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Lactoben
Lactulose
Lactoben
Lactulose
Indications
Osmotic laxative
Indication detailsView
Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient.
Intestinal flora disturbances:
Intestinal flora disturbances:
- In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
- gall bladder diseases
- intestinal diseases ( Colitis, Diverticulosis, Megacolon)
Therapeutic classView
Osmotic purgatives
PharmacologyView
Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.
DosageView
In constipation ( chronic constipation):
- Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
- Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
- Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
- Adults: 1-2 tea-spoons daily
- Children: 1 tea-spoon daily
- Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily.
- In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
Side effectsView
Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
ContraindicationsView
Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
PrecautionsView
Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.
InteractionsView
There is no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
Pregnancy & lactationView
US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
Overdose effectsView
There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Lactoflora
Probiotic Combination [2 Billion]
Lactoflora
Probiotic Combination [2 Billion]
Indication detailsView
Lactobacillus reuteri is a natural supplement that contains the probiotic Lactobacillus reuteri NCIMB 30242, the first and only probiotic that safely supports healthy cholesterol in adults with moderately elevated cholesterol but within the normal range. Lactobacillus reuteri natural bacteria may help to promote overall digestive health and support the body's normal production of vitamin D3. It restores normal fora, used to treat bowel problems (such as diarrhea, irritable bowel), eczema, vaginal yeast infections, lactose intolerance and urinary tract infections.
Therapeutic classView
Herbal and Nutraceuticals, Probiotic
PharmacologyView
Lactobacillus reuteri NCIMB 30242 is a natural, over-the-counter probiotic supplement. It was discovered through Proselect, UAS Lab's proprietary discovery enabling technology that identifies non-GMO probiotic candidates with the potential to promote better metabolic health and natural balance through the microbiome.
DosageView
Take one capsule with food twice daily. Or, as directed by the registered physician.
Side effectsView
No clinically signif icant adverse reactions have been observed in therapeutic dosage. Probiotics are likely safe for most people.
ContraindicationsView
This capsule is contraindicated with known hypersensitivity to any component of the formulation. Lactobacillus preparations are contraindicated in persons with a hypersensitivity to lactose or milk.
InteractionsView
No clinically signif icant drug interaction has been reported.
Pregnancy & lactationView
Lactobacillus preparations have not been studied during pregnancy, in breastfeeding women, or in women trying to become pregnant. If you are pregnant, breastfeeding or trying to become pregnant, you should check with your healthcare provider before using it to ensure it is right for you.
StorageView
Keep out of reach of the children. Keep away from direct sunlight. Store below 30°C in a dry place.
Lactohil
23 herb formula to increase breast milk
Lactohil
23 herb formula to increase breast milk
Indications
Promote the quality and quantity of milk
Indication detailsView
This is a natural formula meant to promote the quality and quantity of milk. This is 100% safe and effective. It can be used as a tonic for physically weak nursing mothers. Breast milk production may increase within a couple of days. However, in order to ensure the best results, the mother should continue taking this preparation for at least 15 days.
Therapeutic classView
Herbal and Nutraceuticals
Lactolax
Lactulose
Lactolax
Lactulose
Indications
Osmotic laxative
Indication detailsView
Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient.
Intestinal flora disturbances:
Intestinal flora disturbances:
- In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
- gall bladder diseases
- intestinal diseases ( Colitis, Diverticulosis, Megacolon)
Therapeutic classView
Osmotic purgatives
PharmacologyView
Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.
DosageView
In constipation ( chronic constipation):
- Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
- Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
- Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
- Adults: 1-2 tea-spoons daily
- Children: 1 tea-spoon daily
- Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily.
- In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
Side effectsView
Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
ContraindicationsView
Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
PrecautionsView
Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.
InteractionsView
There is no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
Pregnancy & lactationView
US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
Overdose effectsView
There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Lactomose
Lactulose
Lactomose
Lactulose
Indications
Osmotic laxative
Indication detailsView
Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient.
Intestinal flora disturbances:
Intestinal flora disturbances:
- In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
- gall bladder diseases
- intestinal diseases ( Colitis, Diverticulosis, Megacolon)
Therapeutic classView
Osmotic purgatives
PharmacologyView
Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.
DosageView
In constipation ( chronic constipation):
- Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
- Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
- Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
- Adults: 1-2 tea-spoons daily
- Children: 1 tea-spoon daily
- Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily.
- In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
Side effectsView
Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
ContraindicationsView
Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
PrecautionsView
Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.
InteractionsView
There is no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
Pregnancy & lactationView
US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
Overdose effectsView
There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Lactoride
Hartmann's Solution
Lactoride
Hartmann's Solution
Indications
Vomiting
Indication detailsView
This is used to treat hypovolemia caused by surgery, hemorrhage and trauma. Excessive sweating, severe diarrhoea or vomiting, excess loss of fluid by nephritic kidneys, inadequate intake of fluid and electrolytes etc. that may lead to typical hypovolemic shock may be corrected with this solution . Severe plasma loss caused by intestinal obstruction, burns or other denuding conditions of the skin may be treated with this solution. It is mainly used as a fluid and electrolyte replenisher. It may be used as an alternative to Sodium Bicarbonate in the treatment of metabolic acidosis associated with dehydration and to alkalinized urine.
Therapeutic classView
Haemodialysis solutions
DosageView
The volume and rate of infusion will depend upon the requirements of the patients and the judgement of the physician. It usually varies with age, weight and clinical condition of the patient. The recommended flow rate is up to 100-drops/minute/70 kg body weight. In burn patients the dose of Hartmann's solution according to the Parkland formula: 4 ml/kg body weight% of Body surface area (BSA) burn (e.g. for a 30% BSA burn of a person having 60 kg body weight, 4 x 60 x 30 ml = 7200 ml of Hartmann's solution would be required in 24 hours). Half of this within 8 hr, the remainder over 16 hr.
