as low as 1 mg/kg per 24 hours, given in a single dose or in two divided doses, may be adequate.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Nitrofurantoin should be taken with food.</p>', '<p>Antacids containing Magnesium Trisilicate, when administered concomitantly with Nitrofurantoin, reduce both the rate and extent of absorption of Uricosuric drugs, such as Probenecid and Sulfinpyrazone, can inhibit renal tubular secretion of Nitrofurantoin.</p>', '<p>Anuria, oliguria or significant impairment of renal function are contraindications. This drug is contraindicated in pregnant patients at 38-42 weeks, during labor and delivery. Nitrofurantoin is also contraindicated in those patients with known hypersensitivity to Nitrofurantoin.</p>', '<p>The most frequent clinical adverse events are nausea, headache, and flatulence. Other less occurred adverse events are diarrhea, dyspepsia, abdominal pain, constipation, emesis, dizziness and drowsiness.</p>', '<p>Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Nitrofurantoin has been detected in human breast milk in trace amounts. Because of the potential for serious adverse reactions from Nitrofurantoin in nursing infants under one month of age, 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>If acute, sub-acute or chronic pulmonary reactions occur, Nitrofurantoin should be discontinued. Antacid preparations containing magnesium trisilicate should not be taken while taking Nitrofurantoin.</p>', '<p>Occasional incidents of acute overdosage of Nitrofurantoin have not resulted in any specific symptoms other than vomiting. Induction of emesis is recommended.</p>', '<p>Systemic Urinary Anti- infective</p>', '<p>Do not store above 30&deg;C. Keep away from light and out of the reach of children.</p>', NULL, '2022-03-11 03:44:16', '2022-03-11 03:44:16'),
(1052, 1052, '<p>For the treatment of and prophylaxis against acute or recurrent, uncomplicated lower urinary tract infections or pyelitis either spontaneous or following surgical procedures. Nitrofurantoin is specifically indicated for the treatment of infections when due to susceptible strains of Escherichia coli, enterococci, staphylococci, Citrobacter, Klebsiella and Enterobacter.</p>', '<p>Each capsule contains two forms of nitrofurantoin. Twenty-five percent is macrocrystalline nitrofurantoin, which has slower dissolution and absorption than nitrofurantoin monohydrate. The remaining 75% is nitrofurantoin monohydrate contained in a powder blend which, upon exposure to gastric and intestinal fluids, forms a gel matrix that releases nitrofurantoin over time. This capsule is highly soluble in urine, to which it may impart a brown color. When administered with food, the bioavailability of nitrofurantoin is increased by approximately 40%.</p>', '<p><strong>Adults and Pediatric Patients Over 12 Years</strong>: One 100 mg capsule every 12 hours for seven days. Capsules should be taken with food.<br />\r\n<br />\r\nThe administration of high doses of nitrofurantoin to rats causes temporary spermatogenic arrest; this is reversible on discontinuing the drug. Doses of 10 mg/kg/day or greater in healthy human males may, in certain unpredictable instances, produce a slight to moderate spermatogenic arrest with a decrease in sperm count.</p>', '<p>Antacids containing magnesium trisilicate, when administered concomitantly with nitrofurantoin, reduce both the rate and extent of absorption. The mechanism for this interaction probably is adsorption of nitrofurantoin onto the surface of magnesium trisilicate. Uricosuric drugs, such as probenecid and sulfinpyrazone, can inhibit renal tubular secretion of nitrofurantoin. The resulting increase in nitrofurantoin serum levels may increase toxicity, and the decreased urinary levels could lessen its efficacy as a urinary tract antibacterial.</p>', NULL, '<p>In clinical trials of Macrobid, the most frequent clinical adverse events that were reported as possibly or probably drug related were nausea (8%), headache (6%), and flatulence (1.5%).</p>', '<p>Pregnancy Category B.&nbsp;Nitrofurantoin has been detected in human breast milk in trace amounts. Because of the potential for serious adverse reactions from nitrofurantoin in nursing infants under one month of age, 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>', NULL, '<p>Occasional incidents of acute overdosage of nitrofurantoin have not resulted in any specific symptoms other than vomiting. Induction of emesis is recommended. There is no specific antidote, but a high fluid&nbsp;intake should be maintained to promote urinary excretion of the drug. Nitrofurantoin is dialyzable.</p>', '<p>Systemic Urinary Anti- infective.</p>', NULL, NULL, '2022-03-11 03:46:30', '2022-03-11 03:46:30'),
(1053, 1053, '<p>Nitrofurazone is indicated in the infectious conditions of the skin such as burns, wounds, ulcers, skin infections and skin grafting.</p>', '<p>Nitrofurazone is a broad spectrum topical antibacterial agent indicated for the treatment of mixed skin infections of superficial wounds and diseases of the skin.</p>', '<p>To be applied directly to the lesion or on gauze first; 2-3 times daily or as advised by the physician.</p>', NULL, '<p>Nitrofurazone is contraindicated to patients with known sensitivity to Nitrofurazone. It is not advisable to use Nitrofurazone after the infection is cured. It should be used with caution in patients with known or suspected renal impairment.</p>', '<p>Sensitization and generalized allergic skin reactions may be produced after few days of initial application. Cross sensitization to other Nitrofurazone derivatives may occur. Intolerance to Nitrofurazone necessitating withdrawal has been encountered.</p>', '<p>Pregnancy category- B.</p>', '<p>G6PD deficiency,&nbsp;renal impairment.</p>', NULL, '<p>Topical Antibiotic preparations</p>', NULL, NULL, '2022-03-11 03:48:02', '2022-03-11 03:48:02'),
(1054, 1054, '<p>Nitroglycerin Injection is indicated for the treatment of peri-operative hypertension; for controlling of congestive heart failure in the setting of acute myocardial infarction; for treatment of angina pectoris in patients who have not responded to sublingual nitroglycerin and beta blockers and for induction of Intraoperative hypotension.</p>', '<p>The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle and consequent dilatation of peripheral arteries and veins. Dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Arteriolar relaxation reduces systemic vascular resistance,systolic arterial pressure, and mean arterial pressure (after load). Dilatation of the coronary arteries also occurs.</p>', '<p>Not for direct intravenous injection. Nitroglycerin injection is a concentrated, potent drug which must be diluted in dextrose (5%) injection or sodium chloride (0.9%) injection prior to its infusion. Nitroglycerin injection should not be mixed with other drugs.<br />\r\n<br />\r\n<strong>Initial Dilution</strong>: Aseptically transfer the contents of one nitroglycerin ampoule (containing 50 mg of nitroglycerin) into a 500 ml glass bottle of either Dextrose (5%) Injection or Sodium Chloride Injection (0.9%).This yields a final concentration of 100 mcg/ml.<br />\r\n<br />\r\n<strong>Maintenance Dilution</strong>: It is important to consider the fluid requirements of the patient as well as the expected duration of infusion in selecting the appropriate dilution of Nitroglycerin Injection. After the initial dosage titration, the concentration of the solution may be increased, if necessary, to limit fluids given to the patient. The nitroglycerin concentration should not exceed 400 mcg/ml.</p>', '<p>The vasodilating effects of nitroglycerin may be additive with those of other vasodilators. Administration of nitroglycerin infusions through the same infusion set as blood can result in pseudoagglutination and hemolysis. More generally, nitroglycerin in 5% dextrose or sodium chloride 0.9% should not be mixed with any other medication of any kind. Intravenous nitroglycerin interferes, at least in some patients, with the anticoagulant effect of heparin. In patients receiving intravenous nitroglycerin, concomitant heparin therapy should be guided by frequent measurement of the activated partial thromboplastin time.</p>', '<p>Allergic reactionsto organic nitrates are extremely rare,but they do occur. Nitroglycerin Injection is contraindicated in patients who are allergic to it. In patients with pericardial tamponade, restrictive cardiomyopathy, or constrictive pericarditis, cardiac output is dependent upon venousreturn. Intravenous nitroglycerin is contraindicated in patients with these conditions.</p>', '<p>Adverse reactions to nitroglycerin are generally dose-related and almost all of these reactions are the result of nitroglycerin&#39;s activity as a vasodilator. Headache, which may be severe, is the most commonly reported side effect. Headache may be recurrent with each daily dose, especially at higher doses. Transient episodes of lightheadedness, occasionally related to blood pressure changes, may also occur. Hypotension occurs infrequently, but in some patients it may be severe enough to warrant discontinuation of therapy. Syncope, crescendo angina, and rebound hypertension have been reported but are uncommon. Extremely rarely, ordinary doses of organic nitrates have caused methemoglobinemia in normal-seeming patients. Methemoglobinemia is so infrequent at these doses that further discussion of its diagnosis and treatment is deferred.</p>', '<p>Pregnancy category C. It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nitroglycerin injection is administered to a nursing mother.</p>', '<p>Severe hypotension and shock may occur with even small doses of nitroglycerin. This drug should therefore be used with caution in patients who may be volume depleted or who, for whatever reason, are already hypotensive. Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris. Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy. As tolerance to other forms of nitroglycerin develops,the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is somewhat blunted. In industrial workers who have had long-term exposure to unknown (presumably high) doses of organic nitrates, tolerance clearly occurs. Chest pain, acute myocardial infarction, and even sudden death have occurred during temporary withdrawal of nitratesfrom these workers, demonstrating the existence of true physical dependence.</p>', '<p>Homodynamic Effects: The ill effects of nitroglycerin overdose are generally the results of nitroglycerin&#39;s capacity to induce vasodilatation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure, with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitation; visual disturbances; nausea and vomiting (possibly with colic and even bloody diarrhea); syncope (especially in the upright posture); air hunger and dyspnea, later followed by reduced ventilatory effort; diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death.</p>', '<p>Nitrates: Coronary vasodilators.</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p>Safety and effectiveness in children have not been established.</p>', '2022-03-11 03:50:29', '2022-03-11 03:50:29'),
(1055, 1055, '<p>The ointment will help to relieve the symptom of pain caused by chronic anal fissures.</p>', '<p>The principal pharmacologic action of glyceryl trinitrate is mediated via the release of nitric oxide. When glyceryl trinitrate ointment is applied by the intra-anal route,the internal anal sphincter becomes relaxed.Hypertonicity of the internal but not the external anal sphincter is a predisposing factor in the formation of anal fissures.</p>', '<p>Nitroglycerin 0.4% ointment should be inserted into the anal cavity with an applicator.The ointment must be inserted at least 1 cm into the anus.The dose is to be applied intra-anally every twelve hours. Treatment may be continued until the pain abates,up to a maximum of 8 weeks.</p>', '<p>The following medicines may increase the blood pressure lowering effect of glyceryl trinitrate ointment-</p>\r\n\r\n<ul>\r\n	<li>Medicines for depression&nbsp;</li>\r\n	<li>Medicines for erectile dysfunction&nbsp;</li>\r\n	<li>Medicines for high blood pressure&nbsp;</li>\r\n	<li>Diuretics</li>\r\n	<li>Commonly used tranquillizers&nbsp;</li>\r\n	<li>Medicines used to treat heart problems&nbsp;</li>\r\n</ul>', '<p>Headache and dizziness is a common side effect experienced with Nitroglycerin 0.4% ointment. A possible side effect is reduced control over bowel movements and leaking of bowel motions although this is expected to be a rare event.</p>', '<p>Headache and dizziness is a common side effect experienced with Nitroglycerin 0.4% ointment. A possible side effect is reduced control over bowel movements and leaking of bowel motions although this is expected to be a rare event.</p>', '<p>There are no adequate data from the use of Nitroglycerin in pregnant women. Animal studies are inconclusive with respect to effects on pregnancy embryonal/foetal parturition and postnatal development. This ointment should not be used during pregnancy. It is not known whether Nitroglycerin is excreted in human milk. Due to the potential harmful effects on the breast fed child, the use of this ointment is not recommended during breast feeding.</p>', '<p>Nitroglycerin 0.4% ointment should be used with caution in patients who have severe hepatic or renal disease.It should not be used if patient suffers from severe anemia, glaucoma, hypotension, increased intracranial pressure.</p>', '<p>Accidental overdose may result in hypotension and reflex tachycardia. Because the hypotension associated with nitroglycerin overdose is the result of venodilation and arterial hypovolaemia, prudent therapy in this situation should be directed toward increasing central fluid volume. Excessive dosage may also give rise to methaemogiobinaemia. This should be treated with methylene blue infusion.</p>', '<p>Drugs used in Ano-rectal region.</p>', '<p>Store below 25&deg;C. Do not freeze. Keep all medicines out of reach of the children.</p>', '<p><strong>Pediatric Use</strong>: It is not recommended for use in children and adolescents below 18 years of age due to lack of data on safety and efficacy.</p>', '2022-03-11 03:52:24', '2022-03-11 03:52:24'),
