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    Cusef

    Cephradine
    Capsule 500 mg Allopathic First generation Cephalosporins

    Indications

    Urinary tract infection

    Indication detailsView
    Cephradine is indicated for the treatment of infections caused by sensitive Gram-positive and Gram-negative bacteria. These include-
    • Undesirable Upper respiratory tract infections: sinusitis, pharyngitis, tonsillitis, laryngo-tracheo bronchitis and otitis media, and also
    • Lower respiratory tract infections: bronchitis (acute and chronic), lobar pneumonia and bronchopneumonia.
    • Urinary tract infections: cystitis, urethritis and pyelonephritis.
    • Skin and soft tissue infections: abscess, cellulitis, furunculosis and impetigo.
    The following microorganisms are susceptible, in vitro to Cephradine:
    • Gram-positive: Staphylococci (both penicillin sensitive and resistant strains and penicillinase-producing species), Streptococci, Streptococci pyogenes (beta haemolytic), Streptococcus pneumonia.
    • Gram-negative: Escherichia coli, Klebsiella spp, Proteus mirabilis, Haemophilus influenza, Shigella spp, Salmonella spp (including Salmonella typhi), Neisseria spp Many strains of E.coli and Staphylococcus aureus that produce the enzyme penicillinase and thus are ampicillin resistant, are susceptible to Cephradine which is unaffected by this enzyme.
    Therapeutic classView
    First generation Cephalosporins
    PharmacologyView
    Cephradine is a semisynthetic broad spectrum bactericidal antibiotic, it is active against infections caused by both gram-positive and gram-negative microorganisms. Both penicillinase producing and nonproducing staphylococci are sensitive to Cephradine. The main site of action of Cephradine is the cell wall of bacteria. Cell wall of sensitive organism contains peptidoglycan. Cephradine inhibits cross-linking process and as a result cell wall with many pores are formed, thus lysis of bacteria occur due to external osmotic pressure.
    DosageView
    For oral administration-
    Adults:
    • Urinary tract infections: 500mg four times daily or 1g twice daily. Infections which are severe or chronic may necessitate the administration of higher doses. Where complications arise including prostatitis and epididymitis continued intensive treatment is required.
    • Respiratory tract infections: 250 to 500mg four times daily or 500mg to 1g twice daily, dependent on the site and severity of the infection.
    • Skin and soft tissue infections: 250 to 500mg four times daily or 500mg to 1g twice daily, again dependent on the site and severity of the infection.
    Children:
    • Total daily dose of 25 to 50mg/kg given in two or four equally divided doses.
    • Otitis media: Total daily dose of 75 to 100mg/kg given in divided doses 6 to 12 hourly.
    • Maximum daily dosage: 4 gm
    Elderly: The normal adult dose is appropriate. Patients with impaired renal or hepatic function should be monitored during treatment.

    For injectable administration-
    • Adult: The usual dose is 2-4 gm daily in four equally divided doses up to 8 gm daily. For prophylaxis a single preoperative dose of 1-2 gm intramuscularly or intravenously is given.
    • Children: The dose is 50-100 mg/kg daily in four equally divided doses, up to 300 mg/kg daily in severe infection.
    Side effectsView
    Limited essentially to gastro-intestinal disturbances and on occasions to hypersensitivity phenomena. The latter are more likely to occur in individuals, who have previously demonstrated hypersensitivity and thos with a history of allergy, asthma, hay fever or urticaria. Skin reactions have occasionally been reported. Rare- Glossitis, heartburn, dizziness, tightness in the chest, nausea, vomiting, diarrhoea, abdominal pain, vaginitis, candida overgrowth. Skin and hypersensitivity reactions include urticaria, skin rashes, joint pains, oedema.
    • Blood and lymphatic system disorders- Unknown: blood disorders (including thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia)
    • Immune system disorders- Unknown: Fever, serum sickness like reactions, anaphylaxis
    • Psychiatric disorders- Unknown: Confusion, sleep disturbances
    • Nervous system disorders- Unknown: hyperactivity, hypertonia, dizziness, nervousness; Rarely: Headache
    • Hepatobiliary disorders- Frequency unknown: Liver, enzyme disturbances, transient hepatitis, cholestatic jaundice
    • Renal and urinary disorders- Unknown: Reversible interstitial nephritis
    • Investigations- Unknown: Elevation of blood urea nitrogen, serum creatinine, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase.
    ContraindicationsView
    Cephradine should not be used in patients with known or suspected hypersensitivity to cephalosporins.
    PrecautionsView
    • Prolonged use of an anti-infective may result in the development of superinfection due to the emergence of resistant organisms.
    • Cephradine should be administered with care to patients hypersensitive to penicillins because of the risk of cross-sensitivity between beta-lactam antibiotics.
    • Cephalosporin antibiotics may cause a positive result in Coombs’ testing. When Coombs testing is performed on neonates whose mothers received cephalosporins prior to labour, it should be noted that a positive result may be due to the drug.
    • Cephradine may cause a false positive urine glucose result when Benedict’s or Fehling’s solutions or tablets such as Clinitest are used in the testing. This does not occur with enzyme-based tests (e.g. Clinistix, Diastix).
    • Dosage adjustment is necessary in renal impairment.
    • This product contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
    InteractionsView
    The concomitant use of nephrotoxic drugs such as aminoglycosides with Cefradine may increase the risk of kidney damage. Diuretics (e.g. frusemide, ethacrynic acid) and probenecid enhanced the possibility of renal toxicity.
    Pregnancy & lactationView
    Although animal studies have not demonstrated any teratogenicity, safety in pregnancy has not been established. Cephradine is excreted in breast milk and should be used with caution in lactating mothers. Since the medicine may cause dizziness, patients should be cautioned about operating hazardous machinery, including automobiles.
    Pediatric usageView
    Renal Impairment: The following doses are recommended (based on 500 mg every 6 hours) for patients not on haemodialysis:
    • CrCl: >20 ml/min: 500 mg every 6 hours
    • CrCl: 5-20 ml/min: 250 mg every 6 hours
    • CrCl: <5 ml/min: 250 mg every 50-70 hours.
    Recommendations for patients on chronic, intermittent haemodialysis:
    • 250 mg at the start of haemodialysis
    • 250 mg 6 to 12 hours after the start
    • 250 mg 36 to 48 hours after the start
    • 250 mg at the start of the next haemodialysis session if more than 30 hours have elapsed since the last dose.
    Additional Information for all patients Regardless of patient age or weight, higher doses of up to 1 gm four times daily may be required for infections which are chronic or severe. Treatment should continue for at least 2 to 3 days after symptoms have resolved or bacteria have been eradicated. To reduce the possibility of rheumatic fever or glomerulonephritis resulting from infections with haemolytic streptococci, treatment should be continued for at least 10 days. Throughout treatment of chronic urinary tract infections and for several months thereafter, regular bacteriological and clinical monitoring is required.

    Doses below those recommended above should not be prescribed. Paediatric dosages should not exceed those specified for adults, regardless of severity of infection. It may be necessary to continue Cephradine therapy for several weeks in persistent infections. Patients may be transferred from intramuscular/intravenous Cephradine therapy to oral treatment at the same dosage level.
    Overdose effectsView
    The symptoms of Sefrad overdose are non-specific and are generally nausea, vomiting, diarrhoea and gastric upsets. Treatment is mainly supportive although gastric lavage will be necessary if a large amount has been ingested.
    StorageView
    Cephradine Suspension should be freshly prepared. Reconstituted Suspension should be used within 7 days if kept at room temperature or within 14 days, if kept in a refrigerator. Cephradine Injection solutions should be used within 2 hours when kept at room temperature. When stored at 5°C, solutions retain potency for 12 hours. Reconstituted solutions may vary in colour from light to straw yellow; however, this does not affect the potency. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician

    Cusef

    Cephradine
    Capsule 250 mg Allopathic First generation Cephalosporins

    Indications

    Urinary tract infection

    Indication detailsView
    Cephradine is indicated for the treatment of infections caused by sensitive Gram-positive and Gram-negative bacteria. These include-
    • Undesirable Upper respiratory tract infections: sinusitis, pharyngitis, tonsillitis, laryngo-tracheo bronchitis and otitis media, and also
    • Lower respiratory tract infections: bronchitis (acute and chronic), lobar pneumonia and bronchopneumonia.
    • Urinary tract infections: cystitis, urethritis and pyelonephritis.
    • Skin and soft tissue infections: abscess, cellulitis, furunculosis and impetigo.
    The following microorganisms are susceptible, in vitro to Cephradine:
    • Gram-positive: Staphylococci (both penicillin sensitive and resistant strains and penicillinase-producing species), Streptococci, Streptococci pyogenes (beta haemolytic), Streptococcus pneumonia.
    • Gram-negative: Escherichia coli, Klebsiella spp, Proteus mirabilis, Haemophilus influenza, Shigella spp, Salmonella spp (including Salmonella typhi), Neisseria spp Many strains of E.coli and Staphylococcus aureus that produce the enzyme penicillinase and thus are ampicillin resistant, are susceptible to Cephradine which is unaffected by this enzyme.
    Therapeutic classView
    First generation Cephalosporins
    PharmacologyView
    Cephradine is a semisynthetic broad spectrum bactericidal antibiotic, it is active against infections caused by both gram-positive and gram-negative microorganisms. Both penicillinase producing and nonproducing staphylococci are sensitive to Cephradine. The main site of action of Cephradine is the cell wall of bacteria. Cell wall of sensitive organism contains peptidoglycan. Cephradine inhibits cross-linking process and as a result cell wall with many pores are formed, thus lysis of bacteria occur due to external osmotic pressure.
    DosageView
    For oral administration-
    Adults:
    • Urinary tract infections: 500mg four times daily or 1g twice daily. Infections which are severe or chronic may necessitate the administration of higher doses. Where complications arise including prostatitis and epididymitis continued intensive treatment is required.
    • Respiratory tract infections: 250 to 500mg four times daily or 500mg to 1g twice daily, dependent on the site and severity of the infection.
    • Skin and soft tissue infections: 250 to 500mg four times daily or 500mg to 1g twice daily, again dependent on the site and severity of the infection.
    Children:
    • Total daily dose of 25 to 50mg/kg given in two or four equally divided doses.
    • Otitis media: Total daily dose of 75 to 100mg/kg given in divided doses 6 to 12 hourly.
    • Maximum daily dosage: 4 gm
    Elderly: The normal adult dose is appropriate. Patients with impaired renal or hepatic function should be monitored during treatment.

