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Phenobarbital is indicated for the following conditions:

• Sedatives
• Hypnotics for the short-term treatment of insomnia
• Pre-anesthetics
• Long-term anticonvulsants for the treatment of generalized tonic-clonic and cortical local seizures. And, in the emergency control of certain acute convulsive episodes, (those associated with status epilepticus, eclampsia meningitis, tetanus, and toxic reactions to Strychnine or local anesthetics).

Adjunct anti-epileptic drugs, Barbiturates

Phenobarbital, the longest-acting barbiturate, is used for its anticonvulsant and sedative-hypnotic properties in the management of all seizure disorders except absence (petit mal). Phenobarbital acts on GABA_A receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Phenobarbital may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of phenobarbital are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.

Suggested doses of Phenobarbital for specific indications are as follows:

Pediatric Oral Dosage:

• Preoperative: 1 mg to 3 mg/kg.
• Anticonvulsant: 1 mg to 6 mg/kg per day

Adult Oral Dosage:

• Daytime sedative: 30 mg to 120 mg daily in 2 to 3 divided doses.
• Bedtime hypnotic: 100 mg to 320 mg.
• Anticonvulsant: 50 mg to 100 mg 2 to 3 times daily.

Pediatric Injection Dosage:

• 15 to 20 mg/kg IV over 10 to 15 min.
• Preoperative Sedation:1 to 3 mg/kg IM/IV;
• Anticonvulsant: 4 to 6 mg/kg IM/IV per day, for 10 days. Alternatively, use 10 to 15 mg/kg IM/IV per day to reach therapeutic level more quickly. Maxium IV rate 60 mg/min.

Adult Injection Dosage:

• Insomnia: 100 to 320 mg IM/IV;
• Convulsions: 100 to 320 mg IV. Repeat if needed (maximum, 600 mg per day);
• Status Epilepticus: 10 to 20 mg/kg IV. Repeat if needed.

The most common adverse reaction is somnolence. Other less frequent adverse reactions are agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality, apnea, bradycardia, hypotension, nausea, vomiting and constipation.

Phenobarbital is contraindicated in patients with known Phenobarbital sensitivity or a history of latent porphyria.

Tolerance and psychological and physical dependence may occur with continuing use. Phenobarbital should be administered with caution to patients who are mentally depressed, have suicidal tendencies, or a history of drug abuse. In patients with hepatic damage, Phenobarbital should be administered with caution and initially reduced doses.

The concomitant use of Alcohol or other CNS depressants may produce additive CNS depressant effects.

Pregnancy Category D. Phenobarbital can cause fetal damage when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be in risk of the potential hazard to the fetus. Caution should be taken when Phenobarbital is administered to a nursing woman since small amounts of Phenobarbital are excreted in the milk.

The toxic dose of barbiturates varies considerably. In general, an oral dose of 1 gram of most barbiturates produces serious poisoning in an adult. Death commonly occurs after 2 to 10 grams of ingested barbiturate. Acute overdosage with barbiturates is manifested by CNS and respiratory depression Treatment of overdosage is mainly supportive and immediate hospitalization is necessary.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Phenobarbital is indicated for the following conditions:

• Sedatives
• Hypnotics for the short-term treatment of insomnia
• Pre-anesthetics
• Long-term anticonvulsants for the treatment of generalized tonic-clonic and cortical local seizures. And, in the emergency control of certain acute convulsive episodes, (those associated with status epilepticus, eclampsia meningitis, tetanus, and toxic reactions to Strychnine or local anesthetics).

Adjunct anti-epileptic drugs, Barbiturates

Phenobarbital, the longest-acting barbiturate, is used for its anticonvulsant and sedative-hypnotic properties in the management of all seizure disorders except absence (petit mal). Phenobarbital acts on GABA_A receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Phenobarbital may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of phenobarbital are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.

Suggested doses of Phenobarbital for specific indications are as follows:

Pediatric Oral Dosage:

• Preoperative: 1 mg to 3 mg/kg.
• Anticonvulsant: 1 mg to 6 mg/kg per day

Adult Oral Dosage:

• Daytime sedative: 30 mg to 120 mg daily in 2 to 3 divided doses.
• Bedtime hypnotic: 100 mg to 320 mg.
• Anticonvulsant: 50 mg to 100 mg 2 to 3 times daily.

