Professional Documents
Culture Documents
Clonidine (Catapres)
Omeprazole
Nimodipine
Bisacodyl (Dulcolax)
Levitiracetam (Keppra)
Furosemide
Diazepam (Valium)
Acetylcysteine (Fluimucil)
Nicardipine
Citicoline
Verapamil
Heparin
Lactulose
Rosuvastatin
Warfarin (Coumadin)
Atorvastatin
Ivabradine (Coralan)
Amlodipine
Piperacillin-Tazobactam
Tramadol
Fondaparinux
Cefuroxime
Neuropeptide (Cerebrolysin)
Enoxaparin
Dexamathasone
Mannitol
Pantoprazole
Paracetamol (Biogesic)
DRUGS
LEVETIRACETAM
(Keppra)
MOA
Anticonvulsant used in the
treatment of partial seizures.
The precise mechanism of
anticonvulsant effect is
unknown.
INDICATION
Monotherapy in the
treatment of partial
onset seizures w/ or
w/o secondary
generalization in
patients 16 yr w/
newly diagnosed
epilepsy. Adjunctive
therapy in the
treatment of partial
onset seizures w/ or
w/o secondary
generalization in
adults & childn 4 yr
w/ epilepsy;
myoclonic seizures in
adults & adolescents
12 yr w/ juvenile
myoclonic epilepsy &
primary generalized
tonic-clonic seizures
in adults & childn 4
yr w/ idiopathic
generalized epilepsy.
DIAZEPAM
(Valium)
Diazepam is a long-acting
benzodiazepine with
anticonvulsant, anxiolytic,
sedative, muscle relaxant
and amnestic properties. It
increases neuronal
membrane permeability to
Tab: Symptomatic
relief of anxiety,
agitation & tension
due to psychoneurotic
states & transient
situational
disturbances.
DOSAGE
Monotherapy Adult &
adolescent 16 yr Initially
250 mg bid, increased to
500 mg bid after 2 wk. May
be further increased by 250
mg bid 2 wkly. Max: 1,500
mg bid. Add-on
therapy Adult (18 yr) &
adolescent 12-17 yr 50
kg Initially 500 mg bid, may
be increased up to 1,500
mg bid. Dose may be
titrated by
increment/decrement of
500 mg bid 2-4 wkly. Childn
& adolescent 50 kg Adult
dose, 4-17 yr <50
kg Initially 10 mg/kg bid,
may be increased up to 30
mg/kg bid. Dose
increment/decrement
should not be >10 mg/kg
bid 2 wkly. Childn 25
kg Start the treatment w/
100 mg/mL oral soln.
Tab Adult 5-20 mg
daily. Elderly the usual
adult dose. Childn 0.1-0.3
mg/kg body wt
daily. InjIndividualized
dosage.
CONTRAINDICATION
Hypersensitivity to
levetiracetam or
other pyrrolidone
derivatives.
ADVERSE EFFECTS
Nasopharyngitis,
somnolence, headache,
fatigue & dizziness.
Anorexia; depression,
hostility/aggression,
anxiety, insomnia,
nervousness/irritability;
convulsion, balance
disorder, tremor,
lethargy; vertigo; cough;
abdominal pain,
diarrhea, dyspepsia,
vomiting, nausea; rash;
asthenia.
Dependence on
other substances
including alcohol
except in
management of
acute w/drawal
reactions. Severe
CITICOLINE Na
Adjunctively in major
mental & organic
disorders. Adjunct for
the relief of reflex
muscle spasm due to
local trauma. To
combat spasticity
arising from damage
to spinal &
supraspinal
interneurons. Inj:
Basal sedation before
stressful therapeutic
measures or
interventions. For preop medication of
anxious or tense
patients. In
psychiatry, treatment
of excitation states
associated w/ acute
anxiety & panic.
Motor unrest &
delirium tremens.
Status epilepticus &
other convulsive
states. Adjunct for
relief of reflex muscle
spasm due to local
trauma. To combat
spasticity arising from
damage to spinal &
supraspinal
interneurons.
Acute and recovery
chronic
hypercapnia.
Patients with
Gastrointestinal
LACTULOSE
phase of cerebral
infarction (eg,
ischemia due to
stroke). Cognitive
dysfunction due to
degenerative (ie,
Alzheimer's disease)
and cerebrovascular
disease. Cerebral
insufficiency (eg,
dizziness, memory
loss, poor
concentration,
disorientation) due to
head trauma or brain
injury.
Lactulose promotes
peristalsis by producing an
osmotic effect in the colon
with resultant distention. In
hepatic encephalopathy, it
reduces absorption of
ammonium ions and toxic
nitrogenous compounds,
resulting in reduced blood
ammonia concentrations.
Relief of constipation
including chronic
constipation. Portal
systemic
encephalopathy:
Hepatic coma or
precoma stages
where
hyperammonemia is
present.
hypertonia of the
parasympathetic
nervous system.
ATORVASTATIN Ca
(Avamax)
Atorvastatin competitively
inhibits HMG-CoA reductase,
the enzyme that catalyses
the conversion of HMG-CoA
to mevalonic acid. This
results in the induction of the
LDL receptors, leading to
lowered LDL-cholesterol
concentration.
Reduces LDLcholesterol,
apolipoprotein B &
triglycerides;
increases HDLcholesterol in the
treatment of
hyperlipidemias.
Adjunct therapy in
patients w/
homozygous familial
hypercholesterolemia
who have some LDLreceptor function.
Primary prophylaxis of
CV events in patients
w/ multiple risk
factors.
