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Specific combined vitamin preparations

Cod Liver Oil is one of the most effective providers of Omega-3 Fatty Acids, and an excellent source of Vitamin A and Vitamin D. It contains Eicosapentaenoic Acid (EPA: 18%) & Docosahexaenoic Acid (DHA: 12%) which are been clinically proven to have positive effects on heart, bone, brain, health. They also help to nourish skin, hair, and nails.

Capsule-

• Adults and children over 6 years: Take 1-2 capsule(s) 3 times a day with meals, or as professionally prescribed.
• Children under 6 years: Only as professionally prescribed.
• Pregnant and lactating women: Take 1 capsule 3 times a day with meals.

Emulsion-

• Infant: ½ tsf daily.
• Child (1-4 year): 1 tsf daily
• Child over 4 years: 1.5 tsf daily

Prolonged usage of large amounts can lead to hypervitaminosis symptoms of which include dry mouth, rough skin, painful joints swelling, fatigue, anorexia, loss of weight, vomiting and other gastrointestinal disturbances. These may disappear on discontinuation of supplementation.

Hypervitaminosis of Vitamin A, D or E and hypersensitivity to any of the ingredients in this preparation.

The product has to be protected from light. Liver storage should be adequate before discontinuation of the therapy. Patients with chronic renal failure should be suggested Cod Liver Oil with caution.

The absorption of Cod Liver Oil may be reduced by taking barbiturates or anti-convulsants.

Safety of amounts exceeding 6,000 Units of Vitamin A daily during pregnancy has not been established yet. The recommended daily allowance (RDA) of vitamin A is 5,000
Units for nursing mothers.

When taken in large amounts, Cod Liver Oil can lead to complications including increased risk for hemorrhagic stroke and internal bleeding.

Store in a cool and dry place protected from light and moisture.

Specific combined vitamin preparations

This preparation contains 8 essential vitamins with Cod Liver Oil. This provides extra protection for the children. It ensures for getting enough vitamins for children that help them to be grown up strong & stay healthy. Cod Liver Oil contains Vitamin A, Vitamin D, EPA & DHA. Vitamin A is essential for the immune system, bone growth, night vision, cellular growth, testicular and ovarian function, Vitamin D is essential for the absorption and utilization of calcium, which is also required for skeletal growth. EPA and DHA; omega-3 fatty acids, which are converted in the body to produce prostaglandins that affect a wide variety of physiological processes due to their modulating effect on the action of hormones. Omega-3 fatty acids relieve the symptoms of osteoarthritis, rheumatoid arthritis which also enhances immune function and promotes healthy blood circulation. It is thought that EPA and DHA may reduce the risk of coronary heart disease. DHA seems essential for normal brain development in unborn babies.

1-12 Months: 2.5 ml (½ teaspoon) daily
1-4 Years: 5 ml (1 teaspoon) daily
4 years up: 7.5 ml (1½ teaspoon) daily
Adult: 10 ml (2 teaspoons) daily.

This syrup can be taken with water or milk.

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

This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.

This medicine may accumulate in the body. So, should not be taken in overdose.

Some drug interaction may occur with- Erythromycin, Conjugated estrogens, Sodium bicarbonate, Chloramphenicol etc.

Should be taken on physician's advice.

Keep in cool and dry place and away from light. Keep away from children

Multi-vitamin & Multi-mineral combined preparations, Specific mineral & vitamin combined preparations

Vitamins and minerals are essential for normal metabolic functions including hematopoiesis. The members of vitamin B-group are components of enzyme system that regulate various stages of carbohydrate, fat and protein metabolism, each of the components playing a specific biological role. Vitamin C is involved in tissue repair and collagen formation. Vitamin A plays an essential role in the function of retina and is essential for growth and differentiation of epithelial tissue. Vitamin E is an antioxidant which preserves essential cellular constituents. Vitamin D is supplemented for prevention and cure of nutritional and metabolic rickets and for treatment of hypoparathyroidism. Iron, Copper, Manganese, Zinc serve as catalysts in enzyme systems which perform vital cellular functions.

Orally one tablet daily for adult and children over 5 years of age or as directed by the physicians.

Side effects have been reported with specific vitamins & minerals, but at level substantially higher than those in this tablet. Iron has been associated with gastrointestinal intolerance in some patients.

This is contraindicated in patients hypersensitive to any of its components. This is not intended for treatment of severe specific deficiencies of vitamins or minerals. It is not recommended for patients undergoing treatment with levodopa as pyridoxine decreases the efficacy of levodopa. During the first trimester of pregnancy, larger doses of vitamin A (more than 10 tablets per day) may be teratogenic.

Not intended for treatment of pernicious anemia or other megaloblastic anemia where vitamin B12 is deficient.

During the first trimester of pregnancy, recommended daily dose should not be exceeded. Because larger doses of Vitamin-A (multiple tablets per day) may be teratogenic.

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

Specific combined vitamin preparations

This preparation contains 8 essential vitamins with Cod Liver Oil. This provides extra protection for the children. It ensures for getting enough vitamins for children that help them to be grown up strong & stay healthy. Cod Liver Oil contains Vitamin A, Vitamin D, EPA & DHA. Vitamin A is essential for the immune system, bone growth, night vision, cellular growth, testicular and ovarian function, Vitamin D is essential for the absorption and utilization of calcium, which is also required for skeletal growth. EPA and DHA; omega-3 fatty acids, which are converted in the body to produce prostaglandins that affect a wide variety of physiological processes due to their modulating effect on the action of hormones. Omega-3 fatty acids relieve the symptoms of osteoarthritis, rheumatoid arthritis which also enhances immune function and promotes healthy blood circulation. It is thought that EPA and DHA may reduce the risk of coronary heart disease. DHA seems essential for normal brain development in unborn babies.