    For injectable administration-
    • Adult: The usual dose is 2-4 gm daily in four equally divided doses up to 8 gm daily. For prophylaxis a single preoperative dose of 1-2 gm intramuscularly or intravenously is given.
    • Children: The dose is 50-100 mg/kg daily in four equally divided doses, up to 300 mg/kg daily in severe infection.
    Side effectsView
    Limited essentially to gastro-intestinal disturbances and on occasions to hypersensitivity phenomena. The latter are more likely to occur in individuals, who have previously demonstrated hypersensitivity and thos with a history of allergy, asthma, hay fever or urticaria. Skin reactions have occasionally been reported. Rare- Glossitis, heartburn, dizziness, tightness in the chest, nausea, vomiting, diarrhoea, abdominal pain, vaginitis, candida overgrowth. Skin and hypersensitivity reactions include urticaria, skin rashes, joint pains, oedema.
    • Blood and lymphatic system disorders- Unknown: blood disorders (including thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia)
    • Immune system disorders- Unknown: Fever, serum sickness like reactions, anaphylaxis
    • Psychiatric disorders- Unknown: Confusion, sleep disturbances
    • Nervous system disorders- Unknown: hyperactivity, hypertonia, dizziness, nervousness; Rarely: Headache
    • Hepatobiliary disorders- Frequency unknown: Liver, enzyme disturbances, transient hepatitis, cholestatic jaundice
    • Renal and urinary disorders- Unknown: Reversible interstitial nephritis
    • Investigations- Unknown: Elevation of blood urea nitrogen, serum creatinine, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase.
    ContraindicationsView
    Cephradine should not be used in patients with known or suspected hypersensitivity to cephalosporins.
    PrecautionsView
    • Prolonged use of an anti-infective may result in the development of superinfection due to the emergence of resistant organisms.
    • Cephradine should be administered with care to patients hypersensitive to penicillins because of the risk of cross-sensitivity between beta-lactam antibiotics.
    • Cephalosporin antibiotics may cause a positive result in Coombs’ testing. When Coombs testing is performed on neonates whose mothers received cephalosporins prior to labour, it should be noted that a positive result may be due to the drug.
    • Cephradine may cause a false positive urine glucose result when Benedict’s or Fehling’s solutions or tablets such as Clinitest are used in the testing. This does not occur with enzyme-based tests (e.g. Clinistix, Diastix).
    • Dosage adjustment is necessary in renal impairment.
    • This product contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
    InteractionsView
    The concomitant use of nephrotoxic drugs such as aminoglycosides with Cefradine may increase the risk of kidney damage. Diuretics (e.g. frusemide, ethacrynic acid) and probenecid enhanced the possibility of renal toxicity.
    Pregnancy & lactationView
    Although animal studies have not demonstrated any teratogenicity, safety in pregnancy has not been established. Cephradine is excreted in breast milk and should be used with caution in lactating mothers. Since the medicine may cause dizziness, patients should be cautioned about operating hazardous machinery, including automobiles.
    Pediatric usageView
    Renal Impairment: The following doses are recommended (based on 500 mg every 6 hours) for patients not on haemodialysis:
    • CrCl: >20 ml/min: 500 mg every 6 hours
    • CrCl: 5-20 ml/min: 250 mg every 6 hours
    • CrCl: <5 ml/min: 250 mg every 50-70 hours.
    Recommendations for patients on chronic, intermittent haemodialysis:
    • 250 mg at the start of haemodialysis
    • 250 mg 6 to 12 hours after the start
    • 250 mg 36 to 48 hours after the start
    • 250 mg at the start of the next haemodialysis session if more than 30 hours have elapsed since the last dose.
    Additional Information for all patients Regardless of patient age or weight, higher doses of up to 1 gm four times daily may be required for infections which are chronic or severe. Treatment should continue for at least 2 to 3 days after symptoms have resolved or bacteria have been eradicated. To reduce the possibility of rheumatic fever or glomerulonephritis resulting from infections with haemolytic streptococci, treatment should be continued for at least 10 days. Throughout treatment of chronic urinary tract infections and for several months thereafter, regular bacteriological and clinical monitoring is required.

    Doses below those recommended above should not be prescribed. Paediatric dosages should not exceed those specified for adults, regardless of severity of infection. It may be necessary to continue Cephradine therapy for several weeks in persistent infections. Patients may be transferred from intramuscular/intravenous Cephradine therapy to oral treatment at the same dosage level.
    Overdose effectsView
    The symptoms of Sefrad overdose are non-specific and are generally nausea, vomiting, diarrhoea and gastric upsets. Treatment is mainly supportive although gastric lavage will be necessary if a large amount has been ingested.
    StorageView
    Cephradine Suspension should be freshly prepared. Reconstituted Suspension should be used within 7 days if kept at room temperature or within 14 days, if kept in a refrigerator. Cephradine Injection solutions should be used within 2 hours when kept at room temperature. When stored at 5°C, solutions retain potency for 12 hours. Reconstituted solutions may vary in colour from light to straw yellow; however, this does not affect the potency. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician

    Cutisone

    Fluticasone Propionate (Topical)
    Cream 0.05% Allopathic Fluticasone & combined preparations topical

    Indications

    Pruritic skin conditions

    Indication detailsView
    Fluticasone Propionate is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid responsive eczema/dermatitis.
    Therapeutic classView
    Fluticasone & combined preparations topical
    PharmacologyView
    Fluticasone propionate is a glucocorticoid with high topical anti-inflammatorypotency, but a low HPA-axis suppressive activity after dermal administration. It, therefore, has a therapeutic index which is greater than most of the commonly available steroids. Fluticasone propionate has a high degree of selectivity for the glucocorticoid receptor. In vitro studies show that fluticasone propionate has a strong affinity for, and agonist activity at, human glucocorticoid receptors. This receptor is believed to be responsible for the anti-inflammatory properties of glucocorticoids. Fluticasone propionate has weak affinity forthe progesterone receptor, andvirtually no affinity for the mineralocorticoid, estrogen, or androgen receptors. The therapeutic potency of glucocorticoids is related to the half-life of the glucocorticoid-receptor complex. The half-life of the Fluticasone propionate glucocorticoid-receptor complex is approximately 10 hours.
    DosageView
    Cream: Apply a thin layer of Fluticasone propionate cream to the affected skin areas once daily.
    Ointment: Apply a thin layer of Fluticasone propionate Ointment to the affected skin areas twice daily.
    Side effectsView
    The fluticasone propionate preparations are usually well tolerated; local burning and pruritus have been reported. If signs of hypersensitivity appear, application should be stopped immediately. Prolonged and intensive treatment with potent corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, dilatation of the superficial blood vessels, hypertrichosis and hypopigmentation.

    Secondary infection, particularly when occlusive dressings are used or when skin folds are involved and allergic contact dermatitis have also been reported with corticosteroid use. Exacerbation of the signs and symptoms of the dermatoses have been reported with corticosteroid use.

    Prolonged use of large amounts of corticosteroids, or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercorticism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. In infants, the napkin may act as an occlusive dressing.
    ContraindicationsView
    Fluticasone propionate is contraindicated in Rosacea, Acne vulgaris, Perioral dermatitis, Primary cutaneous viral infections (e.g., Herpes simplex, chicken pox), Hypersensitivity to any of the ingredients, Perianal and genital pruritus, etc. The use of Fluticasone propionate is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi or bacteria and dermatoses in children under one year of age, including dermatitis and napkin eruptions.
    PrecautionsView
    Fluticasone propionate has a very low propensity for systemic absorption, nevertheless, prolonged application of high doses to large areas of the body surface, especially in infants and small children might lead to adrenal suppression. Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity. The face, more than other areas of the body, may exhibit atropic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating severe eczema. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressing, and so the skin should be cleansed before a fresh dressing is applied.
    InteractionsView
    No information is available.
    Pregnancy & lactationView
    Administration of fluticasone propionate during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the fetus. The excretion of fluticasone propionate into human breast milk has not been investigated. Plasma levels in patients following dermal application of fluticasone propionate at recommended doses are likely to be low. When fluticasone propionate is used in breastfeeding mothers, the therapeutic benefits must be weighed against the potential hazards to the mother and baby.
    Overdose effectsView
    Acute overdosage is very unlikely to occur, however, in case of chronic overdosage or misuse the features of hypercorticism may appear, and in this situation, as with any corticosteroid, the application should be discontinued. Overdosage by ingestion of fluticasone propionate cream or ointment is extremely unlikely to occur due to the very low oral bioavailability of fluticasone propionate.
    StorageView
    Store below 30°C.Do not freeze.

    Cutisone

    Fluticasone Propionate (Topical)
    Ointment 0.01% Allopathic Fluticasone & combined preparations topical

    Indications

    Pruritic skin conditions

    Indication detailsView
    Fluticasone Propionate is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid responsive eczema/dermatitis.
    Therapeutic classView
    Fluticasone & combined preparations topical
    PharmacologyView
    Fluticasone propionate is a glucocorticoid with high topical anti-inflammatorypotency, but a low HPA-axis suppressive activity after dermal administration. It, therefore, has a therapeutic index which is greater than most of the commonly available steroids. Fluticasone propionate has a high degree of selectivity for the glucocorticoid receptor. In vitro studies show that fluticasone propionate has a strong affinity for, and agonist activity at, human glucocorticoid receptors. This receptor is believed to be responsible for the anti-inflammatory properties of glucocorticoids. Fluticasone propionate has weak affinity forthe progesterone receptor, andvirtually no affinity for the mineralocorticoid, estrogen, or androgen receptors. The therapeutic potency of glucocorticoids is related to the half-life of the glucocorticoid-receptor complex. The half-life of the Fluticasone propionate glucocorticoid-receptor complex is approximately 10 hours.
    DosageView
    Cream: Apply a thin layer of Fluticasone propionate cream to the affected skin areas once daily.
    Ointment: Apply a thin layer of Fluticasone propionate Ointment to the affected skin areas twice daily.
    Side effectsView
    The fluticasone propionate preparations are usually well tolerated; local burning and pruritus have been reported. If signs of hypersensitivity appear, application should be stopped immediately. Prolonged and intensive treatment with potent corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, dilatation of the superficial blood vessels, hypertrichosis and hypopigmentation.