PIPERACILLINTAZOBACTAM
Piperacillin has an
antimicrobial activity against
a wide range of gm-ve
organisms including K.
pneumoniae, P.
aeruginosa,Enterobacteriacea
e and against gm+ve
Treatment of
documented
multidrug resistant
gm -ve infections due
to organisms proven
or suspected to be
susceptible to
Hypersensitivity to
-lactams including
penicillins &
cephalosporins or lactamase
inhibitors.
organisms eg E.
faecalis and B. fragilis.
Tazobactam is a penicillanic
acid sulfone derivative with
beta-lactamase inhibitory
properties. In combination,
tazobactam enhances the
activity of piperacillin against
beta-lactamase-producing
bacteria.
CEFUROXIME
DEXAMETHASONE
Dexamethasone is a
synthetic glucocorticoid
which decreases
inflammation by inhibiting
the migration of leukocytes
and reversal of increased
capillary permeability. It
piperacillintazobactam except
CNS infections;
polymicrobial
infections eg mixed
aerobic & anaerobic
infections except CNS
infections in which
other agents have
insufficient activity or
are contraindicated
due to toxic potential.
Treatment of
susceptible infections
which include bone &
joint infections,
bronchitis & other
lower resp tract
infections, gonorrhea,
meningitis, otitis
media, peritonitis,
pharyngitis, sinusitis,
skin infections
(including soft tissue
infections) & UTI. Inj:
Prophylaxis for
surgical infection.
Inflammatory &
allergic conditions
responsive to
corticosteroid therapy
eg skin diseases,
collagen diseases,
blood dyscrasia,
Hypersensitivity to
cephalosporins.
Tablet/Forte
Tablet: Hypersensiti
vity to prednisolone
or to any of the
excipients of
Decilone/Decilone
Forte.
Excessive mental
stimulation, increase
appetite, muscle
twitching, wt gain,
tachycardia, insomnia &
psychic disturbances.
PANTOPRAZOLE
(Prazole IV)
CLONIDINE HCl
(Catapres)
certain neoplastic
disease &
adrenocortical
insufficiency.
Pantoprazole is a substituted
benzimidazole, and also
known as PPI due to its
property to block the final
step of acid secretion by
inhibiting H+/K+ ATPase
enzyme system in gastric
parietal cell. Both basal and
stimulated acid are inhibited.
Clonidine stimulates alpha-2
receptors in brain stem which
results in reduced
sympathetic outflow from the
CNS and a decrease in
peripheral resistance leading
to reduced BP and pulse rate.
It does not alter normal
haemodynamic response to
exercise at recommended
dosages.
Treatment of GERD,
duodenal & gastric
ulcer.
Systemic fungal
infections;
gastrointestinal
ulcer; acute or
chronic infections;
osteoporosis,
diabetes mellitus;
renal insufficiency;
hypertension;
history of psychotic
illness; immediately
before prophylactic
immunization.
Occasionally headache
or diarrhea. Isolated
cases of edema, blurred
vision, fever, dizziness,
thrombophlebitis,
depression or myalgia
subsiding after
termination of therapy.
Sick sinus
syndrome.
Dizziness, headache,
paresthesia, sedation,
gynecomastia, confusion
state, delusional
perception, depression,
hallucination, decreased
libido, nightmare, sleep
disorder,
accommodation
disorder, decreased
lacrimation, AV block,
bradyarrhythmia, sinus
bradycardia, orthostatic
NIMODIPINE
Prevention &
treatment of ischemic
neurological deficits
following aneurysmal
subarachnoid
hemorrhage.
FUROSEMIDE
Furosemide inhibits
reabsorption of Na and
chloride mainly in the
medullary portion of the
ascending Loop of Henle.
Excretion of potassium and
ammonia is also increased
while uric acid excretion is
reduced. It increases plasma-
Treatment of edema
associated w/ heart
failure including
pulmonary edema &
w/ renal & hepatic
disorders.
Renal failure
associated w/
hepatic coma &
caused by
nephrotoxic or
hepatotoxic drugs.
Precomatose states
associated w/ liver
cirrhosis.
hypotension. Raynaud's
phenomenon, nasal
dryness, alopecia,
pruritus, rash, urticaria,
erectile dysfunction,
fatigue, malaise, colonic
pseudo-obstruction,
constipation, dry mouth,
nausea, salivary gland
pain, vomiting.
Dizziness, flushing,
headache, hypotension,
peripheral edema,
tachycardia,
palpitations; nausea,
other GI disturbances,
increased micturition
frequency, lethargy, eye
pain, visual
disturbances; mental
depression; rashes,
fever, liver function
abnormalities including
cholestasis; gingival
hyperplasia, myalgia,
tremor, impotence.
Fluid & electrolyte
imbalance including
hyponatremia,
hypokalemia &
hypochloremic alkalosis;
increased urinary
excretion of Ca;
nephrocalcinosis in
preterm infants.
ACETYLCYSTEINE
(Fluimucil)
VERAPAMIL
Control of
supraventricular
arrhythmias &
management of
angina pectoris &
HTN.
Effervescent tab/Oral
soln Adult 600 mg daily
(preferably in the evening)
or 200 mg bidtid. Childn100 mg bid-qid
according to age. Dissolve
the tab or content of sachet
in a glass of water (75
mL).Inhalant Nebulize 1
amp once-bid for 5-10
days. IM inj 1 amp oncebid. Small childn adult
dose.IV Adult 1 amp bid up
to 2-3 amp bid-tid. Childn 11 amp bid-tid. It is
recommended to dilute IV
inj w/ 0.9% NaCl soln or a
5% glucose soln.