1-12 Months: 2.5 ml (½ teaspoon) daily
1-4 Years: 5 ml (1 teaspoon) daily
4 years up: 7.5 ml (1½ teaspoon) daily
Adult: 10 ml (2 teaspoons) daily.

This syrup can be taken with water or milk.

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

This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.

This medicine may accumulate in the body. So, should not be taken in overdose.

Some drug interaction may occur with- Erythromycin, Conjugated estrogens, Sodium bicarbonate, Chloramphenicol etc.

Should be taken on physician's advice.

Keep in cool and dry place and away from light. Keep away from children

Specific combined vitamin preparations

Cod Liver Oil is one of the most effective providers of Omega-3 Fatty Acids, and an excellent source of Vitamin A and Vitamin D. It contains Eicosapentaenoic Acid (EPA: 18%) & Docosahexaenoic Acid (DHA: 12%) which are been clinically proven to have positive effects on heart, bone, brain, health. They also help to nourish skin, hair, and nails.

Capsule-

• Adults and children over 6 years: Take 1-2 capsule(s) 3 times a day with meals, or as professionally prescribed.
• Children under 6 years: Only as professionally prescribed.
• Pregnant and lactating women: Take 1 capsule 3 times a day with meals.

Emulsion-

• Infant: ½ tsf daily.
• Child (1-4 year): 1 tsf daily
• Child over 4 years: 1.5 tsf daily

Prolonged usage of large amounts can lead to hypervitaminosis symptoms of which include dry mouth, rough skin, painful joints swelling, fatigue, anorexia, loss of weight, vomiting and other gastrointestinal disturbances. These may disappear on discontinuation of supplementation.

Hypervitaminosis of Vitamin A, D or E and hypersensitivity to any of the ingredients in this preparation.

The product has to be protected from light. Liver storage should be adequate before discontinuation of the therapy. Patients with chronic renal failure should be suggested Cod Liver Oil with caution.

The absorption of Cod Liver Oil may be reduced by taking barbiturates or anti-convulsants.

Safety of amounts exceeding 6,000 Units of Vitamin A daily during pregnancy has not been established yet. The recommended daily allowance (RDA) of vitamin A is 5,000
Units for nursing mothers.

When taken in large amounts, Cod Liver Oil can lead to complications including increased risk for hemorrhagic stroke and internal bleeding.

Store in a cool and dry place protected from light and moisture.

Specific combined vitamin preparations

This preparation contains 8 essential vitamins with Cod Liver Oil. This provides extra protection for the children. It ensures for getting enough vitamins for children that help them to be grown up strong & stay healthy. Cod Liver Oil contains Vitamin A, Vitamin D, EPA & DHA. Vitamin A is essential for the immune system, bone growth, night vision, cellular growth, testicular and ovarian function, Vitamin D is essential for the absorption and utilization of calcium, which is also required for skeletal growth. EPA and DHA; omega-3 fatty acids, which are converted in the body to produce prostaglandins that affect a wide variety of physiological processes due to their modulating effect on the action of hormones. Omega-3 fatty acids relieve the symptoms of osteoarthritis, rheumatoid arthritis which also enhances immune function and promotes healthy blood circulation. It is thought that EPA and DHA may reduce the risk of coronary heart disease. DHA seems essential for normal brain development in unborn babies.

1-12 Months: 2.5 ml (½ teaspoon) daily
1-4 Years: 5 ml (1 teaspoon) daily
4 years up: 7.5 ml (1½ teaspoon) daily
Adult: 10 ml (2 teaspoons) daily.

This syrup can be taken with water or milk.

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

This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.

This medicine may accumulate in the body. So, should not be taken in overdose.

Some drug interaction may occur with- Erythromycin, Conjugated estrogens, Sodium bicarbonate, Chloramphenicol etc.

Should be taken on physician's advice.

Keep in cool and dry place and away from light. Keep away from children

This is indicated for the symptomatic relief of upper respiratory tract disorders accompanied by productive cough which benefits from the administration of a nasal decongestant, a histamine H1 receptor antagonist and an expectorant combination.

Combined cough expectorants

Pseudoephedrine is a decongestant as well as a bronchodilator for the upper respiratory tract, which gives symptomatic relief of nasal congestion. Pseudoephedrine is both an α-and β-adrenergic receptor agonist. It causes vasoconstriction via direct stimulation of α-adrenergic receptors of the respiratory mucosa. It also directly stimulates β-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility.

Like ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect. This is its main and direct mechanism of action. The displaced noradrenaline is released into the neuronal synapse where it is free to activate the postsynaptic adrenergic receptors.

Guaifenesin reduces the viscosity of tenacious sputum and is used as an expectorant. It increases the hydration of respiratory tract, thereby increasing the volume and reducing the viscosity of bronchial secretions.

Triprolidine is an antihistamine; it is used for the symptomatic relief of hypersensitivity reactions including rhinitis, conjunctivitis and urticaria.

Adult and Children over 12 years: 10 ml (2 teaspoonful) three times a day.
Children 6-12 years: 5 ml (1 teaspoonful) three times a day.
Children 2-5 years: 2.5 ml (1/2 teaspoonful) three times a day.