    Secondary infection, particularly when occlusive dressings are used or when skin folds are involved and allergic contact dermatitis have also been reported with corticosteroid use. Exacerbation of the signs and symptoms of the dermatoses have been reported with corticosteroid use.

    Prolonged use of large amounts of corticosteroids, or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercorticism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. In infants, the napkin may act as an occlusive dressing.
    ContraindicationsView
    Fluticasone propionate is contraindicated in Rosacea, Acne vulgaris, Perioral dermatitis, Primary cutaneous viral infections (e.g., Herpes simplex, chicken pox), Hypersensitivity to any of the ingredients, Perianal and genital pruritus, etc. The use of Fluticasone propionate is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi or bacteria and dermatoses in children under one year of age, including dermatitis and napkin eruptions.
    PrecautionsView
    Fluticasone propionate has a very low propensity for systemic absorption, nevertheless, prolonged application of high doses to large areas of the body surface, especially in infants and small children might lead to adrenal suppression. Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity. The face, more than other areas of the body, may exhibit atropic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating severe eczema. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressing, and so the skin should be cleansed before a fresh dressing is applied.
    InteractionsView
    No information is available.
    Pregnancy & lactationView
    Administration of fluticasone propionate during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the fetus. The excretion of fluticasone propionate into human breast milk has not been investigated. Plasma levels in patients following dermal application of fluticasone propionate at recommended doses are likely to be low. When fluticasone propionate is used in breastfeeding mothers, the therapeutic benefits must be weighed against the potential hazards to the mother and baby.
    Overdose effectsView
    Acute overdosage is very unlikely to occur, however, in case of chronic overdosage or misuse the features of hypercorticism may appear, and in this situation, as with any corticosteroid, the application should be discontinued. Overdosage by ingestion of fluticasone propionate cream or ointment is extremely unlikely to occur due to the very low oral bioavailability of fluticasone propionate.
    StorageView
    Store below 30°C.Do not freeze.

    Cutivate

    Fluticasone Propionate (Topical)
    Ointment 0.01% Allopathic Fluticasone & combined preparations topical

    Indications

    Pruritic skin conditions

    Indication detailsView
    Fluticasone Propionate is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid responsive eczema/dermatitis.
    Therapeutic classView
    Fluticasone & combined preparations topical
    PharmacologyView
    Fluticasone propionate is a glucocorticoid with high topical anti-inflammatorypotency, but a low HPA-axis suppressive activity after dermal administration. It, therefore, has a therapeutic index which is greater than most of the commonly available steroids. Fluticasone propionate has a high degree of selectivity for the glucocorticoid receptor. In vitro studies show that fluticasone propionate has a strong affinity for, and agonist activity at, human glucocorticoid receptors. This receptor is believed to be responsible for the anti-inflammatory properties of glucocorticoids. Fluticasone propionate has weak affinity forthe progesterone receptor, andvirtually no affinity for the mineralocorticoid, estrogen, or androgen receptors. The therapeutic potency of glucocorticoids is related to the half-life of the glucocorticoid-receptor complex. The half-life of the Fluticasone propionate glucocorticoid-receptor complex is approximately 10 hours.
    DosageView
    Cream: Apply a thin layer of Fluticasone propionate cream to the affected skin areas once daily.
    Ointment: Apply a thin layer of Fluticasone propionate Ointment to the affected skin areas twice daily.
    Side effectsView
    The fluticasone propionate preparations are usually well tolerated; local burning and pruritus have been reported. If signs of hypersensitivity appear, application should be stopped immediately. Prolonged and intensive treatment with potent corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, dilatation of the superficial blood vessels, hypertrichosis and hypopigmentation.

    Secondary infection, particularly when occlusive dressings are used or when skin folds are involved and allergic contact dermatitis have also been reported with corticosteroid use. Exacerbation of the signs and symptoms of the dermatoses have been reported with corticosteroid use.

    Prolonged use of large amounts of corticosteroids, or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercorticism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. In infants, the napkin may act as an occlusive dressing.
    ContraindicationsView
    Fluticasone propionate is contraindicated in Rosacea, Acne vulgaris, Perioral dermatitis, Primary cutaneous viral infections (e.g., Herpes simplex, chicken pox), Hypersensitivity to any of the ingredients, Perianal and genital pruritus, etc. The use of Fluticasone propionate is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi or bacteria and dermatoses in children under one year of age, including dermatitis and napkin eruptions.
    PrecautionsView
    Fluticasone propionate has a very low propensity for systemic absorption, nevertheless, prolonged application of high doses to large areas of the body surface, especially in infants and small children might lead to adrenal suppression. Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity. The face, more than other areas of the body, may exhibit atropic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating severe eczema. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressing, and so the skin should be cleansed before a fresh dressing is applied.
    InteractionsView
    No information is available.
    Pregnancy & lactationView
    Administration of fluticasone propionate during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the fetus. The excretion of fluticasone propionate into human breast milk has not been investigated. Plasma levels in patients following dermal application of fluticasone propionate at recommended doses are likely to be low. When fluticasone propionate is used in breastfeeding mothers, the therapeutic benefits must be weighed against the potential hazards to the mother and baby.
    Overdose effectsView
    Acute overdosage is very unlikely to occur, however, in case of chronic overdosage or misuse the features of hypercorticism may appear, and in this situation, as with any corticosteroid, the application should be discontinued. Overdosage by ingestion of fluticasone propionate cream or ointment is extremely unlikely to occur due to the very low oral bioavailability of fluticasone propionate.
    StorageView
    Store below 30°C.Do not freeze.

    Cutivate

    Fluticasone Propionate (Topical)
    Cream 0.05% Allopathic Fluticasone & combined preparations topical

    Indications

    Pruritic skin conditions

    Indication detailsView
    Fluticasone Propionate is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid responsive eczema/dermatitis.
    Therapeutic classView
    Fluticasone & combined preparations topical
    PharmacologyView
    Fluticasone propionate is a glucocorticoid with high topical anti-inflammatorypotency, but a low HPA-axis suppressive activity after dermal administration. It, therefore, has a therapeutic index which is greater than most of the commonly available steroids. Fluticasone propionate has a high degree of selectivity for the glucocorticoid receptor. In vitro studies show that fluticasone propionate has a strong affinity for, and agonist activity at, human glucocorticoid receptors. This receptor is believed to be responsible for the anti-inflammatory properties of glucocorticoids. Fluticasone propionate has weak affinity forthe progesterone receptor, andvirtually no affinity for the mineralocorticoid, estrogen, or androgen receptors. The therapeutic potency of glucocorticoids is related to the half-life of the glucocorticoid-receptor complex. The half-life of the Fluticasone propionate glucocorticoid-receptor complex is approximately 10 hours.
    DosageView
    Cream: Apply a thin layer of Fluticasone propionate cream to the affected skin areas once daily.
    Ointment: Apply a thin layer of Fluticasone propionate Ointment to the affected skin areas twice daily.
    Side effectsView
    The fluticasone propionate preparations are usually well tolerated; local burning and pruritus have been reported. If signs of hypersensitivity appear, application should be stopped immediately. Prolonged and intensive treatment with potent corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, dilatation of the superficial blood vessels, hypertrichosis and hypopigmentation.

    Secondary infection, particularly when occlusive dressings are used or when skin folds are involved and allergic contact dermatitis have also been reported with corticosteroid use. Exacerbation of the signs and symptoms of the dermatoses have been reported with corticosteroid use.

    Prolonged use of large amounts of corticosteroids, or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercorticism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. In infants, the napkin may act as an occlusive dressing.
    ContraindicationsView
    Fluticasone propionate is contraindicated in Rosacea, Acne vulgaris, Perioral dermatitis, Primary cutaneous viral infections (e.g., Herpes simplex, chicken pox), Hypersensitivity to any of the ingredients, Perianal and genital pruritus, etc. The use of Fluticasone propionate is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi or bacteria and dermatoses in children under one year of age, including dermatitis and napkin eruptions.
    PrecautionsView
    Fluticasone propionate has a very low propensity for systemic absorption, nevertheless, prolonged application of high doses to large areas of the body surface, especially in infants and small children might lead to adrenal suppression. Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity. The face, more than other areas of the body, may exhibit atropic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating severe eczema. Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressing, and so the skin should be cleansed before a fresh dressing is applied.
    InteractionsView
    No information is available.
    Pregnancy & lactationView
    Administration of fluticasone propionate during pregnancy should only be considered if the expected benefit to the mother is greater than any possible risk to the fetus. The excretion of fluticasone propionate into human breast milk has not been investigated. Plasma levels in patients following dermal application of fluticasone propionate at recommended doses are likely to be low. When fluticasone propionate is used in breastfeeding mothers, the therapeutic benefits must be weighed against the potential hazards to the mother and baby.
    Overdose effectsView
    Acute overdosage is very unlikely to occur, however, in case of chronic overdosage or misuse the features of hypercorticism may appear, and in this situation, as with any corticosteroid, the application should be discontinued. Overdosage by ingestion of fluticasone propionate cream or ointment is extremely unlikely to occur due to the very low oral bioavailability of fluticasone propionate.
    StorageView
    Store below 30°C.Do not freeze.