Adult & adolescent >50 kg
body wt CHD, paroxysmal,
supraventricular
tachycardia, atrial
fibrillation/flutter -1 tab
bid. HTN 1 tab in the
morning, may add -1 tab
in the evening if not
sufficient. Max: 480 mg
daily (long-term therapy).
Effervescent
tab/Oral soln:
Phenylketonurics.
Rarely, urticaria,
bronchospasm, nausea,
vomiting. Inhalant:
Rhinitis, stomatitis.
CV shock, acute MI
w/ complications eg
bradycardia,
hypotension, leftsided heart failure,
pronounced
conduction
disturbances eg
2nd- & 3rd-degree
SA or AV block, sick
Nausea, bloating,
constipation. Fatigue,
nervousness; vertigo or
somnolence,
paresthesia, neuropathy,
tremor; development or
exacerbation of cardiac
insufficiency, excessive
fall in BP &/or orthostatic
dysregulation, sinus
ROSUVASTATIN
Rosuvastatin is a selective
and competitive inhibitor of
HMG-CoA reductase, the ratelimiting enzyme in
cholesterol synthesis. It
increases the number of
hepatic LDL receptors on the
cell surface, enhancing
uptake and catabolism of
LDL. It also decreases
apolipoprotein B,
triglycerides and increases
Prevention of CV
events eg CV death,
stroke, MI, unstable
angina or arterial
revascularization;
primary
hypercholesterolemia
(heterozygous familial
& nonfamilial); mixed
dyslipidemia
(Fredrickson types IIa
& IIb); homozygous
sinus syndrome,
manifest cardiac
insufficiency, atrial
fibrillation/flutter &
simultaneous
existing WolffParkinson-White
syndrome. Angina
pectoris <7 days
after acute MI.
Concurrent use w/
IV -blockers.
Galactose &
fructose
intolerance, lactase
& saccharaseisomaltase
deficiency or
glucose-galactose
malabsorption.
Pregnancy (1st &
2nd trimester) &
lactation.
Active liver disease.
Women of
childbearing
potential not using
appropriate
contraceptive
measures.
Pregnancy &
lactation.
bradycardia, 1st-degree
AV block, swollen ankle,
flushing, skin reddening
& warm sensation;
allergic reactions eg
erythema, pruritus,
urticaria, maculopapular
exanthema,
erythromelalgia;
headache.
Headache, myalgia,
asthenia, constipation,
dizziness, nausea,
abdominal pain.
IVABRADINE
(Coralan)
HDL.
familial
hypercholesterolemia
as an adjunct to diet
& other lipid-lowering
treatments or as
monotherapy;
heterozygous familial
hypercholesterolemia.
Treatment of primary
dysbetalipoproteinemi
a (Fredrickson type III
hyperlipoproteinemia
& isolated
hypertriglyceridemia
(Fredrickson type IV
hyperlipidemia). Slow
or delay progression
of atherosclerosis.
Treatment of CAD:
Symptomatic
treatment of chronic
stable angina pectoris
in CAD patients w/
normal sinus rhythm.
Patients unable to
tolerate or w/ a CI to
the use of -blockers;
or in combination w/
-blockers in patients
Luminous visual
phenomena
(phosphenes), blurred
vision, bradycardia
(particularly w/in 1st 2-3
mth of initiation), 1stdegree AV block,
ventricular
extrasystoles,
uncontrolled BP,
headache, dizziness.
TRAMADOL
NEUROPEPTIDE
(Cerebrolysin)
inadequately
controlled w/ an
optimal -blocker
dose & whose heart
rate is >60 beats/min.
Treatment of chronic
heart failure:
Reduction of CV
events (CV mortality
or hospitalization for
worsening heart
failure) in adults in
sinus rhythm w/
symptomatic chronic
heart failure & whose
heart rate is 70
beats/min.
Moderate to severe
pain & post-op pain.
Neurotrophic agent
for the treatment of
acute ischemic stroke,
dementia & traumatic
brain injury.
become worse,
severe hepatic
insufficiency,
pacemakerdependent patient.
Concomitant potent
CYP3A4 inhibitors.
Pregnancy &
lactation. Childn
<18 yr.
Acute alcohol
intoxication.
Hypnotics, centrallyacting analgesics,
opioids or
psychotropic drugs.
Treatment w/ MAOIs
or w/in 2 wk from
w/drawal. Childn
<12 yr.
Epilepsy & severe
renal impairment.
Nausea, vomiting,
diarrhea, constipation.
Tiredness, drowsiness,
dizziness, headache,
confusion,
hallucinations. Skin
rashes, tachycardia,
orthostatic hypotension,
bradycardia, flushing,
allergic reactions.
Aserythema, pruritus &
burning.
MANNITOL
cognitive deficits 10
mL. Severe dementia w/
predominant behavioral
deficits Duration of infusion:
30-50 mL/day up to 20
days, diluted in 50-100 mL
sterile normal saline soln,
30 min to 1 hr infusion
time.
Pulmonary
congestion or
pulmonary edema,
intracranial
bleeding, heart
failure, renal failure.
PARACETAMOL
Paracetamol exhibits
analgesic action by
peripheral blockage of pain
impulse generation. It
produces antipyresis by
inhibiting the hypothalamic
heat-regulating centre. Its
weak anti-inflammatory
activity is related to inhibition
of prostaglandin synthesis in
the CNS.
