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Cilvas
Cilnidipine
Cilvas
Cilnidipine
Indications
Hypertension
Indication detailsView
Cilnidipine is indicated for the management of hypertension for end-organ protection. It is reported to be useful in elderly patients and in those with diabetes and albuminuria. Cilnidipine has been increasingly used in patients with chronic kidney disease
Hypertension is the term used to describe the presence of high blood pressure. The blood pressure is generated by the force of the blood pumped from the heart against the blood vessels. Thus hypertension is caused when there is too much pressure on the blood vessels and this effect can damage the blood vessel
Hypertension is the term used to describe the presence of high blood pressure. The blood pressure is generated by the force of the blood pumped from the heart against the blood vessels. Thus hypertension is caused when there is too much pressure on the blood vessels and this effect can damage the blood vessel
Therapeutic classView
Calcium-channel blockers
PharmacologyView
Cilnidipine is a dihydropyridine calcium-channel blocker. Cilnidipine binds to the dihydropy-ridine binding sites of the L-type voltage dependent calcium channel and inhibits Ca2+ influx across the cell membranes of vascular smooth muscle cells via this channel, consequently vascular smooth muscle is relaxed, causing vasodilation. Cilnidipine inhibits Ca2+ influx via N-type voltage dependent calcium channels in the sympathetic nerve cell membrane. The inhibition of Ca2+ influx via N-type voltage dependent calcium channel was observed over a similar range of drug concentrations to those inhibiting L-type voltage dependent Ca2+ channels. Consequently, release of norepinephrine from sympathetic nerve terminals would be inhibited. Cilnidipine is considered to suppress the reflex increase in heart rate after blood pressure reduction.
DosageView
Adults: 5-10 mg once daily after breakfast. Maximum dose: 20 mg once daily.
Pediatric use: The safety of Cilnidipine in pediatric patients has not been established.
Elderly use: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose (5 mg).
Pediatric use: The safety of Cilnidipine in pediatric patients has not been established.
Elderly use: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose (5 mg).
Side effectsView
The most common side effects of Cilnidipine are: Dizziness; flushing; headache; hypotension; peripheral oedema; palpitations; GI disturbances; increased micturition frequency; lethargy; eye pain; depression.
ContraindicationsView
Cilnidipine is contraindicated in patients with known sensitivity to Cilnidipine or any of the excipients or patients having cardiogenic shock, recent MI or acute unstable angina and severe aortic stenosis.
PrecautionsView
Cilnidipine should be administered with care in the following patients: patients with serious hepatic dysfunction, patients with a history of serious adverse reactions to calcium antagonists. During the discontinuation, the dosage should be gradually decreased under close observation.
InteractionsView
Other anti-hypertensive, antipsychotics that cause hypotension, quinidine, carbamazepine, phenytoin, rifampicin, cimetidine, erythromycin.
Pregnancy & lactationView
Cilnidipine should not be administered in pregnant woman or woman having possibilities of being pregnant. It is also advisable to avoid the administration of Cilnidipine to nursing mothers. However, if the administration is indispensable, the patient should be instructed to discontinue lactation.
StorageView
Store below 30°C, protected from light and moisture. Keep away from reach out of the children.
Cilvas
Cilnidipine
Cilvas
Cilnidipine
Indications
Hypertension
Indication detailsView
Cilnidipine is indicated for the management of hypertension for end-organ protection. It is reported to be useful in elderly patients and in those with diabetes and albuminuria. Cilnidipine has been increasingly used in patients with chronic kidney disease
Hypertension is the term used to describe the presence of high blood pressure. The blood pressure is generated by the force of the blood pumped from the heart against the blood vessels. Thus hypertension is caused when there is too much pressure on the blood vessels and this effect can damage the blood vessel
Hypertension is the term used to describe the presence of high blood pressure. The blood pressure is generated by the force of the blood pumped from the heart against the blood vessels. Thus hypertension is caused when there is too much pressure on the blood vessels and this effect can damage the blood vessel
Therapeutic classView
Calcium-channel blockers
PharmacologyView
Cilnidipine is a dihydropyridine calcium-channel blocker. Cilnidipine binds to the dihydropy-ridine binding sites of the L-type voltage dependent calcium channel and inhibits Ca2+ influx across the cell membranes of vascular smooth muscle cells via this channel, consequently vascular smooth muscle is relaxed, causing vasodilation. Cilnidipine inhibits Ca2+ influx via N-type voltage dependent calcium channels in the sympathetic nerve cell membrane. The inhibition of Ca2+ influx via N-type voltage dependent calcium channel was observed over a similar range of drug concentrations to those inhibiting L-type voltage dependent Ca2+ channels. Consequently, release of norepinephrine from sympathetic nerve terminals would be inhibited. Cilnidipine is considered to suppress the reflex increase in heart rate after blood pressure reduction.
DosageView
Adults: 5-10 mg once daily after breakfast. Maximum dose: 20 mg once daily.
Pediatric use: The safety of Cilnidipine in pediatric patients has not been established.
Elderly use: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose (5 mg).
Pediatric use: The safety of Cilnidipine in pediatric patients has not been established.
Elderly use: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose (5 mg).
Side effectsView
The most common side effects of Cilnidipine are: Dizziness; flushing; headache; hypotension; peripheral oedema; palpitations; GI disturbances; increased micturition frequency; lethargy; eye pain; depression.
ContraindicationsView
Cilnidipine is contraindicated in patients with known sensitivity to Cilnidipine or any of the excipients or patients having cardiogenic shock, recent MI or acute unstable angina and severe aortic stenosis.
PrecautionsView
Cilnidipine should be administered with care in the following patients: patients with serious hepatic dysfunction, patients with a history of serious adverse reactions to calcium antagonists. During the discontinuation, the dosage should be gradually decreased under close observation.
InteractionsView
Other anti-hypertensive, antipsychotics that cause hypotension, quinidine, carbamazepine, phenytoin, rifampicin, cimetidine, erythromycin.
Pregnancy & lactationView
Cilnidipine should not be administered in pregnant woman or woman having possibilities of being pregnant. It is also advisable to avoid the administration of Cilnidipine to nursing mothers. However, if the administration is indispensable, the patient should be instructed to discontinue lactation.
StorageView
Store below 30°C, protected from light and moisture. Keep away from reach out of the children.
Cinagen
Moxifloxacin Hydrochloride (Ophthalmic)
Cinagen
Moxifloxacin Hydrochloride (Ophthalmic)
Indications
Ocular infections
Indication detailsView
The ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms:
- Aerobic Gram-positive microorganisms: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumoniae, Streptococcus viridans group.
- Aerobic Gram-negative microorganisms: Acinetobacterlwoffii, Haemophilusinfluenzae, Haemophilus parainfluenzae.
- Other microorganisms: Chlamydia trachomatis.
Therapeutic classView
Ophthalmic antibacterial drugs
PharmacologyView
The antimicrobial action of Moxifloxacin results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.
DosageView
Eye Drops: One drop in the affected eye 3 times per day for 7 days.
Eye Ointment: It should be applied thinly and evenly to the affected eye three times a day for the first two days and for the next five days apply two times a day or as advised by the registered physician.
Eye Ointment: It should be applied thinly and evenly to the affected eye three times a day for the first two days and for the next five days apply two times a day or as advised by the registered physician.
Side effectsView
The most frequently reported ocular adverse events were conjunctivitis, decreased visual acuity, dry eye, keratitis, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage, and tearing. These events occurred in approximately 1-6% of patients. Nonocular adverse events reported at a rate of 1-4% were fever, increased cough, infection, otitis media, pharyngitis, rash, and rhinitis.
ContraindicationsView
Moxifloxacin Hydrochloride ophthalmic solution is contraindicated in patients with a history of hypersensitivity to Moxifloxacin, to other quinolones, or to any of the components in this medication.
PrecautionsView
As with other anti-infectives, prolonged use may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, discontinue use and institute alternative therapy. Whenever clinical judgment dictates, the patient should be examined with the aid of magnification, such as slit lamp biomicroscopy, and, where appropriate, fluorescein staining. Patients should be advised not to wear contact lenses if they have signs and symptoms of bacterial conjunctivitis.
InteractionsView
Drug-drug interaction studies have not been conducted with Moxifloxacin Hydrochloride ophthalmic solution. In vitro studies indicate that Moxifloxacin does not inhibit CYP3A4, CYP2D6, CYP2C9, CYP2C19, or CYP1A2 indicating that Moxifloxacin is unlikely to alter the pharmacokinetics of drugs metabolized by these cytochrome P450 isozymes.
