English French German Italian Portuguese Russian Spanish

1

One Pharma Ltd | Leading Pharmaceuticals in Bangladesh - By Trade Name
Tuesday, 24 April 2018 11:46

Sharpkil Plus

Written by

Sharpkil Plus

Cefuroxime + Clavulanic Acid

 

Presentation

Sharpkil Plus 250/62.5 Tablet: Each tablet contains Cefuroxime Axetil USP equivalet to Cefuroxime 250 mg and diluted Potassium Clavulanate BP equivalent to Clavulanic Acid 62.5 mg.

Sharpkil Plus 500/125 Tablet: Each tablet contains Cefuroxime Axetil USP equivalet to Cefuroxime 500 mg and diluted Potassium Clavulanate BP equivalent to Clavulanic Acid 125 mg.

 

 

Description

Cefuroxime is one of the bactericidal second generation cephalosporin antibiotics, which is active against a wide range of Gram-positive and Gram-negative susceptible organisms including many b-lactamase producing strains. It is indicated for the treatment of infections caused by sensitive bacteria.

 

Clavulanic acid has a similar structure to the beta-lactam antibiotics but binds irreversibly to the beta-lactamase enzymes. 

 

The presence of clavulanic acid in Sharpkil Plus formulations protects Cefuroxime from degradation by beta-lactamase enzymes and effectively extends the antibacterial spectrum of Cefuroxime to include many bacteria normally resistant to Cefuroxime and other cephalosporins.

 

 

Indications and Uses

>> Pharyngitis/tonsillitis caused by Streptococcus pyogenes

>> Acute bacterial otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Moraxella Catarrhalis (including beta-lactamase-producing strains) or Streptococcus pyogenes

>> Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non-beta-lactamase-producing strains only)

>> Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, Escherichia coli

>> Acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis caused by Streptococcus penumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains)

>> Skin and Skin-Structure Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, Escherichia coli, Klebsiella spp. and Enterobacter spp.

>> Urinary tract infections caused by Escherichia coli or Klebsiella pneumoniae

>> Bone and Joint Infections caused by Staphylococcus aureus (penicillinase and non-penicillinase producing strains)

>> Gonorrhea: Uncomplicated and disseminated gonococcal infections due to Neisseria gonorrhoeae (penicillinase- and non-penicillinase-producing strains) in both males and females

>> Early Lyme disease (erythema migrans) caused by Borrelia burgdorferi

>> Septicemia caused by Staphylococcus aureus (penicillinase and non-penicillinase producing strains), Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae (including ampicillin-resistant strains), and Klebsiella spp.

>> Meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin resistant strains), Neisseria meningitidis and Staphylococcus aureus (penicillinase and non-penicillinase producing strains)

>> Switch therapy (injectable to oral) after surgery when patient’s condition is improved

 

Dosage and Administration

 

 

Sharpkil Plus may be administered without regard to meals.

 

Side-Effects

Generally Cefuroxime and Clavulanic acid are well tolerated. However, a few side effects like nausea, vomiting, diarrhea, abdominal discomfort or pain may occur. As with other broad-spectrum antibiotics, prolonged administration of Cefuroxime and Clavulanic acid combination may result in overgrowth of nonsusceptible microorganisms. Rarely (<0.2%) renal dysfunction, anaphylaxis, angioedema, pruritis, rash and serum sickness like urticaria may appear.

 

Precautions

Cefuroxime and Clavulanic Acid should be given with care to patients receiving concurrent treatment with potent diuretics & who have history of colitis.

 

Use in Pregnancy & Lactation

During pregnancy: While all antibiotics should be avoided in the first trimester if possible. However, Cefuroxime and Clavulanic Acid can be safely used in later pregnancy to treat urinary and other infections.

During lactation: Cefuroxime and Clavulanic Acid is excreted into the breast milk in small quantities. However, the possibility of sensitizing the infant should be kept in mind.

 

Contraindications

Patients with known allergy to cephalosporins & pseudomembranous colitis are contraindicated.

 

Drug Interactions

Concomitant administration of probenecid with Cefuroxime and Clavulanic Acid increases the area under the serum concentration versus time curve by 50%. Drug that reduces gastric acidity may result in a lower bioavailability of Cefuroxime and tend to cancel the effect of postprandial absorption.

 

Overdosage

Signs and symptoms: Overdosage of Cefuroxime and Clavulanic can cause cerebral irritation leading to convulsions.

Management: Serum levels of Cefuroxime and Clavulanic can be reduced by haemodialysis and peritoneal dialysis.

 

Storage

Store in a cool and dry place, keep away from light. Keep out of reach of children.

 

Commercial Pack

Sharpkil Plus 250/62.5 Tablet: Each box contains 7 tablets in 2 Alu-Alu blister within 2 Alu-Alu pouch pack.

Sharpkil Plus 500/125 Tablet: Each box contains 7 tablets in Alu-Alu blister within Alu-Alu pouch pack.

Tuesday, 24 April 2018 11:34

Pileus

Written by

Pileus

Fluconazole

 

Presentation

Pileus 50: Each capsule contains Fluconazole USP 50 mg.

Pileus 150: Each capsule contains Fluconazole USP 150 mg.

 

Description

Fluconazole is a synthetic triazole antifungal drug that inhibits the biosynthesis of ergosterol, a major component of the cell membrane of yeast and fungal cells, leading to abnormalities in membrane permeabilities, inhibition of growth, abnormal cell wall formation and accumulation of intracellular lipids and membranous vesicles. It is active against a broad spectrum of yeast and other fungal pathogens. Following oral administration, absorption is rapid with > 90% of the dose being absorbed. Bioavailability is the same whether taken during fasting or with food, as the pharmacokinetics of Fluconazole is relatively insensitive to physiological changes in the GIT. Unlike other azole drugs, the bioavailability of Fluconazole is unaffected by gastric pH so it can be given during treatment with antiulcer drugs including PPI. 80% of a dose of Fluconazole is excreted unchanged and 11% is excreted as inactive metabolites in the urine, presumably as a result of metabolism in the liver. A further 2% of a dose is recovered unchanged in the feces, and the fate of the remaining is unknown.

 

Indications

  >>Superficial candidal infections such as oral or vaginal thrush

  >>Esophagitis caused by Candida or other susceptible species

  >>Maintenance therapy of cryptococcal meningitis

  >>Disseminated candidiasis

  >>Prophylaxis for fungal infection in neutropenic cancer patients

  >>Acute treatment of other systemic fungal infections

  >>Dermatophyte and Candida skin infections

  >>Fungal UTIs

 

Dosage and administration

Fluconazole is usually given orally. Generally the total daily dose is given at once unless nausea supervenes, in which case the dose may be divided.

>> Vaginal candidiasis and candidal balanitis, by mouth, a single dose of 150 mg.

 >> Mucosal candidiasis (except genital), by mouth, 50 mg daily (100 mg daily in usually difficult infections) given for 7-14 days in oropharyngeal candidiasis; for 14-30 days in other mucosal infections (e.g. oesophagitis, candiduria, non-invasive bronchopulmonary infections); Child by mouth 3-6 mg/kg on 1st day then 3 mg/kg daily (every 72 hours in neonate up to 2  weeks old and every 48 hours in neonate 2-4 weeks old).

>>Tinea pedis, corporis, cruris, pityriasis versicolor, and dermal candidiasis, by mouth, 50 mg daily for 2-4 weeks (for up to 6 weeks in tinea pedis); maximum duration of treatment 6 weeks.

>> Invasive candidal infections including candidaemia and disseminated candidiasis and cryptococcal infections including meningitis, by mouth, 400 mg initially then 200 mg daily, increased if necessary to 400 mg daily, treatment continued according to response (at least 6-8 weeks for cryptococcal meningitis); Child 6-12 mg/kg daily (every 72 hours in neonate up to 2 weeks old, every 48 hours in neonate 2-4 weeks old); maximum 400 mg daily.

>> Prevention of relapse of cryptococcal meningitis, by mouth, 100-200 mg daily.

>> Prevention of fungal infections in immunocompromised patients following cytotoxic chemotherapy or radiotherapy, by mouth 50-400 mg daily adjusted according to risk; Child according to extent and duration of neutropenia, 3-12 mg/kg daily (every 72 hours in neonate up to 2 weeks old, every 48 hours in neonate 2-4 weeks old); maximum 400 mg daily.

 

Side effects

Nausea, abdominal discomfort, diarrhoea, flatulence, headache, rash; less frequently dyspepsia, vomiting, abnormalities in liver enzymes, seizures, alopecia and Stevens Johnson syndrome reported.

 

Precautions

Cautions should be taken in renal impairment; in hepatic disease liver function should be monitored and should be discontinued if signs or symptoms of hepatic disease appear.

 

Use in pregnancy and lactation

Pregnancy: There are limited data on the use of Fluconazole in pregnant woman. However Fluconazole should be used in pregnancy only when the benefit clearly outweighs the risk.

 

Lactation: Fluconazole is excreted in breast milk in levels about half of those found in plasma. Therefore, the drug should be avoided during lactation.

 

Contraindications

>> Known hypersensitivity

>> Advanced liver disease

 

Drug interactions

Fluconazole decreases the metabolism of Cyclosporine and Phenytoin and increases the AUC of Retinoic acid. Fluconazole increases bleeding time in patients treated with Warfarin. Concomitant use of Fluconazole decreases in the mean plasma clearance of Theophyllin and increases the plasma levels of Zidovudine and concentration of Oral hypoglycemics. Rifampin induces the metabolism of Fluconazole.

 

Over dosage

In the case of an overdose, supportive measures should be instituted.

 

Commercial pack

Pileus 50: Each box contains 2 blister strips of 10 capsules.

Pileus 150: Each box contains 1 blister strip of 10 capsules.

Tuesday, 24 April 2018 11:15

Onvas

Written by

Onvas

Atorvastatin

 

Presentation

Onvas 10 Tablet: Each film coated tablet contains Atorvastatin Calcium Trihydrate USP equivalent to Atorvastatin 10 mg.

Onvas 20 Tablet: Each film coated tablet contains Atorvastatin Calcium Trihydrate USP equivalent to Atorvastatin 20 mg.

 

Description

Atorvastatin is a synthetic lipid-lowering agent. Atorvastatin is an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase. This enzyme catalyzes the conversion of HMG-CoA to mevalonate, an early and rate-limiting step in cholesterol biosynthesis.

 

Indications and usage

Atorvastatin is indicated as an adjunct to diet to reduce elevated total-C, LDL-C, apo B, and triglycerides (TG) levels and to increase HDL-C in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia; as an adjunct to diet for the treatment of patients with elevated serum triglycerides (TG) levels; for the treatment of patients with primary dysbetalipoproteinemia who do not respond adequately to diet; to reduce total-C and LDL-C in patients with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) or if such treatments are unavailable.

 

Prior to initiating therapy with atorvastatin, secondary cause for hypercholesterolemia (e.g. poorly controlled diabetes mellitus, hypothyroidism, nephritic syndrome, dysproteinemia, obstructive liver disease, other drug therapy, and alcoholism) should be identified and treated.

 

Dosage and administration

The patient should be placed on a standard cholesterol-lowering diet before receiving Atorvastatin and should continue on this diet during treatment with Atorvastatin. The recommended starting doses are 10 mg, 20 mg or 40 mg. The 40 mg dose is recommended for patients who require a reduction in LDL-cholesterol of more than 45 percent. Therapy for patients requiring further reductions can be adjusted up to the 80 mg dose. Hypercholesterolemia (Heterozygous Familial and Nonfamilial) and Mixed Dyslipidemia: The recommended starting dose of Atorvastatin is 10 mg once daily. The dosage range is 10 to 80 mg once daily. Atorvastatin can be administered as a single dose at any time of the day, with or without food. Therapy should be individualized according to goal of therapy and response. After initiation and/or upon titration of Atorvastatin, lipid levels should be analyzed within 2 to 4 weeks and dosage adjusted accordingly. Since the goal of treatment is to lower LDL-C, the LDL-C levels should be used to initiate and assess treatment response. Only if LDL-C levels are not available, should total-C be used to monitor therapy. Homozygous Familial Hypercholesterolemia: The dosage of Atorvastatin in patients with homozygous FH is 10 to 80 mg daily. Atorvastatin should be used as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) in these patients or if such treatments are unavailable. Concomitant Therapy: Atorvastatin may be used in combination with a bile acid binding resin for additive effect. The combination of HMG-CoA reductase inhibitors and fibrates should generally be avoided. Dosage in Patients With Renal Insufficiency: Renal disease does not affect the plasma concentrations nor LDL-C reduction of atorvastatin; thus, dosage adjustment in patients with renal dysfunction is not necessary. Pediatric Use: Treatment experience in a pediatric population is limited to doses of Atorvastatin up to 80 mg/day for 1 year in 8 patients with homozygous FH. No clinical or biochemical abnormalities were reported in these patients. None of these patients was below 9 years of age. Geriatric Use: Treatment experience in adults age  70 years with doses of Atorvastatin up to 80 mg/day has been evaluated in 221 patients. The safety and efficacy of Atorvastatin in this population were similar to those of patients <70 years of age.

 

Side effects

Atorvastatin is generally well tolerated. Adverse reactions have usually been mild and transient. In controlled clinical studies of 2502 patients, <2% of patients were discontinued due to adverse experiences attributable to atorvastatin. The most frequent adverse events thought to be related to atorvastatin were constipation, flatulence, dyspepsia, and abdominal pain.

 

Precaution

Before instituting therapy with atorvastatin, an attempt should be made to control hypercholesterolemia with appropriate diet, exercise, and weight reduction in obese patients, and to treat other underlying medical problems. Information for Patients: Patients should be advised to report promptly unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever.

 

Use in Pregnancy and Lactation

Since HMG-Co A reductase inhibitors decrease cholesterol synthesis and possibly the synthesis of other biologically active substances derived from cholesterol, they may cause fetal harm when administered to pregnant women. Therefore, HMG-Co A reductase inhibitors are contraindicated during pregnancy and in nursing mothers. Atorvastatin should be administered to women of childbearing age only when such patients are highly unlikely to conceive and have been informed of the potential hazards. If the patient becomes pregnant while taking this drug, therapy should be discontinued and the patient apprised of the potential hazard to the fetus. Because of the potential for adverse reactions in nursing infants, women taking atorvastatin should not breast-feed.

 

Contraindications

Hypersensitivity to any component of this medication. Active liver disease or unexplained persistent elevations of serum transaminases.