    Cuvir

    Acyclovir (Ophthalmic)
    Ophthalmic Ointment 3% Allopathic Ophthalmic Anti-viral Products

    Indications

    Neonatal Conjunctivitis

    Indication detailsView
    Acyclovir is indicated for the treatment of Herpes simplex keratitis.
    Therapeutic classView
    Ophthalmic Anti-viral Products
    PharmacologyView
    Acyclovir is an antiviral agent which is highly active in vitro against Herpes simplex (HSV) types I and II and Varicella zoster viruses, but its toxicity to mammalian cells is low. Acyclovir is phosphorylated to the active compound Acyclovir triphosphate after entry into herpes infected cell. The ­first step in this process requires the presence of the viral-coded thymidine kinase. Acyclovir triphosphate acts as an inhibitor of and substrate for the herpes specifi­ed DNA polymerase preventing further viral DNA synthesis without affecting normal cellular processes.
    DosageView
    The dosage for all age groups is the same. A 10 mm ribbon of the ointment should be placed inside the lower conjunctival sac ­five times a day at approximately four hourly intervals. Treatment should continue for at least 3 days after healing
    Side effectsView
    Very common: Superfi­cial punctate keratopathy. This did not necessitate an early termination of therapy and healed without apparent sequelae. Common: Transient mild stinging of the eye occurring immediately following application, conjunctivitis. Rare: Blepharitis.
    ContraindicationsView
    Acyclovir is contraindicated in patients known to be hypersensitive to Acyclovir or Valacyclovir
    PrecautionsView
    The recommended dosage, frequency of applications, and length of treatment should not be exceeded.
    InteractionsView
    No clinically signi­ficant interactions have been identi­fied.
    Pregnancy & lactationView
    Pregnancy category B. There are no adequate and well-controlled studies of Acyclovir in pregnant women. It is not known whether topically applied Acyclovir is excreted in breast milk.
    Overdose effectsView
    No adverse effects would be expected if the entire contents of the tube containing 90 mg Acyclovir were ingested orally.
    StorageView
    Store in a cool and dry place. Keep away from light. Keep out of reach of children. Do not touch the tip of the tube since this may contaminate the product. After one month of the opening do not use the medicine of tube.

    Cyano-B

    Vitamin B1, B6 & B12
    Tablet 100 mg+200 mg+200 mcg Allopathic Specific combined vitamin preparations

    Indications

    Vitamin B deficiencies

    Indication detailsView
    Vitamin B1, B6 & B12 is indicated for the treatment of vitamin B1, B6 & B12 deficiency syndrome. It is also indicated for the supportive treatment of neuritis & non-inflammatory diseases of the nerves, e.g.- Diabetic neuropathy, Peripheral neuralgin, Lumbago, Myalgia, Optic neuritis, Sciatica, Facial neuralgia, Intercostal neuralgia, Spinal pain.
    Therapeutic classView
    Specific combined vitamin preparations
    PharmacologyView
    Vitamin B1 converts carbohydrates, fatty acids and amino acids into energy, promotes healthy nerves, improves mood, strengthens the heart. Vitamin B6 forms RBCs, helps cells to make proteins, manufactures neurotransmitters e.g. serotonin and releases stored forms of energy, helps to prevent CVS diseases and stroke, helps to lift depression and eases insomnia. Vitamin B12 is essential for cell replication and important for RBC production, prevents anemia, helps to prevent depression, reduces nerve pain, numbness, tingling and lowers the risk of heart diseases.

    The vitamin ingredients are absorbed well in per oral reception. It is widely distributed to most tissues and appears in breast milk. Within the cell, thiamine is mostly present as diphosphate. Thiamine is not stored to any appreciable extent in the body and amounts in excess of the body’s requirements are excreted in the urine as unchanged thiamine or as metabolites. Pyridoxine, pyridoxal and pyridoxamine are readily absorbed from the GIT following oral administration and are converted to the active forms of pyridoxal phosphate an pyridoxamine phosphate. They are stored mainly in liver where there is oxidation to 4-pyridoxic acid and other inactive metabolites, which are excreted in urine. As the dose increases, proportionally greater amounts are excreted unchanged in the urine.
    DosageView
    Tablet: 1-3 Tablets per day or as advised by the physician.

    Injection:
    • In severe (acute) cases: 1 injection daily until the acute symptoms subside or taken as advised by the physician.
    • In mild cases: 1 injection 2-3 times per week. Ampoules are preferably injected intramuscularly.
    Use in children: There is no information on the use of this drug in children.
    Side effectsView
    Generally well tolerated but allergic reactions may be observed in few cases.
    ContraindicationsView
    Vitamin B1, Vitamin B6 and Vitamin B12 is contraindicated in patients on levodopa therapy, and in patients with hypersensitivity to any of the ingredients of the preparation.
    PrecautionsView
    Cyanocobalamin should not be given in patients with subacute degeneration of the spinal cord. Cyanocobalamin is not suitable form of vitamin B12 for the treatment of optic neuropathies associated with raised plasma concentrations of cyanocobalamin.
    InteractionsView
    No drug interaction has been reported yet.
    Pregnancy & lactationView
    Oral tablet form is recommended but due to the presence of benzyl alcohol, injection is not recommended during pregnancy & lactation.
    Overdose effectsView
    No overdosage symptoms are to be expected in the recommended dosage. If there is known overdose then treatment is symptomatic & supportive.
    StorageView
    Keep out of reach of children. Store in a cool (below 25°C temperature) and dry place, protected from light.

    Cyclid

    Procyclidine Hydrochloride
    Tablet 5 mg Allopathic Antiparkinson drugs

    Indications

    Sialorrhea

    Indication detailsView
    Procyclidine is used for the adjunctive treatment of all forms of parkinsonian syndrome. It is mainly used for the symptomatic treatment of idiopathic (paralysis agitants), postencephalitic and arteriosclerotic parkinsonian. It is used to control troublesome extrapyramidal symptoms including pseudoparkinsonian, acute dystonic reactions and akathisia induced by neuroleptic drugs such as phenothiazine derivatives.
    Therapeutic classView
    Antiparkinson drugs
    PharmacologyView
    Procyclidine hydrochloride is an antimuscarinic antiparkinsonian agent of relatively low toxicity. It is a synthetic tertiary amine. This drug exerts their antiparkinsonian effect by correcting the relative cholinergic excess which is thought to occur in parkinsonian as a result of dopamine deficiency. It is absorbed from G.I. tract and disappears rapidly from the tissues. After intravenous administration, it acts within 5 to 20 minutes and has a duration of effect up to 4 hours.
    DosageView
    Tablet: This is administered orally, preferably after meals.
    • Parkinsonism: Initially 2.5 mg 3 times a day, then 5 mg 3 times a day and occasionally 5 mg at bedtime. The dosage being adjusted as tolerated or until the total daily dose reaches 20 to 30 mg divided into 3 to 4 doses.
    • Drug induced extrapyramidal symptom: Initially 2.5 mg 3 times a day. The dosage being increased by 2.5 mg increment per day as needed and tolerated.
    IM or IV injection: 5-10 mg, repeated if necessary after 20 minutes; maximum 20 mg daily can be given.
    Side effectsView
    At usual dosage levels dryness of the mouth is generally the only adverse effect. Mydriasis, blurred vision and adverse G.I. effects (nausea, vomiting, epigastric distress, constipation) occur occasionally. An allergic reaction (e.g. rash) or muscular weakness may occasionally occur. High doses may cause vertigo and possibly confusion and hallucination. Adverse effect may usually be minimized by adjustment of dosage and administration after meal.
    ContraindicationsView
    It should be given with caution in children and geriatric patients. It is advisable to be cautious in giving Procyclidine to patients with diarrhoea and cardiovascular disease, glaucoma, urinary retention, hepatic or renal impairment. The safety of using procyclidine during pregnancy has not been established. No data are available on the excretion of this drug in breast milk.
    PrecautionsView
    Precaution should be taken in case of hepatic & renal impairment, children, elderly, pregnancy and lactation condition. Patients with mental disorders occasionally experience a precipitation of a psychotic episode when Procyclidine is administered for the treatment of the extrapyramidal side-effects of neuroleptic. Procyclidine should not be withdrawn abruptly as rebound Parkinsonism symptoms may occur.
    InteractionsView
    The anticholinergic activity of procyclidine may be increased by agents having anticholinergic amantadine. The absorption of ketoconazole may be reduced by concomitant administration of procyclidine.
    Pregnancy & lactationView
    The safe use of this drug in pregnancy, lactation or in women of childbearing age requires that the potential benefits be weighed against the possible hazards to the mother and child.
    Pediatric usageView
    Use in children: Safety and efficacy have not been established in the pediatric age group; therefore the use of Procyclidine hydrochloride is this group requires that the potential benefits be weighed against the possible hazards to children.
    StorageView
    Protect from light and moisture, store below 25°C. Keep out of the reach of children.

