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    Insulet

    Insulin Human [rDNA] + Isophane Insulin Human
    SC Injection 30%+70% in 100 IU/ml Allopathic Medium Acting Insulin

    Indications

    Type 1 DM

    Indication detailsView
    Treatment of all patients with type 1 diabetes. Treatment of patients with type 2 diabetes who are not adequately controlled by diet and/ or oral hypoglycemic agents.

    For the initial stabilization of diabetes in patients with diabetic ketoacidosis, hyperosmolar non-ketotic syndrome and during periods of stress such as severe infections and major surgery in diabetic patients. Treatment of gestational diabetes.
    Therapeutic classView
    Medium Acting Insulin
    PharmacologyView
    Insulin Human (rDNA) is human insulin made by recombinant DNA technology. It has the same structure and function as natural insulin. Insulin regulates the glucose metabolism and stimulates the ingestion and utilization of glucose by liver, muscle and fat tissue. It also lowers blood glucose by accelerating glycogenesis and inhibiting gluconeogenesis.

    Insulin Human (rDNA) 30/70 & Insulin Human (rDNA) 50/50 start action within 30 minutes after injection, reach peak level within 2-8 hours and last about 24 hours.
    DosageView
    The average range of total daily insulin requirement for maintenance therapy in type 1 diabetic patients lies between 0.5 and 1.0 IU/kg. In pre-pubertal children it usually varies from 0.7 to 1.0 IU/kg, whereas in insulin resistant cases, e.g. during puberty or due to obesity, the daily insulin requirement may be substantially higher. Initial dosages for type 2 diabetic patients are often lower, e.g. 0.3 to 0.6 IU/kg/day.

    The dosage form, the dosage and the administration time of the insulin are different due to the individual differences of each patient. In addition, the dosage is also affected by food, working style and exercising intensity. Therefore, patients should use the insulin under doctor's instruction.
    AdministrationView
    An injection should be followed by a meal or snack containing carbohydrates within 30 minutes. Injection is administered subcutaneously in the upper arm, thigh, buttock or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites. Insulin Human (rDNA) 30/70 & Insulin Human (rDNA) 50/50 are never to be administered intravenously.

    Preparation before use:
    • Clean your hands.
    • Shake or rotate the vial gently to mix the solution uniformly and check if the insulin has the normal appearance.
    • In case of using a new vial, flip off the plastic protective cap and wipe the rubber plug with an alcohol swab.
    • Draw air into your syringe equal to the amount of insulin needed.
    • Puncture the needle into the vial and inject the air.
    • Turn the bottle and syringe upside down and withdraw correct dose of insulin into the syringe.
    • Before pulling out the needle, check if there are any bubbles remain in the syringe. If so, put the syringe upright and tap the syringe to discharge the air bubbles.
    Injection site:
    • Choose the area where skin is less tight, such as the upper arm, thigh, buttock or abdomen.
    • To avoid tissue damage, choose a site for each injection that is at least 1 cm from the previous injection site.
    Injection method:
    • Cleanse the skin with alcohol where the injection is to be made.
    • Put the needle in such a position as to form 45° angle with the skin.
    • Puncture the needle into skin and inject insulin.
    • Keep the needle under the skin for at least 6 seconds to make sure the entire dose is injected.
    • Pull the needle out and apply gentle pressure over the injected site for several seconds.
    • Do not rub the injection site.
    Side effectsView
    Hypoglycemia is the most common adverse effect during insulin treatment and symptoms of hypoglycemia may occur suddenly. Few cases of the allergic reaction such as red and swollen or itching are reported. It usually disappears in a few days. In some instances, the allergy may be caused by other reasons rather than insulin, such as disinfectant and poor injection technique.
    ContraindicationsView
    Hypoglycemia or the patients who have allergic reaction to insulin or any of the excipients.
    PrecautionsView
    Inadequate dosing or discontinuation especially in type 1 diabetes, may lead to hyperglycemia. Hypoglycemia may occur if the insulin dose is too high in relation to the insulin requirement. Omission of a meal or unplanned, strenuous physical exercise may lead to hypoglycemia.
    InteractionsView
    When using oral contraceptive drug, adrenal cortical hormone, thyroid hormone, etc., the drugs that can result in the rise of blood glucose; you might need to increase the amount of Insulin. When using drugs with hypoglycemic activities, salicylate, sulfanilamide and other anti-depressants, which will result in the decrease of blood glucose, the dosage of insulin should be reduced.
    Pregnancy & lactationView
    There are no restrictions on treatment of diabetes with insulin during pregnancy, as insulin does not pass the placental barrier. Insulin treatment of the nursing mother presents no risk to the baby.
    Overdose effectsView
    Excessive use of insulin may lead to hypoglycemia during the treatment. Slight to moderate hypoglycemia may suddenly occur. It is important to get immediate treatment when hypoglycemia occurs. If you have frequent hypoglycemia, you should consult your doctor to discuss possible changes in therapy, diet plans, and/or exercise programs to help you avoid hypoglycemia.
    StorageView
    Store at 2°C - 8°C in a refrigerator. Do not freeze. In case of insulin for recent use need not be refrigerated, try to keep it in a cool place and keep away from heat and light. The insulin in use can be kept under the room temperature for a month.

    Insulet ASP

    Protamine Crystallised Insulin Aspart
    SC Injection 100 IU/ml Allopathic Rapid Acting Insulin

    Indications

    Type 1 DM

    Indication detailsView
    Protamine Crystallised Insulin Aspart is an insulin analog indicated to improve glycemic control in patients with diabetes mellitus.
    Therapeutic classView
    Rapid Acting Insulin
    PharmacologyView
    The primary activity of Insulin Aspart is the regulation of glucose metabolism. Insulin Aspart bind to the insulin receptors on muscle and fat cells and lower blood glucose by facilitating the cellular uptake of glucose and simultaneously inhibiting the output of glucose from the liver.
    DosageView
    Insulin Aspart has a faster onset and a shorter duration of action than soluble human insulin. Due to the faster onset of action, Insulin Aspart should generally be given immediately before a meal. When necessary Insulin Aspart may be given soon after a meal.

    Dosage of Insulin Aspart is individual and determined on the basis of the physician's advice in accordance with the needs of the patient. It should normally be used in combination with long-acting insulin given at least once a day.

    The individual insulin requirement is usually between 0.5 and 1.0 IU/kg/day in adults and children over 2 years of age. In a meal-related treatment 50-70% of this requirement may be provided by Insulin Aspart and the remainder by long-acting insulin. Adjustment of dosage may also be necessary if patients undertake increased physical activity or change their usual diet. Exercise taken immediately after a meal may increase the risk of hypoglycaemia.

    Subcutaneous Injection: Insulin Aspart should be administered by subcutaneous injection in the abdominal region, buttocks, thigh, or upper arm. Because Insulin Aspart has a more rapid onset and a shorter duration of activity than human regular insulin, it should be injected immediately (within 5-10 minutes) before a meal Continuous Subcutaneous Insulin Infusion (CSII) by External Pump Insulin Aspart can also be infused subcutaneously by an external insulin pump. The initial programming of the external insulin infusion pump should be based on the total daily insulin dose of the previous regimen. Approximately 50% of the total dose is usually given as meal-related boluses of Insulin Aspart and the remainder is given as a basal infusion. When used with an infusion pump Insulin Aspart should not be mixed with any other insulin.

    Intravenous Use: Insulin Aspart can be administered intravenously under medical supervision for glycemic control with close monitoring of blood glucose and potassium levels to avoid hypoglycemia and hypokalemia. For intravenous use, Insulin Aspart should be used at concentrations from 0.05 IU/mL to 1.0 IU/mL insulin aspart in infusion systems using polypropylene infusion bags. Insulin Aspart has been shown to be stable in infusion fluids such as 0.9% sodium chloride.
    AdministrationView
    Instructions to be given to the patient before injecting this Insulin:
    • According to the instruction given with ConviPen, insert the cartridge into the pen correctly & equip the needle
    • Gently turn the pen upside down for 8-10 times until the insulin in the cartridge becomes uniformly mixed suspension
    • Remove the needle cap, discharge air bubbles in the catridge
    • Adjust the dosage button to get correct dose & inject to the specific site
    • In order to avoid cross contamination, do not let the needle touch anything during the process of preparation.
    Side effectsView
    Side effects of Insulin Aspart are hypoglycemia, allergic reactions, injection site reaction, lipodystrophy, pruritus and rash.
    PrecautionsView
    Dose adjustment and monitoring: Blood glucose should be monitored in all patients treated with insulin. Insulin regimens should be modified cautiously and only under medical supervision
    InteractionsView
    A number of drugs affect glucose metabolism and may require dose adjustment.

    The following substances may reduce the Insulin as well as Insulin Aspart requirements: Oral anti-diabetic products, angiotensin converting enzyme (ACE) inhibitors, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, propoxyphene, pentoxifylline, salicylates and sulfonamide antibiotics.

    The following substances may increase the Insulin as well as Insulin Aspart requirements: Thiazides, glucocorticoids, thyroid hormones, beta-sympathomimetics, growth hormone and danazol. Beta-blockers, clonidine, lithium salts, and alcohol may either potentiate or weaken the blood glucose lowering effect of insulin.
    Pregnancy & lactationView
    Pregnancy category B. There are no restrictions on treatment with Protamine Crystallised Insulin Aspart during lactation. Insulin treatment of the nursing mother should not affect the baby. However, dosage may need to be adjusted.
    Overdose effectsView
    A specific overdose for insulin cannot be defined, however, hypoglycaemia may develop over sequential stages if too high doses relative to the patient’s requirement are administered. Mild hypoglycaemic episodes can be treated by oral administration of glucose or sugary products. Severe hypoglycaemic episodes, where the patient has become unconscious, can be treated by glucagon (0.5 to 1 mg) given intramuscularly or subcutaneously. Glucose must also be given intravenously if the patient does not respond to glucagon within 10 to 15 minutes. Upon regaining consciousness administration of oral carbohydrate is recommended for the patient in order to prevent relapse.
    StorageView
    Store at 2°C to 8°C in a refrigerator. Do not freeze. Protect from light.

    Insulet GN

    Insulin Glargine [rDNA]
    SC Injection 100 IU/ml Allopathic Long Acting Insulin

    Indications

    Type 1 DM

    Indication detailsView
    Insulin Glargine is indicated to improve glycemic control in adults and children with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus.
    Therapeutic classView
    Long Acting Insulin
    PharmacologyView
    Insulin Glargine is a sterile solution of insulin glargine for use as a subcutaneous injection. Insulin glargine is a recombinant human insulin analogue that is a long-acting (up to 24-hour duration of action), parenteral blood glucose lowering agent. Insulin Glargine is produced by recombinant DNA technology. Primary function of insulin glargine is regulation of glucose metabolism. Insulin and its analogues lower blood glucose by stimulation peripheral glucose uptake, primarily by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin inhibits lipolysis and proteolysis and enhances protein synthesis.
    DosageView
    Insulin Glargine exhibits a relatively constant glucose-lowering profile over 24 hours that permits once-daily dosing. Potency of insulin glargine is approximately the same as human insulin.