 

Drug interactions

The risk of myopathy during treatment with drugs of this class is increased with concurrent administration of cyclosporine, fibric acid derivatives, niacin (nicotinic acid), erythromycin, azole antifungals. When atorvastatin and antacid suspension containing magnesium and aluminum hydroxide were co-administered, plasma concentrations of atorvastatin decreased approximately 35%. However, LDL-C reduction was not altered. Plasma concentrations of atorvastatin decreased approximately 25% when colestipol and atorvastatin were co-administered. However, LDL-C reduction was greater when atorvastatin and colestipol were co-administered than when either drug was given alone. When multiple doses of atorvastatin and digoxin were co-administered, steady state plasma digoxin concentrations increased by approximately 20%. Patients taking digoxin should be monitored appropriately. In healthy individuals, plasma concentrations of atorvastatin increased approximately 40% with co-administration of atorvastatin and erythromycin. Co-administration of atorvastatin and an oral contraceptive increased AUC values for norethindrone and ethinylestradiol by approximately 30% and 20%. These increases should be considered when selecting an oral contraceptive for a woman taking atorvastatin.

 

Overdose

There is no specific treatment for atorvastatin overdose. In the event of an overdose, the patient should be treated symptomatically, and supportive measures instituted as required. Due to extensive drug binding to plasma proteins, hemodialysis is not expected to significantly enhance atorvastatin clearance.

 

Storage

Keep in a cool and dry place, away from light. Keep out of the reach of children.

 

Commercial pack

Onvas 10 Tablet: Each box contains 3 blister strips of 10 tablets.

Onvas 20 Tablet: Each box contains 2 blister strips of 10 tablets.

Tuesday, 24 April 2018 11:09

Onlac

Written by

Onlac

Lactulose

 

Presentation

Onlac 100 ml: Each 5 ml concentrated oral solution contains Lactulose USP 3.35 gm.

Onlac 200 ml: Each 5 ml concentrated oral solution contains Lactulose USP 3.35 gm.

 

Description

Lactulose is a semi-synthetic disaccharide used in the treatment of constipation and hepatic encephalopathy. It consists of the monosaccharides fructose and galactose. In the colon, lactulose is broken down primarily to lactic acid and also to small amounts of formic and acetic acids, by the action of ß-galactosidase from colonic bacteria, which results in an increase in osmotic pressure and slight acidification of the colonic contents. This in turn causes an increase in stool water content and softens the stool. In treating hepatic diseases (hepatic encephalopathy), lactulose draws out ammonia from the body in the same way that it draws out water into the colon.

 

Indication

1. Constipation (chronic constipation)

2. Hepatic encephalopathy (HE): treatment and prevention of hepatic coma or precoma

3. Intestinal flora disturbances: In damage to intestinal flora, following therapy with broad        spectrum antibiotics, gall bladder diseases and intestinal diseases (colitis, diverticulitis,                 megacolon etc.)

4. Increased blood ammonia levels (hyperammoniemia in hepatopathy, portal systemic            encephtopathy, precoma and coma)

 

Dosage & Administration

1. Constipation:

Adults: (including the elderly): 15 ml twice daily.

Children: 5 to 10 years: 10 ml twice daily.

Children under 5 years: 5 ml twice daily.

Babies under 1 year: 2.5 ml twice daily. Onlac solution may, if necessary, be taken with water or fruit juice, etc.

2. Hepatic encephalopathy:

Adults (including the elderly): Initially 30-50 ml three times a day. Subsequently adjust the dose to produce two or three soft stools each day.

Children: No dosage recommended for this indication.

3. In damaged intestinal flora (e.g. following long-term antibiotic treatment):

Adults: 5-10 ml daily.

Children: 5 ml daily.

4. To reduce blood ammonia level (In hepatopathy):

A maximum of 60-100 g lactulose daily.

 

Side-effects

Initial dosing may produce flatulence and intestinal cramps, which are usually transient. Nausea, vomiting and abdominal pain may occur. Excessive dosage can lead to diarrhoea.

 

Precautions

It should be used with caution in patients with lactose intolerance and diabetes.

 

Use in Pregnancy and Lactation

Pregnancy

Pregnancy Category B. Lactulose oral solution has been shown to be safe and effective for the treatment of constipation associated with pregnancy when administered to women at different stages of pregnancy.

Lactation

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 lactulose is administered to a nursing woman.

 

Contraindications

Lactulose is contraindicated in patients with galactosaemia and intestinal obstruction.

 

Drug Interactions

Nonabsorbable antacids given concurrently with lactulose may inhibit the desired lactulose-induced drop in colonic pH. Therefore, a possible lack of desired effect of treatment should be taken into consideration before such drugs are given concomitantly with lactulose.

 

Overdosage

There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.

 

Storage

Keep in a cool and dry place, away from light (below 25° C temperature). Keep out of the reach of children.

 

Commercial Pack

Onlac 100 ml: Each amber PET bottle contains 100 ml oral solution with a measuring cup.

Onlac 200 ml: Each amber PET bottle contains 200 ml oral solution with a measuring cup.

 

Tuesday, 24 April 2018 09:22

Ocimax PFS

Written by

Ocimax

Ciprofloxacin

 

Presentation

Ocimax 500 Tablet: Each film coated tablet contains Ciprofloxacin Hydrochloride BP equivalent to Ciprofloxacin 500 mg.

Ocimax Suspension: Each 5 ml suspension contains Ciprofloxacin USP 250 mg.

 

Description

Ciprofloxacin is a synthetic 4-quinolone derivative with bactericidal activity against a wide range of gram-positive and gram-negative organism. It is active against most gram-negative aerobic bacteria including Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin is also active against gram-positive aerobic bacteria including penicillinase producing, non-penicillinase producing and methicillin resistant Staphylococci. However many strains of Streptococci are relatively resistant to the drug. The bactericidal activity of Ciprofloxacin results from interference with the enzyme DNA gyrase needed for the synthesis of bacterial DNA. The mode of action of Ciprofloxacin is different from other antibiotics like penicillins, cephalosporins, aminoglycosides, tetracyclines and for this reason it is observed that organisms resistant to these antibiotics are susceptible to Ciprofloxacin. Ciprofloxacin is well absorbed from the GIT after oral administration and it is widely distributed into the body tissues and fluid. The half-life of Ciprofloxacin is 3.5 - 4.5 hours. About 30-50% of an oral dose of Ciprofloxacin is excreted in the urine within 24 hours as unchanged drug and active metabolites.

 

Indications

Ciprofloxacin is indicated for the treatment of the following infections caused by sensitive bacteria:

Severe systemic infections: e.g; septicemia, bacteremia, peritonitis, infections in immunosuppressed patients with haematological or solid tumors and in patients in intensive care unit with specific problems such as infected burns.

Respiratory tract infections: Lobar and broncho pneumonia, acute and chronic bronchitis and empyema.

Urinary tract infections: Uncomplicated and complicated urethritis, cystitis, pyelonephritis, prostatitis and epididymitis.

Skin and soft tissue infections: Infected ulcers, wound infections, abscesses, cellulitis, otitis externa, erysipelas and infected burns.

Gastrointestinal infections: Enteric fever, infective diarrhea.

Infections of the biliary tract: Cholangitis, cholecystitis, empyema of the gall bladder.

Intra-abdominal infections: Peritonitis, intra abdominal abscesses.

Bone and joint infections: Osteomyelitis, septic arthritis.

Pelvic infections: Salpingitis, endometritis, pelvic inflammatory diseases.

Eye, ear, nose and throat infections: Otitis media, sinusitis, mastoiditis, tonsillitis.

Gonorrhoea: Urethral, rectal and pharyngeal gonorrhoea caused by beta-lactamase producing organism or organisms moderately sensitive to penicillin.

 

Dosage and Administration

Adult :

 

 

 

* use in conjunction with metronidazole

 

Children and adolescents:

RTI & GI infections: Neonate-15mg/kg twice daily, Child (1 month -18 years)-20mg/kg (max 750 mg) twice daily; UTI: Neonate-10 mg/kg twice daily, Child (1 month -18 years)-10mg/kg (max 750 mg) twice daily; Pseudomonal lower respiratory tract infection in cystic fibrosis: Child (1 month -18 years) - 20mg/kg (max 750 mg) twice daily; Anthrax (treatment & post exposure prophylaxis): Child (1 month -18 years) - 20mg/kg (max 750 mg) twice daily.

 

Use in Pregnancy and Lactation

Reproduction studies performed in rats and rabbits using parenteral and oral administration did not reveal any evidence of teratogenicity, impairment of fertility or impairment of pre or postnatal development. However, as with other quinolones, Ciprofloxacin has been shown to cause arthropathy in immature animals and therefore, its use during pregnancy is not recommended. Studies in rats have indicated that Ciprofloxacin is secreted in milk, administration to nursing mothers is thus not recommended.

 

Side effects

Ciprofloxacin is generally well tolerated. Frequent adverse reactions are- Gastrointestinal disturbance: e.g. nausea, diarrhea, vomiting, dyspepsia, abdominal pain. Disturbance of the CNS: e.g. dizziness, headache, tiredness, confusion, convulsions. Hypersensitivity reactions: e.g. skin rashes, pruritus, and possible systemic reactions. Other possible side effects are - joint pain, light sensitivity, transient increase in liver enzyme (especially in patients with history of liver damage), serum bilirubin, urea or serum creatinine. Arthralgia and myalgia may also occur.

 

Contraindications

Ciprofloxacin is contraindicated in patients who have hypersensitivity to Ciprofloxacin or other quinolones.

 

Precautions

Ciprofloxacin should be used with caution in patients with a history of convulsive disorders. Crystalluria related to the use of Ciprofloxacin has been observed only rarely. Patients receiving Ciprofloxacin should be well hydrated to avoid excessive alkalinity of the urine.

 

Drug interactions

Concurrent administration of Ciprofloxacin with theophylline may lead to elevated plasma concentrations of theophylline. Plasma level of theophylline should be monitored and dosage adjustments made as appropriate. Antacid containing magnesium hydroxide or aluminium hydroxide may interfere with the absorption of Ciprofloxacin & concurrent administration of these agents with Ciprofloxacin should be avoided. Probenecid interferes with renal tubular secretion of Ciprofloxacin and produces an increase in the level of Ciprofloxacin in the serum. As with other broad spectrum antibiotics prolonged use of Ciprofloxacin may result in over growth of non-susceptible organisms. Repeated evaluation of patient's conditions and microbial susceptibility testing is essential. If superinfections occur during therapy, appropriate measure should be taken.

 

Information for patients

Ocimax should be swallowed whole with an adequate amount of liquid, it may be taken with or without meals. The preferred time of dosing is two hours after a meal and patients should not take antacid within two hours of dosing.

 

Commercial pack

Ocimax 500 Tablet: Each box containing 3x10’s tablets of Alu-PVC blister.

Ocimax Suspension: Each pet bottle containing 60 ml pellets for suspension.

Tuesday, 24 April 2018 09:15

Murein

Written by

Murein

Flucloxacillin

Presentation

Murein 500: Each capsule contains Flucloxacillin Sodium BP equivalent to Flucloxacillin 500 mg.

 

Description

Flucloxacillin is a narrow-spectrum antibiotic with considerable activity against the following common Gram-positive organisms:

>>Penicillinase producing Staphylococcus aureus

>>Penicillinase sensitive Staphylococcus aureus

>>ß-haemolytic streptococci (Streptococcus pyogenes)

>>Streptococcus pneumoniae

It has little activity against Gram-negative bacilli. However, the Gram-negative organisms Neisseria gonorrhoeae and Neisseria meningitidis come within the range of activity. Flucloxacillin kills bacteria by inhibiting the formation of cell wall of bacteria.

 

Indications and Uses

>>Skin and Soft Tissue Infections: Boils, abscesses, carbuncles, furunculosis, infected  wounds, infected burns, protection of skin grafts, otitis media and externa, impetigo.

>>Infected Skin Conditions: Ulcer, eczema and acne.

>>Respiratory Tract Infections: Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy.

>>Other infections caused by  Flucloxacillin-sensitive organisms such as osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, septicaemia.

 

Flucloxacillin is also indicated for use as a prophylactic agent during major surgical procedures where appropriate, for example, cardiothoracic and orthopaedic surgery.

 

Dosage

Adults (including elderly patients): 

Oral:

500 mg three to four times a day. Oral doses should be administered 1 hour before meal.

 

Children

2-10 years: Half of adult dose.

Under 2 years: One fourth of adult dose.

Children have been given doses of 12.5mg/kg body weight four times a day.

 

Patients with impaired renal function:

As common with other penicillins, Flucloxacillin usage in patients with renal impairment does not usually require dosage reduction. However, in the presence of severe renal failure (creatinine clearance<10 ml/min) a reduction in dose or an extension of dosage interval should be considered.

 

 

 

 

Side effects

There have been some common side effects of GIT such as nausea, vomiting, diarrhoea, dyspepsia and other minor gastrointestinal disturbances. Besides these rashes, urticaria, purpura, fever, interstitial nephritis, hepatitis and cholestatic jaundice have been reported.

 

Contraindications 

Flucloxacillin should not be given to penicillin-hypersensitive patients.

 

Use in pregnancy

Penicillins are generally considered safe for use in pregnancy. Animal studies with Flucloxacillin have shown no teratogenic effect.

 

Use in lactation

Flucloxacillin is excreted in breast milk in trace amounts. Flucloxacillin may be administered during the period of lactation.

 

Overdosage

Although overdosage problems are unlikely to occur with penicillins, and should be treated symptomatically.

 

Commercial Pack

Murein 500: Each box contains 7 strips of 4 capsules.

Tuesday, 24 April 2018 09:11

Kelorac Injection

Written by

Kelorac

 

Presentation

Kelorac 30 IM/IV injection: Each ampoule contains Ketorolac Tromethamine USP 30 mg.

 

Description

Ketorolac Tromethamine is a drug of pyrrolo-pyrrole group of nonsteroidal anti-inflammatory drug (NSAID). Chemically it is known as 5 benzoyle-2,3-dihydro-1H-pyrroligine-1-carboxylic acid, compound with 2- amino-2-(hydroxymethyl)-1,3-propanediol (1:1). Ketorolac Tromethamine inhibits synthesis of prostaglandins and may be considered as a peripherally acting analgesic. The biological activity of Ketorolac Tromethamine is associated with the S-form. Pharmacokinetic property of Ketorolac Tromethamine is linear. It is highly protein bound and is largely metabolized in liver. The products of metabolism and some unchanged drugs are excreted in the urine.

 

Indications and Uses

Ketorolac Tromethamine is indicated for the short-term (<5 days) management of moderately severe acute pain that requires analgesia at the opioid level, (usually in postoperative setteing). Therapy should always be started with Ketorolac Tromethamine IM/IV injection and Ketorolac Tromethamine oral is to be used only as continuation treatment, if necessary. Combined use of Ketorolac Tromethamine IM/IV and oral is not to exceed 5 days of use because of the potential of increasing the frequency and severity of adverse reactions associated with the recommended doses.