    Cyclid

    Procyclidine Hydrochloride
    IM/IV Injection 10 mg/2 ml Allopathic Antiparkinson drugs

    Indications

    Sialorrhea

    Indication detailsView
    Procyclidine is used for the adjunctive treatment of all forms of parkinsonian syndrome. It is mainly used for the symptomatic treatment of idiopathic (paralysis agitants), postencephalitic and arteriosclerotic parkinsonian. It is used to control troublesome extrapyramidal symptoms including pseudoparkinsonian, acute dystonic reactions and akathisia induced by neuroleptic drugs such as phenothiazine derivatives.
    Therapeutic classView
    Antiparkinson drugs
    PharmacologyView
    Procyclidine hydrochloride is an antimuscarinic antiparkinsonian agent of relatively low toxicity. It is a synthetic tertiary amine. This drug exerts their antiparkinsonian effect by correcting the relative cholinergic excess which is thought to occur in parkinsonian as a result of dopamine deficiency. It is absorbed from G.I. tract and disappears rapidly from the tissues. After intravenous administration, it acts within 5 to 20 minutes and has a duration of effect up to 4 hours.
    DosageView
    Tablet: This is administered orally, preferably after meals.
    • Parkinsonism: Initially 2.5 mg 3 times a day, then 5 mg 3 times a day and occasionally 5 mg at bedtime. The dosage being adjusted as tolerated or until the total daily dose reaches 20 to 30 mg divided into 3 to 4 doses.
    • Drug induced extrapyramidal symptom: Initially 2.5 mg 3 times a day. The dosage being increased by 2.5 mg increment per day as needed and tolerated.
    IM or IV injection: 5-10 mg, repeated if necessary after 20 minutes; maximum 20 mg daily can be given.
    Side effectsView
    At usual dosage levels dryness of the mouth is generally the only adverse effect. Mydriasis, blurred vision and adverse G.I. effects (nausea, vomiting, epigastric distress, constipation) occur occasionally. An allergic reaction (e.g. rash) or muscular weakness may occasionally occur. High doses may cause vertigo and possibly confusion and hallucination. Adverse effect may usually be minimized by adjustment of dosage and administration after meal.
    ContraindicationsView
    It should be given with caution in children and geriatric patients. It is advisable to be cautious in giving Procyclidine to patients with diarrhoea and cardiovascular disease, glaucoma, urinary retention, hepatic or renal impairment. The safety of using procyclidine during pregnancy has not been established. No data are available on the excretion of this drug in breast milk.
    PrecautionsView
    Precaution should be taken in case of hepatic & renal impairment, children, elderly, pregnancy and lactation condition. Patients with mental disorders occasionally experience a precipitation of a psychotic episode when Procyclidine is administered for the treatment of the extrapyramidal side-effects of neuroleptic. Procyclidine should not be withdrawn abruptly as rebound Parkinsonism symptoms may occur.
    InteractionsView
    The anticholinergic activity of procyclidine may be increased by agents having anticholinergic amantadine. The absorption of ketoconazole may be reduced by concomitant administration of procyclidine.
    Pregnancy & lactationView
    The safe use of this drug in pregnancy, lactation or in women of childbearing age requires that the potential benefits be weighed against the possible hazards to the mother and child.
    Pediatric usageView
    Use in children: Safety and efficacy have not been established in the pediatric age group; therefore the use of Procyclidine hydrochloride is this group requires that the potential benefits be weighed against the possible hazards to children.
    StorageView
    Protect from light and moisture, store below 25°C. Keep out of the reach of children.

    Cyclomide

    Cyclophosphamide
    IV Infusion 1 gm/vial Allopathic Cytotoxic Chemotherapy

    Indications

    Vasculitis

    Indication detailsView

    Malignant Diseases:

    Cyclophosphamide is indicated for the treatment of:
    • Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin's disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt's lymphoma
    • Multiple myeloma
    • Leukemias: chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenousand monocytic leukemia, acute lymphoblastic (stem-cell) leukemia (cyclophosphamide given during remission is effective in prolonging its duration)
    • Mycosis fungoides (advanced disease)
    • Neuroblastoma (disseminated disease)
    • Adenocarcinoma of the ovary
    • Retinoblastoma
    • Carcinoma of the breast
    Cyclophosphamide, although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs.

    Minimal Change Nephrotic Syndrome in Pediatric Patients:

    Cyclophosphamide is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatrics patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy.
    Therapeutic classView
    Cytotoxic Chemotherapy
    PharmacologyView
    Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle. It prevents cell division by cross-linking deoxyribonucleic acid (DNA) strands and reducing DNA synthesis. It also exerts a potent immunosuppressive effect.
    DosageView

    Intravenous (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly as a single dose;
    • Moderate dose regimen: 10-15 mg/kg wkly as a single dose;
    • High dose regimen: 20-40 mg/kg as a single dose every 10-20 days.
    Alternatively,
    • 80-300 mg/m2 daily as a single dose, or
    • 300-600 mg/m2 wkly as a single dose, or
    • 600-1,500 mg/m2 as a single dose or
    • Short infusion at 10- to 20-day intervals.

    Oral (Child)-

    Nephrotic syndrome: 
    • 2 mg/kg daily for 8-12 wk.
    • Max cumulative dose: 168 mg/kg.
    • Max duration: 90 days.

    Oral (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly in divided dose.
    • Alternatively, 100-300 mg daily in divided doses, or
    • 50-250 mg/m2 daily or 80-300 mg/m2 daily in divided doses.
    AdministrationView
    Should be taken on an empty stomach. Preferably taken on an empty stomach, but may be taken with meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole.
    Side effectsView
    Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis.
    ContraindicationsView
    Patient with bone marrow aplasia, urinary outflow obstruction, UTI, acute infection, drug- or radiation-induced urothelial toxicity. Pregnancy.
    PrecautionsView
    Patient with DM, severe immunosuppression, acute porphyria, pre-existing CV disease or those at risk for cardiotoxicity. Renal and hepatic impairment. Lactation.
    InteractionsView
    Increased risk of cardiotoxicity with doxorubicin or other cardiotoxic drugs. May increase incidence of mucositis with protease inhibitors. May increase haematotoxicity and/or immunosuppression with ACE inhibitors, natalizumab, paclitaxel, thiazide diuretics, zidovudine. May increase pulmonary toxicity with amiodarone. May increase nephrotoxicity with amphotericin B. May result to acute water intoxication with indometacin. May increase risk of hepatotoxicity with azathioprine. May increase incidence of hepatic veno-occlusive disease and mucositis with busulfan. May increase risk of haemorrhagic cystitis with previous or concomitant radiotherapy. May result to acute encephalopathy with metronidazole. May increase risk of thromboembolic complications. May alter the effect of warfarin. May increase immunosuppressive effect of ciclosporin. May result to prolonged apnoea with depolarising muscle relaxants (e.g. suxamethonium).
    Pregnancy & lactationView
    Pregnancy Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
    Overdose effectsView
    Symptoms: Urotoxicity, myelosuppression, cardiotoxicity (including cardiac failure), stomatitis, veno-occlusive hepatic disease.

    Management: Supportive treatment. May consider haemodialysis. Cystitis prophylaxis with mesna may be useful for urotoxicity.
    ReconstitutionView
    Reconstitute with 25 mL for a 500 mg vial, 50 mL for a 1,000 mg vial or 100 mL for a 2,000 mg vial to a concentration of 20 mg/mL using NaCl 0.9% for direct IV push, or NaCl 0.9% or sterile water for inj for IV infusion. Gently swirl to mix. For IV infusion, dilute further with dextrose 5% in water, NaCl 0.45% or dextrose 5% and NaCl 0.9% inj to a minimum concentration of 2 mg/mL.
    StorageView
    Store at or below 25°C.

    Cyclomide

    Cyclophosphamide
    IV Infusion 200 mg/vial Allopathic Cytotoxic Chemotherapy

    Indications

    Vasculitis

    Indication detailsView

    Malignant Diseases:

    Cyclophosphamide is indicated for the treatment of:
    • Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin's disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt's lymphoma
    • Multiple myeloma
    • Leukemias: chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenousand monocytic leukemia, acute lymphoblastic (stem-cell) leukemia (cyclophosphamide given during remission is effective in prolonging its duration)
    • Mycosis fungoides (advanced disease)
    • Neuroblastoma (disseminated disease)
    • Adenocarcinoma of the ovary
    • Retinoblastoma
    • Carcinoma of the breast
    Cyclophosphamide, although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs.

    Minimal Change Nephrotic Syndrome in Pediatric Patients:

    Cyclophosphamide is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatrics patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy.
    Therapeutic classView
    Cytotoxic Chemotherapy
    PharmacologyView
    Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle. It prevents cell division by cross-linking deoxyribonucleic acid (DNA) strands and reducing DNA synthesis. It also exerts a potent immunosuppressive effect.
    DosageView

    Intravenous (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly as a single dose;
    • Moderate dose regimen: 10-15 mg/kg wkly as a single dose;
    • High dose regimen: 20-40 mg/kg as a single dose every 10-20 days.
    Alternatively,
    • 80-300 mg/m2 daily as a single dose, or
    • 300-600 mg/m2 wkly as a single dose, or
    • 600-1,500 mg/m2 as a single dose or
    • Short infusion at 10- to 20-day intervals.

    Oral (Child)-

    Nephrotic syndrome: 
    • 2 mg/kg daily for 8-12 wk.
    • Max cumulative dose: 168 mg/kg.
    • Max duration: 90 days.

    Oral (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly in divided dose.
    • Alternatively, 100-300 mg daily in divided doses, or
    • 50-250 mg/m2 daily or 80-300 mg/m2 daily in divided doses.
    AdministrationView
    Should be taken on an empty stomach. Preferably taken on an empty stomach, but may be taken with meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole.
    Side effectsView
    Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis.
    ContraindicationsView
    Patient with bone marrow aplasia, urinary outflow obstruction, UTI, acute infection, drug- or radiation-induced urothelial toxicity. Pregnancy.
    PrecautionsView
    Patient with DM, severe immunosuppression, acute porphyria, pre-existing CV disease or those at risk for cardiotoxicity. Renal and hepatic impairment. Lactation.
    InteractionsView
    Increased risk of cardiotoxicity with doxorubicin or other cardiotoxic drugs. May increase incidence of mucositis with protease inhibitors. May increase haematotoxicity and/or immunosuppression with ACE inhibitors, natalizumab, paclitaxel, thiazide diuretics, zidovudine. May increase pulmonary toxicity with amiodarone. May increase nephrotoxicity with amphotericin B. May result to acute water intoxication with indometacin. May increase risk of hepatotoxicity with azathioprine. May increase incidence of hepatic veno-occlusive disease and mucositis with busulfan. May increase risk of haemorrhagic cystitis with previous or concomitant radiotherapy. May result to acute encephalopathy with metronidazole. May increase risk of thromboembolic complications. May alter the effect of warfarin. May increase immunosuppressive effect of ciclosporin. May result to prolonged apnoea with depolarising muscle relaxants (e.g. suxamethonium).
    Pregnancy & lactationView
    Pregnancy Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
    Overdose effectsView
    Symptoms: Urotoxicity, myelosuppression, cardiotoxicity (including cardiac failure), stomatitis, veno-occlusive hepatic disease.