Pediatric Injection Dosage:

• 15 to 20 mg/kg IV over 10 to 15 min.
• Preoperative Sedation:1 to 3 mg/kg IM/IV;
• Anticonvulsant: 4 to 6 mg/kg IM/IV per day, for 10 days. Alternatively, use 10 to 15 mg/kg IM/IV per day to reach therapeutic level more quickly. Maxium IV rate 60 mg/min.

Adult Injection Dosage:

• Insomnia: 100 to 320 mg IM/IV;
• Convulsions: 100 to 320 mg IV. Repeat if needed (maximum, 600 mg per day);
• Status Epilepticus: 10 to 20 mg/kg IV. Repeat if needed.

The most common adverse reaction is somnolence. Other less frequent adverse reactions are agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality, apnea, bradycardia, hypotension, nausea, vomiting and constipation.

Phenobarbital is contraindicated in patients with known Phenobarbital sensitivity or a history of latent porphyria.

Tolerance and psychological and physical dependence may occur with continuing use. Phenobarbital should be administered with caution to patients who are mentally depressed, have suicidal tendencies, or a history of drug abuse. In patients with hepatic damage, Phenobarbital should be administered with caution and initially reduced doses.

The concomitant use of Alcohol or other CNS depressants may produce additive CNS depressant effects.

Pregnancy Category D. Phenobarbital can cause fetal damage when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be in risk of the potential hazard to the fetus. Caution should be taken when Phenobarbital is administered to a nursing woman since small amounts of Phenobarbital are excreted in the milk.

The toxic dose of barbiturates varies considerably. In general, an oral dose of 1 gram of most barbiturates produces serious poisoning in an adult. Death commonly occurs after 2 to 10 grams of ingested barbiturate. Acute overdosage with barbiturates is manifested by CNS and respiratory depression Treatment of overdosage is mainly supportive and immediate hospitalization is necessary.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Phenobarbital is indicated for the following conditions:

• Sedatives
• Hypnotics for the short-term treatment of insomnia
• Pre-anesthetics
• Long-term anticonvulsants for the treatment of generalized tonic-clonic and cortical local seizures. And, in the emergency control of certain acute convulsive episodes, (those associated with status epilepticus, eclampsia meningitis, tetanus, and toxic reactions to Strychnine or local anesthetics).

Adjunct anti-epileptic drugs, Barbiturates

Phenobarbital, the longest-acting barbiturate, is used for its anticonvulsant and sedative-hypnotic properties in the management of all seizure disorders except absence (petit mal). Phenobarbital acts on GABA_A receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Phenobarbital may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of phenobarbital are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.

Suggested doses of Phenobarbital for specific indications are as follows:

Pediatric Oral Dosage:

• Preoperative: 1 mg to 3 mg/kg.
• Anticonvulsant: 1 mg to 6 mg/kg per day

Adult Oral Dosage:

• Daytime sedative: 30 mg to 120 mg daily in 2 to 3 divided doses.
• Bedtime hypnotic: 100 mg to 320 mg.
• Anticonvulsant: 50 mg to 100 mg 2 to 3 times daily.

Pediatric Injection Dosage:

• 15 to 20 mg/kg IV over 10 to 15 min.
• Preoperative Sedation:1 to 3 mg/kg IM/IV;
• Anticonvulsant: 4 to 6 mg/kg IM/IV per day, for 10 days. Alternatively, use 10 to 15 mg/kg IM/IV per day to reach therapeutic level more quickly. Maxium IV rate 60 mg/min.

Adult Injection Dosage:

• Insomnia: 100 to 320 mg IM/IV;
• Convulsions: 100 to 320 mg IV. Repeat if needed (maximum, 600 mg per day);
• Status Epilepticus: 10 to 20 mg/kg IV. Repeat if needed.

The most common adverse reaction is somnolence. Other less frequent adverse reactions are agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality, apnea, bradycardia, hypotension, nausea, vomiting and constipation.

Phenobarbital is contraindicated in patients with known Phenobarbital sensitivity or a history of latent porphyria.

Tolerance and psychological and physical dependence may occur with continuing use. Phenobarbital should be administered with caution to patients who are mentally depressed, have suicidal tendencies, or a history of drug abuse. In patients with hepatic damage, Phenobarbital should be administered with caution and initially reduced doses.

The concomitant use of Alcohol or other CNS depressants may produce additive CNS depressant effects.

