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    Actemra

    Tocilizumab
    IV Infusion 80 mg/4 ml Allopathic Drugs used for Rheumatoid Arthritis

    Indications

    Rheumatoid arthritis

    Indication detailsView
    Tocilizumab is an interleukin-6 (IL-6) receptor antagonist indicated for treatment of:
    • Rheumatoid Arthritis (RA): Adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more Disease-Modifying Anti-Rheumatic Drugs (DMARDs).
    • Giant Cell Arteritis (GCA): Adult patients with giant cell arteritis.
    • Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Slowing the rate of decline in pulmonary function in adult patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD)
    • Polyarticular Juvenile Idiopathic Arthritis (PJIA): Patients 2 years of age and older with active polyarticular juvenile idiopathic arthritis.
    • Systemic Juvenile Idiopathic Arthritis (SJIA): Patients 2 years of age and older with active systemic juvenile idiopathic arthritis.
    • Cytokine Release Syndrome (CRS): Adults and pediatric patients 2 years of age and older with chimeric antigen receptor (CAR) T cell-induced severe or life-threatening cytokine release syndrome.
    Therapeutic classView
    Drugs used for Rheumatoid Arthritis
    PharmacologyView
    Tocilizumab binds to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and has been shown to inhibit IL-6-mediated signaling through these receptors. IL-6 is a pleiotropic pro-inflammatory cytokine produced by a variety of cell types including T- and B-cells, lymphocytes, monocytes and fibroblasts. IL-6 has been shown to be involved in diverse physiological processes such as T-cell activation, induction of immunoglobulin secretion, initiation of hepatic acute phase protein synthesis, and stimulation of hematopoietic precursor cell proliferation and differentiation. IL-6 is also produced by synovial and endothelial cells leading to local production of IL-6 in joints affected by inflammatory processes such as rheumatoid arthritis.
    DosageView
    Rheumatoid Arthritis: Recommended Adult Intravenous Dosage: When used in combination with DMARDs or as monotherapy the recommended starting dose is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response.
    • Patients less than 100 kg weight: 162 mg administered subcutaneously every other week, followed by an increase to every week based on clinical response
    • Patients at or above 100 kg weight: 162 mg administered subcutaneously every week.
    Giant Cell Arteritis: Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with GCA is 162 mg given once every week as a subcutaneous injection, in combination with a tapering course of glucocorticoids. A dose of 162 mg given once every other week as a subcutaneous injection, in combination with a tapering course of glucocorticoids, may be prescribed based on clinical considerations. tocilizumab can be used alone following discontinuation of glucocorticoids. tocilizumab subcutaneous formulation is not intended for intravenous administration.

    Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with SSc-ILD is 162 mg given once every week as a subcutaneous injection.

    Polyarticular Juvenile Idiopathic Arthritis
    Recommended Intravenous PJIA Dosage Every 4 Weeks-
    • Patients less than 30 kg weight: 10 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Recommended Subcutaneous PJIA Dosage-
    • Patients less than 30 kg weight: 162 mg once every three weeks
    • Patients at or above 30 kg weight: 162 mg once every two weeks
    Systemic Juvenile Idiopathic Arthritis
    Recommended Intravenous SJIA Dosage Every 2 Weeks-
    • Patients less than 30 kg weight: 12 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Recommended Subcutaneous SJIA Dosage-
    • Patients less than 30 kg weight 162 mg every two weeks
    • Patients at or above 30 kg weight 162 mg every week
    Cytokine Release Syndrome
    Recommended Intravenous CRS Dosage-
    • Patients less than 30 kg weight: 12 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Alone or in combination with corticosteroids.

    General Dosing Information:
    • It is recommended that tocilizumab not be initiated in patients with an absolute neutrophil count (ANC) below 2000 per mm3, platelet count below 100,000 per mm3, or who have ALT or AST above 1.5 times the upper limit of normal (ULN).
    • tocilizumab doses exceeding 800 mg per infusion are not recommended in RA or CRS patients.
    Side effectsView
    Most common adverse reactions (incidence of at least 5%): upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions.
    ContraindicationsView
    Hypersensitivity to tocilizumab or to any of the excipients.
    PrecautionsView
    • Serious Infections- do not administer tocilizumab during an active infection, including localized infections. If a serious infection develops, interrupt tocilizumab until the infection is controlled.
    • Gastrointestinal (GI) perforation- use with caution in patients who may be at increased risk.
    • Hepatotoxicity- Monitor patients for signs and symptoms of hepatic injury. Modify or discontinue tocilizumab if abnormal liver tests persist or worsen or if clinical signs and symptoms of liver disease develop.
    • Laboratory monitoring- recommended due to potential consequences of treatment-related changes in neutrophils, platelets, lipids, and liver function tests.
    • Hypersensitivity reactions, including anaphylaxis and death have occurred.
    • Live vaccines- Avoid use with tocilizumab.
    InteractionsView
    Interactions with CYP450 Substrates: Cytochrome P450s in the liver are down-regulated by infection and inflammation stimuli including cytokines such as IL-6. Inhibition of IL-6 signaling in RA patients treated with tocilizumab may restore CYP450 activities to higher levels than those in the absence of tocilizumab leading to increased metabolism of drugs that are CYP450 substrates. In vitro studies showed that tocilizumab has the potential to affect expression of multiple CYP enzymes including CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6 and CYP3A4. Its effect on CYP2C8 or transporters is unknown. In vivo studies with omeprazole, metabolized by CYP2C19 and CYP3A4, and simvastatin, metabolized by CYP3A4, showed up to a 28% and 57% decrease in exposure one week following a single dose of tocilizumab, respectively. The effect of tocilizumab on CYP enzymes may be clinically relevant for CYP450 substrates with narrow therapeutic index, where the dose is individually adjusted. Upon initiation or discontinuation of tocilizumab, in patients being treated with these types of medicinal products, perform therapeutic monitoring of effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) and the individual dose of the medicinal product adjusted as needed. Exercise caution when coadministering tocilizumab with CYP3A4 substrate drugs where decrease in effectiveness is undesirable, e.g., oral contraceptives, lovastatin, atorvastatin, etc. The effect of tocilizumab on CYP450 enzyme activity may persist for several weeks after stopping therapy
    Pregnancy & lactationView
    Based on animal data, may cause fetal harm. Discontinue drug or nursing taking into consideration importance of drug to mother.
    Overdose effectsView
    There are limited data available on overdoses with tocilizumab. One case of accidental overdose was reported with intravenous tocilizumab in which a patient with multiple myeloma received a dose of 40 mg per kg. No adverse drug reactions were observed. No serious adverse drug reactions were observed in healthy volunteers who received single doses of up to 28 mg per kg, although all 5 patients at the highest dose of 28 mg per kg developed dose-limiting neutropenia. In case of an overdose, it is recommended that the patient be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate symptomatic treatment.
    StorageView
    Tocilizumab must be refrigerated at 2ºC to 8ºC. Do not freeze. Protect the vials, syringes, and autoinjectors from light by storage in the original package until time of use, and keep syringes and autoinjectors dry.

    Actemra

    Tocilizumab
    IV Infusion 400 mg/20 ml Allopathic Drugs used for Rheumatoid Arthritis

    Indications

    Rheumatoid arthritis

    Indication detailsView
    Tocilizumab is an interleukin-6 (IL-6) receptor antagonist indicated for treatment of:
    • Rheumatoid Arthritis (RA): Adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more Disease-Modifying Anti-Rheumatic Drugs (DMARDs).
    • Giant Cell Arteritis (GCA): Adult patients with giant cell arteritis.
    • Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Slowing the rate of decline in pulmonary function in adult patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD)
    • Polyarticular Juvenile Idiopathic Arthritis (PJIA): Patients 2 years of age and older with active polyarticular juvenile idiopathic arthritis.
    • Systemic Juvenile Idiopathic Arthritis (SJIA): Patients 2 years of age and older with active systemic juvenile idiopathic arthritis.
    • Cytokine Release Syndrome (CRS): Adults and pediatric patients 2 years of age and older with chimeric antigen receptor (CAR) T cell-induced severe or life-threatening cytokine release syndrome.
    Therapeutic classView
    Drugs used for Rheumatoid Arthritis
    PharmacologyView
    Tocilizumab binds to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and has been shown to inhibit IL-6-mediated signaling through these receptors. IL-6 is a pleiotropic pro-inflammatory cytokine produced by a variety of cell types including T- and B-cells, lymphocytes, monocytes and fibroblasts. IL-6 has been shown to be involved in diverse physiological processes such as T-cell activation, induction of immunoglobulin secretion, initiation of hepatic acute phase protein synthesis, and stimulation of hematopoietic precursor cell proliferation and differentiation. IL-6 is also produced by synovial and endothelial cells leading to local production of IL-6 in joints affected by inflammatory processes such as rheumatoid arthritis.
    DosageView
    Rheumatoid Arthritis: Recommended Adult Intravenous Dosage: When used in combination with DMARDs or as monotherapy the recommended starting dose is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response.
    • Patients less than 100 kg weight: 162 mg administered subcutaneously every other week, followed by an increase to every week based on clinical response
    • Patients at or above 100 kg weight: 162 mg administered subcutaneously every week.
    Giant Cell Arteritis: Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with GCA is 162 mg given once every week as a subcutaneous injection, in combination with a tapering course of glucocorticoids. A dose of 162 mg given once every other week as a subcutaneous injection, in combination with a tapering course of glucocorticoids, may be prescribed based on clinical considerations. tocilizumab can be used alone following discontinuation of glucocorticoids. tocilizumab subcutaneous formulation is not intended for intravenous administration.

    Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with SSc-ILD is 162 mg given once every week as a subcutaneous injection.

    Polyarticular Juvenile Idiopathic Arthritis
    Recommended Intravenous PJIA Dosage Every 4 Weeks-
    • Patients less than 30 kg weight: 10 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Recommended Subcutaneous PJIA Dosage-
    • Patients less than 30 kg weight: 162 mg once every three weeks
    • Patients at or above 30 kg weight: 162 mg once every two weeks
    Systemic Juvenile Idiopathic Arthritis
    Recommended Intravenous SJIA Dosage Every 2 Weeks-
    • Patients less than 30 kg weight: 12 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Recommended Subcutaneous SJIA Dosage-
    • Patients less than 30 kg weight 162 mg every two weeks
    • Patients at or above 30 kg weight 162 mg every week
    Cytokine Release Syndrome
    Recommended Intravenous CRS Dosage-
    • Patients less than 30 kg weight: 12 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Alone or in combination with corticosteroids.

    General Dosing Information:
    • It is recommended that tocilizumab not be initiated in patients with an absolute neutrophil count (ANC) below 2000 per mm3, platelet count below 100,000 per mm3, or who have ALT or AST above 1.5 times the upper limit of normal (ULN).
    • tocilizumab doses exceeding 800 mg per infusion are not recommended in RA or CRS patients.
    Side effectsView
    Most common adverse reactions (incidence of at least 5%): upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions.
    ContraindicationsView
    Hypersensitivity to tocilizumab or to any of the excipients.
    PrecautionsView
    • Serious Infections- do not administer tocilizumab during an active infection, including localized infections. If a serious infection develops, interrupt tocilizumab until the infection is controlled.
    • Gastrointestinal (GI) perforation- use with caution in patients who may be at increased risk.
    • Hepatotoxicity- Monitor patients for signs and symptoms of hepatic injury. Modify or discontinue tocilizumab if abnormal liver tests persist or worsen or if clinical signs and symptoms of liver disease develop.
    • Laboratory monitoring- recommended due to potential consequences of treatment-related changes in neutrophils, platelets, lipids, and liver function tests.
    • Hypersensitivity reactions, including anaphylaxis and death have occurred.
    • Live vaccines- Avoid use with tocilizumab.
    InteractionsView
    Interactions with CYP450 Substrates: Cytochrome P450s in the liver are down-regulated by infection and inflammation stimuli including cytokines such as IL-6. Inhibition of IL-6 signaling in RA patients treated with tocilizumab may restore CYP450 activities to higher levels than those in the absence of tocilizumab leading to increased metabolism of drugs that are CYP450 substrates. In vitro studies showed that tocilizumab has the potential to affect expression of multiple CYP enzymes including CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6 and CYP3A4. Its effect on CYP2C8 or transporters is unknown. In vivo studies with omeprazole, metabolized by CYP2C19 and CYP3A4, and simvastatin, metabolized by CYP3A4, showed up to a 28% and 57% decrease in exposure one week following a single dose of tocilizumab, respectively. The effect of tocilizumab on CYP enzymes may be clinically relevant for CYP450 substrates with narrow therapeutic index, where the dose is individually adjusted. Upon initiation or discontinuation of tocilizumab, in patients being treated with these types of medicinal products, perform therapeutic monitoring of effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) and the individual dose of the medicinal product adjusted as needed. Exercise caution when coadministering tocilizumab with CYP3A4 substrate drugs where decrease in effectiveness is undesirable, e.g., oral contraceptives, lovastatin, atorvastatin, etc. The effect of tocilizumab on CYP450 enzyme activity may persist for several weeks after stopping therapy
    Pregnancy & lactationView
    Based on animal data, may cause fetal harm. Discontinue drug or nursing taking into consideration importance of drug to mother.
    Overdose effectsView
    There are limited data available on overdoses with tocilizumab. One case of accidental overdose was reported with intravenous tocilizumab in which a patient with multiple myeloma received a dose of 40 mg per kg. No adverse drug reactions were observed. No serious adverse drug reactions were observed in healthy volunteers who received single doses of up to 28 mg per kg, although all 5 patients at the highest dose of 28 mg per kg developed dose-limiting neutropenia. In case of an overdose, it is recommended that the patient be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate symptomatic treatment.
    StorageView
    Tocilizumab must be refrigerated at 2ºC to 8ºC. Do not freeze. Protect the vials, syringes, and autoinjectors from light by storage in the original package until time of use, and keep syringes and autoinjectors dry.

    Actemra

    Tocilizumab
    IV Infusion 200 mg/10 ml Allopathic Drugs used for Rheumatoid Arthritis

    Indications

    Rheumatoid arthritis

    Indication detailsView
    Tocilizumab is an interleukin-6 (IL-6) receptor antagonist indicated for treatment of:
    • Rheumatoid Arthritis (RA): Adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response to one or more Disease-Modifying Anti-Rheumatic Drugs (DMARDs).
    • Giant Cell Arteritis (GCA): Adult patients with giant cell arteritis.
    • Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Slowing the rate of decline in pulmonary function in adult patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD)
    • Polyarticular Juvenile Idiopathic Arthritis (PJIA): Patients 2 years of age and older with active polyarticular juvenile idiopathic arthritis.
    • Systemic Juvenile Idiopathic Arthritis (SJIA): Patients 2 years of age and older with active systemic juvenile idiopathic arthritis.
    • Cytokine Release Syndrome (CRS): Adults and pediatric patients 2 years of age and older with chimeric antigen receptor (CAR) T cell-induced severe or life-threatening cytokine release syndrome.
    Therapeutic classView
    Drugs used for Rheumatoid Arthritis
    PharmacologyView
    Tocilizumab binds to both soluble and membrane-bound IL-6 receptors (sIL-6R and mIL-6R), and has been shown to inhibit IL-6-mediated signaling through these receptors. IL-6 is a pleiotropic pro-inflammatory cytokine produced by a variety of cell types including T- and B-cells, lymphocytes, monocytes and fibroblasts. IL-6 has been shown to be involved in diverse physiological processes such as T-cell activation, induction of immunoglobulin secretion, initiation of hepatic acute phase protein synthesis, and stimulation of hematopoietic precursor cell proliferation and differentiation. IL-6 is also produced by synovial and endothelial cells leading to local production of IL-6 in joints affected by inflammatory processes such as rheumatoid arthritis.
    DosageView
    Rheumatoid Arthritis: Recommended Adult Intravenous Dosage: When used in combination with DMARDs or as monotherapy the recommended starting dose is 4 mg per kg every 4 weeks followed by an increase to 8 mg per kg every 4 weeks based on clinical response.
    • Patients less than 100 kg weight: 162 mg administered subcutaneously every other week, followed by an increase to every week based on clinical response
    • Patients at or above 100 kg weight: 162 mg administered subcutaneously every week.
    Giant Cell Arteritis: Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with GCA is 162 mg given once every week as a subcutaneous injection, in combination with a tapering course of glucocorticoids. A dose of 162 mg given once every other week as a subcutaneous injection, in combination with a tapering course of glucocorticoids, may be prescribed based on clinical considerations. tocilizumab can be used alone following discontinuation of glucocorticoids. tocilizumab subcutaneous formulation is not intended for intravenous administration.

    Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Recommended Adult Subcutaneous Dosage: The recommended dose of tocilizumab for adult patients with SSc-ILD is 162 mg given once every week as a subcutaneous injection.

    Polyarticular Juvenile Idiopathic Arthritis
    Recommended Intravenous PJIA Dosage Every 4 Weeks-
    • Patients less than 30 kg weight: 10 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Recommended Subcutaneous PJIA Dosage-
    • Patients less than 30 kg weight: 162 mg once every three weeks
    • Patients at or above 30 kg weight: 162 mg once every two weeks
    Systemic Juvenile Idiopathic Arthritis
    Recommended Intravenous SJIA Dosage Every 2 Weeks-
    • Patients less than 30 kg weight: 12 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Recommended Subcutaneous SJIA Dosage-
    • Patients less than 30 kg weight 162 mg every two weeks
    • Patients at or above 30 kg weight 162 mg every week
    Cytokine Release Syndrome
    Recommended Intravenous CRS Dosage-
    • Patients less than 30 kg weight: 12 mg per kg
    • Patients at or above 30 kg weight: 8 mg per kg
    Alone or in combination with corticosteroids.