 

Dosage and Administration

Kelorac injection

Ketorolac Tromethamine injection may be used as a single or multiple doses, on a regular or when necessary schedule for the management of moderately severe, acute pain that requires analgesia at the opioid level, usually in a postoperative setting. When administering Kelorac injection, the IV bolus must be given over no less than 15 seconds. The IM administration should be given slowly and deeply into the muscle. The analgesic effect begins in ~30 minutes with maximum effect in 1 to 2 hours after dosing IV or IM. Duration of analgesic effect is usually 4 to 6 hours.

 

Single-Dose Treatment:  The following regimen should be limited to single administration use only.

Adult Patients:

IM Dosing: Patients < 65 years of age: One dose of 60 mg. Patients > 65 years of age, renally impaired and/or less than 50 kg of body weight: One dose of 30 mg.

IV Dosing: Patients < 65 years of age: One dose of 30 mg. Patients > 65 years of age, renally impaired and/or less than 50 kg of body weight: One dose of 15 mg.

 

Pediatric Patients (2 to 16 years of age):

IM Dosing: One dose of 1 mg/kg up to a maximum of 30 mg.

IV Dosing: One dose of 0.5 mg/kg up to a maximum of 15 mg.

 

Multiple-Dose Treatment (IV or IM):

Patients <65 years of age: The recommended dose is 30 mg Kelorac injection every 6 hours. The maximum daily dose should not exceed 120 mg. Patients ≥ 65 years of age, renally impaired patients, and patients less than 50 kg : The recommended dose is 15 mg Kelorac injection every 6 hours. The maximum daily dose for these populations should not exceed 60 mg. For breakthrough pain, do not increase the dose or the frequency of Ketorolac Tromethamine.

 

Side-effects

It is generally well tolerated. However, side effects like dry mouth, excessive thirst, psychotic reactions, convulsion, myalgia, hyponatremia, hyperkalemia, raised blood urea and creatinine, renal failure, hypertension, bradycardia, chest pain, purpura, post operative haemorrhage, haematoma, liver function change etc may occur in some cases.

Gastrointestinal side-effects include abdominal discomfort, constipation, diarrhea, dyspepsia, flatulence, fullness, gastritis, gastrointestinal bleeding, gastrointestinal pain, nausea, pancreatitis, peptic ulcer, perforation, stomatitis, vomiting etc.

 

Contraindications

Ketorolac Tromethamine is contraindicated in patients with known hypersensitivity to NSAIDs and any of the components of Ketorolac Tromethamine. Moreover, the patient with the history of asthma, nasal polyp, angioedema, peptic ulcer and bleeding, bleeding disorders are contraindicated for this drug.

 

Precautions

Precaution should be taken in Elderly, Allergic disorder, Renal, cardiac & hepatic impairment,  Porphyria, Patient with low body weight (≤50kg).

 

Use in pregnancy & lactation

Pregnancy category C. Ketorolac Tromethamine is contraindicated in pregnancy and lactation.

 

Drug interaction

Warfarin, digoxin, heparin and salicylate should be used carefully with Ketorolac Tromethamine. 

 

Over dosage

Overdosage of Ketorolac Tromethamine may cause abdominal pain, peptic ulcers which healed after discontinuation of doses. Metabolic acidosis has been reported following intentional overdosage.

 

Commercial Pack

Kelorac 30 IM/IV injection: Each box contains 1 ampoule in blister pack and a 3 ml sterile disposable syringe.

Tuesday, 24 April 2018 09:07

Dometic Tablet

Written by

Dometic

Domperidone

 

Presentation

Dometic Tablet: Each film coated tablet contains Domperidone Maleate BP equivalent to Domperidone 10 mg.

Dometic Suspension: Each 5 ml contains Domperidone BP 5 mg.

 

Description

Dometic is a Dopamine antagonist .Because it does not readily enter the central nervous system, its effects are confined to the periphery and acts principally at the receptor in the chemoreceptor trigger zone.

 

Indications

1. Stimulation of gut mobility

  a) Non-ulcer dyspepsia

  b) Esophageal reflux, reflux esophagitis and gastritis

  c) Diabetic gastroparesis

  d) Functional dyspepsia

  e) Speeding barium transit in 'follow-through' radiological studies

2. Prevention and symptomatic relief of acute nausea and vomiting from any cause                   

    including cytotoxic therapy, radio therapy and anti-parkinsonism therapy

3. In the treatment of migraine.

 

Dosage and Administration

The recommended oral dose for

Adults : 10 - 20 mg every 4 - 8 hours daily

Children : 0.2 - 0.4 mg/kg every 4 - 8 hours daily.

Note : Domperidone tablet and suspension should be taken 15 - 30 minutes before a meal. 

For acute nausea and vomiting, maximum period of treatment is 12 weeks.

 

Contraindications

Domperidone is contraindicated to patients who have known hypersensitivity to this drug and in case of neonates.

 

Precautions

Domperidone should be used with absolute caution in case of children because there may be an increased risk of extra-pyramidal reactions in young children because of an incompletely developed blood-brain barrier.

 

Side-effects

Domperidone may produce hyperprolactinemia(1.3% frequency). This may result in galactorrhea, breast enlargement and soreness and reduced libido. Dry mouth (1.9%), thirst, headache (1.2%), nervousness, drowsiness (0.4%), diarrhea (0.2%), skin rash and itching (0.1%) may occur during treatment with Domperidone. Extra-pyramidal reactions are seen in 0.05% of patients in clinical studies.

 

Use in Pregnancy & Lactation 

Pregnant women : The safety of Domperidone has not been proven and it is therefore not recommended during pregnancy.Animal studies have not demonstrated teratogenic effects on the fetus.

Lactating mother : Domperidone may precipitate galactorrhea and improve post-natal lactation. It is secreted in breast milk but in very small quantities insufficient to be considered harmful.

 

Drug interactions

Domperidone may reduce the hypoprolactinemic effect of bromocriptine. The action of Domperidone on GI function may be antagonized by anti-muscarinics and opioid analgesics.

 

Overdosage 

There are no reported cases of  overdosage.

 

Commercial Pack

Dometic Tablet: Each box contains 10 blister strips of 10 Tablets.

Dometic Suspension: Each bottle contains 60 ml of Suspension.

Tuesday, 24 April 2018 09:03

Dometic Suspension

Written by

 

Dometic

Domperidone

 

Presentation

Dometic Tablet: Each film coated tablet contains Domperidone Maleate BP equivalent to Domperidone 10 mg.

Dometic Suspension: Each 5 ml contains Domperidone BP 5 mg.

 

Description

Dometic is a Dopamine antagonist .Because it does not readily enter the central nervous system, its effects are confined to the periphery and acts principally at the receptor in the chemoreceptor trigger zone.

 

Indications

1. Stimulation of gut mobility

  a) Non-ulcer dyspepsia

  b) Esophageal reflux, reflux esophagitis and gastritis

  c) Diabetic gastroparesis

  d) Functional dyspepsia

  e) Speeding barium transit in 'follow-through' radiological studies

2. Prevention and symptomatic relief of acute nausea and vomiting from any cause                   

    including cytotoxic therapy, radio therapy and anti-parkinsonism therapy

3. In the treatment of migraine.

 

Dosage and Administration

The recommended oral dose for

Adults : 10 - 20 mg every 4 - 8 hours daily

Children : 0.2 - 0.4 mg/kg every 4 - 8 hours daily.

Note : Domperidone tablet and suspension should be taken 15 - 30 minutes before a meal. 

For acute nausea and vomiting, maximum period of treatment is 12 weeks.

 

Contraindications

Domperidone is contraindicated to patients who have known hypersensitivity to this drug and in case of neonates.

 

Precautions

Domperidone should be used with absolute caution in case of children because there may be an increased risk of extra-pyramidal reactions in young children because of an incompletely developed blood-brain barrier.

 

Side-effects

Domperidone may produce hyperprolactinemia(1.3% frequency). This may result in galactorrhea, breast enlargement and soreness and reduced libido. Dry mouth (1.9%), thirst, headache (1.2%), nervousness, drowsiness (0.4%), diarrhea (0.2%), skin rash and itching (0.1%) may occur during treatment with Domperidone. Extra-pyramidal reactions are seen in 0.05% of patients in clinical studies.

 

Use in Pregnancy & Lactation 

Pregnant women : The safety of Domperidone has not been proven and it is therefore not recommended during pregnancy.Animal studies have not demonstrated teratogenic effects on the fetus.

Lactating mother : Domperidone may precipitate galactorrhea and improve post-natal lactation. It is secreted in breast milk but in very small quantities insufficient to be considered harmful.

 

Drug interactions

Domperidone may reduce the hypoprolactinemic effect of bromocriptine. The action of Domperidone on GI function may be antagonized by anti-muscarinics and opioid analgesics.

 

Overdosage 

There are no reported cases of  overdosage.

 

Commercial Pack

Dometic Tablet: Each box contains 10 blister strips of 10 Tablets.

Dometic Suspension: Each bottle contains 60 ml of Suspension.

Tuesday, 24 April 2018 08:58

Caftyl

Written by

Caftyl

Paracetamol 500 mg & Caffeine 65 mg

 

Presentation

Caftyl: Each tablet contains Paracetamol BP 500 mg & Caffeine BP 65 mg.

 

Description

Caftyl (Paracetamol & Caffeine) is a fast acting and safe analgesic with marked antipyretic property. It is specially suitable for patients who, for any reason, can not tolerate aspirin or other analgesics. The presence of Caffeine increases the effectiveness of Paracetamol.

 

Indications

The indications of Caftyl are as follows

>>Headache

>>Migraine

>>Toothache

>>Neuralgia

>>Feverishness

>>Period pain

>>Sore throat

>>Rheumatic pain & backache

>>Helps to reduce temperature

>>Pain of colds and flu

 

Dosage and Administration

Adult: 1-2 tablets every 4-6 hours. Maximum dose 4 g (8 tablets) daily.

 

Side effects

Side effects of paracetamol are usually mild, though haematological reactions including thrombocytopenia, leukopenia, pancytopenia, neutropenia and agranulocytosis have been reported. Pancreatitis, skin rashes and other allergic reactions occur occasionally.

 

Precautions

Paracetamol & Caffeine should be given cautiously in the following cases : In patients with hepatic or renal failure, in patients taking other hepatotoxic medication. Prolonged use of the drug without consulting with a physician should be avoided.

 

Contraindications

Paracetamol is contraindicated in patients with severe renal function impairment and hepatic disease (Viral Hepatitis). It is contraindicated in patients with known hypersensitivity to paracetamol or caffeine.

 

Use in pregnancy and lactation

Pregnant mothers should consult with doctors before taking Paracetamol & Caffeine. Paracetamol & Caffeine can be taken while breast feeding.

 

Drug Interactions

Paracetamol & Caffeine increases the effect of chloramphenicol and coumarin anti-coagulant. Risk of hepatotoxicity of paracetamol may be increased in alcoholics or in patients taking other anti- epileptic medications.

 

Overdosage

Symptoms of Paracetamol overdose in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 40 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur.

 

Commercial Pack

Caftyl: Each box contains 10 blister strips of 10 tablets.

 

Dantron

Ondansetron

 

Presentation

Dantron Tablet: Each film coated tablet contains Ondansetron Hydrochloride Dihydrate BP 9.977 mg equivalent to Ondansetron 8 mg.

Dantron Syrup: Each 5 ml syrup contains Ondansetron Hydrochloride Dihydrate BP equivalent to Ondansetron 4 mg.

 

Description

Ondansetron is a selective 5-HT3 receptor antagonist. While its mechanism of action has not been fully characterized, Ondansetron is not a dopamine-receptor antagonist. Serotonin receptors of the 5-HT3 type are present both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone of the area postrema. It is not certain whether Ondansetron's antiemetic action is mediated centrally, peripherally, or in both sites. However, cytotoxic chemotherapy appears to be associated with release of serotonin from the enterochromaffin cells of the small intestine.

 

Indications and Uses

1. Prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including Cisplatin ≥ 50 mg/m2

2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy

3. Prevention of nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen

4. Prevention of post-operative nausea and/or vomiting

5. Nausea-vomiting associated with pregnancy

6. Nausea-vomiting associated with gastroenteritis

 

Dosage and Administration

 

 

Contraindications

Ondansetron is contraindicated for patients known to have hypersensitivity to the drug.

 

Precautions

Ondansetron is not a drug that stimulates gastric or intestinal peristalsis. It should not be used instead of nasogastric suction. The use of Ondansetron in patients following abdominal surgery or in patients with chemotherapy-induced nausea and vomiting may mask a progressive ileus and/or gastric distension.

 

Side-effects

Generally Ondansetron is well tolerated. However few side effects including headache, diarrhoea, fatigue, dizziness and constipation may be seen after Ondansetron is administered.

 

Use in pregnancy & lactation 

Pregnancy: Pregnancy category B.

Nursing mother: It is not known whether Ondansetron is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Ondansetron is administered to a nursing woman.

 

Drug Interactions

The following drugs should be used with caution when concomitantly used with Ondansetron:

Phenytoin, Carbamazepine, Rifampicin & Tramadol.

 

Overdosage

There is no specific antidote for Ondansetron overdose. Hypotension (and faintness) occurred in a patient that took 48 mg of Ondansetron tablets.

 

Commercial Pack

Dantron Tablet: Each box contains 3 blister strips of 10 tablets.

Dantron Syrup: Each bottle contains 50 ml Syrup.

Tuesday, 24 April 2018 08:53

Azikil PFS

Written by

Azikil

Azithromycin

 

Presentation

Azikil 500 Tablet: Each film coated tablet contains Azithromycin Dihydrate USP 524.03 mg equivalent to Azithromycin 500 mg.

Azikil 20 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP equivalent to Azithromycin 200 mg.

Azikil 35 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.

Azikil 50 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.

 

Description

Azithromycin is an azalide antibiotic, a subclass of macrolide antibiotic. It acts by binding to the 50s ribosomal subunit of susceptible microorganisms and thus interfering with microbial protein synthesis. Azithromycin has been shown to be active against most strains in the following microorganisms, both In vitro and in clinical infections:

Gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes.

Gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, Escherichia coli.

