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Avemac
Ivermectin (Tablet)
Avemac
Ivermectin (Tablet)
Indication detailsView
Strongyloidiasis of the intestinal tract: Ivermectin is indicated for the treatment of intestinal (i.e., nondisseminated) strongyloidiasis due to the nematode parasite Strongyloides stercoralis. This indication is based on clinical studies of both comparative and open-label designs, in which 64-100% of infected patients were cured following a single 200-mcg/kg dose of ivermectin.
Onchocerciasis: Ivermectin is indicated for the treatment of onchocerciasis due to the nematode parasite Onchocerca volvulus. This indication is based on randomized, double-blind, placebo-controlled and comparative studies conducted in 1427 patients in onchocerciasis-endemic areas of West Africa. The comparative studies used diethylcarbamazine citrate (DEC-C).
Onchocerciasis: Ivermectin is indicated for the treatment of onchocerciasis due to the nematode parasite Onchocerca volvulus. This indication is based on randomized, double-blind, placebo-controlled and comparative studies conducted in 1427 patients in onchocerciasis-endemic areas of West Africa. The comparative studies used diethylcarbamazine citrate (DEC-C).
Therapeutic classView
Anthelmintic
PharmacologyView
Ivermectin selectively binds and with high affinity to glutamate-gated chloride ion channels, which occur in invertebrate nerve and muscle cells leading to an increase in the permeability of cell membranes to chloride ions with hyperpolarization of the nerve or muscle cell and, ultimately, death of the parasite.
DosageView
For Treatment (If COVIO Positive): 2 Tablets of Ivermectin 6 mg once daily for 5 days. (2+0+0 for 5 days).
For Prophylaxis: Single-dose as mentioned below to be taken on Day 1 & same dose on Day 7.
Strongyloidiasis: The recommended dosage of Ivermectin for the treatment of strongyloidiasis is a single oral dose designed to provide approximately 200 mcg/kg of body weight. Patients should take tablets on an empty stomach with water. In general, additional doses are not necessary. However, follow-up stool examinations should be performed to verify eradication of infection.
Dosage Guidelines for Ivermectin for Strongyloidiasis:
Onchocerciasis: The recommended dosage of Ivermectin is a single oral dose designed to provide approximately 150 mcg of Ivermectin per kg of body weight on an empty stomach with water, the most commonly used dose interval is 12 months. For the treatment of individual patients, retreatment may be considered at intervals as short as 3 months.
Dosage Guidelines for Ivermectin for Onchocerciasis:
For Prophylaxis: Single-dose as mentioned below to be taken on Day 1 & same dose on Day 7.
- Body Weight 15-24 kg: 1 Tablet of Ivermectin 3 mg
- Body Weight 25-35 kg: 1 Tablet of Ivermectin 6 mg
- Body Weight 36-50 kg: 1 Tablet of Ivermectin 6 mg + 1 Tablet of Ivermectin 3 mg
- Body Weight 51-65 kg: 2 Tablets of Ivermectin 6 mg
- Body Weight 66-79 kg: 2 Tablets of Ivermectin 6 mg + 1 Tablet of Ivermectin 3 mg
- Body Weight >80 kg: 3 Tablets of Ivermectin 6 mg
Strongyloidiasis: The recommended dosage of Ivermectin for the treatment of strongyloidiasis is a single oral dose designed to provide approximately 200 mcg/kg of body weight. Patients should take tablets on an empty stomach with water. In general, additional doses are not necessary. However, follow-up stool examinations should be performed to verify eradication of infection.
Dosage Guidelines for Ivermectin for Strongyloidiasis:
- Body Weight (kg) 15-24: Dose 3 mg/kg
- Body Weight (kg) 25-35: Dose 6 mg/kg
- Body Weight (kg) 36-50: Dose 9 mg/kg
- Body Weight (kg) 51-65: Dose 12 mg/kg
- Body Weight (kg) 66-79: Dose 15 mg/kg
- Body Weight (kg) >80: Dose 200 mcg/kg
Onchocerciasis: The recommended dosage of Ivermectin is a single oral dose designed to provide approximately 150 mcg of Ivermectin per kg of body weight on an empty stomach with water, the most commonly used dose interval is 12 months. For the treatment of individual patients, retreatment may be considered at intervals as short as 3 months.
Dosage Guidelines for Ivermectin for Onchocerciasis:
- Body Weight (kg) 15-25: Dose 3 mg/kg
- Body Weight (kg) 26-44: Dose 6 mg/kg
- Body Weight (kg) 45-64: Dose 9 mg/kg
- Body Weight (kg) 65-84: Dose 12 mg/kg
- Body Weight (kg) >85: Dose 150 mcg/kg
Side effectsView
Strongyloidiasis: In four clinical studies involving a total of 109 patients given either one or two doses of 170 to 200 mcg/kg of Ivermectin, the following adverse reactions were reported as possibly, probably, or definitely related to Ivermectin.
- Body as a whole: asthenia/fatigue (0.9%), abdominal pain (0.9%)
- Gastrointestinal: anorexia (0.9%), constipation (0.9%), diarrhea (1.8%), nausea (1.8%), vomiting (0.9%) Nervous System/Psychiatric: dizziness (2.8%), somnolence (0.9%), vertigo (0.9%), tremor (0.9%)
- Skin: pruritus (2.8%), rash (0.9%), and urticaria (0.9%).
ContraindicationsView
It is contraindicated in patients who are hypersensitive to any component of this product.
PrecautionsView
Historical data have shown that microfilaricidal drugs, such as diethylcarbamazine citrate (DEC-C), might cause cutaneous and/or systemic reactions of varying severity (the Mazzotti reaction) and ophthalmological reactions in patients with onchocerciasis. These reactions are probably due to allergic and inflammatory responses to the death of microfilariae. Patients treated with Ivermectin for onchocerciasis may experience these reactions in addition to clinical adverse reactions possibly, probably, or definitely related to the drug itself. The treatment of severe Mazzotti reactions has not been subjected to controlled clinical trials. Oral hydration, recumbency, intravenous normal saline, and/or parenteral corticosteroids have been used to treat postural hypotension. Antihistamines and/or aspirin have been used for most mild to moderate cases. After treatment with microfilaricidal drugs, patients with hyperreactive onchodermatitis (sowda) may be more likely than others to experience severe adverse reactions, especially edema and aggravation of onchodermatitis. Rarely, patients with onchocerciasis who are also heavily infected with Loa loa may develop a serious or even fatal encephalopathy either spontaneously or following treatment with an effective microfilaricide. In these patients, the following adverse experiences have also been reported: back pain, conjunctival hemorrhage, dyspnea, urinary and/or fecal incontinence, difficulty in standing/walking, mental status changes, confusion, lethargy, stupor, or coma.
InteractionsView
Post-marketing reports of increased INR (International Normalized Ratio) have been rarely reported when ivermectin was co-administered with warfarin.
Pregnancy & lactationView
Pregnancy Category C. Ivermectin does not appear to be selectively fetotoxic to the developing fetus. There are, however, no adequate and well-controlled studies in pregnant women. Ivermectin should not be used during pregnancy since safety in pregnancy has not been established.
Nursing Mothers: Ivermectin is excreted in human milk in low concentrations. Treatment of mothers who intend to breast feed should only be undertaken when the risk of delayed treatment to the mother outweighs the possible risk to the newborn
Nursing Mothers: Ivermectin is excreted in human milk in low concentrations. Treatment of mothers who intend to breast feed should only be undertaken when the risk of delayed treatment to the mother outweighs the possible risk to the newborn
Pediatric usageView
Pediatric Use: Safety and effectiveness in pediatric patients weighing less than 15 kg have not been established.
Geriatric Use: Clinical studies of Ivermectin did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
Geriatric Use: Clinical studies of Ivermectin did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
StorageView
Keep in a dry place, below 30°C. Protect from light. Keep out of the reach of children.
Avemac
Ivermectin (Tablet)
Avemac
Ivermectin (Tablet)
Indication detailsView
Strongyloidiasis of the intestinal tract: Ivermectin is indicated for the treatment of intestinal (i.e., nondisseminated) strongyloidiasis due to the nematode parasite Strongyloides stercoralis. This indication is based on clinical studies of both comparative and open-label designs, in which 64-100% of infected patients were cured following a single 200-mcg/kg dose of ivermectin.
Onchocerciasis: Ivermectin is indicated for the treatment of onchocerciasis due to the nematode parasite Onchocerca volvulus. This indication is based on randomized, double-blind, placebo-controlled and comparative studies conducted in 1427 patients in onchocerciasis-endemic areas of West Africa. The comparative studies used diethylcarbamazine citrate (DEC-C).
Onchocerciasis: Ivermectin is indicated for the treatment of onchocerciasis due to the nematode parasite Onchocerca volvulus. This indication is based on randomized, double-blind, placebo-controlled and comparative studies conducted in 1427 patients in onchocerciasis-endemic areas of West Africa. The comparative studies used diethylcarbamazine citrate (DEC-C).
Therapeutic classView
Anthelmintic
PharmacologyView
Ivermectin selectively binds and with high affinity to glutamate-gated chloride ion channels, which occur in invertebrate nerve and muscle cells leading to an increase in the permeability of cell membranes to chloride ions with hyperpolarization of the nerve or muscle cell and, ultimately, death of the parasite.
DosageView
For Treatment (If COVIO Positive): 2 Tablets of Ivermectin 6 mg once daily for 5 days. (2+0+0 for 5 days).
For Prophylaxis: Single-dose as mentioned below to be taken on Day 1 & same dose on Day 7.
Strongyloidiasis: The recommended dosage of Ivermectin for the treatment of strongyloidiasis is a single oral dose designed to provide approximately 200 mcg/kg of body weight. Patients should take tablets on an empty stomach with water. In general, additional doses are not necessary. However, follow-up stool examinations should be performed to verify eradication of infection.
Dosage Guidelines for Ivermectin for Strongyloidiasis:
Onchocerciasis: The recommended dosage of Ivermectin is a single oral dose designed to provide approximately 150 mcg of Ivermectin per kg of body weight on an empty stomach with water, the most commonly used dose interval is 12 months. For the treatment of individual patients, retreatment may be considered at intervals as short as 3 months.
Dosage Guidelines for Ivermectin for Onchocerciasis:
For Prophylaxis: Single-dose as mentioned below to be taken on Day 1 & same dose on Day 7.
- Body Weight 15-24 kg: 1 Tablet of Ivermectin 3 mg
- Body Weight 25-35 kg: 1 Tablet of Ivermectin 6 mg
- Body Weight 36-50 kg: 1 Tablet of Ivermectin 6 mg + 1 Tablet of Ivermectin 3 mg
- Body Weight 51-65 kg: 2 Tablets of Ivermectin 6 mg
- Body Weight 66-79 kg: 2 Tablets of Ivermectin 6 mg + 1 Tablet of Ivermectin 3 mg
- Body Weight >80 kg: 3 Tablets of Ivermectin 6 mg
Strongyloidiasis: The recommended dosage of Ivermectin for the treatment of strongyloidiasis is a single oral dose designed to provide approximately 200 mcg/kg of body weight. Patients should take tablets on an empty stomach with water. In general, additional doses are not necessary. However, follow-up stool examinations should be performed to verify eradication of infection.