A physician’s advice is preferred before administering this preparation to children aged less than 2 years.

CNS depression or excitation, drowsiness (reported most frequently), sleep disturbances, hallucinations (rarely reported), skin rashes with or without irritation, tachycardia, dryness of mouth, nose and throat have occasionally been reported.

This is contraindicated in the cases of known hypersensitivity to any of its constituents, cardiovascular disease including hypertension, lower respiratory symptoms including asthma, monoamine oxidase inhibitor (MAOI) therapy.

As with any other antihistamine therapy, Pseudoephedrine, guaiphenasine & triprolidine may cause drowsiness. If affected, patients should be advised not to drive or operate machinery. Concomitant administration of alcohol or other centrally acting sedatives should be avoided. Although Pseudoephedrine has no pressor effects in normotensive patients but Pseudoephedrine, guaiphenasine & triprolidine should be used with caution to patients suffering from mild to moderate hypertension. Moreover, caution should also be exercised in the following disease conditions - hypertension and heart disease, diabetes, hyperthyroidism, elevated intra-ocular pressure, prostatic enlargement, severe renal and hepatic impairment. This preparation should not be used for persistent or chronic cough, which occurs with smoking, asthma or emphysema or where excessive secretions accompany cough, unless directed by a physician.

Concomitant use of Pseudoephedrine, guaiphenasine & triprolidine with sympathomimetic agents such as decongestants, tricyclic antidepressants, appetite suppressants and amphetamine-like psychostimulants or with monoamine oxidase inhibitors which interfere with the catabolism of sympathomimetic amines may occasionally cause a rise in blood pressure. Because of its pseudoephedrine content, Pseudoephedrine, guaiphenasine & triprolidine partially reverse the hypotensive action of drugs which interfere with sympathetic activity including guanethidine, methyldopa, alpha-adrenergic blocking agents.

Although pseudoephedrine, triprolidine and guaiphenesin have been in widespread use of many years without apparent ill consequence, there are no specific data on their use during pregnancy. Caution should therefore be exercised by balancing the potential benefits of treatment of the mother against any possible hazards to the developing fetus.

The effects of acute toxicity from Pseudoephedrine, guaiphenasine & triprolidine may include drowsiness, irritability, restlessness, lethargy, dizziness, gastrointestinal discomfort, respiratory depression, convulsion, tremor, tachycardia and hypertension. Incase of overdose, necessary measures should be taken to maintain and support respiration and control convulsion. Gastric lavage may be undertaken if indicated. Catheterization of bladder may be necessary.

Store below 25° C. Protect from light. Do not refrigerate.

This is indicated for the symptomatic relief of upper respiratory tract disorders accompanied by productive cough which benefits from the administration of a nasal decongestant, a histamine H1 receptor antagonist and an expectorant combination.

Combined cough expectorants

Pseudoephedrine is a decongestant as well as a bronchodilator for the upper respiratory tract, which gives symptomatic relief of nasal congestion. Pseudoephedrine is both an α-and β-adrenergic receptor agonist. It causes vasoconstriction via direct stimulation of α-adrenergic receptors of the respiratory mucosa. It also directly stimulates β-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility.

Like ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect. This is its main and direct mechanism of action. The displaced noradrenaline is released into the neuronal synapse where it is free to activate the postsynaptic adrenergic receptors.

Guaifenesin reduces the viscosity of tenacious sputum and is used as an expectorant. It increases the hydration of respiratory tract, thereby increasing the volume and reducing the viscosity of bronchial secretions.

Triprolidine is an antihistamine; it is used for the symptomatic relief of hypersensitivity reactions including rhinitis, conjunctivitis and urticaria.

Adult and Children over 12 years: 10 ml (2 teaspoonful) three times a day.
Children 6-12 years: 5 ml (1 teaspoonful) three times a day.
Children 2-5 years: 2.5 ml (1/2 teaspoonful) three times a day.

A physician’s advice is preferred before administering this preparation to children aged less than 2 years.

CNS depression or excitation, drowsiness (reported most frequently), sleep disturbances, hallucinations (rarely reported), skin rashes with or without irritation, tachycardia, dryness of mouth, nose and throat have occasionally been reported.

This is contraindicated in the cases of known hypersensitivity to any of its constituents, cardiovascular disease including hypertension, lower respiratory symptoms including asthma, monoamine oxidase inhibitor (MAOI) therapy.

As with any other antihistamine therapy, Pseudoephedrine, guaiphenasine & triprolidine may cause drowsiness. If affected, patients should be advised not to drive or operate machinery. Concomitant administration of alcohol or other centrally acting sedatives should be avoided. Although Pseudoephedrine has no pressor effects in normotensive patients but Pseudoephedrine, guaiphenasine & triprolidine should be used with caution to patients suffering from mild to moderate hypertension. Moreover, caution should also be exercised in the following disease conditions - hypertension and heart disease, diabetes, hyperthyroidism, elevated intra-ocular pressure, prostatic enlargement, severe renal and hepatic impairment. This preparation should not be used for persistent or chronic cough, which occurs with smoking, asthma or emphysema or where excessive secretions accompany cough, unless directed by a physician.