 

Indications and Uses

Azithromycin is indicated for infections caused by susceptible organisms in-

 

>>Upper respiratory tract infections including sinusitis, pharyngitis and tonsillitis

>>Lower respiratory tract infections including bronchitis, acute bacterial exacerbations of chronic obstructive pulmonary  disease (COPD)

>>Otitis media

>>Skin and soft tissue infections including cellulitis, pyoderma, erysipelas, wound infections

>>Diarrhea, Shigellosis

>>Sexually transmitted diseases, especially in the treatment of non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis

>>Genital ulcer disease in men due to Haemophilus ducreyi (chancroid)

>>Mild or moderate typhoid due to multiple-antibacterial resistant organisms

>>Prophylaxis against a-hemolytic (viridans group) streptococcal bacterial endocarditis

>>Other infections including odontogenic infections, bartonella infections, toxoplasmosis, babesiosis

 

Dosage and Administration

Azithromycin tablet can be taken with or without food. Azithromycin suspension should be taken at least 1 hour before or 2 hours after meal.

Adult

For respiratory tract infections, otitis media and skin & soft tissue infections: 500 mg once daily for 3 days or an alternative to this as 500 mg once on day 1, followed by 250 mg once daily for next 4 days. For sexually transmitted diseases like genital ulcer, non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis : a single 1 gm (1000 mg) dose. For the treatment of urethritis and cervicitis due to Neisseria gonorrhoeae : a single 2 gm (2000 mg) dose. In typhoid, 500 mg once daily for 7 days. In Cholera, a single 1 gm (1000 mg) dose. In Shigellosis, 500 mg once on day 1, followed by 250 mg once daily for next 4 days.

Children:

 

 

Elderly:  same as for adults.

 

Side effects

Azithromycin is well tolerated with a low incidence of side efects. The side effects include nausea, vomiting, abdominal discomfort (pain/cramps), flatulence, diarrhea, headache, dizziness, and skin rashes and are reversible upon discontinuation of therapy. Reversible elevations in liver transaminases have been observed occasionally. Transient mild reductions in neutrophil counts have occasionally been observed in clinical trials, although causal relationship to Azithromycin has not been established.

 

Contraindications

Azithromycin is contraindicated in patients hypersensitive to Azithromycin or any other macrolide antibiotic. Co-administration of ergot derivative and Azithromycin is contraindicated. Azithromycin is contraindicated in patients with hepatic diseases.

 

Precautions

As with any antibiotic, observation for signs of super infection with non-susceptable organisms, including fungi, is recommended. Precaution should be taken in patients with more severe renal impairment.

 

Use in pregnancy & lactation

Pregnancy: US FDA pregnancy category B. In the animal studies, no evidence of harm to the fetus due to Azithromycin was found. Because animal reproduction studies are not always predictive of human response, Azithromycin should be used during pregnancy only if clearly needed.

Lactation: It is not known whether Azithromycin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Azithromycin is administered to nursing mother.

 

Drug interactions

Peak serum levels but not the total extent of absorption were reduced by the presence of magnesium and aluminum-containing antacids. Azithromycin should be taken at least 1 hr before or 2 hrs after these antacids. In patients receiving ergot alkaloids, Azithromycin should be avoided concurrently because of the possibilty of ergotism result in from interaction of Azithromycin with the cytochrome P-450 system However, no cases of such interaction have been reported. Macrolides have been known to increase the plasma concentration of digoxin and cyclosporine. Therefore, if co-administration is necessary caution should be exercised and serum levels of digoxin and cyclosporine should be checked. There have been no pharmacokinetic drug interactions between Azithromycin and warfarin, theophylline, carbamazepine, methylprednisolone and cimetidine.

 

Direction for reconstitution of suspension

Shake the bottle to loosen powder.

20 ml: To reconstitute pour the diluent from glass bottle into drug containing PET bottle & shake well.

35 ml: To reconstitute pour the diluent from glass bottle into drug containing PET bottle & shake well.

50 ml: To reconstitute pour the diluent from glass bottle into drug containing PET bottle & shake well.

For ease of preparation, add diluent to the PET bottle in two proportions. Shake well after each addition until all the powder is in suspension.

Note: Shake the suspension well before each use. Keep the bottle tightly closed. The reconstituted suspension should be stored in a cool and dry place, preferably in refrigerator.

 

Overdosage

There are no data available on overdose with Azithromycin. Typical symptoms of overdosage with macrolide antibiotics include hearing loss, severe nausea, vomiting and diarrhoea. Gastric lavage and general supportive measures are indicated.

 

Commercial Pack

Azikil 500 Tablet: Each box contains 8’s/12’s tablets in Alu-Alu blister strip.

Azikil 20 ml Powder for Suspension: Each box contains one PET bottle of Azithromycin powder and one Glass bottle of diluent for suspension. After reconstitution as per direction bottle contains 20 ml suspension.

Azikil 35 ml Powder for Suspension: Each box contains one PET bottle of Azithromycin powder and one Glass bottle of diluent for suspension. After reconstitution as per direction bottle contains 35 ml suspension.

Azikil 50 ml Powder for Suspension: Each box contains one PET bottle of Azithromycin powder and one Glass bottle of diluent for suspension. After reconstitution as per direction bottle contains 50 ml suspension.

Tuesday, 24 April 2018 08:46

Azikil-500

Written by

Azikil

Azithromycin

 

Presentation

Azikil 500 Tablet: Each film coated tablet contains Azithromycin Dihydrate USP 524.03 mg equivalent to Azithromycin 500 mg.

Azikil 20 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP equivalent to Azithromycin 200 mg.

Azikil 35 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.

Azikil 50 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.

 

Description

Azithromycin is an azalide antibiotic, a subclass of macrolide antibiotic. It acts by binding to the 50s ribosomal subunit of susceptible microorganisms and thus interfering with microbial protein synthesis. Azithromycin has been shown to be active against most strains in the following microorganisms, both In vitro and in clinical infections:

Gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes.

Gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, Escherichia coli.

 

Indications and Uses

Azithromycin is indicated for infections caused by susceptible organisms in-

 

>>Upper respiratory tract infections including sinusitis, pharyngitis and tonsillitis

>>Lower respiratory tract infections including bronchitis, acute bacterial exacerbations of chronic obstructive pulmonary  disease (COPD)

>>Otitis media

>>Skin and soft tissue infections including cellulitis, pyoderma, erysipelas, wound infections

>>Diarrhea, Shigellosis

>>Sexually transmitted diseases, especially in the treatment of non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis

>>Genital ulcer disease in men due to Haemophilus ducreyi (chancroid)

>>Mild or moderate typhoid due to multiple-antibacterial resistant organisms

>>Prophylaxis against a-hemolytic (viridans group) streptococcal bacterial endocarditis

>>Other infections including odontogenic infections, bartonella infections, toxoplasmosis, babesiosis

 

Dosage and Administration

Azithromycin tablet can be taken with or without food. Azithromycin suspension should be taken at least 1 hour before or 2 hours after meal.

Adult

For respiratory tract infections, otitis media and skin & soft tissue infections: 500 mg once daily for 3 days or an alternative to this as 500 mg once on day 1, followed by 250 mg once daily for next 4 days. For sexually transmitted diseases like genital ulcer, non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis : a single 1 gm (1000 mg) dose. For the treatment of urethritis and cervicitis due to Neisseria gonorrhoeae : a single 2 gm (2000 mg) dose. In typhoid, 500 mg once daily for 7 days. In Cholera, a single 1 gm (1000 mg) dose. In Shigellosis, 500 mg once on day 1, followed by 250 mg once daily for next 4 days.

Children:

 

 

Elderly:  same as for adults.

 

Side effects

Azithromycin is well tolerated with a low incidence of side efects. The side effects include nausea, vomiting, abdominal discomfort (pain/cramps), flatulence, diarrhea, headache, dizziness, and skin rashes and are reversible upon discontinuation of therapy. Reversible elevations in liver transaminases have been observed occasionally. Transient mild reductions in neutrophil counts have occasionally been observed in clinical trials, although causal relationship to Azithromycin has not been established.

 

Contraindications

Azithromycin is contraindicated in patients hypersensitive to Azithromycin or any other macrolide antibiotic. Co-administration of ergot derivative and Azithromycin is contraindicated. Azithromycin is contraindicated in patients with hepatic diseases.

 

Precautions

As with any antibiotic, observation for signs of super infection with non-susceptable organisms, including fungi, is recommended. Precaution should be taken in patients with more severe renal impairment.

 

Use in pregnancy & lactation

Pregnancy: US FDA pregnancy category B. In the animal studies, no evidence of harm to the fetus due to Azithromycin was found. Because animal reproduction studies are not always predictive of human response, Azithromycin should be used during pregnancy only if clearly needed.

Lactation: It is not known whether Azithromycin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Azithromycin is administered to nursing mother.

 

Drug interactions

Peak serum levels but not the total extent of absorption were reduced by the presence of magnesium and aluminum-containing antacids. Azithromycin should be taken at least 1 hr before or 2 hrs after these antacids. In patients receiving ergot alkaloids, Azithromycin should be avoided concurrently because of the possibilty of ergotism result in from interaction of Azithromycin with the cytochrome P-450 system However, no cases of such interaction have been reported. Macrolides have been known to increase the plasma concentration of digoxin and cyclosporine. Therefore, if co-administration is necessary caution should be exercised and serum levels of digoxin and cyclosporine should be checked. There have been no pharmacokinetic drug interactions between Azithromycin and warfarin, theophylline, carbamazepine, methylprednisolone and cimetidine.

 

Direction for reconstitution of suspension

Shake the bottle to loosen powder.

20 ml: To reconstitute pour the diluent from glass bottle into drug containing PET bottle & shake well.

35 ml: To reconstitute pour the diluent from glass bottle into drug containing PET bottle & shake well.

50 ml: To reconstitute pour the diluent from glass bottle into drug containing PET bottle & shake well.

For ease of preparation, add diluent to the PET bottle in two proportions. Shake well after each addition until all the powder is in suspension.

Note: Shake the suspension well before each use. Keep the bottle tightly closed. The reconstituted suspension should be stored in a cool and dry place, preferably in refrigerator.

 

Overdosage

There are no data available on overdose with Azithromycin. Typical symptoms of overdosage with macrolide antibiotics include hearing loss, severe nausea, vomiting and diarrhoea. Gastric lavage and general supportive measures are indicated.

 

Commercial Pack

Azikil 500 Tablet: Each box contains 8’s/12’s tablets in Alu-Alu blister strip.

Azikil 20 ml Powder for Suspension: Each box contains one PET bottle of Azithromycin powder and one Glass bottle of diluent for suspension. After reconstitution as per direction bottle contains 20 ml suspension.

Azikil 35 ml Powder for Suspension: Each box contains one PET bottle of Azithromycin powder and one Glass bottle of diluent for suspension. After reconstitution as per direction bottle contains 35 ml suspension.

Azikil 50 ml Powder for Suspension: Each box contains one PET bottle of Azithromycin powder and one Glass bottle of diluent for suspension. After reconstitution as per direction bottle contains 50 ml suspension.

Tuesday, 24 April 2018 06:34

Maxzone

Written by

MAXZON

Ceftriaxone

 

Composition

Maxzon 250 mg IM injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 250 mg and each ampoule contains 2 ml Lidocaine Hydrochloride BP 1% solution.

Maxzon 500 mg IM injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 500 mg and each ampoule contains 2 ml Lidocaine Hydrochloride BP 1% solution.

Maxzon 1 g IV injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 1 g and each ampoule contains 10 ml water for Injection USP.

Maxzon 2 g IV injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 2 g and also contains 2 ampoules of 10 ml water for Injection USP.

 

Description

Maxzon (Ceftriaxone) is a sterile, semi-synthetic, third generation broad-spectrum cephalosporin antibiotic for intravenous/intramuscular administration. The bactericidal activity of ceftriaxone results from inhibition of cell wall synthesis, Ceftriaxone has a high degree of stability in the presence of beta-lactamases both penicillinases and cephalosporinases of gram-positive and gram-negative bacteria.

 

Pharmacology

Ceftriaxone is most effective against the following microorganisms: Gram-positive bacteria; Staphylococcus aureus (including penicillinase producing strains). S. epidermis, S. pneumoniae &    S. bovis. Gram-negative bacteria: Escherichia coli, Heamophilus influenzae (including penicillinase- producing strains), Neisseria gonorrhoeae, Neisseria meningitidis, Proteus mirabilis & Proteus vulgaris. A remarkable feature of ceftriaxone is its relatively long plasma elimination half-life of about 6 to 9 hours, which makes single or once-daily dosage of the drug appropriate for most patients. Ceftriaxone is not metabolized in the body. About 40-65% of a dose of Ceftriaxone is excreted unchanged in the urine; the remainder is excreted in the bile and ultimately found in the feces as unchanged drug and microbiologically inactive compound. The drug is highly protein bound (95%).

 

Indications

Maxzon is indicated for the treatment of the following major infections when caused by susceptible organisms:

1. Renal and urinary tract infections

2. Lower respiratory tract infections, particularly pneumonia

3. Gonococcal infections

4. Skin, soft tissue, bone and joint infections

5. Bacterial meningitis

6. Serious bacterial infections e.g. septicemia

7. ENT infections

8. Infections in cancer patients

9. Prevention of postoperative infections

10. Perioperative prophylaxis of infections associated with surgery

11. Typhoid fever.

 

Dosage & Administration

Dose and mode of administration should be determined by the severity of infection, susceptibility of causitive organisms and the patient’s condition. Maxzon may be administered by deep intramuscular injection or slow intravenous injection.

 

Adults & Children over 12 years: The usual adult daily dose standard is 1 g given once a day. In case of severe infections, 2-4 g daily, normally as a single dose every 24 hours. The total daily dose should not exceed 4 g.

 

Paediatric Patient (Children under 12 years): should receive a standard therapeutic dose of 20-50 mg/kg body weight once daily. Incase of severe infections, patient should receive up to 80 mg/kg body weight daily. The total daily dose should not exceed 2 g.

 

Preoperative Use (surgical prophylaxis): A single dose of 1 g administered intravenously 30 minutes to 2 hours before surgery is recommended. 

 

Duration of therapy

Generally, Ceftriaxone therapy should be continued for at least 2 days after the signs and symptoms of infection have disappeared. The usual duration of therapy is 4 to 14 days; in complicated infections, longer therapy may be required.

 

Preparation of Solutions for Intravenous/Intramuscular Injections

For Intravenous Injection: 1 g Maxzon dry powder should be dissolved in 10 ml of water for injection USP with vigorous shaking or 2 g Maxzon dry powder should be dissolved in 20 ml of water for injection USP with vigorous shaking. The injection should be administered over 2-4 minutes, directly into the vein or via the tubing of an intravenous infusion.

 

For Intramuscular Injection: 250 & 500 mg Maxzon dry powder should be dissolved in 2 ml of Lidocaine HCL BP 1% solution with vigorous shaking. It should be injected well within the body of a relatively large muscle. It is recommended that not more than 1 g be injected at one site. The lidocaine solution should never be administered intravenously.