AdministrationView
- Check infusion set and infusion solution prior to use
- Pull moderately to tear off the protective cover of the Eurohead
- Hold lightly the Eurohead but not the bag
- Open the flow regulator fully and hold the giving set on the top white area, but not the membrane venting region
- Insert the spike of the administration set to the Eurohead and fit the connector of the administration set firmly to the needle
- Gradually allow the fluid to flow down to the needle tip and close
- Remove the protective cover of the needle
- Locate the veinpuncture site and clean the site with an antiseptic solution, and then insert the needle
- Securely tape the puncture site
- Securely tape the wings and tubing
- Start infusion while adjusting drip speed
Side effectsView
Hands, ankles and feet may become mildly swollen from fluid retention. Rarely, the lungs can also be affected, which may cause breathing difficulty. Other possible symptoms include nausea, vomiting, headache, dizziness, drowsiness, confusion, and inflammation or swelling of the veins around the site of the injection.
ContraindicationsView
Do not take this medicine and tell your doctor if: Hartmann's solution may be relatively contraindicated in patients with diabetes mellitus, as one of the isomers of lactate is gluconeogenic.
PrecautionsView
Hartmann's solution should not be administered rapidly or for prolonged periods. Since the solution contains different electrolytes, it should be infused with caution in patients where electrolyte imbalance may cause detrimental effects; e.g. in pregnancy, renal impairment, heart failure, pulmonary congestion, etc. or to patients receiving potassium sparing diuretics. In Pregnancy: Pregnancy Category C. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process. Do not use if the solution is cloudy, contains particles, or after expiry date. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process. Do not use if the solution is cloudy, contains particles, or after expiry date.
Pregnancy & lactationView
Pregnancy Category C. Animal reproduction studies have not been conducted with Lactated Ringer’s Irrigation. It is also not known whether it can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. It should be given to a pregnant woman only if clearly needed.
StorageView
Electrosal should be stored at controlled room temperature.
Lactoring
Hartmann's Solution
Lactoring
Hartmann's Solution
Indications
Vomiting
Indication detailsView
This is used to treat hypovolemia caused by surgery, hemorrhage and trauma. Excessive sweating, severe diarrhoea or vomiting, excess loss of fluid by nephritic kidneys, inadequate intake of fluid and electrolytes etc. that may lead to typical hypovolemic shock may be corrected with this solution . Severe plasma loss caused by intestinal obstruction, burns or other denuding conditions of the skin may be treated with this solution. It is mainly used as a fluid and electrolyte replenisher. It may be used as an alternative to Sodium Bicarbonate in the treatment of metabolic acidosis associated with dehydration and to alkalinized urine.
Therapeutic classView
Haemodialysis solutions
DosageView
The volume and rate of infusion will depend upon the requirements of the patients and the judgement of the physician. It usually varies with age, weight and clinical condition of the patient. The recommended flow rate is up to 100-drops/minute/70 kg body weight. In burn patients the dose of Hartmann's solution according to the Parkland formula: 4 ml/kg body weight% of Body surface area (BSA) burn (e.g. for a 30% BSA burn of a person having 60 kg body weight, 4 x 60 x 30 ml = 7200 ml of Hartmann's solution would be required in 24 hours). Half of this within 8 hr, the remainder over 16 hr.
AdministrationView
- Check infusion set and infusion solution prior to use
- Pull moderately to tear off the protective cover of the Eurohead
- Hold lightly the Eurohead but not the bag
- Open the flow regulator fully and hold the giving set on the top white area, but not the membrane venting region
- Insert the spike of the administration set to the Eurohead and fit the connector of the administration set firmly to the needle
- Gradually allow the fluid to flow down to the needle tip and close
- Remove the protective cover of the needle
- Locate the veinpuncture site and clean the site with an antiseptic solution, and then insert the needle
- Securely tape the puncture site
- Securely tape the wings and tubing
- Start infusion while adjusting drip speed
Side effectsView
Hands, ankles and feet may become mildly swollen from fluid retention. Rarely, the lungs can also be affected, which may cause breathing difficulty. Other possible symptoms include nausea, vomiting, headache, dizziness, drowsiness, confusion, and inflammation or swelling of the veins around the site of the injection.
ContraindicationsView
Do not take this medicine and tell your doctor if: Hartmann's solution may be relatively contraindicated in patients with diabetes mellitus, as one of the isomers of lactate is gluconeogenic.
PrecautionsView
Hartmann's solution should not be administered rapidly or for prolonged periods. Since the solution contains different electrolytes, it should be infused with caution in patients where electrolyte imbalance may cause detrimental effects; e.g. in pregnancy, renal impairment, heart failure, pulmonary congestion, etc. or to patients receiving potassium sparing diuretics. In Pregnancy: Pregnancy Category C. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process. Do not use if the solution is cloudy, contains particles, or after expiry date. Infusion of fluid should be immediately discontinued if rigor arises for any reason during the process. Do not use if the solution is cloudy, contains particles, or after expiry date.
Pregnancy & lactationView
Pregnancy Category C. Animal reproduction studies have not been conducted with Lactated Ringer’s Irrigation. It is also not known whether it can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. It should be given to a pregnant woman only if clearly needed.
StorageView
Electrosal should be stored at controlled room temperature.
Lactro
Ketorolac Tromethamine
Lactro
Ketorolac Tromethamine
Indications
Soft tissue inflammation
Indication detailsView
Ketorolac Tromethamine is indicated for the short-term management of moderate to severe acute post-operative pain.
Therapeutic classView
Drugs used for Rheumatoid Arthritis, Non-Opioid Analgesics
PharmacologyView
Ketorolac Tromethamine is a potent analgesic of the non-steroidal anti-inflammatory drugs (NSAIDs). It acts by inhibiting the cyclooxygenase enzyme system and hence inhibits the prostaglandin synthesis. It demonstrates a minimal anti-inflammatory effect at its analgesic dose.