    Management: Supportive treatment. May consider haemodialysis. Cystitis prophylaxis with mesna may be useful for urotoxicity.
    ReconstitutionView
    Reconstitute with 25 mL for a 500 mg vial, 50 mL for a 1,000 mg vial or 100 mL for a 2,000 mg vial to a concentration of 20 mg/mL using NaCl 0.9% for direct IV push, or NaCl 0.9% or sterile water for inj for IV infusion. Gently swirl to mix. For IV infusion, dilute further with dextrose 5% in water, NaCl 0.45% or dextrose 5% and NaCl 0.9% inj to a minimum concentration of 2 mg/mL.
    StorageView
    Store at or below 25°C.

    Cyclopan

    Dicycloverine Hydrochloride
    Syrup 10 mg/5 ml Allopathic Anticholinergics (antimuscarinics)/ Anti-spasmodics

    Indications

    Spasm

    Indication detailsView
    Dicycloverine is indicated in:
    • Functional bowel/irritable bowel syndrome
    • Urinary incontinence secondary to unstable detrusor muscle
    • Infantile colic
    • GIT spasm
    • Colicky abdominal pain
    • Diverticulitis
    • Abdominal colic
    Therapeutic classView
    Anticholinergics (antimuscarinics)/ Anti-spasmodics
    PharmacologyView
    Dicycloverine hydrochloride is an antispasmodic and anticholinergic (antimuscarinic) agent. Chemically, it is [Bicyclohexyl-]1-carboxylic acid, 2-(diethylammo) ethyl ester, hydrochloride. Dicycloverine relieves smooth muscle spasm of the gastrointestinal tract. Dicycloverine HCl Injection is a sterile, pyrogen-free, aqueous solution for intramuscular injection (Not For Intravenous Use). It works at specific receptors, called cholinergic (or muscarinic) receptors, located on the involuntary muscle in the walls of the gut. By binding to these receptors dicycloverine prevents certain chemicals produced by the body from interacting with these receptors. This causes the gut muscle to relax, relieving the pain of colic produced by gut muscle contraction and spasm.
    DosageView
    For oral dosage forms:
    • Adults:10 to 20 mg three times a day.
    • Children over 6 months of age: 5 to 10 mg three times a day.
    For injectable dosage form:
    • Adults: Intramuscular injection. Not for intravenous use. The recommended intramuscular dose is 80 mg daily (in 4 equally divided doses).
    Oral dicycloverine Hydrochloride should be started as soon as possible and the intramuscular form should not be used for periods longer than 1 or 2 days.

    Children: Dose must be determined by the doctor.
    Side effectsView
    Insomnia, mydriasis, cycloplegia, increased ocular tension, urinary hesitancy, palpitations, dyspnea.
    PrecautionsView
    Use with caution in patients with autonomic neuropathy, hepatic or renal disease, ulcerative colitis, coronary heart disease, congestive heart failure, cardiac tachyarrhythmia, hiatal hernia, known or suspected prostatic hypertrophy.
    Pregnancy & lactationView
    Pregnancy Category B. Dicycloverine was neither teratogenic nor embryocidal in animal trial. It, like other drugs should be used during pregnancy only if clearly needed. There are no data on the secretion of this drug into breast milk. Dicycloverine should be used cautiously in case of lactating mother.
    Overdose effectsView
    Toxic reaction seldom occurs with dicycloverine. The signs and symptoms of overdosage are headache; nausea; vomiting; blurred vision; dilated pupils; hot, dry skin; dizziness; dryness of the mouth; difficulty in swallowing; and CNS stimulation.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Cyclopan

    Dicycloverine Hydrochloride
    IM Injection 20 mg/2 ml Allopathic Anticholinergics (antimuscarinics)/ Anti-spasmodics

    Indications

    Spasm

    Indication detailsView
    Dicycloverine is indicated in:
    • Functional bowel/irritable bowel syndrome
    • Urinary incontinence secondary to unstable detrusor muscle
    • Infantile colic
    • GIT spasm
    • Colicky abdominal pain
    • Diverticulitis
    • Abdominal colic
    Therapeutic classView
    Anticholinergics (antimuscarinics)/ Anti-spasmodics
    PharmacologyView
    Dicycloverine hydrochloride is an antispasmodic and anticholinergic (antimuscarinic) agent. Chemically, it is [Bicyclohexyl-]1-carboxylic acid, 2-(diethylammo) ethyl ester, hydrochloride. Dicycloverine relieves smooth muscle spasm of the gastrointestinal tract. Dicycloverine HCl Injection is a sterile, pyrogen-free, aqueous solution for intramuscular injection (Not For Intravenous Use). It works at specific receptors, called cholinergic (or muscarinic) receptors, located on the involuntary muscle in the walls of the gut. By binding to these receptors dicycloverine prevents certain chemicals produced by the body from interacting with these receptors. This causes the gut muscle to relax, relieving the pain of colic produced by gut muscle contraction and spasm.
    DosageView
    For oral dosage forms:
    • Adults:10 to 20 mg three times a day.
    • Children over 6 months of age: 5 to 10 mg three times a day.
    For injectable dosage form:
    • Adults: Intramuscular injection. Not for intravenous use. The recommended intramuscular dose is 80 mg daily (in 4 equally divided doses).
    Oral dicycloverine Hydrochloride should be started as soon as possible and the intramuscular form should not be used for periods longer than 1 or 2 days.

    Children: Dose must be determined by the doctor.
    Side effectsView
    Insomnia, mydriasis, cycloplegia, increased ocular tension, urinary hesitancy, palpitations, dyspnea.
    PrecautionsView
    Use with caution in patients with autonomic neuropathy, hepatic or renal disease, ulcerative colitis, coronary heart disease, congestive heart failure, cardiac tachyarrhythmia, hiatal hernia, known or suspected prostatic hypertrophy.
    Pregnancy & lactationView
    Pregnancy Category B. Dicycloverine was neither teratogenic nor embryocidal in animal trial. It, like other drugs should be used during pregnancy only if clearly needed. There are no data on the secretion of this drug into breast milk. Dicycloverine should be used cautiously in case of lactating mother.
    Overdose effectsView
    Toxic reaction seldom occurs with dicycloverine. The signs and symptoms of overdosage are headache; nausea; vomiting; blurred vision; dilated pupils; hot, dry skin; dizziness; dryness of the mouth; difficulty in swallowing; and CNS stimulation.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Cyclopan

    Dicycloverine Hydrochloride
    Tablet 10 mg Allopathic Anticholinergics (antimuscarinics)/ Anti-spasmodics

    Indications

    Spasm

    Indication detailsView
    Dicycloverine is indicated in:
    • Functional bowel/irritable bowel syndrome
    • Urinary incontinence secondary to unstable detrusor muscle
    • Infantile colic
    • GIT spasm
    • Colicky abdominal pain
    • Diverticulitis
    • Abdominal colic
    Therapeutic classView
    Anticholinergics (antimuscarinics)/ Anti-spasmodics
    PharmacologyView
    Dicycloverine hydrochloride is an antispasmodic and anticholinergic (antimuscarinic) agent. Chemically, it is [Bicyclohexyl-]1-carboxylic acid, 2-(diethylammo) ethyl ester, hydrochloride. Dicycloverine relieves smooth muscle spasm of the gastrointestinal tract. Dicycloverine HCl Injection is a sterile, pyrogen-free, aqueous solution for intramuscular injection (Not For Intravenous Use). It works at specific receptors, called cholinergic (or muscarinic) receptors, located on the involuntary muscle in the walls of the gut. By binding to these receptors dicycloverine prevents certain chemicals produced by the body from interacting with these receptors. This causes the gut muscle to relax, relieving the pain of colic produced by gut muscle contraction and spasm.
    DosageView
    For oral dosage forms:
    • Adults:10 to 20 mg three times a day.
    • Children over 6 months of age: 5 to 10 mg three times a day.
    For injectable dosage form:
    • Adults: Intramuscular injection. Not for intravenous use. The recommended intramuscular dose is 80 mg daily (in 4 equally divided doses).
    Oral dicycloverine Hydrochloride should be started as soon as possible and the intramuscular form should not be used for periods longer than 1 or 2 days.

    Children: Dose must be determined by the doctor.
    Side effectsView
    Insomnia, mydriasis, cycloplegia, increased ocular tension, urinary hesitancy, palpitations, dyspnea.
    PrecautionsView
    Use with caution in patients with autonomic neuropathy, hepatic or renal disease, ulcerative colitis, coronary heart disease, congestive heart failure, cardiac tachyarrhythmia, hiatal hernia, known or suspected prostatic hypertrophy.
    Pregnancy & lactationView
    Pregnancy Category B. Dicycloverine was neither teratogenic nor embryocidal in animal trial. It, like other drugs should be used during pregnancy only if clearly needed. There are no data on the secretion of this drug into breast milk. Dicycloverine should be used cautiously in case of lactating mother.
    Overdose effectsView
    Toxic reaction seldom occurs with dicycloverine. The signs and symptoms of overdosage are headache; nausea; vomiting; blurred vision; dilated pupils; hot, dry skin; dizziness; dryness of the mouth; difficulty in swallowing; and CNS stimulation.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Cyclorin

    Cyclosporine (Ophthalmic)
    Ophthalmic Emulsion 0.05% Allopathic Drugs for Dry eyes

    Indications

    Scleritis

    Indication detailsView
    Cyclosporine Ophthalmic Emulsion is indicated to increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with dry eye syndrome (keratoconjunctivitis sicca).