Concomitant use of Pseudoephedrine, guaiphenasine & triprolidine with sympathomimetic agents such as decongestants, tricyclic antidepressants, appetite suppressants and amphetamine-like psychostimulants or with monoamine oxidase inhibitors which interfere with the catabolism of sympathomimetic amines may occasionally cause a rise in blood pressure. Because of its pseudoephedrine content, Pseudoephedrine, guaiphenasine & triprolidine partially reverse the hypotensive action of drugs which interfere with sympathetic activity including guanethidine, methyldopa, alpha-adrenergic blocking agents.

Although pseudoephedrine, triprolidine and guaiphenesin have been in widespread use of many years without apparent ill consequence, there are no specific data on their use during pregnancy. Caution should therefore be exercised by balancing the potential benefits of treatment of the mother against any possible hazards to the developing fetus.

The effects of acute toxicity from Pseudoephedrine, guaiphenasine & triprolidine may include drowsiness, irritability, restlessness, lethargy, dizziness, gastrointestinal discomfort, respiratory depression, convulsion, tremor, tachycardia and hypertension. Incase of overdose, necessary measures should be taken to maintain and support respiration and control convulsion. Gastric lavage may be undertaken if indicated. Catheterization of bladder may be necessary.

Store below 25° C. Protect from light. Do not refrigerate.

Cough expectorants & mucolytics

Ambroxol is the active metabolite of bromhexine and it has been proven that this metabolite possesses a greater bronchosecretolytic effect than bromhexine. It improves sputum rheology by hydrating mechanism leading to liquefaction of mucus in the lumen of respiratory tract, thus facilitating expectoration of mucus and reducing dyspnea. It stimulates production of phospholipids of surfactant by alveolar cells, thus contributing to the lowering of superficial tension in the alveoli. It also reduces bronchial hyperactivity. Ambroxol has anti inflammatory properties owing to the inhibitory effect on the production of cellular cytokines and arachidonic acid metabolites. In patients with COPD it traditionally improves airway patency.

Average daily dose (preferably after meal):

Pediatric Drops:

• 0-6 months: 0.5 ml 2 times a day
• 6-12 months: 1 ml 2 times a day
• 1-2 years: 1.25 ml 2 times a day

Syrup:

• 2-5 years: 2.5 ml (1/2 teaspoonful) 2-3 times a day
• 5-10 years: 5 ml (1 teaspoonful) 2-3 times a day
• 10 years and adults: 10 ml (2 teaspoonful) 3 times a day.

Sustained release capsule: Adult and children over 12 years old: 1 capsule once daily.

Gastrointestinal side effects like epigastric pain, stomach overfill feeling may occur occasionally. Rarely allergic responses such as eruption, urticaria or angioneurotic edema have been reported.

Contraindicated in known hypersensitivity to Ambroxol or Bromhexine.

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

Ambroxol should not be taken simultaneously with antitussives (e.g.Codeine) because phlegm, which has been liquefied by Ambroxol might not be expectorated.

Teratogenic and fetal toxicity studies have shown no harmful effect of Ambroxol. However, it is advised not to use it in pregnancy, especially during the1st trimester. Safety during lactation has not been established yet.

Protect from direct light exposure, Store in a dry place at a temperature not exceeding 30°C, Keep out of the reach of children.

Bromhexine is indicated in the treatment of respiratory tract disorders associated with productive cough. This include-

• Tracheobronchitis
• Bronchitis with emphysema
• Bronchiectasis
• Bronchitis with bronchospasm
• Chronic inflammatory pulmonary conditions and
• Pneumoconiosis.

Cough expectorants & mucolytics

Bromhexine Hydrochloride is an oral mucolytic agent. It disrupts the structure of acid mucopolysaccharide fibres in mucoid sputum and produces less viscous mucus, which makes easier the expectoration. It is rapidly & completely absorbed from the gastrointestinal tract. It is widely distributed into the body tissues.

The recommended doses for adults and children are stated below:

• Adult & Children over 12 years: 10 ml (2 teaspoons) 3 times daily
• Children 6-12 years: 5 ml (1 teaspoon) 3 times daily
• Children 2-6 years: 2.5 ml (1/2 teaspoon) 3 times daily
• Bromhexine Hydrochloride is not recommended for children under 2 years of age without advice.

Gastrointestinal side effects may occur occasionally. A transient rise in serum aminotransferase values has been reported. Other reported side effects include-headache, vertigo (dizziness) and allergic reactions.

It is contraindicated in known hypersensitivity to Bromhexine Hydrochloride or any of the ingredients of this product.

Since mucolytics may disrupt the gastric mucosa bromhexine should be used with care in patients with a history of peptic ulcer disease. Care is also advisable in asthmatic patients. Clearance of bromhexine and its metabolites may be reduced in patients with severe hepatic or renal impairment.

There are no known significant interactions with other drugs.

Use in Pregnancy: Special care is recommended during pregnancy. The benefits of bromhexine must be assessed against possible effects on children.

Use in Lactation: Bromhexine is expected to enter breast milk. Therefore it is not recommended that bromhexine be taken by lactating mothers.

Keep in a dry place away from light and heat. Keep out of reach of children.

Fast & effective relief of Chest congestion, Cough, Sore throat

Combined cough expectorants, Combined cough suppressants

Guaifenesin is an expectorant. It helps loosen congestion in the chest and throat, making it easier to cough out through the mouth.

Dextromethorphan Hydrobromide is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Menthol is an organic compound made synthetically or obtained from corn mint, peppermint, or other mint oils. It has local anesthetic and counterirritant qualities, and it is widely used to relieve minor throat irritation.