(1056, 1056, '<p>Nitroglycerin is indicated for the prophylaxis of angina pectoris. The onset of action is not sufficiently rapid for this form to be useful in aborting an acute anginal episode.</p>', '<p>Nitroglycerin causes relaxation of vascular smooth muscle, producing a vasodilator effect on both peripheral arteries and veins. Dilation of veins promote peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure (preload) and relaxation of arteries reduce systemic vascular resistance and arterial pressure (afterload).</p>', '<p>Dosage should always to be adjusted according to the requirement and response obtained by the individual patient and the severity of the anginal pain. For adults, one Nitroglycerin 2.6 mg sustained released tablet or capsule in morning and evening. This should be taken empty stomach.</p>', '<p>Nitroglycerin dilates peripheral blood vessels and may increase the antihypertensive properties of vasodilators, calcium antagonists, beta-adrenergic blockers. Concomitant use of nitrates with tricyclic antidepressants and alcohol may cause high blood pressure. Concomitant use of nitrates with phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, vardenafil and tadalafil cause fall in blood pressure. Aspirin decreases the clearance and enhances the hemodynamic effects of nitroglycerin. Nitroglycerin may reduce the pharmacologic effects of heparin when used concomitantly. Nitrates increase the bioavailability of dihydroergotamine.</p>', '<p>Nitroglycerin is contraindicated in patients with a known hypersensitivity to nitroglycerin, other organic nitrates, or nitrites or to the excipients of the medicine. It is also contraindicated in patients with acute myocardial infarction, marked anaemia, head trauma, cerebral haemorrhage, or closed angle glaucoma.</p>', '<p>Headache may occur at the onset of treatment but will usually subside after a few days. If the headache persists dosage should be decreased. Other side effects include tachycardia, postural hypotension and syncope, cyanosis and methaemoglobinaemia.</p>', '<p>Nitroglycerin should not be used during pregnancy or lactation unless considered essential by the physician.</p>', '<p>Nitroglycerin should be used with caution in patients who are predisposed to closed-angle glaucoma. As with other drugs for the treatment of angina pectoris, abrupt discontinuation of therapy may lead to exacerbation of symptoms. When discontinuing long term treatment, the dosage should be reduced gradually over several days, and the patient carefully monitored. The use of nitroglycerin during the early days of acute myocardial infarction requires particular attention to hemodynamic monitoring and clinical status to avoid the hazards of hypotension and tachycardia.</p>', NULL, '<p>Nitrates: Coronary vasodilators.</p>', '<p>Store in a cool and dry place away from light and heat. Keep all medicines out of the reach of children.</p>', NULL, '2022-03-11 03:54:07', '2022-03-11 03:54:07'),
(1057, 1057, '<p>Nitroglycerin sublingual spray is indicated for acute relief of an attack or prophylaxis of angina pectoris due to coronary artery disease.</p>', '<p>The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle, producing a vasodilator effect on both peripheral arteries and veins with more prominent effects on the latter. Dilation of the post-capillary vessels, including large veins, promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular enddiastolic pressure (pre-load). Arteriolar relaxation reduces systemic vascular resistance and arterial pressure (after-load).</p>', '<p>At the onset of an attack, 1 or 2 metered sprays should be administered under the tongue. No more than 3 metered sprays are recommended within a 15 minute period. If the chest pain persists, prompt medical attention is recommended. Nitroglycerin spray may be used prophylactically 5 to 10 minutes prior to engaging in activities which might precipitate an acute attack.</p>', '<p>Use of alcohol with Nitroglycerin may produce severe hypotension and collapse. Oral Nitroglycerin may enhance the bioavailability of dihydroergotamine. Orthostatic hypotension may occur with the combined use of calcium channel blocker, phenothiazines and tricyclic antidepressants.</p>', '<p>Hypersensitivity to nitrates or any constituents of the formulation. Hypotension, hypovolaemia, severe anaemia, cerebral haemorrhage and brain trauma, mitral stenosis and angina caused by hypertrophic obstructive cardiomyopathy. Concomitant administration of phosphodiesterase inhibitors used for the treatment of erectile dysfunction.</p>', '<p>A number of nitrate related adverse effects may occur including headache, facial flushing, dizziness, nausea, vomiting, feelings of weakness, postural hypotension and reflex tachycardia .</p>', '<p>Pregnancy Category C. There are no adequate and well controlled studies in pregnant women. Nitroglycerin should be given to pregnant women only if clearly needed. It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Nitroglycerin spray is administered to a nursing woman.</p>', '<p>The use of Nitroglycerin during the early days of acute myocardial infarction requires particular attention to monitoring hemodynamics and clinical status. Nitroglycerin should be used with caution in patients with severely impaired renal or hepatic function, hypothyroidism, malnutrition or hypothermia.</p>', '<p>Nitrate overdosage may result in: severe hypotension, persistent throbbing headache, vertigo, palpitation, visual disturbance, flushing and perspiring skin (later becoming cold and cyanotic), nausea and vomiting (possibly with colic and even bloody diarrhea), syncope (especially in the upright posture), methemoglobinemia with cyanosis and anorexia, initial hyperpnea, dyspnea and slow breathing, slow pulse, heart block, increased intracranial pressure with cerebral symptoms of confusion and moderate fever, paralysis and coma followed by clonic convulsions and possibly death due to circulatory collapse.<br />\r\n<br />\r\nMethemoglobinemia: Case reports of clinically significant methemoglobinemia are rare at conventional doses of organic nitrates. The formation of methemoglobin is dose-related and in the case of genetic abnormalities of hemoglobin that favor methemoglobin formation, even conventional doses of organic nitrates could produce harmful concentrations of methemoglobin.<br />\r\n<br />\r\nTreatment of Overdosage: Keep the patient recumbent in a shock position and comfortably warm. Passive movement of the extremities may aid venous return. Administer oxygen and artificial ventilation, if necessary. If methemoglobinemia is present, administration of methylene blue (1% solution), 1-2 mg per kilogram of body weight intravenously, may be required. If an excessive quantity of Nitroglycerin spray has been recently swallowed, gastric lavage may be of use.</p>', '<p>Nitrates: Coronary vasodilators.</p>', '<p>Store in a cool and dry place away from light and heat. Keep all medicines out of the reach of children.</p>', '<p>Safety and effectiveness of nitroglycerin in pediatric patients have not been established.</p>', '2022-03-11 03:55:57', '2022-03-11 03:55:57');
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
(1058, 1058, '<p>Nitroglycerin sublingual tablet is indicated for the acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease.</p>', '<p>Nitroglycerin forms free radical nitric oxide (NO) which activates guanylate cyclase, resulting in an increase of guanosine 3&#39;5&#39; monophosphate in smooth muscle and other tissues. These events lead to dephosphorylation of myosin light chains, which regulate the contractile state in smooth muscle and result in vasodilatation.</p>', '<p>One sublingual tablet should be dissolved under the tongue at the first sign of an acute anginal attack. The dose may be repeated approximately every five minutes, until relief is obtained. If the pain persists after a total of 3 tablets in a 15-minute period, prompt medical attention is recommended.</p>', '<p>Patients receiving antihypertensive drugs, beta-adrenergic blockers or phenothiazines and nitrates should be observed for possible additive hypotensive effects. Marked orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used concomitantly. Concomitant use of nitrates and alcohol may cause hypotension. The vasodilatory and hemodynamic effects of Nitroglycerin may be enhanced by concomitant administration of aspirin. Patients receiving sublingual Nitroglycerin should avoid ergotamine and related drugs or be monitored for symptoms of ergotism if this is not possible.</p>', '<p>Sublingual Nitroglycerin therapy is contraindicated in patients with early myocardial infarction, severe anemia, increased intracranial pressure and those with a known hypersensitivity to Nitroglycerin. Administration of Nitroglycerin is contraindicated in patients who are using sildenafil citrate since sildenafil citrate has been shown to potentiate the hypotensive effects of organic nitrates.</p>', '<p>Headache which may be severe and persistent may occur immediately after use. Vertigo, dizziness, weakness, palpitation and other manifestations of postural hypotension may develop occasionally.</p>', '<p>Nitroglycerin should be given to a pregnant woman only if clearly needed. It is not known whether Nitroglycerin is excreted in human milk.</p>', '<p>Only the smallest dose required for effective control of the acute anginal attack should be used. Excessive use may lead to the development of tolerance. This drug should be used with caution in patients who may be volume-depleted or are alredy hypotensive.</p>', NULL, '<p>Nitrates: Coronary vasodilators</p>', '<p>Store in a cool and dry place away from light and heat. Keep all medicines out of the reach of children.</p>', NULL, '2022-03-11 03:57:40', '2022-03-11 03:57:40'),
(1059, 1059, '<p>A gas that can cause general anesthesia. Nitrous oxide is sometimes given in the company of other anesthetic agents but it is not used today as the only anesthetic agent because the concentration of nitrous oxide needed to produce anesthesia is close to the concentration that seriously lowers the blood oxygen level and creates a hazardous&nbsp;hypoxic&nbsp;state.<br />\r\n<br />\r\nNitrous oxide figured in the history of&nbsp;anesthesiology. In 1840 a dentist named Horace Wells had the idea that, with the recently discovered &quot;exhilarating or&nbsp;laughing gas&quot;, teeth might be extracted without pain. Under its influence he had one of his own teeth pulled in 1844 and afterwards frequently used it in his practice.</p>', '<p>The pharmacological&nbsp;mechanism of action of N2O in medicine is not fully known. However, it has been shown to directly modulate a broad range of&nbsp;ligand-gated ion channels, and this likely plays a major role in many of its effects. It moderately blocks NMDA and&nbsp;&beta;2-subunit-containing&nbsp;nACh channels, weakly inhibits AMPA, kainate, GABAC, and&nbsp;5-HT3&nbsp;receptors, and slightly potentiates GABAA&nbsp;and&nbsp;glycine receptors. It also has been shown to activate&nbsp;two-pore-domain&nbsp;K+&nbsp;channels. While N2O affects quite a few ion channels, its anaesthetic, hallucinogenic, and&nbsp;euphoriant&nbsp;effects are likely caused predominantly, or fully, via inhibition of NMDA receptor-mediated currents. In addition to its effects on ion channels, N2O&nbsp;may act to imitate&nbsp;nitric oxide in the central nervous system, and this may be related to its analgesic and anxiolytic properties.</p>', '<p><strong>Adult</strong>: This gas must be used with close clinical supervision with hematological monitoring as required.<br />\r\n<br />\r\n<strong>Child</strong>: Safety &amp; Efficacy has not been established.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Pneumothorax, abdominal distension, suspected intestinal obstruction, bullous emphysema. It should also be avoided where the patient is unable to effectively make use of the gas delivery equipment such as maxillo-facial injuries, impaired consciousness, sedation or intoxication.</p>', '<p>Generally well tolerated.</p>', '<p>Pregnancy Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Prolonged inhalation can also result in dryness of the mouth and discomfort.</p>', NULL, '<p>General (Inhalation) anesthetics</p>', NULL, NULL, '2022-03-11 03:59:14', '2022-03-11 03:59:14'),