Pregnancy Category D. Phenobarbital can cause fetal damage when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be in risk of the potential hazard to the fetus. Caution should be taken when Phenobarbital is administered to a nursing woman since small amounts of Phenobarbital are excreted in the milk.

The toxic dose of barbiturates varies considerably. In general, an oral dose of 1 gram of most barbiturates produces serious poisoning in an adult. Death commonly occurs after 2 to 10 grams of ingested barbiturate. Acute overdosage with barbiturates is manifested by CNS and respiratory depression Treatment of overdosage is mainly supportive and immediate hospitalization is necessary.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Phenobarbital is indicated for the following conditions:

• Sedatives
• Hypnotics for the short-term treatment of insomnia
• Pre-anesthetics
• Long-term anticonvulsants for the treatment of generalized tonic-clonic and cortical local seizures. And, in the emergency control of certain acute convulsive episodes, (those associated with status epilepticus, eclampsia meningitis, tetanus, and toxic reactions to Strychnine or local anesthetics).

Adjunct anti-epileptic drugs, Barbiturates

Phenobarbital, the longest-acting barbiturate, is used for its anticonvulsant and sedative-hypnotic properties in the management of all seizure disorders except absence (petit mal). Phenobarbital acts on GABA_A receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Phenobarbital may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of phenobarbital are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.

Suggested doses of Phenobarbital for specific indications are as follows:

Pediatric Oral Dosage:

• Preoperative: 1 mg to 3 mg/kg.
• Anticonvulsant: 1 mg to 6 mg/kg per day

Adult Oral Dosage:

• Daytime sedative: 30 mg to 120 mg daily in 2 to 3 divided doses.
• Bedtime hypnotic: 100 mg to 320 mg.
• Anticonvulsant: 50 mg to 100 mg 2 to 3 times daily.

Pediatric Injection Dosage:

• 15 to 20 mg/kg IV over 10 to 15 min.
• Preoperative Sedation:1 to 3 mg/kg IM/IV;
• Anticonvulsant: 4 to 6 mg/kg IM/IV per day, for 10 days. Alternatively, use 10 to 15 mg/kg IM/IV per day to reach therapeutic level more quickly. Maxium IV rate 60 mg/min.

Adult Injection Dosage:

• Insomnia: 100 to 320 mg IM/IV;
• Convulsions: 100 to 320 mg IV. Repeat if needed (maximum, 600 mg per day);
• Status Epilepticus: 10 to 20 mg/kg IV. Repeat if needed.

The most common adverse reaction is somnolence. Other less frequent adverse reactions are agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality, apnea, bradycardia, hypotension, nausea, vomiting and constipation.

Phenobarbital is contraindicated in patients with known Phenobarbital sensitivity or a history of latent porphyria.

Tolerance and psychological and physical dependence may occur with continuing use. Phenobarbital should be administered with caution to patients who are mentally depressed, have suicidal tendencies, or a history of drug abuse. In patients with hepatic damage, Phenobarbital should be administered with caution and initially reduced doses.

The concomitant use of Alcohol or other CNS depressants may produce additive CNS depressant effects.

Pregnancy Category D. Phenobarbital can cause fetal damage when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be in risk of the potential hazard to the fetus. Caution should be taken when Phenobarbital is administered to a nursing woman since small amounts of Phenobarbital are excreted in the milk.

The toxic dose of barbiturates varies considerably. In general, an oral dose of 1 gram of most barbiturates produces serious poisoning in an adult. Death commonly occurs after 2 to 10 grams of ingested barbiturate. Acute overdosage with barbiturates is manifested by CNS and respiratory depression Treatment of overdosage is mainly supportive and immediate hospitalization is necessary.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Entecavir is indicated for the treatment of chronic hepatitis B virus infection in adults and pediatric patients 2 years of age and older with evidence of active viral replication and either evidence of persistent elevation in serum aminotransferases (ALT or AST) or histologically active disease.

Hepatic viral infections (Hepatitis B)

By competing with the natural substrate deoxyguanosine triphosphate, entecavir functionally inhibits all three activities of the HBV polymerase (reverse transcriptase, rt):

• Base priming,
• Reverse transcription of the negative strand from the pregenomic messenger RNA, and
• Synthesis of the positive strand of HBV DNA. Upon activation by kinases, the drug can be incorporated into the DNA which has the ultimate effect of inhibiting the HBV polymerase activity.