Pregnancy & lactationView
Since there are no adequate and well-controlled studies in pregnant women, Moxifloxacin Hydrochloride ophthalmic solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Moxifloxacin has not been measured in human milk, although it can be presumed to be excreted in human milk. Caution should be exercised when Moxifloxacin hydrochloride ophthalmic solution is administered to a nursing mother.
StorageView
Store bellow 25°C. Do not freeze. Store in cool and dry place, protected from light. Keep out of the reach of children. Do not touch dropper tip to any surface as this may contaminate this preparation. Do not use after one month of first opening.
Cinagen XG
Moxifloxacin Hydrochloride + Xanthan Gum
Cinagen XG
Moxifloxacin Hydrochloride + Xanthan Gum
Indications
Conjunctivitis
Indication detailsView
This ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms-
Aerobic Gram-positive microorganisms: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumonia, Streptococcus viridans group.
Aerobic Gram-negative microorganisms: Acinetobacter iwoffii, Haemophilus influenza, Haemophilus parainfluenzae.
Aerobic Gram-positive microorganisms: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumonia, Streptococcus viridans group.
Aerobic Gram-negative microorganisms: Acinetobacter iwoffii, Haemophilus influenza, Haemophilus parainfluenzae.
Therapeutic classView
Ophthalmic antibacterial drugs
PharmacologyView
The antimicrobial action of Moxifloxacin results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.
DosageView
One drop in the affected eye(s) 2 times daily for 7 days.
Side effectsView
In 1-6% patients the most frequently reported ocular adverse events are eye irritation, pyrexia, conjunctivitis, decreased visual acuity, dry eye, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage and tearing.
PrecautionsView
Prolonged use may result in overgrowth of non-susceptible organisms, including fungi with other anti-infective.
InteractionsView
Drug-drug interaction studies have not been conducted with Moxifloxacin Hydrochloride.
Pregnancy & lactationView
Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus as there are no adequate and well-documented studies in pregnant women. Moxifloxacin has not been measured in human milk, although it can be presumed to be excreted in human milk. Caution should be exercised when Moxifloxacin is administered to a breast feeding mother.
Pediatric usageView
Pediatric Use: The safety and effectiveness of Moxifloxacin in infants below four months of age was not proven. However, several clinical studies show that the drug may be used safely in children even younger than one month of age.
Geriatric Use: No overall differences in safety and effectiveness have been observed between elderly and younger patients.
Geriatric Use: No overall differences in safety and effectiveness have been observed between elderly and younger patients.
Overdose effectsView
There is practically no risk of adverse effects due to accidental ingestion, since a bottle of 5 ml eye drops solution contains only 25 mg Moxifloxacin that is much lower than recommended daily oral dose.
StorageView
Store in a cool and dry place away from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. After one month of the first opening do not use the medicine of dropper.
Cinagen-D
Moxifloxacin Hydrochloride + Dexamethasone
Cinagen-D
Moxifloxacin Hydrochloride + Dexamethasone
Indications
Steroid-responsive inflammatory ocular conditions
Indication detailsView
Moxifloxacin & Dexamethasone eye drop is indicated in the treatment of eye infections caused by susceptible microorganisms and in the prevention of inflammation and bacterial infection that may occur after eye surgery.
Therapeutic classView
Ophthalmic Steroid preparations
PharmacologyView
This Eye Drops is a combination of a fourth generation fluoroquinolone Moxifloxacin and a potent corticosteroid Dexmethasone. Moxifloxacin controls infection by inhibitting the DNA gyrase & Topoisomerase IV. Dexamethasone effectively controls the inflammation by inhibiting the release inflammatory mediators.
DosageView
In the prevention of infection and post-surgical ocular inflammation: Instill 1 drop, 4 times a day, in the eye to be operated, from 1 day before surgery until 15 days after surgery.
In patients undergoing cataract surgery: The day of surgery instill the medication immediately after eye surgery.
In patients undergoing LASIK refractive surgery: On the day of surgery instill the medication at least 15 minutes after ocular surgery.
In eye infections caused by susceptible microorganisms: Instill 1 drop, 4 times a day, for up to 7 days.
In patients undergoing cataract surgery: The day of surgery instill the medication immediately after eye surgery.
In patients undergoing LASIK refractive surgery: On the day of surgery instill the medication at least 15 minutes after ocular surgery.
In eye infections caused by susceptible microorganisms: Instill 1 drop, 4 times a day, for up to 7 days.
Side effectsView
Moxifloxacin: Conjunctivitis decreased visual acuity, dry eye, keratitis, Ocular discomfort, hyperemia, pain, Subconjunctival hemorrhage and tearing.
Dexamethasone: Visual acuity & field defects, cataract formation, secondary ocular infection following suppression of host response & perforation of the globe.
Dexamethasone: Visual acuity & field defects, cataract formation, secondary ocular infection following suppression of host response & perforation of the globe.
ContraindicationsView
Hypersensitivity to quinolones. Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella & other viral diseases of cornea & conjunctiva. Mycobacterial infection of the eye. Fungal diseases of ocular structures. Glaucoma & diseases causing thinning of cornea or sclera.
PrecautionsView
For ophthalmic use only. The solution should not be injected under the conjunctiva, nor introduced directly into the anterior chamber of the eye. Prolonged use of steroids may result in ocular hypertension
Pregnancy & lactationView
There are no adequate and well-controlled studies in pregnant women. Moxifloxacin & Dexamethasone combination eye drops should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution is advised when Moxifloxacin & Dexamethasone combination eye drops is given to nursing women.
Pediatric usageView
Use in the elderly: No change in dosage is required when the product is administered in elderly patients.
Use in Children: The efficacy and safety of Moxifloxacin & Dexamethasone combination eye drops in pediatric patients have not been established.
Use in Children: The efficacy and safety of Moxifloxacin & Dexamethasone combination eye drops in pediatric patients have not been established.
Overdose effectsView
No information is available on overdosage with this product in humans.
StorageView
Store in a cool place, below 30°C, protected from light. Once the container is opened the contents must be used within 28 days and may be stored at room temperature up to 30°C. Discard after the 28 days. Keep out of reach of children.
Cinalid
Azithromycin Dihydrate
Cinalid
Azithromycin Dihydrate
Indication detailsView
Azithromycin is indicated for infections (caused by susceptible organisms) in lower respiratory tract infections including bronchitis and pneumonia, in upper respiratory tract infections including sinusitis and pharyngitis/tonsillitis, in otitis media, and in skin and soft tissue infections. In sexually transmitted diseases in men and women, Azithromycin is indicated in the treatment of non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis.
PharmacologyView
Azithromycin is acid-stable and can therefore be taken orally with no need of protection from gastric acids. It is readily absorbed; its absorption is greater on an empty stomach. Time to peak concentration in adults is 2.1 to 3.2 hours for oral dosage forms. Due to the high concentration in phagocytes, azithromycin is actively transported to the site of infection. During active phagocytosis, large concentrations of azithromycin are released. The concentration of azithromycin in the tissues can be over 50 times higher than in plasma. This is due to ion trapping and the high lipid solubility.
Azithromycin's half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drug from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as unchanged drug in urine.
Microbiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:
Azithromycin's half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drug from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as unchanged drug in urine.
Microbiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:
- Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes
- Aerobic and facultative gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae
- Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis , Mycoplasma pneumoniae , Betalactamase production should have no effect on azithromycin activity.
- Aerobic and facultative gram-positive microorganisms: Streptococci (Groups C,F,G), Viridans group streptococci
- Aerobic and facultative gram-negative microorganisms: Bordetella pertussis, Legionella pneumophila
- Anaerobic microorganisms: Peptostreptococcus species, Prevotella bivia
DosageView
Oral-
Adult: 500 mg once daily orally for 3 days or 500 mg once on day 1, then 250 mg once on days 2-5 for 4 days. For sexually transmitted diseases caused by Chlamydia trachomatis in adults, the dose is 1 gm given as a single dose or 500 mg once on day 1, followed by 250 mg once daily for next 2 days may also be given.
Children:
Azithromycin Injection (For IV Infusion only): The recommended dose of Azithromycin for injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is:
Adult: 500 mg once daily orally for 3 days or 500 mg once on day 1, then 250 mg once on days 2-5 for 4 days. For sexually transmitted diseases caused by Chlamydia trachomatis in adults, the dose is 1 gm given as a single dose or 500 mg once on day 1, followed by 250 mg once daily for next 2 days may also be given.