(1060, 1060, '<p>Nivolumab is a programmed death receptor-1 (PD-1)-blocking antibody indicated for the treatment of:<br />\r\n<br />\r\n<strong>Melanoma</strong>:</p>\r\n\r\n<ul>\r\n	<li>patients with unresectable or metastatic melanoma, as a single agent or in combination with ipilimumab.</li>\r\n	<li>patients with melanoma with lymph node involvement or metastatic disease who have undergone complete resection, in the adjuvant setting.</li>\r\n</ul>\r\n\r\n<p><strong>Non-Small Cell Lung Cancer (NSCLC)</strong>:</p>\r\n\r\n<ul>\r\n	<li>adult patients with metastatic non-small cell lung cancer expressing PD-L1 (&ge;1%) as determined by an FDA-approved test, with no EGFR or ALK genomic tumor aberrations, as first-line treatment in combination with ipilimumab.</li>\r\n	<li>adult patients with metastatic or recurrent non-small cell lung cancer with no EGFR or ALK genomic tumor aberrations as first-line treatment, in combination with ipilimumab and 2 cycles of platinum doublet chemotherapy.</li>\r\n	<li>patients with metastatic non-small cell lung cancer and progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving Nivolumab.</li>\r\n</ul>\r\n\r\n<p><strong>Malignant Pleural Mesothelioma</strong>: adult patients with unresectable malignant pleural mesothelioma, as first-line treatment in combination with ipilimumab.<br />\r\n<br />\r\n<strong>Renal Cell Carcinoma (RCC)</strong>:</p>\r\n\r\n<ul>\r\n	<li>patients with intermediate or poor risk advanced renal cell carcinoma, as a first-line treatment in combination with ipilimumab.</li>\r\n	<li>patients with advanced renal cell carcinoma, as a first-line treatment in combination with cabozantinib.</li>\r\n	<li>patients with advanced renal cell carcinoma who have received prior anti-angiogenic therapy.</li>\r\n</ul>\r\n\r\n<p><strong>Classical Hodgkin Lymphoma (cHL)</strong>: adult patients with classical Hodgkin lymphoma that has relapsed or progressed after</p>\r\n\r\n<ul>\r\n	<li>autologous hematopoietic stem cell transplantation (HSCT) and brentuximab vedotin, or</li>\r\n	<li>3 or more lines of systemic therapy that includes autologous HSCT.</li>\r\n</ul>\r\n\r\n<p><strong>Squamous Cell Carcinoma of the Head and Neck (SCCHN)</strong>: patients with recurrent or metastatic squamous cell carcinoma of the head and neck with disease progression on or after a platinum-based therapy.<br />\r\n<br />\r\n<strong>Urothelial Carcinoma</strong>: patients with locally advanced or metastatic urothelial carcinoma who a: have disease progression during or following platinum-containing chemotherapy; have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.<br />\r\n<br />\r\n<strong>Colorectal Cancer</strong>: adult and pediatric (12 years and older) patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan, as a single agent or in combination with ipilimumab.<br />\r\n<br />\r\n<strong>Hepatocellular Carcinoma (HCC)</strong>: patients with hepatocellular carcinoma who have been previously treated with sorafenib, as a single agent or in combination with ipilimumab. a (1.10)<br />\r\n<br />\r\n<strong>Esophageal Squamous Cell Carcinoma (ESCC)</strong>: patients with unresectable advanced, recurrent or metastatic esophageal squamous cell carcinoma after prior fluoropyrimidine- and platinum-based chemotherapy.<br />\r\n<br />\r\n<strong>Gastric Cancer, Gastroesophageal Junction Cancer, and Esophageal Adenocarcinoma</strong>:</p>\r\n\r\n<ul>\r\n	<li>patients with advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma in combination with fluoropyrimidine- and platinum-containing chemotherapy.</li>\r\n	<li>This indication is approved under accelerated approval based on overall response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.</li>\r\n	<li>Treatment of patients with multiple myeloma with a PD-1 or PD-L1 blocking antibody in combination with a thalidomide analog plus dexamethasone is not recommended outside of controlled clinical trials.</li>\r\n</ul>', '<p>Binding of the PD-1 ligands, PD-L1 and PD-L2, to the PD-1 receptor found on T cells, inhibits T-cell proliferation and cytokine production. Upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway can contribute to inhibition of active T-cell immune surveillance of tumors. Nivolumab is a human immunoglobulin G4 (IgG4) monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response. In syngeneic mouse tumor models, blocking PD-1 activity resulted in decreased tumor growth.<br />\r\n<br />\r\nCombined nivolumab (anti-PD-1) and ipilimumab (anti-CTLA-4) mediated inhibition results in enhanced T-cell function that is greater than the effects of either antibody alone, and results in improved anti-tumor responses in metastatic melanoma and advanced RCC. In murine syngeneic tumor models, dual blockade of PD-1 and CTLA-4 resulted in increased anti-tumor activity.</p>', '<p>Administer by intravenous infusion based upon recommended infusion rate for each indication.<br />\r\n<br />\r\n<strong>Unresectable or metastatic melanoma</strong>:</p>\r\n\r\n<ul>\r\n	<li>240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n	<li>1 mg/kg followed by ipilimumab 3 mg/kg on the same day every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n</ul>\r\n\r\n<p><strong>Adjuvant treatment of melanoma</strong>: 240 mg every 2 weeks or 480 mg every 4 weeks.<br />\r\n<br />\r\n<strong>Metastatic non-small-cell lung cancer</strong>:</p>\r\n\r\n<ul>\r\n	<li>3 mg/kg every 2 weeks with ipilimumab 1 mg/kg every 6 weeks.</li>\r\n	<li>360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks and 2 cycles of platinum-doublet chemotherapy.</li>\r\n	<li>240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n</ul>\r\n\r\n<p><strong>Malignant pleural mesothelioma</strong>: 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks.<br />\r\n<br />\r\n<strong>Advanced renal cell carcinoma</strong>:</p>\r\n\r\n<ul>\r\n	<li>3 mg/kg followed by ipilimumab 1 mg/kg on the same day every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n	<li>240 mg every 2 weeks or 480 mg every 4 weeks administered in combination with cabozantinib 40 mg once daily without food.</li>\r\n	<li>240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n</ul>\r\n\r\n<p><strong>Classical Hodgkin lymphoma</strong>: 240 mg every 2 weeks or 480 mg every 4 weeks.<br />\r\n<br />\r\n<strong>Recurrent or metastatic squamous cell carcinoma of the head and neck</strong>: 240 mg every 2 weeks or 480 mg every 4 weeks.<br />\r\n<br />\r\n<strong>Locally advanced or metastatic urothelial carcinoma</strong>: 240 mg every 2 weeks or 480 mg every 4 weeks.<br />\r\n<br />\r\n<strong>Microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer</strong>:</p>\r\n\r\n<ul>\r\n	<li>Adult and pediatric patients &ge;40 kg: 240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n	<li>Pediatric patients &lt;40 kg: 3 mg/kg every 2 weeks.</li>\r\n	<li>Adult and pediatric patients &ge;40 kg: 3 mg/kg followed by ipilimumab 1 mg/kg on the same day every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n</ul>\r\n\r\n<p><strong>Hepatocellular carcinoma</strong>:</p>\r\n\r\n<ul>\r\n	<li>240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n	<li>1 mg/kg followed by ipilimumab 3 mg/kg on the same day every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks.</li>\r\n</ul>\r\n\r\n<p><strong>Esophageal squamous cell carcinoma</strong>: 240 mg every 2 weeks or 480 mg every 4 weeks.<br />\r\n<br />\r\n<strong>Gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC, GEJC, or EAC)</strong>:</p>\r\n\r\n<ul>\r\n	<li>360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks.</li>\r\n	<li>240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks.</li>\r\n</ul>', NULL, '<p>None</p>', '<p>Most common adverse reactions (incidence &ge;20%) in patients were:</p>\r\n\r\n<ul>\r\n	<li><strong>As a single agent</strong>: fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, asthenia, cough, dyspnea, constipation, decreased appetite, back pain, arthralgia, upper respiratory tract infection, pyrexia, headache, abdominal pain, and vomiting.</li>\r\n	<li><strong>In combination with ipilimumab</strong>: fatigue, diarrhea, rash, pruritus, nausea, musculoskeletal pain, pyrexia, cough, decreased appetite, vomiting, abdominal pain, dyspnea, upper respiratory tract infection, arthralgia, headache, hypothyroidism, decreased weight, and dizziness.</li>\r\n	<li><strong>In combination with ipilimumab and platinum-doublet chemotherapy</strong>: fatigue, musculoskeletal pain, nausea, diarrhea, rash, decreased appetite, constipation, and pruritus.</li>\r\n	<li><strong>In combination with cabozantinib</strong>: diarrhea, fatigue, hepatotoxicity, palmar-plantar<br />\r\n	erythrodysaesthesia syndrome, stomatitis, rash, hypertension, hypothyroidism,<br />\r\n	musculoskeletal pain, decreased appetite, nausea, dysgeusia, abdominal pain, cough,<br />\r\n	and upper respiratory tract infection.</li>\r\n	<li><strong>In combination with fluoropyrimidine- and platinum-containing chemotherapy</strong>: peripheral neuropathy, nausea, fatigue, diarrhea, vomiting, decreased appetite, abdominal pain, constipation, and musculoskeletal pain.</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: Based on data from animal studies and its mechanism of action, Nivolumab can cause fetal harm when administered to a pregnant woman. In animal reproduction studies, administration of nivolumab to cynomolgus monkeys from the onset of organogenesis through delivery resulted in increased abortion and premature infant death. Human IgG4 is known to cross the placental barrier and nivolumab is an immunoglobulin G4 (IgG4); therefore, nivolumab has the potential to be transmitted from the mother to the developing fetus. The effects of Nivolumab are likely to be greater during the second and third trimesters of pregnancy. There are no available data on Nivolumab use in pregnant women to evaluate a drug-associated risk. Advise pregnant women of the potential risk to a fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no data on the presence of nivolumab in human milk, the effects on the breastfed child, or the effects on milk production. Because of the potential for serious adverse reactions in the breastfed child, advise women not to breastfeed during treatment and for 5 months after the last dose of nivolumab.</p>', '<p><strong>Immune-Mediated Adverse Reactions</strong>:</p>\r\n\r\n<ul>\r\n	<li>Immune-mediated adverse reactions, which may be severe or fatal, can occur in any organ system or tissue, including the following: immune-mediated pneumonitis, immune-mediated colitis, immune-mediated hepatitis and hepatotoxicity, immune-mediated endocrinopathies, immune-mediated dermatologic adverse reactions, and immune-mediated nephritis and renal dysfunction.</li>\r\n	<li>Monitor for early identification and management. Evaluate liver enzymes, creatinine, and thyroid function at baseline and periodically during treatment.</li>\r\n	<li>Withhold or permanently discontinue based on severity and type of reaction.</li>\r\n</ul>\r\n\r\n<p><strong>Infusion-related reactions</strong>: Interrupt, slow the rate of infusion, or permanently discontinue Nivolumab based on severity of reaction.<br />\r\n<br />\r\n<strong>Complications of allogeneic HSCT</strong>: Fatal and other serious complications can occur in patient who receive allogeneic HSCT before or after being treated with a PD-1/PD-L1 blocking antibody.<br />\r\n<br />\r\n<strong>Embryo-Fetal toxicity</strong>: Can cause fetal harm. Advise females of reproductive potential of potential risk to a fetus and to use effective contraception.</p>', NULL, '<p>Immunological Chemotherapy, Immunosuppressant</p>', '<p>Store under refrigeration at 2&deg;C to 8&deg;C. Protect from light by storing in the original package until time of use. Do not freeze or shake.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Nivolumab as a single agent and in combination with ipilimumab have been established in pediatric patients age 12 years and older with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer (mCRC) that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan.</p>', '2022-03-11 04:01:16', '2022-03-11 04:01:16'),
(1061, 1061, '<p>Nizatidine is indicated for up to 8 weeks for the treatment of active&nbsp;duodenal ulcer. In most patients, the&nbsp;ulcer&nbsp;will heal within 4 weeks.<br />\r\n<br />\r\nNizatidine is indicated for&nbsp;maintenance therapy&nbsp;for&nbsp;duodenalulcer patients, at a reduced dosage of 150 mg h.s. after healing of an active duodenal ulcer. The consequences of continuous&nbsp;therapy&nbsp;with Nizatidine for longer than 1 year are not known.<br />\r\n<br />\r\nNizatidine is indicated for up to 12 weeks for the treatment of endoscopically diagnosed esophagitis, including erosive and ulcerative esophagitis, and associated heartburn due to&nbsp;GERD.<br />\r\n<br />\r\nNizatidine is indicated for up to 8 weeks for the treatment of active&nbsp;benign&nbsp;gastric ulcer. Before initiating therapy, care should be taken to exclude the possibility of malignant gastric&nbsp;ulceration.</p>', '<p>Nizatidine is a competitive, reversible inhibitor of histamine at the histamine H2-receptors, particularly those in the gastric parietal cells. By inhibiting the action of histamine on stomach cells, nizatidine reduces stomach acid production. Nizatidine had no demonstrable antiandrogenic action. Full-dose therapy for the problems treated by nizatidine lasts no longer than 8 weeks. It has been demonstrated that treatment with a reduced dose of nizatidine is effective as maintenance therapy following healing of active duodenal ulcers.</p>', '<p><strong>Active Duodenal Ulcer</strong>: The recommended oral dosage for adults is 300 mg once daily at bedtime. An alternative dosage regimen is 150 mg twice daily.<br />\r\n<br />\r\n<strong>Maintenance of Healed Duodenal Ulcer</strong>: The recommended oral dosage for adults is 150 mg once daily at bedtime.<br />\r\n<br />\r\n<strong>Gastroesophageal Reflux&nbsp;Disease</strong>: The recommended oral dosage in adults for the treatment of erosions, ulcerations, and associated heartburn is 150mg twice daily.<br />\r\n<br />\r\n<strong>Active Benign Gastric Ulcer</strong>: The recommended oral dosage is 300 mg given either as 150 mg twice daily or 300 mg once daily at bedtime. Prior to treatment, care should be taken to exclude the possibility of malignant gastric ulceration.</p>', '<p>No interactions have been observed between Nizatidine&nbsp;and theophylline, chlordiazepoxide, lorazepam, lidocaine, phenytoin, and&nbsp;warfarin. Nizatidine&nbsp;does not inhibit the cytochrome P-450-linked drug-metabolizing enzyme system; therefore, drug interactions mediated by inhibition of hepatic&nbsp;metabolism&nbsp;are not expected to occur. In patients given very high doses (3,900 mg) of&nbsp;aspirin&nbsp;daily, increases in serum salicylate levels were seen when nizatidine, 150 mg&nbsp;b.i.d., was administered concurrently.