Adult Use Only (12 years and over): 2 teaspoonful syrup (10 ml) every 6 hours. Maximum 8 teaspoonful syrup (40 ml)/day.

Common side effects may include:

• Dizziness, drowsiness;
• Gastrointestinal disturbance
• Feeling nervous, restless, anxious, or irritable

Do not use for children less than 12 years of age.

If you are now taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric or emotional conditions, or Parkinson’s disease), or for two weeks after stopping the MAOI drug. If you do not know if your prescription drug contains an MAOI, ask a doctor or pharmacist before taking this product.

Talk to a doctor before using this product if you have asthma, chronic lung disease or shortness of breath, persistent/chronic cough, or taking a drug for depression, including monoamine oxidase (MAO) inhibitor drugs.

Possible reactions systemically may occur with acetaminophen / hydrocodone, diphenhydramine, escitalopram, acetaminophen / codeine, alprazolam and ondansetron.

Dextromethorphan Hydrobromide-guaifenesin have been assigned to pregnancy category C by the FDA. There are no controlled data on this combination product in human pregnancy.

Dextromethorphan Hydrobromide-guaifenesin is only recommended for use during pregnancy when benefit outweighs risk.

There are no data on the excretion of dextromethorphan-guaifenesin into human milk. In nursing infants, a decision should be made to discontinue. There are no human studies on the use of menthol during pregnancy; thus, its risk is undetermined.

Overdosage with guaifenesin is unlikely to produce toxic effects since its toxicity is low. In severe cases of overdosage, treatment should be aimed at reducing further absorption of the drug. Gastric emptying (emesis and/or gastric lavage) is recommended as soon as possible after ingestion. Overdosage with Dextromethorphan Hydrobromide may produce excitement and mental confusion. Very high doses may produce respiratory depression. One case of toxic psychosis (hyper-activity, marked visual and auditory hallucinations) after ingestion of a single 300 mg dose of Dextromethorphan Hydrobromide has been reported. Menthol can be harmful in large amounts. Symptoms may include abdominal pain, diarrhea, nausea and vomiting, dizziness, rapid breathing etc.

Keep out of the reach of children. Keep in a cool & dry place. Protect from light.

Cough suppressant

Butamirate Citrate acts directly on the brain's cough center to suppress cough. Butamirate Citrate is safe and non-sedating which is neither chemically nor pharmacologically related to opium alkaloids. Butamirate Citrate is rapidly and completely absorbed after oral administration. Maximum concentration is reached within 9 hours with the sustained-release tablet. This is extremely protein-bound and plasma elimination half-life is about 13 hours. The active metabolites of Butamirate Citrate have also antitussive action.

Use in adult:

• Butamirate Citrate 50 mg tablet: 2-3 tablets daily.
• Butamirate Citrate syrup: 15 ml 4 times daily.

Use in children & adolescents:
Butamirate Citrate 50 mg tablet:

• Adolescent over 12 years old: 1-2 tablets daily.

Butamirate Citrate syrup:

• Children (3-6 yrs): 5 ml 3 times daily.
• Children (6-12 yrs): 10 ml 3 times daily.
• Adolescent: 15 ml 3 times daily.

Butamirate Citrate pediatric drops:

• Children ( 2 months- 1 yrs): 0.50 ml 4 times daily.
• Children (1-3 yrs): 0.75 ml 4 times daily.

Tolerance of Butamirate Citrate is good.Adverse reactions such as rash,nausea,diarrhoea and vertigo have been observed in a few rare cases,resolving after dose reduction or treatment withdrawal.

Hypersensitivity to the active ingredient.

Butamirate Citrate suppresses the cough reflex and therefore the concomitant use with expectorants should be avoided, since it may lead to mucus retention in the airways, which increases the risk of bronchospasm and respiratory infections. If the cough persists for more than 7 days (more than 3 days in children younger than12 years of age) doctor must be consulted.

Concomitant use with expectorants should be avoided.

Butamirate Citrate should not be used during the first trimester of pregnancy. During the remainder of pregnancy, it can be used if indicated by a physician but with caution. As a general rule, for safety reasons, in the absence of data on elimination of the active substance in breast milk, the benefits of Butamirate Citrate administration during breast feeding should be carefully weighed against the risks.

Accidental overdose with Butamirate Citrate can cause the following symptoms: drowsiness, nausea, vomiting, diarrhoea, loss of balance and hypotension. Standard emergency procedures should be followed: activated charcoal, saline laxatives and standard cardio-respiratory resuscitation.

Keep away from light and moisture, store below 30°C. Keep all the medicines out of the reach of children.

Cough suppressant

Butamirate Citrate acts directly on the brain's cough center to suppress cough. Butamirate Citrate is safe and non-sedating which is neither chemically nor pharmacologically related to opium alkaloids. Butamirate Citrate is rapidly and completely absorbed after oral administration. Maximum concentration is reached within 9 hours with the sustained-release tablet. This is extremely protein-bound and plasma elimination half-life is about 13 hours. The active metabolites of Butamirate Citrate have also antitussive action.

Use in adult:

• Butamirate Citrate 50 mg tablet: 2-3 tablets daily.
• Butamirate Citrate syrup: 15 ml 4 times daily.

Use in children & adolescents:
Butamirate Citrate 50 mg tablet:

• Adolescent over 12 years old: 1-2 tablets daily.