Children:
- 10 mg/kg body weight once daily for 3 days for child over 6 months
- 200 mg (1 teaspoonful) for 3 days if body weight is 15-25 kg
- 300 mg (1½ teaspoonfuls) for 3 days if body weight is 26-35 kg; 400 mg (2 teaspoonfuls) for 3 days if body weight is 36-45 kg.
- In typhoid fever, 500 mg (2½ teaspoonfuls) once daily for 7-10 days is given.
Azithromycin Injection (For IV Infusion only): The recommended dose of Azithromycin for injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is:
- 500 mg as a single daily dose by the intravenous route for at least two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 500 mg, administered as two 250-mg tablets to complete a 7 to 10-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response.
- The recommended dose of Azithromycin for the treatment of adult patients with pelvic inflammatory disease due to the indicated organisms is: 500 mg as a single daily dose by the intravenous route for one or two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 250 mg to complete a 7-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response. If anaerobic microorganisms are suspected of contributing to the infection, an antimicrobial agent with anaerobic activity should be administered in combination with Azithromycin.
- Safety and effectiveness of azithromycin for injection in children or adolescents under 16 years have not been established.
AdministrationView
Reconstitution procedure of suspension-
- Step 01: Shake the bottle well to loosen the powder.
- Step 02: Add boiled and cooled water up to the water mark of the bottle label.
- Step 03: Shake until powder is completely mixed with water.
Side effectsView
Azithromycin is well tolerated with a low incidence of side effects. The side effects include nausea, vomiting, abdominal discomfort (pain/cramps), flatulence, diarrhoea, headache, dizziness, and skin rashes and are reversible upon discontinuation of therapy.
ContraindicationsView
Azithromycin is contraindicated in patients hypersensitive to Azithromycin or any other macrolide antibiotic. Co-administration of ergot derivatives and Azithromycin is contraindicated. Azithromycin is contraindicated in patients with hepatic diseases.
PrecautionsView
As with any antibiotic, observation for signs of superinfection with non-susceptible organisms, including fungi, is recommended. No dose adjustment is needed in patients with renal impairment.
InteractionsView
Azithromycin absorption is reduced in presence of food and antacid. In patients receiving ergot alkaloids Azithromycin should be avoided because of the possibility of ergotism resulting from interaction of Azithromycin with the cytochrome P-450 system. As macrolides increase the plasma concentration of digoxin and cyclosporin, caution should be exercised while co-administration. There have been no drug interactions between Azithromycin and Warfarin, Theophylline, Carbamazepine, Methylprednisolone or Cimetidine.
Pregnancy & lactationView
Pregnancy Category of Azithromycin is B. Animal reproduction studies have demonstrated that Azithromycin has no evidence of harm to the fetus. There are no adequate and well controlled studies in pregnant women. Since animal reproduction studies are not always predictive of human response, Azithromycin should be used during pregnancy only if adequate alternatives are not available. It is not known whether Azithromycin is secreted in breast milk. So, caution should be exercised when Azithromycin is administered to nursing women.
Overdose effectsView
There is no data on overdosage with Azithromycin. Typical symptoms of overdosage with macrolide antibiotics include hearing loss, severe nausea, vomiting and diarrhoea. Gastric lavage and general supportive measures are indicated.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Cinalid
Azithromycin Dihydrate
Cinalid
Azithromycin Dihydrate
Indication detailsView
Azithromycin is indicated for infections (caused by susceptible organisms) in lower respiratory tract infections including bronchitis and pneumonia, in upper respiratory tract infections including sinusitis and pharyngitis/tonsillitis, in otitis media, and in skin and soft tissue infections. In sexually transmitted diseases in men and women, Azithromycin is indicated in the treatment of non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis.
PharmacologyView
Azithromycin is acid-stable and can therefore be taken orally with no need of protection from gastric acids. It is readily absorbed; its absorption is greater on an empty stomach. Time to peak concentration in adults is 2.1 to 3.2 hours for oral dosage forms. Due to the high concentration in phagocytes, azithromycin is actively transported to the site of infection. During active phagocytosis, large concentrations of azithromycin are released. The concentration of azithromycin in the tissues can be over 50 times higher than in plasma. This is due to ion trapping and the high lipid solubility.
Azithromycin's half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drug from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as unchanged drug in urine.
Microbiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:
Azithromycin's half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drug from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as unchanged drug in urine.
Microbiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:
- Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes
- Aerobic and facultative gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae
- Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis , Mycoplasma pneumoniae , Betalactamase production should have no effect on azithromycin activity.
- Aerobic and facultative gram-positive microorganisms: Streptococci (Groups C,F,G), Viridans group streptococci
- Aerobic and facultative gram-negative microorganisms: Bordetella pertussis, Legionella pneumophila
- Anaerobic microorganisms: Peptostreptococcus species, Prevotella bivia
DosageView
Oral-
Adult: 500 mg once daily orally for 3 days or 500 mg once on day 1, then 250 mg once on days 2-5 for 4 days. For sexually transmitted diseases caused by Chlamydia trachomatis in adults, the dose is 1 gm given as a single dose or 500 mg once on day 1, followed by 250 mg once daily for next 2 days may also be given.
Children:
Azithromycin Injection (For IV Infusion only): The recommended dose of Azithromycin for injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is:
Adult: 500 mg once daily orally for 3 days or 500 mg once on day 1, then 250 mg once on days 2-5 for 4 days. For sexually transmitted diseases caused by Chlamydia trachomatis in adults, the dose is 1 gm given as a single dose or 500 mg once on day 1, followed by 250 mg once daily for next 2 days may also be given.
Children:
- 10 mg/kg body weight once daily for 3 days for child over 6 months
- 200 mg (1 teaspoonful) for 3 days if body weight is 15-25 kg
- 300 mg (1½ teaspoonfuls) for 3 days if body weight is 26-35 kg; 400 mg (2 teaspoonfuls) for 3 days if body weight is 36-45 kg.
- In typhoid fever, 500 mg (2½ teaspoonfuls) once daily for 7-10 days is given.
Azithromycin Injection (For IV Infusion only): The recommended dose of Azithromycin for injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is:
- 500 mg as a single daily dose by the intravenous route for at least two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 500 mg, administered as two 250-mg tablets to complete a 7 to 10-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response.
- The recommended dose of Azithromycin for the treatment of adult patients with pelvic inflammatory disease due to the indicated organisms is: 500 mg as a single daily dose by the intravenous route for one or two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 250 mg to complete a 7-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response. If anaerobic microorganisms are suspected of contributing to the infection, an antimicrobial agent with anaerobic activity should be administered in combination with Azithromycin.
- Safety and effectiveness of azithromycin for injection in children or adolescents under 16 years have not been established.
AdministrationView
Reconstitution procedure of suspension-
- Step 01: Shake the bottle well to loosen the powder.
- Step 02: Add boiled and cooled water up to the water mark of the bottle label.
- Step 03: Shake until powder is completely mixed with water.
Side effectsView
Azithromycin is well tolerated with a low incidence of side effects. The side effects include nausea, vomiting, abdominal discomfort (pain/cramps), flatulence, diarrhoea, headache, dizziness, and skin rashes and are reversible upon discontinuation of therapy.
ContraindicationsView
Azithromycin is contraindicated in patients hypersensitive to Azithromycin or any other macrolide antibiotic. Co-administration of ergot derivatives and Azithromycin is contraindicated. Azithromycin is contraindicated in patients with hepatic diseases.
PrecautionsView
As with any antibiotic, observation for signs of superinfection with non-susceptible organisms, including fungi, is recommended. No dose adjustment is needed in patients with renal impairment.
InteractionsView
Azithromycin absorption is reduced in presence of food and antacid. In patients receiving ergot alkaloids Azithromycin should be avoided because of the possibility of ergotism resulting from interaction of Azithromycin with the cytochrome P-450 system. As macrolides increase the plasma concentration of digoxin and cyclosporin, caution should be exercised while co-administration. There have been no drug interactions between Azithromycin and Warfarin, Theophylline, Carbamazepine, Methylprednisolone or Cimetidine.
Pregnancy & lactationView
Pregnancy Category of Azithromycin is B. Animal reproduction studies have demonstrated that Azithromycin has no evidence of harm to the fetus. There are no adequate and well controlled studies in pregnant women. Since animal reproduction studies are not always predictive of human response, Azithromycin should be used during pregnancy only if adequate alternatives are not available. It is not known whether Azithromycin is secreted in breast milk. So, caution should be exercised when Azithromycin is administered to nursing women.