DosageView
Tablet-
Recommended dose is 10 mg every 4-6 hours. It should be used short-term only (up to 7 days) and are not recommended for chronic use. Doses exceeding 40 mg/day is not recommended.Injection-
Ketorolac injection may be used as a single or multiple doses, on a regular or when necessary schedule for the management of moderately severe, acute pain that requires analgesia at the opioid level, usually in a postoperative setting. When administering Ketorolac injection, the IV bolus must be given over no less than 15 seconds. The IM administration should be given slowly and deeply into the muscle. The analgesic effect begins within 30 minutes with maximum effect in 1 to 2 hours after dosing IV or IM. Duration of analgesic effect is usually 4 to 6 hours.Single-Dose Treatment-
IM Dosing (Adult):
- Patients <65 years of age: One dose of 60 mg.
- Patients >65 years of age, renally impaired and/or less than 50 kg of body weight: One dose of 30 mg.
- Patients <65 years of age: One dose of 30 mg.
- Patients >65 years of age, renally impaired and/or less than 50 kg of body weight: One dose of 15 mg.
- IM Dosing: One dose of 1 mg/kg up to a maximum of 30 mg.
- IV Dosing: One dose of 0.5 mg/kg up to a maximum of 15 mg.
- Patients <65 years of age: The recommended dose is 30 mg Ketorolac injection every 6 hours. The maximum daily dose should not exceed 120 mg. Patients >65 years of age, renally impaired patients and patients less than 50 kg: The recommended dose is 15 mg Ketorolac injection every 6 hours. The maximum daily dose for these populations should not exceed 60 mg. For breakthrough pain, do not increase the dose or the frequency of Ketorolac Tromethamine.
- Conversion from Parenteral to Oral Therapy: Ketorolac tablets may be used either as monotherapy or as follow-on therapy to parenteral Ketorolac. When Ketorolac tablets are used as a follow-on therapy to parenteral Ketorolac, the total combined daily dose of ketorolac (oral + parenteral) should not exceed 120 mg in younger adult patients or 60 mg in elderly patients on the day the change of formulation is made. On subsequent days, oral dosing should not exceed the recommended daily maximum of 40 mg. Ketorolac IM should be replaced by Ketorolac tablet as soon as feasible. The total duration of combined parenteral and oral treatment should not exceed 5 days.
Side effectsView
Commonly occurring side effects are nausea, vomiting, gastro-intestinal bleeding, melana, peptic ulcer, pancreatitis, anxiety, drowsiness, headache, excessive thirst, fatigue, bradycardia, hypertension, palpitation, chest pain, infertility in female and pulmonary edema.
ContraindicationsView
Ketorolac is contraindicated in patients having hypersensitivity to this drug or other NSAIDs. It should not be used in children under 16 years of age. lt is also contraindicated as prophylactic analgesic before surgery.
PrecautionsView
Caution should be exercised in patients over the age of 65 years. Caution should also be taken in patients with active or suspected peptic ulcer or gastrointestinal bleeding or asthma and liver dysfunction.
InteractionsView
Other NSAIDs or aspirin: Increase the side effects of ketorolac Tromethamine.
Anti-coagulants: Enhance anti-coagulant effect.
Beta Blocker: Reduce the anti-hypertensive effect .
ACE Inhibitors: Increase the risk of renal impairment.
Methotrexate: Enhance the toxicity of methotrexate.
Anti-coagulants: Enhance anti-coagulant effect.
Beta Blocker: Reduce the anti-hypertensive effect .
ACE Inhibitors: Increase the risk of renal impairment.
Methotrexate: Enhance the toxicity of methotrexate.
Pregnancy & lactationView
US FDA Pregnancy category of Ketorolac Tromethamine is C. So, Ketorolac Tromethamine should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Lactu
Lactulose
Lactu
Lactulose
Indications
Osmotic laxative
Indication detailsView
Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient.
Intestinal flora disturbances:
Intestinal flora disturbances:
- In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
- gall bladder diseases
- intestinal diseases ( Colitis, Diverticulosis, Megacolon)
Therapeutic classView
Osmotic purgatives
PharmacologyView
Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.
DosageView
In constipation ( chronic constipation):
- Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
- Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
- Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
- Adults: 1-2 tea-spoons daily
- Children: 1 tea-spoon daily
- Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily.
- In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
Side effectsView
Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
ContraindicationsView
Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
PrecautionsView
Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.
InteractionsView
There is no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
Pregnancy & lactationView
US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
Overdose effectsView
There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Lactulose H
Lactulose
Lactulose H
Lactulose
Indications
Osmotic laxative
Indication detailsView
Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient.
Intestinal flora disturbances:
Intestinal flora disturbances:
- In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
- gall bladder diseases
- intestinal diseases ( Colitis, Diverticulosis, Megacolon)
Therapeutic classView
Osmotic purgatives
PharmacologyView
Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.
DosageView
In constipation ( chronic constipation):
- Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
- Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
- Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
- Adults: 1-2 tea-spoons daily
- Children: 1 tea-spoon daily
- Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily.
- In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
Side effectsView
Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
ContraindicationsView
Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
PrecautionsView
Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.
InteractionsView
There is no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
Pregnancy & lactationView
US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
Overdose effectsView
There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Laczym
Lactase
Laczym
Lactase
Indication detailsView
Prevention of symptoms of lactose intolerance-
- Infantile colic
- Abdominal pain
- Bloating
- Flatulence
- Diarrhea
- Borborygmi
PharmacologyView
Lactase is an enzyme that helps to prevent symptoms of lactose intolerance by breaking down milk sugar (lactose) to produce glucose and galactose via hydrolysis and making dairy foods easier to digest.
DosageView
Adult: 1 tablet (300 mg) with dairy food. If needed dose can be adjusted up to 2 tablets (600 mg) at a time.