</p>', '<p>Nizatidine is contraindicated in patients with known hypersensitivity to the drug. Because cross&nbsp;sensitivity&nbsp;in this class of compounds has been observed, H2-receptor antagonists, including Nizatidine , should not be administered to patients with a history of hypersensitivity to other H2-receptor antagonists.</p>', '<p>Headache, dizziness, insomnia, abnormal dreams, somnolence, asthenia, anxiety, excessive sweating, diarrhoea, nausea and/or vomiting, abdominal pain/discomfort, constipation, flatulence, dyspepsia, dry mouth, anorexia, tooth disorder, urticaria, rash, pruritus, exfoliative dermatitis, anaemia, rhinitis, pharyngitis, sinusitis, reversible hepatocellular injury, diaphoresis, myalgia, fever. Rarely, asymptomatic ventricular tachycardia, thrombocytopenic purpura, decreased libido, gynaecomastia, reversible cholestatic or mixed cholestatic-hepatocellular injury with jaundice.</p>', '<p>Pregnancy&nbsp;Category B. Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st&nbsp;trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>Possibility of malignancy should be excluded prior to therapy as the drug may mask symptoms and delay diagnosis of gastric malignancy. Increased risk of community-acquired pneumonia. Renal impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Lacrimation, salivation, emesis, miosis, and diarrhoea.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. Activated charcoal, emesis or lavage may reduce absorption.</p>', '<p>H2 receptor antagonist.</p>', '<p>Store at 25&deg;C.</p>', '<p>Dosage Adjustment for Patients With Moderate to Severe&nbsp;Renal Insufficiency-<br />\r\n<br />\r\nActive Duodenal Ulcer, GERD and Benign Gastric Ulcer:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl 20-50 ml/min</strong>: 150 mg daily</li>\r\n	<li><strong>CrCl &lt;20 ml/min</strong>: 150 mg every other day</li>\r\n</ul>\r\n\r\n<p>Maintenance Therapy:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl 20-50 ml/min</strong>: 150 mg every other day</li>\r\n	<li><strong>CrCl</strong>&nbsp;<strong>&lt;20 mL/min</strong>: 150 mg every 3 days</li>\r\n</ul>\r\n\r\n<p>Some elderly patients may have creatinine clearances of less than 50 ml/min, and, based on pharmacokinetic data in patients with renal impairment, the dose for such patients should be reduced accordingly. The clinical effects of this dosage reduction in patients with renal failure have not been evaluated.</p>', '2022-03-11 04:03:16', '2022-03-11 04:03:16'),
(1062, 1062, '<p>For blood pressure control in certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, myocardial infarction, septicemia, blood transfusion, and drug reactions). As an adjunct in the treatment of cardiac arrest and profound hypotension.</p>', '<p>Norepinephrine is a direct-acting sympathomimetic which stimulates &beta;1- and &alpha;-adrenergic receptors. Its &alpha;-agonist effects cause vasoconstriction, thereby raising systolic and diastolic BP with reflex slowing of heart rate.</p>', '<p>An infusion of Norepinephrine should be given into a large vein. Restoration of Blood Pressure in Acute Hypotensive States. Blood volume depletion should always be corrected as fully as possible before any vasopressor is administered. When, as an emergency measure, intraaortic pressures must be maintained to prevent cerebral or coronary artery ischemia, Norepinephrine can be administered before and concurrently with blood volume replacement.<br />\r\n<br />\r\n<strong>Diluent</strong>: Norepinephrine should be diluted in 5 percent dextrose injection or 5 percent dextrose and sodium chloride injections. These dextrose containing fluids are protection against significant loss of potency due to oxidation. Administration in saline solution alone is not recommended. Whole blood or plasma, if indicated to increase blood volume, should be administered separately (for example, by use of a Y-tube and individual containers if given simultaneously).<br />\r\n<br />\r\n<strong>Average Dosage</strong>: Add the content of the ampoule (4 mg/4 ml) of Norepinephrine to 1,000 mL of a 5 percent dextrose containing solution. Each ml of this dilution contains 4 mcg of the base of Norepinephrine. Give this solution by intravenous infusion. Insert a plastic intravenous catheter through a suitable bore needle well advanced centrally into the vein and securely fixed with adhesive tape, avoiding, if possible, a catheter tie-in technique as this promotes stasis. An IV drip chamber or other suitable metering device is essential to permit an accurate estimation of the rate of flow in drops per minute. After observing the response to an initial dose of 2 ml to 3 ml (from 8 mcg to 12 mcg of base) per minute, adjust the rate of flow to establish and maintain a low normal blood pressure (usually 80 mm Hg to 100 mm Hg systolic) sufficient to maintain the circulation to vital organs. In previously hypertensive patients, it is recommended that the blood pressure should be raised no higher than 40 mm Hg below the preexisting systolic pressure. The average maintenance dose ranges from 0.5 ml to 1 ml per minute (from 2 mcg to 4 mcg of base).<br />\r\n<br />\r\n<strong>High Dosage</strong>: In all cases, dosage of Norepinephrine should be titrated according to the response of the patient. Occasionally much larger or even enormous daily doses (as high as 68 mg base or 17 ampoules) may be necessary if the patient remains hypotensive, but occult blood volume depletion should always be suspected and corrected when present. Central venous pressure monitoring is usually helpful in detecting and treating this situation.<br />\r\n<br />\r\n<strong>Fluid Intake</strong>: The degree of dilution depends on clinical fluid volume requirements. If large volumes of fluid (dextrose) are needed at a flow rate that would involve an excessive dose of the pressor agent per unit of time, a solution more dilute than 4 mcg per ml should be used. On the other hand, when large volumes of fluid are clinically undesirable, a concentration greater than 4 mcg per ml may be necessary.<br />\r\n<br />\r\n<strong>Duration of Therapy</strong>: The infusion should be continued until adequate blood pressure and tissue perfusion are maintained without therapy. Infusions of Norepinephrine should be reduced gradually, avoiding abrupt withdrawal. In some of the reported cases of vascular collapse due to acute myocardial infarction, treatment was required for up to six days.<br />\r\n<br />\r\n<strong>Adjunctive Treatment in Cardiac Arrest</strong>: Infusions of Norepinephrine are usually administered intravenously during cardiac resuscitation to restore and maintain an adequate blood pressure after an effective heartbeat and ventilation have been established by other means. Norepinephrine powerful beta-adrenergic stimulating action is also thought to increase the strength and effectiveness of systolic contractions once they occur.<br />\r\n<br />\r\n<strong>Average Dosage</strong>: To maintain systemic blood pressure during the management of cardiac arrest, Norepinephrine is used in the same manner as described under Restoration of Blood Pressure in Acute Hypotensive States. Do not use the solution if its color is pinkish or darker than slightly yellow or if it contains a precipitate. Avoid contact with iron salts, alkalis, or oxidizing agents.</p>', '<p>Cyclopropane and halothane anesthetics increase cardiac autonomic irritability and therefore seem to sensitize the myocardium to the action of intravenously administered epinephrine or norepinephrine. Hence, the use of Norepinephrine during cyclopropane and halothane anesthesia is generally considered contraindicated because of the risk of producing ventricular tachycardia or fibrillation. The same type of cardiac arrhythmias may result from the use of Norepinephrine in patients with profound hypoxia or hypercarbia. Norepinephrine should be used with extreme caution in patients receiving monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types, because severe, prolonged hypertension may result.</p>', '<p>Norepinephrine should not be given to patients who are hypotensive from blood volume deficits except as an emergency measure to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed. If Norepinephrine is continuously administered to maintain blood pressure in the absence of blood volume replacement, the following may occur: severe peripheral and visceral vasoconstriction, decreased renal perfusion and urine output, poor systemic blood flow despite &ldquo;normal&rdquo; blood pressure, tissue hypoxia, and lactate acidosis. Norepinephrine should also not be given to patients with mesenteric or peripheral vascular thrombosis (because of the risk of increasing ischemia and extending the area of infarction) unless, in the opinion of the attending physician, the administration of Norepinephrine is necessary as a life-saving procedure. Cyclopropane and halothane anesthetics increase cardiac autonomic irritability and therefore seem to sensitize the myocardium to the action of intravenously administered epinephrine or norepinephrine. Hence, the use of Norepinephrine during cyclopropane and halothane anesthesia is generally considered contraindicated because of the risk of producing ventricular tachycardia or fibrillation. The same type of cardiac arrhythmias may result from the use of Norepinephrine in patients with profound hypoxia or hypercarbia.</p>', '<p><strong>Body as a whole</strong>: Ischemic injury due to potent vasoconstrictor action and tissue hypoxia.<br />\r\n<br />\r\n<strong>Cardiovascular System</strong>: Bradycardia, probably as a reflex result of a rise in blood pressure, arrhythmias.<br />\r\n<br />\r\n<strong>Nervous System</strong>: Anxiety, transient headache.<br />\r\n<br />\r\n<strong>Respiratory System</strong>: Respiratory difficulty.<br />\r\n<br />\r\n<strong>Skin and Appendages</strong>: Extravasation necrosis at injection site. Prolonged administration of any potent vasopressor may result in plasma volume depletion which should be continuously corrected by appropriate fluid and electrolyte replacement therapy. If plasma volumes are not corrected, hypotension may recur when Norepinephrine is discontinued, or blood pressure may be maintained at the risk of severe peripheral and visceral vasoconstriction (e.g., decreased renal perfusion) with diminution in blood flow and tissue perfusion with subsequent tissue hypoxia and lactic acidosis and possible ischemic injury. Gangrene of extremities has been rarely reported. Overdoses or conventional doses in hypersensitive persons (e.g., hyperthyroid patients) cause severe hypertension with violent headache, photophobia, stabbing retrosternal pain, pallor, intense sweating, and vomiting.</p>', '<p>Pregnancy Category C. Animal reproduction studies have not been conducted with Norepinephrine. It is also not known whether Norepinephrine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Norepinephrine should be given to a pregnant woman only if clearly needed. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Norepinephrine is administered to a nursing woman.</p>', '<p><strong>Avoid Hypertension</strong>: Because of the potency of Norepinephrine and because of varying response to pressor substances, the possibility always exists that dangerously high blood pressure may be produced with overdoses of this pressor agent. It is desirable, therefore, to record the blood pressure every two minutes from the time administration is started until the desired blood pressure is obtained, then every five minutes if administration is to be continued. The rate of flow must be watched constantly, and the patient should never be left unattended while receiving Norepinephrine. Headache may be a symptom of hypertension due to overdosage.<br />\r\n<br />\r\n<strong>Site of Infusion</strong>: Whenever possible, infusions of Norepinephrine should be given into a large vein, particularly an antecubital vein because, when administered into this vein, the risk of necrosis of the overlying skin from prolonged vasoconstriction is apparently very slight. Some authors have indicated that the femoral vein is also an acceptable route of administration. A catheter tie-in technique should be avoided, if possible, since the obstruction to blood flow around the tubing may cause stasis and increased local concentration of the drug. Occlusive vascular diseases (for example, atherosclerosis, arteriosclerosis, diabetic endarteritis, Buerger&rsquo;s disease) are more likely to occur in the lower than in the upper extremity. Therefore, one should avoid the veins of the leg in elderly patients or in those suffering from such disorders. Gangrene has been reported in a lower extremity when infusions of Norepinephrine were given in an ankle vein.<br />\r\n<br />\r\n<strong>Extravasation</strong>: The infusion site should be checked frequently for free flow. Care should be taken to avoid extravasation of Norepinephrine into the tissues, as local necrosis might ensue due to the vasoconstrictive action of the drug. Blanching along the course of the infused vein, sometimes without obvious extravasation, has been attributed to vasa vasorum constriction with increased permeability of the vein wall, permitting some leakage. This also may progress on rare occasions to superficial slough, particularly during infusion into leg veins in elderly patients or in those suffering from obliterative vascular disease. Hence, if blanching occurs, consideration should be given to the advisability of changing the infusion site at intervals to allow the effects of local vasoconstriction to subside.<br />\r\n<br />\r\n<strong>Antidote for Extravasation Ischemia</strong>: To prevent sloughing and necrosis in areas in which extravasation has taken place, the area should be infiltrated as soon as possible with 10 mL to 15 mL of saline solution containing from 5 mg to 10 mg of phentolamine, an adrenergic blocking agent. A syringe with a fine hypodermic needle should be used, with the solution being infiltrated liberally throughout the area, which is easily identified by its cold, hard, and pallid appearance. Sympathetic blockade with phentolamine causes immediate and conspicuous local hyperemic changes if the area is infiltrated within 12 hours. Therefore, phentolamine should be given as soon as possible after the extravasation is noted.</p>', '<p>Overdosage with Norepinephrine may result in headache, severe hypertension, reflex bradycardia, marked increase in peripheral resistance, and decreased cardiac output. In case of accidental overdosage, as evidenced by excessive blood pressure elevation, discontinue Norepinephrine until the condition of the patient stabilizes.</p>', '<p>Alpha and Beta-adrenergic agonist</p>', '<p>Store at a temperature not exceeding 30&deg;C in a dry place. Protect from light.</p>', '<p><strong>Use in Children &amp; Adolescents</strong>: Safety and effectiveness in pediatric patients has not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of Norepinephrine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Norepinephrine&nbsp;infusions should not be administered into the veins in the leg in elderly patients.<br />\r\n<br />\r\n<strong>Carcinogenesis, Mutagenesis, Impairment of Fertility</strong>: Studies have not been performed.</p>', '2022-03-11 04:05:20', '2022-03-11 04:05:20'),