    General Dosing Information:
    • It is recommended that tocilizumab not be initiated in patients with an absolute neutrophil count (ANC) below 2000 per mm3, platelet count below 100,000 per mm3, or who have ALT or AST above 1.5 times the upper limit of normal (ULN).
    • tocilizumab doses exceeding 800 mg per infusion are not recommended in RA or CRS patients.
    Side effectsView
    Most common adverse reactions (incidence of at least 5%): upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions.
    ContraindicationsView
    Hypersensitivity to tocilizumab or to any of the excipients.
    PrecautionsView
    • Serious Infections- do not administer tocilizumab during an active infection, including localized infections. If a serious infection develops, interrupt tocilizumab until the infection is controlled.
    • Gastrointestinal (GI) perforation- use with caution in patients who may be at increased risk.
    • Hepatotoxicity- Monitor patients for signs and symptoms of hepatic injury. Modify or discontinue tocilizumab if abnormal liver tests persist or worsen or if clinical signs and symptoms of liver disease develop.
    • Laboratory monitoring- recommended due to potential consequences of treatment-related changes in neutrophils, platelets, lipids, and liver function tests.
    • Hypersensitivity reactions, including anaphylaxis and death have occurred.
    • Live vaccines- Avoid use with tocilizumab.
    InteractionsView
    Interactions with CYP450 Substrates: Cytochrome P450s in the liver are down-regulated by infection and inflammation stimuli including cytokines such as IL-6. Inhibition of IL-6 signaling in RA patients treated with tocilizumab may restore CYP450 activities to higher levels than those in the absence of tocilizumab leading to increased metabolism of drugs that are CYP450 substrates. In vitro studies showed that tocilizumab has the potential to affect expression of multiple CYP enzymes including CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6 and CYP3A4. Its effect on CYP2C8 or transporters is unknown. In vivo studies with omeprazole, metabolized by CYP2C19 and CYP3A4, and simvastatin, metabolized by CYP3A4, showed up to a 28% and 57% decrease in exposure one week following a single dose of tocilizumab, respectively. The effect of tocilizumab on CYP enzymes may be clinically relevant for CYP450 substrates with narrow therapeutic index, where the dose is individually adjusted. Upon initiation or discontinuation of tocilizumab, in patients being treated with these types of medicinal products, perform therapeutic monitoring of effect (e.g., warfarin) or drug concentration (e.g., cyclosporine or theophylline) and the individual dose of the medicinal product adjusted as needed. Exercise caution when coadministering tocilizumab with CYP3A4 substrate drugs where decrease in effectiveness is undesirable, e.g., oral contraceptives, lovastatin, atorvastatin, etc. The effect of tocilizumab on CYP450 enzyme activity may persist for several weeks after stopping therapy
    Pregnancy & lactationView
    Based on animal data, may cause fetal harm. Discontinue drug or nursing taking into consideration importance of drug to mother.
    Overdose effectsView
    There are limited data available on overdoses with tocilizumab. One case of accidental overdose was reported with intravenous tocilizumab in which a patient with multiple myeloma received a dose of 40 mg per kg. No adverse drug reactions were observed. No serious adverse drug reactions were observed in healthy volunteers who received single doses of up to 28 mg per kg, although all 5 patients at the highest dose of 28 mg per kg developed dose-limiting neutropenia. In case of an overdose, it is recommended that the patient be monitored for signs and symptoms of adverse reactions. Patients who develop adverse reactions should receive appropriate symptomatic treatment.
    StorageView
    Tocilizumab must be refrigerated at 2ºC to 8ºC. Do not freeze. Protect the vials, syringes, and autoinjectors from light by storage in the original package until time of use, and keep syringes and autoinjectors dry.

    Acteria

    Probiotic Combination [4 Billion]
    Oral Powder 4 billion/sachet Herbal Herbal and Nutraceuticals

    Indications

    Lactose intolerance such as bloating, flatulence, diarrhea

    Indication detailsView
    This is indicated in the following indications-
    • Diarrhea
    • Digestive discomfort
    • Lactose intolerance
    • Vaginal infection
    • Antibiotic associated diarrhea
    Therapeutic classView
    Herbal and Nutraceuticals, Probiotic
    PharmacologyView
    Studies of probiotic activity in recent years provide evidence that probiotics counter experimental and human gastrointestinal inflammation (human inflammatory bowel disease) by their effects on epithelial cell function, including epithelial cell barrier function, epithelial cytokine secretion and their antibacterial effects relating to colonization of the epithelial layer. It reduces gastrointestinal pH through stimulation of lactic-acid-producing bacteria; provide a direct antagonistic action on gastrointestinal pathogens. Moreover it competes with pathogens for binding and receptor sites. In addition, there is emerging evidence that probiotics induce regulatory T cells that act as a break on the effector T cells that would otherwise cause inflammation.

    Lactobacillus acidophilus and Bifidobacterium bifidum appear to enhance the nonspecific immune phagocytic activity of circulating blood granulocytes. This effect may account, in part, for the stimulation of IgA responses in infants infected with rotavirus. Lactic acid bacteria, like strains of Lactobacillus acidophilus, Lactobacillus bulgaricus have also demonstrated antioxidant ability. Mechanisms include chelation of metal ions (iron, copper), scavenging of reactive oxygen species and reducing activity.
    DosageView
    1 or 2 probiotics capsules 3 times daily or as directed by the physician.
    Side effectsView
    No known toxicity or side-effects.
    ContraindicationsView
    The use of probiotics is not advised in patients at risk of opportunistic infections and in those with badly damaged GI tracts.
    InteractionsView
    None well documented.
    Pregnancy & lactationView
    Probiotics are unlikely to reach the systemic circulation of the fetus & therefore are unlikely to cause harm. Probiotics are unlikely to be transferred into breast milk.
    StorageView
    Store below 25ºC, dry place and away from direct sunlight. Keep out of reach of children.

    Acteria

    Probiotic Combination [4 Billion]
    Capsule 4 billion Herbal Herbal and Nutraceuticals

    Indications

    Lactose intolerance such as bloating, flatulence, diarrhea

    Indication detailsView
    This is indicated in the following indications-
    • Diarrhea
    • Digestive discomfort
    • Lactose intolerance
    • Vaginal infection
    • Antibiotic associated diarrhea
    Therapeutic classView
    Herbal and Nutraceuticals, Probiotic
    PharmacologyView
    Studies of probiotic activity in recent years provide evidence that probiotics counter experimental and human gastrointestinal inflammation (human inflammatory bowel disease) by their effects on epithelial cell function, including epithelial cell barrier function, epithelial cytokine secretion and their antibacterial effects relating to colonization of the epithelial layer. It reduces gastrointestinal pH through stimulation of lactic-acid-producing bacteria; provide a direct antagonistic action on gastrointestinal pathogens. Moreover it competes with pathogens for binding and receptor sites. In addition, there is emerging evidence that probiotics induce regulatory T cells that act as a break on the effector T cells that would otherwise cause inflammation.

    Lactobacillus acidophilus and Bifidobacterium bifidum appear to enhance the nonspecific immune phagocytic activity of circulating blood granulocytes. This effect may account, in part, for the stimulation of IgA responses in infants infected with rotavirus. Lactic acid bacteria, like strains of Lactobacillus acidophilus, Lactobacillus bulgaricus have also demonstrated antioxidant ability. Mechanisms include chelation of metal ions (iron, copper), scavenging of reactive oxygen species and reducing activity.
    DosageView
    1 or 2 probiotics capsules 3 times daily or as directed by the physician.
    Side effectsView
    No known toxicity or side-effects.
    ContraindicationsView
    The use of probiotics is not advised in patients at risk of opportunistic infections and in those with badly damaged GI tracts.
    InteractionsView
    None well documented.
    Pregnancy & lactationView
    Probiotics are unlikely to reach the systemic circulation of the fetus & therefore are unlikely to cause harm. Probiotics are unlikely to be transferred into breast milk.
    StorageView
    Store below 25ºC, dry place and away from direct sunlight. Keep out of reach of children.