Dosage Guidelines for Ivermectin for Strongyloidiasis:
- Body Weight (kg) 15-24: Dose 3 mg/kg
- Body Weight (kg) 25-35: Dose 6 mg/kg
- Body Weight (kg) 36-50: Dose 9 mg/kg
- Body Weight (kg) 51-65: Dose 12 mg/kg
- Body Weight (kg) 66-79: Dose 15 mg/kg
- Body Weight (kg) >80: Dose 200 mcg/kg
Onchocerciasis: The recommended dosage of Ivermectin is a single oral dose designed to provide approximately 150 mcg of Ivermectin per kg of body weight on an empty stomach with water, the most commonly used dose interval is 12 months. For the treatment of individual patients, retreatment may be considered at intervals as short as 3 months.
Dosage Guidelines for Ivermectin for Onchocerciasis:
- Body Weight (kg) 15-25: Dose 3 mg/kg
- Body Weight (kg) 26-44: Dose 6 mg/kg
- Body Weight (kg) 45-64: Dose 9 mg/kg
- Body Weight (kg) 65-84: Dose 12 mg/kg
- Body Weight (kg) >85: Dose 150 mcg/kg
Side effectsView
Strongyloidiasis: In four clinical studies involving a total of 109 patients given either one or two doses of 170 to 200 mcg/kg of Ivermectin, the following adverse reactions were reported as possibly, probably, or definitely related to Ivermectin.
- Body as a whole: asthenia/fatigue (0.9%), abdominal pain (0.9%)
- Gastrointestinal: anorexia (0.9%), constipation (0.9%), diarrhea (1.8%), nausea (1.8%), vomiting (0.9%) Nervous System/Psychiatric: dizziness (2.8%), somnolence (0.9%), vertigo (0.9%), tremor (0.9%)
- Skin: pruritus (2.8%), rash (0.9%), and urticaria (0.9%).
ContraindicationsView
It is contraindicated in patients who are hypersensitive to any component of this product.
PrecautionsView
Historical data have shown that microfilaricidal drugs, such as diethylcarbamazine citrate (DEC-C), might cause cutaneous and/or systemic reactions of varying severity (the Mazzotti reaction) and ophthalmological reactions in patients with onchocerciasis. These reactions are probably due to allergic and inflammatory responses to the death of microfilariae. Patients treated with Ivermectin for onchocerciasis may experience these reactions in addition to clinical adverse reactions possibly, probably, or definitely related to the drug itself. The treatment of severe Mazzotti reactions has not been subjected to controlled clinical trials. Oral hydration, recumbency, intravenous normal saline, and/or parenteral corticosteroids have been used to treat postural hypotension. Antihistamines and/or aspirin have been used for most mild to moderate cases. After treatment with microfilaricidal drugs, patients with hyperreactive onchodermatitis (sowda) may be more likely than others to experience severe adverse reactions, especially edema and aggravation of onchodermatitis. Rarely, patients with onchocerciasis who are also heavily infected with Loa loa may develop a serious or even fatal encephalopathy either spontaneously or following treatment with an effective microfilaricide. In these patients, the following adverse experiences have also been reported: back pain, conjunctival hemorrhage, dyspnea, urinary and/or fecal incontinence, difficulty in standing/walking, mental status changes, confusion, lethargy, stupor, or coma.
InteractionsView
Post-marketing reports of increased INR (International Normalized Ratio) have been rarely reported when ivermectin was co-administered with warfarin.
Pregnancy & lactationView
Pregnancy Category C. Ivermectin does not appear to be selectively fetotoxic to the developing fetus. There are, however, no adequate and well-controlled studies in pregnant women. Ivermectin should not be used during pregnancy since safety in pregnancy has not been established.
Nursing Mothers: Ivermectin is excreted in human milk in low concentrations. Treatment of mothers who intend to breast feed should only be undertaken when the risk of delayed treatment to the mother outweighs the possible risk to the newborn
Nursing Mothers: Ivermectin is excreted in human milk in low concentrations. Treatment of mothers who intend to breast feed should only be undertaken when the risk of delayed treatment to the mother outweighs the possible risk to the newborn
Pediatric usageView
Pediatric Use: Safety and effectiveness in pediatric patients weighing less than 15 kg have not been established.
Geriatric Use: Clinical studies of Ivermectin did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
Geriatric Use: Clinical studies of Ivermectin did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
StorageView
Keep in a dry place, below 30°C. Protect from light. Keep out of the reach of children.
Avenac
Aceclofenac
Avenac
Aceclofenac
Indications
Spondylitis
Indication detailsView
Aceclofenac is indicated for the relief of pain and inflammation in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, toothache, trauma and lumbago.
Therapeutic classView
Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
PharmacologyView
Aceclofenac is a non-steroidal drug with anti-inflammatory and analgesic properties. It is a potent inhibitor of the enzyme cyclooxygenase, which is involved in the production of prostaglandin. After oral administration, it is rapidly and completely absorbed an unchanged drug.
DosageView
Extended release tablet: The recommended dose in adults is one 200 mg Aceclofenac tablet daily or as prescribed by the physician.
Film coated tablet: The recommended dose in adults is 100 mg, twice daily.
Side effectsView
Aceclofenac is a non-steroidal drug with anti-inflammatory and analgesic properties. It is a potent inhibitor of the enzyme cyclooxygenase, which is involved in the production of prostaglandin. After oral administration, it is rapidly and completely absorbed an unchanged drug.
ContraindicationsView
Aceclofenac is contraindicated in patients with known hypersensitivity to it or in whom aspirin or NSAIDs precipitate attacks of asthma.
PrecautionsView
Caution should be exercised to patients with active or suspected peptic ulcer or gastro-intestinal bleeding moderate to severe hepatic impairment and cardiac or renal impairment. Caution should also be exercised in patients suffering from dizziness or urticaria.
InteractionsView
No significant drug interactions has not been observed but close monitoring of patients is required when it is used with:
- Lithium and Digoxin: may increase plasma concentration of lithium and digoxin.
- Diuretics: may interact the activity of diuretics.
- Anticoagulants: may enhance the activity of anticoagulant.
- Methotrexate: may increase the plasma level of methotrexate.
Pregnancy & lactationView
The use of Aceclofenac should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.
Pediatric usageView
There are no clinical data on the use of Aceclofenac in children.
StorageView
keep in a dry place away from light and heat. Keep out of the reach of children.
Avert
Meclizine Hydrochloride
Avert
Meclizine Hydrochloride
Indications
Vertigo
Indication detailsView
Meclizine Hydrochloride is indicated in nausea, vomiting, motion sickness, vertigo.
Therapeutic classView
Anti-emetic drugs
PharmacologyView
Meclizine has antiemetic, anticholinergic and antihistaminic properties. It reduces the sensitivity of the labyrinthine apparatus. The action may be mediated through nerve pathways to the vomiting center (VC) from the chemoreceptor trigger zone (CTZ), peripheral nerve pathways, the VC, or other CNS centers. Meclizine has an onset of action of 30 to 60 minutes, depending on dosage; their duration of action is 12 to 24 hours.
DosageView
Adult & children over 12 years of age:
Use in elderly: There is no specific information available. However older people may be especially sensitive to the anticholinergic effects of medicine.
- Nausea and vomiting: 25-50 mg once daily.
- Motion sickness: Take an initial dose of 25 to 50 mg, 1 hour prior to travel. May repeat dose every 24 hours for the duration of the journey. Children: Age 6-12 years, 12.5 mg once daily. Age 2-6 years, 6.25 mg once daily.
- Vertigo: 25 to 100 mg daily in divided doses.
- Radiotherapy induced nausea and vomiting: 50 mg two to twelve hours prior to radiotherapy.
- Emergency contraception: 25-50 mg, 1 hour before first ECP dose; repeat if needed in 24 hours.
Use in elderly: There is no specific information available. However older people may be especially sensitive to the anticholinergic effects of medicine.
Side effectsView
Common side effects are Drowsiness, dry mouth, and on rare occasions, blurred vision have been reported.
ContraindicationsView
Meclizine is contraindicated in patients hypersensitive to Meclizine or any of its excipeints.
PrecautionsView
Patients with asthma, bronchitis, emphysema, enlarged prostate, glaucoma or urinary tract blockage should take Meclizine (like other antiemetics) with caution.
InteractionsView
Meclizine may increase the toxicity with CNS depressants, neuroleptics and anticholinergic. Alcohol, sedatives and tranquilizers can increase the drowsiness of the patient.
Pregnancy & lactationView
Meclizine shows no risk of birth defects or abnormalities when administered during pregnancy. Although Meclizine may excrete into the milk, it causes no harm in nursing babies.
Overdose effectsView
Symptoms: Extreme excitability, seizures, drowsiness and hallucinations.
Treatment: Appropriate supportive and symptomatic treatment. Consider dialysis.
Treatment: Appropriate supportive and symptomatic treatment. Consider dialysis.
StorageView
Store in a cool & dry place and away from children.
Avert Plus
Meclizine + Pyridoxine
Avert Plus
Meclizine + Pyridoxine
Indications
Pregnancy-associated nausea and vomiting
Indication detailsView
Prevention and treatment of nausea, vomiting, dizziness, motion sickness, radiation sickness and vertigo associated with diseases of the vestibular system (e.g. Meniere's syndrome, labyrinthitis and other vestibular disturbances).
Therapeutic classView
Anti-emetic drugs
PharmacologyView
Meclizine is a piperazine-derivative antihistamine that is used as an antiemetic. It has antiemetic, anticholinergic and antihistaminic properties. It reduces the sensitivity of the labyrinthine apparatus. The action may be mediated through nerve pathways to the vomiting center (VC) from the chemoreceptor trigger zone (CTZ), peripheral nerve pathways, the VC, or other CNS centers. Pyridoxine is vitamin B-6. It has been added to enhance the anti-emetic effects & as a dietary suppliment.
DosageView
Adult and Children 12 years of age & over:
- Nausea and vomiting: 25-50 mg daily or as directed by a physician.
- Motion sickness: Take an initial dose of 25-50 mg, 1 hour prior to travel. May repeat the dose every 24 hours for the duration of the journey.
- Radiation sickness: 50 mg administered 2-12 hours prior to radiation treatment.
- Vertigo: 25-100 mg daily in divided doses.
- Prevention of nausea and vomiting associated with emergency contraceptive pill (ECP): 25-50 mg, 1 hour before first ECP dose; repeat if needed in 24 hours.
Side effectsView
Drowsiness, dry mouth and, on rare occasions, blurred vision have been reported.
ContraindicationsView
Meclizine Hydrochloride and Pyridoxine Hydrochloride is contraindicated in patients who are hypersensitive to these ingredients.
PrecautionsView
Patients should be warned that Meclizine Hydrochloride may impair their ability to perform hazardous activities requiring mental alertness or physical coordination (e.g., operating machinery, driving a motor vehicle). Patients should avoid alcoholic beverages while taking this drug. Due to its potential anticholinergic action, this drug should be used with caution in patients with asthma, glaucoma or enlargement of the prostate gland.