OMEPRAZOLE
Omeprazole is a substituted
benzimidazole gastric
antisecretory agent and is
also known as PPI. It blocks
the final step in gastric acid
secretion by specific
inhibition of H+/K+ ATPase
enzyme system present on
the secretory surface of the
gastric parietal cell. Both
basal and stimulated acid are
inhibited.
excrete toxic
substances by forced
diuresis.
Relief of fever, minor
aches & pains.
Conditions where
inhibition of gastric
acid secretion may be
beneficial including
aspiration syndromes,
dyspepsia, GERD,
PUD, Zollinger-Ellison
syndrome.
BISACODYL
(Dulcolax)
INSULIN GLARGINE
(Lantus)
NICARDIPINE
Nicardipine is a
dihydropyridine calciumchannel blocker. It inhibits
calcium ion from entering the
slow channels or select
voltage-sensitive areas of
vascular smooth muscle and
myocardium during
depolarisation, producing a
relaxation of coronary
vascular smooth muscle and
daily.Zollinger-Ellison
syndrome 60 mg once daily.
Constipation Adult 1-2 tab,
4-10 tab, relief in 6-12
hr. Adult/Ped supp Relief in
15-30 min. For complete
bowel clearance Adult &
childn >10 yr 2-4 tab the
night before & 1 adult supp
on the day of the
procedure; <10 yr 1 tab the
night before & 1 ped supp
on the day of the
procedure.
Administer SC once daily at
the same time every day.
Dose & timing of dose
should be individually
adjusted.
Prophylaxis of angina.
2 mg/2 mL inj:
Management of mild
to moderate HTN. 10
mg/10 mL inj:
Management of
moderate to severe
HTN where immediate
correction of BP is
required; pre- & postop HTN.
Ileus, intestinal
obstruction, acute
surgical abdominal
conditions; severe
dehydration.
Appendicitis &
acute inflammatory
bowel diseases.
Rarely, abdominal
discomfort & diarrhea.
Hypersensitivity to
insulin glargine or to
any of the
excipients of
Lantus.
Hypoglycemia,
temporary visual
impairment,
lipohypertrophy, inj site
& allergic reactions
including redness, pain,
itch, hives, swelling or
inflammation. Rarely,
sodium retention &
edema.
Peripheral edema,
headache, tachycardia,
palpitations, localized
thrombophlebitis &
hypotension.
HEPARIN
WARFARIN
(Coumadin)
coronary vasodilatation. It
also increases myocardial
oxygen delivery in patients
with vasospastic angina.
Heparin increases the
inhibitory action of
antithrombin III (AT III) on
clotting factors XIIa, XIa, IXa,
Xa and thrombin. This inhibits
the conversion of
prothrombin to thrombin and
fibrinogen to fibrin. It also
inhibits platelet function. It
may reduce the activity of
ATIII at very high doses.
Treatment &
prophylaxis of
thromboembolic
disorders.
Prophylaxis &
treatment of venous
thrombosis, atrial
fibrillation w/
embolization,
Hypersensitivity.
Severe
thrombocytopenia
Hemorrhage, local
irritation, erythema, mild
pain, hematoma or
ulceration. Generalized
hypersensitivity, chills,
fever, urticaria, asthma,
rhinitis, lacrimation &
anaphylactoid reactions.
Osteoporosis,
aldosterone synthesis
suppression, delayed
transient alopecia, &
priapism & rebound
hyperlipidemia on
discontinuation.
Hypersensitivity.
Hemorrhagic
tendency or blood
dyscrasias. Recent
or contemplated
Fatal or non-fatal
hemorrhage, bleeding,
necrosis of skin & other
tissues.
AMLODIPINE
(Norvasc)
effects on established
thrombus but further
extension of the clot can be
prevented. Secondary
embolic phenomena are
avoided.
pulmonary embolism,
adjunct in prophylaxis
of systemic embolism
after MI & in
treatment of coronary
occlusion.
HTN, angina,
myocardial ischemia.
Reduce the risk of
coronary
Headache, edema,
fatigue, somnolence,
nausea, abdominal pain,
flushing, palpitations,
AMLODIPINE +
ATORVASTATIN
(Norgesic Protect)
revascularization,
fatal CHD, non-fatal
MI & stroke.
Treatment of patients
at increased CV risk
due to concomitant
HTN & dyslipidemia;
symptomatic CHD
expressed as angina
w/ dyslipidemia.
Prevention of CV
complications in
hypertensive patients.
Per 5 mg/10 mg
tab Amlodipine besilate 5
mg, atorvastatin Ca 10
mg. Per 10 mg/10 mg
tabAmlodipine besilate 10
mg, atorvastatin Ca 10 mg
Individualized starting &
maintenance doses. Dose
range: 5 mg/10 mg to max
of 10 mg/10 mg once daily.
dizziness. Asthenia,
vasodilatation &
epistaxis..
Hypersensitivity to
amlodipine besilate,
atorvastatin Ca &
dihydropyridines.
Active liver disease
or unexplained
persistent
elevations of serum
transaminases
exceeding 3 times
the upper limit of
normal. Women of
childbearing
potential. Pregnancy
& lactation.
Amlodipine: Headache,
dizziness, somnolence,
palpitations, flushing,
abdominal pain, nausea,
edema & fatigue.
Atorvastatin:
Nasopharyngitis,
hyperglycemia,
pharyngeal pain,
epistaxis, diarrhea,
dyspepsia, nausea,
flatulence, abnormal
liver function tests,
increased blood
creatinine
phosphokinase,
arthralgia & myalgia.