(1063, 1063, '<p>Norethisterone is indicated in:</p>\r\n\r\n<ul>\r\n	<li>Metropathia hemorrhagic (dysfunctional uterine bleeding),</li>\r\n	<li>Premenstrual syndrome,</li>\r\n	<li>Postponement of menstruation,</li>\r\n	<li>Endometriosis &amp;</li>\r\n	<li>Menorrhagia.</li>\r\n</ul>', '<p>Norethisterone tablet is a preparation of Norethisterone which has progestational actions similar to those of progesterone, but is a more potent inhibitor of ovulation and has weak estrogenic and androgenic properties. It is used to treat a number of disorders of the menstrual cycle. Norethisterone is absorbed from the gastrointestinal tract and its effects last for at least 24 hours. It is excreted in the urine.</p>', '<p>Oral administration. Not intended for use in children.<br />\r\n<br />\r\n<strong>Metropathia haemorrhagica (dysfunctional uterine bleeding)</strong>: 1 tablet 3 times daily for 10 days. Bleeding is arrested usually within 1-3 days. A withdrawal bleeding resembling normal menstruation occurs within 2-4 days after discontinuing treatment.<br />\r\n<br />\r\n<strong>Prophylaxis against recurrence of dysfunctional bleeding</strong>: If there are no signs of resumption of normal ovarian function (no rise in the second half of the cycle of the morning temperature, which should be measured daily) recurrence must be anticipated. Cyclical bleeding can be established with 1 tablet twice daily from the 19th to the 26th day of the cycle.<br />\r\n<br />\r\n<strong>Premenstrual syndrome (including premenstrual mastalgia)</strong>: Premenstrual symptoms such as headache, migraine, breast discomfort, water retention, tachycardia, and psychological disturbances may be relieved by the administration of 2-3 tablets daily from the 19th to the 26th day of the cycle. Treatment should be repeated for several cycles. When treatment is stopped, the patient may remain symptom-free for a number of months.<br />\r\n<br />\r\n<strong>Postponement of menstruation</strong>: In cases of too frequent menstrual bleeding, and in special circumstances (e.g. operations, travel, sports) the postponement of menstruation is possible. 1 tablet of Norethisterone three times daily, starting 3 days before the expected onset of menstruation. A normal period should occur 2-3 days after the patient has stopped taking tablets.<br />\r\n<br />\r\n<strong>Endometriosis (pseudo-pregnancy therapy)</strong>: Long-term treatment is commenced on the 5th day of the cycle with 2 tablets of Norethisterone daily for the first few weeks. In the event of spotting, the dosage is increased to 4, and, if necessary, 5 tablets daily. After bleeding has ceased, the initial dose is usually sufficient. Duration of treatment: 4-6 months continuously, or longer if necessary.<br />\r\n<br />\r\n<strong>Menorrhagia (hypermenorrhoea)</strong>: 1 tablet 2-3 times a day from the 19th to the 26th day of the cycle (counting the first day of menstruation as day 1).</p>', '<p>Not known.</p>', '<ul>\r\n	<li>Pregnancy</li>\r\n	<li>Severe disturbances of liver function</li>\r\n	<li>Dubin-Johnson syndrome</li>\r\n	<li>Rotor syndrome</li>\r\n	<li>Previous or existing liver tumours</li>\r\n	<li>History during pregnancy of idiopathic jaundice, severe pruritus or herpes gestationis</li>\r\n	<li>Current thromboembolic processes</li>\r\n	<li>Hypersensitivity to the active substances or to any of the excipients</li>\r\n</ul>', '<p>Side-effects are more common during the first months after start of intake of Norethisterone, and subside with a duration of treatment. The side-effects are mentioned below:</p>\r\n\r\n<ul>\r\n	<li>Eye disorders- Visual disturbance</li>\r\n	<li>GI disorders- Nausea</li>\r\n	<li>General disorders and administration site- conditions headache, edema</li>\r\n	<li>Nervous system disorders- Migraine, Respiratory, thoracic and mediastinal disorders- Dyspnoea,</li>\r\n	<li>Skin and subcutaneous tissue disorders- Hypersensitivity (eg. Rash, urticaria).</li>\r\n</ul>', '<p>The administration of Norethisterone during pregnancy is contraindicated. Norethisterone should not be used during lactation.</p>', '<p>There is a general opinion, based on statistical evidence that users of combined oral contraceptives experience, more often than non-users, venous thromboembolism, arterial thrombosis, including cerebral and myocardial infarction and subarachnoid haemorrhage. Full recovery from such disorders does not always occur, and it should be realized that in a few cases they are fatal. Although Norethisterone does not contain oestrogen, one should keep the possibility of an increased thromboembolic risk in mind, particularly where there is a history of thromboembolic disease or in the presence of severe diabetes with vascular changes or sickle-cell anaemia.<br />\r\n<br />\r\nIn rare cases benign, and in even rarer cases, malignant liver tumours leading in isolated cases to life-threatening intra-abdominal haemorrhage have been observed after the use of hormonal substances such as the one contained in Norethisterone. If severe upper abdominal complaints, liver enlargement or signs of intra-abdominal haemorrhage occur, a liver tumour should be included in the differential diagnosis and, if necessary, the preparation should be withdrawn.<br />\r\nNorethisterone can influence carbohydrate metabolism. Parameters of carbohydrate metabolism should be examined carefully in all diabetics before and regularly during treatment.<br />\r\n<br />\r\nReasons for stopping Norethisterone immediately-</p>\r\n\r\n<ul>\r\n	<li>Occurrence for the first time of migrainous headaches or more frequent occurrence of unusually severe headaches</li>\r\n	<li>Sudden perceptual disorders (e.g. disturbances of vision or hearing)</li>\r\n	<li>First signs of thrombophlebitis or thromboembolic symptoms, feeling of pain and tightness in the chest</li>\r\n	<li>Pending operations (six weeks beforehand), immobilisation (e.g. after accidents)</li>\r\n	<li>Onset of jaundice, hepatitis, general pruritus</li>\r\n	<li>Significant rise in blood pressure</li>\r\n	<li>Pregnancy.</li>\r\n</ul>', '<p>There have been no reports from overdosage and treatment is generally unnecessary. There are no special antidotes and treatment should be symptomatic.</p>', '<p>Drugs for menopausal symptoms: Hormone replacement therapy, Female Sex hormones, Oral Contraceptive preparations.</p>', '<p>Store below 30&deg;C in a cool &amp; dry place. Keep out of reach of children.</p>', NULL, '2022-03-11 04:07:12', '2022-03-11 04:07:12');
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
(1064, 1064, '<p>Norgestrel tablets are indicated for use by females of reproductive potential to prevent pregnancy. This tablet are not for use as emergency contraception.</p>', '<p>Progestin-only oral contraceptives such as Norgestrel tablets prevent conception by suppres sing ovulation in approximately half of the cycles in users, thickening the cervical mucus to inhibit sperm penetration, lowering the midcycle LH and FSH peaks, slowing the movement of the ovum through the fallopian tubes, and altering the endometrium. Serum progestin levels peak about two hours after oral administration, followed by rapid distribution and elimination. By 24 hours after drug ingestion, serum levels are near baseline, making efficacy dependent upon rigid adherence to the dosing schedule. There are large variations in serum levels among individual users. Progestin-only administration results in lower steady-state progestin levels and a shorter elimination half-life than concomitant administration with estrogens.</p>', '<p>To achieve maximum contraceptive effectiveness, Norgestrel Tablets must be taken exactly as directed. The woman should take one tablet every day, at the same time. The administration is continuous, with no interruption between pill packs.</p>', NULL, '<p>Norgestrel tablet is contraindicated for use by women who are known to have the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Known or suspected pregnancy</li>\r\n	<li>Known or suspected carcinoma of the breast, or other progestin-sensitive cancer, now or in the past</li>\r\n	<li>Undiagnosed abnormal uterine bleeding</li>\r\n	<li>Hypersensitivity to any component of this product</li>\r\n	<li>Benign or malignant liver tumors</li>\r\n</ul>', '<p>An increased risk of the following adverse reactions has been reported with the use of progestin-only oral contraceptives: Delayed follicular atresia/ovarian cysts, Menstrual irregularity, changes in menstrual flow; breakthrough bleeding/spotting; amenorrhea, prolonged bleeding. The following adverse reactions were reported in &ge;5% of subjects in the Norgestrel&nbsp;Tablet clinical studies:</p>\r\n\r\n<ul>\r\n	<li>Headache</li>\r\n	<li>Dizziness</li>\r\n	<li>Nausea</li>\r\n	<li>Increased appetite</li>\r\n	<li>Abdominal pain, cramps and bloating</li>\r\n	<li>Fatigue</li>\r\n	<li>Vaginal discharge</li>\r\n	<li>Dysmenorrhea</li>\r\n	<li>Nervousness</li>\r\n	<li>Backache</li>\r\n	<li>Breast discomfort</li>\r\n	<li>Acne</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: Norgestrel Tablets are contraindicated for use in pregnant women because there is no need for pregnancy prevention in a woman who is already pregnant. Published studies report no harmful effects on fetal development associated with long-term use of contraceptive doses of oral progestins in pregnant women. Discontinue Norgestrel Tablets if pregnancy is confirmed.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: Small amounts of progestin pass into the breast milk, resulting in steroid levels in infant plasma. No adverse effects have been reported on breastfeeding performance or infant health. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Norgestrel Tablets and any potential adverse effects on the breastfed infant from Norgestrel Tablets or from the underlying maternal condition.</p>', '<p><strong>Migraine/Headache</strong>: The onset or exacerbation of migraine, or development of headache with a new pattern that is recurrent, persistent, or severe requires evaluation of the cause because women with migraine may be at increased risk of stroke.<br />\r\n<br />\r\nDrug Interactions:</p>\r\n\r\n<ul>\r\n	<li>The effectiveness of progestin-only pills is reduced by hepatic enzyme-inducing drugs such as phenytoin, carbamazepine, barbiturates, rifampin, efavirenz, bosentan and herbal preparations containing St. John&rsquo;s Wort (hypericum perforatum ). This could result in unintended pregnancy or breakthrough bleeding. During concomitant use of Norgestrel and substances that may affect its efficacy, it is recommended that a nonhormonal back-up method of contraception (such as condom) be used in addition to the regular intake of Norgestrel Tablets. Use of a nonhormonal back-up method is recommeded for 28 days after discontinuation of substances that have led to induction of hepatic microsomal enzymes. For women receiving long-term therapy with hepatic enzyme inducers, another method of contraception should be considered.</li>\r\n	<li>Effectiveness of progestin-containing hormonal contraceptives and emergency contraceptive ulipristal acetate may be decreased if progestin-containing hormonal contraceptives are used within five days after ulipristal acetate dosing. If a woman wishes to use Norgestrel Tablets after using ulipristal acetate, she should do so no sooner than 5 days after the intake of ulipristal acetate and she should use a reliable barrier method for subsequent acts of intercourse until her next menstrual period.</li>\r\n</ul>\r\n\r\n<p><strong>Gastrointestinal</strong>: Diarrhea and/or vomiting within 4 hours after taking a pill may reduce hormone absorption. Women should use of a nonhormonal back-up method of birth control (such as a condom or spermicide) during the next 48 hours.<br />\r\n<br />\r\n<strong>Interactions with Laboratory Tests</strong>: The following endocrine tests may be affected by Norgestrel Tablets use:</p>\r\n\r\n<ul>\r\n	<li>Sex hormone-binding globulin (SHBG) concentrations may be decreased.</li>\r\n	<li>Total thyroxine concentrations may be decreased, due to a decrease in thyroid binding globulin (TBG). However, free thyroxine level should remain unchanged.</li>\r\n</ul>', '<p>Symptoms of oral contraceptive overdosage may include nausea, vomiting, breast tenderness, dizziness, somnolence ( drowsiness/fatigue), and withdrawal bleeding in females. There is no specific antidote and further treatment of overdose, if necessary, is directed to the symptoms.</p>', '<p>Oral Contraceptive preparations</p>', '<p>Store at controlled room temperature between 20&deg; to 25&deg;C.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Norgestrel tablets have been established in women of reproductive age, including adolescents as young as 15 years of age, and almost 30% of subjects in the clinical trials who were under 20 years of age. Use of this product before menarche is not indicated.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Norgestrel tablet Tablets have not been studied in postmenopausal women and is not indicated in this population.</p>', '2022-03-11 04:10:04', '2022-03-11 04:10:04'),