The recommended dose of Entecavir for chronic hepatitis B virus infection in nucleoside-treatment-naive adults and adolescents 16 years of age is 0.5 mg once daily. For Lamivudine-refractory or known Lamivudine or Telbivudine resistance mutations, the recommended dose of Entecavir is 1 mg once daily. For patients with decompensated liver disease (adult) the recommended dose of Entecavir is 1 mg once daily. Entecavir should be administered on an empty stomach (at least 2 hours after a meal or 2 hours before the next meal).

Missed Dose: If it is almost time for next dose, skip the missed dose and take the next dose at the proper time. Nobody should take a double dose to make up for the missed dose.

The most common adverse events are headache, fatigue, dizziness and nausea.

Entecavir is contraindicated in patients with previously demonstrated hypersensitivity to Entecavir or any component of the product.

Lactic acidosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases have been reported with the use of nucleoside analogues alone or in combination with antiretrovirals.

Exacerbations of hepatitis after discontinuation of treatment: Severe acute exacerbations of hepatitis B have been reported in patients who have discontinued anti-hepatitis B therapy, including Entecavir.

Co-administration of Entecavir with Lamivudine or Adefovir dipivoxil did not result in significant drug interactions. The effects of co-administration of Entecavir with other drugs that are eliminated through renal or are known to affect renal function have not been evaluated and patients should be monitored closely for adverse events when coadministered with such drugs.

There are no data on the effect of Entecavir on the transmission of HBV from mother to infant. Therefore, appropriate care should be taken. It is not known whether it is excreted in human milk. Mothers should be instructed not to breastfeed if they are taking Entecavir.

Pediatric: Safety and effectiveness of Entecavir in pediatric patients below the age of 2 years have not been established.

Geriatric: Clinical studies of Entecavir did not include sufficient numbers of subjects aged 65 years and over to determine whether they respond differently from younger subjects. But care should be taken in dose selection, and it may be useful to monitor renal function.

Dose adjustment in renal impairment: Dose adjustment is recommended for patients with CrCl <50 ml/min including patients on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) as shown below:

• CrCl ≥50 ml/min: 0.5 mg every 24 hours
• CrCl 30 to <50 ml/min: 0.5 mg every 48 hours
• CrCl 10 to <30 ml/min: 0.5 mg every 72 hours
• CrCl <10 ml/min or  Hemodialysis or CAPD: 0.5 mg every 7 days

There is no experience of Entecavir overdosage reported in patients. Healthy subjects who received up to 20 mg daily for up to 14 days and single doses up to 40 mg had no unexpected adverse events. If overdosage occurs, the patient must be monitored for evidence of toxicity and standard supportive treatment as necessary.

Keep in a dry place and store below 30°C. Protect from light and keep out of the reach of children.

Entecavir is indicated for the treatment of chronic hepatitis B virus infection in adults and pediatric patients 2 years of age and older with evidence of active viral replication and either evidence of persistent elevation in serum aminotransferases (ALT or AST) or histologically active disease.

Hepatic viral infections (Hepatitis B)

By competing with the natural substrate deoxyguanosine triphosphate, entecavir functionally inhibits all three activities of the HBV polymerase (reverse transcriptase, rt):

• Base priming,
• Reverse transcription of the negative strand from the pregenomic messenger RNA, and
• Synthesis of the positive strand of HBV DNA. Upon activation by kinases, the drug can be incorporated into the DNA which has the ultimate effect of inhibiting the HBV polymerase activity.

The recommended dose of Entecavir for chronic hepatitis B virus infection in nucleoside-treatment-naive adults and adolescents 16 years of age is 0.5 mg once daily. For Lamivudine-refractory or known Lamivudine or Telbivudine resistance mutations, the recommended dose of Entecavir is 1 mg once daily. For patients with decompensated liver disease (adult) the recommended dose of Entecavir is 1 mg once daily. Entecavir should be administered on an empty stomach (at least 2 hours after a meal or 2 hours before the next meal).

Missed Dose: If it is almost time for next dose, skip the missed dose and take the next dose at the proper time. Nobody should take a double dose to make up for the missed dose.

The most common adverse events are headache, fatigue, dizziness and nausea.

Entecavir is contraindicated in patients with previously demonstrated hypersensitivity to Entecavir or any component of the product.

Lactic acidosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases have been reported with the use of nucleoside analogues alone or in combination with antiretrovirals.

Exacerbations of hepatitis after discontinuation of treatment: Severe acute exacerbations of hepatitis B have been reported in patients who have discontinued anti-hepatitis B therapy, including Entecavir.