FONDAPARINUX
in cholesterol biosynthesis.
Fondaparinux, a synthetic
pentasaccharide, acts as a
selective inhibitor of
activated factor X. It works by
binding selectively to ATIII,
and potentiates the
neutralisation of Factor Xa.
This will interrupt the blood
coagulation cascade and
inhibit both thrombin
formation and thrombus
development. At the
recommended dosage,
fondaparinux does not affect
fibrinolytic activity or platelet
function. It cannot lyse
established thrombi and does
not affect clotting function
tests (e.g. aPPT, INR).
Prevention of venous
thromboembolic
events (VTE) in
patients undergoing
major orthopedic
surgery of the lower
limbs eg hip fracture
including extended
prophylaxis, knee &
hip replacement
surgery; abdominal
surgery at risk of
thromboembolic
complications,
restricted mobility
during acute illness
who are at risk of
thromboembolic
complications.
Treatment of acute
DVT & pulmonary
embolism (PE),
unstable angina or
non-ST segment
elevation MI
(UA/NSTEMI) acute
coronary syndrome
for the prevention of
death, MI & refractory
ischemia; ST segment
elevation MI (STEMI)
acute coronary
syndrome for the
prevention of death &
Hypersensitivity.
Active clinically
significant bleeding,
acute bacterial
endocarditis.
Anemia, bleeding,
purpura; edema.
ENOXAPARIN
Prophylaxis of venous
thrombosis In surgical
patients, give 1st inj 2 hr
before surgical procedure.
In orthopedic surgery, give
initial dose 12 hr preop. Patient w/ moderate risk
of thromboembolism 20 mg
SC once daily. Patient w/
high risk of
thromboembolism 40 mg
SC once daily. Ave duration:
7-10 days. May continue
therapy at 40 mg once daily
for 3 wk esp in orthopedic
surgery. Prophylaxis of VTE
in medical patients 40 mg
once daily by SC inj for a
min of 6 days & continued
until return to full
ambulation. Max: 14
days. Treatment of DVT w/
or w/o pulmonary
embolism By SC inj 1.5
mg/kg once daily or 1
mg/kg bid. Complicated
thromboembolic disorders 1
mg/kg bid. Ave duration: 10
Conditions w/ a high
risk of uncontrolled
hemorrhage
including major
bleeding disorders.
Hypersensitivity to
enoxaparin Na,
heparin or its
derivatives
including other low
MW heparins.
Hemorrhage.
Thrombocytopenia. Local
reactions (exceptionally
small local hematoma).
Exceptional cases of skin
necrosis (discontinue
treatment). Rarely,
cutaneous or systemic
allergic reactions.
Increase in liver
enzymes, platelet
counts. Hypersensitivity
cutaneous vasculitis.
ERDOSTEINE
(Ectrin)
Acute bronchitis,
chronic bronchitis &
its exacerbations.
Resp disorders
characterised by
abnormal bronchial
secretions & impaired
mucus transport.
days. Prevention of
extracorporeal thrombus
during hemodialysis 1
mg/kg introduced into the
arterial line of the circuit
prior to hemodialysis,
sufficient for a 4-hr session.
For longer sessions,
additional dose of 0.5-1
mg/kg may be given. For
patients w/ high risk of
hemorrhage, dose reduced
to 0.5 mg/kg for double
vascular access or 0.75
mg/kg for single vascular
access. Treatment of
unstable angina & non-Qwave MI 1 mg/kg 12 hrly by
SC inj w/ aspirin (100-325
mg orally) for min of 2 days
& continue until clinically
stabilized (usual duration of
treatment is 2-8 days).
Cap 1 cap bidtid. Susp Adult & childn >30
kg 10 mL bid, 20-30 kg 5
mL tid, 15-19 kg 5 mL bid.
No gastrointestinal nor
systemic side effects
due to Ectrin have been
observed..
PARACETAMOL +
ORPHENADRINE
(Norgesic/ Norgesic
Forte)
RACECADOTRIL
CARBIMAZOLE
Acute or chronic
painful muscular
conditions, nonarticular rheumatism,
whiplash injury, acute
torticollis, tension
headache,
dysmenorrhea.
Per Norgesic
tab Orphenadrine citrate 35
mg, paracetamol 450
mg. Per Norgesic Forte
tabOrphenadrine citrate 50
mg, paracetamol 650 mg
Glaucoma;
myasthenia gravis;
prostatic
hypertrophy or
bladder neck
obstruction. Childn
<12 yr.
Cap: Treatment of
acute diarrhea. Powd:
Adjunct to oral or
parenteral rehydration
in the treatment of
acute watery diarrhea
in infants & childn.
Hypersensitivity.
Powd: Renal or
hepatic impairment.
Fructose
intolerance, glucose
& galactose
malabsorption
syndrome or
sucrase isomaltase
deficiency.
Drowsiness.
Management of
hyperthyroidism;
treatment of Grave's
Pregnancy &
lactation.
Nausea, vomiting,
gastric discomfort,
headache, arthralgia,
TRIMETAZIDINE
(Vastarel MR)
ISOSORBIDE
DINITRATE (Isoket
5/Isoket 10/ Isoket
Retard 20/ Isoket
Retard 40)
Trimetazidine is a cellular
acting anti-ischaemic agent.
It has 3 main properties by
which it acts as a
cytoprotective agent. It
inhibits the anaerobic
glycolysis and fatty acid
metabolism, thus allowing
only aerobic glycolysis. This
action helps to restore the
energy balance in the cell. It
inhibits acidosis and free
radical accumulation in the
cell. All these action help the
cell to restore the normal
ionic and metabolic balance.