    Insulin Glargine is recommended for once daily subcutaneous administration & may be administered at any time during the day. However, once started should be administered at the same time every day. The dose of Insulin Glargine must be individualized based on clinical response. Blood glucose monitoring is essential in all patients with diabetes. In patients with type 1 diabetes, Insulin Glargine must be used in regimens with short-acting insulin. Insulin Glargine is not recommended for intravenous administration. Intravenous administration of the usual subcutaneous dose could result in severe hypoglycemia.

    Initiation of Insulin Glargine therapy:
    • The recommended starting dose of Insulin Glargine in patients with type 1 diabetes should be approximately one-third of the total daily insulin requirements. Short-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements.
    • The recommended starting dose of Insulin Glargine in patients with type 2 diabetes who are not currently treated with insulin is 10 units (or 0.2 Units/kg) once daily, which should subsequently be adjusted to the patient's needs.
    Converting to Insulin Glargine from other insulin therapies: If changing from a treatment regimen with an intermediate-or long-acting insulin to a regimen with Insulin Glargine , the amount and timing of shorter-acting insulins and doses of any oral anti-diabetic drugs may need to be adjusted.
    • If transferring patients from once-daily NPH insulin to once-daily Insulin Glargine , the recommended initial Insulin Glargine dose is the same as the dose of NPH that is being discontinued.
    • If transferring patients from twice-daily NPH insulin to once-daily Insulin Glargine , the recommended initial Insulin Glargine dose is 80% of the total NPH dose that is being discontinued.
    AdministrationView
    Insulin Glargine should be injected subcutaneously once daily at any time of day, but at the same time everyday.

    Cartridge:
    • Insert the Insulin Glargine cartridge into the pen correctly and equip the needle. Gently turn the pen upside down for 8-10 times until the insulin in the cartridge becomes uniformly mixed.
    • Adjust the dosage button to get correct dose. After removal of the needle cap and discharge air bubbles in the cartridge, it is ready to be injected. In order to avoid cross contamination, do not let the needle touch anything during the process of preparation.
    Vial:
    • Firstly, clean your hands. Shake or rotate the vial gently to mix the solution uniformly and check if the insulin has the normal appearance.
    • If using a new Insulin Glargine bottle then flip off the plastic protective cap and wipe the rubber stopper with an alcohol swab.
    • Draw air into your syringe equal to the amount of Insulin Glargine needed. Puncture the needle into the vial and inject the air.
    • Turn the bottle and syringe upside down. Withdraw correct dose of Insulin Glargine into the syringe. Before pulling out the needle, check if there are any bubbles remain in the syringe.
    • If so, put the syringe upright and tap the syringe to discharge the air bubbles.
    Injection Site: Choose the area where skin is less tight, such as the upper arm, thigh, buttock and abdomen, etc. To avoid tissue damage, choose a site for each injection that is at least 1 cm from the previous injection site.

    Injection Method: Cleanse the skin with alcohol where the injection is to be made. Put the needle in such a position as to form 45° angle with the skin. Puncture the needle into skin and inject insulin. Then pull the needle out and apply gentle pressure over the injected site for several seconds. Do not rub the injection site.
    Side effectsView
    Side effects of Insulin glargine are hypoglycemia, allergic reactions, injection site reaction, lipodystrophy, pruritus, and rash.
    ContraindicationsView
    Insulin glargine is contraindicated in patients with hypersensitivity to insulin glargine or any of its excipients.
    PrecautionsView
    Dose adjustment and monitoring: Blood glucose should be monitored in all patients treated with insulin. Insulin regimens should be modified cautiously and only under medical supervision.

    Administration: Insulin glargine must not be diluted or mixed with any other insulin or solution. It should not be administered subcutaneously via an insulin pump or intravenously because severe hypoglycemia can occur.

    Renal or hepatic impairment: Reduction in the Insulin glarginedose may require in these cases.
    InteractionsView
    A number of drugs affect glucose metabolism and may require dose adjustment.

    The following substances may reduce the Insulin as well as Insulin glargine requirements: Oral anti-diabetic products, angiotensin converting enzyme (ACE) inhibitors, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, propoxyphene, pentoxifylline, salicylates and sulfonamide antibiotics.

    The following substances may increase the Insulin as well as Insulin glargine requirements: Thiazides, glucocorticoids, thyroid hormones, beta-sympathomimetics, growth hormone and danazol. Beta-blockers, clonidine, lithium salts, and alcohol may either potentiate or weaken the blood-glucose-lowering effect of insulin.
    Pregnancy & lactationView
    Pregnancy category C. Insulin glargine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

    Lactation: It is unknown whether insulin glargine is excreted in human milk. Because many drugs, including human insulin, are excreted in human milk, caution should be exercised when Insulin glargine is administered to a nursing woman. Lactating women may require adjustments in insulin dose & diet.
    Pediatric usageView
    Use in Renal/ Hepatic impairment: Reduction in the insulin glargine doses may be required in these cases.
    Overdose effectsView
    Insulin glargine overdose may result in hypoglycemia. Mild episodes of hypoglycemia can usually be treated with oral carbohydrates. Severe hypoglycemia may be treated with parenteral glucose or injections of glucagon. Adjustments in drug dosage, meal patterns, or exercise may be needed.
    StorageView
    Store at 2° C to 8° C in a refrigerator. Do not freeze. In case of insulin for recent use need not to be refrigerated, try to keep it in a cool place and keep away from heat and light. The insulin in use can be kept under the room temperature for a month.

    Insulet N

    Insulin Human [Long-Acting]
    SC Injection 100 IU/ml Allopathic Long Acting Insulin

    Indications

    Type 1 DM

    Indication detailsView
    Treatment of all patients with type 1 diabetes. Treatment of patients with type 2 diabetes who are not adequately controlled by diet and/ or oral hypoglycemic agents. For the initial stabilization of diabetes in patients with diabetic ketoacidosis, hyperosmolar non-ketotic syndrome and during periods of stress such as severe infections and major surgery in diabetic patients. Treatment of gestational diabetes.
    Therapeutic classView
    Long Acting Insulin
    PharmacologyView
    The blood glucose lowering effect of insulin is due to the facilitated uptake of glucose following binding of insulin to receptors on muscle and fat cells and to the simultaneous inhibition of glucose output from the liver. Insulatard is a long-acting insulin. Onset of action is within 1½ hours, reaches a maximum effect within 4-12 hours and the entire time of duration is approximately 24 hours.

    Insulin in the blood stream has a half-life of a few minutes. Consequently, the time-action profile of an insulin preparation is determined solely by its absorption characteristics. This process is influenced by several factors (e.g. insulin dosage, injection route and site, thickness of subcutaneous fat, type of diabetes). The pharmacokinetics of insulins is therefore affected by significant intra- and inter-individual variation
    DosageView
    Dosage is individual and determined in accordance with the needs of the patient. The individual insulin requirement is usually between 0.3 and 1.0 IU/kg day. The daily insulin requirement may be higher in patients with insulin resistance (e.g. during puberty or due to obesity) and lower in patients with residual, endogenous insulin production.

    The physician determines one or several daily injections are necessary. Insulatard may be used alone or mixed with fast-acting insulin. In intensive insulin therapy the suspension may be used as basal insulin (evening and/or morning injection) with fast-acting insulin given at meals. In patients with diabetes mellitus optimised glycaemic control delays the onset of late diabetic complications. Close blood glucose monitoring is recommended.
    AdministrationView
    For subcutaneous use. Insulatard is usually administered subcutaneously in the thigh. If convenient, the abdominal wall, the gluteal region or the deltoid region may also be used. Subcutaneous injection into the thigh results in a slower and less variable absorption compared to the other injection sites. Injection into a lifted skin fold minimises the risk of unintended intramuscular injection.

    Keep the needle under the skin for at least 6 seconds to make sure the entire dose is injected. Injection sites should be rotated within an anatomic region in order to avoid lipodystrophy. Insulin suspensions are never to be administered intravenously. Insulatard is accompanied by a package leaflet with detailed instruction for use to be followed. The vials are for use with insulin syringes with corresponding unit scale. When two types of insulin are mixed, draw the amount of fast-acting insulin first, followed by the amount of long-acting insulin
    Side effectsView
    Hypoglycemia is the most common adverse effect during insulin treatment and symptoms of hypoglycemia may occur suddenly. Few cases of the allergic reaction such as red and swollen or itching are reported. It usually disappears in a few days. In some instances, the allergy may be caused by other reasons rather than insulin, such as disinfectant and poor injection technique.
    ContraindicationsView
    Hypoglycaemia, Hypersensitivity to human insulin or to any of the excipients
    PrecautionsView
    Inadequate dosage or discontinuation of treatment, especially in type 1 diabetes, may lead to hyperglycaemia. Usually the first symptoms of hyperglycaemia set in gradually, over a period of hours or days. They include thirst, increased frequency of urination, nausea, vomiting, drowsiness, flushed dry skin, dry mouth, loss of appetite as well as acetone odour of breath In type 1 diabetes, untreated hyperglycaemic events eventually lead to diabetic ketoacidosis, which is potentially lethal. Hypoglycaemia may occur if the insulin dose is too high in relation to the insulin requirement

    Omission of a meal or unplanned, strenuous physical exercise may lead to hypoglycaemia. Patients whose blood glucose control is greatly improved e.g. by intensified insulin therapy, may experience a change in their usual warning symptoms of hypoglycaemia and should be advised accordingly Usual warning symptoms may disappear in patients with longstanding diabetes.
    InteractionsView
    A number of medicinal products are known to interact with the glucose metabolism. Physicians must therefore take possible interactions into account and should always ask their patients about any medicinal products they take.

    The following substances may reduce insulin requirement: Oral hypoglycaemic agents (OHA), monoamine oxidase inhibitors (MAOI), non-selective beta-blocking agents, angiotensin converting enzyme (ACE) inhibitors, salicylates and alcohol.

    The following substances may increase insulin requirement: Thiazides, glucocorticoids, thyroid hormones and beta-sympathomimetics, growth hormone and danazol. Beta-blocking agents may mask the symptoms of hypoglycaemia and delay recovery from hypoglycaemia. Octreotide/lanreotide may both decrease and increase insulin requirement. Alcohol may intensify and prolong the hypoglycaemic effect of insulin.
    Pregnancy & lactationView
    There are no restrictions on treatment of diabetes with insulin during pregnancy, as insulin does not pass the placental barrier.
    Overdose effectsView
    A specific overdose of insulin cannot be defined. However, hypoglycaemia may develop over sequential stages
    StorageView
    Store in a refrigerator (2°C-8°C). Do not freeze. Keep the container cartridge or vial in the outer carton in order to protect from light.