Butamirate Citrate syrup:

• Children (3-6 yrs): 5 ml 3 times daily.
• Children (6-12 yrs): 10 ml 3 times daily.
• Adolescent: 15 ml 3 times daily.

Butamirate Citrate pediatric drops:

• Children ( 2 months- 1 yrs): 0.50 ml 4 times daily.
• Children (1-3 yrs): 0.75 ml 4 times daily.

Tolerance of Butamirate Citrate is good.Adverse reactions such as rash,nausea,diarrhoea and vertigo have been observed in a few rare cases,resolving after dose reduction or treatment withdrawal.

Hypersensitivity to the active ingredient.

Butamirate Citrate suppresses the cough reflex and therefore the concomitant use with expectorants should be avoided, since it may lead to mucus retention in the airways, which increases the risk of bronchospasm and respiratory infections. If the cough persists for more than 7 days (more than 3 days in children younger than12 years of age) doctor must be consulted.

Concomitant use with expectorants should be avoided.

Butamirate Citrate should not be used during the first trimester of pregnancy. During the remainder of pregnancy, it can be used if indicated by a physician but with caution. As a general rule, for safety reasons, in the absence of data on elimination of the active substance in breast milk, the benefits of Butamirate Citrate administration during breast feeding should be carefully weighed against the risks.

Accidental overdose with Butamirate Citrate can cause the following symptoms: drowsiness, nausea, vomiting, diarrhoea, loss of balance and hypotension. Standard emergency procedures should be followed: activated charcoal, saline laxatives and standard cardio-respiratory resuscitation.

Keep away from light and moisture, store below 30°C. Keep all the medicines out of the reach of children.

It is indicated for the symptomatic relief of burning, irritation, and discomfort due to dryness of the eye or exposure to wind or sun. It is also indicated for the treatment of keratoconjunctivitis sicca.

Drugs for Dry eyes

This eye drop is an almost colorless, clear aqueous lubricant sterile ocular solution administered to the eye(s). After topical application of this eye drop, it spreads rapidly over the conjunctiva and cornea forming a lubricating and protective film. Polyethylene Glycol 400 increases the stability of tear film and due to greater muco-adhesive properties hypromellose helps the tear film to attach with the ocular surface. Glycerin restores moisture to the dry eye. Electrolytes which are similar to the natural tears maintain good corneal epithelial surface.

1 to 2 drops in the affected eye(s) up to 4 times daily.

Occasionally mild, transient burning or sticky sensation and very rarely irritation or hypersensitivity reactions reported. Blurred vision after application may occur.

This eye drops is contraindicated in patients with known hypersensitivity to any ingredient of the product.

Remove contact lenses before using this drug. Do not use if this solution changes color or becomes cloudy. Don't touch tip of container to any surface to avoid contamination and replace cap after each use.

If several medicines are to be administered to the eye, there should be an interval of at least 5 minutes between each application.

There is no experience regarding the safety of this eye drops in human pregnancy or lactation. If pregnant or breast feeding, ask a doctor before use.

Store at room temperature. It is desirable that the contents should not be used more than 4 weeks after first opening of the bottle.

Fast & effective relief of Chest congestion, Cough, Sore throat

Combined cough expectorants, Combined cough suppressants

Guaifenesin is an expectorant. It helps loosen congestion in the chest and throat, making it easier to cough out through the mouth.

Dextromethorphan Hydrobromide is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Menthol is an organic compound made synthetically or obtained from corn mint, peppermint, or other mint oils. It has local anesthetic and counterirritant qualities, and it is widely used to relieve minor throat irritation.

Adult Use Only (12 years and over): 2 teaspoonful syrup (10 ml) every 6 hours. Maximum 8 teaspoonful syrup (40 ml)/day.

Common side effects may include:

• Dizziness, drowsiness;
• Gastrointestinal disturbance
• Feeling nervous, restless, anxious, or irritable

Do not use for children less than 12 years of age.

If you are now taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric or emotional conditions, or Parkinson’s disease), or for two weeks after stopping the MAOI drug. If you do not know if your prescription drug contains an MAOI, ask a doctor or pharmacist before taking this product.

Talk to a doctor before using this product if you have asthma, chronic lung disease or shortness of breath, persistent/chronic cough, or taking a drug for depression, including monoamine oxidase (MAO) inhibitor drugs.

Possible reactions systemically may occur with acetaminophen / hydrocodone, diphenhydramine, escitalopram, acetaminophen / codeine, alprazolam and ondansetron.

Dextromethorphan Hydrobromide-guaifenesin have been assigned to pregnancy category C by the FDA. There are no controlled data on this combination product in human pregnancy.

Dextromethorphan Hydrobromide-guaifenesin is only recommended for use during pregnancy when benefit outweighs risk.

There are no data on the excretion of dextromethorphan-guaifenesin into human milk. In nursing infants, a decision should be made to discontinue. There are no human studies on the use of menthol during pregnancy; thus, its risk is undetermined.

Overdosage with guaifenesin is unlikely to produce toxic effects since its toxicity is low. In severe cases of overdosage, treatment should be aimed at reducing further absorption of the drug. Gastric emptying (emesis and/or gastric lavage) is recommended as soon as possible after ingestion. Overdosage with Dextromethorphan Hydrobromide may produce excitement and mental confusion. Very high doses may produce respiratory depression. One case of toxic psychosis (hyper-activity, marked visual and auditory hallucinations) after ingestion of a single 300 mg dose of Dextromethorphan Hydrobromide has been reported. Menthol can be harmful in large amounts. Symptoms may include abdominal pain, diarrhea, nausea and vomiting, dizziness, rapid breathing etc.