Overdose effectsView
There is no data on overdosage with Azithromycin. Typical symptoms of overdosage with macrolide antibiotics include hearing loss, severe nausea, vomiting and diarrhoea. Gastric lavage and general supportive measures are indicated.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Cinamak
Amikacin
Cinamak
Amikacin
Indications
Urinary tract infection
Indication detailsView
Amikacin is indicated in the short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria. Amikacin is effective in bacterial septicemia (including neonatal sepsis); in serious infections of the respiratory tract, bones and joints, central nervous system (including meningitis) and skin and soft tissue; intra-abdominal infections (including peritonitis); and in burns and postoperative infections (including postvascular surgery). Clinical studies have shown Amikacin also to be effective in serious complicated and recurrent urinary tract infections due to those organisms.
Amikacin was effective in infections caused by gentamicin and/or tobramycin-resistant strains of Gram-negative organisms, particularly Proteus rettgeri, Providencia stuartii, Serratia marcescens, and Pseudomonas aeruginosa.
Amikacin has also been shown to be effective in staphylococci infections and may be considered as initial therapy under certain conditions in the treatment of known or suspected staphylococcal disease such as, severe infections where the causative organism may be either a Gram-negative bacterium or a staphylococcus.
Amikacin was effective in infections caused by gentamicin and/or tobramycin-resistant strains of Gram-negative organisms, particularly Proteus rettgeri, Providencia stuartii, Serratia marcescens, and Pseudomonas aeruginosa.
Amikacin has also been shown to be effective in staphylococci infections and may be considered as initial therapy under certain conditions in the treatment of known or suspected staphylococcal disease such as, severe infections where the causative organism may be either a Gram-negative bacterium or a staphylococcus.
Therapeutic classView
Aminoglycosides
PharmacologyView
Amikacin Sulfate is a semi-synthetic aminoglycoside antibiotic. Amikacin is active in vitro against pseudomonas species, Escherichia coli, Proteus species, Providencia species, Klebsiella-Enterobacter species, Acinetobacter species, and Citrobacter freundii. When strains of the above organisms are found to be resistant to other aminoglycosides, including Gentamicin, TobrAmykin and KanAmykin, many are susceptible to Amikacin. Amikacin sulfate is active in vitro against penicillinase and nonpenicillinase-producing Staphylococcus species including methicillin-resistant strains.
DosageView
Adults and children: 15 mg/kg/day in two equally-divided doses (equivalent to 500 mg bid in adults). Use of the 100 mg is recommended for children for the accurate measurement of the appropriate dose.
Neonates and premature children: An initial loading dose of 10 mg/kg followed by 15 mg/kg/day in two equally divided doses.
Elderly: Amikacin is excreted by the renal route. Renal function should be assessed whenever possible and dosage adjusted as described under impaired renal function.
Life-threatening infections and/or those caused by Pseudomonas: The adult dose may be increased to 500 mg every eight hours but should neither exceed 1.5g/day nor be administered for a period longer than 10 days. A maximum total adult dose of 15g should not be exceeded.
Urinary tract infections (other than pseudomonal infections): 7.5mg/kg/day in two equally divided doses (equivalent to 250 mg b.i.d. in adults).
Impaired renal function: In patients with impaired renal function, the daily dose should be reduced and/or the intervals between doses increased to avoid accumulation of the drug.
Neonates and premature children: An initial loading dose of 10 mg/kg followed by 15 mg/kg/day in two equally divided doses.
Elderly: Amikacin is excreted by the renal route. Renal function should be assessed whenever possible and dosage adjusted as described under impaired renal function.
Life-threatening infections and/or those caused by Pseudomonas: The adult dose may be increased to 500 mg every eight hours but should neither exceed 1.5g/day nor be administered for a period longer than 10 days. A maximum total adult dose of 15g should not be exceeded.
Urinary tract infections (other than pseudomonal infections): 7.5mg/kg/day in two equally divided doses (equivalent to 250 mg b.i.d. in adults).
Impaired renal function: In patients with impaired renal function, the daily dose should be reduced and/or the intervals between doses increased to avoid accumulation of the drug.
AdministrationView
Intramuscular or intravenous administration: For most infections the intramuscular route is preferred, but in life threatening infections, or in patients in whom intramuscular injection route is not feasible the intravenous route may be used.
Intraperitoneal use: Amikacin may be used as an irrigant after recovery from anesthesia in concentration of 0.25%.
Intraperitoneal use: Amikacin may be used as an irrigant after recovery from anesthesia in concentration of 0.25%.
Side effectsView
The adverse effects have been reported with the use of Amikacin are tinnitus, vertigo, partial reversible or irreversible deafness, skin rash, drug fever, headache, paraesthesia, nausea and vomiting.
ContraindicationsView
Amikacin Injection is contraindicated in patients with a known history of hypersensitivity to Amikacin, any constituents of the injection.
PrecautionsView
Since Amikacin is present in high concentrations in the renal excretory system, patients should be well hydrated to minimize chemical irritation of the renal tubules. If azotemia increases, treatment should be stopped. Monitoring of renal function during treatment with aminoglycosides is particularly important.
InteractionsView
Concurrent administration of Amikacin with myorelaxants leads to potentiation of their effects and there is a possibility of cessation of the breathing. The combination with other Aminoglycoside antibiotics should be avoided because of the augmentation of their ototoxic and nephrotoxic effects. Concurrent administration of Amikacin with fast acting diuretics increases the risk of ototoxicity in patients with renal failure. Combination with Cephalosporins or Polymixins increases the risk of nephrotoxicity.
Pregnancy & lactationView
Amikacin rapidly crosses the placenta into the foetal circulation and amniotic fluid and there is a potential risk of ototoxicity in the foetus. There is no information available regarding the safety of this drug during breastfeeding.
Pediatric usageView
Pediatric Use: Safety and effectiveness of Amikacin for injection in children or adolescents under 16 years have not been established
Overdose effectsView
In the event of overdose or toxic reaction, peritoneal dialysis or haemodialysis will aid in the removal of Amikacin from the blood.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinamycin
Clindamycin
Cinamycin
Clindamycin
Indications
Toxic shock syndrome
Indication detailsView
Clindamycin has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci; Upper respiratory infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.
Therapeutic classView
Macrolides
DosageView
Dosage of Clindamycin Capsule:
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
Dosage of Clindamycin IV/IM Injection:
Adults-
Pediatric patients (1 month of age to 16 years):
- Serious Infections: 150 mg-300 mg every six hours.
- More severe infections: 300 mg-450 mg every six hours.
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
- Serious infections: 8-12 mg/kg/day divided into 3 or 4 equal doses.
- Severe infections: 13-16 mg/kg/day divided into 3 or 4 equal doses.
- More severe infections: 17-25 mg/kg/day divided into 3 or 4 equal doses.
Dosage of Clindamycin IV/IM Injection:
Adults-
- Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600-1200 mg/day in 2- 4 equal doses.
- More severe infections: 1200-2700 mg/day in 2-4 equal doses.
- For more serious infections: these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes, these doses may be increased.
- Doses of as much as 4800 mg daily have been given intravenously to adults. Single intramuscular injections of greater than 600 mg are not recommended.
Pediatric patients (1 month of age to 16 years):
- 20 to 40 mg/kg/day in 3 or 4 equal doses. The higher doses would be used for more severe infections.
- Parenteral therapy may be changed to Capsules (clindamycin hydrochloride) when the condition warrants and at the discretion of the physician.
- In cases of (3-hemolytic streptococcal infections, treatment should be continued for at least 10 days.
Side effectsView
The adverse effects have been reported with the use of clindamycin are- abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhoea, pruritus, skin rashes, urticaria.
ContraindicationsView
Clindamycin is contraindicated in patients previously found to be sensitive to clindamycin or any of the ingredients of this medicine.
PrecautionsView
Clindamycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
InteractionsView
Clindamycin enhances the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Antagonism has been demonstrated between clindamycin and erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.
Pregnancy & lactationView
Pregnancy Category B. Clindamycin crosses the placenta in humans. After multiple doses, amniotic fluid concentrations were approximately 30% of maternal concentrations. Clindamycin should be used in pregnancy only if clearly needed. Clindamycin has been reported to appear in breast milk. Therefore, it is not recommended for nursing mothers if not clearly needed.