(1065, 1065, '<p>Oral contraceptives are indicated for the prevention of pregnancy in women who elect to use this product as a method of contraception.&nbsp;Oral contraceptives are highly effective.&nbsp;The efficacy of these contraceptive methods, except sterilization, the IUD, and implants depends upon the reliability with which they are used. Correct and consistent use of methods can result in lower failure rates.</p>', '<p>Combination oral contraceptives (COC) act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation).</p>', '<p>To achieve maximum contraceptive effectiveness, Norgestrel &amp; Ethinyl Estradiol and ferrous fumarate must be taken exactly as directed and at intervals not exceeding 24 hours. The possibility of ovulation and conception prior to initiation of medication should be considered. The dosage of Norgestrel &amp; Ethinyl Estradiol and ferrous fumarate is one white tablet daily for 21 consecutive days, followed by one brown tablet daily for 7 consecutive days, according to prescribed schedule. It is recommended that tablets be taken at the same time each day.</p>', '<p>Reduced contraceptive effectiveness with antibiotics, anticonvulsants and drugs that may increase contraceptive steroids clearance (e.g. bosentan, rifampicin, rifabutin, barbiturates, primidone, phenytoin, carbamazepine, oxcarbazepine, topiramate, griseofulvin, aprepitant). Severe pruritus and jaundice with troleandomycin, avoid concurrent use. Decreased effectiveness of ursodeoxycholic acid by increasing the elimination of cholesterol in bile. Effects of danazol or gestrinone and hormonal contraceptives might be altered or reduced by concurrent use, avoid concomittant use.<br />\r\n<br />\r\nDecreased contraceptive effectiveness with anti-HIV protease inhibitors. Increased tacrolimus levels with ethinyl estradiol. May increase theophylline, selegiline and tizanidine levels with oral contraceptives.</p>', '<p>Pregnancy, undiagnosed vaginal bleeding, severe arterial disease (or family history of atherogenic lipid profile); liver adenoma; porphyria; after evacuation of hydatidiform mole; history of breast cancer; hepatic impairment; thrombophloebitis or thromboembolic disorders; breast carcinoma except in selected patients being treated for metastatic disease; oestrogen-dependent tumour; smoking &gt;40 cigarettes daily; &gt;50 yr; diabetes complications present; BMI &gt;39 kg/m2; migraine with typical focal aura, lasting &gt;72 hr despite treatment or migraine treated with ergot derivatives; BP &gt;160 mmHg systolic and 100 mmHg diastolic; transient ischaemic attacks without headaches; SLE; gallstones; history of haemolytic uraemic syndrome, pruritis during pregnancy; cholestatic jaundice; chorea or deterioration of otosclerosis pemphigoid; breast feeding during 1 st 6 mth after delivery.</p>', '<p>Edema, Weakness, Amenorrhea, Breakthrough bleeding, Change in menstrual flow, Spotting, Anorexia, DVT, Thrombophlebitis, Depression, Dizziness, Headache, Nervousness, Somnolence, B reast tenderness, Galactorrhea, Abdominal pain, Nausea, Vomiting, Change in weight, Cholestatic jaundice.</p>', '<p>Extensive epidemiological studies have revealed no increased risk of birth defects in infants born to women who have used oral contraceptives prior to pregnancy. Studies also do not suggest a teratogenic effect, particularly insofar as cardiac anomalies and limb-reduction defects are concerned, when taken inadvertently during early pregnancy<br />\r\n<br />\r\nThe administration of oral contraceptives to induce withdrawal bleeding should not be used as a test for pregnancy. Oral contraceptives should not be used during pregnancy to treat threatened or habitual abortion.&nbsp;<br />\r\n<br />\r\nIt is recommended that for any patient who has missed two consecutive periods, pregnancy should be ruled out before continuing oral-contraceptive use. If the patient has not adhered to the prescribed schedule, the possibility of pregnancy should be considered at the time of the first missed period. Oral-contraceptive use should be discontinued if pregnancy is confirmed.</p>', '<p>Sex-steroid dependent cancer; past ectopic pregnancy; malabsorption syndromes; functional ovarian cysts; active liver disease, recurrent cholestatic jaundice, history of jaundice in pregnancy; history of CV or renal impairment; DM; asthma; epilepsy; migraine; depression; lactation; conditions exacerbated by fluid retention; hypercalcaemia; CV and gall bladder diseases; lipid effects; familial defects of lipoprotein metabolism; patients at risk of venous thromboembolism, breast cancer, preexisting uterine leiomyomata and benign hepatic adenoma; family history of arterial disease in 1 st degree relative systolic 140 mmHg and diastolic 90 mmHg; &gt;35 yr; BMI 30-39 kg/m2; migraine without focal aura, controlled with 5HT1; Gl upset (vomiting and diarrhoea), missed pills and interaction with other drugs may require additional contraceptive precautions. Should be taken at same time each day.<br />\r\n<br />\r\nLactation: small amounts of steroids are excreted in breast milk; estrogens may reduce quality/quantity of milk; may be prudent to use other forms of birth control until full weaning.</p>', NULL, '<p>Oral Contraceptive preparations.</p>', NULL, NULL, '2022-03-11 04:11:50', '2022-03-11 04:11:50'),
(1066, 1066, '<p>Nortriptyline is indicated for the treatment of depression and nocturnal enuresis.</p>', '<p>Nortriptyline, a dibenzocycloheptadiene tricyclic antidepressant, is the primary active metabolite of amitriptyline. It increases synaptic concentration of serotonin and/or norepinephrine in the CNS by blocking the neuronal reuptake of norepinephrine and serotonin.</p>', '<p>Depression:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Low dose initially increased as necessary to 75-100 mg daily in divided doses or as a single dose (max. 150 mg daily)</li>\r\n	<li><strong>Adolescent &amp; Elderly</strong>: 30-50 mg daily in divided doses; Child not recommended for depression</li>\r\n</ul>\r\n\r\n<p>Nocturnal enuresis:</p>\r\n\r\n<ul>\r\n	<li><strong>Child 7 years</strong>: 10 mg</li>\r\n	<li><strong>8-11 years</strong>: 10-20 mg</li>\r\n	<li><strong>Over 11 years</strong>: 25-35 mg, 30 minutes before bedtime; max period of treatment (including gradual withdrawal) 3 months- full physical examination and ECG before further course.</li>\r\n</ul>', '<p>Nortriptyline should not be given with adrenaline, ephedrine, isoprenaline, noradrenaline, phenylephrine, phenylpropanolamine, drugs that are metabolized by CYP4502D6, MAOIs, guanethidine, debrisoquine, bethanidine, clonidine and reserpine etc. Barbiturates may increase the rate of metabolism of nortriptyline.</p>', '<p>Nortriptyline is contraindicated in patients with hypersensitivity to nortriptyline. Concomitant administration with MAOI is contraindicated. Do not use with or within 2 weeks of stopping an MAOI. Nortriptyline is contraindicated during the acute recovery period after myocardial infarction.</p>', '<p>The most common side effects include dry mouth, sedation, constipation and increased appetite, mild blurred vision, tinnitus, often euphoria and mania. An occasional side effect is a rapid or irregular heartbeat. Alcohol may exacerbate some of its side effects and should be avoided.</p>', '<p>The safety of nortriptyline for use in pregnancy has not been established. Nortriptyline should only be given during pregnancy when there are no alternatives and benefit outweighs risk.</p>', '<p>Not intended for treatment of bipolar depression. Avoid abrupt withdrawal. Patient at risk of seizures, with DM, narrow angle glaucoma, urinary retention, prostatic hyperplasia, chronic constipation, history of CV disease. Renal and hepatic impairment. Elderly, childn. Pregnancy and lactation.</p>', '<p><strong>Symptoms:</strong>&nbsp;Severe hypotension, cardiac dysrhythmias, shock, CHF, pulmonary oedema, convulsions, and CNS depression, including coma; changes in ECG.<br />\r\n<br />\r\n<strong>Management:</strong>&nbsp;Symptomatic and supportive treatment. Admin IV Na bicarbonate, benzodiazepines. Admin activated charcoal to reduce absorption. Emesis is contraindicated. Initiate cardiac monitoring and observe for signs of CNS or resp depression, hypotension, cardiac dysrhythmias and/or conduction blocks, and seizures.</p>', '<p>Tricyclic &amp; related anti-depressant drugs, Tricyclic Anti-depressant.</p>', '<p>Store at 15-30&deg; C. Protect from light and moisture.</p>', NULL, '2022-03-11 04:13:45', '2022-03-11 04:13:45'),
(1067, 1067, '<p>Nystatin is an antifungal antibiotic active against a wide range of yeasts and yeast like fungi including Candida albicans. It is used for the prevention and treatment of Candida infections of oral cavity, esophagus and intestinal tract. It provides effective prophylaxis against oral candidiasis in those born of mothers with vaginal candidiasis. It is used for the prophylaxis of Candida overgrowth during courses of broadspectrum antibiotics.</p>', '<p>Nystatin is an antifungal antibiotic. Which has fungistatic or fungicidal activity against variety of pathogenic and nonpathogenic yeast and fungi, including Candida albicans. Nystatin exerts its antifungal activity by binding to sterols in the fungal cell membrane. As a result of binding, the membrane is no longer able to function as a selective barrier, and potassium and other cellular constituents are lost. It is poorly absorbed from the gastrointestinal tract.</p>', '<p>Children:</p>\r\n\r\n<ul>\r\n	<li><strong>In intestinal and oral candidiasis (thrush):</strong>&nbsp;1,00,000 units (1 ml) should be dropped into the mouth four times daily.The longer the suspension is kept in contact with the affected area in the mouth, before swallowing, the greater will be its effect.</li>\r\n	<li><strong>For prophylaxis in the newborn:</strong>&nbsp;The suggested dose is 1,00,000 units (1 ml) once daily or as prescribed by the physician.</li>\r\n</ul>\r\n\r\n<p>Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>For the treatment of intestinal or esophageal candidiasis:</strong>&nbsp;5,00,000 units (5 ml) by mouth 3 or 4 times daily. The dose may be doubled, if required.</li>\r\n	<li><strong>For prophylaxis of intestinal candidiasis in adults:</strong>&nbsp;10,00,000 units (10 ml) daily.</li>\r\n	<li><strong>For prophylaxis to suppress the over growth of Candida albicans in patients receiving broad spectrum antibiotic therapy:</strong>&nbsp;10,00,000 units (10 ml) daily.</li>\r\n	<li><strong>For the treatment of dental sores and oral infection:</strong>&nbsp;1,00,000 units (1 ml) suspension should be dropped into the mouth four times daily.</li>\r\n</ul>\r\n\r\n<p>Elderly: Older people with intestinal candidiasis who are unable to swallow tablets should be given 5,00,000 units (5 ml) suspension four times daily.</p>', NULL, '<p>There is no known contraindication to the use of Nystatin.</p>', '<p>Nausea, vomiting and diarrhoea have occasionally been reported with high doses of Nystatin. No systemic effects or allergic reactions have been associated with its oral dose.</p>', '<p>Absorption of Nystatin&nbsp;from the gastrointestinal tract is negligible, therefore no special precautions apply in pregnancy.</p>', '<p>Absorption from the gastrointestinal tract is negligible, therefore no special precaution is required to apply in pregnancy and lactation.</p>', NULL, '<p>Drugs for subcutaneous and mycoses, Drugs used in Vaginal and Vulval condition</p>', '<p>Store in a cool and dry place, protect from light. Keep out of reach of children.</p>', NULL, '2022-03-11 04:15:37', '2022-03-11 04:15:37'),