    In addition to this, several clinical studies have showed that cyclosporine is effective in the management of different eye diseases like vernal keratoconjunctivitis, posterior blepharitis, non-infectious uveitis, superior limbic keratoconjunctivitis, phlyctenular keratoconjunctivitis and meibomian gland diseases.
    Therapeutic classView
    Drugs for Dry eyes
    PharmacologyView
    Cyclosporine is an immunosuppressive agent when administered systemically. In patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca, topical Cyclosporine is thought to act as a partial immunomodulator.
    DosageView
    One drop of Cyclosporine eye drop should be instilled twice a day in each eye approximately 12 hours apart. Cyclosporine eye drop can be used concomitantly with artificial tears, allowing a 15-minute interval between products.
    Side effectsView
    The most common adverse event was ocular burning. Other events reported included conjunctival hyperemia, discharge, epiphora, eye pain, foreign body sensation, pruritus, stinging, and visual disturbance (most often blurring).
    ContraindicationsView
    Cyclosporine is contraindicated in patients with active ocular infections and in patients with known or suspected hypersensitivity to any of the ingredients in the formulation.
    PrecautionsView
    Cyclosporine eye drop should not be administered while wearing contact lenses. Patients with decreased tear production typically should not wear contact lenses. If contact lenses are worn, they should be removed prior to the administration of this formulation. Lenses may be reinserted 15 minutes following administration of Cyclosporine eye drop.
    Pregnancy & lactationView
    Pregnancy: There are no adequate and well-controlled studies of Cyclosporine Ophthalmic Emulsion in pregnant women. It should be administered to pregnant women if clearly needed.

    Lactation: Cyclosporine is known to be excreted in human milk following systemic administration but excretion in human milk after topical treatment has not been investigated. Although blood concentrations are undetectable after topical administration of Cyclosporine eye drop, caution should be exercised when Cyclosporine is administered to a nursing woman.

    Cyclotox

    Cyclophosphamide
    IV Infusion 200 mg/vial Allopathic Cytotoxic Chemotherapy

    Indications

    Vasculitis

    Indication detailsView

    Malignant Diseases:

    Cyclophosphamide is indicated for the treatment of:
    • Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin's disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt's lymphoma
    • Multiple myeloma
    • Leukemias: chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenousand monocytic leukemia, acute lymphoblastic (stem-cell) leukemia (cyclophosphamide given during remission is effective in prolonging its duration)
    • Mycosis fungoides (advanced disease)
    • Neuroblastoma (disseminated disease)
    • Adenocarcinoma of the ovary
    • Retinoblastoma
    • Carcinoma of the breast
    Cyclophosphamide, although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs.

    Minimal Change Nephrotic Syndrome in Pediatric Patients:

    Cyclophosphamide is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatrics patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy.
    Therapeutic classView
    Cytotoxic Chemotherapy
    PharmacologyView
    Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle. It prevents cell division by cross-linking deoxyribonucleic acid (DNA) strands and reducing DNA synthesis. It also exerts a potent immunosuppressive effect.
    DosageView

    Intravenous (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly as a single dose;
    • Moderate dose regimen: 10-15 mg/kg wkly as a single dose;
    • High dose regimen: 20-40 mg/kg as a single dose every 10-20 days.
    Alternatively,
    • 80-300 mg/m2 daily as a single dose, or
    • 300-600 mg/m2 wkly as a single dose, or
    • 600-1,500 mg/m2 as a single dose or
    • Short infusion at 10- to 20-day intervals.

    Oral (Child)-

    Nephrotic syndrome: 
    • 2 mg/kg daily for 8-12 wk.
    • Max cumulative dose: 168 mg/kg.
    • Max duration: 90 days.

    Oral (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly in divided dose.
    • Alternatively, 100-300 mg daily in divided doses, or
    • 50-250 mg/m2 daily or 80-300 mg/m2 daily in divided doses.
    AdministrationView
    Should be taken on an empty stomach. Preferably taken on an empty stomach, but may be taken with meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole.
    Side effectsView
    Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis.
    ContraindicationsView
    Patient with bone marrow aplasia, urinary outflow obstruction, UTI, acute infection, drug- or radiation-induced urothelial toxicity. Pregnancy.
    PrecautionsView
    Patient with DM, severe immunosuppression, acute porphyria, pre-existing CV disease or those at risk for cardiotoxicity. Renal and hepatic impairment. Lactation.
    InteractionsView
    Increased risk of cardiotoxicity with doxorubicin or other cardiotoxic drugs. May increase incidence of mucositis with protease inhibitors. May increase haematotoxicity and/or immunosuppression with ACE inhibitors, natalizumab, paclitaxel, thiazide diuretics, zidovudine. May increase pulmonary toxicity with amiodarone. May increase nephrotoxicity with amphotericin B. May result to acute water intoxication with indometacin. May increase risk of hepatotoxicity with azathioprine. May increase incidence of hepatic veno-occlusive disease and mucositis with busulfan. May increase risk of haemorrhagic cystitis with previous or concomitant radiotherapy. May result to acute encephalopathy with metronidazole. May increase risk of thromboembolic complications. May alter the effect of warfarin. May increase immunosuppressive effect of ciclosporin. May result to prolonged apnoea with depolarising muscle relaxants (e.g. suxamethonium).
    Pregnancy & lactationView
    Pregnancy Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
    Overdose effectsView
    Symptoms: Urotoxicity, myelosuppression, cardiotoxicity (including cardiac failure), stomatitis, veno-occlusive hepatic disease.

    Management: Supportive treatment. May consider haemodialysis. Cystitis prophylaxis with mesna may be useful for urotoxicity.
    ReconstitutionView
    Reconstitute with 25 mL for a 500 mg vial, 50 mL for a 1,000 mg vial or 100 mL for a 2,000 mg vial to a concentration of 20 mg/mL using NaCl 0.9% for direct IV push, or NaCl 0.9% or sterile water for inj for IV infusion. Gently swirl to mix. For IV infusion, dilute further with dextrose 5% in water, NaCl 0.45% or dextrose 5% and NaCl 0.9% inj to a minimum concentration of 2 mg/mL.
    StorageView
    Store at or below 25°C.

    Cyclotox

    Cyclophosphamide
    IV Infusion 1 gm/vial Allopathic Cytotoxic Chemotherapy

    Indications

    Vasculitis

    Indication detailsView

    Malignant Diseases:

    Cyclophosphamide is indicated for the treatment of:
    • Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin's disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt's lymphoma
    • Multiple myeloma
    • Leukemias: chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenousand monocytic leukemia, acute lymphoblastic (stem-cell) leukemia (cyclophosphamide given during remission is effective in prolonging its duration)
    • Mycosis fungoides (advanced disease)
    • Neuroblastoma (disseminated disease)
    • Adenocarcinoma of the ovary
    • Retinoblastoma
    • Carcinoma of the breast
    Cyclophosphamide, although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs.

    Minimal Change Nephrotic Syndrome in Pediatric Patients:

    Cyclophosphamide is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatrics patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy.
    Therapeutic classView
    Cytotoxic Chemotherapy
    PharmacologyView
    Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle. It prevents cell division by cross-linking deoxyribonucleic acid (DNA) strands and reducing DNA synthesis. It also exerts a potent immunosuppressive effect.
    DosageView

    Intravenous (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly as a single dose;
    • Moderate dose regimen: 10-15 mg/kg wkly as a single dose;
    • High dose regimen: 20-40 mg/kg as a single dose every 10-20 days.
    Alternatively,
    • 80-300 mg/m2 daily as a single dose, or
    • 300-600 mg/m2 wkly as a single dose, or
    • 600-1,500 mg/m2 as a single dose or
    • Short infusion at 10- to 20-day intervals.

    Oral (Child)-

    Nephrotic syndrome: 
    • 2 mg/kg daily for 8-12 wk.
    • Max cumulative dose: 168 mg/kg.
    • Max duration: 90 days.

    Oral (Adult)-

    Malignancies: 
    • Low dose regimen: 2-6 mg/kg wkly in divided dose.
    • Alternatively, 100-300 mg daily in divided doses, or
    • 50-250 mg/m2 daily or 80-300 mg/m2 daily in divided doses.
    AdministrationView
    Should be taken on an empty stomach. Preferably taken on an empty stomach, but may be taken with meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole.
    Side effectsView
    Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis.
    ContraindicationsView
    Patient with bone marrow aplasia, urinary outflow obstruction, UTI, acute infection, drug- or radiation-induced urothelial toxicity. Pregnancy.
    PrecautionsView
    Patient with DM, severe immunosuppression, acute porphyria, pre-existing CV disease or those at risk for cardiotoxicity. Renal and hepatic impairment. Lactation.
    InteractionsView
    Increased risk of cardiotoxicity with doxorubicin or other cardiotoxic drugs. May increase incidence of mucositis with protease inhibitors. May increase haematotoxicity and/or immunosuppression with ACE inhibitors, natalizumab, paclitaxel, thiazide diuretics, zidovudine. May increase pulmonary toxicity with amiodarone. May increase nephrotoxicity with amphotericin B. May result to acute water intoxication with indometacin. May increase risk of hepatotoxicity with azathioprine. May increase incidence of hepatic veno-occlusive disease and mucositis with busulfan. May increase risk of haemorrhagic cystitis with previous or concomitant radiotherapy. May result to acute encephalopathy with metronidazole. May increase risk of thromboembolic complications. May alter the effect of warfarin. May increase immunosuppressive effect of ciclosporin. May result to prolonged apnoea with depolarising muscle relaxants (e.g. suxamethonium).
    Pregnancy & lactationView
    Pregnancy Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
    Overdose effectsView
    Symptoms: Urotoxicity, myelosuppression, cardiotoxicity (including cardiac failure), stomatitis, veno-occlusive hepatic disease.

    Management: Supportive treatment. May consider haemodialysis. Cystitis prophylaxis with mesna may be useful for urotoxicity.
    ReconstitutionView
    Reconstitute with 25 mL for a 500 mg vial, 50 mL for a 1,000 mg vial or 100 mL for a 2,000 mg vial to a concentration of 20 mg/mL using NaCl 0.9% for direct IV push, or NaCl 0.9% or sterile water for inj for IV infusion. Gently swirl to mix. For IV infusion, dilute further with dextrose 5% in water, NaCl 0.45% or dextrose 5% and NaCl 0.9% inj to a minimum concentration of 2 mg/mL.
    StorageView
    Store at or below 25°C.