Pediatric usageView
Use in newborns and infants: When Clindamycin is administered to newborns and infants (birth to 16 years), appropriate monitoring of organ system functions is desirable.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Overdose effectsView
Overdosage with orally administered clindamycin has been rare. Adverse reactions similar to those seen with normal doses can be expected, however, unexpected reactions could occur. Haemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Overdosage should be treated with simple gastric lavage. No specific antidote is known.
ReconstitutionView
Direction for reconstitution (powder for oral solution): Shake the bottle well to loosen the powder. Add 80 ml of boiled and cooled water to the dry mixture in the bottle. For ease of preparation, add water to the bottle in two proportions. Shake well after each addition until all the powder is in solution. Keep the bottle tightly closed. The reconstituted solution should be used within 2 weeks if kept at room temperature.
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
- Administration of more than 1200 mg in a single 1 hour infusion is not recommended.
- Single IM injections of greater than 600 mg are not recommended. Dilution is not required for intramuscular administration.
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
- Room temperature: 16 days at 25°C.
- Refrigeration: 32 days at 4°C.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinamycin
Clindamycin
Cinamycin
Clindamycin
Indications
Toxic shock syndrome
Indication detailsView
Clindamycin has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci; Upper respiratory infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.
Therapeutic classView
Macrolides
DosageView
Dosage of Clindamycin Capsule:
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
Dosage of Clindamycin IV/IM Injection:
Adults-
Pediatric patients (1 month of age to 16 years):
- Serious Infections: 150 mg-300 mg every six hours.
- More severe infections: 300 mg-450 mg every six hours.
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
- Serious infections: 8-12 mg/kg/day divided into 3 or 4 equal doses.
- Severe infections: 13-16 mg/kg/day divided into 3 or 4 equal doses.
- More severe infections: 17-25 mg/kg/day divided into 3 or 4 equal doses.
Dosage of Clindamycin IV/IM Injection:
Adults-
- Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600-1200 mg/day in 2- 4 equal doses.
- More severe infections: 1200-2700 mg/day in 2-4 equal doses.
- For more serious infections: these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes, these doses may be increased.
- Doses of as much as 4800 mg daily have been given intravenously to adults. Single intramuscular injections of greater than 600 mg are not recommended.
Pediatric patients (1 month of age to 16 years):
- 20 to 40 mg/kg/day in 3 or 4 equal doses. The higher doses would be used for more severe infections.
- Parenteral therapy may be changed to Capsules (clindamycin hydrochloride) when the condition warrants and at the discretion of the physician.
- In cases of (3-hemolytic streptococcal infections, treatment should be continued for at least 10 days.
Side effectsView
The adverse effects have been reported with the use of clindamycin are- abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhoea, pruritus, skin rashes, urticaria.
ContraindicationsView
Clindamycin is contraindicated in patients previously found to be sensitive to clindamycin or any of the ingredients of this medicine.
PrecautionsView
Clindamycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
InteractionsView
Clindamycin enhances the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Antagonism has been demonstrated between clindamycin and erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.
Pregnancy & lactationView
Pregnancy Category B. Clindamycin crosses the placenta in humans. After multiple doses, amniotic fluid concentrations were approximately 30% of maternal concentrations. Clindamycin should be used in pregnancy only if clearly needed. Clindamycin has been reported to appear in breast milk. Therefore, it is not recommended for nursing mothers if not clearly needed.
Pediatric usageView
Use in newborns and infants: When Clindamycin is administered to newborns and infants (birth to 16 years), appropriate monitoring of organ system functions is desirable.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Overdose effectsView
Overdosage with orally administered clindamycin has been rare. Adverse reactions similar to those seen with normal doses can be expected, however, unexpected reactions could occur. Haemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Overdosage should be treated with simple gastric lavage. No specific antidote is known.
ReconstitutionView
Direction for reconstitution (powder for oral solution): Shake the bottle well to loosen the powder. Add 80 ml of boiled and cooled water to the dry mixture in the bottle. For ease of preparation, add water to the bottle in two proportions. Shake well after each addition until all the powder is in solution. Keep the bottle tightly closed. The reconstituted solution should be used within 2 weeks if kept at room temperature.
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
- Administration of more than 1200 mg in a single 1 hour infusion is not recommended.
- Single IM injections of greater than 600 mg are not recommended. Dilution is not required for intramuscular administration.
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
- Room temperature: 16 days at 25°C.
- Refrigeration: 32 days at 4°C.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinamycin
Clindamycin
Cinamycin
Clindamycin
Indications
Toxic shock syndrome
Indication detailsView
Clindamycin has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci; Upper respiratory infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.
Therapeutic classView
Macrolides
DosageView
Dosage of Clindamycin Capsule:
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
Dosage of Clindamycin IV/IM Injection:
Adults-
Pediatric patients (1 month of age to 16 years):
- Serious Infections: 150 mg-300 mg every six hours.
- More severe infections: 300 mg-450 mg every six hours.
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
- Serious infections: 8-12 mg/kg/day divided into 3 or 4 equal doses.
- Severe infections: 13-16 mg/kg/day divided into 3 or 4 equal doses.
- More severe infections: 17-25 mg/kg/day divided into 3 or 4 equal doses.
Dosage of Clindamycin IV/IM Injection:
Adults-
- Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600-1200 mg/day in 2- 4 equal doses.
- More severe infections: 1200-2700 mg/day in 2-4 equal doses.
- For more serious infections: these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes, these doses may be increased.
- Doses of as much as 4800 mg daily have been given intravenously to adults. Single intramuscular injections of greater than 600 mg are not recommended.
Pediatric patients (1 month of age to 16 years):
- 20 to 40 mg/kg/day in 3 or 4 equal doses. The higher doses would be used for more severe infections.
- Parenteral therapy may be changed to Capsules (clindamycin hydrochloride) when the condition warrants and at the discretion of the physician.
- In cases of (3-hemolytic streptococcal infections, treatment should be continued for at least 10 days.
Side effectsView
The adverse effects have been reported with the use of clindamycin are- abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhoea, pruritus, skin rashes, urticaria.
ContraindicationsView
Clindamycin is contraindicated in patients previously found to be sensitive to clindamycin or any of the ingredients of this medicine.
PrecautionsView
Clindamycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
InteractionsView
Clindamycin enhances the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Antagonism has been demonstrated between clindamycin and erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.
Pregnancy & lactationView
Pregnancy Category B. Clindamycin crosses the placenta in humans. After multiple doses, amniotic fluid concentrations were approximately 30% of maternal concentrations. Clindamycin should be used in pregnancy only if clearly needed. Clindamycin has been reported to appear in breast milk. Therefore, it is not recommended for nursing mothers if not clearly needed.
Pediatric usageView
Use in newborns and infants: When Clindamycin is administered to newborns and infants (birth to 16 years), appropriate monitoring of organ system functions is desirable.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Overdose effectsView
Overdosage with orally administered clindamycin has been rare. Adverse reactions similar to those seen with normal doses can be expected, however, unexpected reactions could occur. Haemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Overdosage should be treated with simple gastric lavage. No specific antidote is known.
ReconstitutionView
Direction for reconstitution (powder for oral solution): Shake the bottle well to loosen the powder. Add 80 ml of boiled and cooled water to the dry mixture in the bottle. For ease of preparation, add water to the bottle in two proportions. Shake well after each addition until all the powder is in solution. Keep the bottle tightly closed. The reconstituted solution should be used within 2 weeks if kept at room temperature.
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
- Administration of more than 1200 mg in a single 1 hour infusion is not recommended.
- Single IM injections of greater than 600 mg are not recommended. Dilution is not required for intramuscular administration.
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
- Room temperature: 16 days at 25°C.
- Refrigeration: 32 days at 4°C.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinamycin
Clindamycin
Cinamycin
Clindamycin
Indications
Toxic shock syndrome
Indication detailsView
Clindamycin has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci; Upper respiratory infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.
Therapeutic classView
Macrolides
DosageView
Dosage of Clindamycin Capsule:
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
Dosage of Clindamycin IV/IM Injection:
Adults-
Pediatric patients (1 month of age to 16 years):
- Serious Infections: 150 mg-300 mg every six hours.
- More severe infections: 300 mg-450 mg every six hours.
Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.
Dosage of Clindamycin Powder for oral solution:
- Serious infections: 8-12 mg/kg/day divided into 3 or 4 equal doses.
- Severe infections: 13-16 mg/kg/day divided into 3 or 4 equal doses.