InteractionsView
The CNS depressant effects of Meclizine can be potentiated by concurrent use of Ethanol or other CNS depressant agents such as Benzodiazepines, Barbiturates, Tricyclic antidepressants, opiate agonists, skeletal muscle relaxants and antihistamines. Concurrent use of other anticholinergics can potentiate the anticholinergic effects of Meclizine. Meclizine can increase the absorption of digoxin by decreasing gastrointestinal motility.
Pregnancy & lactationView
Pregnancy Category B. Large-scale human studies have not demonstrated adverse fetal effects. It has been suggested that based on available data, Meclizine presents the lowest risk of teratogenicity and is the drug of first choice in treating nausea and vomiting during pregnancy. Safety for use in the nursing mother has not been established.
Overdose effectsView
Symptoms: Extreme excitability, seizures, drowsiness and hallucinations.
Treatment: Appropriate supportive and symptomatic treatment. Consider dialysis
Treatment: Appropriate supportive and symptomatic treatment. Consider dialysis
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Avidol
Carvedilol
Avidol
Carvedilol
Indications
Myocardial infarction
Indication detailsView
Carvedilol is indicated for the treatment of mild, moderate or severe heart failure of ischemic or cardiomyopathic origin, in conjunction with digitalis, diuretics and ACE inhibitor, to reduce the progression of disease as evidenced by cardiovascular death, cardiovascular hospitalization, or the need to adjust other heart failure medications. Carvedilol may be used in patients unable to tolerate an ACE inhibitor. Carvedilol may be used in patients who are not receiving digitalis, hydralazine or nitrate therapy.
Therapeutic classView
Alpha adrenoceptor blocking drugs, Beta-adrenoceptor blocking drugs, Beta-blockers
PharmacologyView
Carvedilol is a cardiovascular drug whose main pharmacological action is non-selective antagonism of β-adrenergic receptors but which also possesses appreciable a-adrenergic antagonistic activity. It also has antiproliferative properties and is a scavenger of reactive free oxidant radicals. It is used in the treatment of hypertension, angina pectoris and congestive heart failure.
DosageView
In hypertension: initially, 12.5 mg once daily, increased after 2 days to the usual dose of 25 mg once daily; if necessary the dose may be further increased at intervals of at least 2 weeks to maximum 50 mg daily in single or divided doses. In elderly patients, the initial dose of 12.5 mg daily may provide satisfactory control.
In angina pectoris: the recommended dose for initiation of therapy is 12.5 mg twice daily for the first 2 days. Thereafter, the recommended dosage is 25 mg twice daily. For elderly patients, the maximum daily dose is 50 mg daily in divided doses.
In heart failure: initially, 3.125 mg twice daily (with food) may be given, the dose may be increased at intervals of at least 2 weeks to 6.25 mg twice daily, then to 12.5 mg twice daily, then to 25 mg twice daily. The dose may be increased to the highest dose tolerated, maximum 25 mg twice daily in patients less than 85 kg body-weight and 50 mg twice daily in patients over 85 kg.
In angina pectoris: the recommended dose for initiation of therapy is 12.5 mg twice daily for the first 2 days. Thereafter, the recommended dosage is 25 mg twice daily. For elderly patients, the maximum daily dose is 50 mg daily in divided doses.
In heart failure: initially, 3.125 mg twice daily (with food) may be given, the dose may be increased at intervals of at least 2 weeks to 6.25 mg twice daily, then to 12.5 mg twice daily, then to 25 mg twice daily. The dose may be increased to the highest dose tolerated, maximum 25 mg twice daily in patients less than 85 kg body-weight and 50 mg twice daily in patients over 85 kg.
Side effectsView
Postural hypotension, dizziness, headache, fatigue, gastro-intestinal disturbances, bradycardia; occasionally diminished peripheral circulation, peripheral oedema and painful extremities, dry mouth, dry eyes, eye irritation or disturbed vision, impotence, disturbances of micturition, influenza-like symptoms, rarely angina, AV block, exacerbation of intermittent claudication or Raynaud's phenomenon, allergic skin reactions, exacerbation of psoriasis, nasal stuffiness, wheezing, depressed mood, sleep disturbances, paresthesia, heart failure, changes in liver enzymes, thrombocytopenia, leukopenia are also reported.
ContraindicationsView
Carvedilol is contraindicated in patients with decompensated heart failure requiring intravenous inotropic therapy, bronchial asthma or related bronchospastic conditions, second or third-degree AV block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock or severe bradycardia.
PrecautionsView
Take caution in hepatic impairment and in heart failure monitor clinical status for 2-3 hours after initiation and after increasing each dose. Before increasing dose ensure that the renal function and heart failure are not deteriorating
InteractionsView
Digoxin: In normal healthy volunteers a single dose of carvedilol taken together with a single dose of digoxin resulted in significantly increased levels of digoxin 24 hours later. Patients with congestive heart failure stabilized on digoxin have been given carvedilol concomitantly without any adverse effects. Increased monitoring of digoxin is recommended when initiating, adjusting, or discontinuing the dose of carvedilol.
Rifampin: Pretreatment with rifampin resulted in a 60% decrease in Cmax and AUC.
Warfarin: Carvedilol did not alter the in vitro plasma protein binding of warfarin.
Clonidine: β-receptor antagonists potentiate the pressor reaction which may follow the sudden withdrawal of treatment with clonidine although, in theory, the a-blocking action of carvedilol should modify the pressure rise.
Rifampin: Pretreatment with rifampin resulted in a 60% decrease in Cmax and AUC.
Warfarin: Carvedilol did not alter the in vitro plasma protein binding of warfarin.
Clonidine: β-receptor antagonists potentiate the pressor reaction which may follow the sudden withdrawal of treatment with clonidine although, in theory, the a-blocking action of carvedilol should modify the pressure rise.
Pregnancy & lactationView
Carvedilol should not be used during breast-feeding, since no studies have been performed in lactating women and animal studies have shown that carvedilol is excreted in breast milk. Safety and efficacy in children have not been established with carvedilol. Carvedilol should not be used during pregnancy as no studies have been performed in this group. Animal studies have shown that carvedilol crosses the placental barrier. No information is available on the safety and efficacy of Carvedilol use in neonates.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Avidro
Pizotifen
Avidro
Pizotifen
Indications
Migraine
Indication detailsView
Pizotifen is indicated as prophylactic treatment of vascular headache of migraine type such as classical migraine, common migraine and cluster headache. It is not effective in relieving migraine attacks once in progress.
Therapeutic classView
Anti-histamine Preparations, Other drugs for migraine
PharmacologyView
Pizotifen works by inhibiting the peripheral actions of serotonin and histamine in increasing the membrane permeability of cranial vessels and transudation of plasmakinin, while altering pain thresholds in migraines. By blocking 5-HT receptors, pizotifen attenuates the signalling of serotonin in causing cranial vasoconstriction, as well as serotonin-enhanced platelet function and aggregation. There is evidence that it also inhibits the peripheral actions of bradykinin. Pizotifen may inhibit serotonin reuptake by blood platelets, which affects the tonicity and decreases passive distension of extracranial arteries. The effects of pizotifen leading to appetite stimulation may be due to the drug acting at the metabolic level rather than a direct stimulation of the appetite centre.
DosageView
Adults: Usually 1.5 mg daily. This may be taken as a single dose at night or in three divided doses. Dosage should be adjusted to the individual patient requirements up to a maximum of 4.5 mg daily. Up to 3 mg may be given as a single dose.
Children (aged over 2 years): Up to 1.5 mg daily, usually as a divided dose, although up to 1 mg has been given as a single dose at night.
Children (aged over 2 years): Up to 1.5 mg daily, usually as a divided dose, although up to 1 mg has been given as a single dose at night.
Side effectsView
The most common side effects are appetite stimulating effect, increase in body weight and drowsiness.
ContraindicationsView
Pizotifen is contraindicated in patients with known hypersensitivity to any of its ingredients.
PrecautionsView
Urinary retention, renal impairment should be taken in consideration. Drowsiness may affect the performance driving vehicles & operation of machineries. Pizotifen enhances the action of alcohol.
InteractionsView
The central effects of sedatives, hypnotics, antihistamines (including certain common cold preparations) and alcohol may be enhanced by Pizotifen. Pizotifen antagonizes the hypotensive effect of adrenergic neurone blockers.
Pregnancy & lactationView
Information of using Pizotifen in pregnancy is limited, although no ill effects have been reported. The drug should therefore only be given during pregnancy if the potential benefit to mother justifies the potential risk to the fetus. The safety of Pizotifen during lactation has not been established, so mothers should avoid taking it when breast feeding.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Avidro
Pizotifen
Avidro
Pizotifen
Indications
Migraine
Indication detailsView
Pizotifen is indicated as prophylactic treatment of vascular headache of migraine type such as classical migraine, common migraine and cluster headache. It is not effective in relieving migraine attacks once in progress.
Therapeutic classView
Anti-histamine Preparations, Other drugs for migraine
PharmacologyView
Pizotifen works by inhibiting the peripheral actions of serotonin and histamine in increasing the membrane permeability of cranial vessels and transudation of plasmakinin, while altering pain thresholds in migraines. By blocking 5-HT receptors, pizotifen attenuates the signalling of serotonin in causing cranial vasoconstriction, as well as serotonin-enhanced platelet function and aggregation. There is evidence that it also inhibits the peripheral actions of bradykinin. Pizotifen may inhibit serotonin reuptake by blood platelets, which affects the tonicity and decreases passive distension of extracranial arteries. The effects of pizotifen leading to appetite stimulation may be due to the drug acting at the metabolic level rather than a direct stimulation of the appetite centre.
DosageView
Adults: Usually 1.5 mg daily. This may be taken as a single dose at night or in three divided doses. Dosage should be adjusted to the individual patient requirements up to a maximum of 4.5 mg daily. Up to 3 mg may be given as a single dose.
Children (aged over 2 years): Up to 1.5 mg daily, usually as a divided dose, although up to 1 mg has been given as a single dose at night.
Children (aged over 2 years): Up to 1.5 mg daily, usually as a divided dose, although up to 1 mg has been given as a single dose at night.
Side effectsView
The most common side effects are appetite stimulating effect, increase in body weight and drowsiness.
ContraindicationsView
Pizotifen is contraindicated in patients with known hypersensitivity to any of its ingredients.
PrecautionsView
Urinary retention, renal impairment should be taken in consideration. Drowsiness may affect the performance driving vehicles & operation of machineries. Pizotifen enhances the action of alcohol.
InteractionsView
The central effects of sedatives, hypnotics, antihistamines (including certain common cold preparations) and alcohol may be enhanced by Pizotifen. Pizotifen antagonizes the hypotensive effect of adrenergic neurone blockers.
Pregnancy & lactationView
Information of using Pizotifen in pregnancy is limited, although no ill effects have been reported. The drug should therefore only be given during pregnancy if the potential benefit to mother justifies the potential risk to the fetus. The safety of Pizotifen during lactation has not been established, so mothers should avoid taking it when breast feeding.