    During use: do not refrigerate. Do not store vials above 25°C and cartridges above 30°C. Protect from excessive heat and sunlight.

    Insulet R

    Insulin Human [Fast-Acting]
    SC Injection 100 IU/ml Allopathic Rapid Acting Insulin

    Indications

    Type 1 DM

    Indication detailsView
    Treatment of all patients with type 1 diabetes. Treatment of patients with type 2 diabetes who are not adequately controlled by diet and/ or oral hypoglycemic agents. For the initial stabilization of diabetes in patients with diabetic ketoacidosis, hyperosmolar non-ketotic syndrome and during periods of stress such as severe infections and major surgery in diabetic patients. Treatment of gestational diabetes.
    Therapeutic classView
    Rapid Acting Insulin
    PharmacologyView
    The blood glucose lowering effect of insulin is due to the facilitated uptake of glucose following binding of insulin to receptors on muscle and fat cells and to the simultaneous inhibition of glucose output from the liver. Insulatard is a long-acting insulin. Onset of action is within 1½ hours, reaches a maximum effect within 4-12 hours and the entire time of duration is approximately 24 hours.

    Insulin in the blood stream has a half-life of a few minutes. Consequently, the time-action profile of an insulin preparation is determined solely by its absorption characteristics. This process is influenced by several factors (e.g. insulin dosage, injection route and site, thickness of subcutaneous fat, type of diabetes). The pharmacokinetics of insulins is therefore affected by significant intra- and inter-individual variation
    DosageView
    Always use your insulin and adjust your dose exactly as your doctor has told you. Check with your doctor, pharmacist or nurse if you are not sure. Eat a meal or snack containing carbohydrates within 30 minutes of the injection to avoid low blood sugar. Do not change your insulin unless your doctor tells you to. If your doctor has switched you from one type or brand of insulin to another, your dose may have to be adjusted by your doctor.
    AdministrationView
    For subcutaneous use. Insulatard is usually administered subcutaneously in the thigh. If convenient, the abdominal wall, the gluteal region or the deltoid region may also be used. Subcutaneous injection into the thigh results in a slower and less variable absorption compared to the other injection sites. Injection into a lifted skin fold minimises the risk of unintended intramuscular injection.

    Keep the needle under the skin for at least 6 seconds to make sure the entire dose is injected. Injection sites should be rotated within an anatomic region in order to avoid lipodystrophy. Insulin suspensions are never to be administered intravenously. Insulatard is accompanied by a package leaflet with detailed instruction for use to be followed. The vials are for use with insulin syringes with corresponding unit scale. When two types of insulin are mixed, draw the amount of fast-acting insulin first, followed by the amount of long-acting insulin.
    Side effectsView
    Low blood sugar (hypoglycaemia) is a very common side effect. It may affect more than 1 in 10 people.

    Signs of low blood sugar: Cold sweat; cool pale skin; headache; rapid heartbeat; feeling sick; feeling very hungry; temporary changes in vision; drowsiness; unusual tiredness and weakness; nervousness or tremor; feeling anxious; feeling confused; difficulty in concentrating.
    PrecautionsView
    • If you have trouble with your kidneys or liver, or with your adrenal, pituitary or thyroid glands.
    • If you exercise more than usual or if you want to change your usual diet, as this may affect your blood sugar level.
    • If you are ill, carry on taking your insulin and consult your doctor.
    • If you are going abroad, travelling over time zones may affect your insulin needs and the timing hereof.
    Pregnancy & lactationView
    If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. This insulin can be used during pregnancy. Your insulin dose may need to be changed during pregnancy and after delivery. Careful control of your diabetes, particularly prevention of hypoglycaemia, is important for the health of your baby. There are no restrictions on treatment with this insulin during breast-feeding.
    Pediatric usageView
    Use in children and adolescents: Can be used in children and adolescents.

    Use in special patient groups: If you have reduced kidney or liver function, or if you are above 65 years of age, you need to check your blood sugar more regularly and discuss changes in your insulin dose with your doctor.
    StorageView
    Store in a refrigerator at 2°C-8°C. Keep away from the cooling element. Do not freeze.

    Insuman Comb

    Insulin Human [rDNA] + Isophane Insulin Human
    SC Injection 25%+75% in 100 IU/ml Allopathic Medium Acting Insulin

    Indications

    Type 1 DM

    Indication detailsView
    Treatment of all patients with type 1 diabetes. Treatment of patients with type 2 diabetes who are not adequately controlled by diet and/ or oral hypoglycemic agents.

    For the initial stabilization of diabetes in patients with diabetic ketoacidosis, hyperosmolar non-ketotic syndrome and during periods of stress such as severe infections and major surgery in diabetic patients. Treatment of gestational diabetes.
    Therapeutic classView
    Medium Acting Insulin
    PharmacologyView
    Insulin Human (rDNA) is human insulin made by recombinant DNA technology. It has the same structure and function as natural insulin. Insulin regulates the glucose metabolism and stimulates the ingestion and utilization of glucose by liver, muscle and fat tissue. It also lowers blood glucose by accelerating glycogenesis and inhibiting gluconeogenesis.

    Insulin Human (rDNA) 30/70 & Insulin Human (rDNA) 50/50 start action within 30 minutes after injection, reach peak level within 2-8 hours and last about 24 hours.
    DosageView
    The average range of total daily insulin requirement for maintenance therapy in type 1 diabetic patients lies between 0.5 and 1.0 IU/kg. In pre-pubertal children it usually varies from 0.7 to 1.0 IU/kg, whereas in insulin resistant cases, e.g. during puberty or due to obesity, the daily insulin requirement may be substantially higher. Initial dosages for type 2 diabetic patients are often lower, e.g. 0.3 to 0.6 IU/kg/day.

    The dosage form, the dosage and the administration time of the insulin are different due to the individual differences of each patient. In addition, the dosage is also affected by food, working style and exercising intensity. Therefore, patients should use the insulin under doctor's instruction.
    AdministrationView
    An injection should be followed by a meal or snack containing carbohydrates within 30 minutes. Injection is administered subcutaneously in the upper arm, thigh, buttock or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites. Insulin Human (rDNA) 30/70 & Insulin Human (rDNA) 50/50 are never to be administered intravenously.

    Preparation before use:
    • Clean your hands.
    • Shake or rotate the vial gently to mix the solution uniformly and check if the insulin has the normal appearance.
    • In case of using a new vial, flip off the plastic protective cap and wipe the rubber plug with an alcohol swab.
    • Draw air into your syringe equal to the amount of insulin needed.
    • Puncture the needle into the vial and inject the air.
    • Turn the bottle and syringe upside down and withdraw correct dose of insulin into the syringe.
    • Before pulling out the needle, check if there are any bubbles remain in the syringe. If so, put the syringe upright and tap the syringe to discharge the air bubbles.
    Injection site:
    • Choose the area where skin is less tight, such as the upper arm, thigh, buttock or abdomen.
    • To avoid tissue damage, choose a site for each injection that is at least 1 cm from the previous injection site.
    Injection method:
    • Cleanse the skin with alcohol where the injection is to be made.
    • Put the needle in such a position as to form 45° angle with the skin.
    • Puncture the needle into skin and inject insulin.
    • Keep the needle under the skin for at least 6 seconds to make sure the entire dose is injected.
    • Pull the needle out and apply gentle pressure over the injected site for several seconds.
    • Do not rub the injection site.
    Side effectsView
    Hypoglycemia is the most common adverse effect during insulin treatment and symptoms of hypoglycemia may occur suddenly. Few cases of the allergic reaction such as red and swollen or itching are reported. It usually disappears in a few days. In some instances, the allergy may be caused by other reasons rather than insulin, such as disinfectant and poor injection technique.
    ContraindicationsView
    Hypoglycemia or the patients who have allergic reaction to insulin or any of the excipients.
    PrecautionsView
    Inadequate dosing or discontinuation especially in type 1 diabetes, may lead to hyperglycemia. Hypoglycemia may occur if the insulin dose is too high in relation to the insulin requirement. Omission of a meal or unplanned, strenuous physical exercise may lead to hypoglycemia.
    InteractionsView
    When using oral contraceptive drug, adrenal cortical hormone, thyroid hormone, etc., the drugs that can result in the rise of blood glucose; you might need to increase the amount of Insulin. When using drugs with hypoglycemic activities, salicylate, sulfanilamide and other anti-depressants, which will result in the decrease of blood glucose, the dosage of insulin should be reduced.
    Pregnancy & lactationView
    There are no restrictions on treatment of diabetes with insulin during pregnancy, as insulin does not pass the placental barrier. Insulin treatment of the nursing mother presents no risk to the baby.
    Overdose effectsView
    Excessive use of insulin may lead to hypoglycemia during the treatment. Slight to moderate hypoglycemia may suddenly occur. It is important to get immediate treatment when hypoglycemia occurs. If you have frequent hypoglycemia, you should consult your doctor to discuss possible changes in therapy, diet plans, and/or exercise programs to help you avoid hypoglycemia.
    StorageView
    Store at 2°C - 8°C in a refrigerator. Do not freeze. In case of insulin for recent use need not be refrigerated, try to keep it in a cool place and keep away from heat and light. The insulin in use can be kept under the room temperature for a month.

    Intafenac

    Diclofenac Sodium
    Tablet 50 mg Allopathic Drugs for Osteoarthritis

    Indications

    Tendonitis

    Indication detailsView
    Rheumatology: Inflammatory and degenerative forms of rheumatism, chronic involutive, polyarthritis, ankylosing spondylarthritis, osteoarthritis, spondylarthroses, acute gout, peri-articular rheumatic disorders.

    Surgery and Traumatology: Sprain, bruises, dislocations, fractures, softtissue injuries, surgical interventions.

    Obstetrics and Gynecology: Primary dysmenorrhoea, episiotomy, adnexitis, endometritis, parametritis, salpingitis, and mastitis.

    Otorhinolaryngology: As pre-operative medication for the prevention of pain, inflammation, and swelling.

    Dentistry: Post-operative and post-traumatic pain, inflammation, and swelling.

    Other indications: For the prevention of pain and treatment of inflammation and swelling of patients operated in the urogenital tract, renal and biliary colic.
    Therapeutic classView
    Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
    PharmacologyView
    Dilofenac Sodium is a potent non-steroidal anti-inflammatory drug (NSAID) with pronounced anti-rheumatic, anti-inflammatory, analgesic and antipyretic properties. It has also some uricosuric effect. Diclofenac exerts its effect by inhibiting prostaglandin biosynthesis which plays a major role in causing inflammation, pain and fever. Diclofenac is rapidly and completely absorbed from the gastro-intestinal tract when taken with or after meal. Peak plasma concentrations are reached within an average of 2 hours after ingestion of it. At therapeutic concentrations, it is 99.7% bound to plasma proteins. Diclofenac is metabolized in the liver and undergoes first pass metabolism.
    DosageView
    Diclofenac FC Tablet: Adults: 75-150 mg daily in 2 to 3 divided doses, preferably after food. Dose should be reduced in long term use.