Isosorbide dinitrate relaxes
vascular smooth muscles by
stimulating cyclic-GMP. It
decreases left ventricular
pressure (preload) and
arterial resistance (afterload).
disease; preparation
of hyperthyroid
patients for
thyroidectomy.
Adjunct to radioiodine therapy &
treatment of thyroid
storm.
Preventive treatment
of episodes of angina
pectoris. Adjuvant
symptomatic
treatment of vertigo &
tinnitus. Adjuvant
treatment of visual
disorders of
circulatory origin.
5-15 mg daily.
Hypersensitivity.
Parkinson's disease,
parkinsonian
symptoms, tremors,
restless leg
syndrome & other
related movement
disorders. Severe
renal impairment
(CrCl <30 mL/min).
Lactation. Childn.
Hypersensitivity to
isosorbide dinitrate,
nitrates or nitrites.
Low-filling pressure,
hypertrophic
obstructive
cardiomyopathy,
constrictive
pericarditis, cardiac
tamponade,
cardiogenic shock,
EPERISONE
(Myonal)
Eperisone is centrally-acting
skeletal muscle relaxant used
to improve myotonic
symptoms.
circulatory collapse,
shock, aortic &/or
mitral valve
stenosis, severe
hypotension,
disease associated
w/ an increased
intracranial
pressure, marked
anemia,
hypovolemia,
closed-angle
glaucoma.
Concomitant use w/
phosphodiesterase
inhibitors.
1 tab tid.
Weakness, dizziness,
insomnia, drowsiness,
numbness in the
extremities, hepatic &
renal dysfunction,
hematological changes,
rashes, GI disturbances,
urinary disorders.
TRAMADOL +
PARACETAMOL
(Dolcet)
TRAMADOL +
PARACETAMOL
(Algesia)
myotonic symptoms
in cervical syndrome,
periarthritis of the
shoulders & lumbago,
tension-type
headache.
Moderate to severe
pain.
Moderate to severe
pain.
Acute intoxication
w/ alcohol,
hypnotics,
narcotics, centrallyacting analgesics,
opioids or
psychotropic drugs.
Hypersensitivity.
Hypersensitivity to
codeine or opioids.
Acute intoxication
w/ alcohol,
hypnotics,
narcotics, centrallyacting analgesics,
opioids or
psychotropic drugs.
Opioid-dependent
patients, chronic
alcoholism.
Lactation.
Dizziness, nausea,
somnolence. Asthenia,
fatigue, hot flushes,
headache, tremor,
abdominal pain,
constipation, diarrhea,
dyspepsia, flatulence,
dry mouth, vomiting,
anorexia, anxiety,
confusion, euphoria,
insomnia, nervousness,
pruritus, rash, increased
sweating.
PANTOPRAZOLE +
DOMPERIDONE
(Prazole Plus)
REBAMIPIDE
(Mucosta)
Symptomatic
management of
burning in various
acid peptic disorders
associated w/ nausea
& vomiting; GERD,
reflux esophagitis,
non-ulcer dyspepsia,
gastroparesis &
idiopathic hiccup or
any other peptic
disease accompanied
by nausea &/or
vomiting eg acute
gastritis including that
induced by NSAIDs.
1 cap daily.
Treatment of gastric
mucosal lesions
(erosion, bleeding,
redness & edema) in
acute gastritis &
exacerbation of
chronic gastritis;
gastric ulcer.
Prevention of NSAIDinduced gastropathy.
Pregnancy &
lactation.
Rarely hypersensitivity
reactions; GI
disturbances; increased
SGOT, SGPT, -glutamyl
transferase, alkaline
phosphatase & BUN
levels; leukopenia;
mammary gland
expansion, nonpuerperal
lactation, menstrual
disorder, dizziness,
edema & foreign body
feeling in the pharynx.
BETAHISTINE (Serc)
NIFEDIPINE
(Calcibloc)
LOSARTAN (Lifezar)
Meniere's disease,
Meniere-like
syndrome
characterized by
attacks of vertigo,
tinnitus &
sensorineural
deafness, peripheral
vertigo.
All forms of HTN; HTN
in pregnancy;
coronary insufficiency
w/ or w/o angina;
vasospastic angina, to
increase heart rate in
sinus bradycardia &
sick sinus syndrome.
Hypersensitivity.
Acute MI.
Infrequently, flushing,
nausea, dizziness,
headache, tiredness,
sedation; leg edema.
Treatment of HTN,
alone or in
combination w/ other
antihypertensives.
Pregnancy.
LOSARTAN +
HYDROCHLOROTHI
AZIDE (Combizar)
Hydrochlorothiazide
increases renal excretion of
sodium and chloride and
reduces cardiac load.
Losartan is an angiotensin II
receptor (type AT1)
antagonist antihypertensive
which acts by blocking the
actions of angiotensin II of
renin-angiotensin-
Management of HTN.
CLONAZEPAM
(Rivotril)
Clonazepam is an effective
anticonvulsant. It raises the
threshold for propagation of
seizure activity and prevents
generalisation of focal or
local activity. Clinically, it
improves focal epilepsy and
generalised seizures. It is also
believed to enhance the
activity of GABA, and acts as
anxiolytic.