StorageView
Keep in a dry place away from light and heat. Keep out of the reach of children.
Avifanz
Efavirenz
Avifanz
Efavirenz
Indications
HIV infection
Indication detailsView
Efavirenz in combination with other antiretroviral agents is indicated for the treatment of HIV-1 infection. This indication is based on analyses of plasma HIV- RNA levels and CD4 cell counts in controlled studies of up to 24 weeks in duration. At present, there are no results from controlled trials evaluating long term suppression of HIVRNA with Efavirenz.
Therapeutic classView
Drugs for HIV / Anti-retroviral drugs
PharmacologyView
Efavirenz is a non-nucleoside reverse transcriptase inhibitor (NNRTI) with activity against HIV-1. It blocks the RNA- and DNA-dependent polymerase activities including HIV-1 replication.
DosageView
Adults: The recommended dosage of Efavirenz is 600 mg orally, once daily, in combination with a protease inhibitor and/or nucleoside analogue reverse transcriptase inhibitors (NRTIs).
Pediatric Patients: Following table describes the recommended dose of Efavirenz for pediatric patients 3 years of age or older and weighing between 10 and 40 kg. The recommended dosage of Efavirenz for pediatric patients weighing greater than 40 kg is 600 mg, once daily.
Pediatric Patients: Following table describes the recommended dose of Efavirenz for pediatric patients 3 years of age or older and weighing between 10 and 40 kg. The recommended dosage of Efavirenz for pediatric patients weighing greater than 40 kg is 600 mg, once daily.
- 10 to <15 kg: 200 mg
- 15 to < 20 kg: 250 mg
- 20 to < 25 kg: 300 mg
- 25 to < 32.5 kg: 350 mg
- 32.5 to < 40 kg: 400 mg
- 40 kg: 600 mg
AdministrationView
It is recommended that Efavirenz be taken on an empty stomach, preferably at bedtime.
Side effectsView
Rashes, psychiatric or CNS disturbances, amnesia, agitation, confusion, dizziness, vertigo, headache, euphoria, insomnia or somnolence, impaired concentration, abnormal thinking or dreaming, depersonalisation, convulsions, hallucinations, nausea, vomiting, diarrhoea, pancreatitis, fatigue, hepatic failure, photoallergic dermatitis; autoimmune disorders (e.g. Graves’ disease, polymyositis, Guillain-Barre syndrome), osteonecrosis. Accumulation or redistribution of body fat (lipodystrophy) including central obesity, peripheral and facial wasting, buffalo hump, breast enlargement, cushingoid appearance. Metabolic abnormalities e.g. hypercholesterolaemia, hyperglycaemia, hypertriglyceridaemia, hyperlactataemia, insulin resistance.
ContraindicationsView
Hypersensitivity. Severe hepatic impairment. Lactation. Concomitant admin with terfenadine, astemizole, cisapride, midazolam, triazolam, pimozide, bepridil, ergot alkaloids, St John’s wort.
PrecautionsView
Patient with history of seizures and psychiatric disorders; acute porphyria. Patients receiving voriconazole or rifampicin (weighing ≥50 kg). Discontinue if severe rash or fever develops. Moderate hepatic and severe renal impairment. Childn. Pregnancy.
InteractionsView
Additive CNS effects w/ psychoactive drugs. May alter plasma warfarin concentrations. May reduce plasma concentrations of HIV integrase inhibitors (e.g. dolutegravir), other HIV NNRTIs (e.g. etravirine), HMG-CoA reductase inhibitors (e.g. simvastatin). Plasma concentrations of efavirenz is increased and that of voriconazole is reduced when given concomitantly. Reduced plasma concentrations w/ rifampicin.
Pregnancy & lactationView
Category D: There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Lactation: Efavirenz may pass through breast milk and cause serious harm to the baby. It should not be used during lactation.
Lactation: Efavirenz may pass through breast milk and cause serious harm to the baby. It should not be used during lactation.
Pediatric usageView
Paediatric use: Efavirenz has not been studied in pediatric patients below 3 years of age or who weigh less than 10 kg.
Women taking hormone-based birth control: Women should not rely only on hormone-based birth control, such as pills, injections, or implants, because Efavirenz may make these contraceptives ineffective.
Women taking hormone-based birth control: Women should not rely only on hormone-based birth control, such as pills, injections, or implants, because Efavirenz may make these contraceptives ineffective.
Overdose effectsView
Symptoms: Increased adverse CNS effects including involuntary muscle contractions.
Management: Supportive and symptomatic treatment. May administer activated charcoal.
Management: Supportive and symptomatic treatment. May administer activated charcoal.
StorageView
Store at 25°C.
Avifix
Nelfinavir
Avifix
Nelfinavir
Indications
HIV infection
Indication detailsView
Nelfinavir is indicated for the treatment of HIV infection when antiretroviral therapy is warranted
Therapeutic classView
Drugs for HIV / Anti-retroviral drugs
PharmacologyView
Nelfinavir is a selective, competitive, reversible HIV protease inhibitor. It inhibits HIV-1 protease preventing the cleavage of the gag-pol polyprotein resulting in the production of noninfectious virus.
DosageView
Adults: The recommended dose is 1250 mg (five 250 mg tablets) twice daily or 750 mg (three 250 mg tablets) three times daily. Nelfinavir should be taken with a meal. Antiviral activity is enhanced when Nelfinavir is administered in combination with nucleoside analogues. Therefore, it is recommended that Nelfinavir should be used in combination with nucleoside analogues.
Paediatric patients (2-13 years): The recommended oral dose of Nelfinavir for paediatric patients 2 to 13 years of age is 20-30 mg/kg per dose, three times daily with a meal.
Paediatric patients (2-13 years): The recommended oral dose of Nelfinavir for paediatric patients 2 to 13 years of age is 20-30 mg/kg per dose, three times daily with a meal.
Side effectsView
The safety of Nelfinavir was studied in over 1500 patients who received drug either alone or in combination with nucleoside analogues. The majority of adverse events were of mild intensity. The most frequently reported adverse event among patients receiving Nelfinavir was diarrhoea, which was generally of mild to moderate intensity. Adverse events occurring in less than 2% of patients receiving Nelfinavir in all phase II/III clinical trials and considered at least possibly related or of unknown relationship to treatment and of at least moderate severity are listed below.
General: Abdominal pain, accidental injury, allergic reaction, asthenia, back pain, fever, headache, malaise, pain and redistribution/accumulation of body fat.
Digestive system: Anorexia, dyspepsia, epigastric pain, gastrointestinal bleeding, hepatitis, mouth ulceration, pancreatitis and vomiting.
Haemic/Lymphatic system: Anaemia, leukopenia and thrombocytopenia.
Metabolic/Nutritional: Increase in alkaline phosphate, amylase, creatinine phosphokinase, lactic dehydrogenase, SGOT, SGPT and g glutamyl transpeptidase, hyperlipaemia, hyperuricaemia, hyperglycaemia, hypoglycaemia, dehydration and liver function tests abnormal.
Musculoskeletal system: Arthralgia, arthritis, cramps, myalgia, myasthenia and myopathy.
Nervous system: Anxiety, depression, dizziness, emotional lability, hyperkinesia, insomnia, migraine, paraesthesia, seizures, sleep disorder, somnolence and suicide ideation.
Respiratory system: Dyspnoea, pharyngitis, rhinitis and sinusitis.
Skin/Appendages: Dermatitis, folliculitis, fungal dermatitis, maculopapular rash, pruitus, sweating, and urticaria.
Ophthalmic: Acute iritis and eye disorder.
Urogenital system: Kidney calculas, sexual dysfunction.
General: Abdominal pain, accidental injury, allergic reaction, asthenia, back pain, fever, headache, malaise, pain and redistribution/accumulation of body fat.
Digestive system: Anorexia, dyspepsia, epigastric pain, gastrointestinal bleeding, hepatitis, mouth ulceration, pancreatitis and vomiting.
Haemic/Lymphatic system: Anaemia, leukopenia and thrombocytopenia.
Metabolic/Nutritional: Increase in alkaline phosphate, amylase, creatinine phosphokinase, lactic dehydrogenase, SGOT, SGPT and g glutamyl transpeptidase, hyperlipaemia, hyperuricaemia, hyperglycaemia, hypoglycaemia, dehydration and liver function tests abnormal.
Musculoskeletal system: Arthralgia, arthritis, cramps, myalgia, myasthenia and myopathy.
Nervous system: Anxiety, depression, dizziness, emotional lability, hyperkinesia, insomnia, migraine, paraesthesia, seizures, sleep disorder, somnolence and suicide ideation.
Respiratory system: Dyspnoea, pharyngitis, rhinitis and sinusitis.
Skin/Appendages: Dermatitis, folliculitis, fungal dermatitis, maculopapular rash, pruitus, sweating, and urticaria.
Ophthalmic: Acute iritis and eye disorder.
Urogenital system: Kidney calculas, sexual dysfunction.
ContraindicationsView
Nelfinavir is contraindicated in patients with clinically significant hypersensitivity to any of its components. Co-administration of Avifix is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening adverse events
PrecautionsView
Nelfinavir should not be administered concurrently with Terfenadine, Astemizole, Cisapride, Triazolam, Midazolam, Ergot derivatives, Amiodarone or Quinidine because Nelfinavir may affect the hepatic metabolism of these drugs and create potential for serious and/or life-threatening adverse events. New onset diabetes mellitus, exacerbation of pre-existing diabetes mellitus and hyperglycaemia have been reported during post-marketing surveillance in HIV-infected patients receiving protease inhibitor therapy. Some patients required either initiation or dose adjustments of insulin or oral hypoglycaemic agents for treatment of these events. In some cases diabetic ketoacidosis has occurred. In those patients who discontinued protease inhibitor therapy, hyperglycaemia persisted in some cases.
General: Nelfinavir is principally metabolised by the liver. Therefore, caution should be exercised when administering this drug to patients with hepatic impairment.
Haemophilia: There have been reports of increased bleeding, including spontaneous skin haematomas and haemarthrosis, in patients with haemophilia type A and B treated with protease inhibitors. In some patients, additional factor VIII was given. In more than half of the reported cases, treatment with protease inhibitors was continued or reintroduced. A causal relationship has not been established.
General: Nelfinavir is principally metabolised by the liver. Therefore, caution should be exercised when administering this drug to patients with hepatic impairment.
Haemophilia: There have been reports of increased bleeding, including spontaneous skin haematomas and haemarthrosis, in patients with haemophilia type A and B treated with protease inhibitors. In some patients, additional factor VIII was given. In more than half of the reported cases, treatment with protease inhibitors was continued or reintroduced. A causal relationship has not been established.
InteractionsView
Reduced levels/effects with antacids, phenobarbital, carbamazepine, aminoglutethimide, phenytoin, rifampicin, nafcillin, nevirapine, omeprazole, nevirapine. Increased serum levels/effects with azole antifungal agents, cimetidine, efavirenz. Increased serum levels/effects of azithromycin, calcium channel blockers, clarithromycin, corticosteroids (e.g. fluticasone), mirtazapine, nateglinide, nefazodone, ciclosporin, sirolimus, tacrolimus, venlafaxine, eplerinone, fentanyl, atorvastatin, phosphodiesterase-5 (PDE-5) inhibitors, rifabutin, trazodone, TCAs. Reduced serum levels/effects of hormonal contraceptives, methadone, theophylline derivatives.