    ActiMom

    Multivitamin & Multimineral [For nursing mother]
    Tablet Allopathic Multi-vitamin & Multi-mineral combined preparations

    Indications

    Vitamin deficiency

    Indication detailsView
    This is an advanced formula of 16 essential vitamins & minerals indicated for women while planning conception, throughout pregnancy and when breast feeding. As a complete daily nutritional supplement this is also indicated to meet the increased demands for necessary vitamins and minerals.
    Therapeutic classView
    Multi-vitamin & Multi-mineral combined preparations
    PharmacologyView
    This tablet is specially formulated with 16 essential nutrients to provide multivitamin & multimineral support when planning conception, throughout pregnancy and while breast feeding. It is carefully developed by experts so that all ingredients are within safe levels for pregnancy and are moderate rather than excessive. It provides iodine to promote healthy development of baby's brain, eyesight & hearing; provides folic acid that may reduce the risk of brain and/or spinal cord birth defects such as spina bifida if taken daily for 1 month prior to conception and throughout pregnancy. It also provides vitamin D to support calcium absorption to assist with healthy development of baby's bones.
    DosageView
    Two tablets daily with a meal or as prescribed by the physician.
    Side effectsView
    Generally well tolerated.
    ContraindicationsView
    This product is contraindicated in patients with a known hypersensitivity to any of the ingredients of this preparation.
    PrecautionsView
    If any pregnant woman has a baby with neural tube defect she is advised to consult with her physician. To be dispensed only on the prescription of a registered
    physician
    Pregnancy & lactationView
    Recommended to use in pregnancy and lactation.
    StorageView
    Keep in a cool and dry place, protect from light. Keep out of the reach of children.

    Acticol

    Ambroxol Hydrochloride
    Syrup 15 mg/5 ml Allopathic Cough expectorants & mucolytics

    Indications

    Sore throat

    Indication detailsView
    This is indicated in-
    • Productive cough
    • Acute and chronic inflammatory disorders of upper and lower respiratory tracts associated with viscid mucus including acute and chronic bronchitis
    • Inflammatory disease of rhinopharyngeal tract (laryngitis, pharyngitis, sinusitis and rhinitis) associated with viscid mucus
    • Asthmatic bronchitis bronchial asthma with thick expectoration
    • Bronchiectasis
    • Chronic pneumonia etc.
    Therapeutic classView
    Cough expectorants & mucolytics
    PharmacologyView
    Ambroxol is the active metabolite of bromhexine and it has been proven that this metabolite possesses a greater bronchosecretolytic effect than bromhexine. It improves sputum rheology by hydrating mechanism leading to liquefaction of mucus in the lumen of respiratory tract, thus facilitating expectoration of mucus and reducing dyspnea. It stimulates production of phospholipids of surfactant by alveolar cells, thus contributing to the lowering of superficial tension in the alveoli. It also reduces bronchial hyperactivity. Ambroxol has anti inflammatory properties owing to the inhibitory effect on the production of cellular cytokines and arachidonic acid metabolites. In patients with COPD it traditionally improves airway patency.
    DosageView
    Average daily dose (preferably after meal):

    Pediatric Drops:
    • 0-6 months: 0.5 ml 2 times a day
    • 6-12 months: 1 ml 2 times a day
    • 1-2 years: 1.25 ml 2 times a day
    Syrup:
    • 2-5 years: 2.5 ml (1/2 teaspoonful) 2-3 times a day
    • 5-10 years: 5 ml (1 teaspoonful) 2-3 times a day
    • 10 years and adults: 10 ml (2 teaspoonful) 3 times a day.
    Sustained release capsule: Adult and children over 12 years old: 1 capsule once daily.
    Side effectsView
    Gastrointestinal side effects like epigastric pain, stomach overfill feeling may occur occasionally. Rarely allergic responses such as eruption, urticaria or angioneurotic edema have been reported.
    ContraindicationsView
    Contraindicated in known hypersensitivity to Ambroxol or Bromhexine.
    PrecautionsView
    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.
    InteractionsView
    Ambroxol should not be taken simultaneously with antitussives (e.g.Codeine) because phlegm, which has been liquefied by Ambroxol might not be expectorated.
    Pregnancy & lactationView
    Teratogenic and fetal toxicity studies have shown no harmful effect of Ambroxol. However, it is advised not to use it in pregnancy, especially during the1st trimester. Safety during lactation has not been established yet.
    StorageView
    Protect from direct light exposure, Store in a dry place at a temperature not exceeding 30°C, Keep out of the reach of children.

    Actidex

    Dexketoprofen
    Tablet 25 mg Allopathic Drugs for Osteoarthritis

    Indications

    Rheumatic disorders

    Indication detailsView
    Symptomatic treatment of pain and inflammation of mild or moderate intensity, such as musculo-skeletal pain, menstrual pain, & dental pain
    Therapeutic classView
    Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
    PharmacologyView
    Dexketoprofen is the S(+)-enantiomer of Ketoprofen and is responsible for the analgesic and anti-inflammatory activity of Ketoprofen. The inactive R(-)-enantiomer does not contribute to the therapeutic properties of Ketoprofen but adds to the metabolic load. Dexketoprofen has been formulated as a trometamol salt. Its high solubility in water means a rapid absorption through the gut wall which results in a more rapid onset of action than Ketoprofen. Peak plasma concentrations are attained more quickly than other widely used analgesics with an onset of action of 30 minutes. Dexketoprofen trometamol, given as a tablet, is rapidly absorbed, with a time to maximum plasma concentration (tmax) of between 0.25 and 0.75 hours, whereas the tmax for the S-enantiomer after the racemic drug, administered as tablets or capsules prepared with the free acid, is between 0.5 and 3 hours. Peak plasma concentrations of 1.4 and 3.1 mg/L are reached after administration of Dexketoprofen trometamol 12.5 and 25 mg, respectively. From 70 to 80% of the administered dose is recovered in the urine during the first 12 hours, mainly as the acyl-glucuronoconjugated parent drug. No R(-)-Ketoprofen is found in the urine after administration of Dexketoprofen [S(+)-Ketoprofen], confirming the absence of bioinversion of the S(+)-enantiomer in humans. The anti-inflammatory potency of Dexketoprofen was always equivalent to that demonstrated by twice the dose of Ketoprofen.
    DosageView
    The dose of Dexketoprofen 25 mg tablets depends on the type, severity, and duration of pain. The recommended dose is generally 1 tablet every 8 hours, with no more than 3 tablets daily. The elderly and patients with renal or hepatic impairment should start treatment with a total daily dose of no more than 2 tablets. Normally it is recommended to take the tablets with food. In the case of acute pain, it is recommended that tablets be taken at least 30 minutes before meals. Dexketoprofen is not recommended for children.
    Side effectsView
    As with all medicines, Dexketoprofen 25 mg tablets may cause some unwanted effects in some patients. These are described below and are characteristic of non-steroidal antiinflammatory drugs:
    • Common (1-10%): nausea, vomiting, diarrhoea, stomach pain or heartburn.
    • Uncommon (0.1-1%): sleep disorders, nervousness, headache, dizziness, vertigo, palpitations, constipation, dry mouth, flatulence, skin rash, fatigue, hot flushes, shivering, general malaise.
    • Rare (0.01 0.1%): stomach ulceration, gastric haemorrhage or perforation; pins and needles, high blood pressure, water retention, slowed breathing rate, hepatic enzymes increased, increased sweating.
    • Very rare/isolated cases (<0.01%): blurred vision, ringing in the ear, low blood pressure, haematological reactions, hepatic or renal damage, dermatological and photosensitivity reactions, bronchospasm or anaphylaxis.
    • In patients with systemic lupus erythematosus or mixed connective tissue disease, antiinflammatory medicines may rarely cause isolated cases of fever, headache and rigidity of the nape (back of the neck).
    ContraindicationsView
    Dexketoprofen tablets are not recommended to use in patients who are allergic to this product or aspirin or other non-steroidal anti-inflammatory medicines; who have suffered attacks of asthma, bronchospasm, acute rhinitis, nasal polyps, urticaria, angioedema (swollen face, eyes, lips, or tongue, or difficulty in breathing) after taking aspirin or other non-steroidal anti-inflammatory medicines; who have or previously suffered from a peptic ulcer or chronic gastro-intestinal disorders; who had previously gastro-intestinal haemorrhage (bleeding); who have suffered bronchial asthma; who have severe heart failure, moderate to severe renal dysfunction or severely impaired hepatic function; who have a bleeding disorder, a blood clotting disorder or are taking an anticoagulant; and who are pregnant or breast-feeding.
    PrecautionsView
    Precaution should be exercised during using Dexketoprofen tablets in patient who are allergic to any other NSAIDs; who have kidney disease, liver disease, heart disease or fluid retention conditions; and who have blood disorder, systemic lupus erythematosus or mixed connective tissue disease.
    InteractionsView
    Any of the following drugs cannot be used at the same time while taking Dexketoprofen. Other non-steroidal anti-inflammatory drugs, anticoagulant medicines; lithium; methotrexate; hydantoins (a type of medicine used for epilepsy) or some antibiotics of sulphonamide type (e.g. sulfamethoxazole); medications used to treat high blood pressure (ACE inhibitors, diuretics and beta-blockers); pentoxifylline; zidovudine; cyclosporine or tacrolimus; some oral medicines for diabetes (sulphonylureas); thrombolytic medicines; probenecid; cardiac glycosides; mifepristone; and quinolone antibiotics.
    Pregnancy & lactationView
    The use of Dexketoprofen tablets during pregnancy or breast-feeding is not recommended.
    Pediatric usageView
    Should not be given to children.
    StorageView
    Store at a cool & dry place protected from light and moisture. Keep out of reach of children.