Co-administration of Entecavir with Lamivudine or Adefovir dipivoxil did not result in significant drug interactions. The effects of co-administration of Entecavir with other drugs that are eliminated through renal or are known to affect renal function have not been evaluated and patients should be monitored closely for adverse events when coadministered with such drugs.

There are no data on the effect of Entecavir on the transmission of HBV from mother to infant. Therefore, appropriate care should be taken. It is not known whether it is excreted in human milk. Mothers should be instructed not to breastfeed if they are taking Entecavir.

Pediatric: Safety and effectiveness of Entecavir in pediatric patients below the age of 2 years have not been established.

Geriatric: Clinical studies of Entecavir did not include sufficient numbers of subjects aged 65 years and over to determine whether they respond differently from younger subjects. But care should be taken in dose selection, and it may be useful to monitor renal function.

Dose adjustment in renal impairment: Dose adjustment is recommended for patients with CrCl <50 ml/min including patients on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) as shown below:

• CrCl ≥50 ml/min: 0.5 mg every 24 hours
• CrCl 30 to <50 ml/min: 0.5 mg every 48 hours
• CrCl 10 to <30 ml/min: 0.5 mg every 72 hours
• CrCl <10 ml/min or  Hemodialysis or CAPD: 0.5 mg every 7 days

There is no experience of Entecavir overdosage reported in patients. Healthy subjects who received up to 20 mg daily for up to 14 days and single doses up to 40 mg had no unexpected adverse events. If overdosage occurs, the patient must be monitored for evidence of toxicity and standard supportive treatment as necessary.

Keep in a dry place and store below 30°C. Protect from light and keep out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Febuxostat is indicated for the chronic management of hyperuricemia in patients with gout. Febuxostat is not recommended for the treatment of asymptomatic hyperuricemia.

Drugs used in Gout

Febuxostat is a non-purine, selective xanthine oxidase (XO) inhibitor. It decreases serum uric acid level by inhibiting xanthine oxidase, which is responsible for uric acid production. Xanthine oxidase breaks down hypoxanthine to xanthine and thus to uric acid. Febuxostat is not expected to inhibit other enzymes involved in purine and pyrimidine synthesis and metabolism at therapeutic concentrations.

Febuxostat is recommended at 40 mg or 80 mg once daily. The recommended starting dose of Febuxostat is 40 mg once daily. For patients who do not achieve a serum uric acid less than 6 mg /dL after 2 weeks with 40 mg, Febuxostat 80 mg is recommended. Febuxostat can be administered without regard to food or antacid use. No dose adjustment is necessary when administering Febuxostat to patients with mild to moderate renal or hepatic impairment.

The most common adverse events associated with the use of Febuxostat may include liver function abnormalities, nausea, arthralgia, and rash.

Febuxostat is contraindicated in patients being treated with azathioprine, mercaptopurine, or theophylline.

Gout Flare: An increase in gout flares is frequently observed during initiation of anti-hyperuricemic agents, including Febuxostat. If a gout flare occurs during treatment, Febuxostat need not be discontinued. Prophylactic therapy (i.e., non-steroidal anti-inflammatory drug (NSAID) or colchicine upon initiation of treatment) may be beneficial for up to six months.

Cardiovascular Events: A higher rate of cardiovascular thromboembolic events was observed in patients treated with febuxostat than allopurinol in clinical trials. Monitor for signs and symptoms of MI and stroke.

Liver Enzyme Elevation: Transaminase elevations have been observed in febuxostat -treated patients. Monitor liver function tests periodically.

Concomitant administration of Febuxostat with azathioprine, mercaptopurine or theophylline could increase plasma concentrations of these drugs resulting in severe toxicity.

Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Febuxostat should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. Caution should be exercised when Febuxostat is administered to a nursing woman.

Pediatric Use: Safety and effectiveness in pediatric patients under 18 years of age have not been established

Febustat was studied in healthy subjects in doses up to 300 mg daily for seven days without evidence of dose-limiting toxicities.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Febuxostat is indicated for the chronic management of hyperuricemia in patients with gout. Febuxostat is not recommended for the treatment of asymptomatic hyperuricemia.

Drugs used in Gout

Febuxostat is a non-purine, selective xanthine oxidase (XO) inhibitor. It decreases serum uric acid level by inhibiting xanthine oxidase, which is responsible for uric acid production. Xanthine oxidase breaks down hypoxanthine to xanthine and thus to uric acid. Febuxostat is not expected to inhibit other enzymes involved in purine and pyrimidine synthesis and metabolism at therapeutic concentrations.