    Diclofenac SR Tablet:
    • Adult: 1 tablet daily, taken whole with liquid, preferably at meal times. If necessary, the daily dose can be increased to 150 mg by supplementation with conventional tablets.
    • Children: 1-3 mg of diclofenac/kg body wt. daily in divided doses.
    • Elderly patients: In elderly or debilitated patients, the lowest effective dosage is recommended, although the pharmacokinetics of diclofenac sodium is not impaired to any clinically relevant extent in elderly patients.
    Diclofenac Dispersible Tablet:
    • Adults: The recommended daily dosage is 2-3 tablets and the maximum daily dose is 150 mg. In milder cases, 2 tablets of Diclofenac DT per day are sufficient. Diclofenac DT should preferably be taken before meals.
    • Children: Diclofenac is not recommended in children for other indications except juvenile rheumatoid arthritis where the recommended dose is 1-3 mg/kg body weight. Diclofenac DT is to be dropped into a half-glass of water and the liquid is to be stirred to aid dispersion before swallowing. There is no information on the use of Diclofenac DT for more than 03 months.
    Diclofenac TR Capsule: One capsule daily. Diclofenac TR should be taken preferably after mealtimes.

    Diclofenac Suppository: For adults: 50 mg suppository 2-3 times daily. Maximum daily dose is 150 mg.

    Diclofenac injection: For adults the usual dose is 1 ampoule daily. In serious cases this dose may be increased up to 2 ampoules daily.

    Diclofenac Gel: For external use only. Depending on the size of area to be treated, 2-4 g of Diclofenac gel should be applied to the skin 3-4 times daily. To the affected area gel should be rubbed in lightly. This gel may also be given in addition to further treatment with other dosage forms of Diclofenac.
    Side effectsView
    Diclofenac Sodium is generally well tolerated. Adverse effects are mild, rare and transient. At the starting of the treatment, however, patients may be sometimes complaining of epigastric pain, eructation, nausea and diarrhea or dizziness or headache. These effects are usually mild in nature. Peripheral edema and skin reactions, such as rash and eczema have also been encountered. Diclofenac Sodium Gel may cause local irritation and reddening of the skin and skin rash.
    ContraindicationsView
    Contraindicated to the patients hypersensitive to any ingredient of the products. Peptic ulcer, hypersensitivity to Diclofenac like other non-steroid anti-inflammatory agents, Diclofenac is also contra-indicated in asthmatic patient in whom attack with asthma, urticaria or acute rhinitis are precipitated by acetylsalicylic acid or by other drugs with prostaglandin synthetase inhibitor. This Gel should not be used under occlusive airtight dressings.
    PrecautionsView
    In rare instances where peptic ulceration or gastrointestinal bleeding occurs in patients under treatment with Diclofenac. In patients with advanced age should be kept under close observation. Diclofenac Sodium Gel should not be allowed to come in contact with the eyes or mucus membranes, after application the hands should be washed properly and not to be taken by mouth.
    Pregnancy & lactationView
    During pregnancy, Diclofenac should be employed only for compelling reasons. The lowest effective dose should be used. These types of drugs are not recommended during the first trimester of pregnancy. In view of insufficient clinical data, Diclofenac Sodium Gel is not recommended during pregnancy. A very insignificant quantity of Diclofenac may be detected in breast milk but no undesirable effects on the infant to be expected.
    StorageView
    Store in a cool and dry place, protected from light. Store below 30°C. Keep out of the reach of children.

    Intafenac

    Diclofenac Sodium (Ophthalmic)
    Ophthalmic Solution 0.10% Allopathic Ophthalmic Non-Steroid drugs

    Indications

    Ocular inflammation

    Indication detailsView
    Diclofenac Sodium ophthalmic preparation is indicated in- 
    • Inhibition of miosis during cataract surgery.
    • Post-operative inflammation after cataract surgery and other ocular surgical procedures.
    • Pre-operative and post-operative prevention of cystoid macular edema (CME) associated with lens extraction & intraocular lens implantation.
    • Post-traumatic inflammation in penetrating and non- penetrating wounds (as an adjuvant to local anti-infective therapy).
    • Non-infected chronic conjunctivitis, keratoconjunctivitis.
    Therapeutic classView
    Ophthalmic Non-Steroid drugs
    PharmacologyView
    Diclofenac Eye Drops contains Diclofenac Sodium, a potent non-steroidal anti-inflammatory drug with analgesic property. Diclofenac Sodium produces anti-inflammatory effect by inhibiting cyclooxygenase activity with a reduction in the tissue prostaglandin ( such as PgE2 and Pg F2α) .
    DosageView
    Ophthalmic (Adult)-
    • Postoperative ocular inflammation: Instill into the appropriate eye 4 times daily starting 24 hr after surgery for up to 28 days.
    • Inflammation and discomfort after strabismus surgery: Instill 1 drop 4 times daily for the 1st wk; then tid in the 2nd wk, bid in the 3rd wk, and as required for the 4th wk.
    • Pain and discomfort after radial keratotomy: Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.
    • Pain after accidental trauma: Instill 1 drop 4 times daily for up to 2 days.
    • Control of inflammation after argon laser trabeculoplasty: Instill 1 drop 4 times during the 2 hr before procedure followed by 1 drop 4 times daily, up to 7 days after procedure.
    • Prophylaxis of intra-operative miosis: Instill into appropriate eye 4 times w/in 2 hr before surgery.
    • Post-photorefractive keratectomy pain: Instill into the affected eye twice, an hr before surgery, then 1 drop twice at 5-min intervals immediately after surgery, then every 2-5 hr while awake for up to 24 hr.
    • Seasonal allergic conjunctivitis: Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.
    Side effectsView
    Mild to moderate burning sensation in 5-15% patients which is transient in nature and almost never necessitated discontinuation of treatment. Other less common side-effects are sensitivity to light, bad taste, feeling of pressure, allergic reactions etc.
    ContraindicationsView
    Hypersensitivity to any of the components Like other non steroidal anti-inflammatory agents, Diclofenac Sodium eye drops is contraindicated in patients in whom attacks of asthma, urticaria or acute rhinitis have been observed following application of acetyl salicylic acid or other cyclo-oxygenase inhibitors
    PrecautionsView
    Diclofenac eye drops may mask the signs of infection. So physicians should be alert to the development of infections in patients receiving the drug. During prolonged use, it is recommended that physicians conduct periodic examinations of the eye, including measurement of the intraocular pressure. Contact lenses should not be worn during treatment.
    InteractionsView
    No drug interaction is reported. There should be at least 5 minutes interval when another ophthalmic solution (e.g., steroid) is given.
    Pregnancy & lactationView
    The safety of Diclofenac eye drops in pregnancy & lactation has not been established and its use therefore is not recommended unless the potential benefit to the mother outweighs the possible risk to the child.
    Overdose effectsView
    Accidental ingestion of Diclofenac Sodium presents virtually no risk of unwanted effects, since one 5 ml bottle of eye drop solution contains only 5 mg of Diclofenac Sodium, which is equivalent to about 3% of the recommended maximum oral dose for adults.
    StorageView
    Close the bottle immediately after use. Do not use for more than four weeks after opening. Store at room temperature.

    Intafenac K

    Diclofenac Potassium
    Tablet (Immediate Release) 50 mg Allopathic Drugs for Osteoarthritis

    Indications

    Tendonitis

    Indication detailsView
    Short-term treatment in the following acute conditions:
    • Post-traumatic pain, inflammation and swelling,e.g.due to sprains
    • Post-operative pain, inflammation and swelling,e.g.following dental or orthopaedic surgery
    • Painful and/or inflammatory conditions in gynaecology, e.g. primary dysmenorrhoea or adnexitis
    • Migraine attacks
    • Painful syndromes of the vertebral column
    • Non-articular rheumatism
    • As an adjuvant in severe painful inflammatory infections of the ear, nose, or throat, e.g. pharyngotonsillitis, otitis.
    Therapeutic classView
    Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
    PharmacologyView
    The mechanism of action of Diclofenac Potassium, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2).

    Diclofenac is a potent inhibitor of prostaglandin synthesis in vitro. Diclofenac concentrations reached during therapy have produced in vivo effects. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in inducing pain in animal models. Prostaglandins are mediators of inflammation. Because diclofenac is an inhibitor of prostaglandin synthesis, its mode of action may be due to a decrease of prostaglandins in peripheral tissues.
    DosageView
    Adults: Following an initial loading dose of 50 mg, 25-50 mg is to be taken every eight hours if necessary.

    Migraine: An initial loading dose of 50 mg, then if necessary a further 25-50 mg after 2 hours. The maximum daily dose is 150 mg. The tablets should be swallowed whole with liquid, preferably before meals.

    Children: Children over 14 years of age: upto 75 mg daily in divided doses.
    Side effectsView
    Side-effects of Diclofenac are usually mild and transient. However, if serious side-effects occur. Diclofenac should be discontinued. Occasional: epigastric pain, other gastro-intestinal disorders (e.g., nausea, vomiting, diarrhoea, abdominal cramps, dyspepsia,flatulence,anorexia). Rare: gastro-intestinal bleeding, peptic ulcer (with or without bleeding or perforation), bloody diarrhoea.
    ContraindicationsView
    Diclofenac Potassium tablets are contraindicated in patients with known hypersensitivity to Diclofenac. Diclofenac should not be given to patients who have experienced asthma, urticaria, or allergic type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients. Diclofenac is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
    InteractionsView
    Diclofenac may have the following drug interactions:
    • Lithium and Digoxin: Diclofenac may increase plasma concentrations of Lithium and Digoxin.
    • Anticoagulant:There are isolated reports of and increased risk of haemorrhage with the combined use of Diclofenac and anticoagulant therapy.
    • Cyclosporin: Cases of nephrotoxicity have been reported in patients receiving Cyclosporin and Diclofenac concomitantly.
    • Methotrexate: Cases of serious toxicity have been reported when Methotrexate and NSAIDs are given within 24 hours of each other.
    • Diuretics: Like other NSAIDs, Diclofenac may inhibit the activity of diuretics.
    • Other NSAIDs and steroids; Co-administration of Diclofenac with other systemic NSAIDs and steroids may increase the frequency of unwanted effects.
    Pregnancy & lactationView
    Diclofenac should not be prescribed during pregnancy, unless there are compelling reasons for doing so. The lowest effective dosage should be used. This type of drugs are not recommended during the last trimester of pregnancy. Very small quantities of diclofenac may be detected in breast milk, but no undesirable effects on the infant are to be expected.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Intafenac Plus