    Cyclovex

    Acyclovir (Ophthalmic)
    Ophthalmic Ointment 3% Allopathic Ophthalmic Anti-viral Products

    Indications

    Neonatal Conjunctivitis

    Indication detailsView
    Acyclovir is indicated for the treatment of Herpes simplex keratitis.
    Therapeutic classView
    Ophthalmic Anti-viral Products
    PharmacologyView
    Acyclovir is an antiviral agent which is highly active in vitro against Herpes simplex (HSV) types I and II and Varicella zoster viruses, but its toxicity to mammalian cells is low. Acyclovir is phosphorylated to the active compound Acyclovir triphosphate after entry into herpes infected cell. The ­first step in this process requires the presence of the viral-coded thymidine kinase. Acyclovir triphosphate acts as an inhibitor of and substrate for the herpes specifi­ed DNA polymerase preventing further viral DNA synthesis without affecting normal cellular processes.
    DosageView
    The dosage for all age groups is the same. A 10 mm ribbon of the ointment should be placed inside the lower conjunctival sac ­five times a day at approximately four hourly intervals. Treatment should continue for at least 3 days after healing
    Side effectsView
    Very common: Superfi­cial punctate keratopathy. This did not necessitate an early termination of therapy and healed without apparent sequelae. Common: Transient mild stinging of the eye occurring immediately following application, conjunctivitis. Rare: Blepharitis.
    ContraindicationsView
    Acyclovir is contraindicated in patients known to be hypersensitive to Acyclovir or Valacyclovir
    PrecautionsView
    The recommended dosage, frequency of applications, and length of treatment should not be exceeded.
    InteractionsView
    No clinically signi­ficant interactions have been identi­fied.
    Pregnancy & lactationView
    Pregnancy category B. There are no adequate and well-controlled studies of Acyclovir in pregnant women. It is not known whether topically applied Acyclovir is excreted in breast milk.
    Overdose effectsView
    No adverse effects would be expected if the entire contents of the tube containing 90 mg Acyclovir were ingested orally.
    StorageView
    Store in a cool and dry place. Keep away from light. Keep out of reach of children. Do not touch the tip of the tube since this may contaminate the product. After one month of the opening do not use the medicine of tube.

    Cyclox

    Cloxacillin Sodium
    Capsule 500 mg Allopathic Penicillinase-resistant penicillins

    Indications

    UTI caused by Staphylococcus Aureus

    Indication detailsView
    গ্রাম-পজিটিভ জীবাণু দ্বারা সৃষ্ট সংক্রমণের চিকিৎসায় ক্লক্সাসিলিন নির্দেশিত। পেনিসিলিনেজ উৎপাদনক্ষম স্টেফাইলোকক্কাই জনিত সংক্রমণের চিকিৎসায়ও এটি নির্দেশিত। এ জাতীয় সংক্রমণের মধ্যে রয়েছেঃ

    স্কিন ও সফ্‌ট টিস্যু সংক্রমণ: ফোঁড়া (boils), পূজাশয় (abscess), কার্বাংকল, ফারানকুলোসিস, সেলুলাইটিস, সংক্রমিত ক্ষত (infected wounds), সংক্রমিত পোড়া (infected burns), ত্বক প্রতিস্থাপন প্রতিরক্ষা (protection for skin grafts), ত্বকের বিভিন্ন সংক্রমণ যেমন আলসার, একজিমা ও একনি।

    রেসপিরেটরী ট্র্যাক্ট, নাক, কান ও গলার সংক্রমণ: নিউমোনিয়া, ফুসফুসের পূজাশয় (lung abscess), এমপায়েমা, সাইনোসাইটিস, ফ্যারিনজাইটিস, টনসিলাইটিস, কুইনসি, অটাইটিস মিডিয়া ও এক্সটারণা।

    ক্লক্সাসিলিন-সংবেদনশীল (sensitive), জীবাণু জনিত অন্যান্য সংক্রমণ: অসটিওমায়েলাইটিস, এনটেরাইটিস, এনডোকারডাইটিস, ইউরিনারী ট্র্যাক্ট সংক্রমণ ও সেপটিসেমিয়া।
    Therapeutic classView
    Penicillinase-resistant penicillins
    DosageView
    প্রাপ্তবয়স্কদের প্রচলিত মাত্রা-
    খাওয়ার জন্য: ৫০০ মিগ্রা দিনে চার বার আহারের আধা থেকে এক ঘন্টা আগে।
    ইনজেকশন হিসেবে:
    • মাংসপেশীতে ইনজেকশন হিসেবে: ২৫০ মিগ্রা চার থেকে ছয় ঘন্টা পর পর।
    • শিরাপথে ইনজেকশন হিসেবে: ৫০০ মিগ্রা চার থেকে ছয় ঘন্টা পর পর। প্রয়োজনবোধে উপরোল্লিখিত মাত্রাকে দ্বিগুণ করা যেতে পারে।
    • প্লুরাল কেভিটিতে ইনজেকশন হিসেবে: ৫০০ মিগ্রা দিনে এক বার। 
    • জয়েন্ট কেভিটিতে ইনজেকশন হিসেবে: ৫০০ মিগ্রা দিনে এক বার।

    শিশুদের প্রচলিত মাত্রা-
    খাওয়ার জন্য: ২ থেকে ১০ বৎসর পর্যন্ত- প্রাপ্তবয়স্ক মাত্রার অর্ধেক। ২ বৎসরের নীচে- প্রাপ্তবয়স্ক মাত্রার এক-চতুর্থাংশ।
    ইনজেকশন হিসেবে:
    • মাংসপেশীতে ইনজেকশন হিসেবে: ২৫০ মিগ্রা এর সাথে ১.৫ মিলি কিংবা ৫০০ মিগ্রা এর সাথে ২ মিলি ওয়াটার ফর ইনজেকশন বিপি মিশিয়ে দ্রবীভূত করতে হবে।
    • শিরাপথে ইনজকেশন হিসাবে: ৫০০ মিগ্রা এর সাথে ৫-১০ মিলি ওয়াটার ফর ইনজকেশন বিপি মিশিয়ে দ্রবীভূত করতে হবে। এরপর এই দ্রবণকে তিন থেকে চার মিনিট ধরে ধীরে ধীরে শরীরে প্রয়োগ করতে হবে। ক্লক্সাসিলিন ইনজকেশনকে ইনফিউশন উপযোগী যে কোন তরলে মিশিয়ে দেয়া যায় অথবা যথাযথ ভাবে হালকা করে ড্রপি টউিবে তিন থেকে চার মিনিট ধরে ধীরে ধীরে প্রয়োগ করা যায়।
    • প্লুরাল কেভেটিতে ইনজেকশন হিসেবে: ৫০০ মিগ্রা এর সাথে ৫ থেকে ১০ মিলি ওয়াটার ফর ইনজকেশন বিপি মিশিয়ে দ্রবীভূত করে প্রয়োগ করতে হবে।
    • জয়েন্টে কেভেটিতে ইনজেকশন হিসেবে: ৫০০ মিগ্রা এর সাথে অনধকি ৫ মিলি ওয়াটার ফর ইনজকেশন বিপি অথবা ০.৫% লিগনোকেইন হাইড্রোক্লোরাইড দ্রবণ মিশিয়ে দ্রবীভূত করে প্রয়োগ করতে হবে।
    Side effectsView
    ক্লক্সাসিলিন এর পার্শ্ব-প্রতিক্রিয়া অন্যান্য পেনিসিলিনের মতই। এগুলো সাধারণতঃ মৃদু ও ক্ষণস্থায়ী হয়ে থাকে। এই সমস্ত পার্শ্ব-প্রতিক্রিয়ার মধ্যে রয়েছে জ্বর, ডায়রিয়া, অজীর্ণ (indigestion), র‍্যাশ-আরটিকারিয়েল অথবা ইরিথিমেটাস জাতীয়। যে কোন ধরণের র‍্যাশে রোগীকে এ ওষুধ দেয়া বন্ধ করতে হবে।
    ContraindicationsView

    পেনিসিলিনে অতি-সংবেদনশীল (hypersensitive) রোগীদের ক্ষেত্রে ক্লক্সাসিলিন প্রয়োগ নিষিদ্ধ।

    PrecautionsView
    যে সব রোগীর এলার্জির পূর্ব ইতিহাস আছে তাদের বেলায় ক্লক্সাসিলিন সতর্কতার সাথে ব্যবহার করতে হবে। ক্লক্সাসিলিন সাব-কনজাংটিভাল ইনজেকশন হিসেবে অথবা চোখের ড্রপস হিসেবে দেয়া যাবে না।

    ক্লক্সাসিলিন সিরাপ ও ড্রপস ব্যবহরের আগে তাৎক্ষনিকভাবে তৈরী করে ঠাণ্ডা স্থানে (সম্ভব হলে রেফ্রিজারেটরে) রাখতে হবে। সংমিশ্রিত সিরাপ ও ড্রপস সাধারণ তাপমাত্রায় রাখলে পাঁচ দিনের মধ্যে অথবা রেফ্রিজারেটরে রাখলে সাত দিনের মধ্যে ব্যবহার করতে হবে। মাংসপেশীতে বা শিরাপথে প্রয়োগের জন্য প্রস্তুতকৃত ক্লক্সাসিলিন দ্রবণ তৈরীর ৩০ মিনিটের মধ্যে ব্যবহার করতে হবে। অবশ্য ক্লক্সাসিলিন এর জলীয় দ্রবণ স্বাভাবিক তাপমাত্রায় (২৫° সেঃ) অনধিক ২৪ ঘন্টা পর্যন্ত কার্যকর থাকে।

    শিরাপথের প্রয়োগোপযোগী অধিকাংশ তরলের সাথেই ক্লক্সাসিলিন মেশানো যায়। তবে কখনোই আমিষ জাতীয় তরল (যেমন প্রোটিন হাইড্রোলাইসেটস) এর সাথে মেশানো যাবে না।
    StorageView
    ক্লক্সাসিলিন এর সকল ডোসেজ ফরমকে ঠান্ডা ও শুকনো স্থানে রাখতে হবে। ক্লক্সাসিলিন ইনজেকশন ভায়ালকে অনধিক ২৫° সেঃ তাপমাত্রায় সংরক্ষণ করুন।