Infants: Add lactase enzyme to breast milk or formula in the following directions-
Breast Milk:
Infants: Add lactase enzyme to breast milk or formula in the following directions-
Breast Milk:
- Express a few tablespoons (2-3 tablespoons) of breast milk into sterilized container
- Add 4 drops of lactase paediatric drops
- Give mixture to infant on a spoon or oral syringe before initiating breastfeeding
- Breast feed as normal
- Add 4 drops of lactase paediatric drops to warm (not hot) formula
- Wait 30 minutes, shaking formula occasionally
- Add 2 drops of lactase paediatric drops to warm formula
- Store in refrigerator for minimum 4 hours
- Feed Infant as normal
- Use within 12 hour
- Discard any unused formula
Side effectsView
There are no major side effects reported. The very few side effects may include rash, difficulty in breathing, tightness in chest etc.
ContraindicationsView
This drug is contraindicated in patients with known hypersensitivity to lactase or any other components of the product.
InteractionsView
No information for lactase interactions has been found yet.
Pregnancy & lactationView
It is unknown if lactase may cause harm to the fetus. Therefore, lactase should be given during pregnancy only when clearly needed. It is unknown if lactase is excreted in breast milk. Thus, lactase should be given during lactation only when clearly needed.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Ladica
Black Cohosh [Cimicifuga Racemosa]
Ladica
Black Cohosh [Cimicifuga Racemosa]
Indications
Vertigo
Indication detailsView
Black Cohosh is indicated in Premenstrual discomfort, Dysmenorrhea, Menopausal complaints such as hot flashes, heart palpitations, nervousness, irritability, sleep disturbances, tinnitus, vertigo, perspiration and depression.
Therapeutic classView
Herbal and Nutraceuticals
PharmacologyView
Black cohosh (Cimicifuga racemosa) is popular as an alternative to hormonal therapy in the treatment of menopausal (climacteric) symptoms such as hot flashes, mood disturbances, diaphoresis, palpitations and vaginal dryness.
DosageView
1-2 capsules daily or as directed by the physician. Duration of treatment should be maximum six months at a time.
Side effectsView
Black cohosh is safe for most people. It might cause some mild side effects such as stomach upset, cramping, headache, rash, a feeling of heaviness, and weight gain. Occasional gastrointestinal discomfort may occur.
ContraindicationsView
No significant contraindication is observed.
PrecautionsView
Black cohosh should be used cautiously in patients with liver disease, kidney disease and seizure disorders.
InteractionsView
Black cohosh may interact with birth control pills, hormone replacement therapy, sedatives or antihypertensive.
Pregnancy & lactationView
Not recommended during pregnancy due to an increased risk of spontaneous abortion. Not recommended during lactation.
StorageView
Store in a cool and dry place, away from light & moisture. Keep out of reach of children.
Lagita
Sodium Alginate + Potassium Bicarbonate
Lagita
Sodium Alginate + Potassium Bicarbonate
Indication detailsView
This preparation is indicated for the treatment of symptoms resulting from the reflux of acid, bile and pepsin into the esophagus such as acid regurgitation, heartburn, indigestion for instance, after gastric surgery, as a result of hiatus hernia, during pregnancy, accompanying reflux esophagitis, including symptoms of laryngopharyngeal reflux such as hoarseness and other voice disorders, sore throats and cough. This preparation can also be used to treat the symptoms of gastroesophageal reflux during concomitant treatment with or following the withdrawal of acid suppressing therapy.
Therapeutic classView
Antacids
PharmacologyView
This is the combination of Sodium Alginate and Potassium Bicarbonate. Sodium Alginate is a naturally occurring substance. It reacts with the acid in the stomach to form a gel. Potassium Bicarbonate also reacts with the acid in the stomach to form bubbles of carbon dioxide. These bubbles are trapped by the gel formed by Sodium Alginate and they allow the gel to float like a raft on top of the stomach contents. The raft prevents acid in the stomach from flowing back into the esophagus. This relieves the symptoms of reflux such as heartburn. The mode of action of this is physical and does not depend on absorption into the systemic circulation. The raft lasts for up to 4 hours on top of the stomach contents and is then broken down in the digestive system and excreted in the feces.
DosageView
Tablet:
Elderly: No dose modifications are necessary for this age group.
Hepatic Impairment: No dose modifications are necessary.
Renal Insufficiency: Caution if a highly restricted salt diet is necessary.
- Adults and children over 12 years: 1-2 tablets 3-4 times daily, after meals and before bedtime.
- Children 6-12 years: ½-1 tablet 3-4 times daily, after meals and before bedtime.
- Adults and children 12 years and above: 5-10 ml (1-2 teaspoonfuls) 3-4 times daily, after meals and before bedtime.
- Children 2-12 years: 2.5-5ml (½-1 teaspoonful) 3-4 times daily, after meals and before bedtime.
Elderly: No dose modifications are necessary for this age group.
Hepatic Impairment: No dose modifications are necessary.
Renal Insufficiency: Caution if a highly restricted salt diet is necessary.
Side effectsView
In addition to the desired effect of the drug, some side effects may appear such as: nausea, constipation, diarrhea or headache. In these cases consult a physician In case too big dosage has been taken, there might appear a sensation of swelling. In this case it is advisable to consult a physician.
ContraindicationsView
Sodium alginate and potassium bicarbonate is contraindicated in patients with known hypersensitivity to these.
PrecautionsView
Sodium Alginate and Potassium Bicarbonate should be prescribed with caution in patients with renal impairment and congestive cardiac failure. Care needs to be taken in treating patients with hypercalcemia, nephrocalcinosis and recurrent calcium-containing renal calculi. There is a possibility of reduced efficacy in patients with very low levels of gastric acid. If symptoms do not improve after seven days, the clinical situation should be reviewed.
InteractionsView
A time interval of 2 hours should be considered between this intake and the administration of other medicinal products, especially tetracyclines, fluoroquinolones, iron salts, thyroid hormones, chloroquine, bisphosphonates, and estramustine.
Pregnancy & lactationView
This combination (Sodium Alginate and Potassium Bicarbonate) can be used during pregnancy, if clinically needed. No known effect on breast-fed infants. This combination can be used during breastfeeding.