    Diclofenac Sodium + Lidocaine Hydrochloride
    IM Injection (75 mg+20 mg)/2 ml Allopathic Drugs for Osteoarthritis

    Indications

    Osteoarthritis (degenerative arthritis)

    Indication detailsView
    The injection contains Diclofenac Sodium that is used to relief all grades of pain and inflammation in a wide range of conditions including:
    • Arthritic conditions such as rheumatoid arthritis, osteoarthritis, juvenile chronic arthritis, ankylosing spondylitis, acute gout.
    • Acute musculoskeletal disorders such as periarthritis (e.g., Frozen shoulder), tendinitis, tenosynovitis, bursitis.
    • Other painful conditions resulting from trauma including, fracture, low back pain, sprains, strains, dislocations, control of pain and inflammation in orthopaedic, dental and other minor surgeries, postoperative pain, pain of renal colic etc.
    The injection also contains Lidocaine which acts as a local anaesthetic. Therefore the possibility of pain at the injection site, which is most likely to occur after intramuscular injection, is minimized if the Lidocaine containing injection is used in the above indications.
    Therapeutic classView
    Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
    PharmacologyView
    Diclofenac Sodium is a potent nonsteroidal antiinflammatory drug (NSAID) with marked analgesic and antipyretic properties. It also has some uricosuric effects. The action of Diclofenac appeared to be associated with the inhibition of prostaglandin synthesis. Diclofenac may inhibit synthesis of prostaglandins by inhibiting cyclooxygenase, an enzyme that catalyses the formation of prostaglandin precursors from arachidonic acid. Peak plasma concentration is achieved within half an hour following injection. Lidocaine is the most widely used local anaesthetic drug. It acts more rapidly and is more stable than most other local anaesthetics. It is a very useful surface anaesthetic. Like other local anaesthetics, Lidocaine impairs the generation and conduction of nerve impulses by slowing depolarization. The onset of anaesthesia of Lidocaine Hydrochloride is more rapid and the duration is 1-2 hours.
    DosageView
    Adult: One ampoule once (or in severe cases, twice) daily by intramuscular injection.

    Renal colic: One ampoule once daily intramuscularly. A second dose may be administered after 30 minutes if necessary.

    Children: In Juvenile chronic arthritis, 1-3 mg of Diclofenac Sodium per kg body weight daily in divided doses.

    Elderly patients: In elderly or debilitated patients, the lowest effective dosage is recommended, commensurate with age and physical status, or as prescribed by the physician.
    Side effectsView
    Side effects to Diclofenac Sodium and Lidocaine injection are usually mild and transient. However if serious side effects occur the injection should be discontinued. Gastrointestinal discomfort, nausea, diarrhea and occasionally bleeding may occur. In very rare instances, injection site disorder may occur. In isolated cases, abscesses and local necrosis may occur. The adverse effects due to Lidocaine mainly involve the CNS, are usually of short duration, and are dose related. The CNS reactions may be manifested by drowsiness, dizziness, disorientation, confusion, lightheadedness etc.
    ContraindicationsView
    It is contraindicated for those patients who are hypersensitive to Diclofenac. In patients with active or suspected peptic ulcer or gastrointestinal bleeding or for those patients in whom attacks of asthma, urticaria or acute rhinitis are precipitated by Aspirin or other NSAIDs possessing prostaglandin synthetase inhibiting activity Diclofenac is also contraindicated. Because of the presence of Lidocaine, this injection is also contraindicated for those patients who are hypersensitive to local anaesthetics of the amide type, although the incidence is very rare. In patients with Adams-Stokes syndrome or with severe degrees of SA, AV, or intraventricular heart block in the absence of an artificial pacemaker, and for those patients who are hypersensitive to any of the excipients used in the formulation (Sodium Metabisulphite, Disodium Edetate, Benzyl Alcohol, Sodium Hydroxide, Propylene Glycol), this injection is also contraindicated.
    PrecautionsView
    Renal: Patients with severe hepatic, cardiac or renal insufficiency or the elderly should be kept under close observation, since the use of NSAIDs may result in deterioration of renal function. The lowest effective dose should be used and renal function should be monitored.

    Hepatic: If abnormal liver function tests persist or worsen, clinical signs or symptoms consistent with liver disease develop or if other manifestations occur (eosinophilia, rash), Diclofenac should be discontinued. All patients who are receiving long term treatment with NSAIDs should be monitored as a precautionary measure (e.g., renal, hepatic function and blood counts).
    InteractionsView
    Lithium and Digoxin: Diclofenac may increase plasma concentrations of Lithium and Digoxin.

    Anticoagulants: There are isolated reports of an increased risk of haemorrhage with the combined use of Diclofenac and anticoagulant therapy, although clinical investigations do not appear to indicate any influence on anticoagulant effect.

    Antidiabetic agents: Clinical studies have shown that Diclofenac can be given together with oral antidiabetic agents without influencing their clinical effect.

    Cyclosporin: Cases of nephrotoxicity have been reported in patients receiving Cyclosporin and Diclofenac concomitantly.

    Methotrexate: Cases of serious toxicity have been reported when Methotrexate and NSAIDs are given within 24 hours of each other.

    Quinolone antimicrobials: Convulsions may occur due to an interaction between quinolones and NSAIDs. Therefore, caution should be exercised when considering concomitant therapy of NSAIDs and quinolones.

    Other NSAIDs and steroids: Co-administration of Diclofenac with other systemic NSAIDs and steroids may increase the frequency of unwanted effects. With Aspirin, the plasma levels of each are lowered, although no clinical significance is known.

    Diuretics: Various NSAIDs are liable to inhibit the activity of diuretics. Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels. So, serum potassium should be monitored.
    Pregnancy & lactationView
    It should not be prescribed during pregnancy unless there are compelling reasons for doing so. The lowest effective dosage should be used. These types of drugs are not recommended during the last trimester of pregnancy. Very small quantities of Diclofenac may be detected in breast milk, but no undesirable effects on the infant are to be expected.
    StorageView
    Store at temparature not exceeding 30°C in a dry place. Protected from light.

    Intaflam

    Ibuprofen
    Tablet 400 mg Allopathic Drugs for Osteoarthritis

    Indications

    Yellow fever infection

    Indication detailsView
    Ibuprofen is indicated in the following indications-
    • Rheumatoid arthritis
    • Osteoarthritis
    • Gouty arthritis
    • Juvenile polyarthritis
    • Ankylosing spondylitis
    • Synovitis
    • Low back pain
    • Dysmenorrhoea
    • Fever
    • Migraine
    • Soft tissue injuries
    • Pain & Inflammation in dental and musculoskeletal origin.
    Therapeutic classView
    Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
    PharmacologyView
    Ibuprofen has a high level of anti-inflammatory, anti-pyretic, and analgesic activity. The analgesic effects of Ibuprofen are due to both a peripheral and a central effect. Ibuprofen is a potent inhibitor of the enzyme cyclooxygenase, which thus results in a marked reduction in prostaglandin synthesis. Ibuprofen also inhibits the synthesis of some lipo-oxygenase products. Ibuprofen thus quickly relieves pain and stiffness, reduces swelling, and improves the movement of different joints of arthritis sufferers.
    DosageView
    Adults: The dose is initially, 400 mg 3 times daily. A dose of 2400 mg daily should not be exceeded.

    Children:
    • 3-6 months (body-weight over 5 kg): ½ tsp (2.5 ml) 3 times daily; max. 30 mg/kg daily in 3-4 divided doses.
    • 6 months-1 year: ½ tsp (2.5 ml) 3-4 times daily; max. 30 mg/kg daily in 3-4 divided doses.
    • 1-4 years: 1 tsp (5 ml) 3 times daily; max. 30 mg/kg daily in 3-4 divided doses.
    • 4-7 years: 1½ tsp (7.5 ml) 3 times daily; max. 30 mg/kg daily in 3-4 divided doses.
    • 7-10 years: 2 tsp (10 ml) 3 times daily; upto 30 mg/kg (max. 2.4 gm) daily in 3-4 divided doses.
    • 10-12 years: 3 tsp (15 ml) 3 times daily; upto 30 mg/kg (max. 2.4 gm) daily in 3-4 divided doses.
    children weighing less than 5 kg: Not recommended for children weighing less than 5 kg.

    In juvenile rheumatoid arthritis: up to 30-40 mg/kg of body weight daily in 3-4 divided doses may be taken or as directed by the physician.
    Side effectsView
    Upset stomach, vomiting, heartburn, nausea may occur.
    ContraindicationsView
    Ibuprofen is contraindicated in patients who have shown the previous hypersensitivity to Ibuprofen, and in patients with severe or active peptic ulceration.
    PrecautionsView
    Ibuprofen should be used with caution and the lowest effective doses should be given if there is a history of gastrointestinal hemorrhage or ulcer. Patients on long-term therapy with Ibuprofen require ocular monitoring at regular intervals, as changes in ocular function have been reported. Patients with systemic lupus erythematosus are more likely than others to develop hypersensitivity to Ibuprofen. Ibuprofen should be prescribed with caution in patients with asthma and in patients with a history of hypersensitivity to other nonsteroidal anti-inflammatory agents.
    Pregnancy & lactationView
    Adverse effects of Ibuprofen on the developing fetus cannot be fully excluded. Ibuprofen should not be used during pregnancy and for nursing mothers unless the potential benefits to the mothers outweigh the potential risks.
    StorageView
    Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.

    Intamycin

    Gentamicin Sulfate (Injection)
    IM/IV Injection 80 mg/2 ml Allopathic Aminoglycosides

    Indications

    Urinary tract infection

    Indication detailsView
    Gentamicin Injection is indicated in the treatment of serious infections caused by susceptible strains of the microorganisms including: Pseudomonas aeruginosa, Proteus sp, Escherichia coli, Klebsiella, Enterobacter, Serratia and Staphylococcus spp.

    Gentamicin Injection is used for the treatment of the following conditions when caused by susceptible organisms: Septicaemia, Meningitis, Respiratory tract infections, Infected wounds, Skin and skin structure infection, bone and soft tissue infections including peritonitis, septic abortion and burns complicated by sepsis, urinary tract infections.
    Therapeutic classView
    Aminoglycosides
    PharmacologyView
    Gentamicin Sulfate is an aminoglycoside antibiotic. This is a proven bactericidal antibiotic active against a broad spectrum of Gram-negative pathogens including E. coli, Klebsiella, Proteus spp, Enterobacter, Pseudomonas aeruginosa and Serratia species. It is also active against some Gram-positive organisms (e.g. penicillin & methicillin resistant strains of Staphylococcus aureus). In vitro, Gentamicin is also active against Salmonella and Shigella. Gentamicin interferes with bacterial protein synthesis by binding primarily to the 30S sub-units of bacterial ribosomes in susceptible organisms. Cell death results. Other mechanisms of action may contribute to the bactericidal effect of Gentamicin.
    DosageView
    Gentamicin is given by the intramuscular route normally. But intravenous administration may be used if required. The dosage is the same for either route of administration.