Keep out of the reach of children. Keep in a cool & dry place. Protect from light.

This is indicated for the symptomatic relief of upper respiratory tract disorders accompanied by productive cough which benefits from the administration of a nasal decongestant, a histamine H1 receptor antagonist and an expectorant combination.

Combined cough expectorants

Pseudoephedrine is a decongestant as well as a bronchodilator for the upper respiratory tract, which gives symptomatic relief of nasal congestion. Pseudoephedrine is both an α-and β-adrenergic receptor agonist. It causes vasoconstriction via direct stimulation of α-adrenergic receptors of the respiratory mucosa. It also directly stimulates β-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility.

Like ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect. This is its main and direct mechanism of action. The displaced noradrenaline is released into the neuronal synapse where it is free to activate the postsynaptic adrenergic receptors.

Guaifenesin reduces the viscosity of tenacious sputum and is used as an expectorant. It increases the hydration of respiratory tract, thereby increasing the volume and reducing the viscosity of bronchial secretions.

Triprolidine is an antihistamine; it is used for the symptomatic relief of hypersensitivity reactions including rhinitis, conjunctivitis and urticaria.

Adult and Children over 12 years: 10 ml (2 teaspoonful) three times a day.
Children 6-12 years: 5 ml (1 teaspoonful) three times a day.
Children 2-5 years: 2.5 ml (1/2 teaspoonful) three times a day.

A physician’s advice is preferred before administering this preparation to children aged less than 2 years.

CNS depression or excitation, drowsiness (reported most frequently), sleep disturbances, hallucinations (rarely reported), skin rashes with or without irritation, tachycardia, dryness of mouth, nose and throat have occasionally been reported.

This is contraindicated in the cases of known hypersensitivity to any of its constituents, cardiovascular disease including hypertension, lower respiratory symptoms including asthma, monoamine oxidase inhibitor (MAOI) therapy.

As with any other antihistamine therapy, Pseudoephedrine, guaiphenasine & triprolidine may cause drowsiness. If affected, patients should be advised not to drive or operate machinery. Concomitant administration of alcohol or other centrally acting sedatives should be avoided. Although Pseudoephedrine has no pressor effects in normotensive patients but Pseudoephedrine, guaiphenasine & triprolidine should be used with caution to patients suffering from mild to moderate hypertension. Moreover, caution should also be exercised in the following disease conditions - hypertension and heart disease, diabetes, hyperthyroidism, elevated intra-ocular pressure, prostatic enlargement, severe renal and hepatic impairment. This preparation should not be used for persistent or chronic cough, which occurs with smoking, asthma or emphysema or where excessive secretions accompany cough, unless directed by a physician.

Concomitant use of Pseudoephedrine, guaiphenasine & triprolidine with sympathomimetic agents such as decongestants, tricyclic antidepressants, appetite suppressants and amphetamine-like psychostimulants or with monoamine oxidase inhibitors which interfere with the catabolism of sympathomimetic amines may occasionally cause a rise in blood pressure. Because of its pseudoephedrine content, Pseudoephedrine, guaiphenasine & triprolidine partially reverse the hypotensive action of drugs which interfere with sympathetic activity including guanethidine, methyldopa, alpha-adrenergic blocking agents.

Although pseudoephedrine, triprolidine and guaiphenesin have been in widespread use of many years without apparent ill consequence, there are no specific data on their use during pregnancy. Caution should therefore be exercised by balancing the potential benefits of treatment of the mother against any possible hazards to the developing fetus.

The effects of acute toxicity from Pseudoephedrine, guaiphenasine & triprolidine may include drowsiness, irritability, restlessness, lethargy, dizziness, gastrointestinal discomfort, respiratory depression, convulsion, tremor, tachycardia and hypertension. Incase of overdose, necessary measures should be taken to maintain and support respiration and control convulsion. Gastric lavage may be undertaken if indicated. Catheterization of bladder may be necessary.

Store below 25° C. Protect from light. Do not refrigerate.

This syrup is indicated for the relief of cough, associated congestive symptoms and aiding restful sleep

Combined cough expectorants

Guaifenesin is reported to reduce the viscosity of tenacious sputum end is used as an expectorant. Levomenthol has mild local anesthetic and decongestant properties. Diphenhydramine Hydrochloride possesses antitussive, antihistaminic, and anticholinergic properties.

For adults and children over 12 years: 2 teaspoonfuls syrup 4 times a day or as directed by the physicians. Do not take more than 8 teaspoonful syrup in 24 hours.

Use in Children & Adolescents: The efficacy and safety of Guaifenesin have not been established in pediatric patients and adolescents.

This syrup may cause drowsiness, dizziness, nausea and vomiting, gastro-intestinal disturbance, dry mouth, nose and throat difficulty in urination or blurred vision.

This syrup is contraindicated in individuals with known hypersensitivity to the product or any of its components. This medicine should not be administered to patients who have received treatment with MAOIs within last two weeks.

This syrup may cause drowsiness; if affected, individuals should not drive or operate machinery. Diphenhydramine Hydrochloride should not be taken by individuals with narrow-angle glaucoma or symptomatic prostatic hypertrophy. This product should not be used for persistent or chronic cough, such as occurs with asthma, or where cough is accompanied by excessive secretions unless directed by a physician.