Pregnancy & lactationView
Pregnancy Category B. There are no adequate and well controlled studies in pregnant women.
Lactation: The US Public Health Service Centers for Disease Control and Prevention advises HIV-infected women not to breast-feed to avoid postnatal transmission of HIV to a child.
Lactation: The US Public Health Service Centers for Disease Control and Prevention advises HIV-infected women not to breast-feed to avoid postnatal transmission of HIV to a child.
Pediatric usageView
Paediatric use: The safety, effectiveness and pharmacokinetics of Nelfinavir have not been evaluated in paediatric patients below the age of 2 years.
StorageView
Store at 15-30° C
Avil
Pheniramine Maleate
Avil
Pheniramine Maleate
Indications
Motion sickness
Indication detailsView
Pheniramine Maleate is indicated for-
- Allergic conditions including hay fever, drug rashes, angioneurotic edema, serum sickness, allergic conjunctivitis, food allergy etc.
- Conditions of the respiratory tract that are accompanied by increased secretion, including vasomotor rhinitis and acute rhinitis.
- All itching skin conditions, including neurodermatitis, eczema of any origin, lichen planus, acute and chronic urticaria, pruritis of the anus or genitals, pruritus in icterus and diabetes, radiation sickness etc.
- Prevention and treatment of motion sickness.
- Prevention and treatment of nausea, vomiting and vertigo due to Meniere’s disease and other labyrinthine disturbances.
Therapeutic classView
Sedating Anti-histamine
PharmacologyView
Pheniramine competes with histamine for the histamine H1 receptor, acting as an inverse agonist once bound. The reduction in H1 receptor activity is responsible for reduced itching as well as reduced vasodilation and capillary leakage leading to less redness and edema. This can be seen in the suppression of the histamine-induced wheal (swelling) and flare (vasodilation) response. Inverse agonism of the H1 receptor in the CNS is also responsible for the sedation produced by first-generation antihistamines like pheniramine. The binding of pheniramine to H4 receptors, and subsequent inverse agonism, may also contribute to reduced itching by antagonizing inflammation.
DosageView
Doses must be individually determined in all cases and should be taken with or soon after food. Treatment should be commenced at the lowest possible dose because experience has shown that antihistamines are often effective at low doses. The maximum dose of 3 mg/kg per day should not be exceeded. Elderly patients should use the adult dose with caution.
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
- In adults and children over 10 years of age: Treatment is commenced with half a tablet taken up to three times daily. This dose may be increased to one tablet taken up to three times daily if required.
- Children 5-10 years of age: Half a tablet up to three times daily. Pheniramine Maleate tablets are not recommended in children under 5 years of age.
Side effectsView
The most common adverse reaction is sedation, which often disappears after a few days if tolerance is acquired. Hypersensitivity reactions have been reported.
- Central Nervous System: Lassitude, dizziness, tinnitus, inability to concentrate, incoordination, irritability, insomnia and tremors. Agitation and convulsions, especially in children and restlessness, disorientation and hallucinations in adults, are common symptoms following overdose.
- Gastrointestinal: Nausea, vomiting, diarrhoea, colic, epigastric pain, anorexia, dryness of mouth and constipation.
- Genitourinary: Urinary retention.
- Cardiovascular: Palpitations, headache.
- Ocular: Blurred vision, increased intraocular pressure.
- Musculoskeletal: Muscular weakness.
- Haematological: Rare cases of blood dyscrasias including agranulocytosis and haemolytic anaemia have been reported.
ContraindicationsView
- Patients with hypersensitivity to pheniramine or any other ingredient (eg. Methyl hydroxybenzoate or propyl hydroxybenzoate in the syrup).
- Patients with symptomatic prostatic hypertrophy.
- Patients receiving MAO-inhibitor therapy.
- Newborn and premature infants.
PrecautionsView
- Pheniramine Maleate may cause drowsiness. Both the dosage and the time of administration should be carefully considered in patients whose activities (e.g. driving a car or operating machinery) demand special concentration.
- Patients should be cautioned against the simultaneous ingestion of alcohol and other central nervous system depressants. Pheniramine Maleate may possibly be hallucinogenic in toxic doses. Due to the possible CNS stimulating effects of antihistamines, pheniramine has the potential for abuse.
- Due to the anticholinergic effect of pheniramine, caution and close monitoring are required if it is used in patients with conditions such as prostatic hypertrophy, narrow angle glaucoma, asthma or severe cardiovascular disease.
- The anti-emetic effect of pheniramine may mask the signs of other conditions. Products containing pheniramine should not be taken on an empty stomach.
InteractionsView
- MAO-inhibitors may prolong and intensify the anticholinergic effect of pheniramine (see Contraindications).
- Adverse CNS effects of pheniramine may be enhanced when it is taken with alcohol or other CNS depressants (eg. hypnotics, sedatives, tranquilizers).
- Atropine and related drugs may enhance the anticholinergic activity of pheniramine.
Pregnancy & lactationView
pregnancy Category A. Use only if strictly indicated. Use only if strictly indicated.
Overdose effectsView
Symptoms: Antihistamine drugs in toxic doses produce a complex of CNS excitatory and depressant effects. Accidental ingestion in small children has resulted in convulsions and sometimes death.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
StorageView
Store in a cool and dry place, protected from light. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.
Avil
Pheniramine Maleate
Avil
Pheniramine Maleate
Indications
Motion sickness
Indication detailsView
Pheniramine Maleate is indicated for-
- Allergic conditions including hay fever, drug rashes, angioneurotic edema, serum sickness, allergic conjunctivitis, food allergy etc.
- Conditions of the respiratory tract that are accompanied by increased secretion, including vasomotor rhinitis and acute rhinitis.
- All itching skin conditions, including neurodermatitis, eczema of any origin, lichen planus, acute and chronic urticaria, pruritis of the anus or genitals, pruritus in icterus and diabetes, radiation sickness etc.
- Prevention and treatment of motion sickness.
- Prevention and treatment of nausea, vomiting and vertigo due to Meniere’s disease and other labyrinthine disturbances.
Therapeutic classView
Sedating Anti-histamine
PharmacologyView
Pheniramine competes with histamine for the histamine H1 receptor, acting as an inverse agonist once bound. The reduction in H1 receptor activity is responsible for reduced itching as well as reduced vasodilation and capillary leakage leading to less redness and edema. This can be seen in the suppression of the histamine-induced wheal (swelling) and flare (vasodilation) response. Inverse agonism of the H1 receptor in the CNS is also responsible for the sedation produced by first-generation antihistamines like pheniramine. The binding of pheniramine to H4 receptors, and subsequent inverse agonism, may also contribute to reduced itching by antagonizing inflammation.
DosageView
Doses must be individually determined in all cases and should be taken with or soon after food. Treatment should be commenced at the lowest possible dose because experience has shown that antihistamines are often effective at low doses. The maximum dose of 3 mg/kg per day should not be exceeded. Elderly patients should use the adult dose with caution.
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
- In adults and children over 10 years of age: Treatment is commenced with half a tablet taken up to three times daily. This dose may be increased to one tablet taken up to three times daily if required.
- Children 5-10 years of age: Half a tablet up to three times daily. Pheniramine Maleate tablets are not recommended in children under 5 years of age.
Side effectsView
The most common adverse reaction is sedation, which often disappears after a few days if tolerance is acquired. Hypersensitivity reactions have been reported.
- Central Nervous System: Lassitude, dizziness, tinnitus, inability to concentrate, incoordination, irritability, insomnia and tremors. Agitation and convulsions, especially in children and restlessness, disorientation and hallucinations in adults, are common symptoms following overdose.
- Gastrointestinal: Nausea, vomiting, diarrhoea, colic, epigastric pain, anorexia, dryness of mouth and constipation.
- Genitourinary: Urinary retention.
- Cardiovascular: Palpitations, headache.
- Ocular: Blurred vision, increased intraocular pressure.
- Musculoskeletal: Muscular weakness.
- Haematological: Rare cases of blood dyscrasias including agranulocytosis and haemolytic anaemia have been reported.
ContraindicationsView
- Patients with hypersensitivity to pheniramine or any other ingredient (eg. Methyl hydroxybenzoate or propyl hydroxybenzoate in the syrup).
- Patients with symptomatic prostatic hypertrophy.
- Patients receiving MAO-inhibitor therapy.
- Newborn and premature infants.
PrecautionsView
- Pheniramine Maleate may cause drowsiness. Both the dosage and the time of administration should be carefully considered in patients whose activities (e.g. driving a car or operating machinery) demand special concentration.
- Patients should be cautioned against the simultaneous ingestion of alcohol and other central nervous system depressants. Pheniramine Maleate may possibly be hallucinogenic in toxic doses. Due to the possible CNS stimulating effects of antihistamines, pheniramine has the potential for abuse.
- Due to the anticholinergic effect of pheniramine, caution and close monitoring are required if it is used in patients with conditions such as prostatic hypertrophy, narrow angle glaucoma, asthma or severe cardiovascular disease.
- The anti-emetic effect of pheniramine may mask the signs of other conditions. Products containing pheniramine should not be taken on an empty stomach.
InteractionsView
- MAO-inhibitors may prolong and intensify the anticholinergic effect of pheniramine (see Contraindications).
- Adverse CNS effects of pheniramine may be enhanced when it is taken with alcohol or other CNS depressants (eg. hypnotics, sedatives, tranquilizers).
- Atropine and related drugs may enhance the anticholinergic activity of pheniramine.
Pregnancy & lactationView
pregnancy Category A. Use only if strictly indicated. Use only if strictly indicated.
Overdose effectsView
Symptoms: Antihistamine drugs in toxic doses produce a complex of CNS excitatory and depressant effects. Accidental ingestion in small children has resulted in convulsions and sometimes death.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
StorageView
Store in a cool and dry place, protected from light. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.
Avil
Pheniramine Maleate
Avil
Pheniramine Maleate
Indications
Motion sickness
Indication detailsView
Pheniramine Maleate is indicated for-
- Allergic conditions including hay fever, drug rashes, angioneurotic edema, serum sickness, allergic conjunctivitis, food allergy etc.
- Conditions of the respiratory tract that are accompanied by increased secretion, including vasomotor rhinitis and acute rhinitis.
- All itching skin conditions, including neurodermatitis, eczema of any origin, lichen planus, acute and chronic urticaria, pruritis of the anus or genitals, pruritus in icterus and diabetes, radiation sickness etc.
- Prevention and treatment of motion sickness.
- Prevention and treatment of nausea, vomiting and vertigo due to Meniere’s disease and other labyrinthine disturbances.