    Adult: In case of adults, the usual dose is 3-5 mg/kg/day in three divided doses 8 hourly for 7 to 10 days. In patients with impaired renal function, the interval between doses should be increased to 12 hours when the creatinine clearance is 30-70 ml/min, 24 hours for 10-30 ml/min, 48 hours for 5-10 ml/min or may be given as directed by the physician.

    Pediatric: Up to 2 weeks: 3 mg/kg/every 12 hours 2 weeks to 12 years: 2 mg/kg/every 8 hours or as directed by the physician.

    Intravenous administration: For I.V. administration, the prescribed dose of Gentamicin should be diluted with 100-200 ml sterile normal saline or 5% glucose in water. The concentration of Gentamicin in the solution should not exceed 1 mg/ml. Infusion periods of 30 minutes to 2 hours have been advocated. Gentamicin Injection should be discarded following a single use.
    Side effectsView
    Vestibular damage, reversible nephrotoxicity, auditory ototoxicity may occur. Symptoms are dizziness, vertigo, tinnitus, roaring in the ears, rarely hearing loss. Adverse renal effects may be also caused, more frequently in patients with a history of renal impairment treated with larger doses than recommended.
    InteractionsView
    Concurrent use with other potentially nephrotoxic or ototoxic drug substances should be avoided. Potent diuretics such as ethacrynic acid or frusemide may potentiate ototoxic effects of gentamicin. As gentamicin is inactivated by solutions containing beta-lactam antibiotics (penicillins & cephalosporins), the two drugs should not be administered simultaneously.
    Pregnancy & lactationView
    Safety for use in pregnancy and lactation has not been established. Gentamicin crosses the placenta and there is a risk of ototoxicity in the fetus. Gentamicin should only be used where the seriousness of the mother's condition justifies the risk. Small amounts of gentamicin have been detected in breast milk. Therefore it is recommended that breastfeeding be discontinued during therapy unless the expected benefits outweigh any potential risk.
    StorageView
    Should be stored in cool and dry place

    Intamycin

    Gentamicin Sulfate (Injection)
    IM/IV Injection 20 mg/2 ml Allopathic Aminoglycosides

    Indications

    Urinary tract infection

    Indication detailsView
    Gentamicin Injection is indicated in the treatment of serious infections caused by susceptible strains of the microorganisms including: Pseudomonas aeruginosa, Proteus sp, Escherichia coli, Klebsiella, Enterobacter, Serratia and Staphylococcus spp.

    Gentamicin Injection is used for the treatment of the following conditions when caused by susceptible organisms: Septicaemia, Meningitis, Respiratory tract infections, Infected wounds, Skin and skin structure infection, bone and soft tissue infections including peritonitis, septic abortion and burns complicated by sepsis, urinary tract infections.
    Therapeutic classView
    Aminoglycosides
    PharmacologyView
    Gentamicin Sulfate is an aminoglycoside antibiotic. This is a proven bactericidal antibiotic active against a broad spectrum of Gram-negative pathogens including E. coli, Klebsiella, Proteus spp, Enterobacter, Pseudomonas aeruginosa and Serratia species. It is also active against some Gram-positive organisms (e.g. penicillin & methicillin resistant strains of Staphylococcus aureus). In vitro, Gentamicin is also active against Salmonella and Shigella. Gentamicin interferes with bacterial protein synthesis by binding primarily to the 30S sub-units of bacterial ribosomes in susceptible organisms. Cell death results. Other mechanisms of action may contribute to the bactericidal effect of Gentamicin.
    DosageView
    Gentamicin is given by the intramuscular route normally. But intravenous administration may be used if required. The dosage is the same for either route of administration.

    Adult: In case of adults, the usual dose is 3-5 mg/kg/day in three divided doses 8 hourly for 7 to 10 days. In patients with impaired renal function, the interval between doses should be increased to 12 hours when the creatinine clearance is 30-70 ml/min, 24 hours for 10-30 ml/min, 48 hours for 5-10 ml/min or may be given as directed by the physician.

    Pediatric: Up to 2 weeks: 3 mg/kg/every 12 hours 2 weeks to 12 years: 2 mg/kg/every 8 hours or as directed by the physician.

    Intravenous administration: For I.V. administration, the prescribed dose of Gentamicin should be diluted with 100-200 ml sterile normal saline or 5% glucose in water. The concentration of Gentamicin in the solution should not exceed 1 mg/ml. Infusion periods of 30 minutes to 2 hours have been advocated. Gentamicin Injection should be discarded following a single use.
    Side effectsView
    Vestibular damage, reversible nephrotoxicity, auditory ototoxicity may occur. Symptoms are dizziness, vertigo, tinnitus, roaring in the ears, rarely hearing loss. Adverse renal effects may be also caused, more frequently in patients with a history of renal impairment treated with larger doses than recommended.
    InteractionsView
    Concurrent use with other potentially nephrotoxic or ototoxic drug substances should be avoided. Potent diuretics such as ethacrynic acid or frusemide may potentiate ototoxic effects of gentamicin. As gentamicin is inactivated by solutions containing beta-lactam antibiotics (penicillins & cephalosporins), the two drugs should not be administered simultaneously.
    Pregnancy & lactationView
    Safety for use in pregnancy and lactation has not been established. Gentamicin crosses the placenta and there is a risk of ototoxicity in the fetus. Gentamicin should only be used where the seriousness of the mother's condition justifies the risk. Small amounts of gentamicin have been detected in breast milk. Therefore it is recommended that breastfeeding be discontinued during therapy unless the expected benefits outweigh any potential risk.
    StorageView
    Should be stored in cool and dry place

    Intas

    Aceclofenac
    Tablet 100 mg Allopathic Drugs for Osteoarthritis

    Indications

    Spondylitis

    Indication detailsView
    Aceclofenac is indicated for the relief of pain and inflammation in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, toothache, trauma and lumbago.
    Therapeutic classView
    Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
    PharmacologyView

    Aceclofenac is a non-steroidal drug with anti-inflammatory and analgesic properties. It is a potent inhibitor of the enzyme cyclooxygenase, which is involved in the production of prostaglandin. After oral administration, it is rapidly and completely absorbed an unchanged drug.

    DosageView

    Extended release tablet: The recommended dose in adults is one 200 mg Aceclofenac tablet daily or as prescribed by the physician.
    Film coated tablet: The recommended dose in adults is 100 mg, twice daily.

    Side effectsView

    Aceclofenac is a non-steroidal drug with anti-inflammatory and analgesic properties. It is a potent inhibitor of the enzyme cyclooxygenase, which is involved in the production of prostaglandin. After oral administration, it is rapidly and completely absorbed an unchanged drug.

    ContraindicationsView

    Aceclofenac is contraindicated in patients with known hypersensitivity to it or in whom aspirin or NSAIDs precipitate attacks of asthma.

    PrecautionsView

    Caution should be exercised to patients with active or suspected peptic ulcer or gastro-intestinal bleeding moderate to severe hepatic impairment and cardiac or renal impairment. Caution should also be exercised in patients suffering from dizziness or urticaria.

    InteractionsView
    No significant drug interactions has not been observed but close monitoring of patients is required when it is used with:
    • Lithium and Digoxin: may increase plasma concentration of lithium and digoxin.
    • Diuretics: may interact the activity of diuretics.
    • Anticoagulants: may enhance the activity of anticoagulant.
    • Methotrexate: may increase the plasma level of methotrexate.
    Pregnancy & lactationView

    The use of Aceclofenac should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.

    Pediatric usageView
    There are no clinical data on the use of Aceclofenac in children.
    StorageView

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

    Intasone

    Hydrocortisone Acetate
    Cream 1% Allopathic Other Topical corticosteroids

    Indications

    Vitiligo

    Indication detailsView
    The anti-inflammatory activity of Hydrocortisone Acetate is its main therapeutic property. It also has immunosuppressant and antimitotic actions. Hydrocortisone Acetate is indicated in:
    • Primary irritant dermatitis
    • Contact allergic dermatitis
    • Eczema: atopic, infantile, discoid, stasis
    • Seborrheic dermatitis
    • Lichen simplex and pruritus ani
    • Flexural psoriasis
    • Skin irritations, itching and rashes, for example those caused by insect bites, minor thermal burns, sunburn, etc
    Therapeutic classView
    Other Topical corticosteroids
    PharmacologyView
    Hydrocortisone binds to the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes. The anti-inflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which then binds to cell membranes preventing the phospholipase A2 from coming into contact with its substrate arachidonic acid. This leads to diminished eicosanoid production. The cyclooxygenase (both COX-1 and COX-2) expression is also suppressed, potentiating the effect. In other words, the two main products in inflammation Prostaglandins and Leukotrienes are inhibited by the action of Glucocorticoids. Glucocorticoids also stimulate the lipocortin-1 escaping to the extracellular space, where it binds to the leukocyte membrane receptors and inhibits various inflammatory events: epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst and the release of various inflammatory mediators (lysosomal enzymes, cytokines, tissue plasminogen activator, chemokines etc.) from neutrophils, macrophages and mastocytes. Additionally the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.
    DosageView
    Hydrocortisone Acetate should be applied in a small quantity to the affected area 2 or 3 times daily.
    Side effectsView
    Hydrocortisone Acetate 1% cream is usually well-tolerated, but if signs of hypersensitivity appear, application should be stopped.
    ContraindicationsView
    • Infections: bacterial, viral, fungal.
    • Skin ulcers.
    • Hypersensitivity to the preparation.
    PrecautionsView
    In infants and children, long-term continuous topical therapy should be avoided where possible, as adrenal suppression can occur. As with all corticosteroids, prolonged application to the face is undesirable.
    Pregnancy & lactationView
    There is inadequate evidence for safety in human pregnancy. It is recommended that topical corticosteroids should not be used extensively during pregnancy. It is highly unlikely that sufficiently high blood levels of Hydrocortisone are achieved during topical therapy to reach breast milk.
    Overdose effectsView
    Acute overdosage is very unlikely to occur, however, in the case of chronic overdosage or misuse, the features of hypercorticism may appear and in this situation topical steroids should be discontinued.
    StorageView
    Store in a cool and dry place, away from light. Keep out of reach of children.