 

Side Effect

Ceftriaxone is generally well tolerated. A few side effects such as gastro-intestinal effects including diarrhoea, nausea and vomiting, stomatitis & glossitis; cutaneous reactions including rash, pruritus, urticaria, oedema & erythema multiforme; hematologic reactions including eosinophilia, thrombocytopenia, leucopenia, anemia and neutropenia; hepatic reactions including elevations of SGOT or SGPT, bilirubinemia; CNS reactions including headache, hyperactivity, nervousness, sleep disturbances, confusion, hypertonia and dizziness were reported. Local phlebitis occurs rarely following intravenous administration but can be minimized by slow injections over 2-4 minutes.

 

Use In Pregnancy & Lactation

Ceftriaxone has not been associated with adverse effects on fetal development in laboratory animals, but its safety in human pregnancy has not been established. Therefore, it should not be used in pregnancy unless absolutely indicated. Because low conc. of ceftriaxone is distributed into breast milk, the drug should be used with caution in nursing woman.

 

Contraindication

Ceftriaxone should not be given to patients with a history of hypersensitivity to Cephalosporin antibiotics. Serious acute hypersensitivity reaction may require the use of subcutaneous epinephrine and other emergency.

 

Precaution

As with other Cephalosporins anaphylactic shock cannot be ruled out even if a thorough patient history is taken. Anaphylactic shock requires immediate counter measures. The stated dosage should not be exceeded. In severe renal impairment accompanied by hepatic insufficiency, dosage reduction is required.

 

Drug Interaction

No impairment of renal function or increased nephrotoxicity has been observed in man after simultaneous administration of Ceftriaxone with diuretics, or with aminoglycosides. A possible disulfiram-like reaction may occur with alcohol. It doesn't interfere with the protein binding of bilirubin. Simultaneous administration of probenecid doesn't alter the elimination of Ceftriaxone.

 

Storage Condition

The recommended maximum storage temperature for Maxzon (Ceftriaxone) injection is 25º C, preferably between 15º-30º C. Reconstituted solutions retain their stability for 6 hours at room temperature or 24 hours at 5º C.

 

Commercial Pack

Maxzon 250 mg IM Injection: Each box containing one vial 250 mg Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 1 ampoule of 2 ml Lidocaine Hydrochloride BP 1 % solution. It also contains disposable syringe (5 ml), baby needle, alcohol pad and first aid bandage.

Maxzon 500 mg IM Injection: Each box containing one vial 500 mg Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 1 ampoule of 2 ml Lidocaine Hydrochloride BP 1 % solution. It also contains disposable syringe (5 ml), baby needle, alcohol pad and first aid bandage.

Maxzon 1 g IV Injection: Each box containing one vial 1 g Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 1 ampoule of 10 ml water for injection USP. It also contains disposable syringe (10 ml), butterfly needle, alcohol pad and first aid bandage.

Maxzon 2 g IV Injection: Each box containing one vial 2 g Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 2 ampoules of 10 ml water for injection USP. It also contains disposable syringe (20 ml), butterfly needle, alcohol pad and first aid bandage.

 

Nevrona

Vitamin B1, B6 & B12

 

Presentation

Nevrona tablet: Each tablet contains Thiamine Mononitrate BP (100 mg), Pyridoxine Hydrochloride BP (200 mg), Cyanocobalamin BP (200 mcg).

 

 

Description

Nevrona is a special preparation of vitamin B1, B6 and B12. The vitamins B1, B6 and B12 are indispensable for a normal course of the nervous metabolism.

 

 Indication & Uses

Nevrona is indicated for the treatment of B1, B6 and B12 deficiency syndrome. It is also indicated in  the treatment of:

>>Diabetic neuropathy

>>Sciatica

>>Peripheral neuralgia

>>Facial neuralgia

>>Lumbago

>>Intercostal neuralgia

>>Myalgia

>>Spinal pain

>>Optic Neuritis

 

Dosage and Administration

Tablets may be administered in a dose of 1 to 3 tablets per day or as directed by the physician.

 

Side Effects

Generally well tolerated. However, a few allergic reactions may be seen.

 

Precautions

Cyanocobalamin should not be given before a diagnosis has been fully established because of the possibility of masking symptoms of subacute degeneration of the spinal cord. Cyanocobalamin is not a suitable form of Vitamin B12 for the treatment of optic neuropathies associated with raised plasma concentrations of cyanocobalamin.

 

Use in pregnancy & lactation

Oral tablet form is recommended but injectable preparation is not recommended due to presence of benzyl alcohol.

 

Contraindications

Should not be used in the patients on Levodopa therapy and hypersensitivity to any of the active ingredients.

 

Drug Interactions

No such drug interactions have been reported.

 

Overdosage

If there is known overdose then treatment is symptomatic and supportive.

 

Commercial Pack

Nevrona Tablet: Each box contains 3 blister strips of 10 tablets.

Sunday, 16 October 2016 04:07

Ozink-B

Written by

Ozink-B

(Zinc & Vitamin B Complex Syrup)

 

Presentation

Ozink-B syrup: Each 5 ml syrup contains Zinc Sulfate Monohydrate USP 27.45 mg equivalent to Elemental Zinc 10 mg, Thiamine Hydrochloride (B1) BP 5 mg, Riboflavin 5-Phosphate Sodium BP 2.74 mg equivalent to Riboflavin (B2) 2 mg, Pyridoxine Hydrochloride (B6) BP 2 mg, Nicotinamide (B3) BP 20 mg.

 

Description

Ozink-B is a special preparation of B-Vitamins and Zinc.

 

Indications

Ozink-B is indicated for the treatment and prevention of B-vitamins and Zinc deficiencies. B-vitamins are needed to release energy from food. They play an important role in ensuring healthy brain and nerve function, formation of healthy red blood cells (RBC) in children & adults. They are specially required for healthy growth and development of children. Zinc is necessary to maintain a healthy immune system. It ensures normal growth & sexual development of children. It is further necessary for the growth and maintenance of muscles.

 

Dosage & Administration

Ozink-B syrup

Adults: 10 ml (1 measuring cup) 2 to 3 times daily or as recommended by the physician.

Children: 10 ml (1 measuring cup) 1 to 3 times daily or as recommended by the physician.

Infants: 5 ml (1/2 measuring cup) 1 to 2 times daily or as recommended by the physician.

 

Side Effect

Ozink-B is generally well tolerated.

 

Contraindication

Ozink-B is contraindicated in patients with a known hypersensitivity to any of the ingredients of this product.

 

Use in Pregnancy & Lactation

Recommended.

 

Overdose

In case of overdosage, initially epigastric pain, diarrhoea and vomiting can occur. Should seek emergency medical attention immediately. Initially an emetic should be given and then gastric lavage and general supportive measures should be employed.

 

Storage

Store in a cool and dry place, keep away from light. Keep all medicines out of reach of children.

 

Commercial Pack

Ozink-B syrup 100 ml: Each amber PET bottle contains 100 ml syrup with a measuring cup.

Sunday, 16 October 2016 03:56

Onepro

Written by

Onepro

(Esomeprazole)

Presentation

Onepro 20 tablet: Each delayed release tablet contains Esomeprazole Magnesium Trihydrate BP equivalent to Esomeprazole 20 mg.

Onepro 40 tablet: Each delayed release tablet contains Esomeprazole Magnesium Trihydrate BP equivalent to Esomeprazole 40 mg.

 

Description

Esomeprazole (Onepro) is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H+/K+ATPase in the gastric parietal cell. By acting specifically on the proton pump, Onepro blocks the final step in acid production, thus reducing gastric acidity.

 

 

Indications and Usage

Treatment of Gastroesophageal Reflux Disease (GERD)

Healing of Erosive Esophagitis

Maintenance of Healing of Erosive Esophagitis

Symptomatic Gastroesophageal Reflux Disease

H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence

Zollinger-Ellison Syndrome

Acid Related Dyspepsia

Duodenal and Gastric Ulcer

 

Dosage and Administration

Tablet: The recommended adult dosages are outlined in the table below. Onepro delayed release tablet/capsule should be swallowed whole and taken at least one hour before eating.

The majority of patients are healed within 4 to 8 weeks. For patients who do not heal after 4-8 weeks, an additional 4-8 weeks of treatment may be considered.

**If symptoms do not resolve completely after 4 weeks, an additional 4 weeks of treatment may be considered.

 

Use in Pregnancy and Lactation

In Pregnancy: Pregnancy Category B. This drug should be used during pregnancy only if clearly needed.

 

In Lactation: The excretion of Esomeprazole in milk has not been studied. As Esomeprazole is likely to be excreted in human milk, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

 

Side-effects

In general, Esomeprazole was well tolerated in both short- and long-term clinical trials. The most frequently occurring adverse events (≥1%) are headache and diarrhea. Nausea, flatulence, abdominal pain, constipation and dry mouth occurred at similar rates among patients taking Esomeprazole.

 

Contraindications

Esomeprazole is contraindicated in patients with known hypersensitivity to any component of the formulation or to substituted Benzimidazoles.

 

Precautions

Symptomatic response to therapy with Esomeprazole does not preclude the presence of gastric malignancy. Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole, of which Esomeprazole is an enantiomer.

 

Drug Interactions

Drug interaction studies have shown that Esomeprazole does not have any clinically significant interactions with Phenytoin, Warfarin, Quinidine, Clarithromycin or Amoxicillin.  Esomeprazole inhibits gastric acid secretion. Therefore, Esomeprazole may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (eg, Ketoconazole, Iron salts and Digoxin). Coadministration of oral contraceptives, Diazepam, Phenytoin or Quinidine did not seem to change the pharmacokinetic profile of Esomeprazole.

 

Commercial Pack

Onepro 20 tablet: Each box contains 6 Alu-Alu blister strips of 10 tablets.

Onepro 40 tablet: Each box contains 3 Alu-Alu blister strips of 10 tablets.

Sunday, 16 October 2016 03:21

Onefix

Written by

CapsulOnefix

(Cefixime)

Presentation

Onefix 200 Capsule: Each capsule contains Cefixime Trihydrate USP equivalent to Cefixime 200 mg.

Onefix 400 Capsule: Each capsule contains Cefixime Trihydrate USP equivalent to Cefixime 400 mg.

Onefix 30 ml Powder for Suspension: After reconstitution according to direction, each 5 ml suspension contains Cefixime Trihydrate USP equivalent to Cefixime 100 mg.

Onefix 50 ml Powder for Suspension: After reconstitution according to direction, each 5 ml suspension contains Cefixime Trihydrate USP equivalent to Cefixime 100 mg.

 



Description:

Cefixime is a semi-synthetic, broad spectrum cephalosporin antibiotic of third generation for oral administration. It is a bactericidal antibiotic, kills bacteria by interfering in the synthesis of the bacterial cell wall. Cefixime is highly stable in the presence of beta-lactamase enzymes. Cefixime has marked in-vitro bactericidal activity against a wide variety of Gram-positive and Gram-negative organisms including beta lactamase producers.

Clinical efficacy of Cefixime has been demonstrated in infections caused by commonly occurring pathogens including Gram-positive organism Streptococcus pneumoniae, Streptococcus pyogenes, Gram-negative organism Escherichia coli, Proteus mirabilis, Klebsiella spp., Haemophilus influenzae (beta-lactamase positive and negative), Moraxella catarrhalis (beta-lactamase positive and negative), Salmonella typhi and Enterobacter species.

 

Indications and Uses:

Onefix is indicated in the following infectious diseases -

Respiratory Tract Infections:

Pneumonia

Sinusitis

Pharyngitis and Tonsillitis

Acute Bronchitis and Acute Exacerbations of Chronic Bronchitis (AECB)

Otitis Media

Typhoid Fever

Urinary Tract Infection

Uncomplicated gonorrhea (cervical/urethral)

 

Dosage and Administration:

The usual treatment of Onefix is 7 days. This may be continued for up to 14 days according to the severity of infection.

Side-effects

Cefixime is generally well tolerated. The majority of adverse reactions observed in clinical trials are mild and self limiting in nature.

Gastro-intestinal disturbance: Diarrhoea (if severe diarrhoea occurs, Cefixime should be discontinued), changes in the color of stool, nausea, abdominal pain, dyspepsia, vomiting, flatulence have been reported.

CNS disturbances: Headache, dizziness.

Others: Hypersensitivity reactions which usually subsided upon discontinuation of therapy; infrequent and reversible hematological changes; elevation of serum amylase.

 

Precautions

Cefixime should be prescribed with caution in individuals with a history of gastrointestinal diseases, particularly colitis.  Dosage adjustment is only necessary in severe renal failure (creatinine clearance < 20 ml/min)

 

Use in Pregnancy and Lactation

Pregnancy: Pregnancy category B. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Lactation: It is not known whether Cefixime is excreted in human milk. Consideration should be given to discontinuing nursing temporarily during treatment with this drug.

 

Use in Elderly

No special precautions are necessary. No dosage adjustment is required for elderly.

 

Contraindication

Patients with known hypersensitivity to Cefixime or cephalosporin group of drugs.

 

Drug Interactions

Carbamazepine: Elevated carbamazepine levels have been reported in postmarketing experience when Cefixime is administered concomitantly. Drug monitoring may be of assistance in detecting alterations in carbamazepine plasma concentrations.

Warfarin and Anticoagulants: Increased prothrombin time, with or without clinical bleeding, has been reported when cefixime is administered concomitantly.

 

Direction for Reconstitution of Suspension

uTo prepare 50 ml suspension, 30 ml boiled and cooled water is required.

uTo prepare 30 ml suspension, 20 ml boiled and cooled water is required.

 

Tap the bottle several times to loosen powder contents prior to reconstitution. Add approximately half of the total amount of water and shake well. Add remainder of water, and then shake again.

Note:  Shake the suspension well before each use. Keep the bottle tightly closed. The reconstituted suspension should be stored in a cool and dry place, preferably in refrigerator and unused portion should be discarded after 14 days.

 

Overdosage

Gastric lavage may be indicated; otherwise, no specific antidote exists. Cefixime is not removed in significant quantities from the circulation by hemodialysis or peritoneal dialysis. Adverse reactions in small numbers of healthy adult volunteers receiving single doses up to 2 g of Cefixime did not differ from the profile seen in patients treated at the recommended doses.

 

Commercial Pack

Onefix 200 Capsule: Box containing 2 Alu-Alu blister strips of 6 capsules.

Onefix 400 Capsule: Box containing 2 Alu-Alu blister strip of 4 capsules.

Onefix 30 ml Powder for Suspension: Bottle containing powder for the preparation of 30 ml suspension.

Onefix 50 ml Powder for Suspension: Bottle containing powder for the preparation of 50 ml suspension.