Overdose effectsView
Overdosage with this formulation is a rare case. In case of overdose please consult with a registered physician.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Lameptil
Lamotrigine
Lameptil
Lamotrigine
Indications
Unipolar and bipolar depression
Indication detailsView
Lamotrigine is indicated for:
Epilepsy-combination therapy in patients aged 2 years and older:
Adults with Bipolar Disorder.
Epilepsy-combination therapy in patients aged 2 years and older:
- partial-onset seizures
- primary generalized tonic-clonic seizures
- generalized seizures of Lennox-Gastaut syndrome
Adults with Bipolar Disorder.
Therapeutic classView
Primary anti-epileptic drugs
PharmacologyView
The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
DosageView
Epilepsy-
Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
- In patients taking Valproate: 25 mg every day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
- In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
- In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
- In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
- In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
- In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
Weeks 1 & 2:
- If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
- If the patients weight is 14.1 kg to 27 kg: 2 mg every day
- If the patients weight is 27.1 kg to 34 kg: 4 mg every day
- If the patients weight is 34.1 kg to 40 kg: 5 mg every day
- If the patients weight is 6.7 kg to 14 kg: 2 mg every day
- If the patients weight is 14.1 kg to 27 kg: 4 mg every day
- If the patients weight is 27.1 kg to 34 kg: 8 mg every day
- If the patients weight is 34.1 kg to 40 kg: 10 mg every day
Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
- In patients taking Valproate: 25 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
- In patients taking Valproate: 50 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
Side effectsView
Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
PrecautionsView
Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
InteractionsView
Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
Pregnancy & lactationView
Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Pediatric usageView
Pediatric Use:
- Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
- Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
Overdose effectsView
Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
StorageView
Store below 30°C. Protect from light and moisture. Keep out of the reach of children.
Lameptil
Lamotrigine
Lameptil
Lamotrigine
Indications
Unipolar and bipolar depression
Indication detailsView
Lamotrigine is indicated for:
Epilepsy-combination therapy in patients aged 2 years and older:
Adults with Bipolar Disorder.
Epilepsy-combination therapy in patients aged 2 years and older:
- partial-onset seizures
- primary generalized tonic-clonic seizures
- generalized seizures of Lennox-Gastaut syndrome
Adults with Bipolar Disorder.
Therapeutic classView
Primary anti-epileptic drugs
PharmacologyView
The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
DosageView
Epilepsy-
Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
- In patients taking Valproate: 25 mg every day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
- In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
- In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
- In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
- In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
- In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
Weeks 1 & 2:
- If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
- If the patients weight is 14.1 kg to 27 kg: 2 mg every day
- If the patients weight is 27.1 kg to 34 kg: 4 mg every day
- If the patients weight is 34.1 kg to 40 kg: 5 mg every day
- If the patients weight is 6.7 kg to 14 kg: 2 mg every day
- If the patients weight is 14.1 kg to 27 kg: 4 mg every day
- If the patients weight is 27.1 kg to 34 kg: 8 mg every day
- If the patients weight is 34.1 kg to 40 kg: 10 mg every day
Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
- In patients taking Valproate: 25 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
- In patients taking Valproate: 50 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
Side effectsView
Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
PrecautionsView
Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
InteractionsView
Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
Pregnancy & lactationView
Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Pediatric usageView
Pediatric Use:
- Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
- Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
Overdose effectsView
Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
StorageView
Store below 30°C. Protect from light and moisture. Keep out of the reach of children.
Lamicet
Lamotrigine
Lamicet
Lamotrigine
Indications
Unipolar and bipolar depression
Indication detailsView
Lamotrigine is indicated for:
Epilepsy-combination therapy in patients aged 2 years and older:
Adults with Bipolar Disorder.
Epilepsy-combination therapy in patients aged 2 years and older:
- partial-onset seizures
- primary generalized tonic-clonic seizures
- generalized seizures of Lennox-Gastaut syndrome
Adults with Bipolar Disorder.
Therapeutic classView
Primary anti-epileptic drugs
PharmacologyView
The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
DosageView
Epilepsy-
Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
- In patients taking Valproate: 25 mg every day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
- In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
- In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
- In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
- In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
- In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
Weeks 1 & 2:
- If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
- If the patients weight is 14.1 kg to 27 kg: 2 mg every day
- If the patients weight is 27.1 kg to 34 kg: 4 mg every day
- If the patients weight is 34.1 kg to 40 kg: 5 mg every day
- If the patients weight is 6.7 kg to 14 kg: 2 mg every day
- If the patients weight is 14.1 kg to 27 kg: 4 mg every day
- If the patients weight is 27.1 kg to 34 kg: 8 mg every day
- If the patients weight is 34.1 kg to 40 kg: 10 mg every day
Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
- In patients taking Valproate: 25 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
- In patients taking Valproate: 50 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
Side effectsView
Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
PrecautionsView
Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
InteractionsView
Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
Pregnancy & lactationView
Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Pediatric usageView
Pediatric Use:
- Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
- Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
Overdose effectsView
Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
StorageView
Store below 30°C. Protect from light and moisture. Keep out of the reach of children.
Lamictal
Lamotrigine
Lamictal
Lamotrigine
Indications
Unipolar and bipolar depression
Indication detailsView
Lamotrigine is indicated for:
Epilepsy-combination therapy in patients aged 2 years and older:
Adults with Bipolar Disorder.
Epilepsy-combination therapy in patients aged 2 years and older:
- partial-onset seizures
- primary generalized tonic-clonic seizures
- generalized seizures of Lennox-Gastaut syndrome
Adults with Bipolar Disorder.
Therapeutic classView
Primary anti-epileptic drugs
PharmacologyView
The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.
Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
DosageView
Epilepsy-
Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
- In patients taking Valproate: 25 mg every day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
- In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
- In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
- In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
- In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
- In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
Weeks 1 & 2:
- If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
- If the patients weight is 14.1 kg to 27 kg: 2 mg every day
- If the patients weight is 27.1 kg to 34 kg: 4 mg every day
- If the patients weight is 34.1 kg to 40 kg: 5 mg every day
- If the patients weight is 6.7 kg to 14 kg: 2 mg every day
- If the patients weight is 14.1 kg to 27 kg: 4 mg every day
- If the patients weight is 27.1 kg to 34 kg: 8 mg every day
- If the patients weight is 34.1 kg to 40 kg: 10 mg every day
Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
- In patients taking Valproate: 25 mg every other day
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
- In patients taking Valproate: 25 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
- In patients taking Valproate: 50 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
- In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
- In patients taking Valproate: 100 mg daily
- In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
Side effectsView
Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
PrecautionsView
Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
InteractionsView
Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
Pregnancy & lactationView
Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Pediatric usageView
Pediatric Use:
- Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
- Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
Overdose effectsView
Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
StorageView
Store below 30°C. Protect from light and moisture. Keep out of the reach of children.
Lamidin
Lamivudine [For Chronic Hepatitis B]
Lamidin
Lamivudine [For Chronic Hepatitis B]
Indications
Hepatitis B virus
Indication detailsView
Lamivudine is indicated for the treatment of chronic hepatitis B associated with evidence of hepatitis B viral replication and active liver inflammation.
Therapeutic classView
Hepatic viral infections (Hepatitis B)
PharmacologyView
Lamivudine is a synthetic nucleoside analogue. Lamivudine is phosphorylated intracellularly to lamivudine triphosphate. Incorporation of the monophosphate form into viral DNA occurs by hepatitis B virus (HBV) polymerase. As a result DNA chain is terminated. Lamivudine triphosphate also inhibits the RNA and DNA-dependent DNA polymerase activities of HIV-1 reverse transcriptase (RT). Lamivudine triphosphate is a very weak inhibitor of mammalian alpha, beta, and gamma-DNA polymerases.
DosageView
The recommended oral dose of Lamivudine for the treatment of chronic hepatitis B in adults is 100 mg once daily.
Side effectsView
Several serious adverse events reported with lamivudine (lactic acidosis and severe hepatomegaly with steatosis, post treatment exacerbations of hepatitis B, pancreatitis, and emergence of viral mutants associated with reduced drug susceptibility and diminished treatment response). Malaise, fatigue, fever, ENT infections, sore throat, nausea, vomiting, abdominal discomfort, pain, diarrhea, myalgia, arthralgia, headache, skin rashes may occur. Lactic acidosis and severe hepatomegaly with steatosis, have been reported.
ContraindicationsView
Lamivudine is contraindicated in patients hypersensitive to any of the components of the product.
PrecautionsView
Patients should be assessed before beginning treatment and during treatment with lamivudine by a physician experienced in the management of chronic hepatitis B.
InteractionsView
Trimethoprim 160 mg / Sulfamethoxazole 800 mg once daily has been shown to increase lamivudine exposure (AUC). The effect of higher doses of trimethoprim /sulfamethoxazole on lamivudine pharmacokinetics has not been investigated.
Pregnancy & lactationView
There is no adequate and well-controlled study in pregnant women. Lamivudine should be used during pregnancy only if the potential benefits outweigh the risks. Although it is not known if lamivudine is excreted in human milk, there is the potential for adverse effects from lamivudine in nursing infants. Mothers should be instructed not to breast feed if they are receiving lamivudine.
Pediatric usageView
It is recommended that doses of Lamivudine should be adjusted in accordance with renal function. Dosage adjustment of Lamivudine in accordance with creatinine clearance is as follows:
- CrCl 50 ml/min: 100 mg once daily
- CrCl 30-49 ml/min: 100 mg first dose, then 50 mg once daily
- CrCl 15-29 ml/min: 100 mg first dose, then 25 mg once daily
- CrCl 5-14 ml/min: 35 mg first dose, then 15 mg once daily
- CrCl <5 ml/min: 35 mg first dose, then 10 mg once daily
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Lamitan
Lasmiditan Hemisuccinate
Lamitan
Lasmiditan Hemisuccinate
Indications
Migraine
Indication detailsView
Lasmiditan is indicated for the acute treatment of migraine with or without aura in adults. Lasmiditan is not indicated for the preventive treatment of migraine.
Therapeutic classView
Other drugs for migraine
PharmacologyView
The acute treatment of migraine headaches has, in the past, been achieved via constriction of cerebral blood vessels, as the acute dilation of these vessels observed during migraines was thought to be the cause of the associated pain. The neurogenic hypothesis of migraine pathophysiology, an alternative to the vascular hypothesis, suggests that cerebral vasodilation is a secondary mechanism in migraine pathogenesis, and that the main contributor to migraine headache pain is the increased pathogenic firing of trigeminal nerve pathways.
While the precise mechanism of action of lasmiditan is unclear, it likely supports this neurogenic hypothesis by exerting its therapeutic effects through potent and selective agonism of the 5-HT1F receptor. 5-HT1F receptors are found in both the central and peripheral nervous system (on the central and peripheral ends of trigeminal neurons) and appear to contribute to hyperpolarization of nerve terminals and inhibition of trigeminal neuronal activity. Lasmiditan's agonism at these receptors may, therefore, inhibit the firing of trigeminal nerves responsible for migraine headache pain.
Lasmiditan has virtually no affinity for other 5-HT receptor subtypes or monoamine receptors (e.g. adrenergic, dopaminergic).
While the precise mechanism of action of lasmiditan is unclear, it likely supports this neurogenic hypothesis by exerting its therapeutic effects through potent and selective agonism of the 5-HT1F receptor. 5-HT1F receptors are found in both the central and peripheral nervous system (on the central and peripheral ends of trigeminal neurons) and appear to contribute to hyperpolarization of nerve terminals and inhibition of trigeminal neuronal activity. Lasmiditan's agonism at these receptors may, therefore, inhibit the firing of trigeminal nerves responsible for migraine headache pain.
Lasmiditan has virtually no affinity for other 5-HT receptor subtypes or monoamine receptors (e.g. adrenergic, dopaminergic).