Therapeutic classView
Sedating Anti-histamine
PharmacologyView
Pheniramine competes with histamine for the histamine H1 receptor, acting as an inverse agonist once bound. The reduction in H1 receptor activity is responsible for reduced itching as well as reduced vasodilation and capillary leakage leading to less redness and edema. This can be seen in the suppression of the histamine-induced wheal (swelling) and flare (vasodilation) response. Inverse agonism of the H1 receptor in the CNS is also responsible for the sedation produced by first-generation antihistamines like pheniramine. The binding of pheniramine to H4 receptors, and subsequent inverse agonism, may also contribute to reduced itching by antagonizing inflammation.
DosageView
Doses must be individually determined in all cases and should be taken with or soon after food. Treatment should be commenced at the lowest possible dose because experience has shown that antihistamines are often effective at low doses. The maximum dose of 3 mg/kg per day should not be exceeded. Elderly patients should use the adult dose with caution.
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
- In adults and children over 10 years of age: Treatment is commenced with half a tablet taken up to three times daily. This dose may be increased to one tablet taken up to three times daily if required.
- Children 5-10 years of age: Half a tablet up to three times daily. Pheniramine Maleate tablets are not recommended in children under 5 years of age.
Side effectsView
The most common adverse reaction is sedation, which often disappears after a few days if tolerance is acquired. Hypersensitivity reactions have been reported.
- Central Nervous System: Lassitude, dizziness, tinnitus, inability to concentrate, incoordination, irritability, insomnia and tremors. Agitation and convulsions, especially in children and restlessness, disorientation and hallucinations in adults, are common symptoms following overdose.
- Gastrointestinal: Nausea, vomiting, diarrhoea, colic, epigastric pain, anorexia, dryness of mouth and constipation.
- Genitourinary: Urinary retention.
- Cardiovascular: Palpitations, headache.
- Ocular: Blurred vision, increased intraocular pressure.
- Musculoskeletal: Muscular weakness.
- Haematological: Rare cases of blood dyscrasias including agranulocytosis and haemolytic anaemia have been reported.
ContraindicationsView
- Patients with hypersensitivity to pheniramine or any other ingredient (eg. Methyl hydroxybenzoate or propyl hydroxybenzoate in the syrup).
- Patients with symptomatic prostatic hypertrophy.
- Patients receiving MAO-inhibitor therapy.
- Newborn and premature infants.
PrecautionsView
- Pheniramine Maleate may cause drowsiness. Both the dosage and the time of administration should be carefully considered in patients whose activities (e.g. driving a car or operating machinery) demand special concentration.
- Patients should be cautioned against the simultaneous ingestion of alcohol and other central nervous system depressants. Pheniramine Maleate may possibly be hallucinogenic in toxic doses. Due to the possible CNS stimulating effects of antihistamines, pheniramine has the potential for abuse.
- Due to the anticholinergic effect of pheniramine, caution and close monitoring are required if it is used in patients with conditions such as prostatic hypertrophy, narrow angle glaucoma, asthma or severe cardiovascular disease.
- The anti-emetic effect of pheniramine may mask the signs of other conditions. Products containing pheniramine should not be taken on an empty stomach.
InteractionsView
- MAO-inhibitors may prolong and intensify the anticholinergic effect of pheniramine (see Contraindications).
- Adverse CNS effects of pheniramine may be enhanced when it is taken with alcohol or other CNS depressants (eg. hypnotics, sedatives, tranquilizers).
- Atropine and related drugs may enhance the anticholinergic activity of pheniramine.
Pregnancy & lactationView
pregnancy Category A. Use only if strictly indicated. Use only if strictly indicated.
Overdose effectsView
Symptoms: Antihistamine drugs in toxic doses produce a complex of CNS excitatory and depressant effects. Accidental ingestion in small children has resulted in convulsions and sometimes death.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
StorageView
Store in a cool and dry place, protected from light. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.
Avil Retard
Pheniramine Maleate
Avil Retard
Pheniramine Maleate
Indications
Motion sickness
Indication detailsView
Pheniramine Maleate is indicated for-
- Allergic conditions including hay fever, drug rashes, angioneurotic edema, serum sickness, allergic conjunctivitis, food allergy etc.
- Conditions of the respiratory tract that are accompanied by increased secretion, including vasomotor rhinitis and acute rhinitis.
- All itching skin conditions, including neurodermatitis, eczema of any origin, lichen planus, acute and chronic urticaria, pruritis of the anus or genitals, pruritus in icterus and diabetes, radiation sickness etc.
- Prevention and treatment of motion sickness.
- Prevention and treatment of nausea, vomiting and vertigo due to Meniere’s disease and other labyrinthine disturbances.
Therapeutic classView
Sedating Anti-histamine
PharmacologyView
Pheniramine competes with histamine for the histamine H1 receptor, acting as an inverse agonist once bound. The reduction in H1 receptor activity is responsible for reduced itching as well as reduced vasodilation and capillary leakage leading to less redness and edema. This can be seen in the suppression of the histamine-induced wheal (swelling) and flare (vasodilation) response. Inverse agonism of the H1 receptor in the CNS is also responsible for the sedation produced by first-generation antihistamines like pheniramine. The binding of pheniramine to H4 receptors, and subsequent inverse agonism, may also contribute to reduced itching by antagonizing inflammation.
DosageView
Doses must be individually determined in all cases and should be taken with or soon after food. Treatment should be commenced at the lowest possible dose because experience has shown that antihistamines are often effective at low doses. The maximum dose of 3 mg/kg per day should not be exceeded. Elderly patients should use the adult dose with caution.
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
To prevent travel sickness, it is recommended that the first dose be taken at least 30 minutes before traveling. Due to the risk of drowsiness, the patient should not drive a motor vehicle or operate machinery after taking a dose.
Pheniramine Maleate tablets:
- In adults and children over 10 years of age: Treatment is commenced with half a tablet taken up to three times daily. This dose may be increased to one tablet taken up to three times daily if required.
- Children 5-10 years of age: Half a tablet up to three times daily. Pheniramine Maleate tablets are not recommended in children under 5 years of age.
Side effectsView
The most common adverse reaction is sedation, which often disappears after a few days if tolerance is acquired. Hypersensitivity reactions have been reported.
- Central Nervous System: Lassitude, dizziness, tinnitus, inability to concentrate, incoordination, irritability, insomnia and tremors. Agitation and convulsions, especially in children and restlessness, disorientation and hallucinations in adults, are common symptoms following overdose.
- Gastrointestinal: Nausea, vomiting, diarrhoea, colic, epigastric pain, anorexia, dryness of mouth and constipation.
- Genitourinary: Urinary retention.
- Cardiovascular: Palpitations, headache.
- Ocular: Blurred vision, increased intraocular pressure.
- Musculoskeletal: Muscular weakness.
- Haematological: Rare cases of blood dyscrasias including agranulocytosis and haemolytic anaemia have been reported.
ContraindicationsView
- Patients with hypersensitivity to pheniramine or any other ingredient (eg. Methyl hydroxybenzoate or propyl hydroxybenzoate in the syrup).
- Patients with symptomatic prostatic hypertrophy.
- Patients receiving MAO-inhibitor therapy.
- Newborn and premature infants.
PrecautionsView
- Pheniramine Maleate may cause drowsiness. Both the dosage and the time of administration should be carefully considered in patients whose activities (e.g. driving a car or operating machinery) demand special concentration.
- Patients should be cautioned against the simultaneous ingestion of alcohol and other central nervous system depressants. Pheniramine Maleate may possibly be hallucinogenic in toxic doses. Due to the possible CNS stimulating effects of antihistamines, pheniramine has the potential for abuse.
- Due to the anticholinergic effect of pheniramine, caution and close monitoring are required if it is used in patients with conditions such as prostatic hypertrophy, narrow angle glaucoma, asthma or severe cardiovascular disease.
- The anti-emetic effect of pheniramine may mask the signs of other conditions. Products containing pheniramine should not be taken on an empty stomach.
InteractionsView
- MAO-inhibitors may prolong and intensify the anticholinergic effect of pheniramine (see Contraindications).
- Adverse CNS effects of pheniramine may be enhanced when it is taken with alcohol or other CNS depressants (eg. hypnotics, sedatives, tranquilizers).
- Atropine and related drugs may enhance the anticholinergic activity of pheniramine.
Pregnancy & lactationView
pregnancy Category A. Use only if strictly indicated. Use only if strictly indicated.
Overdose effectsView
Symptoms: Antihistamine drugs in toxic doses produce a complex of CNS excitatory and depressant effects. Accidental ingestion in small children has resulted in convulsions and sometimes death.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
Management: As there is no specific antidote, treatment should be symptomatic and supportive. Induction of vomiting should only be used immediately after ingestion as the sedative action of any absorbed antihistamine can lead to life-threatening pulmonary aspiration during emesis. Gastric lavage with a cuffed endotracheal tube in situ may be useful for some time after ingestion of antihistamines as their anticholinergic action slows down gastric emptying. Stimulants should not be used as they may precipitate convulsions. Diazepam or short-acting barbiturates may be used to control convulsions. Vasopressors may be used to treat hypotension. Mechanical support of respiration may be required if respiration is seriously depressed. Continuous ECG monitoring is recommended if cardiac toxicity develops, which can be treated with centrally-acting anticholinesterases such as physostigmine.
StorageView
Store in a cool and dry place, protected from light. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician.
Avilam
Lamivudine [For HIV Infection]
Avilam
Lamivudine [For HIV Infection]
Indications
HIV infection
Indication detailsView
Lamivudine in combination with other antiretroviral agents is indicated for the treatment of HIV infection.
Therapeutic classView
Drugs for HIV / Anti-retroviral drugs
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
Adults and adolescents over 12 years of age: The recommended dose for HIV infection is 300 mg daily. This is administered as 150 mg twice daily.
Children:
Children:
- Three months to 12 years of age: The recommended dose for HIV infection is 4 mg/kg twice daily up to a maximum of 300 mg daily.
- Less than three months of age: The limited data available are insufficient to propose specific dosage recommendations.
AdministrationView
Lamivudine may be administered with or without food.
Side effectsView
The following adverse events have been reported during therapy for HIV disease with Lamivudine.
Blood and lymphatic systems disorders-
Blood and lymphatic systems disorders-
- Uncommon: Neutropenia, anaemia and thrombocytopenia
- Very rare: Pure red cell aplasia
- Common: Headache, insomnia
- Very rare: Cases of peripheral neuropathy (or paraesthesia).
- Common: Cough, nasal symptoms-
- Common: Nausea, vomiting, abdominal pain or cramps, diarrhea
- Rare: Rises in serum amylase. Cases of pancreatitis have been reported.
- Uncommon: Transient rises in liver enzymes (AST, ALT).
- Rare: Hepatitis
- Common: Rash, alopecia
- Common: Arthralgia, muscle disorders
- Rare: Rhabdomyolysis, Lipodystrophy
- Common: Fatigue, malaise, fever.
ContraindicationsView
Hypersensitivity to Lamivudine or to any of the excipients.