SALMETEROL +
FLUTICASONE
(Seretide)
Regular treatment of
reversible obstructive
airways disease
Per 50/12.5 mg
tab Losartan K 50 mg,
hydrochlorothiazide 12.5
mg. Per 100/25 mg
tab Losartan K 100 mg,
hydrochlorothiazide 25 mg
50/12.5-mg 1 tab. Max
dose: 50/12.5-mg 2 tab
or 100/25-mg 1 tab.
Antihypertensive effect is
achieved w/in 3 wk.
Initial treatment: Adult &
childn >10 yr (>30 kg body
wt) 1-2 mg/day. Infant &
childn <10 yr (30 kg body
wt) Initially 10-30 mcg/kg
body wt/day.
Maintenance: Adult 2-4
mg/day. Max dose: 20
mg/day.Childn 10-16 yr 1.53 mg/day. Infant & childn
<10 yr 50-100 mcg/kg body
wt/day.
Hypersensitivity to
sulfonamides.
Patients w/ anuria &
depleted
intravascular vol.
Pregnancy.
Hypersensitivity.
Resp insufficiency.
Neonates.
Hypersensitivity.
visual disturbances,
taste perversion,
tinnitus; impotence,
nocturia, UTI.
Abdominal pain, edema,
asthenia, headache;
palpitation; diarrhea,
nausea; back pain;
dizziness; dry cough,
sinusitis, bronchitis,
pharyngitis, upper resp
infection. Rash.
Fatigue, somnolence,
muscular hypotonia,
coordination
disturbances, salivary or
bronchial hypersecretion
in infants & small childn;
aggressiveness,
irritability or agitation.
Muscle weakness,
restlessness, confusion,
disorientation,
depression, paradoxical
reactions, nervousness,
hostility, anxiety, sleep
disturbance, nightmares,
vivid dreams.
Headache; mouth &
throat candidiasis,
pneumonia (in COPD
bronchodilation. Fluticasone,
a corticosteroid with mainly
glucocorticoid activity,
reduce symptoms and
exacerbations of asthma.
IPATROPIUM
BROMIDE +
SALBUTAMOL
Ipratropium bromide is an
anticholinergic agent that
inhibits vagally-mediated
(ROAD) including
asthma where use of
combination therapy
(bronchodilator &
inhaled corticosteroid)
is appropriate; COPD
including chronic
bronchitis &
emphysema.
Management of
reversible
bronchospasm
patients),
hoarseness/dysphonia,
muscle cramps,
arthralgia.
Hypertrophic
obstructive
cardiomyopathy or
Headache, pain,
influenza, chest pain;
nausea. Bronchitis,
SULFATE (Duavent)
MONTELUKAST NA
+ LEVOCETIRIZINE
DIHYDROCHLORIDE
(Zykast)
HYDROXYZINE
(Iterax)
associated w/
obstructive airway
diseases eg bronchial
asthma, COPD.
Montelukast is a selective
leukotriene receptor
antagonist that blocks the
effects of cysteinyl
leukotrienes in the airways.
Levocetirizine, an active
isomer of cetirizine,
selectively inhibits histamine
H1-receptors.
Hydroxyzine blocks histamine
H1-receptors on effector cells
of the GI tract, blood vessels
and respiratory tract; a
sedating anihistamine with
antimuscarinic and significant
sedative properties. It also
possesses skeletal muscle
relaxing, bronchodilator,
antiemetic and analgesic
properties.
Relief of symptoms
associated w/
seasonal & persistent
allergic rhinitis.
Symptomatic
treatment of anxiety,
pruritus of allergic
origin; premed to
general anesth.
tachyarrhythmia.
Hypersensitivity to
soya lecithin or
related food
products (for MDI).
dyspnea, coughing,
pneumonia,
bronchospasm,
pharyngitis, sinusitis,
rhinitis.
Hypersensitivity to
hydroxyzine,
cetirizine & other
piperazine
derivatives,
aminophylline or
ethylenediamine.
Porphyria;
preexisting
prolonged QT
interval. Pregnancy
Somnolence, headache,
fatigue, dry mouth.
LEVODROPROPIZIN
E (Levopront)
Levodropropizine is a cough
suppressant that exerts
peripheral action in
nonproductive cough.
Symptomatic
treatment of cough.
CLOPIDOGREL
(Plavix)
Clopidogrel inhibits
adenosine diphosphate (ADP)
from binding to its receptor
sites on the platelets and
subsequent activation of
glycoprotein GP IIb/IIIa
complex thus preventing
fibrinogen binding, platelet
adhesion and aggregation.
& lactation.
Patients w/
excessive discharge
of mucus, w/ limited
mucociliary
function, severe
liver dysfunction.
Pregnancy &
lactation. Childn
<24 mth.
Severe liver
impairment. Peptic
ulcer & intracranial
hemorrhage.
Galactose
intolerance, Lapplactase deficiency
or glucosegalactose
malabsorption.
GI effects, exhaustion,
faintness, somnolence,
clouding of
consciousness,
numbness, dizziness,
headache, palpitations.
Rarely, allergic
reactions.
GI hemorrhage,
diarrhea, abdominal
pain, dyspepsia;
haematoma; epistaxis;
bruising; bleeding at
puncture site.
PIROXICAM
(Feldene/ Feldene
Flash)
Piroxicam is a NSAID,
belonging to the oxicam
group. It inhibits
prostaglandin synthesis,
reduces fever by acting on
the heat-regulating center of
the hypothalamus, inhibits
platelet-aggregating
substance thromboxane
A2 and reduces pain receptor
sensitivity. It also exerts antiinflammatory effect by
lysosomal stabilisation, kinin
and leukotriene production,
alteration of chemotactic
factors and neutrophil
activation inhibition.`
undergoing a stent
placement following
percutaneous
coronary intervention
in combination w/ ASA
in medically-treated
patients eligible for
thrombolytic therapy.