- More severe infections: 17-25 mg/kg/day divided into 3 or 4 equal doses.
Dosage of Clindamycin IV/IM Injection:
Adults-
- Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600-1200 mg/day in 2- 4 equal doses.
- More severe infections: 1200-2700 mg/day in 2-4 equal doses.
- For more serious infections: these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes, these doses may be increased.
- Doses of as much as 4800 mg daily have been given intravenously to adults. Single intramuscular injections of greater than 600 mg are not recommended.
Pediatric patients (1 month of age to 16 years):
- 20 to 40 mg/kg/day in 3 or 4 equal doses. The higher doses would be used for more severe infections.
- Parenteral therapy may be changed to Capsules (clindamycin hydrochloride) when the condition warrants and at the discretion of the physician.
- In cases of (3-hemolytic streptococcal infections, treatment should be continued for at least 10 days.
Side effectsView
The adverse effects have been reported with the use of clindamycin are- abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhoea, pruritus, skin rashes, urticaria.
ContraindicationsView
Clindamycin is contraindicated in patients previously found to be sensitive to clindamycin or any of the ingredients of this medicine.
PrecautionsView
Clindamycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
InteractionsView
Clindamycin enhances the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Antagonism has been demonstrated between clindamycin and erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.
Pregnancy & lactationView
Pregnancy Category B. Clindamycin crosses the placenta in humans. After multiple doses, amniotic fluid concentrations were approximately 30% of maternal concentrations. Clindamycin should be used in pregnancy only if clearly needed. Clindamycin has been reported to appear in breast milk. Therefore, it is not recommended for nursing mothers if not clearly needed.
Pediatric usageView
Use in newborns and infants: When Clindamycin is administered to newborns and infants (birth to 16 years), appropriate monitoring of organ system functions is desirable.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Geriatric use: Dose adjustment of Clindamycin is not necessary.
Overdose effectsView
Overdosage with orally administered clindamycin has been rare. Adverse reactions similar to those seen with normal doses can be expected, however, unexpected reactions could occur. Haemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Overdosage should be treated with simple gastric lavage. No specific antidote is known.
ReconstitutionView
Direction for reconstitution (powder for oral solution): Shake the bottle well to loosen the powder. Add 80 ml of boiled and cooled water to the dry mixture in the bottle. For ease of preparation, add water to the bottle in two proportions. Shake well after each addition until all the powder is in solution. Keep the bottle tightly closed. The reconstituted solution should be used within 2 weeks if kept at room temperature.
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
Dilution of Clindamycin injection for intravenous use: Clindamycin phosphate must be diluted prior to IV administration. The concentration of clindamycin in diluent for infusion should not exceed 18 mg per ml. Infusion rates should not exceed 30 mg per minute.
- Administration of more than 1200 mg in a single 1 hour infusion is not recommended.
- Single IM injections of greater than 600 mg are not recommended. Dilution is not required for intramuscular administration.
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Physico-Chemical Stability of diluted solutions of Clindacin Injection-
- Room temperature: 16 days at 25°C.
- Refrigeration: 32 days at 4°C.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinamycin Plus
Clindamycin + Tretinoin
Cinamycin Plus
Clindamycin + Tretinoin
Indications
Acne vulgaris
Indication detailsView
Clindamycin and Tretinoin gel is indicated for the topical treatment of Acne vulgaris.
Therapeutic classView
Topical antibiotic & retinoid preparations
PharmacologyView
This is a combination of lincosamide antibiotic Clindamycin phosphate and retinoid Tretinoin. Clindamycin binds with the 50s ribosomal subunit of susceptible bacteria and prevents elongation of peptide chain by interfering with the peptidyl transfer, thereby suppressing bacterial protein synthesis. Clindamycin inhibits the activity of Propionibacterium acne as reduces the occurrence of acne. Tretinoin decreases the cohesiveness of follicular epithelial cells and increases the turn over thereby brings the comedones out.
DosageView
Before sleep: Wash the face gently with a mild soap and water, then pat the skin dry. Apply the Gel with finger tips through the face gently.
In the morning: Apply a sunscreen after the application of Gel. Do not wash your face more than 2 or 3 times a day. Apply the sunscreen cream as needed.
Safety and effectiveness in children below 12 years of age have not been established.
In the morning: Apply a sunscreen after the application of Gel. Do not wash your face more than 2 or 3 times a day. Apply the sunscreen cream as needed.
Safety and effectiveness in children below 12 years of age have not been established.
Side effectsView
Erythema, scaling, nasopharyngitis, dry skin, cough, sinusitis and diarrhea are the common side effects.
ContraindicationsView
Clindamycin and Tretinoin should not be administered to individuals who are hypersensitive to Clindamycin or Tretinoin or any other component of the Gel.
PrecautionsView
Clindamycin and Tretinoin should not be applied to eyes, nose, ear, lips, cut, burn and other infections. After the application of the Gel, keep away from sunlight.
InteractionsView
- Concomitant use of other potentially irritating topical products (medicated or abrasive soaps and cleansers, soaps and cosmetics that have a strong drying effect, products with high concentrations of alcohol, astringents, spices or lime) should be approached with caution.
- While using concomitantly with Erythromycin, the activity of both Clindamycin and Erythromycin are decreased. So, Clindamycin should not be used with Erythromycin concomitantly.
- While using concomitantly with neuromuscular medicine, the activity of the neuromuscular medicine is increased. So, care should be taken during these concomitant uses.
Pregnancy & lactationView
It is not known whether Clindamycin or Tretinoin is excreted in human milk. Exercise special caution while applying Clindamycin or Tretinoin to a nursing mother.
StorageView
Keep below 25°C temperature, away from light & moisture. Keep out of the reach of children.
Cinarex
Tobramycin (Ophthalmic)
Cinarex
Tobramycin (Ophthalmic)
Indications
Ocular infections
Indication detailsView
Tobramycin is a topical antibiotic indicated in the treatment of external bacterial infections of the eye caused by susceptible organisms. Such as,
Gram-positive bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus spp. of group A beta-hemolytic and some nonhemolytic species.
Gram-negative bacteria: E.coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella spp., Proteusmirabillis, Proteus vulgaris, Haemophilus influenzae, Morganella morganii, Acinetobacter calcoaceticus, Providentia, Serratia, Salmonella spp and some strains of Neisseria.
Gram-positive bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus spp. of group A beta-hemolytic and some nonhemolytic species.
Gram-negative bacteria: E.coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella spp., Proteusmirabillis, Proteus vulgaris, Haemophilus influenzae, Morganella morganii, Acinetobacter calcoaceticus, Providentia, Serratia, Salmonella spp and some strains of Neisseria.
Therapeutic classView
Ophthalmic antibacterial drugs
PharmacologyView
Like other aminoglycosides, the bactericidal activity of Tobramycin is taken up into sensitive bacterial cells by an active transport process. Within the cell Tobramycin bind to the 30s, and to some extent to the 50s subunits of the bacterial ribosome, inhibiting protein synthesis and generating errors in the transcription of the genetic code. The manner in which cell death is brought about is imperfectly understood, and other mechanisms may contribute, including effects on membrane permeability.
DosageView
Ophthalmic ointment:
- In mild to moderate infection, apply a small amount 2-3 times daily into the conjunctival sac(s).
- In severe cases of infection, apply a small amount 3-4 times daily into the conjunctival sac(s) until improvement is obtained, then reduce the dose gradually.
- In mild to moderate infections: Instill 1or 2 drops into the affected eye(s) every 4 hours.
- In severe infections: Instill 2 drops into the affected eye(s) every hour until improvement is observed.
Side effectsView
The most frequent side effect of Tobramycin ophthalmic solution is localized ocular toxicity, conjunctival erythema, hypersensitivity including lid itching and swelling.
ContraindicationsView
It is contraindicated in patients who are hypersensitive to Tobramycin or any of the ingredients of the preparation.
PrecautionsView
Minor sensitivity may occur to topically applied aminoglycosides in some patients. If a sensitivity reaction occurs, discontinue use. Prolonged use may result in overgrowth of nonsusceptible organisms and fungi.
InteractionsView
Care should be exercised when tobramycin is given to patients receiving other drugs with neuromauscular blocking agents or ototoxic.
Pregnancy & lactationView
Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should only be used during pregnancy, if the potential benefits outweigh the possible risk to the fetus. Drug may excreted into human milk. A decision should be made whether to discontinue nursing or to taking the drug.
Overdose effectsView
Sign and symptoms of overdose may be similar to side effects as described above.