This syrup contains Diphenhydramine Hydrochloride and therefore may potentiate the effects of alcohol, and other CNS depressants. As Diphenhydramine Hydrochloride possess some anticholinergic activity, the effects of anticholinergics (e.g. some psychotrophic drugs and atropine) may be potentiated by this product. This may result in tachycardia, mouth dryness, gastrointestinal disturbances (e.g. colic), urinary retention and headache.

As with any other medicine, care should be taken In administration during pregnancy. This product has not been associated with adverse effects in the human fetus or suckling infant.

When taken in excess, Guaifenesin may cause renal calculi. Treatment of overdose should be symptomatic and supportive.

Store at a temperature not exceeding 30° C in a dry place. Protect from light & moisture. Keep out of the reach of children.

CNS stimulant drugs

Citicoline is a naturally occurring substance that is an essential intermediate in the synthesis of structural phospholipids of cell membrane. Oral dose of Citicoline is metabolized to choline & cytidine. These then enter into the systemic circulation, cross the blood-brain barrier and recombine to form Citicoline within the central nervous system. Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, promotes rapid repair of injured cell surface & mitochondrial membrane & increases the level of various neurotransmitters like acetylcholine & dopamine. Citicoline has neuroprotective effects in situations of hypoxia & ischemia, as well as improved learning & memory performance in animal models for the aging brain. Citicoline inhibits the activation of Phospholipase A2 to prevent apoptotic & necrotic cell death.

Oral:

• Immediate treatment of stroke due to a clot (ischemic stroke): 500-2000 mg of Citicoline per day, start within 24 hours of stroke.
• For decline in thinking skills due to stroke: 1000-2000 mg of Citicoline per day.
• Chronic cerebrovascular disease: 1000 mg daily in divided dose with or between meals for ongoing disease of the blood vessels that serve the brain.

Injection:

• 1 to 2 injections daily.
• Adjust dosage according to the severity.
• Can be administered through intramuscular (IM), or intravenous (IV) [ 3 to 5 minutes] route.

Occasionally Citicoline may exert stimulating action of the parasympathetic system as well as a fleeting & discrete hypotensive effect.

Patients with hypertonic of the parasympathetic nervous system.

In case of persistent intracranial hemorrhage, it is recommended not to exceed the dose of 1000 mg of Citicoline daily.

Citicoline may enhance the effects of levodopa, carbidopa & entacapone. Citicoline must not be administered with products containing meclophenoxate.

There are no adequate & well controlled studies of Citicoline during pregnancy & lactation. Citicoline should be used during pregnancy & lactation only if the potential benefits justify the potential risks.

Geriatric use: No dosage adjustment is required & the usual dose can be administered.

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

For the treatment and prevention of infection in cuts, wounds abrasion, surgical incisions and burns. For the treatment of decubitus or stasis ulcers, advance chronic wounds, infected traumatic lesions etc.

Dressing products for wounds/burns/ulcers

The active ingredient, Lysine hydrochloride is an essential amino acid, soluble in water; has been observed to promote in-situ cellular expansion in acute and chronic wound beds, in presence of blood plasma derived growth factor(s). The essential amino acid promotes healing of wounds by active and controlled regeneration of in-situ cells. It also protects the wounds against common organisms.

Gel or Ointment may be used as often as required, preferably at an interval of 24, 48, 72 hrs. The affected areas should be cleaned with normal saline and/or surgically if necessary till the wound bed looks red/few bleeding points appear in the cleaned wound bed. Then gel should be applied liberally. The areas may be covered with a moist dressing and/or a bandage.

Slight itching sensation might be there on application.

Not to be used in known cases of hypersensitivity to the amino acid. No other known contraindication is known for this essential amino acid.

In cases of discomfort on application, please consult with the physician.

No information provided.

No known adverse reactions/side effects are known for the essential amino acid.

Store in a cool and dry place, protected from light.

Drugs for Megaloblastic Anemia

Mecobalamin is the neurologically active form of vitamin B12 and occurs as a water-soluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine. In anaemia, it increases erythrocyte production by promoting nucleic acid synthesis in the bone marrow and by promoting maturation and division of erythrocytes.

Tablet: The usual adult dosage is 500 mcg tablet three times daily. The dosage should be adjusted according to the age of patient and the severity of symptoms. 

Injection:

• Peripheral neuropathies: The usual adult dosage is  500 mcg Mecobalamin administered intramuscularly or intravenously three times a week.The dosage should be adjusted according to the age of patient and the severity of symptoms. 
• Megaloblastic anemia: The usual adult dosage is  500 mcg Mecobalamin administered intramuscularly or intravenously three times a week. After about two months of administration, dosage should be changed to one ampoule equivalent to 500 mcg of Mecobalamin every one to three months as maintenance therapy

Generally Mecobalamin is well tolerated. However, a few side effects like GI discomfort (including anorexia, nausea or diarrhea) & rash may be seen after administration of Mecobalamin.

Hypersensitivity to any component of this product.

The medicine should not be used for months if there is no response at all after its use for a certain period of time.

Decreased GI tract absorption with neomycin, aminosalicylic acid, H2-blockers and colchicine. Reduced serum concentrations with oral contraceptives. Reduced effects in anaemia with parenteral chloramphenicol.

Not recommended during pregnancy & lactation.

Use in children: Not recommended.

Oral: Store at room temperature. Protect from moisture and light.
Parenteral: Store at room temperature. Do not expose to direct light.