 

Sunday, 16 October 2016 03:17

Onecof

Written by

 

 

 

Onecof

Ambroxol

 (Presentation)


Onecof Syrup: Each 5 ml syrup contains Ambroxol hydrochloride BP 15 mg.

 

Description

Ambroxol is the active metabolite of Bromhexine and it has a greater bronchosecretolytic effect than Bromhexine. Ambroxol stimulates the serous cells of the glands of the mucous membrane of bronchi, increasing the content of mucus secretion. The mucolytic effect is associated with depolymerization and splitting of mucoproteins and mucopolysaccharide fibres, which leads to reduction in the viscosity of mucus. Expectoration of mucus is facilitated and breathing is eased considerably. Ambroxol stimulates production of phospholipids of surfactant by alveolar cells. Ambroxol has anti-inflammatory properties. In patients with COPD, it improves airway patency. Beside these, Ambroxol also exhibits anti-oxidant activity. Long-term use is possible because of the good tolerability of the preparation.

 

Indications

Acute and chronic diseases of respiratory tracts associated with viscid mucus

including acute and chronic bronchitis

Productive cough

Inflammatory diseases of Rhinopharyngeal tract (e.g. Laryngitis, Pharyngitis, Sinusitis and Rhinitis)          

Asthmatic bronchitis, Bronchial asthma with difficult departure of mucus

Bronchiectasis

Chronic pneumonia

 

Dosage and Administration

Average daily dose (preferably after meal):

 

 

Side-effects

Gastrointestinal side-effects like epigastric pain, gastric fullness may occur occasionally. Rarely allergic responses such as eruption, urticaria or angioneurotic edema may occur.

 

Precautions

Ambroxol should be given cautiously to patients with gastric and duodenal ulceration or convulsive disorders. Patients with hepatic and renal insufficiency should take it with caution.

 

Use in Pregnancy and Lactation

Pregnancy: Teratogenic and fetal toxicity studies have shown no harmful effect of Ambroxol. However, it is advised not to use during pregnancy, especially in the 1st trimester.

Lactation: Safety during lactation has not been established yet.

 

Contraindications

Contraindicated in known hypersensitivity to Ambroxol or Bromhexine.

 

Drug Interactions

Ambroxol has no interaction with cardioactive glycosides, corticosteroids, bronchodilators, diuretics and antibiotics (normally used in the treatment of bronchopulmonary affections). But Ambroxol should not be taken simultaneously with antitussives (e.g. Codeine) because mucus, which has been liquefied by Ambroxol, might not be expectorated.

 

Commercial Pack

Onecof Syrup: Each PET bottle contains 100 ml syrup and a measuring cup.

 

 

 

Sunday, 16 October 2016 03:11

NX-1

Written by

NX-1

(Naproxen)

 

Presentation

NX-1 Tablet: Each enteric coated tablet contains Naproxen Sodium USP equivalent to Naproxen USP 500 mg.

 

Description

Naproxen is a nonsteroidal anti-inflammatory drug with analgesic and antipyretic properties. Naproxen works by reducing the levels of prostaglandins, chemicals that are responsible for pain, fever and inflammation. Naproxen blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced.

 

Indications and Uses

Naproxen is indicated for its anti-inflammatory and analgesic action in the treatment of rheumatoid arthritis, osteoarthritis (degenerative arthritis), ankylosing spondylitis, juvenile rheumatoid arthritis, acute gout, acute musculoskeletal disorders, post-operative pain and dysmenorrhoea. It is also indicated in the relief of mild to moderate pain, and for the treatment of tendonitis and bursitis.

 



Dosage and administration

Adults

For rheumatoid arthritis, osteoarthritis and ankylosing spondylitis

The usual dose is 500-1000 mg per day taken in 2 doses at 12 hours intervals after meals.

For acute gout

750 mg should be given initially, followed in 8 hours with 500 mg, and thereafter 250 mg at 12 hours intervals until the attack has passed.

For dysmennorhoea

500 mg should be given initially, followed by 250 mg at 6-8 hour intervals for up to 5 days.

For analgesia and acute muscular skeletal disorders

500 mg should be given initially, followed by 250 mg at 6-8 hour intervals.

Children over 5 years

For juvenile rheumatoid arthritis

10mg/kg/day given as 2 divided doses at 12 hour intervals.

 

Contraindications

The drug is contraindicated in patients who have had allergic reactions to Naproxen. It is also contraindicated in patients in whom aspirin or other nonsteroidal anti-inflammatory/analgesic drugs induce the syndrome of asthma, rhinitis, and nasal polyps. Both types of reactions have the potential of being fatal.

 

Precautions

Serious GI toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms, in patients treated chronically with NSAID therapy. Although minor upper GI problems, such as dyspepsia, are common, usually developing early in therapy, physicians should remain alert for ulcerations and bleeding in patients treated chronically with NSAIDs even in the absence of previous GI tract symptoms.

 

Side-effects

The most common side effects from Naproxen are rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation, heartburn, fluid retention and shortness of breath. Naproxen also may cause stomach and intestinal bleeding and ulcers.

 

Use in pregnancy and lactation

Pregnancy: Pregnancy Category C.

Naproxen should be used during pregnancy only if the potential benefits justify the potential risks to the fetus.

Nursing mother: The Naproxen has been found in the milk of lactating women. Because of the possible adverse effects of prostaglandin-inhibiting drugs on neonates, use in nursing mothers should be avoided.

 

Drug interactions

Naproxen may increase the blood levels of lithium by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.

Naproxen may reduce the blood pressure lowering effects of blood pressure medications.

When naproxen is used in combination with aminoglycosides (e.g., gentamicin) the blood levels of the aminoglycoside may increase. This may lead to more aminoglycoside-related side effects.

Individuals taking anticoagulants (e.g. Warfarin) should avoid naproxen because naproxen also thins the blood, and excessive blood thinning may lead to bleeding.

 

Overdosage

Naproxen overdosage may be characterized by drowsiness, heartburn, indigestion, nausea, or vomiting. In animals 0.5 g/kg of activated charcoal was effective in reducing plasma levels of Naproxen. Hemodialysis does not decrease the plasma concentration of Naproxen.

 

Commercial pack

NX-1 Tablet: Each box contains 3 blister strips of 10 tablets.

Sunday, 16 October 2016 03:04

Nevrona

Written by

Nevrona

(Vitamin B1, B6 & B12)

 

Presentation

Nevrona tablet: Each tablet contains Thiamine Mononitrate BP (100 mg), Pyridoxine Hydrochloride BP (200 mg), Cyanocobalamin BP (200 mcg).

 

Description

Nevrona is a special preparation of vitamin B1, B6 and B12. The vitamins B1, B6 and B12 are indispensable for a normal course of the nervous metabolism.

 

 

 

Indication & Uses

Nevrona is indicated for the treatment of B1, B6 and B12 deficiency syndrome. It is also indicated in  the treatment of:

 

 

Dosage and Administration

Tablets may be administered in a dose of 1 to 3 tablets per day or as directed by the physician.

 

Side Effects

Generally well tolerated. However, a few allergic reactions may be seen.

 

Precautions

Cyanocobalamin should not be given before a diagnosis has been fully established because of the possibility of masking symptoms of subacute degeneration of the spinal cord. Cyanocobalamin is not a suitable form of Vitamin B12 for the treatment of optic neuropathies associated with raised plasma concentrations of cyanocobalamin.

 

Use in pregnancy & lactation

Oral tablet form is recommended but injectable preparation is not recommended due to presence of benzyl alcohol.

 

Contraindications

Should not be used in the patients on Levodopa therapy and hypersensitivity to any of the active ingredients.

 

Drug Interactions

No such drug interactions have been reported.

 

Overdosage

If there is known overdose then treatment is symptomatic and supportive.

 

Commercial Pack

Nevrona Tablet: Each box contains 3 blister strips of 10 tablets.

Sunday, 16 October 2016 02:54

Dantron

Written by

Dantron

(Ondansetron)

 

Presentation

Dantron Tablet: Each film coated tablet contains Ondansetron Hydrochloride Dihydrate BP 9.977 mg equivalent to Ondansetron 8 mg.

Dantron Syrup: Each 5 ml syrup contains Ondansetron Hydrochloride Dihydrate BP equivalent to Ondansetron 4 mg.

 

Description

Ondansetron is a selective 5-HT3 receptor antagonist. While its mechanism of action has not been fully characterized, Ondansetron is not a dopamine-receptor antagonist. Serotonin receptors of the 5-HT3 type are present both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone of the area postrema. It is not certain whether Ondansetron's antiemetic action is mediated centrally, peripherally, or in both sites. However, cytotoxic chemotherapy appears to be associated with release of serotonin from the enterochromaffin cells of the small intestine.

 

Indications and Uses

1. Prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy, including Cisplatin ≥ 50 mg/m2

2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy

3. Prevention of nausea and vomiting associated with radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen

4. Prevention of post-operative nausea and/or vomiting

5. Nausea-vomiting associated with pregnancy

6. Nausea-vomiting associated with gastroenteritis

 

Dosage and Administration

 

Contraindications

Ondansetron is contraindicated for patients known to have hypersensitivity to the drug.

 

Precautions

Ondansetron is not a drug that stimulates gastric or intestinal peristalsis. It should not be used instead of nasogastric suction. The use of Ondansetron in patients following abdominal surgery or in patients with chemotherapy-induced nausea and vomiting may mask a progressive ileus and/or gastric distension.

 

Side-effects

Generally Ondansetron is well tolerated. However few side effects including headache, diarrhoea, fatigue, dizziness and constipation may be seen after Ondansetron is administered.

 

Use in pregnancy & lactation 

Pregnancy: Pregnancy category B.

Nursing mother: It is not known whether Ondansetron is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Ondansetron is administered to a nursing woman.

 

Drug Interactions

The following drugs should be used with caution when concomitantly used with Ondansetron:

Phenytoin, Carbamazepine, Rifampicin & Tramadol.

 

Overdosage

There is no specific antidote for Ondansetron overdose. Hypotension (and faintness) occurred in a patient that took 48 mg of Ondansetron tablets.

 

Commercial Pack

Dantron Tablet: Each box contains 3 blister strips of 10 tablets.

Dantron Syrup: Each bottle contains 50 ml Syrup.

Wednesday, 09 March 2016 19:13

P-lock

Written by

P-lock

Pantoprazole

 

Presentation

P-lock 20 tablet: Each delayed release tablet contains Pantoprazole Sodium Sesquihydrate USP equivalent to Pantoprazole 20 mg.

P-lock 40 tablet: Each delayed release tablet contains Pantoprazole Sodium Sesquihydrate USP equivalent to Pantoprazole 40 mg.

 

Description

Pantoprazole (P-lock) is chemically a novel substituted benzimidazole derivative, which suppresses the final step in gastric acid production by forming a covalent bond to two sites of the H+, K+ - ATPase enzyme system at the secretory surface of the gastric parietal cell. This leads to inhibition of both basal and stimulated gastric acid secretion irrespective of the stimulus. The binding to the H+/K+ - ATPase results in duration of antisecretory effect that persists longer than 24 hours. Pantoprazole (P-lock) is quantitatively absorbed and bioavailability does not change upon multiple dosing. Pantoprazole (P-lock) is extensively metabolized in the liver. Almost 80% of an oral dose is excreted as metabolites in urine; the remainder is found in feces and originates from biliary secretion.

 

Indications and Usage

Pantoprazole (P-lock) is indicated where suppression of acid secretion is of therapeutic benefit. Pantoprazole (P-lock) is registered for the following indications: -

1. Peptic ulcer diseases (PUD)

2. Gastro esophageal reflux diseases (GERD)

3. Treatment of ulcer resistant to H2 receptor antagonists (H2RAs)

4. Treatment of ulcers induced by non-steroidal anti-inflammatory drugs (NSAIDs)

5. Gastrointestinal (GI) bleeding from stress or acid peptic diseases

6. Eradication of Helicobacter pylori (in combination with antibiotics)

7. Zollinger-Ellison syndrome

8. Prophylaxis for acid aspiration syndrome during induction of anaesthesia

 

Dosage and Administration

Delayed release tablet

The usual recommended adult oral dose is 40 mg given once daily, before breakfast. The duration of therapy is ranging from 2-8 weeks. Duodenal Ulcers: P-lock 40 mg tablet, once daily for 2 to 4 weeks. Duodenal ulcer generally heals within 2 weeks. Gastric ulcers: P-lock 40 mg tablet, once daily for 4 to 8 weeks. Gastric ulcer generally heals within 4 weeks. Reflux esophagitis: P-lock 40 mg tablet, once daily for 4 to 8 weeks. Reflux esophagitis generally heals within 4 weeks of treatment. In resistant ulcers: P-lock 40 mg tablet, once daily for 8 weeks. Ulcers induced by NSAIDs: P-lock 40 mg tablet once daily, in patients receiving continuous treatment with NSAIDs. GI bleeding from stress or acid peptic diseases: Usual adult oral dosage, if required the dosage may be increased. Eradication of Helicobacter pylori: Triple therapy of P-lock 40 mg twice daily in combination with appropriate antibiotic for one week achieved eradication rates of 90 to100%. Zollinger-Ellison syndrome: 4 P-lock 40 mg tablets per day. Once control of acid secretion has been achieved, the dose should be gradually reduced to the lowest effective dose that maintains acid control. Prophylaxis for acid aspiration syndrome during induction of anaesthesia: 1 or 2 P-lock 40 mg tablet should be given the evening before surgery and repeated again the morning of surgery.

 

Maintenance therapy

Maintenance treatment should involve the lowest dose of the drug. Both 20 and 40 mg doses of Pantoprazole (P-lock) are safe and effective in maintaining patients with healed reflux esophagitis and PUD in remission.

 

Contraindication

P-lock delayed release tablets are contraindicated in patients with known hypersensitivity to any of the formulation.

 

Precautions

Patients should be cautioned that P-lock delayed release tablets should not be split, chewed or crushed.

 

Side effects

Potentially life-threatening effects: None has been reported with respect to Pantoprazole.

Severe or irreversible adverse effects: No serious adverse reactions have been described to date.

Symptomatic adverse effects: Headache (1.3%) and diarrhoea (1.5%) are the two commonest reported adverse events. It doesn't influence renal, cardiovascular, respiratory, endocrine, cognitive or motor functions and no consistent change have been found in any biochemical or haematological parameters. Peripheral edema has occasionally been reported in female patients. Other side effects may include abdominal pain, dizziness, nausea, epigastric discomfort, flatulence, skin rash, pruritus etc. 

 

Pregnancy & Lactation 

Pregnant women: USFDA pregnancy category B. Studies using animals have not found any risk to the fetus.

Lactating mother: There are no data on the excretion of Pantoprazole into the breast milk.