Febuxostat is recommended at 40 mg or 80 mg once daily. The recommended starting dose of Febuxostat is 40 mg once daily. For patients who do not achieve a serum uric acid less than 6 mg /dL after 2 weeks with 40 mg, Febuxostat 80 mg is recommended. Febuxostat can be administered without regard to food or antacid use. No dose adjustment is necessary when administering Febuxostat to patients with mild to moderate renal or hepatic impairment.

The most common adverse events associated with the use of Febuxostat may include liver function abnormalities, nausea, arthralgia, and rash.

Febuxostat is contraindicated in patients being treated with azathioprine, mercaptopurine, or theophylline.

Gout Flare: An increase in gout flares is frequently observed during initiation of anti-hyperuricemic agents, including Febuxostat. If a gout flare occurs during treatment, Febuxostat need not be discontinued. Prophylactic therapy (i.e., non-steroidal anti-inflammatory drug (NSAID) or colchicine upon initiation of treatment) may be beneficial for up to six months.

Cardiovascular Events: A higher rate of cardiovascular thromboembolic events was observed in patients treated with febuxostat than allopurinol in clinical trials. Monitor for signs and symptoms of MI and stroke.

Liver Enzyme Elevation: Transaminase elevations have been observed in febuxostat -treated patients. Monitor liver function tests periodically.

Concomitant administration of Febuxostat with azathioprine, mercaptopurine or theophylline could increase plasma concentrations of these drugs resulting in severe toxicity.

Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Febuxostat should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. Caution should be exercised when Febuxostat is administered to a nursing woman.

Pediatric Use: Safety and effectiveness in pediatric patients under 18 years of age have not been established

Febustat was studied in healthy subjects in doses up to 300 mg daily for seven days without evidence of dose-limiting toxicities.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

Immunosuppressant

Baricitinib is a Janus kinase (JAK) inhibitor. JAKs are intracellular enzymes which transmit signals arising from cytokine or growth factor-receptor interactions on the cellular membrane to influence cellular processes of hematopoiesis and immune cell function. Within the signaling pathway, JAKs phosphorylate and activate Signal Transducers and Activators of Transcription (STATs) which modulate intracellular activity including gene expression. Baricitinib modulates the signaling pathway at the point of JAKs, preventing the phosphorylation and activation of STATs.

The recommended dose of Baricitinib is 2 mg once daily. Baricitinib may be used as monotherapy or in combination with Methotrexate or other DMARDs.

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

The recommended dose of Baricitinib in patients taking strong Organic Anion Transporter 3 (OAT3) inhibitors (e.g., probenecid) is 1 mg once daily

It is not known if Baricitinib will harm an unborn baby. Because of the potential for serious adverse reactions in nursing infants, advice an Baricitinib treated woman not to breastfeed.

Moderate Renal Impairment: Reduce dose to 1 mg once daily.

In case of an overdose, it is recommended that the patient should be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate treatment.

Store below 30°C. Protect from light & moisture. Keep all medicines out of the reach of children.

This syrup relieves alergic and dry irritable cough. It liquifies phlegm. It is very effective in asthma, smoker’s cough and throat hoarseness.

Herbal and Nutraceuticals

This syrup is a justified combination of herbs that is used to treat cough and some other respiratory tract disorders. All of the herbs in this combination are clinically effective in case of cough and cold. It is effective, well tolerated, safe and non-sedating with expectorant and antihistaminic properties. This syrup is effective for both children and adults. It is free from side effects like drowsiness, constipation and dryness of mouth.