    Actifast

    Ketorolac Tromethamine
    Tablet 10 mg Allopathic Drugs used for Rheumatoid Arthritis

    Indications

    Soft tissue inflammation

    Indication detailsView
    Ketorolac Tromethamine is indicated for the short-term management of moderate to severe acute post-operative pain.
    Therapeutic classView
    Drugs used for Rheumatoid Arthritis, Non-Opioid Analgesics
    PharmacologyView
    Ketorolac Tromethamine is a potent analgesic of the non-steroidal anti-inflammatory drugs (NSAIDs). It acts by inhibiting the cyclooxygenase enzyme system and hence inhibits the prostaglandin synthesis. It demonstrates a minimal anti-inflammatory effect at its analgesic dose.
    DosageView

    Tablet-

    Recommended dose is 10 mg every 4-6 hours. It should be used short-term only (up to 7 days) and are not recommended for chronic use. Doses exceeding 40 mg/day is not recommended.

    Injection-

    Ketorolac 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 Ketorolac 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 within 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-
    IM Dosing (Adult):
    • 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 (Adult):
    • 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.
    IV or IM Dosing (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 Ketorolac 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 Ketorolac 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.
    • Conversion from Parenteral to Oral Therapy: Ketorolac tablets may be used either as monotherapy or as follow-on therapy to parenteral Ketorolac. When Ketorolac tablets are used as a follow-on therapy to parenteral Ketorolac, the total combined daily dose of ketorolac (oral + parenteral) should not exceed 120 mg in younger adult patients or 60 mg in elderly patients on the day the change of formulation is made. On subsequent days, oral dosing should not exceed the recommended daily maximum of 40 mg. Ketorolac IM should be replaced by Ketorolac tablet as soon as feasible. The total duration of combined parenteral and oral treatment should not exceed 5 days.
    Side effectsView
    Commonly occurring side effects are nausea, vomiting, gastro-intestinal bleeding, melana, peptic ulcer, pancreatitis, anxiety, drowsiness, headache, excessive thirst, fatigue, bradycardia, hypertension, palpitation, chest pain, infertility in female and pulmonary edema.
    ContraindicationsView
    Ketorolac is contraindicated in patients having hypersensitivity to this drug or other NSAIDs. It should not be used in children under 16 years of age. lt is also contraindicated as prophylactic analgesic before surgery.
    PrecautionsView
    Caution should be exercised in patients over the age of 65 years. Caution should also be taken in patients with active or suspected peptic ulcer or gastrointestinal bleeding or asthma and liver dysfunction.
    InteractionsView
    Other NSAIDs or aspirin: Increase the side effects of ketorolac Tromethamine.
    Anti-coagulants: Enhance anti-coagulant effect.
    Beta Blocker: Reduce the anti-hypertensive effect .
    ACE Inhibitors: Increase the risk of renal impairment.
    Methotrexate: Enhance the toxicity of methotrexate.
    Pregnancy & lactationView
    US FDA Pregnancy category of Ketorolac Tromethamine is C. So, Ketorolac Tromethamine should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.
    StorageView
    Keep in a dry place away from light and heat. Keep out of the reach of children.

    Actilac

    Lactulose
    Oral Solution 3.35 gm/5 ml Allopathic Osmotic purgatives

    Indications

    Osmotic laxative

    Indication detailsView
    Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient.

    Intestinal flora disturbances:
    • In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
    • gall bladder diseases
    • intestinal diseases ( Colitis, Diverticulosis, Megacolon)
    Increased blood ammonia levels (hyper ammoniemia in hepatopathy, portal-systemic encephalopathy)
    Therapeutic classView
    Osmotic purgatives
    PharmacologyView
    Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.
    DosageView
    In constipation ( chronic constipation):
    • Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
    • Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
    • Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
    In damaged intestinal flora:
    • Adults: 1-2 tea-spoons daily
    • Children: 1 tea-spoon daily
    For reduction of blood ammonia level:
    • Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily.
    • In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
    Side effectsView
    Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
    ContraindicationsView
    Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
    PrecautionsView
    Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.
    InteractionsView
    There is no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
    Pregnancy & lactationView
    US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
    Overdose effectsView
    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.
    StorageView
    Keep in a dry place away from light and heat. Keep out of the reach of children.

    Actilyse

    Alteplase
    IV Infusion 1 mg/1 ml Allopathic Fibrinolytics (Thrombolytics)

    Indications

    Stroke

    Indication detailsView
    Acute Ischemic Stroke: Alteplase is indicated for the treatment of acute ischemic stroke. Exclude intracranial hemorrhage as the primary cause of stroke signs and symptoms prior to initiation of treatment. Initiate treatment as soon as possible but within 3 hours after symptom onset.

    Acute Myocardial Infarction: Alteplase is indicated for use in acute myocardial infarction (AMI) for the reduction of mortality and the reduction of the incidence of heart failure.

    Pulmonary Embolism: Alteplase is indicated for the lysis of acute massive pulmonary embolism, defined as:
    • Acute pulmonary emboli obstructing blood flow to a lobe or multiple lung segments.
    • Acute pulmonary emboli accompanied by unstable hemodynamics, e.g., failure to maintain blood pressure without supportive measures.
    Therapeutic classView
    Anti-platelet drugs, Fibrinolytics (Thrombolytics)
    PharmacologyView
    Alteplase is a serine protease responsible for fibrin-enhanced conversion of plasminogen to plasmin. It produces limited conversion of plasminogen in the absence of fibrin. When introduced into the systemic circulation at pharmacologic concentration, alteplase binds to fibrin in a thrombus and converts the entrapped plasminogen to plasmin. This initiates local fibrinolysis with limited systemic proteolysis.

    Pharmacodynamics: Following administration of 100 mg Alteplase, there is a decrease (16%-36%) in circulating fibrinogen. In a controlled trial, 8 of 73 patients (11%) receiving Alteplase (1.25 mg/kg body weight over 3 hours) experienced a decrease in fibrinogen to below 100 mg/dL.

    Pharmacokinetics: Alteplase in acute myocardial infarction (AMI) patients is rapidly cleared from the plasma with an initial half-life of less than 5 minutes. There is no difference in the dominant initial plasma half-life between the 3-hour and accelerated regimens for AMI. The plasma clearance of alteplase is 380-570 mL/min, primarily mediated by the liver. The initial volume of distribution approximates plasma volume.
    DosageView
    Acute Ischemic Stroke: Administer Alteplase as soon as possible but within 3 hours after onset of symptoms. The recommended dose is 0.9 mg/kg (not to exceed 90 mg total dose), with 10% of the total dose administered as an initial intravenous bolus over 1 minute and the remainder infused over 60 minutes. During and following Alteplase administration for the treatment of acute ischemic stroke, frequently monitor and control blood pressure. In patients without recent use of oral anticoagulants or heparin, Alteplase treatment can be initiated prior to the availability of coagulation study results. Discontinue Alteplase if the pretreatment International Normalized Ratio (INR) is greater than 1.7 or the activated partial thromboplastin time (aPTT) is elevated.

    Acute Myocardial Infarction: Administer Alteplase as soon as possible after the onset of symptoms. The recommended total doses for acute myocardial infarction (AMI) is based on patient weight, not to exceed 100 mg, regardless of the selected administration regimen (accelerated or 3 hour). There are two Alteplase dose regimens (accelerated and 3-hour) for use in the management of AMI; there are no controlled studies to compare clinical outcomes with these regimens