StorageView
Protect from light, store in cool (below 25°C) & dry place. Keep out of reach of children. Used within 4 weeks after first opening.
Cinarex D
Dexamethasone + Tobramycin
Cinarex D
Dexamethasone + Tobramycin
Indications
Pink eye
Indication detailsView
This sterile Eye Suspension is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or a risk of bacterial ocular infection exists.
Therapeutic classView
Ophthalmic steroid - antibiotic combined preparations
PharmacologyView
Like other amino-glycosides, the bactericidal activity of Tobramycin is accomplished by specific inhibition of normal protein synthesis in susceptible bacteria, but at the present time, very little is known about this action. It is thought that inhibition of protein synthesis is due to an action on ribosome that causes bacterial misreading of messenger RNA. The action of Dexamethasone is to inhibit the phospholipase A2, the first step in prostaglandin synthesis. Also Dexamethasone inhibits the chemo-tactic infiltration of neutrophils into the site of inflammation. The result is that its anti-inflammatory activity is 25 times greater and its overall therapeutic effectiveness 8-10 times greater than that of hydrocortisone.
DosageView
Insert 1 drop into the conjunctival sac 3-5 times per day. During the initial 24 to 48 hours, the dosage may be increased to 1 drop every 2 hours.
Side effectsView
The most frequent side effects to topical ocular Tobramycin are localized ocular toxicity and hypersensitivity, including lid itching and swelling and conjuntival erythema. The reactions due to the steroid component are elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsule cataract formation.
ContraindicationsView
Epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella and other viral disease of the cornea and conjunctiva. Mycobacterial infections of the eye caused by, but not limited to, acid-fast bacilli such as Mycobacterium tuberculosis, Mycobacterium leprae, or Mycobacterium avium. Fungal diseases of ocular structures. Untreated purulent infection of the eye. Hypersensitivity to any component of the medication.
PrecautionsView
Shake the bottle well before use. To prevent contamination do not touch the tip of the bottle to affected eye, eyelid or any surface of of the affected eye. Keep the bottle tightly closed after use.
InteractionsView
No specific interaction studies were performed with this combination eye drops. In case of concomitant therapy with other topical ophthalmic medicines, an interval of 10 minutes should be allowed between successive applications.
Pregnancy & lactationView
Safety for use during pregnancy and lactation in humans has not been established
Pediatric usageView
Use in paediatric: Safety and effectiveness in paediatric patients below 2 years have not been established.
Overdose effectsView
Overdose of this eye drops may be flushed from the eye(s) with lukewarm tap water.
StorageView
Store at room temperature. Close the bottle immediately after use. Do not use for longer than one month after opening the bottle.
Cinarin
Cinnarizine
Cinarin
Cinnarizine
Indications
Vertigo
Indication detailsView
It is mainly used for the symptomatic treatment of nausea and vertigo due to Meniere's disease and other labyrinthine disturbances and for the prevention and treatment of motion sickness. It is also used in the management of various vascular disorders.
Cerebral circulatory disorders:
Disorders of balance:
Cerebral circulatory disorders:
- Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.
- Sequel of cerebral and cranial trauma.
- Post-apoplectic disorders.
- Migraine.
Disorders of balance:
- Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis, vestibular irritability, Meniere's syndrome, such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.
- Prophylaxis of motion sickness.
Therapeutic classView
Anti vertigo drugs
PharmacologyView
Cinnarizine acts as an antihistamine, labyrinthine sedative and a peripheral antivasoconstrictor. Cinnarizine is a selective calcium antagonist, inhibiting the influx of Ca2+ intracellularly. It prevents the Ca2+ dependent contraction of arterial smooth muscle by inhibiting Ca2+ influx through smooth muscle calcium channels and thereby, improves vestibular symptoms and prevents peripheral arterial disease
DosageView
Usual adult dose: 15 to 30 mg three times daily.
Children (5 to 12 years): Half of the adult dose.
Motion sickness: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.
Peripheral arterial diseases: 75 mg two or three times daily.
Children (5 to 12 years): Half of the adult dose.
Motion sickness: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.
Peripheral arterial diseases: 75 mg two or three times daily.
Side effectsView
Side effects such as somnolence and gastrointestinal disturbances are extremely rare. They are transient and may be readily prevented by achieving the optimal dosage gradually. Allergic skin reactions and fatigue have been reported on rare occasions. An aggravation or appearance of extrapyramidal symptoms has been reported extremely rarely in elderly people during prolonged therapy. The treatment should be reduced or stopped in such cases.
ContraindicationsView
There are no specific contraindications. It has been found to decrease blood pressure significantly. However, the drug should be used with reasonable caution in hypotensive patients.
PrecautionsView
Cinnarizine may cause drowsiness; patients affected in this way should not drive or operate machinery. Avoid alcoholic drink.
InteractionsView
No drug interactions have been seen with Cinnarizine when administered concomitantly with antihypertensives, diuretics, anticoagulants or hypoglycaemics.
Pregnancy & lactationView
The safety of Cinnarizine in human pregnancy has not been established although studies in animals have not demonstrated teratogenic effects. Therefore, it is not advisable to administer Cinnarizine in pregnancy
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinaron
Cinnarizine
Cinaron
Cinnarizine
Indications
Vertigo
Indication detailsView
It is mainly used for the symptomatic treatment of nausea and vertigo due to Meniere's disease and other labyrinthine disturbances and for the prevention and treatment of motion sickness. It is also used in the management of various vascular disorders.
Cerebral circulatory disorders:
Disorders of balance:
Cerebral circulatory disorders:
- Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.
- Sequel of cerebral and cranial trauma.
- Post-apoplectic disorders.
- Migraine.
Disorders of balance:
- Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis, vestibular irritability, Meniere's syndrome, such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.
- Prophylaxis of motion sickness.
Therapeutic classView
Anti vertigo drugs
PharmacologyView
Cinnarizine acts as an antihistamine, labyrinthine sedative and a peripheral antivasoconstrictor. Cinnarizine is a selective calcium antagonist, inhibiting the influx of Ca2+ intracellularly. It prevents the Ca2+ dependent contraction of arterial smooth muscle by inhibiting Ca2+ influx through smooth muscle calcium channels and thereby, improves vestibular symptoms and prevents peripheral arterial disease
DosageView
Usual adult dose: 15 to 30 mg three times daily.
Children (5 to 12 years): Half of the adult dose.
Motion sickness: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.
Peripheral arterial diseases: 75 mg two or three times daily.
Children (5 to 12 years): Half of the adult dose.
Motion sickness: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.
Peripheral arterial diseases: 75 mg two or three times daily.
Side effectsView
Side effects such as somnolence and gastrointestinal disturbances are extremely rare. They are transient and may be readily prevented by achieving the optimal dosage gradually. Allergic skin reactions and fatigue have been reported on rare occasions. An aggravation or appearance of extrapyramidal symptoms has been reported extremely rarely in elderly people during prolonged therapy. The treatment should be reduced or stopped in such cases.
ContraindicationsView
There are no specific contraindications. It has been found to decrease blood pressure significantly. However, the drug should be used with reasonable caution in hypotensive patients.
PrecautionsView
Cinnarizine may cause drowsiness; patients affected in this way should not drive or operate machinery. Avoid alcoholic drink.
InteractionsView
No drug interactions have been seen with Cinnarizine when administered concomitantly with antihypertensives, diuretics, anticoagulants or hypoglycaemics.
Pregnancy & lactationView
The safety of Cinnarizine in human pregnancy has not been established although studies in animals have not demonstrated teratogenic effects. Therefore, it is not advisable to administer Cinnarizine in pregnancy
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinaron Plus
Cinnarizine + Dimenhydrinate
Cinaron Plus
Cinnarizine + Dimenhydrinate
Indications
Vertigo
Indication detailsView
Cerebral circulatory disorders:
Disorders of balance:
- Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as: dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.
- Sequelae of cerebral and cranial trauma.
- Postapoplectic disorders.
- Migraine.
Disorders of balance:
- Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis; vestibular irritability; Meniere's syndrome such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.
- Prophylaxis of motion sickness.
Therapeutic classView
Anti vertigo drugs
PharmacologyView
This contains two active ingredients Cinnarizine and Dimenhydrinate. The two substances belong to different groups of medicines. Cinnarizine is part of a group called calcium antagonists. Dimenhydrinate belongs to a group called antihistamines. Both substances work by reducing symptoms of vertigo (a feeling of dizziness or spinning) and nausea (feeling sick). The combination product is more effective than the individual compounds.