• Adhatoda vasica (Vasak): Relieves cough, bronchial spasm and breathlessness. It has also mucolytic and expectorant action.
• Piper longum (Pipul) : It is used in cough, coryza, asthma, hoarseness of voice, bronchitis etc.
• Glycyrrhiza glabra (Jasthi madhu) : It is widely used in fever, cold, cough and catarrh. It has an expectorant and anti-inflammatory action.
• Terminalia chebula (Haritaki): It is used in cough conditions, asthma and itching.
• Ficas infectoria (Kur): It is used in curing cough and bronchial asthma.
• Acorus calamus (Bacha): It is used to treat a cough. It has expectorant properties. Moreover, it is used to treat fever, headache, asthma, bronchitis and tonsillitis.
• Zingiber officinale (Shunthi): Shown to have significant effects in common cold.
• Piper nigrum (Marich) : It has bacteriostatic, fungistatic and anti-inflammatory properties.
• Syzygium aromaticum (Labanga) : Useful in cough and other respiratory disorders. It improves the breath and is a remedy for sore throat, headaches and coryza.
• Cinnamomum zeylanicum (Darchini): It has anti- bacterial and anti-fungal activity. It is useful in relieving cough due to its soothing action.
• Cinnamomum tamala (Tejpata) : It is a tonic, digestive, carminative, uterine stimulant & appetizer agent.
• Rhus succedanea (Kakra sringi): It is an expectorant and soothe the irritability of the respiratory tract. It is known to help in cough, asthma and anorexia.
• Myrica nagi (Katphal) : It is useful in catarrhal fever, cough and in the affections of throat.
• Tulsi extract: Tulsi extract has been added to this syrup. It gives relief from common cold, bronchitis and cough.

Children under 12 years: 1-2 teaspoonful (5-10 ml) 3 times a day.
Adult: 3 teaspoonful (15 ml) 2-3 times a day. In acute cough warm water can be added for better result.

Ayurvedic medicine is clinically proven as safe & well tolerated. In the recommended doses, side effects are rare.

There is no evidence available on contraindication but it may happen in-patients who are hypersensitive to any of its ingredients.

No clinically significant drug interactions have been reported.

The safety of this syrup in pregnancy has not been established. Therefore, it should be used with caution during pregnancy, considering benefits to the mother greater than the risks to fetus.

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

This syrup relieves alergic and dry irritable cough. It liquifies phlegm. It is very effective in asthma, smoker’s cough and throat hoarseness.

Herbal and Nutraceuticals

This syrup is a justified combination of herbs that is used to treat cough and some other respiratory tract disorders. All of the herbs in this combination are clinically effective in case of cough and cold. It is effective, well tolerated, safe and non-sedating with expectorant and antihistaminic properties. This syrup is effective for both children and adults. It is free from side effects like drowsiness, constipation and dryness of mouth.

• Adhatoda vasica (Vasak): Relieves cough, bronchial spasm and breathlessness. It has also mucolytic and expectorant action.
• Piper longum (Pipul) : It is used in cough, coryza, asthma, hoarseness of voice, bronchitis etc.
• Glycyrrhiza glabra (Jasthi madhu) : It is widely used in fever, cold, cough and catarrh. It has an expectorant and anti-inflammatory action.
• Terminalia chebula (Haritaki): It is used in cough conditions, asthma and itching.
• Ficas infectoria (Kur): It is used in curing cough and bronchial asthma.
• Acorus calamus (Bacha): It is used to treat a cough. It has expectorant properties. Moreover, it is used to treat fever, headache, asthma, bronchitis and tonsillitis.
• Zingiber officinale (Shunthi): Shown to have significant effects in common cold.
• Piper nigrum (Marich) : It has bacteriostatic, fungistatic and anti-inflammatory properties.
• Syzygium aromaticum (Labanga) : Useful in cough and other respiratory disorders. It improves the breath and is a remedy for sore throat, headaches and coryza.
• Cinnamomum zeylanicum (Darchini): It has anti- bacterial and anti-fungal activity. It is useful in relieving cough due to its soothing action.
• Cinnamomum tamala (Tejpata) : It is a tonic, digestive, carminative, uterine stimulant & appetizer agent.
• Rhus succedanea (Kakra sringi): It is an expectorant and soothe the irritability of the respiratory tract. It is known to help in cough, asthma and anorexia.
• Myrica nagi (Katphal) : It is useful in catarrhal fever, cough and in the affections of throat.
• Tulsi extract: Tulsi extract has been added to this syrup. It gives relief from common cold, bronchitis and cough.

Children under 12 years: 1-2 teaspoonful (5-10 ml) 3 times a day.
Adult: 3 teaspoonful (15 ml) 2-3 times a day. In acute cough warm water can be added for better result.

Ayurvedic medicine is clinically proven as safe & well tolerated. In the recommended doses, side effects are rare.

There is no evidence available on contraindication but it may happen in-patients who are hypersensitive to any of its ingredients.

No clinically significant drug interactions have been reported.

The safety of this syrup in pregnancy has not been established. Therefore, it should be used with caution during pregnancy, considering benefits to the mother greater than the risks to fetus.

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