PrecautionsView
Lamivudin is not recommended for use as monotherapy. In pediatric patients with a history of prior antiretroviral nucleoside exposure, a history of pancreatitis, or other significant risk factors for the development of pancreatitis, Lamivudine should be used with caution. Treatment with Lamivudine should be stopped immediately if clinical signs, symptoms, or laboratory abnormalities suggestive of pancreatitis occur
Lactic Acidosis/Severe Hepatomegaly with Steatosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including Lamivudine and other antiretrovirals. A majority of these cases have been in women. Obesity and prolonged nucleoside exposure may be risk factors. Particular caution should be exercised when administering Lamivudine to any patient with known risk factors for liver disease.
In patients with moderate to severe renal impairment, the dose should be adjusted. Patients receiving Lamivudin or any other antiretroviral therapy may continue to develop opportunistic infections and other complications of HIV infection, and therefore should remain under close clinical observation by physicians experienced in the treatment of patients with associated HIV diseases.
Lactic Acidosis/Severe Hepatomegaly with Steatosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including Lamivudine and other antiretrovirals. A majority of these cases have been in women. Obesity and prolonged nucleoside exposure may be risk factors. Particular caution should be exercised when administering Lamivudine to any patient with known risk factors for liver disease.
In patients with moderate to severe renal impairment, the dose should be adjusted. Patients receiving Lamivudin or any other antiretroviral therapy may continue to develop opportunistic infections and other complications of HIV infection, and therefore should remain under close clinical observation by physicians experienced in the treatment of patients with associated HIV diseases.
InteractionsView
The possibility of interactions with other medicinal products administered concurrently should be considered, particularly when the main route of elimination is active renal secretion. Administration of trimethoprim/sulfamethoxazole 160 mg/800 mg results in a 40% increase in Lamivudine exposure. Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Therefore, use of Lamivudine in combination with zalcitabine is not recommended.
Pregnancy & lactationView
Pregnancy Category C. The safety of Lamivudine in human pregnancy has not been established.
Lactation: Following oral administration Lamivudine excreted in breast milk at similar concentrations to those found in serum. That’s why it is recommended that mothers taking Lamivudine do not breast-feed their infants.
Lactation: Following oral administration Lamivudine excreted in breast milk at similar concentrations to those found in serum. That’s why it is recommended that mothers taking Lamivudine do not breast-feed their infants.
Pediatric usageView
Renal impairment: Lamivudine concentrations are increased in patients with moderate to severe renal impairment due to decreased clearance. The dose should therefore be adjusted.
Adults and adolescents over 12 years:
Adults and adolescents over 12 years:
- CrCl 50 ml/min: first dose 150 mg & maintenance dose 150 mg twice daily
- CrCl 30 to <50 ml/min: first dose 150 mg & maintenance dose 150 mg once daily
- CrCl 15 to 29 ml/min: first dose 150 mg & maintenance dose 100 mg once daily
- CrCl 5 to 14 ml/min: first dose 150 mg & maintenance dose 50 mg once daily
- CrCl <5 ml/min: first dose 50 mg & maintenance dose 25 mg once daily
StorageView
Tablet: Store in a cool and dry place, protect from light and moisture.
Oral Solution: Store in a cool and dry place, protect from light.
Oral Solution: Store in a cool and dry place, protect from light.
Avintol
Vinpocetine
Avintol
Vinpocetine
Indications
Ischaemic events
Indication detailsView
Acute Cerebro-Vascular Accidents (Strokes): Ischaemic strokes due to cerebral thrombosis, cerebral embolism, acute circulatory disorder, hypertensive crisis; the acute cardiovascular disorders, ischaemic neurological defcit, complete stroke (CS), multiinfarct dementia, cerebral arteriosclerosis, hypertensive encephalopathy, post-apoplectic conditions with the background of haemorrhagic strokes etc.
Senile Disorder: For relief of psychosomatic symptoms in the elderly due to cerebral insufciency eg. forgetfulness, memory disturbances, slow thinking, lack of concentration, dizziness, mood instability, aphasia, sleep disturbances, vasovegetative symptoms of menopausal syndrome etc.
Visual Disorder: Vascular disorders of the choroid and retina due to arteriosclerosis. Vasospasm, macula degenerations, arterial or venous thrombosis or embolism and glaucoma secondary to the above mentioned disorders.
Hearing Disorder: For the treatment of impaired hearing of vascular or toxic (iatrogenic) origin presbyacusis, meniere's disease, cochleovestibular neuritis, tinnitus and dizziness of labirynth origin.
Senile Disorder: For relief of psychosomatic symptoms in the elderly due to cerebral insufciency eg. forgetfulness, memory disturbances, slow thinking, lack of concentration, dizziness, mood instability, aphasia, sleep disturbances, vasovegetative symptoms of menopausal syndrome etc.
Visual Disorder: Vascular disorders of the choroid and retina due to arteriosclerosis. Vasospasm, macula degenerations, arterial or venous thrombosis or embolism and glaucoma secondary to the above mentioned disorders.
Hearing Disorder: For the treatment of impaired hearing of vascular or toxic (iatrogenic) origin presbyacusis, meniere's disease, cochleovestibular neuritis, tinnitus and dizziness of labirynth origin.
Therapeutic classView
Cerebral vasodilator & Neurosensory oxygenator drugs
PharmacologyView
Vinpocetine increases cerebral metabolism; it increases glucose and O2 consumption; improves cerebral hypoxia tolerance; shifts glucose metabolism to the energetically more favourable aerobic pathway, but it increases the anaerobic pathway as well; it elevates the ATP concentration and the ATP/AMP ratio in the brain, and elevates the cerebral norepinephrine, dopamine and serotonin levels.
Vinpocetine considerably improves cerebral microcirculation by inhibiting platelet aggregation, reducing the pathologically increased blood viscosity, and increases erythrocyte deformability. It also promotes O2 transport into the tissues by reducing the O2 affinity of erythrocytes.
It selectively and intensely increases cerebral blood flow and the share of the brain in cardiac output, it reduces cerebral vascular resistance without affecting systemic circulation (blood pressure, heart rate, cardiac output, total peripheral resistance). It does not elicit steal phenomenon; on the contrary, it primarily improves the blood supply of the injured and ischaemic area while it remains unchanged in the intact areas (inverse steal effect). It further increases blood flow which is already increased as a result of hypoxia.
Vinpocetine considerably improves cerebral microcirculation by inhibiting platelet aggregation, reducing the pathologically increased blood viscosity, and increases erythrocyte deformability. It also promotes O2 transport into the tissues by reducing the O2 affinity of erythrocytes.
It selectively and intensely increases cerebral blood flow and the share of the brain in cardiac output, it reduces cerebral vascular resistance without affecting systemic circulation (blood pressure, heart rate, cardiac output, total peripheral resistance). It does not elicit steal phenomenon; on the contrary, it primarily improves the blood supply of the injured and ischaemic area while it remains unchanged in the intact areas (inverse steal effect). It further increases blood flow which is already increased as a result of hypoxia.
DosageView
Tablet: 1-2 tablets thrice daily, the maintenance dose is 1 tablet thrice daily.
IM Injection: Daily dose of 20-40 mg are to be given until improvement of symptoms is reached (for not longer than 10 days) then oral treatment should be applied. If this regimen fails, infusion treatment should be started.
IV Infusion: The daily starting dose is 20 mg in slow drip infusion (2 ampoules in 500-1000 ml infusion solution). This dose can be increased to 1 mg/kg body weight during 3 to 4 days. Treatment should be continued for 10-14 days depending on the tolerance of the patients and the dose should be gradually reduced before discontinuation of treatment.
IM Injection: Daily dose of 20-40 mg are to be given until improvement of symptoms is reached (for not longer than 10 days) then oral treatment should be applied. If this regimen fails, infusion treatment should be started.
IV Infusion: The daily starting dose is 20 mg in slow drip infusion (2 ampoules in 500-1000 ml infusion solution). This dose can be increased to 1 mg/kg body weight during 3 to 4 days. Treatment should be continued for 10-14 days depending on the tolerance of the patients and the dose should be gradually reduced before discontinuation of treatment.
Side effectsView
Transient hypotension, tachycardia may occur.
ContraindicationsView
Parenteral treatment- Severe ischaemic heart disease, severe rhythm disorders and pregnancy.
PrecautionsView
In the acute stage until the improvement of symptoms parenteral treatment is recommended followed by oral treatment. In chronic cases oral therapy should be applied.
InteractionsView
The injection is chemically incompatible with heparin, therefore, it should not be injected in the same syringe.
Pregnancy & lactationView
In Pregnancy and Lactation the drug is contraindicated.
StorageView
Store in a cool and dry place, protected from light and moisture.
Avison
Econazole Nitrate + Triamcinolone Acetonide
Avison
Econazole Nitrate + Triamcinolone Acetonide
Indications
Tinea corporis (ringworm)
Indication detailsView
Econazole Nitrate & Triamcinolone Acetonide indicated for the treatment of:
- Eczematous Mycoses
- Psoriasis
- Tinea Pedis (Athlete’s foot)
- Tinea Corporis (Ring worm)
- Tinea Cruris (Jock itch)
- Inflammatory Intertrigo
- Diaper Dermatitis
Therapeutic classView
Triamcinolone & Combined preparations
DosageView
Adults: This cream should be applied sparingly to the skin lesion no more than 2 times daily, preferably once in the morning and once in the evening. This cream should not be applied with an occlusive dressing, or to large areas of skin on the body. The duration of treatment with this cream should continue until the inflammatory symptoms subside but not longer than 2 weeks; after 2 weeks of therapy with this cream, continue therapy as needed with a preparation containing econazole or econazole nitrate alone.
Pediatric Use: Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight. Caution should be exercised.
Pediatric Use: Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight. Caution should be exercised.
Side effectsView
Rarely, transient local mild irritation, itching & redness may occur immediately after application. Econazole has the minimal allergenic effect and is well tolerated, even by delicate skin. Adrenal suppression on long term continuous topical steroid therapy may occur, particularly in infants or children, or when occlusive dressings are applied. It should be noted that an infant's napkin may act as an occlusive dressing.
ContraindicationsView
This Cream is contraindicated-
- In individuals who have shown hypersensitivity to any of its ingredients.
- Like any other dermatological preparation containing corticosteroids, this Cream is contraindicated in specific skin conditions such as tuberculous, varicella, herpes simplex or other viral infections of the skin, or fresh vaccination sites.
- Decubitus ulcers: Viral, bacterial or fungal skin infections (e.g. tuberculosis of the skin, syphilis of the skin, herpes simplex, herpes zoster, chickenpox).
- Rosacea and rosacea-like dermatitis.
PrecautionsView
- For external use only. This Cream is not for ophthalmic or oral use.
- If a reaction suggesting hypersensitivity or chemical irritation should occur, use of the medication should be discontinued.
- Corticosteroids applied to the skin can be absorbed in sufficient amounts to produce systemic effects, including adrenal suppression. Systemic absorption may be increased by various factors such as application over a large skin surface area, application to damaged skin, application under occlusive skin dressings and prolonged duration of therapy.
- Topical corticosteroids are associated with skin thinning and atrophy, striae, telangiectasis and purpura.
- Topical corticosteroids may lead to increased risk of dermatological superinfection or opportunistic infection.
Visual disturbance may be associated with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR).