    Pulmonary Embolism (PE): The recommended dose is 100 mg administered by IV infusion over 2 hours. Institute parenteral anticoagulation near the end of or immediately following the Alteplase infusion when the partial thromboplastin time or thrombin time returns to twice normal or less.
    AdministrationView
    Following bolus dose, if indicated:
    • 50 mg vials: administer using either a polyvinyl chloride bag or glass vial and infusion set.
    • 100 mg vials: remove from the vial any quantity of drug in excess of that specified for patient treatment. Insert the spike end of an infusion set through the same puncture site created by the transfer device in the stopper of the vial of reconstituted Alteplase. Peel the clear plastic hanger from the vial label. Hang the Alteplase vial from the resulting loop.
    Alteplase is for intravenous administration only. Extravasation of Alteplase infusion can cause ecchymosis or inflammation. If extravasation occurs, terminate the infusion at that IV site and apply local therapy. Do not add any other medication to infusion solutions containing Alteplase.
    Side effectsView
    The following adverse reactions are:
    • Bleeding 
    • Orolingual Angioedema 
    • Cholesterol Embolization
    • Reembolization of Deep Venous Thrombi during Treatment for Acute Massive Pulmonary
    • Embolism.
    ContraindicationsView
    Acute Ischemic Stroke: Do not administer Alteplase to treat acute ischemic stroke in the following situations in which the risk of bleeding is greater than the potential benefit [see Warnings and Precautions (5.1)]:
    • Current intracranial hemorrhage
    • Subarachnoid hemorrhage
    • Active internal bleeding
    • Recent (within 3 months) intracranial or intraspinal surgery or serious head trauma
    • Presence of intracranial conditions that may increase the risk of bleeding (e.g., some neoplasms, arteriovenous malformations, or aneurysms)
    • Bleeding diathesis
    • Current severe uncontrolled hypertension.
    Acute Myocardial Infarction or Pulmonary Embolism: Do not administer Alteplase for treatment of AMI or PE in the following situations in which the risk of bleeding is greater than the potential benefit:
    • Active internal bleeding
    • History of recent stroke
    • Recent (within 3 months) intracranial or intraspinal surgery or serious head trauma
    • Presence of intracranial conditions that may increase the risk of bleeding (e.g. some neoplasms, arteriovenous malformations, or aneurysms)
    • Bleeding diathesis
    • Current severe uncontrolled hypertension.
    PrecautionsView
    • Increases the risk of bleeding. Avoid intramuscular injections. Monitor for bleeding. If serious bleeding occurs, discontinue Alteplase.
    • Monitor patients during and for several hours after infusion for orolingual angioedema. If angioedema develops, discontinue Alteplase.
    • Cholesterol embolism has been reported rarely in patients treated with thrombolytic agents.
    • Consider the risk of reembolization from the lysis of underlying deep venous thrombi in patients with pulmonary embolism.
    InteractionsView
    The interaction of Alteplase with other cardioactive or cerebroactive drugs has not been studied. Anticoagulants and antiplatelet drugs increase the risk of bleeding if administered prior to, during, or after Alteplase therapy. In the post-marketing setting, there have been reports of orolingual angioedema in patients (primarily patients with AIS) receiving concomitant angiotensin-converting enzyme inhibitors.
    Pregnancy & lactationView
    Pregnancy Category C. Alteplase is embryocidal in rabbits when intravenously administered in doses of approximately two times (3 mg/kg) the human dose for AMI. No maternal or fetal toxicity was evident at 0.65 times (1 mg/kg) the human dose in pregnant rats and rabbits dosed during the period of organogenesis. There are no adequate and well-controlled studies in pregnant women. It is not known whether Alteplase is excreted in human milk. Many drugs are excreted in human milk.
    Pediatric usageView
    Pediatric Use: Safety and effectiveness of Alteplase in pediatric patients have not been established.

    Geriatric Use:
    • Acute Ischemic Stroke: In exploratory, multivariate analyses of Studies 1 and 2, age greater than 77 years was one of several interrelated baseline characteristics associated with an increased risk of intracranial hemorrhage. Efficacy results suggest a reduced but still favorable clinical outcome for Alteplase-treated elderly.
    • Acute Myocardial Infarction: In a large trial of accelerated-infusion Alteplase that enrolled 41,021 patients with AMI to one of four thrombolytic regimens [see Clinical Studies (14.2)], patients over 75 years of age, a predefined subgroup, comprised 12% of enrolment. In these patients, the incidence of stroke was 4.0% for the Alteplase accelerated infusion group, 2.8% for streptokinase IV [SK (IV)], and 3.2% for streptokinase SQ [SK (SQ)]. The incidence of combined 30-day mortality or nonfatal stroke was 20.6% for accelerated infusion of Alteplase, 21.5% for SK (IV), and 22.0% for SK (SQ).
    StorageView
    Store lyophilized Alteplase at controlled room temperature not to exceed 30°C, or under refrigeration (2-8°C). Protect the lyophilized material during extended storage from excessive exposure to light. If stored between 2-30°C, Alteplase may be used within 8 hours following reconstitution. Discard any unused solution after administration is complete. Do not use beyond the expiration date stamped on the vial.

    Actisal

    Levosalbutamol (Oral)
    Syrup 1 mg/5 ml Allopathic Short-acting selective & β2-adrenoceptor stimulants

    Indications

    COPD

    Indication detailsView
    Levosalbutamol is indicated for the treatment or prevention of bronchospasm in adults, adolescents and children 6 years of age and older with reversible obstructive airway disease.
    Therapeutic classView
    Short-acting selective & β2-adrenoceptor stimulants
    PharmacologyView
    Levosalbutamol is a single isomer beta 2-agonist that differs from racemic salbutamol by elimination of (S)-salbutamol. Levosalbutamol is an effective bronchodilator whose primary mechanism of action is unimpeded by (S)-salbutamol. Thus, when compared with racemic salbutamol, clinically comparable bronchodilation can be achieved with doses that substantially lessen beta-mediated side effects.
    DosageView
    Tablet-
    • Adults and adolescents above 12 years: 1-2 mg three times daily.
    • Children (6 -11 years): 1 mg three times daily.
    Syrup-
    • Adults : 5-10 ml three times daily.
    • Childrn (6-11 years): 5 ml three times daily.
    Side effectsView
    Hypocalcaemia, palpitation, fine tremors of the skeletal muscle and muscle cramps may occur. The other likely side effects are nausea, vomiting, burning substernal or epigastric pain and diarrhoea.
    ContraindicationsView
    Levosalbutamol is contraindicated in patients with a history of hypersensitivity to levosalbutamol or any of its components.
    PrecautionsView
    Particular caution is advised in acute severe asthma as this effect may be potentiated by hypoxia and by concomitant treatment with xanthine derivatives, steroids and diuretics. Serum potassium levels should be monitored in such situations.
    InteractionsView
    Other short acting sympathomimetic bronchodilators or epinephrine should be used with caution with Levosalbutamol. If additional adrenergic drugs are to be administered by any route, they will be used with caution to avoid deleterious cardiovascular effects.
    Pregnancy & lactationView
    The drug should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus. It is not known whether Levosalbutamol is excreted in human milk. Caution should be exercised when oral Levosalbutamol is administered to a nursing woman.
    Overdose effectsView
    The expected symptoms with over dosage are those of excessive beta-adrenergic stimulation and the symptoms listed under side effects. In the event of serious poisoning, the stomach should be emptied and, if necessary, a beta-blocker administered with caution in patients with a history of bronchospasm.
    StorageView
    Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.

    Actisal

    Levosalbutamol (Oral)
    Tablet 1 mg Allopathic Short-acting selective & β2-adrenoceptor stimulants

    Indications

    COPD

    Indication detailsView
    Levosalbutamol is indicated for the treatment or prevention of bronchospasm in adults, adolescents and children 6 years of age and older with reversible obstructive airway disease.
    Therapeutic classView
    Short-acting selective & β2-adrenoceptor stimulants
    PharmacologyView
    Levosalbutamol is a single isomer beta 2-agonist that differs from racemic salbutamol by elimination of (S)-salbutamol. Levosalbutamol is an effective bronchodilator whose primary mechanism of action is unimpeded by (S)-salbutamol. Thus, when compared with racemic salbutamol, clinically comparable bronchodilation can be achieved with doses that substantially lessen beta-mediated side effects.
    DosageView
    Tablet-
    • Adults and adolescents above 12 years: 1-2 mg three times daily.
    • Children (6 -11 years): 1 mg three times daily.
    Syrup-
    • Adults : 5-10 ml three times daily.
    • Childrn (6-11 years): 5 ml three times daily.
    Side effectsView
    Hypocalcaemia, palpitation, fine tremors of the skeletal muscle and muscle cramps may occur. The other likely side effects are nausea, vomiting, burning substernal or epigastric pain and diarrhoea.
    ContraindicationsView
    Levosalbutamol is contraindicated in patients with a history of hypersensitivity to levosalbutamol or any of its components.
    PrecautionsView
    Particular caution is advised in acute severe asthma as this effect may be potentiated by hypoxia and by concomitant treatment with xanthine derivatives, steroids and diuretics. Serum potassium levels should be monitored in such situations.
    InteractionsView
    Other short acting sympathomimetic bronchodilators or epinephrine should be used with caution with Levosalbutamol. If additional adrenergic drugs are to be administered by any route, they will be used with caution to avoid deleterious cardiovascular effects.
    Pregnancy & lactationView
    The drug should be used during pregnancy only if the potential benefit justifies the potential risk of the fetus. It is not known whether Levosalbutamol is excreted in human milk. Caution should be exercised when oral Levosalbutamol is administered to a nursing woman.
    Overdose effectsView
    The expected symptoms with over dosage are those of excessive beta-adrenergic stimulation and the symptoms listed under side effects. In the event of serious poisoning, the stomach should be emptied and, if necessary, a beta-blocker administered with caution in patients with a history of bronchospasm.
    StorageView
    Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.