Neonates & Children

No data are available on administration of Pantoprazole.

 

Elder patient

No problems with Pantoprazole have been encountered in clinical use in this patient group.

 

Concurrent disease

No dosage adjustment of Pantoprazole is required in patients with mild, moderate or severe renal insufficiency or in elderly patients. No dosage adjustment is necessary in patients undergoing haemodialysis. No dosage adjustment is needed in patients with mild or moderate hepatic impairment. In hepatic cirrhosis, it is recommended that the dosing is reduced to every other day.

 

Drug Interactions

Pantoprazole is metabolized through the cytochrome P-450 system, and subsequently undergoes Phase II conjugation. Based on studies evaluating possible interactions of Pantoprazole with other drugs metabolized by the cytochoreme P-450 system, no dosage adjustment is needed with concomitant use of the following drugs; theophylline, antipyrine, caffeine, carbamazepine, diazepam, diclofenac, digoxin, ethanol, glyburide, an oral contraceptive (Levonorgestrel/ethinyl estradiol), metoprolol, nifedipine, phenytion, or warfarin. There was also no interaction with concomitantly administered antacids.

 

Overdosage

There are no known symptoms of overdosage in humans. Since Pantoprazole is highly protein bound, it is not readily dialyzable. Apart from symptomatic and supportive management, no specific therapy is recommended.

 

Commercial Pack

P-lock 20 tablet: Each box contains 6 Alu-Alu blister strips of 10 tablets.

P-lock 40 tablet: Each box contains 3 Alu-Alu blister strips of 10 tablets.

Wednesday, 09 March 2016 19:02

Onecal-M

Written by

 

Onecal-M

Calcium, Vitamin-D3 & Minerals

 

Composition

Onecal-M Tablet: Each film coated tablet contains Calcium BP 500 mg, Vitamin-D3 BP 200 IU, Zinc Oxide BP 9.71 mg, Cupric Oxide BP 4.94 mg, Magnesium Oxide BP 66.32 mg, Manganese Sulphate BP 4.94 mg, Boron Citrate BP 4.26 mg.

 

Description

Calcium is an essential element and plays vital roles in the body. It helps body's framework stronger by building bone. Clinical evidence suggests that calcium is useful for prevention and treatment of osteoporosis and associated fractures. Vitamin-D is also essential for healthy bones as it aids in calcium absorption from the GI tract. In addition to this it stimulates bone formation. Controlled clinical studies shows that calcium and vitamin-D has synergistic effects on bone growth as well as in osteoporosis and fracture prevention.

 

Indication

• Treatment of osteoporosis, rickets, osteomalacia, tetany and hypoparathyroidism

• In pregnancy & lactation due to increase demand

• In kidney disease and pancreatitis

• During therapy with antiseizure medications

• The prevention and treatment of calcium deficiency/vitamin D deficiency especially in the housebound and institutionalized elderly subjects.

 

Dosage and Administration

Adults and Elderly and children above 12 years of age: 2 tablets per day, preferably one tablet each morning and evening.Children: Not recommended for children under 12 years.

 

Side Effect

The use of calcium supplements has, rarely, given rise to mild gastro-intestinal disturbances, such as constipation, flatulence, nausea, gastric pain, diarrhoea. Following administration of vitamin D supplements occasional skin rash has been reported. Hypercalciuria, and in rare cases hypercalcaemia have been seen with long term treatment at high dosages.

 

Contraindication

Absolute contra-indications are hypercalcaemia resulting for example from myeloma, bone metastases or other malignant bone disease, sarcoidosis; primary hyperparathyroidism and vitamin D overdosage. Severe renal failure. Hypersensitivity to any of the tablet ingredients. Relative contra-indications are osteoporosis due to prolonged immobilisation, renal stones, severe hypercalciuria.

 

Overdose

The most serious consequence of acute or chronic overdose is hypercalcaemia due to vitamin D toxicity. Symptoms include nausea, vomiting, polyuria, and constipation. Chronic overdoses can lead to vascular and organ calcification as a result of hypercalcaemia. Treatment should consist of stopping all intake of calcium and vitamin D and rehydration.

 

Precaution

Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. Periodic checks of plasma calcium levels and urinary calcium excretion should be made in patients with mild to moderate renal failure or mild hypercalciuria. Urinary calcium excretion should also be measured. In patients with a history of renal stones urinary calcium excretion should be measured to exclude hypercalciuria. With long-term treatment it is advisable to monitor serum and urinary calcium levels and kidney function, and reduce or stop treatment temporarily if urinary calcium exceeds 7.5mmol/24 hours. Allowances should be made for calcium and vitamin D supplements from other sources.

 

Use in Pregnancy & Lactation

During pregnancy and lactation treatment should always be under the direction of a physician. During pregnancy and lactation, requirements for calcium and vitamin D are increased but in deciding on the required supplementation allowances should be made for availability of these agents from other sources. If calcium iron supplements are both required to be administered to the patient, they should be taken at different times. Overdoses of vitamin D have shown teratogenic effects in pregnant animals. In humans, long term hypercalcaemia can lead to physical and mental retardation, aortic stenosis and retinopathy in a new born child. Vitamin D and its metabolites pass into the breast milk. children.

 

Commercial Pack

Onecal-M Tablet: Each box containing 3x10’s tablets of Alu-PVC blister.

Wednesday, 09 March 2016 18:59

Onecal-D

Written by

Onecal-D

Calcium 500 mg & Vitamin D3 200 IU

 

Composition

Onecal-D Tablet: Each film coated tablet contains Calcium Carbonate BP 1250 mg equivalent to elemental Calcium 500 mg, Vitamin-D3 BP 200 IU as Cholecalciferol.

 

Description

Calcium is needed for the formation of strong bones and healthy teeth and is involved in helping the blood to clot. It is also required to transmit nerve signals and help muscles work. Inadequate Calcium intake results in reduced bone mass and osteoporosis. Vitamin D3 is needed for Calcium to be absorbed from the gut and deficiency can lead to low Calcium levels and subsequent weakening of bones. Calcium and vitamin- D3 has synergistic effects on bone growth as well as in osteoporosis and in fracture prevention.

 

Indication

Calcium and Vitamin- D3 is used for the treatment of osteoporosis, osteomalacia, rickets, tetany, disorders of osteogenesis and tooth formation (addition to specific treatment) and parathyroid disease.

Also used in raised Calcium requirement for children and adolescents at times of rapid growth and during pregnancy and lactation. It is also used as routine supplement and phosphate binder in chronic renal failure.

 

Dosage and Administration

Adults and Elderly : The usual doses are two tablets daily at morning and evening. Higher doses should not be used unless recommended by the physician. Tablet must be swallowed. 

 

Side Effect

Orally administered Calcium Carbonate may be irritating to the GI tract. It may also cause constipation. Hypercalcaemia is rarely produced by administration of Calcium alone, but may occur when large doses are given to patients with chronic renal failure. Also there may be occasional allergic reactions, irregular heartbeats, nausea, vomiting, decreased appetite, dry mouth and drowsiness. Following the administration of Vitamin D3 supplements occasional skin rash has been reported.

 

Contraindication

It is contraindicated in case of hypercalcaemia, hyperthyroidism, renal calculi & nephrolithiasis, Zoliinger-Elison syndrome and in concomitant digoxin therapy.

 

Overdose

Symptoms of overdose may include nausea and vomiting, severe drowsiness, dry mouth, loss of appetite, metallic taste, stomach cramps, unconsciousness, diarrhea, weakness, headache, constipation, dizziness or irritability.

 

Precaution

Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. Periodic checks of plasma calcium levels and urinary calcium excretion should be made in patients with mild to moderate renal failure or mild hypercalciuria. Urinary calcium excretion should also be measured. In patients with a history of renal stones urinary calcium excretion should be measured to exclude hypercalciuria. With long-term treatment it is advisable to monitor serum and urinary calcium levels and kidney function, and reduce or stop treatment temporarily if urinary calcium exceeds 7.5mmol/24 hours. Allowances should be made for calcium and vitamin D supplements from other sources.

 

Use in Pregnancy & Lactation

During pregnancy and lactation treatment should always be under the direction of a physician. During pregnancy and lactation, requirements for calcium and vitamin D are increased but in deciding on the required supplementation allowances should be made for availability of these agents from other sources. If calcium iron supplements are both required to be administered to the patient, they should be taken at different times. Overdoses of vitamin D have shown teratogenic effects in pregnant animals. In humans, long term hypercalcaemia can lead to physical and mental retardation, aortic stenosis and retinopathy in a new born child. Vitamin D and its metabolites pass into the breast milk. children.

 

Commercial Pack

Onecal-D Tablet: Each box containing 3x10’s tablets of Alu-PVC blister.

Wednesday, 09 March 2016 18:55

Sharpkil

Written by

Sharpkil

Cefuroxime

 

Presentation

Sharpkil 250: Each film coated tablet contains Cefuroxime Axetil BP equivalent to Cefuroxime 250 mg.

Sharpkil 500: Each film coated tablet contains Cefuroxime Axetil BP equivalent to Cefuroxime 500 mg.

Sharpkil 70: Each 5 ml suspension contains Cefuroxime Axetil BP equivalent to Cefuroxime 125 mg.

 

Description

Cefuroxime is one of the bactericidal second generation cephalosporin antibiotic which is active against a wide range of Gram-positive and Gram-negative susceptible organisms including many beta-lactamase producing strains. It is indicated for the treatment of infections caused by sensitive bacteria.

 

Indications and Uses

Pharyngitis/tonsillitis caused by Streptococcus pyogenes

Acute bacterial otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Moraxella Catarrhalis (including beta-lactamase-producing strains) or Streptococcus pyogenes.

Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae, or Haemophilus influenzae (nonbeta-lactamase-producing strains only)

Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, Escherichia coli.

Acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis caused by Streptococcus penumoniae, Haemophilus influenzae (beta-lactamase negative strains), or Haemophilus parainfluenzae (beta-lactamase negative strains).

Skin and Skin-Structure Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, Escherichia coli, Klebsiella spp., and Enterobacter spp.

Urinary tract infections caused by Escherichia coli or Klebsiella pneumoniae.

Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).

Gonorrhea: Uncomplicated and disseminated gonococcal infections due to Neiseria gonorrhoeae (penicillinase- and non-penicillinase-producing strains) in both males and females.

Early Lyme disease (erythema migrans) caused by Borrelia burgdorferi.

Septicemia caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae (including ampicillin-resistant strains), and Klebsiella spp.

Meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin-resistant strains), Neisseira menintitidis, and Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).

Surgical Prophylaxis: Prophylaxis against infections in abdominal, pelvic, orthopedic, cardiac, pulmonary, esophageal and vascular surgery where there is increased risk for infection.

 

Dosage and Administration

 

 

Side-effects

Generally Cefuroxime is well tolerated. However, a few side effects like nausea, vomiting, diarrhoea, abdominal discomfort or pain may occur. As with other broad-spectrum antibiotics, prolonged administration of Cefuroxime may result in overgrowth of nonsusceptible microorganisms. Rarely (<0.2%) renal dysfunction, anaphylaxis, angioedema, pruritis, rash and serum sickness like urticaria may appear.

 

Precautions

Cefuroxime should be given with care to patients receiving concurrent treatment with potent diuretics & who have history of colitis.

 

Use in pregnancy & lactation

Pregnancy: While all antibiotics should be avoided in the first trimester if possible. However, Cefuroxime has been safely used in later pregnancy to treat urinary and other infections. 

Nursing mothers: Cefuroxime is excreted into the breast milk in small quantities. However, the possibility of sensitizing the infant should be kept in mind.

 

Contraindications

Patients with known allergy to cephalosporins & pseudomembranous colitis are contraindicated.

 

Drug interactions

Concomitant administration of probenecid with Cefuroxime increases the area under the serum concentration versus time curve by 50%. Drug that reduces gastric acidity may result in a lower bioavailability of Cefuroxime and tend to cancel the effect of postprandial absorption.

 

Overdosage

Signs and symptoms: Overdosage of Cefuroxime can cause cerebral irritation leading to convulsions. 

Management: Serum levels of Cefuroxime can be reduced by haemodialysis and peritoneal dialysis.

 

Directions for reconstitution

 

 

 

Shake the bottle well to loosen the powder. Add required amount (with the help of supplied measuring cup) of boiled and cooled water to the dry mixture in the bottle. Shake the bottle vigorously until all the powder is in suspension.

Note: Shake the bottle vigorously before each use. Keep the bottle tightly closed. The reconstituted suspension should be stored in a cool and dry place, preferably in a refrigerator and used within 10 days after reconstitution.

 

Pharmaceutical precaution

Cefuroxime tablet and powder for suspension should be kept in a cool (15° - 30°C) and dry place and protected from light. 

 

Commercial Pack

Sharpkil 250: Each box contains 2 Alu-Alu blister strips of 6 tablets.

Sharpkil 500: Each box contains 1 Alu-Alu blister strips of 6 tablets.

Sharpkil 70: Each bottle contains dry powder for 70 ml suspension.

Wednesday, 09 March 2016 18:52

Omelock

Written by


Omelock

Omeprazole

 

Presentation

Omelock 20 capsule : Each capsule contains Omeprazole BP 20 mg as enteric coated 8.5% pellets.

Omelock 40 capsule : Each capsule contains Omeprazole BP 40 mg as enteric coated 8.5% pellets.

 

Description

Omeprazole is a substituted benzimidazole that suppresses gastric acid secretion by specific inhibition of the gastric acid proton pump (H+/K+ ATPase enzyme) at the secretory surface of the gastric parietal cell. It blocks the final step of acid secretion. After oral administration, the onset of the antisecretory effect of Omeprazole occurs within one hour, with the maximum effect occurring within two hours and the duration of inhibition lasts up to 72 hours. The antisecretory effect lasts far longer than would be expected from the very short (less than one hour) plasma half-life, apparently due to prolonged binding to the parietal H+/K+ ATPase enzyme. Following absorption, Omeprazole is almost completely metabolized and rapidly eliminated mostly through urine.

 

Indications and Uses

Omelock (Omeprazole) is indicated for the treatment of-

Heartburn, Any symptoms of GERD, Erosive esophagitis (both curative and maintenance therapy), Duodenal ulcer, Gastric ulcer, Reduction of risk of upper GI bleeding in critically ill patients.

 

 

Dosage and Administration

Omelock (Omeprazole) should be taken before meal. No dosage adjustment is necessary for patients with renal impairment, hepatic dysfunction or for the elderly.

Duodenal Ulcer: The recommended adult oral dose is 20 mg once daily. Most patients heal within four weeks. Some patients may require an additional four weeks of therapy.

Gastric Ulcer: The recommended adult oral dose is 40 mg once a day for 4-8 weeks.