    Intasone

    Hydrocortisone
    IM/IV Injection 100 mg/2 ml Allopathic Glucocorticoids

    Indications

    Supplement in adrenal insufficiency during minor surgery under general anaesthesia

    Indication detailsView
    Hydrocortisone is indicated for use in the following conditions: 
    • Primary or secondary adrenocortical insufficiency
    • Acute adrenocortical insufficiency
    • Shock unresponsive to conventional therapy
    • Congenital adrenal hyperplasia
    • Hypercalcemia associated with cancer
    • Nonsuppurative thyroiditis
    • Rheumatic Disorders
    • Dermatologic Diseases (Allergic States, Severe seborrheic dermatitis, Severe psoriasis, Pemphigus, Severe erythema multiforme)
    • Control of severe or incapacitating allergic conditions (Bronchial asthma, Contact dermatitis, Atopic dermatitis, Serum sickness, Seasonal or perennial allergic rhinitis, Drug hypersensitivity reactions, Urticarial transfusion reactions, Acute noninfectious laryngeal edema)
    • Ophthalmic Diseases (Herpes zoster ophthalmicus, Iritis, iridocyclitis, Chorioretinitis, Diffuse posterior uveitis and choroiditis, Optic neuritis)
    • Gastrointestinal Diseases
    • Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy
    • Loeffler's syndrome
    • Aspiration pneumonitis
    • Hematologic Disorders (Acquired, autoimmune hemolytic anemia, Idiopathic thrombocytopenic purpura in adults, Secondary thrombocytopenia, Erythroblastopenia)
    • Neoplastic Diseases (Leukemias and lymphomas in adults, Acute leukemia of childhood)
    • Edematous States
    • Acute exacerbations of multiple sclerosis
    Therapeutic classView
    Glucocorticoids
    PharmacologyView
    Hydrocortisone inhibits prostaglandin synthesis by inhibiting the enzyme phospholipase A2. Hydrocortisone reduces various vasoactive agents released during inflammation. It also controls the rate of protein synthesis.
    DosageView
    Tablet: The initial dosage of Hydrocortisone Tablets may vary from 20 mg to 240 mg of hydrocortisone per day depending on the specific disease entity being treated. In situations of less severity, lower doses will generally suffice, while in selected patients higher initial doses may be required. The initial dosage should be maintained or adjusted until a satisfactory response is noted. If after a reasonable period of time there is a lack of satisfactory clinical response, Hydrocortisone Tablets should be discontinued and the patient transferred to other appropriate therapy. 

    It should be emphasized that dosage requirements are variable and must be individualized on the basis of the disease under treatment and the response of the patients. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response. It should be kept in mind that constant monitoring is needed in regard to drug dosage. If, after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually, rather than abruptly.

    Injection:
    • Adult: By IM injection or slow IV injection or infusion. The initial dose of Hydrocortisone sterile powder is 100 mg to 500 mg, depending on the severity of the condition. This dose may be repeated at intervals of 2, 4 or 6 hours as indicated by the patient's response and clinical condition. 
    • Children: By slow IV injection, up to 1 year 25 mg, 1-5 years 50 mg, 6-12 years 100 mg.
    Side effectsView
    Hydrocortisone is generally well tolerated except in prolonged high doses. It may cause cardiac arrhythmia, esophageal candidiasis, menstrual irregularity, decreased carbohydrate & glucose tolerance, fluid retention, increased appetite, weight gain, euphoria, mood swings, depression, insomnia, acne etc.
    ContraindicationsView
    Hydrocortisone is contraindicated in severe systemic fungal infections and patients with known hypersensitivity to any component of this product.
    PrecautionsView
    Hydrocortisone should be used with caution in patients with a history of peptic ulceration as it increases the incidence of peptic ulceration. This drug should be used with caution in patients with congestive heart failure, hypertension, glaucoma, diabetic mellitus and epilepsy.
    InteractionsView
    Drugs that induce hepatic enzymes such as Phenobarbital, Phenytoin and Rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response. Drugs such as Troleandomycin and Ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity.
    Pregnancy & lactationView
    This should be prescribed in pregnancy and lactation only if absolutely required.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Intasone

    Hydrocortisone
    Tablet 10 mg Allopathic Glucocorticoids

    Indications

    Supplement in adrenal insufficiency during minor surgery under general anaesthesia

    Indication detailsView
    Hydrocortisone is indicated for use in the following conditions: 
    • Primary or secondary adrenocortical insufficiency
    • Acute adrenocortical insufficiency
    • Shock unresponsive to conventional therapy
    • Congenital adrenal hyperplasia
    • Hypercalcemia associated with cancer
    • Nonsuppurative thyroiditis
    • Rheumatic Disorders
    • Dermatologic Diseases (Allergic States, Severe seborrheic dermatitis, Severe psoriasis, Pemphigus, Severe erythema multiforme)
    • Control of severe or incapacitating allergic conditions (Bronchial asthma, Contact dermatitis, Atopic dermatitis, Serum sickness, Seasonal or perennial allergic rhinitis, Drug hypersensitivity reactions, Urticarial transfusion reactions, Acute noninfectious laryngeal edema)
    • Ophthalmic Diseases (Herpes zoster ophthalmicus, Iritis, iridocyclitis, Chorioretinitis, Diffuse posterior uveitis and choroiditis, Optic neuritis)
    • Gastrointestinal Diseases
    • Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy
    • Loeffler's syndrome
    • Aspiration pneumonitis
    • Hematologic Disorders (Acquired, autoimmune hemolytic anemia, Idiopathic thrombocytopenic purpura in adults, Secondary thrombocytopenia, Erythroblastopenia)
    • Neoplastic Diseases (Leukemias and lymphomas in adults, Acute leukemia of childhood)
    • Edematous States
    • Acute exacerbations of multiple sclerosis
    Therapeutic classView
    Glucocorticoids
    PharmacologyView
    Hydrocortisone inhibits prostaglandin synthesis by inhibiting the enzyme phospholipase A2. Hydrocortisone reduces various vasoactive agents released during inflammation. It also controls the rate of protein synthesis.
    DosageView
    Tablet: The initial dosage of Hydrocortisone Tablets may vary from 20 mg to 240 mg of hydrocortisone per day depending on the specific disease entity being treated. In situations of less severity, lower doses will generally suffice, while in selected patients higher initial doses may be required. The initial dosage should be maintained or adjusted until a satisfactory response is noted. If after a reasonable period of time there is a lack of satisfactory clinical response, Hydrocortisone Tablets should be discontinued and the patient transferred to other appropriate therapy. 

    It should be emphasized that dosage requirements are variable and must be individualized on the basis of the disease under treatment and the response of the patients. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response. It should be kept in mind that constant monitoring is needed in regard to drug dosage. If, after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually, rather than abruptly.

    Injection:
    • Adult: By IM injection or slow IV injection or infusion. The initial dose of Hydrocortisone sterile powder is 100 mg to 500 mg, depending on the severity of the condition. This dose may be repeated at intervals of 2, 4 or 6 hours as indicated by the patient's response and clinical condition. 
    • Children: By slow IV injection, up to 1 year 25 mg, 1-5 years 50 mg, 6-12 years 100 mg.
    Side effectsView
    Hydrocortisone is generally well tolerated except in prolonged high doses. It may cause cardiac arrhythmia, esophageal candidiasis, menstrual irregularity, decreased carbohydrate & glucose tolerance, fluid retention, increased appetite, weight gain, euphoria, mood swings, depression, insomnia, acne etc.
    ContraindicationsView
    Hydrocortisone is contraindicated in severe systemic fungal infections and patients with known hypersensitivity to any component of this product.
    PrecautionsView
    Hydrocortisone should be used with caution in patients with a history of peptic ulceration as it increases the incidence of peptic ulceration. This drug should be used with caution in patients with congestive heart failure, hypertension, glaucoma, diabetic mellitus and epilepsy.
    InteractionsView
    Drugs that induce hepatic enzymes such as Phenobarbital, Phenytoin and Rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response. Drugs such as Troleandomycin and Ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity.
    Pregnancy & lactationView
    This should be prescribed in pregnancy and lactation only if absolutely required.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Intasone

    Hydrocortisone
    Tablet 20 mg Allopathic Glucocorticoids

    Indications

    Supplement in adrenal insufficiency during minor surgery under general anaesthesia

    Indication detailsView
    Hydrocortisone is indicated for use in the following conditions: 
    • Primary or secondary adrenocortical insufficiency
    • Acute adrenocortical insufficiency
    • Shock unresponsive to conventional therapy
    • Congenital adrenal hyperplasia
    • Hypercalcemia associated with cancer
    • Nonsuppurative thyroiditis
    • Rheumatic Disorders
    • Dermatologic Diseases (Allergic States, Severe seborrheic dermatitis, Severe psoriasis, Pemphigus, Severe erythema multiforme)
    • Control of severe or incapacitating allergic conditions (Bronchial asthma, Contact dermatitis, Atopic dermatitis, Serum sickness, Seasonal or perennial allergic rhinitis, Drug hypersensitivity reactions, Urticarial transfusion reactions, Acute noninfectious laryngeal edema)
    • Ophthalmic Diseases (Herpes zoster ophthalmicus, Iritis, iridocyclitis, Chorioretinitis, Diffuse posterior uveitis and choroiditis, Optic neuritis)
    • Gastrointestinal Diseases
    • Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy
    • Loeffler's syndrome
    • Aspiration pneumonitis
    • Hematologic Disorders (Acquired, autoimmune hemolytic anemia, Idiopathic thrombocytopenic purpura in adults, Secondary thrombocytopenia, Erythroblastopenia)
    • Neoplastic Diseases (Leukemias and lymphomas in adults, Acute leukemia of childhood)
    • Edematous States
    • Acute exacerbations of multiple sclerosis
    Therapeutic classView
    Glucocorticoids
    PharmacologyView
    Hydrocortisone inhibits prostaglandin synthesis by inhibiting the enzyme phospholipase A2. Hydrocortisone reduces various vasoactive agents released during inflammation. It also controls the rate of protein synthesis.
    DosageView
    Tablet: The initial dosage of Hydrocortisone Tablets may vary from 20 mg to 240 mg of hydrocortisone per day depending on the specific disease entity being treated. In situations of less severity, lower doses will generally suffice, while in selected patients higher initial doses may be required. The initial dosage should be maintained or adjusted until a satisfactory response is noted. If after a reasonable period of time there is a lack of satisfactory clinical response, Hydrocortisone Tablets should be discontinued and the patient transferred to other appropriate therapy. 

    It should be emphasized that dosage requirements are variable and must be individualized on the basis of the disease under treatment and the response of the patients. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response. It should be kept in mind that constant monitoring is needed in regard to drug dosage. If, after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually, rather than abruptly.