    Activa

    Sildenafil Citrate
    Tablet 50 mg Allopathic Drugs for Erectile Dysfunction

    Indications

    Pulmonary arterial hypertension

    Indication detailsView
    Sildenafil is indicated for the treatment of erectile dysfunction.
    Therapeutic classView
    Drugs for Erectile Dysfunction
    PharmacologyView
    Sildenafil is a selective inhibitor of cyclic Guanosine Monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5) used for treatment of erectile dysfunction. Danafil (Sildenafil) enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum that results in smooth muscle relaxation and inflow of blood to the corpus cavernosum.
    DosageView
    The recommended dose of Sildenafil is 50 mg taken approximately 1 hour before sexual activity. However, Sildenafil may be taken anywhere from half an hour to 4 hours before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.
    AdministrationView
    Sildenafil may takes longer time to work if you take it with a heavy meal.
    Side effectsView
    The adverse effects treated with Sildenafil are headache, flushing, dyspepsia, nasal congestion, urinary tract infection, abnormal vision, diarrhea, dizziness and rash.
    ContraindicationsView
    Sildenafil is contraindicated in patient with hypersensitivity to any component of this medication. Sildenafil potentiates the hypotensive effects of nitrates, so it is contraindicated in patients who are using organic nitrates, either regularly or intermittently.
    PrecautionsView
    Caution should be exercised if patients have any allergies to any other medicines or any other substances such as foods, preservatives or dyes, heart or blood vessel problems, sudden loss of eyesight in one or both eyes. Caution should be taken if patients have any of the following medical conditions such as diabetes, kidney or liver problems, leukaemia, multiple myeloma, any disease or deformity of penis, any bleeding disorder such as haemophilia, stomach ulcer, sickle cell anaemia, color vision problems, sudden decrease or loss of hearing or receiving any other treatment for impotence.
    InteractionsView
    Concomitant use of Sildenafil with organic nitrates for angina may cause hypotension. Cimetidine, a medicine used to treat gastric ulcers, some antibiotics including Erythromycin and Rifampicin, some protease inhibitors such as Ritonavir and Saquinavir for the treatment of HIV infection may increase the plasma concentration of Sildenafil. Some medicines used to treat fungal infections including Ketoconazole and Itraconazole may reduce the clearance of Sildenafil.
    Pregnancy & lactationView
    Pregnancy category B. There are no adequate and well-controlled studies of Sildenafil in pregnant women. Sildenafil is not indicated for use by women. In animal study shows that Sildenafil has no evidence of teratogenicity or embryotoxicity.
    StorageView
    Keep in a dry place, away from light and heat. Keep out of the reach of children.

    Activa

    Sildenafil Citrate
    Tablet 100 mg Allopathic Drugs for Erectile Dysfunction

    Indications

    Pulmonary arterial hypertension

    Indication detailsView
    Sildenafil is indicated for the treatment of erectile dysfunction.
    Therapeutic classView
    Drugs for Erectile Dysfunction
    PharmacologyView
    Sildenafil is a selective inhibitor of cyclic Guanosine Monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5) used for treatment of erectile dysfunction. Danafil (Sildenafil) enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum that results in smooth muscle relaxation and inflow of blood to the corpus cavernosum.
    DosageView
    The recommended dose of Sildenafil is 50 mg taken approximately 1 hour before sexual activity. However, Sildenafil may be taken anywhere from half an hour to 4 hours before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.
    AdministrationView
    Sildenafil may takes longer time to work if you take it with a heavy meal.
    Side effectsView
    The adverse effects treated with Sildenafil are headache, flushing, dyspepsia, nasal congestion, urinary tract infection, abnormal vision, diarrhea, dizziness and rash.
    ContraindicationsView
    Sildenafil is contraindicated in patient with hypersensitivity to any component of this medication. Sildenafil potentiates the hypotensive effects of nitrates, so it is contraindicated in patients who are using organic nitrates, either regularly or intermittently.
    PrecautionsView
    Caution should be exercised if patients have any allergies to any other medicines or any other substances such as foods, preservatives or dyes, heart or blood vessel problems, sudden loss of eyesight in one or both eyes. Caution should be taken if patients have any of the following medical conditions such as diabetes, kidney or liver problems, leukaemia, multiple myeloma, any disease or deformity of penis, any bleeding disorder such as haemophilia, stomach ulcer, sickle cell anaemia, color vision problems, sudden decrease or loss of hearing or receiving any other treatment for impotence.
    InteractionsView
    Concomitant use of Sildenafil with organic nitrates for angina may cause hypotension. Cimetidine, a medicine used to treat gastric ulcers, some antibiotics including Erythromycin and Rifampicin, some protease inhibitors such as Ritonavir and Saquinavir for the treatment of HIV infection may increase the plasma concentration of Sildenafil. Some medicines used to treat fungal infections including Ketoconazole and Itraconazole may reduce the clearance of Sildenafil.
    Pregnancy & lactationView
    Pregnancy category B. There are no adequate and well-controlled studies of Sildenafil in pregnant women. Sildenafil is not indicated for use by women. In animal study shows that Sildenafil has no evidence of teratogenicity or embryotoxicity.
    StorageView
    Keep in a dry place, away from light and heat. Keep out of the reach of children.

    Active Plus

    Betacarotene + Vitamin C + Vitamin E
    Tablet 6 mg+200 mg+50 mg Allopathic Anti-oxidant Multivitamin preparations

    Indications

    Vitamin deficiency

    Indication detailsView
    Antioxidant vitamins are used in a wide range of conditions where free radical damage is playing a role. Antioxidant vitamin combination is used in the prevention of coronary heart diseases, certain types of cancer, aging as well as free radical damage caused by excessive exercise, illness, certain medications, air pollution, smoke, radiation and pesticides. The main role of the antioxidant vitamins is as follows:

    β carotene prevents free radical formation by quenching singlet oxygen, a highly reactive form of oxygen. Vitamin C is another free radical scavenger which deactivates free radicals. It works specially in the plasma, lung fluid, aqueous humour and interstitial fluid. It can increase white blood cell activity; play important roles in the biochemistry of antibodies, prostaglandin E 1 , B and T lymphocytes, and interferon. Vitamin E also scavenges free radicals in the blood along with β carotene and vitamin C. Moreover, vitamin E is essential to protect against some of the ill effects of smog and smoke. In relation to other nutrients vitamin E protects vitamin A from being destroyed in the body.
    Therapeutic classView
    Anti-oxidant Multivitamin preparations
    PharmacologyView
    Beta carotene of this tablet is converted to vitamin A (Retinol) when required. Retinol has several biochemical functions e.g. on retina, growth, tissue differentiation, immunological response. It has also some anti-cancer activity.

    Vitamin C is the most powerful reducing agent known to be present in living tissues. Vitamin C deficiency produces scurvy. It is a cofactor in numerous biological processes. Vitamin C and molecular oxygen are essential for the conversion of proline to hydroxyproline, dopamine to noradrenaline . Vitamin C is also essential for the synthesis of adrenal steroid hormones. Vitamin C is important in the defense against infection and studies shown that vitamin C is important for the normal functioning of T-lymphocyte and leukocyte. Ascorbic acid has some antiinflammatory activity and protects cells against oxidation of essential molecules. In high doses, (1-2 g daily) ascorbic acid increases iron absorption.

    vitamin E seems to be as a defense against oxidative stress and lipid peroxidation. In most cell membranes there is one molecule of tocopherol for every 1000 lipid molecules. Tocopherol mops up peroxide radicals and then needs a supply of reduced hydrogen to restore the steady-state situation. This is usually supplied by ascorbic acid or reduced glutathione.
    DosageView
    This tablet is administered orally. The adult dose of this combination of antioxidant vitamin tablet is 1 tablet daily or as prescribed by the physician.
    Side effectsView
    β carotene is comparatively safe even at high and prolonged exposure. Individuals who routinely ingest large amounts of carotenoids can develop hypercarotenosis, which is characterised by a yellowish colouration of the skin and a very high concentration of carotenoids in the plasma. This benign condition, although resembling jaundice, gradually disappears upon correcting the excessive intake of carotenoids.

    Vitamin C is generally a safe drug for human use in normal doses. Larger doses may lead to gastrointestinal tract upset and renal stone formation.

    Vitamin E is considered safe even in large doses. Doses over 800 mg may cause diarrhoea, abdominal pain or cramps, fatigue and reduced resistance to bacterial infection and transiently raised blood pressure.
    ContraindicationsView
    Carocet is contraindicated in patients with hypersensitivity to any of its components.
    PrecautionsView
    There are some evidences that β carotene may cause harm to heavy smokers and alcoholics. Therefore, caution should be exercised in these cases. Vitamin C should be given with caution to patients with hyperoxaluria. Vitamin E should be used with caution in patients taking anticoagulant drugs, because vitamin E may enhance the anticoagulant activity of these drugs.
    InteractionsView
    Cholestyramine, Colestipol, Neomycin cause decreased absorption of β carotene. Circulating vitamin C levels have been shown to be reduced during prolonged administration of oral contraceptives containing Oestrogen, Tetracycline and Aspirin. The decrease in vitamin C level may be due to drug induced impaired absorption or increased utilization of the vitamin for drug metabolism. Vitamin E may enhance the anticoagulant activity of anticoagulant drugs. High doses of vitamin E can impair intestinal absorption of vitamins A and K.
    Pregnancy & lactationView
    β carotene, vitamin C and vitamin E have no teratogenic effects in humans. However, like any other drugs caution should be taken in prescribing to pregnant women.
    StorageView
    Should be stored in a dry place below 30˚C.