DosageView
The recommended dose of Lasmiditan is 50 mg, 100 mg, or 200 mg taken orally, as needed. No more than one dose should be taken in 24 hours, and Lasmiditan should not be taken unless the patient can wait at least 8 hours between dosing and driving or operating machinery. A second dose of Lasmiditan has not been shown to be effective for the same migraine attack. The safety of treating an average of more than 4 migraine attacks in a 30-day period has not been established. Lasmiditan may be taken with or without food.
Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
Hepatic Impairment: No dosage adjustment is needed for patients with mild or moderate hepatic impairment (Child-Pugh A or B). In patients with severe hepatic impairment (Child-Pugh C) and its use in these patients is not recommended.
Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
Hepatic Impairment: No dosage adjustment is needed for patients with mild or moderate hepatic impairment (Child-Pugh A or B). In patients with severe hepatic impairment (Child-Pugh C) and its use in these patients is not recommended.
Side effectsView
The most common side effects of Lasmiditan include: dizziness, sleepiness, numbness, feeling tired, tingling.
PrecautionsView
Driving Impairment: Advise patients not to drive or operate machinery until at least 8 hours after taking each dose of Lasmiditan. Patients who cannot follow this advice should not take Lasmiditan. Patients may not be able to assess their own driving competence and the degree of impairment caused by Lasmiditan.
Central Nervous System (CNS) Depression: Lasmiditan may cause CNS depression and should be used with caution if used in combination with alcohol or other CNS depressants.
Serotonin Syndrome: Reactions consistent with serotonin syndrome were reported in patients treated with Lasmiditan. Discontinue Lasmiditan if symptoms of serotonin syndrome occur.
Medication Overuse Headache: Detoxification may be necessary.
Central Nervous System (CNS) Depression: Lasmiditan may cause CNS depression and should be used with caution if used in combination with alcohol or other CNS depressants.
Serotonin Syndrome: Reactions consistent with serotonin syndrome were reported in patients treated with Lasmiditan. Discontinue Lasmiditan if symptoms of serotonin syndrome occur.
Medication Overuse Headache: Detoxification may be necessary.
InteractionsView
CNS Depressants: Concomitant administration of Lasmiditan and alcohol or other CNS depressant drugs has not been evaluated in clinical studies. Because of the potential of Lasmiditan to cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions, Lasmiditan should be used with caution if used in combination with alcohol or other CNS depressants
Serotonergic Drugs: Concomitant administration of Lasmiditan and drugs (e.g., SSRIs, SNRIs, TCAs, MAO inhibitors, trazodone, etc.), over-the-counter medications (e.g., dextromethorphan), or herbal supplements (e.g., St. John’s Wort) that increase serotonin may increase the risk of serotonin syndrome. Use Lasmiditan with caution in patients taking medications that increase serotonin.
Heart Rate Lowering Drugs: Lasmiditan has been associated with a lowering of heart rate. In a drug interaction study, addition of a single 200 mg dose of Lasmiditan to propranolol decreased heart rate by an additional 5 beats per minute compared to propranolol alone, for a mean maximum of 19 beats per minute. Use Lasmiditan with caution in patients taking concomitant medications that lower heart rate if this magnitude of heart rate decrease may pose a concern.
P-gp and Breast Cancer Resistant Protein (BCRP): Lasmiditan inhibits P-gp and BCRP in vitro. Concomitant use of Lasmiditan and drugs that are P-gp or BCRP substrates should be avoided.
Serotonergic Drugs: Concomitant administration of Lasmiditan and drugs (e.g., SSRIs, SNRIs, TCAs, MAO inhibitors, trazodone, etc.), over-the-counter medications (e.g., dextromethorphan), or herbal supplements (e.g., St. John’s Wort) that increase serotonin may increase the risk of serotonin syndrome. Use Lasmiditan with caution in patients taking medications that increase serotonin.
Heart Rate Lowering Drugs: Lasmiditan has been associated with a lowering of heart rate. In a drug interaction study, addition of a single 200 mg dose of Lasmiditan to propranolol decreased heart rate by an additional 5 beats per minute compared to propranolol alone, for a mean maximum of 19 beats per minute. Use Lasmiditan with caution in patients taking concomitant medications that lower heart rate if this magnitude of heart rate decrease may pose a concern.
P-gp and Breast Cancer Resistant Protein (BCRP): Lasmiditan inhibits P-gp and BCRP in vitro. Concomitant use of Lasmiditan and drugs that are P-gp or BCRP substrates should be avoided.
Pregnancy & lactationView
There are no adequate data on the developmental risk associated with the use of Lasmiditan in pregnant women. There are no data on the presence of lasmiditan in human milk, the effects of lasmiditan on the breastfed infant, or the effects of lasmiditan on milk production. Excretion of lasmiditan and/or metabolites into milk, at levels times those in maternal plasma, was observed in lactating rats following oral administration of lasmiditan. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Lasmiditan and any potential adverse effects on the breastfed infant from Lasmiditan or from the underlying maternal condition.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Lamitan
Lasmiditan Hemisuccinate
Lamitan
Lasmiditan Hemisuccinate
Indications
Migraine
Indication detailsView
Lasmiditan is indicated for the acute treatment of migraine with or without aura in adults. Lasmiditan is not indicated for the preventive treatment of migraine.
Therapeutic classView
Other drugs for migraine
PharmacologyView
The acute treatment of migraine headaches has, in the past, been achieved via constriction of cerebral blood vessels, as the acute dilation of these vessels observed during migraines was thought to be the cause of the associated pain. The neurogenic hypothesis of migraine pathophysiology, an alternative to the vascular hypothesis, suggests that cerebral vasodilation is a secondary mechanism in migraine pathogenesis, and that the main contributor to migraine headache pain is the increased pathogenic firing of trigeminal nerve pathways.
While the precise mechanism of action of lasmiditan is unclear, it likely supports this neurogenic hypothesis by exerting its therapeutic effects through potent and selective agonism of the 5-HT1F receptor. 5-HT1F receptors are found in both the central and peripheral nervous system (on the central and peripheral ends of trigeminal neurons) and appear to contribute to hyperpolarization of nerve terminals and inhibition of trigeminal neuronal activity. Lasmiditan's agonism at these receptors may, therefore, inhibit the firing of trigeminal nerves responsible for migraine headache pain.