DosageView
Adults: 1 tablet three times daily, to be taken after meals. Children and
adolescents under the age of 18 years: Not recommended
Elderly: Dosage as for adults.
adolescents under the age of 18 years: Not recommended
Elderly: Dosage as for adults.
Side effectsView
Drowsiness, dry mouth, headache, and stomach pain may occur. Rare side effects are impaired vision, allergic reactions, light sensitivity, and difficulty in urinating. Other possible reactions which may occur: weight gain, constipation, tightness of the chest, jaundice, worsening of angle-closure glaucoma, uncontrollable movements, unusual excitement and restlessness, severe skin reactions.
ContraindicationsView
Cinnarizine and Dimenhydrinate should not be used by patients with severe hepatic impairment. Cinnarizine and Dimenhydrinate is contra-indicated in patients with known hypersensitivity to the active substances or to any of the excipients. Cinnarizine and Dimenhydrinate should not be used in patients with angle-closure glaucoma, convulsions, suspicion of raised intracranial pressure, and alcohol abuse or urine retention due to urethroprostatic disorders.
PrecautionsView
Cinnarizine and Dimenhydrinate do not reduce blood pressure significantly; however, it should be used with caution in hypotensive patients. Cinnarizine and Dimenhydrinate should be taken after meals to minimize any gastric irritation. Caution should be exercised when administering Cinnarizine and Dimenhydrinate to patients with Parkinson’s disease.
InteractionsView
Concurrent use of alcohol, CNS depressants or tricyclic antidepressants may potentiate the sedative effects of either these drugs or of Cinnarizine and Dimenhydrinate. Therefore, it is advisable to avoid these drugs while taking Cinnarizine and Dimenhydrinate.
Pregnancy & lactationView
Dimenhydrinate and cinnarizine should not be used during pregnancy and lactation.
Overdose effectsView
Drowsiness, dizziness and ataxia with anticholinergic effects such as dry mouth, flushing of the face, dilated pupils, tachycardia, pyrexia, headache and urinary retention. General supportive measures should be used to treat respiratory insufficiency or circulatory failure. Gastric lavage with isotonic sodium chloride solution is recommended.
StorageView
Store in a cool (below 30°C) and dry place. Keep away from light and out of reach of children.
Cinaryl
Cinnarizine
Cinaryl
Cinnarizine
Indications
Vertigo
Indication detailsView
It is mainly used for the symptomatic treatment of nausea and vertigo due to Meniere's disease and other labyrinthine disturbances and for the prevention and treatment of motion sickness. It is also used in the management of various vascular disorders.
Cerebral circulatory disorders:
Disorders of balance:
Cerebral circulatory disorders:
- Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.
- Sequel of cerebral and cranial trauma.
- Post-apoplectic disorders.
- Migraine.
Disorders of balance:
- Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis, vestibular irritability, Meniere's syndrome, such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.
- Prophylaxis of motion sickness.
Therapeutic classView
Anti vertigo drugs
PharmacologyView
Cinnarizine acts as an antihistamine, labyrinthine sedative and a peripheral antivasoconstrictor. Cinnarizine is a selective calcium antagonist, inhibiting the influx of Ca2+ intracellularly. It prevents the Ca2+ dependent contraction of arterial smooth muscle by inhibiting Ca2+ influx through smooth muscle calcium channels and thereby, improves vestibular symptoms and prevents peripheral arterial disease
DosageView
Usual adult dose: 15 to 30 mg three times daily.
Children (5 to 12 years): Half of the adult dose.
Motion sickness: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.
Peripheral arterial diseases: 75 mg two or three times daily.
Children (5 to 12 years): Half of the adult dose.
Motion sickness: A dose of 30 mg two hours before the start of the journey and 15 mg every 8 hours during the journey.
Peripheral arterial diseases: 75 mg two or three times daily.
Side effectsView
Side effects such as somnolence and gastrointestinal disturbances are extremely rare. They are transient and may be readily prevented by achieving the optimal dosage gradually. Allergic skin reactions and fatigue have been reported on rare occasions. An aggravation or appearance of extrapyramidal symptoms has been reported extremely rarely in elderly people during prolonged therapy. The treatment should be reduced or stopped in such cases.
ContraindicationsView
There are no specific contraindications. It has been found to decrease blood pressure significantly. However, the drug should be used with reasonable caution in hypotensive patients.
PrecautionsView
Cinnarizine may cause drowsiness; patients affected in this way should not drive or operate machinery. Avoid alcoholic drink.
InteractionsView
No drug interactions have been seen with Cinnarizine when administered concomitantly with antihypertensives, diuretics, anticoagulants or hypoglycaemics.
Pregnancy & lactationView
The safety of Cinnarizine in human pregnancy has not been established although studies in animals have not demonstrated teratogenic effects. Therefore, it is not advisable to administer Cinnarizine in pregnancy
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Cinaryl Plus
Cinnarizine + Dimenhydrinate
Cinaryl Plus
Cinnarizine + Dimenhydrinate
Indications
Vertigo
Indication detailsView
Cerebral circulatory disorders:
Disorders of balance:
- Prophylaxis and maintenance therapy for symptoms of cerebral vascular spasms and arteriosclerosis such as: dizziness, ear buzzing (tinnitus), vascular headache, unsociability and irritability, fatigue, sleep rhythm disorders such as premature awakening, involutional depressions, loss of memory and lack of concentration, incontinence and other disorders due to aging.
- Sequelae of cerebral and cranial trauma.
- Postapoplectic disorders.
- Migraine.
Disorders of balance:
- Prophylaxis and maintenance therapy for symptoms of labyrinthine arteriosclerosis; vestibular irritability; Meniere's syndrome such as vertigo, dizziness, giddiness, syncopal attacks, tinnitus, nystagmus, nausea and vomiting.
- Prophylaxis of motion sickness.
Therapeutic classView
Anti vertigo drugs
PharmacologyView
This contains two active ingredients Cinnarizine and Dimenhydrinate. The two substances belong to different groups of medicines. Cinnarizine is part of a group called calcium antagonists. Dimenhydrinate belongs to a group called antihistamines. Both substances work by reducing symptoms of vertigo (a feeling of dizziness or spinning) and nausea (feeling sick). The combination product is more effective than the individual compounds.
DosageView
Adults: 1 tablet three times daily, to be taken after meals. Children and
adolescents under the age of 18 years: Not recommended
Elderly: Dosage as for adults.
adolescents under the age of 18 years: Not recommended
Elderly: Dosage as for adults.
Side effectsView
Drowsiness, dry mouth, headache, and stomach pain may occur. Rare side effects are impaired vision, allergic reactions, light sensitivity, and difficulty in urinating. Other possible reactions which may occur: weight gain, constipation, tightness of the chest, jaundice, worsening of angle-closure glaucoma, uncontrollable movements, unusual excitement and restlessness, severe skin reactions.
ContraindicationsView
Cinnarizine and Dimenhydrinate should not be used by patients with severe hepatic impairment. Cinnarizine and Dimenhydrinate is contra-indicated in patients with known hypersensitivity to the active substances or to any of the excipients. Cinnarizine and Dimenhydrinate should not be used in patients with angle-closure glaucoma, convulsions, suspicion of raised intracranial pressure, and alcohol abuse or urine retention due to urethroprostatic disorders.
PrecautionsView
Cinnarizine and Dimenhydrinate do not reduce blood pressure significantly; however, it should be used with caution in hypotensive patients. Cinnarizine and Dimenhydrinate should be taken after meals to minimize any gastric irritation. Caution should be exercised when administering Cinnarizine and Dimenhydrinate to patients with Parkinson’s disease.
InteractionsView
Concurrent use of alcohol, CNS depressants or tricyclic antidepressants may potentiate the sedative effects of either these drugs or of Cinnarizine and Dimenhydrinate. Therefore, it is advisable to avoid these drugs while taking Cinnarizine and Dimenhydrinate.
Pregnancy & lactationView
Dimenhydrinate and cinnarizine should not be used during pregnancy and lactation.
Overdose effectsView
Drowsiness, dizziness and ataxia with anticholinergic effects such as dry mouth, flushing of the face, dilated pupils, tachycardia, pyrexia, headache and urinary retention. General supportive measures should be used to treat respiratory insufficiency or circulatory failure. Gastric lavage with isotonic sodium chloride solution is recommended.
StorageView
Store in a cool (below 30°C) and dry place. Keep away from light and out of reach of children.