(1068, 1068, '<p>Nystatin Cream is indicated in the treatment of&nbsp;cutaneous&nbsp;or mucocutaneous mycotic infections caused by&nbsp;Candida albicans&nbsp;and other susceptible&nbsp;Candida&nbsp;species. This cream is not indicated for systemic, oral, intravaginal or ophthalmic use.</p>', '<p>Nystatin has fungistatic or fungicidal activity against variety of pathogenic and nonpathogenic yeast and fungi, including Candida albicans. Nystatin exerts its antifungal activity by binding to sterols in the&nbsp;fungal cell membrane. As a result of binding, the membrane is no longer able to function as a selective barrier, and potassium and other cellular constituents are lost. It is poorly absorbed from the gastrointestinal tract.</p>', '<p><strong>Adults and Pediatric Patients (Neonates and Older)</strong>: Apply liberally to affected areas twice daily or as indicated until healing is complete.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness have been established in the pediatric population from birth to 16 years.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies with nystatin cream did not include sufficient numbers of subjects aged 65 years and older to determine whether they respond differently than younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.</p>', NULL, '<p>Nystatin cream is contraindicated in patients with a history of hypersensitivity to any of its components.</p>', '<p>The frequency of adverse events reported in patients using nystatin cream is less than 0.1%. The more common events that were reported include allergic reactions, burning, itching, rash,&nbsp;eczema, and pain on application.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C. Animal reproduction studies have not been conducted with any nystatin cream. It also is not known whether this cream can cause fetal harm when used by a pregnant woman or can affect reproductive capacity. Nystatin cream should be prescribed for a pregnant woman only if the potential benefit to the mother outweighs the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether nystatin is excreted in human milk. Caution should be exercised when nystatin is prescribed for a nursing woman.</p>', '<p>Nystatin cream should not be used for the treatment of systemic, oral, intravaginal or ophthalmic infections. If irritation or sensitization develops, treatment should be discontinued and appropriate measures taken as indicated. It is recommended that KOH smears, cultures, or other diagnostic methods be used to confirm the diagnosis of&nbsp;cutaneous&nbsp;or mucocutaneous candidiasis and to rule out infection caused by other pathogens.</p>', NULL, '<p>Drugs for subcutaneous and mycoses, Drugs used in Vaginal and Vulval condition.</p>', '<p>Store at 20&deg; to 25&deg;C. Avoid freezing.</p>', NULL, '2022-03-11 04:17:31', '2022-03-11 04:17:31'),
(1069, 1069, '<p>Obeticholic Acid is indicated for the treatment of primary biliary cholangitis (PBC) in combination with Ursodeoxycholic Acid (UDCA) in adults with an inadequate response to UDCA, or as monotherapy in adults unable to tolerate UDCA, cholestatic liver disease &amp; non-alcoholic fatty liver disease (NAFLD) including non-alcoholic steatohepatitis (NASH).</p>', '<p>Obeticholic Acid is an agonist for FXR, a nuclear receptor expressed in the liver and intestine. FXR is a key regulator of bile acid, inflammatory, fibrotic, and metabolic pathways. FXR activation decreases the intracellular hepatocyte concentrations of bile acids by suppressing de novo synthesis from cholesterol as well as by increased transport of bile acids out of the hepatocytes. These mechanisms limit the overall size of the circulating bile acid pool while promoting choleresis, thus reducing hepatic exposure to bile acids.</p>', '<p><strong>Starting Dosage</strong>: The recommended starting dosage of Obeticholic Acid is 5 mg orally once daily in adult patients who have not achieved an adequate biochemical response to an appropriate dosage of Ursodeoxycholic Acid (UDCA) for at least 1 year or are intolerant to UDCA.<br />\r\n<br />\r\n<strong>Dosage Titration</strong>: If an adequate reduction in alkaline phosphatase (ALP) and/or total bilirubin has not been achieved after 3 months of Obeticholic Acid 5 mg once daily, and the patient is tolerating Obeticholic Acid, increase the dosage of Obeticholic Acid to 10 mg once daily.<br />\r\n<br />\r\n<strong>Maximum Dosage</strong>: The maximum recommended dosage of Obeticholic Acid is 10 mg once daily.<br />\r\n<br />\r\n<strong>Management of Patients with Intolerable Pruritus on Obeticholic Acid</strong>: For patients with intolerable pruritus on Obeticholic Acid, consider one or more of the following:<br />\r\n<br />\r\nAdd an antihistamine or bile acid binding resin. Reduce the dosage of Obeticholic Acid to:</p>\r\n\r\n<ul>\r\n	<li>5 mg every other day, for patients intolerant to 5 mg once daily</li>\r\n	<li>5 mg once daily, for patients intolerant to 10 mg once daily</li>\r\n</ul>\r\n\r\n<p>Temporarily interrupt Obeticholic Acid dosing for up to 2 weeks followed by restarting at a reduced dosage<br />\r\n<br />\r\nIncrease the dosage of Obeticholic Acid to 10 mg once daily, as tolerated, to achieve optimal response. Consider discontinuing Obeticholic Acid treatment in patients who continue to experience persistent, intolerable pruritus.</p>', '<p><strong>Bile Acid Binding Resins</strong>: Bile acid binding resins such as cholestyramine, colestipol, or colesevelam adsorb and reduce bile acid absorption and may reduce the absorption, systemic exposure, and efficacy of Obeticholic Acid. If taking a bile acid binding resin, take Obeticholic Acid at least 4 hours before or 4 hours after taking the bile acid binding resin, or at as great an interval as possible.<br />\r\n<br />\r\n<strong>Warfarin</strong>: The International Normalized Ratio (INR) decreased following co-administration of warfarin and Obeticholic Acid. Monitor INR and adjust the dosage of warfarin, as needed, to maintain the target INR range when co-administering Obeticholic Acid and warfarin.<br />\r\n<br />\r\n<strong>CYP1A2 Substrates with Narrow Therapeutic Index</strong>: Obeticholic Acid may increase the exposure to concomitant drugs that are CYP1A2 substrates. Therapeutic monitoring of CYP1A2 substrates with a narrow therapeutic index.</p>', '<p>Contraindicated in patients known to have hypersensitivity to the drug or any of its components &amp; in patients with complete biliary obstruction.</p>', '<p>The most common side effects of Obeticholic Acid include: Pruritus, Fatigue &amp; Stomach pain and discomfort. Other common side effects include rash, arthralgia (joint pain), oropharyngeal pain (pain in the middle part of the throat), dizziness, constipation, abnormal thyroid function, and eczema (inflammation of the skin).</p>', '<p>The limited available human data on the use of Obeticholic Acid during pregnancy are not sufficient to inform a drug-associated risk.There is no information on the presence of Obeticholic Acid in human milk, the effects on the breast-fed infant or the effects on milk production.</p>', '<p>The following clinically significant reactions are described:</p>\r\n\r\n<ul>\r\n	<li>Liver-Related Adverse Reactions</li>\r\n	<li>Severe Pruritus</li>\r\n	<li>Reduction in high density lipoprotein-cholesterol (HDL-C)</li>\r\n</ul>\r\n\r\n<p>Special monitoring is essential for the patient with such type of problems</p>', '<p>In PBC patients who received Obeticholic Acid 25 mg once daily (2.5 times the highestrecommended dosage) or 50 mg once daily (5 times the highest recommended dosage), a dose-dependent increase in the incidence of liver-related adverse reactions, including elevations in liver biochemical tests, ascites, jaundice, portal hypertension, and primary biliary cholangitis flare, was reported. In the case of over dosage, patients should be carefully observed and supportive care administered, as appropriate.</p>', '<p>Farnesoid X Receptor Agonists.</p>', '<p>Store at 15&deg;C to 30&deg;C in a dry place protected from light. Keep out of reach of children.</p>', '<p><strong>Geriatric Use</strong>: No dosage adjustment is recommended in elderly patientless than 65 years of age.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and efficacy have not been established in patients younger than 18 years.<br />\r\n<br />\r\n<strong>Use in Patients with Impaired Renal Function</strong>: Obeticholic Acid has not been studied in patients with moderate and severe renal impairment (estimated glomerular filtration rate [eGFR] less than 60 ml/min/1.73 m2). In the population pharmacokinetic analysis, an eGFR greater than 50 ml/min/1.73 m2 did not have a meaningful effect on the pharmacokinetics of Obeticholic Acid and its conjugated metabolites.<br />\r\n<br />\r\n<strong>Use in Patients with Impaired Hepatic Function</strong>: Obeticholic Acid is metabolized in the liver. Plasma exposure to Obeticholic Acid and its active conjugates, increases significantly in patients with moderate to severe hepatic impairment (Child-Pugh Classes B and C).The recommended starting dosage of Obeticholic Acid for moderate (Child-Pugh Class B) and severe (Child-Pugh Class C) hepatic impairment is 5 mg once weekly. If an adequate reduction in ALP and/or total bilirubin has not been achieved after 3 months of Obeticholic Acid 5 mg once weekly, and the patient is tolerating the drug, increase the dosage of Obeticholic Acid to 5 mg twice weekly (at least three days apart) and subsequently to 10 mg twice weekly (at least three days apart) depending on response and tolerability.</p>', '2022-03-11 04:44:09', '2022-03-11 04:44:09'),
(1070, 1070, '<p><strong>Chronic Lymphocytic Leukemia (CLL)</strong>: Obinutuzumab in combination with chlorambucil is indicated for the treatment of patients with previously untreated chronic lymphocytic leukemia.<br />\r\n<br />\r\n<strong>Follicular Lymphoma (FL)</strong>: Obinutuzumab in combination with chemotherapy, followed by Obinutuzumab maintenance is indicated for the treatment of patients with previously untreated follicular lymphoma. Obinutuzumab in combination with bendamustine, followed by Obinutuzumab maintenance, is indicated for the treatment of patients with FL who did not respond to, or who progressed during or after treatment with rituximab or a rituximab-containing regimen.</p>', '<p>Obinutuzumab is a monoclonal antibody that targets the CD20 antigen expressed on the surface of pre-B and mature B lymphocytes. Upon binding to CD20, obinutuzumab mediates B-cell lysisthrough (1) engagement of immune effector cells (2) by directly activating intracellular death signaling pathways (direct cell death), and/or (3) activation of the complement cascade. The immune effector cell mechanisms include antibody-dependent cellular cytotoxicity (ADCC) and antibodydependent cellular phagocytosis.<br />\r\n<br />\r\nAs an antibody with reduced fucose content, obinutuzumab induces greater ADCC activity than rituximab in vitro using human cancer cell lines. Obinutuzumab also demonstrated an increased ability to induce direct cell death when compared to rituximab. Obinutuzumab binds to Fc&gamma;RIII using purified proteins with a higher affinity than rituximab. Obinutuzumab and rituximab bind with similar affinity to overlapping epitopes on CD20.</p>', NULL, '<p>No formal drug-drug interaction studies have been performed, although limited drug interaction sub-studies have been undertaken for Obinutuzumab with bendamustine, CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone), FC (fludarabine, cyclophosphamide) and chlorambucil. Co administration with Obinutuzumab had no effect on the pharmacokinetics of bendamustine, FC or the individual components of CHOP; in addition, there were no apparent effects of bendamustine, FC, chlorambucil or CHOP on the pharmacokinetics of Obinutuzumab. A risk for interactions with concomitantly used medicinal products cannot be excluded.</p>', '<p>Obinutuzumab is contraindicated in patients with a known hypersensitivity to obinutuzumab or to any of the excipients.</p>', '<p>The following adverse reactions are discussed in greater detail in other sections of the label:</p>\r\n\r\n<ul>\r\n	<li>Hepatitis B reactivation</li>\r\n	<li>Progressive multifocal leukoencephalopathy</li>\r\n	<li>Infusion reactions&nbsp;</li>\r\n	<li>Tumor lysis syndrome</li>\r\n	<li>Infections&nbsp;</li>\r\n	<li>Neutropenia&nbsp;</li>\r\n	<li>Thrombocytopenia</li>\r\n</ul>', '<p><strong>Pregnancy</strong>: Obinutuzumab is likely to cause fetal B-cell depletion based on findings from animal studies and the drug&rsquo;s mechanism of action. There are no data with Obinutuzumab use in pregnant women to inform a drug-associated risk. Monoclonal antibodies are transferred across the placenta. In animal reproduction studies, weekly intravenous administration of obinutuzumab to pregnant cynomolgus monkeys from day 20 of pregnancy until parturition which includes the period of organogenesis at doses with exposures up to 2.4 times the exposure at the clinical dose of 1000 mg monthly produced opportunistic infections and immune complex mediated hypersensitivity reactions. No embryo-toxic or teratogenic effects were observed in the monkeys. Consider the potential risk to the fetus when prescribing Obinutuzumab to a pregnant woman.<br />\r\n<br />\r\nThe background risk of major birth defects and miscarriage for the indicated population is unknown; however, the estimated background risk in the U.S. general population of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies.<br />\r\n<br />\r\n<strong>Lactation</strong>: There is no information regarding the presence of Obinutuzumab in human milk, the effects on the breastfed child, or the effects on milk production. However, low levels of obinutuzumab were present in the milk of lactating cynomolgus monkeys [see Pregnancy]. Human IgG is known to be present in human milk. Published data suggest that antibodies in breast milk do not enter the neonatal and child circulations in substantial amounts. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Obinutuzumab and any potential adverse effects on the breastfed child from Obinutuzumab or from the underlying maternal condition.</p>', '<p>In order to improve the traceability of biological medicinal products, the trade name and batch number of the administered product should be clearly recorded (or stated) in the patient file.</p>', NULL, '<p>Anti neoplastic preparations.</p>', '<p>Store vials in a refrigerator at 2&deg;C-8&deg;C. Keep vial in the outer carton in order to protect from light. Do not freeze. Do not shake.</p>', '<p><strong>Pediatric Use</strong>: The safety and efficacy of Obinutuzumab in children below 18 years of age have not been established.<br />\r\n<br />\r\nGeriatric Use:</p>\r\n\r\n<ul>\r\n	<li><strong>Chronic Lymphocytic Leukemia (CLL)</strong>: In the pivotal study in CLL, 46% (156 out of 336) of patients treated with Obinutuzumab plus chlorambucil were 75 years old or older (median age was 74 years). These patients experienced more serious adverse events and adverse events leading to death than patients &lt;75 years of age. No significant differences in efficacy were observed between patients &ge;75 years of age and those &lt;75 years of age</li>\r\n	<li><strong>Non-Hodgkin Lymphoma (NHL)</strong>: In the pivotal studies in NHL, patients 65 years old or older experienced more serious adverse events, and adverse events leading to withdrawal or death than patients &lt;65 years of age. No clinically meaningful differences in efficacy were observed.</li>\r\n</ul>', '2022-03-11 04:46:19', '2022-03-11 04:46:19'),