Lasmiditan has virtually no affinity for other 5-HT receptor subtypes or monoamine receptors (e.g. adrenergic, dopaminergic).
While the precise mechanism of action of lasmiditan is unclear, it likely supports this neurogenic hypothesis by exerting its therapeutic effects through potent and selective agonism of the 5-HT1F receptor. 5-HT1F receptors are found in both the central and peripheral nervous system (on the central and peripheral ends of trigeminal neurons) and appear to contribute to hyperpolarization of nerve terminals and inhibition of trigeminal neuronal activity. Lasmiditan's agonism at these receptors may, therefore, inhibit the firing of trigeminal nerves responsible for migraine headache pain.
Lasmiditan has virtually no affinity for other 5-HT receptor subtypes or monoamine receptors (e.g. adrenergic, dopaminergic).
DosageView
The recommended dose of Lasmiditan is 50 mg, 100 mg, or 200 mg taken orally, as needed. No more than one dose should be taken in 24 hours, and Lasmiditan should not be taken unless the patient can wait at least 8 hours between dosing and driving or operating machinery. A second dose of Lasmiditan has not been shown to be effective for the same migraine attack. The safety of treating an average of more than 4 migraine attacks in a 30-day period has not been established. Lasmiditan may be taken with or without food.
Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
Hepatic Impairment: No dosage adjustment is needed for patients with mild or moderate hepatic impairment (Child-Pugh A or B). In patients with severe hepatic impairment (Child-Pugh C) and its use in these patients is not recommended.
Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
Hepatic Impairment: No dosage adjustment is needed for patients with mild or moderate hepatic impairment (Child-Pugh A or B). In patients with severe hepatic impairment (Child-Pugh C) and its use in these patients is not recommended.
Side effectsView
The most common side effects of Lasmiditan include: dizziness, sleepiness, numbness, feeling tired, tingling.
PrecautionsView
Driving Impairment: Advise patients not to drive or operate machinery until at least 8 hours after taking each dose of Lasmiditan. Patients who cannot follow this advice should not take Lasmiditan. Patients may not be able to assess their own driving competence and the degree of impairment caused by Lasmiditan.
Central Nervous System (CNS) Depression: Lasmiditan may cause CNS depression and should be used with caution if used in combination with alcohol or other CNS depressants.
Serotonin Syndrome: Reactions consistent with serotonin syndrome were reported in patients treated with Lasmiditan. Discontinue Lasmiditan if symptoms of serotonin syndrome occur.
Medication Overuse Headache: Detoxification may be necessary.
Central Nervous System (CNS) Depression: Lasmiditan may cause CNS depression and should be used with caution if used in combination with alcohol or other CNS depressants.
Serotonin Syndrome: Reactions consistent with serotonin syndrome were reported in patients treated with Lasmiditan. Discontinue Lasmiditan if symptoms of serotonin syndrome occur.
Medication Overuse Headache: Detoxification may be necessary.
InteractionsView
CNS Depressants: Concomitant administration of Lasmiditan and alcohol or other CNS depressant drugs has not been evaluated in clinical studies. Because of the potential of Lasmiditan to cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions, Lasmiditan should be used with caution if used in combination with alcohol or other CNS depressants
Serotonergic Drugs: Concomitant administration of Lasmiditan and drugs (e.g., SSRIs, SNRIs, TCAs, MAO inhibitors, trazodone, etc.), over-the-counter medications (e.g., dextromethorphan), or herbal supplements (e.g., St. John’s Wort) that increase serotonin may increase the risk of serotonin syndrome. Use Lasmiditan with caution in patients taking medications that increase serotonin.
Heart Rate Lowering Drugs: Lasmiditan has been associated with a lowering of heart rate. In a drug interaction study, addition of a single 200 mg dose of Lasmiditan to propranolol decreased heart rate by an additional 5 beats per minute compared to propranolol alone, for a mean maximum of 19 beats per minute. Use Lasmiditan with caution in patients taking concomitant medications that lower heart rate if this magnitude of heart rate decrease may pose a concern.
P-gp and Breast Cancer Resistant Protein (BCRP): Lasmiditan inhibits P-gp and BCRP in vitro. Concomitant use of Lasmiditan and drugs that are P-gp or BCRP substrates should be avoided.
Serotonergic Drugs: Concomitant administration of Lasmiditan and drugs (e.g., SSRIs, SNRIs, TCAs, MAO inhibitors, trazodone, etc.), over-the-counter medications (e.g., dextromethorphan), or herbal supplements (e.g., St. John’s Wort) that increase serotonin may increase the risk of serotonin syndrome. Use Lasmiditan with caution in patients taking medications that increase serotonin.
Heart Rate Lowering Drugs: Lasmiditan has been associated with a lowering of heart rate. In a drug interaction study, addition of a single 200 mg dose of Lasmiditan to propranolol decreased heart rate by an additional 5 beats per minute compared to propranolol alone, for a mean maximum of 19 beats per minute. Use Lasmiditan with caution in patients taking concomitant medications that lower heart rate if this magnitude of heart rate decrease may pose a concern.
P-gp and Breast Cancer Resistant Protein (BCRP): Lasmiditan inhibits P-gp and BCRP in vitro. Concomitant use of Lasmiditan and drugs that are P-gp or BCRP substrates should be avoided.
Pregnancy & lactationView
There are no adequate data on the developmental risk associated with the use of Lasmiditan in pregnant women. There are no data on the presence of lasmiditan in human milk, the effects of lasmiditan on the breastfed infant, or the effects of lasmiditan on milk production. Excretion of lasmiditan and/or metabolites into milk, at levels times those in maternal plasma, was observed in lactating rats following oral administration of lasmiditan. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Lasmiditan and any potential adverse effects on the breastfed infant from Lasmiditan or from the underlying maternal condition.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.