    Injection:
    • Adult: By IM injection or slow IV injection or infusion. The initial dose of Hydrocortisone sterile powder is 100 mg to 500 mg, depending on the severity of the condition. This dose may be repeated at intervals of 2, 4 or 6 hours as indicated by the patient's response and clinical condition. 
    • Children: By slow IV injection, up to 1 year 25 mg, 1-5 years 50 mg, 6-12 years 100 mg.
    Side effectsView
    Hydrocortisone is generally well tolerated except in prolonged high doses. It may cause cardiac arrhythmia, esophageal candidiasis, menstrual irregularity, decreased carbohydrate & glucose tolerance, fluid retention, increased appetite, weight gain, euphoria, mood swings, depression, insomnia, acne etc.
    ContraindicationsView
    Hydrocortisone is contraindicated in severe systemic fungal infections and patients with known hypersensitivity to any component of this product.
    PrecautionsView
    Hydrocortisone should be used with caution in patients with a history of peptic ulceration as it increases the incidence of peptic ulceration. This drug should be used with caution in patients with congestive heart failure, hypertension, glaucoma, diabetic mellitus and epilepsy.
    InteractionsView
    Drugs that induce hepatic enzymes such as Phenobarbital, Phenytoin and Rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response. Drugs such as Troleandomycin and Ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity.
    Pregnancy & lactationView
    This should be prescribed in pregnancy and lactation only if absolutely required.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Integril

    Eptifibatide
    IV Injection 2 mg/ml Allopathic Anti-platelet drugs

    Indications

    Unstable angina

    Indication detailsView
    Eptifibatide is indicated in-
    • Patients with acute coronary syndrome (unstable angina/non-ST- segment elevation myocardial infarction), including patients who are to be managed medically and those undergoing percutaneous coronary intervention (PCI).
    • Patients undergoing PCI, including those undergoing intracoronary stenting.
    Therapeutic classView
    Anti-platelet drugs
    PharmacologyView
    Eptifibatide is a cyclic heptapeptide containing six amino acids and one mercaptopropionyl (des-amino cysteinyl) residue. Integril binds to the platelet receptor glycoprotein (GP) IIb/IIIa of human platelets and reversibly inhibits platelet aggregation by preventing the binding of fibrinogen, von Willebrand factor, and other adhesive ligands to GP IIb/IIIa.
    DosageView

    Patients with ACS (Acute Coronary Syndrome):

    Normal renal function: 180 μg/kg IV bolus of as soon as possible following diagnosis followed by a continuous infusion of 2 μg/kg/min.

    Creatinine clearance: 180 μg/kg IV bolus of as soon as possible following diagnosis followed by a continuous infusion of 1 μg/kg/min.
    • Infusion should continue until hospital discharge or initiation of coronary artery bypass graft surgery (CABG), up to 72 hours.
    • If a patient is to undergo PCI, the infusion should be continued until hospital discharge or for up to 18 to 24 hours after the procedure, whichever comes first, allowing for up to 96 hours of therapy.

    Patients with PCI ( Percutaneous Coronary Intervention):

    Normal renal function: 180 μg/kg IV bolus immediately before PCI followed by a continuous infusion of 2 μg/kg/min & a second bolus of 180 μg/kg (given 10 minutes after the first bolus)

    Creatinine clearance: 180 μg/kg IV bolus immediately before PCI followed by a continuous infusion of 1 μg/kg/min & a second bolus of 180 μg/kg (given 10 minutes after the first bolus)
    • Infusion should be continued until hospital discharge, or for up to 18 to 24 hours, whichever comes first. A minimum of 12 hours of infusion is recommended.
    • In patients who undergo CABG surgery, INTEGRILIN infusion should be discontinued prior to surgery.
    AdministrationView
    1. Integril solutions should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

    2. Integril may be administered in the same IV line as alteplase, atropine, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine, nitroglycerin, or verapamil. Integril should not be administered through the same IV line as furosemide.

    3. Integril may be administered in the same IV line with 0.9% NaCl or 0.9% NaCl/5% dextrose. With either vehicle, the infusion may also contain up to 60 mEq/L of KCl.

    4. The bolus dose(s) of Integril should be withdrawn from the 10-mL vial into a syringe. The bolus dose(s) should be administered by IV push.

    5. Immediately following the bolus dose administration, a continuous infusion of Integril should be initiated. When using an intravenous infusion pump, Integril should be administered undiluted directly from the 100 mL vial. The 100-mL vial should be spiked with a vented infusion set. Care should be taken to center the spike within the circle on the stopper top.
    Side effectsView
    Bleeding is the most common adverse effect. Adverse reactions include intracranial hemorrhage & stroke, thrombocytopenia, allergic reactions and hypotension.
    ContraindicationsView
    contraindicated in patients with:
    • A history of bleeding diathesis, or evidence of active abnormal bleeding within the previous 30 days.
    • Severe hypertension (systolic blood pressure > 200 mm Hg or diastolic blood pressure > 110 mm Hg) not adequately controlled on antihypertensive therapy.
    InteractionsView
    • In various clinical studies, eptifibatide was used concomitantly with unfractionated heparin and aspirin. In another study, clopidogrel or ticlopidine were used routinely starting the day of PCI. Because eptifibatide inhibits platelet aggregation, caution should be employed when it is used with other drugs that affect hemostasis, including thrombolytics, oral anticoagulants, NSAIDS and dipyridamole. To avoid potentially additive pharmacologic effects, concomitant treatment with other inhibitors of platelet receptor GP IIb/IIIa should be avoided

    • Enoxaparin did not alter the pharmacokinetics of Integril
    Pregnancy & lactationView
    Pregnancy: Category B. Animal studies revealed no evidence of harm to the fetus due to Integril. There are, however, no adequate and well-controlled studies in pregnant women with Integril.

    Lactating Mothers: It is not known whether Integril is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Integril is administered to a nursing mother.
    Pediatric usageView
    Use in Children: Safety and effectiveness of Integril in pediatric patients have not been studied.
    Overdose effectsView
    • There has been only limited experience with overdosage of Integril. Symptoms of acute toxicity were loss of righting reflex, dyspnea, ptosis, and decreased muscle tone in rabbits, and petechial hemorrhages in the femoral and abdominal areas of monkeys.

    • From in vitro studies, eptifibatide is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis.
    StorageView
    • Vials should be stored refrigerated at 2-8° C
    • Vials may be transferred to room temperature storage for up to 2 months.
    • Unused portion left in the vial should be discarded.
    • Vials should be protected from light until administration.

    Integril

    Eptifibatide
    IV Injection 0.75 mg/ml Allopathic Anti-platelet drugs

    Indications

    Unstable angina

    Indication detailsView
    Eptifibatide is indicated in-
    • Patients with acute coronary syndrome (unstable angina/non-ST- segment elevation myocardial infarction), including patients who are to be managed medically and those undergoing percutaneous coronary intervention (PCI).
    • Patients undergoing PCI, including those undergoing intracoronary stenting.
    Therapeutic classView
    Anti-platelet drugs
    PharmacologyView
    Eptifibatide is a cyclic heptapeptide containing six amino acids and one mercaptopropionyl (des-amino cysteinyl) residue. Integril binds to the platelet receptor glycoprotein (GP) IIb/IIIa of human platelets and reversibly inhibits platelet aggregation by preventing the binding of fibrinogen, von Willebrand factor, and other adhesive ligands to GP IIb/IIIa.
    DosageView

    Patients with ACS (Acute Coronary Syndrome):

    Normal renal function: 180 μg/kg IV bolus of as soon as possible following diagnosis followed by a continuous infusion of 2 μg/kg/min.

    Creatinine clearance: 180 μg/kg IV bolus of as soon as possible following diagnosis followed by a continuous infusion of 1 μg/kg/min.
    • Infusion should continue until hospital discharge or initiation of coronary artery bypass graft surgery (CABG), up to 72 hours.
    • If a patient is to undergo PCI, the infusion should be continued until hospital discharge or for up to 18 to 24 hours after the procedure, whichever comes first, allowing for up to 96 hours of therapy.

    Patients with PCI ( Percutaneous Coronary Intervention):

    Normal renal function: 180 μg/kg IV bolus immediately before PCI followed by a continuous infusion of 2 μg/kg/min & a second bolus of 180 μg/kg (given 10 minutes after the first bolus)

    Creatinine clearance: 180 μg/kg IV bolus immediately before PCI followed by a continuous infusion of 1 μg/kg/min & a second bolus of 180 μg/kg (given 10 minutes after the first bolus)
    • Infusion should be continued until hospital discharge, or for up to 18 to 24 hours, whichever comes first. A minimum of 12 hours of infusion is recommended.
    • In patients who undergo CABG surgery, INTEGRILIN infusion should be discontinued prior to surgery.
    AdministrationView
    1. Integril solutions should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

    2. Integril may be administered in the same IV line as alteplase, atropine, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine, nitroglycerin, or verapamil. Integril should not be administered through the same IV line as furosemide.

    3. Integril may be administered in the same IV line with 0.9% NaCl or 0.9% NaCl/5% dextrose. With either vehicle, the infusion may also contain up to 60 mEq/L of KCl.

    4. The bolus dose(s) of Integril should be withdrawn from the 10-mL vial into a syringe. The bolus dose(s) should be administered by IV push.

    5. Immediately following the bolus dose administration, a continuous infusion of Integril should be initiated. When using an intravenous infusion pump, Integril should be administered undiluted directly from the 100 mL vial. The 100-mL vial should be spiked with a vented infusion set. Care should be taken to center the spike within the circle on the stopper top.
    Side effectsView
    Bleeding is the most common adverse effect. Adverse reactions include intracranial hemorrhage & stroke, thrombocytopenia, allergic reactions and hypotension.
    ContraindicationsView
    contraindicated in patients with:
    • A history of bleeding diathesis, or evidence of active abnormal bleeding within the previous 30 days.
    • Severe hypertension (systolic blood pressure > 200 mm Hg or diastolic blood pressure > 110 mm Hg) not adequately controlled on antihypertensive therapy.
    InteractionsView
    • In various clinical studies, eptifibatide was used concomitantly with unfractionated heparin and aspirin. In another study, clopidogrel or ticlopidine were used routinely starting the day of PCI. Because eptifibatide inhibits platelet aggregation, caution should be employed when it is used with other drugs that affect hemostasis, including thrombolytics, oral anticoagulants, NSAIDS and dipyridamole. To avoid potentially additive pharmacologic effects, concomitant treatment with other inhibitors of platelet receptor GP IIb/IIIa should be avoided

    • Enoxaparin did not alter the pharmacokinetics of Integril
    Pregnancy & lactationView
    Pregnancy: Category B. Animal studies revealed no evidence of harm to the fetus due to Integril. There are, however, no adequate and well-controlled studies in pregnant women with Integril.

    Lactating Mothers: It is not known whether Integril is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Integril is administered to a nursing mother.
    Pediatric usageView
    Use in Children: Safety and effectiveness of Integril in pediatric patients have not been studied.
    Overdose effectsView
    • There has been only limited experience with overdosage of Integril. Symptoms of acute toxicity were loss of righting reflex, dyspnea, ptosis, and decreased muscle tone in rabbits, and petechial hemorrhages in the femoral and abdominal areas of monkeys.

    • From in vitro studies, eptifibatide is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis.
    StorageView
    • Vials should be stored refrigerated at 2-8° C
    • Vials may be transferred to room temperature storage for up to 2 months.
    • Unused portion left in the vial should be discarded.
    • Vials should be protected from light until administration.