InteractionsView
Econazole: compound metabolized by CYP3A4/2C9 oral anticoagulants (warfarin & acenocoumarol).
Triamcinolone: lowering of plasma salicylates levels. Increased risk of Gl bleeding and ulceration with NSAIDs. Antagonised blood glucose-lowering effects of the antidiabetics. Increased risk of Hyperkalemia with amphotericin B, beta-blockers, potassium-depleting diuretics, theophylline. Increased clearance of the triamcinolone with ciclosporin, carbamazepine, phenytoin, barbiturate, rifampicin.
Triamcinolone: lowering of plasma salicylates levels. Increased risk of Gl bleeding and ulceration with NSAIDs. Antagonised blood glucose-lowering effects of the antidiabetics. Increased risk of Hyperkalemia with amphotericin B, beta-blockers, potassium-depleting diuretics, theophylline. Increased clearance of the triamcinolone with ciclosporin, carbamazepine, phenytoin, barbiturate, rifampicin.
Pregnancy & lactationView
Pregnancy: Not the Econazole but the Triamcinolone Acetonide crosses the placenta and topical administration of corticosteroids during pregnancy can cause abnormalities of foetal development. The relevance of this finding to human beings has not been established. However, topical steroids in large amounts or for prolonged periods
should not be used in pregnancy.
Lactation: Negligible amount of econazole and to some extent Triamcinolone may be excreted in small amounts in breast milk. So this cream should not be prescribed to the lactating mother or if prescribed lactation should be withheld during treatment.
should not be used in pregnancy.
Lactation: Negligible amount of econazole and to some extent Triamcinolone may be excreted in small amounts in breast milk. So this cream should not be prescribed to the lactating mother or if prescribed lactation should be withheld during treatment.
Overdose effectsView
This Cream is for cutaneous application only. Corticosteroids applied to the skin, including triamcinolone, can be absorbed in sufficient amounts to produce systemic effects. In the event of accidental ingestion, treat symptomatically. If this cream is accidentally applied to the eyes, wash with clean water or saline and seek medical attention if symptoms persist.
StorageView
Store in a cool (below 30°C) and dry place, away from light. Keep out of the reach of children.
Avista
Super antioxidant [vitamins & minerals]
Avista
Super antioxidant [vitamins & minerals]
Indication detailsView
This is indicated in the following cases:
- To develop immune system.
- To prevent the well known deficiency diseases such as scurvey, beriberi, pellagra and others.
- Prevent certain types of cancer by blocking the formation of cancer causing substances in the body.
- It is also capable of combating cardiovascular and immunological disorders.
- To prevent aging.
PharmacologyView
Vitamin A is essential for human health. Vitamin A is highly important for vision, cell development and immunity. Vitamin A's role on immunity contributes to its anti-cancer properties.
Vitamin C is one of the most widely taken supplements and plays a primary role in the formation of collagen, which is important for the growth and repair of cells, gums, blood vessels, bones and teeth. Thus vitamin C helps in faster recovery after surgery or any other trauma. Vitamin C quenches free radicals in the water based cellular components and thus acts as an antioxidant.
Vitamin E is a fat-soluble vitamin, which is stored in the liver, adipose tissues, heart, muscles etc. It is an active antioxidant, which prevents oxidation of fat compounds. It works in synergy with Selenium.
Vitamin K is a key anti-aging vitamin and it prevents heart disease and osteoporosis.
Zinc is an important mineral that can actually rejuvenate the shrinking thymus gland that involves the working of the immune system. Zinc is a co-factor in over 100 enzymes of the body.
Selenium: Apart from being a co-factor in antioxidant enzymes, Selenium by itself has potent antioxidant capabilities. So, it prevents aging and hardening of tissues through oxidation. Vitamin E and Selenium are synergistic and seem to potentiate each other's antioxidant activities.
Copper is an important co-factor of a number of enzymes present in our body. This enzymes act as endogenous antioxidant systems.
Manganese, an antioxidant, is one of the minerals required to form SOD (Super Oxide Dismutase). SOD is an enzyme that protect against cell damaging free radicals.
Vitamin C is one of the most widely taken supplements and plays a primary role in the formation of collagen, which is important for the growth and repair of cells, gums, blood vessels, bones and teeth. Thus vitamin C helps in faster recovery after surgery or any other trauma. Vitamin C quenches free radicals in the water based cellular components and thus acts as an antioxidant.
Vitamin E is a fat-soluble vitamin, which is stored in the liver, adipose tissues, heart, muscles etc. It is an active antioxidant, which prevents oxidation of fat compounds. It works in synergy with Selenium.
Vitamin K is a key anti-aging vitamin and it prevents heart disease and osteoporosis.
Zinc is an important mineral that can actually rejuvenate the shrinking thymus gland that involves the working of the immune system. Zinc is a co-factor in over 100 enzymes of the body.
Selenium: Apart from being a co-factor in antioxidant enzymes, Selenium by itself has potent antioxidant capabilities. So, it prevents aging and hardening of tissues through oxidation. Vitamin E and Selenium are synergistic and seem to potentiate each other's antioxidant activities.
Copper is an important co-factor of a number of enzymes present in our body. This enzymes act as endogenous antioxidant systems.
Manganese, an antioxidant, is one of the minerals required to form SOD (Super Oxide Dismutase). SOD is an enzyme that protect against cell damaging free radicals.
DosageView
The adult dose is 1 (one) tablet daily, or as prescribed by the physician.
Side effectsView
Generally, this preparation is well-tolerated. Diarrhea may occasionally occur during treatment with beta carotene and the skin may assume a slightly yellow discoloration. The side-effects of vitamin A are reversible. Vitamin C and vitamin E may cause diarrhea and other gastrointestinal disturbances.
ContraindicationsView
This product is contraindicated in patients with a known hypersensitivity to any of the ingredients.
Pregnancy & lactationView
This preparation is recommended in pregnancy and lactation
Overdose effectsView
In case of accidental overdose, call a doctor or poison control center immediately.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Avlocid
Aluminium Hydroxide + Magnesium Hydroxide
Avlocid
Aluminium Hydroxide + Magnesium Hydroxide
Indications
Upper Gl bloating
Indication detailsView
Aluminium Hydroxide and Magnesium Hydroxide is indicated for Hyperacidity, peptic ulcer, gastritis, heartburn, sour stomach & dyspepsia.
Therapeutic classView
Antacids
PharmacologyView
This drug is well-balanced combination of essential non-systemic antacids which excel in efficacy and palatability. These are dependable antacid preparations without acid rebound, constipating or cathertic effects. Both the preparations provide symptomatic relief of hyperacidity associated with heartburn, acid ingestion or sour stomach.
Aluminium hydroxide gel, a slow acting antacid and an adsorbent with prolonged effect, has high neutralizing power. Magnesium Hydroxide possesses a slow but sustained acid neutralizing property. Antacids of both tablet and suspension possess adsorbent property. They form a protecting coating over the ulcer surface facilitating its healing; thus protecting the sensitive mucosa of stomach and duodenum from further irritation.
Aluminium hydroxide gel, a slow acting antacid and an adsorbent with prolonged effect, has high neutralizing power. Magnesium Hydroxide possesses a slow but sustained acid neutralizing property. Antacids of both tablet and suspension possess adsorbent property. They form a protecting coating over the ulcer surface facilitating its healing; thus protecting the sensitive mucosa of stomach and duodenum from further irritation.
DosageView
Tablet: Two tablets 1-3 hours after meal and at bed time or as directed by the physician.
Suspension: 2 tea spoonful 1-3 hours after meal and at bed time or as directed by the physician.
Suspension: 2 tea spoonful 1-3 hours after meal and at bed time or as directed by the physician.
Side effectsView
Long term use of any antacid results in alkaluria, which may predispose to nephrolithiasis by forming precipitation of calcium phosphate.
ContraindicationsView
This is contraindicated in hypophosphataemia. It is also contraindicated in alkalosis and hypermagnesaemia where abdominal distention may be due to partial or complete intestinal obstruction.
PrecautionsView
Antacids reduce the absorption of tetracycline when given concomitantly. These should not be used concomitantly
InteractionsView
This drug inhibits the absorption of following drugs: Azithromycin, cefpodoxime, ciprofloxacin, isoniazid, rifampicin, norfloxacin, ofloxacin, pivampicillin, tetracyclines, Gabapentin and phenytoin, Itraconazole, ketoconazole, Chloroquine, hydroxychloroquine and Phenothiazines.
Pregnancy & lactationView
It is advised to avoid antacid preparations in the first trimester of pregnancy.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Avlocid
Aluminium Hydroxide + Magnesium Hydroxide
Avlocid
Aluminium Hydroxide + Magnesium Hydroxide
Indications
Upper Gl bloating
Indication detailsView
Aluminium Hydroxide and Magnesium Hydroxide is indicated for Hyperacidity, peptic ulcer, gastritis, heartburn, sour stomach & dyspepsia.
Therapeutic classView
Antacids
PharmacologyView
This drug is well-balanced combination of essential non-systemic antacids which excel in efficacy and palatability. These are dependable antacid preparations without acid rebound, constipating or cathertic effects. Both the preparations provide symptomatic relief of hyperacidity associated with heartburn, acid ingestion or sour stomach.
Aluminium hydroxide gel, a slow acting antacid and an adsorbent with prolonged effect, has high neutralizing power. Magnesium Hydroxide possesses a slow but sustained acid neutralizing property. Antacids of both tablet and suspension possess adsorbent property. They form a protecting coating over the ulcer surface facilitating its healing; thus protecting the sensitive mucosa of stomach and duodenum from further irritation.
Aluminium hydroxide gel, a slow acting antacid and an adsorbent with prolonged effect, has high neutralizing power. Magnesium Hydroxide possesses a slow but sustained acid neutralizing property. Antacids of both tablet and suspension possess adsorbent property. They form a protecting coating over the ulcer surface facilitating its healing; thus protecting the sensitive mucosa of stomach and duodenum from further irritation.
DosageView
Tablet: Two tablets 1-3 hours after meal and at bed time or as directed by the physician.
Suspension: 2 tea spoonful 1-3 hours after meal and at bed time or as directed by the physician.
Suspension: 2 tea spoonful 1-3 hours after meal and at bed time or as directed by the physician.
Side effectsView
Long term use of any antacid results in alkaluria, which may predispose to nephrolithiasis by forming precipitation of calcium phosphate.
ContraindicationsView
This is contraindicated in hypophosphataemia. It is also contraindicated in alkalosis and hypermagnesaemia where abdominal distention may be due to partial or complete intestinal obstruction.
PrecautionsView
Antacids reduce the absorption of tetracycline when given concomitantly. These should not be used concomitantly
InteractionsView
This drug inhibits the absorption of following drugs: Azithromycin, cefpodoxime, ciprofloxacin, isoniazid, rifampicin, norfloxacin, ofloxacin, pivampicillin, tetracyclines, Gabapentin and phenytoin, Itraconazole, ketoconazole, Chloroquine, hydroxychloroquine and Phenothiazines.
Pregnancy & lactationView
It is advised to avoid antacid preparations in the first trimester of pregnancy.
StorageView
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.