    Activit Gold

    Multivitamin & Multimineral [A-Z gold preparation]
    Tablet Allopathic Multi-vitamin & Multi-mineral combined preparations

    Indications

    Vitamin deficiency

    Indication detailsView
    This is indicated for the prevention and treatment of vitamins & minerals deficiencies. As a complete daily nutritional supplement, it is also indicated to meet the increased demand for vitamins and minerals in the conditions like physical and emotional stress, chronic diseases, infection illness, osteoporosis, injuries or wound, surgery, poor digestion, old age, pregnancy and lactation, poor appetite, excess dieting, exposure to environmental pollution, heavy exercise etc.
    Therapeutic classView
    Multi-vitamin & Multi-mineral combined preparations
    PharmacologyView
    This is a film coated tablet, which combines 32 high potency vitamins and minerals. This preparation maintains a healthy body and active life-style.
    DosageView
    One tablet daily or as recommended by the physician.
    Side effectsView
    Generally, this preparation is well tolerated. Diarrhoea may occasionally occur during treatment with beta carotene and the skin may assume a slightly yellow discoloration. Vitamin C and vitamin E may cause diarrhoea and other gastrointestinal disturbances.
    ContraindicationsView
    This product is contraindicated in patients with known hypersensitivity to any of the ingredients.
    PrecautionsView
    Long term intake of high level of vitamin A (excluding that sourced from beta carotene) may increase the risk of osteoporosis in postmenopausal women.
    InteractionsView
    No drug interactions have been reported.
    Pregnancy & lactationView
    Recommended by the consultation with physician.
    StorageView
    Keep in a dry place, away from light and heat. Keep out of the reach of children.

    Activit Silver

    Multivitamin & Multimineral [A-Z silver preparation]
    Tablet Allopathic Multi-vitamin & Multi-mineral combined preparations

    Indications

    Vitamin deficiency

    Indication detailsView
    This is specially formulated for the prevention and treatment of vitamin and mineral deficiencies for adults over 45 years of age. This Silver is also indicated to meet the increase demands of vitamin and minerals for adults over 45 years of age.
    Therapeutic classView
    Multi-vitamin & Multi-mineral combined preparations
    PharmacologyView
    This preparation is a comprehensive well-balanced multivitamin and multimineral preparation scientifically adjusted and designed to serve as the complete nutritional program for the elderly people. This preparation maintains a healthy body and active lifestyle and keeps proper nutrition covered for elderly people
    DosageView
    One tablet once daily with food or as indicated by the physician.
    Side effectsView
    Generally, this preparation is well tolerated. Allergic sensitization has been reported following oral administration of folic acid. Vitamin C and vitamin E may cause diarrhea and other gastrointestinal disturbances.
    ContraindicationsView
    This product is contraindicated in patients with known hypersensitivity to any of the ingredients. Do not take this product if taking other vitamin A supplements.
    PrecautionsView
    Long term intake of high levels of vitamin A (excluding that sourced from beta carotene) may increase the risk of osteoporosis in postmenopausal women.
    InteractionsView
    No drug interactions have been reported.
    Pregnancy & lactationView
    Recommended by the consultation with physician.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Activit Z

    Vitamin B Complex + Zinc
    Syrup Allopathic Specific mineral & vitamin combined preparations

    Indications

    Vitamins B and Zinc deficiencies

    Indication detailsView
    This is indicated for the treatment and prevention of zinc and vitamin B deficiencies.
    Therapeutic classView
    Specific mineral & vitamin combined preparations
    PharmacologyView
    Zinc is vital for many biological functions such as immunity enhancement, wound healing, digestion, reproduction, physical growth and mental development. Zinc supports normal growth and development during pregnancy, childhood, and adolescence. Zinc also has some antioxidant properties. Zinc is used to treat ADHD (Attention Deficit Hyper-activity Disorder) in children. In adult, due to zinc deficiency loss of appetite, poor sense of taste and smell, tendency towards depression, white marks on fingernails, frequent infections, low fertility, prostate problems, mental problems, poor wound healing, a poor immune system, diarrhoea, mental lethargy, rough skin and weight loss may occur.

    B-Vitamins are needed to release energy from food. They play an important role in ensuring healthy brain and nerve function, healthy red blood cells formation in children & adults. They are specially needed for healthy growth and development of children. B-Vitamin deficiencies in adult cause profound fatigue and various types of neurologic manifestations, which may include weakness, poor balance, confusion, irritability, memory loss, nervousness, tingling of the limbs and loss of coordination. Additional symptoms of vitamin B deficiency are sleep disturbances, nausea, poor appetite, frequent infections, and skin lesions.
    DosageView
    Syrup-
    • Adults: 10 ml (2 teaspoonful) 2 to 3 times daily or as recommended by the physician.
    • Children: 10 ml (2 teaspoonful) 1 to 3 times daily or as recommended by the physician.
    • Infants: 5 ml (1 teaspoonful) 1 to 2 times daily or as recommended by the physician.
    Tablet-
    • Adults & Children over 30 kg: 1 to 2 tablets 2 to 3 times daily or as recommended by the physician.
    Side effectsView
    This is generally well tolerated. However, a few side effects like nausea, vomiting, diarrhoea & stomach upset may occur. Side effects have been reported with specific vitamins but generally at levels substantially higher than recommended doses.
    ContraindicationsView
    Vitamin B Complex & Zinc is contraindicated in patients with a known hypersensitivity to any of the ingredients of this product.
    PrecautionsView
    In acute renal failure, zinc accumulation may occur, so dosage adjustment is needed. This is not intended for the treatment of severe specific deficiencies.
    InteractionsView
    Concomitant intake of tetracyclines and zinc may decrease the Gl absorption and serum levels of tetracyclines. Similarly concomitant administration of zinc and fluroquinolones may decrease the Gl absorption and serum  levels of some fluroquinolones. Coadministration of Niacin and HMG-CoA reductase inhibitors (eg. lovastatin) may result mayopathy and rhabdomyolysis. Pyridoxine reduces levodopa's effectiveness by increasing its peripheral metabolism. Co-administration of pyridoxine with phenytoin may decrease serum levels of phenytoin.
    Pregnancy & lactationView
    This is recommended in pregnancy and lactation.
    Overdose effectsView
    In case of overdosage, initially epigastric pain, diarrhoea and vomiting can occur. In that case, one should seek emergency medical attention. Initially, an emetic should be given and then gastric lavage and general supportive measures should be employed.
    StorageView
    Store in a cool & dry place, protected from light. Keep all medicines out of reach of children.

    Activit ZI

    Iron Polymaltose Complex + Vitamin B Complex + Zinc
    Syrup Allopathic Iron & Vitamin Combined preparations

    Indications

    Vitamin deficiency

    Indication detailsView
    This syrup is indicated for the treatment and prevention of Iron, Vitamin B complex and Zinc deficiencies, specially during pregnancy and lactation.
    Therapeutic classView
    Iron & Vitamin Combined preparations
    PharmacologyView
    This syrup is the preparation of Iron, Vitamin B complex and Zinc. In this preparation, Iron is present as Iron (III) Hydroxide Polymaltose Complex. Iron (III) Hydroxide Polymaltose Complex facilitates a controlled absorption of the iron when it comes in contact with the mucosal cell surface. Due to non-ionic nature, this Iron (III) Hydroxide Polymaltose Complex is more stable than conventional Iron form.
    DosageView
    Adults: 5 ml-10 ml (1-2 teaspoonful) 3 times daily or as recommended by the physician.

    Children: 5 ml (1 teaspoonful) 3 times daily or as recommended by the physician.

    Infants: 0.33 ml/kg body weight daily or as recommended by the physician.
    Side effectsView
    This syrup is generally well tolerated. However, a few side effects of oral Iron preparations, including nausea, vomiting, constipation or diarrhoea may occur.
    ContraindicationsView
    It is contraindicated in patients with a known hypersensitivity to any of the ingredients of this product.
    PrecautionsView
    Caution should be taken in the conditions where there is a risk of Iron overload, such as hemochromatosis, thalassemia, hemosiderosis or hemolytic anemia.
    InteractionsView
    Since Iron is complex bound, ionic interaction with foodstuff components (phytates, oxalates, tannin etc.) and concomitant administrations of medicaments (tetracyclines, antacids) are unlikely to occur.
    Pregnancy & lactationView
    Recommended in pregnancy & lactation
    Pediatric usageView
    Recommended in children
    Overdose effectsView
    In case of overdose, epigastric pain, diarrhoea, vomiting, metabolic acidosis and convulsion may occur. Should seek emergency medical attention in case of overdose. Initially an emetic should be given and then gastric lavage & general supportive measures should be employed.
    StorageView
    Keep in a dry place away from light and heat. Keep out of the reach of children.