Gastroesophageal Reflux Disease (GERD): The recommended adult oral dose is 20 mg daily for up to 4 weeks.

Erosive esophagitis: The recommended adult oral dose is 20 mg daily for 4 to 8 weeks.

Zollinger-Ellison syndrome: The recommended adult oral starting dose is 60 mg once a day. Dosage should be adjusted to individual patient needs and should continue for as long as clinically indicated. Doses up to 120 mg t.i.d. have been administered. Daily dosages of greater than 80 mg should be administered in divided doses.

 

Side Effects

Omeprazole is well tolerated and adverse reactions have generally been mild and reversible. Side effects may include headache, diarrhoea, constipation, abdominal pain, nausea/vomiting and flatulence, dizziness, paraesthesia, somnolence, insomnia and vertigo, increased liver enzymes, rash, dermatitis and/or pruritis, urticaria, Malaise. Others include hypersensitivity reactions e.g. angioedema, fever, bronchospasm, interstitial nephritis and anaphylactic shock.

 

Precautions

Symptomatic response to therapy with Omeprazole does not preclude the presence of gastric malignancy. Immediate Release Omeprazole formulations contain sodium bicarbonate which should be taken into consideration for patients on a Sodium-restricted diet.

 

Use in Pregnancy and Lactation

Pregnancy: There are no adequate and well-controlled studies on the use of Omeprazole in pregnant women. Therapeutic doses during pregnancy are unlikely to pose a substantial teratogenic risk. Omeprazole should be used during pregnancy only if the potential benefit to pregnant women justifies the potential risk to the fetus.

 

Lactation: Omeprazole is excreted in human milk. Thus, a decision should be taken to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.   

 

Contraindications

Omeprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.

 

Drug interactions

Omeprazole can prolong the elimination of Diazepam, Warfarin, Phenytoin and other vitamin K antagonists. No interaction with Theophylline or Propranolol was found. There have been clinical reports of interaction with other drugs metabolized via the cytochrome P-450 system e.g. Cyclosporine, Disulfiram, Benzodiazepines. Patients should be monitored to determine if it is necessary to adjust the dosage of these drugs when taken concomitantly with Omeprazole.

 

Overdose

Symptoms were transient, and no serious clinical outcome has been reported with Omeprazole overdose. No specific antidote for Omeprazole overdose is known. Omeprazole is extensively bound with protein and is, therefore, not readily dialyzable. In the event of overdose, treatment should be symptomatic and supportive.

 

Pharmaceutical Precautions

Patients should be cautioned that the Omeprazole capsule should not be chewed or crushed and should be swallowed whole. Omeprazole should be stored in a cool and dry place, away from light. Keep out of the reach of children.

 

Commercial Pack

Omelock 20 capsule : Each box contains 6 alu-alu blister strips of 10 capsules.

Omelock 40 capsule : Each box contains 3 alu-alu blister strips of 10 capsules.

Wednesday, 09 March 2016 18:46

Ocimax

Written by


Ocimax

Ciprofloxacin

 

Presentation

Ocimax 500 Tablet: Each film coated tablet contains Ciprofloxacin Hydrochloride BP equivalent to Ciprofloxacin 500 mg.

Ocimax Granules for suspension 60 ml: Each 5 ml contains Ciprofloxacin BP 250 mg.

 

Description

Ciprofloxacin is a synthetic 4-quinolone derivative with bactericidal activity against a wide range of gram-positive and gram-negative organism. It is active against most gram-negative aerobic bacteria including Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin is also active against gram-positive aerobic bacteria including penicillinase producing, non-penicillinase producing and methicillin resistant Staphylococci. However many strains of Streptococci are relatively resistant to the drug. The bactericidal activity of Ciprofloxacin results from interference with the enzyme DNA gyrase needed for the synthesis of bacterial DNA. The mode of action of Ciprofloxacin is different from other antibiotics like penicillins, cephalosporins, aminoglycosides, tetracyclines and for this reason it is observed that organisms resistant to these antibiotics are susceptible to Ciprofloxacin. Ciprofloxacin is well absorbed from the GIT after oral administration and it is widely distributed into the body tissues and fluid. The half-life of Ciprofloxacin is 3.5 - 4.5 hours. About 30-50% of an oral dose of Ciprofloxacin is excreted in the urine within 24 hours as unchanged drug and active metabolites.

 

Indications

Ciprofloxacin is indicated for the treatment of the following infections caused by sensitive bacteria:

Severe systemic infections: e.g; septicemia, bacteremia, peritonitis, infections in immunosuppressed patients with haematological or solid tumors and in patients in intensive care unit with specific problems such as infected burns.

Respiratory tract infections: Lobar and broncho pneumonia, acute and chronic bronchitis and empyema.

Urinary tract infections: Uncomplicated and complicated urethritis, cystitis, pyelonephritis, prostatitis and epididymitis.

Skin and soft tissue infections: Infected ulcers, wound infections, abscesses, cellulitis, otitis externa, erysipelas and infected burns.

Gastrointestinal infections: Enteric fever, infective diarrhea.

Infections of the biliary tract: Cholangitis, cholecystitis, empyema of the gall bladder.

Intra-abdominal infections: Peritonitis, intra abdominal abscesses.

Bone and joint infections: Osteomyelitis, septic arthritis.

Pelvic infections: Salpingitis, endometritis, pelvic inflammatory diseases.

Eye, ear, nose and throat infections: Otitis media, sinusitis, mastoiditis, tonsillitis.

Gonorrhoea: Urethral, rectal and pharyngeal gonorrhoea caused by beta-lactamase producing organism or organisms moderately sensitive to penicillin.

 

Dosage and Administration

Adult :

* use in conjunction with metronidazole

 

Children and adolescents:

RTI & GI infections: Neonate-15mg/kg twice daily, Child (1 month -18 years)-20mg/kg (max 750 mg) twice daily; UTI: Neonate-10 mg/kg twice daily, Child (1 month -18 years)-10mg/kg (max 750 mg) twice daily; Pseudomonal lower respiratory tract infection in cystic fibrosis: Child (1 month -18 years) - 20mg/kg (max 750 mg) twice daily; Anthrax (treatment & post exposure prophylaxis): Child (1 month -18 years) - 20mg/kg (max 750 mg) twice daily.

Use in Pregnancy and Lactation

Reproduction studies performed in rats and rabbits using parenteral and oral administration did not reveal any evidence of teratogenicity, impairment of fertility or impairment of pre or postnatal development. However, as with other quinolones, Ciprofloxacin has been shown to cause arthropathy in immature animals and therefore, its use during pregnancy is not recommended. Studies in rats have indicated that Ciprofloxacin is secreted in milk, administration to nursing mothers is thus not recommended.

 

Side effects

Ciprofloxacin is generally well tolerated. Frequent adverse reactions are- Gastrointestinal disturbance: e.g. nausea, diarrhea, vomiting, dyspepsia, abdominal pain. Disturbance of the CNS: e.g. dizziness, headache, tiredness, confusion, convulsions. Hypersensitivity reactions: e.g. skin rashes, pruritus, and possible systemic reactions. Other possible side effects are - joint pain, light sensitivity, transient increase in liver enzyme (especially in patients with history of liver damage), serum bilirubin, urea or serum creatinine. Arthralgia and myalgia may also occur.

 

Contraindications

Ciprofloxacin is contraindicated in patients who have hypersensitivity to Ciprofloxacin or other quinolones.

 

Precautions

Ciprofloxacin should be used with caution in patients with a history of convulsive disorders. Crystalluria related to the use of Ciprofloxacin has been observed only rarely. Patients receiving Ciprofloxacin should be well hydrated to avoid excessive alkalinity of the urine.

 

Drug interactions

Concurrent administration of Ciprofloxacin with theophylline may lead to elevated plasma concentrations of theophylline. Plasma level of theophylline should be monitored and dosage adjustments made as appropriate. Antacid containing magnesium hydroxide or aluminium hydroxide may interfere with the absorption of Ciprofloxacin & concurrent administration of these agents with Ciprofloxacin should be avoided. Probenecid interferes with renal tubular secretion of Ciprofloxacin and produces an increase in the level of Ciprofloxacin in the serum. As with other broad spectrum antibiotics prolonged use of Ciprofloxacin may result in over growth of non-susceptible organisms. Repeated evaluation of patient's conditions and microbial susceptibility testing is essential. If superinfections occur during therapy, appropriate measure should be taken.

 

Information for patients

Ocimax should be swallowed whole with an adequate amount of liquid, it may be taken with or without meals. The preferred time of dosing is two hours after a meal and patients should not take antacid within two hours of dosing.

 

Commercial pack

Ocimax 500 Tablet: Each box containing 3x10’s tablets of Alu-PVC blister.

Ocimax Granules for suspension 60 ml: Each glass bottle contains Granules for preparing 60 ml  suspension.

Wednesday, 09 March 2016 18:21

Kelorac 10

Written by

Kelorac 10

Ketorolac

 

Presentation

Kelorac 10 tablet: Each film coated tablet contains Ketorolac Tromethamine USP 10 mg.

 

Description

Ketorolac Tromethamine is a drug of pyrrolo-pyrrole group of nonsteroidal antiinflammatory drug (NSAID). Chemically it is known as ±5 benzoyle-2,3-dihydro-1H-pyrroligine-1-carboxylic acid, compound with 2 amino-2-(hydroxymethyl)-1,3-propanediol. Ketorolac Tromethamine inhibits synthesis of prostaglandins and may be considered as a peripherally acting analgesic. The biological activity of Ketorolac Tromethamine is associated with the S-form. Pharmacokinetic property of Ketorolac Tromethamine is linear. It is highly protein bound and is largely metabolized in liver. The products of metabolism and some unchanged drugs are excreted in the urine.

 

Indications and Uses

Ketorolac Tromethamine is indicated for the short-term (5 days) management of moderate to severe  acute pain that requires analgesia at the opiod level (usually in a postoperative setting).

 

Dosage and Administration

By mouth: 10 mg every 4-6 hours (elderly, every 6-8 hours) or 40mg daily; maximum duration of treatment is 7 days.

 

Side effects

It is generally well tolerated. However, side effects like dry mouth, excessive thirst, psychotic reactions, convulsion, myalgia, hyponatremia, hyperkalemia, raised blood urea and creatinine, renal failure, hypertension, bradycardia, chest pain, purpura, post operative haemorrhage, haematoma, liver function change etc may occur in some cases.

 

Contraindications

Ketorolac Tromethamine is contraindicated in patients with known hypersensitivity to NSAIDs and any of the components of Ketorolac Tromethamine. Moreover, the patient with the history of asthma, nasal polyp, angioedema, peptic ulcer and bleeding, bleeding disorder are contraindicated for this drug.

 

Precautions

Precaution should be taken in the following conditions

- Elderly

- Allergic disorder

- Renal, cardiac & hepatic impairment

- Porphyria

- Patient with low body weight (<50kg): reduce dose.

 

Use in pregnancy & lactation

Ketorolac Tromethamine is contraindicated in pregnancy and lactation.

 

Use in children

Not recommended for children below 16 years of age.

 

Drug Interaction

Warfarin, digoxin, heparin and salicylate should be used carefully with Ketorolac Tromethamine. 

 

Over dosage

Overdosage of Ketorolac Tromethamine may cause abdominal pain, peptic ulcers which healed after discontinuation of doses. Metabolic acidosis has been reported following intentional overdosage.

 

Commercial Pack :

Kelorac 10  tablet : Each box contains 3 Alu-Alu blister strips of 10 tablets.

Wednesday, 09 March 2016 18:05

Airway

Written by

 

 

Airway

Montelukast

 

Presentation

Airway 5 Tablet: Each film coated tablet contains Montelukast Sodium BP equivalent to Montelukast 5 mg.

Airway 10 Tablet: Each film coated tablet contains Montelukast Sodium BP equivalent to Montelukast 10 mg.

 

Description

Montelukast is a selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene CysLT1 receptor. Cysteinyl leukotrienes and leukotriene receptor occupation have been correlated with the pathophysiology of asthma ( such as, airway edema, smooth muscle contraction and altered cellular activity associated with the inflammatory process, which contribute to the signs and symptoms of asthma).

 

Indications and Uses

Montelukast is indicated for the prophylaxis and chronic treatment of asthma in adults and pediatric patients.

 

Dosage and Administration

Adults  (15 years of age or over): 10 mg daily to be taken in the evening.

Children (6-14 years of age): 5 mg daily to be taken in the evening.

The safety and efficacy of Montelukast was demonstrated in clinical trials where it was administered in the evening without regard to the time of food ingestion.

 

Side effects

Generally, Montelukast is well-tolerated. Side effects include dizziness, headache, diarrhea, restlessness, abdominal pain, cough, fever, asthenia, rash and upper respiratory tract infection.

 

Contraindication

Montelukast is contraindicated to patients with hypersensitivity to any component of this product.

 

Precautions

Montelukast is not indicated for use in the reversal of bronchospasm in acute asthma attacks (in case of status asthmaticus).

Patients with known aspirin sensitivity should continue avoidance of aspirin or other NSAID, while taking Montelukast.

In rare cases, patients on therapy with Montelukast may present with systemic eosinophilia, sometimes presenting with clinical features of vasculitis consistent with churg-strauss syndrome, a condition which is often treated with systemic corticosteroid therapy. Physician should be alert to eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients. A causal association between Montelukast and these underlying conditions has not been established.

 

Use in pregnancy and lactation

Pregnancy: There are no adequate and well-controlled studies of Montelukast in pregnant women. Because animal reproductive studies are not always predictive of human response, so Montelukast should be used during pregnancy only if clearly needed.

Lactation: It is not known if Montelukast is excreted in human milk. Because many drugs are excreted in human milk, so caution should be exercised when Montelukast is given to a nursing mother.

 

Drug interaction

Montelukast has been administered with other therapies routinely used in the prophylaxis and chronic treatment of asthma with no appropriate increase in adverse reactions.

Cytochrome P-450 inducers: Although Phenobarbital induces hepatic metabolism, no dosage adjustment for Montelukast is recommended. It is reasonable to employ appropriate clinical monitoring when potent cytochrome P-450 enzyme inducers, such as Phenobarbital or Rifampin, are co-administered with Montelukast.

 

Overdosage

There were no adverse experiences reported in the majority of overdosage reports. The most frequent adverse experiences observed were thirst, mydriasis, hyperkinesia, and abdominal pain. 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.

 

Commercial Pack

Airway  5 Tablet: Each box contains 2 Alu-Alu blister strip of 10 tablets.

Airway 10 Tablet: Each box contains 2 Alu-Alu blister strip of 10 tablets.

FacebookTwitterGoogle Bookmarks