(1071, 1071, '<p><strong>Acromegaly</strong>: Octreotide acetate injection is indicated to reduce blood levels of growth hormone and IGF-I (somatomedin C) in acromegaly patients who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation, and bromocriptine mesylate at maximally tolerated doses. The goal is to achieve normalization of growth hormone and IGF-I (somatomedin C) levels. In patients with acromegaly, Octreotide acetate injection reduces growth hormone to within normal ranges in 50% of patients and reduces IGF-I (somatomedin C) to within normal ranges in 50% to 60% of patients. Since the effects of pituitary irradiation may not become maximal for several years, adjunctive therapy with Octreotide acetate injection to reduce blood levels of growth hormone and IGF-I (somatomedin C) offers potential benefit before the effects of irradiation are manifested.<br />\r\n<br />\r\nImprovement in clinical signs and symptoms or reduction in tumor size or rate of growth were not shown in clinical trials performed with Octreotide acetate injection; these trials were not optimally designed to detect such effects.<br />\r\n<br />\r\n<strong>Carcinoid Tumors</strong>: Octreotide acetate injection is indicated for the symptomatic treatment of patients with metastatic carcinoid tumors where it suppresses or inhibits the severe diarrhea and flushing episodes associated with the disease.<br />\r\n<br />\r\nOctreotide acetate injection studies were not designed to show an effect on the size, rate of growth or development of metastases.<br />\r\n<br />\r\n<strong>Vasoactive Intestinal Peptide Tumors</strong>&nbsp;(VIPomas): Octreotide acetate injection is indicated for the treatment of the profuse watery diarrhea associated with VIP-secreting tumors. Octreotide acetate injection studies were not designed to show an effect on the size, rate of growth or development of metastases.</p>', '<p>Octreotide is a synthetic analogue of somatostatin which acts by suppressing basal and stimulated secretion of growth hormone (GH). It also suppresses LH response to gonadotrophin-releasing hormone and reduces the secretion of gastrin, vasoactive intestinal peptide (VIP), insulin, glucagon, secretin, motilin and pancreatic polypeptide.</p>', '<p><strong>Intramuscular-</strong><br />\r\nAcromegaly:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Following initial control with SC therapy: As a depot preparation, initially 20 mg every 4 wk. Adjust if required after 3 mth to 10-30 mg every 4 wk. Max: 40 mg every 4 wk.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous-</strong><br />\r\nVariceal haemorrhage in patients with cirrhosis:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;As continuous IV infusion: 25 mcg/hr for 48 hr (up to 5 days in patients at high risk of re-bleeding).</li>\r\n	<li><strong>Child:</strong>&nbsp;&ge;1 mth: 1 mcg/kg/hr (up to 50 mcg/hr); given as continuous IV infusion. Higher doses may be needed initially, reduce dose gradually over 24 hr until bleeding has stopped.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nProphylaxis of complications following pancreatic surgery:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;100 mcg tid of a rapid-acting preparation given for 7 consecutive days, starting at least 1 hr before operation.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nAcromegaly:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially 50 mcg tid, increased as necessary to usual dose 100-200 mcg tid. Max: 500 mcg tid.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nSecretory neoplasms:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initially, 50 mcg 1-2 times daily, increased gradually to up to 600 mcg daily in 2-4 divided doses according to response. Continued treatment is not recommended if there is no benefit within a wk of starting treatment for carcinoid tumour. Initial dose may be given via IV admin of a rapid response is required.</li>\r\n</ul>\r\n\r\n<p><strong>Subcutaneous-</strong><br />\r\nHIV-associated diarrhoea:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult:</strong>&nbsp;Initial dose 100 mcg tid. If symptoms are not controlled after 1 wk, increase dose to 250 mcg tid, if still not effective after 1 wk stop therapy.</li>\r\n</ul>', '<p>Dosage adjustment of concurrent therapy may be necessary with calcium channel blockers, oral hypoglycaemics, &beta;-blockers, diuretics. May increase concentration of bromocriptine.</p>', '<p>Hypersensitivity</p>', '<p>Local pain, stinging, tingling at site of inj; anorexia, nausea, vomiting, abdominal pain, bloating, flatulence, loose stools, steatorrhoea; biliary tract abnormalities. Hypoglycaemia and hyperglycaemia, hypothyroidism, cardiac conduction abnormalitles, pancreatitis.</p>', '<p><strong>Category B:</strong>&nbsp;Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>Renal disease; risk of gall bladder disease; DM; hypothyroidism. Pregnancy, lactation, children, elderly. Monitor levels of vitamin B12 during long term therapy.</p>', NULL, '<p>Growth hormone antagonist</p>', '<p>Store at 2-8&deg; C. Stable at room temperature for up to 14 days.</p>', '<p><strong>Renal Impairment:</strong>&nbsp;Dosage may need to be reduced in severe renal impairment requiring dialysis.</p>', '2022-03-11 04:48:20', '2022-03-11 04:48:20'),
(1072, 1072, '<p><strong>Eye</strong>: It is indicated for the treatment of external ocular infections such as acute &amp; sub-acute conjunctivitis, keratitis, kerato-conjunctivitis, blepharo-conjunctivitis, blepharitis, corneal ulcer and pre-operative prophylaxis in ocular surgery.<br />\r\n<br />\r\n<strong>Ear</strong>: It is indicated for the treatment of external ear infections (otitis externa) and certain middle ear infections (otitis media).</p>', '<p>Ofloxacin is a synthetic 4-fluoroquinolone antibacterial agent with bactericidal activity against a wide range of Gram-negative and Gram-positive organisms. Ofloxacin is thought to exert bactericidal effect by inhibiting DNA gyrase, an essential enzyme that is a critical catalyst in the duplication, transcription and repair of bacterial DNA.</p>', '<p><strong>Eye</strong>: Instill 1 drop in the affected eye(s) every 2 to 4 hours for the first two days and then 4 times daily. The length of treatment should not exceed ten days.<br />\r\n<br />\r\n<strong>Ear</strong>: Instill 1-2 drops in the affected ear(s) twice daily or as needed.</p>', NULL, '<p>It is contraindicated in patients who are hypersensitive to Ofloxacin or any other component of this preparation.</p>', '<p><strong>Eye</strong>: Transient ocular irritation, burning, stinging, redness, itching or photophobia have been reported.&nbsp;<br />\r\n<br />\r\n<strong>Ear</strong>: Mild irritation or mild discomfort in the ear may occur. Symptoms of an allergic reaction include rash, itching, swelling or trouble breathing.</p>', '<p><strong>Use in pregnancy</strong>: 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.<br />\r\n<br />\r\n<strong>Use in lactation</strong>: It is not known whether Ofloxacin is excreted in human milk. Cautions should be taken when Ofloxacin eye &amp; ear drops is administered during lactation.</p>', '<p>Prolonged use of eye drops &amp; ear drops may result in overgrowth of non-susceptible organisms and secondary infection respectively.</p>', NULL, '<p>4-Quinolone preparations, Ophthalmic antibacterial drugs.</p>', NULL, NULL, '2022-03-11 04:49:49', '2022-03-11 04:49:49'),
(1073, 1073, '<p>Ofloxacin&nbsp;are indicated for the treatment of adults with mild to moderate infections caused by susceptible strains.</p>\r\n\r\n<ul>\r\n	<li>Lower Respiratory Tract: Acute bacterial exacerbation of chronic bronchitis lung abscess, pneumonia.</li>\r\n	<li>Gastrointestinal Tract: Enteric fever, shigellosis.</li>\r\n	<li>Multi-drug-resistant Tuberculosis.</li>\r\n	<li>Skin and skin structures: Uncomplicated skin and skin structure infections.</li>\r\n	<li>Sexually Transmitted Diseases: Acute, Uncomplicated urethral and cervical gonorrhoea. Nongonococcal urethritis and cervicitis. Mixed infections of the urethra and cervix.</li>\r\n	<li>Urinary tract: Uncomplicated Urinary Tract Infections, Complicated urinary tract infections.</li>\r\n</ul>', '<p>Ofloxacin is a synthetic 4-fluoroquinolone antibacterial agent with bactericidal activity against a wide range of Gram-negative and Gram-positive organisms. Ofloxacin is thought to exert bactericidal effect by inhibiting DNA gyrase, an essential enzyme that is a critical catalyst in the duplication, transcription and repair of bacterial DNA.</p>', '<p>Intravenous (Adult):</p>\r\n\r\n<ul>\r\n	<li><strong>Skin and soft tissue infections</strong>: 400 mg bid infused over at least 1 hr.</li>\r\n	<li><strong>Complicated urinary tract infections</strong>: 200 mg daily by infusion over at least 30 min. Max: 400 mg bid infused over at least 1 hr.</li>\r\n	<li><strong>Lower respiratory tract infections, Septicaemia</strong>: 200 mg bid by infusion over at least 30 min. Max: 400 mg bid infused over at least 1 hr.</li>\r\n</ul>\r\n\r\n<p>Oral (Adult):</p>\r\n\r\n<p><strong>General dosage recommendations</strong>: The dose of ofloxacin is determined by the type and severity of the infection. The dosage range for adults is 200 mg to 800 mg daily. Up to 400 mg may be given as a single dose, preferably in the morning, larger doses should be given as two divided doses. Ofloxacin tablets should be swallowed with liquid; they should not be taken within two hours of intake of magnesium/aluminium containing antacids or iron preparations since reduction of absorption of ofloxacin can occur.</p>\r\n\r\n<ul>\r\n	<li><strong>Enteric fever</strong>: For adults 200 mg, every 12 hours, for 5 days. For children 15 mg/kg/day in 2 divided doses for 3 days.</li>\r\n	<li><strong>Shigellosis</strong>: 400 mg single dose.</li>\r\n	<li><strong>Multi-drug-resistant tuberculosis</strong>: 400 mg twice daily along with conventional anti-tuberculosis drugs.</li>\r\n	<li><strong>Lower respiratory tract infection</strong>: 400 mg daily, increasing, if necessary, to 400 mg twice daily.</li>\r\n	<li><strong>Uncomplicated Urinary Tract Infections</strong>: A single dose of 200/400 mg.</li>\r\n	<li><strong>Uncomplicated urethral and cervical gonorrhoea</strong>: A single dose of 400 mg.</li>\r\n	<li><strong>Non-gonococcal urethral and cervicitis</strong>: 400 mg daily in single or divided doses.</li>\r\n	<li><strong>Complicated Urinary Tract Infection</strong>: 200/400 mg/day for 7 days.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: Ofloxacin is usually not indicated for use in children or growing adolescents.<br />\r\n<br />\r\n<strong>Elderly</strong>: No adjustment of dosage is required in the elderly.</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>May be taken with or without food. Avoid antacids or supplements containing Fe or Zn within 2 hr before or after ofloxacin. Ensure adequate hydration.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Antacids containing magnesium, aluminium or calcium may decrease absorption of ofloxacin. Iron or Zinc may decrease oral absorption of ofloxacin.</p>', '<p>Ofloxacin should not be used in-patients with known hypersensitivity to 4-fluoroquinolone antibacterials. It is contraindicated in-patients with a history of epilepsy or with a lowered seizure threshold. Ofloxacin is usually contraindicated in children or growing adolescents and in pregnant or breast feeding women.</p>', '<p>Ofloxacin is generally well tolerated and clinical side-effects of ofloxacin has been quite low. Among the adverse effects gastrointestinal and central nervous systems&#39; reactions are common. Nausea, rash, vomiting, abdominal pain, diarrhoea and gastrointestinal distress are the gastrointestinal adverse effects. Common central nervous system reactions are headache, dizziness and insomnia.</p>', '<p>The safety of ofloxacin during pregnancy has not been established. Ofloxacin may enter breast milk but data are not available.</p>', '<p>Patients being treated with Ofloxacin should not expose themselves unnecessarily to strong sunlight and should avoid UV rays. Caution is recommended if the drug is to be used in psychotic patients or in-patients with a history of psychiatric disease.</p>', '<p><strong>Symptoms</strong>: Confusion, dizziness, impairment of consciousness, convulsive seizures, GI reactions (e.g. nausea, mucosal erosions).<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. Remove any unabsorbed drug by gastric lavage or admin of adsorbants and Na sulfate. Antacids are recommended for protection of gastric mucosa. Elimination may be increased by forced diuresis.</p>', '<p>4-Quinolone preparations, Aural Anti-bacterial preparations.</p>', '<p>Store between 15-30&deg; C. Protect from light.</p>', '<p>Renal Impairment:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl &lt;20 and patients on haemodialysis or peritoneal dialysis</strong>: 100 mg 24 hrly following usual initial dose.</li>\r\n	<li><strong>CrCl 20-50</strong>: Reduce dose by half 24 hrly following usual initial dose.</li>\r\n</ul>\r\n\r\n<p>Hepatic Impairment:Severe: Reduce dose. Max: 400 mg daily</p>', '2022-03-11 04:52:34', '2022-03-11 04:52:34');