Variety of conditions
requiring antiinflammatory and/or
analgesic activity eg,
rheumatoid arthritis,
juvenile rheumatoid
arthritis, osteoarthritis
(arthrosis and
degenerative joint
disease), ankylosing
spondylitis, acute
musculoskeletal
disorders, acute gout,
pain after operative
intervention and
following acute
trauma.
Treatment of primary
dysmenorrhea in
patients 12 years.
Relief of fever and
pain associated with
acute upper
respiratory tract
inflammation.
Hypersensitivity to
aspirin & NSAIDs.
CVA, MI, CABG,
uncontrolled HTN,
CHF (NYHA II-IV).
Active peptic
ulceration. Severe
renal & hepatic
failure. Severe heart
failure. Pregnancy &
lactation.
GI symptoms. Ankle
edema (occasional). CNS
effects (rare). Swollen
eyes, blurred vision &
eye irritations, tinnitus.
Malaise. Skin rash &
pruritus. Anemia,
vasculitis. Rarely severe
hepatic reactions.
Hypersensitivity.
Decreased female
fertility.
ETORICOXIB
(Arcoxia/ Arcoxia
AC)
OA 30 or 60 mg. RA,
ankylosing spondylitis &
post-op dental pain 90
mg. Acute pain & post-op
gynecological pain 90 or
120 mg. Acute gouty
arthritis & primary
dysmenorrhea 120 mg,
limited to a max of 8 days
treatment. Mild hepatic
insufficiency (Child-Pugh
score 5-6) 60 mg. All doses
to be taken once
daily. Moderate hepatic
insufficiency (Child-Pugh 79) Dose should be reduced,
should not exceed 60 mg
every other day. The dose
for post-op acute dental &
gynecological surgery pain
should not exceed 90 & 120
mg/day, respectively.
Asthenia/fatigue,
dizziness, lower
extremity edema, HTN,
dyspepsia, heartburn,
nausea, increased ALT &
AST. Thrombocytopenia,
hypersensitivity
reactions including
anaphylactic/anaphylact
oid reactions including
shock; hyperkalemia,
anxiety, insomnia,
confusion,
hallucinations,
depression, restlessness;
dysgeusia, somnolence,
blurred vision, CHF,
palpitations, angina,
arrhythmia,
hypertensive crisis,
bronchospasm,
abdominal pain, oral
ulcers, peptic ulcer
including perforation or
bleeding (elderly),
vomiting, diarrhea,
hepatitis, jaundice;
hepatic failure,
angioedema, pruritus,
erythema, rash,
Stevens-Johnson
syndrome, toxic
epidermal necrolysis,
urticaria; fixed-drug
eruption, renal
Acute bronchitis,
bronchiectasis w/
infection, secondary
infections of chronic
resp tract diseases,
pneumonia.
Pyelonephritis,
cystitis, gonococcal
urethritis.
Cholecystitis,
cholangitis, sinusitis,
tonsillitis, pharyngitis.
Scarlet fever.
SITAGLIPTIN
(Januvia)
Monotherapy: Adjunct
to diet & exercise to
improve glycemic
control in patients w/
type 2 DM.
Combination therapy:
PPAR- agonist (eg
thiazolidinediones) or
metformin as initial
therapy or when the
single agent alone, w/
diet & exercise does
not provide adequate
Hypersensitivity to
cephalosporins,
penicillins.
insufficiency including
renal failure.
Hypersensitivity
reactions; GI, hepatic,
renal & CNS effects;
hematologic & lymphatic
systems disorders.
Hypoglycemia (based on
all reports of
symptomatic
hypoglycemia,
concurrent glucose
measurement was not
required); abdominal
pain, nausea, vomiting,
diarrhea, dyspepsia,
flatulence;
hypersensitivity
reactions including
anaphylaxis,
METFORMIN Hcl +
SITAGLIPTIN
(Janumet)
glycemic control.
Combination w/ a
sulfonylurea: Patients
w/ type 2 DM to
improve glycemic
control when
treatment w/ single
agent alone, w/ diet &
exercise, does not
provide adequate
glycemic control.
Combination w/
metformin & a
sulfonylurea or
metformin & PPAR-
agonists: Patients w/
type 2 DM to improve
glycemic control when
dual therapy w/ these
agents, does not
provide adequate
glycemic control.
Combination w/
insulin: Adjunct to diet
& exercise to improve
glycemic control in
combination w/ insulin
(w/ or w/o metformin).
Type 2 DM as initial
therapy to improve
glycemic control when
diet & exercise alone
do not provide
adequate glycemic
control. Type 2 DM as
angioedema, rash,
urticaria, cutaneous
vasculitis & exfoliative
skin conditions including
Stevens-Johnson
syndrome; influenza,
headache, acute
pancreatitis including
fatal & nonfatal
hemorrhagic &
necrotizing pancreatitis,
worsening renal
function, upper resp
tract infection, fungal
skin infection, peripheral
edema, nasopharyngitis,
constipation, arthralgia,
myalgia, pain in
extremity, back pain.
Renal disease or
dysfunction, which
may also result from
conditions eg CV
collapse (shock),
acute MI &
septicemia. Acute or
Hypoglycemia,
dyspepsia, flatulence,
nausea, vomiting,
diarrhea, abdominal
pain, loss of appetite,
metallic taste, upper
resp tract infection,
monotherapySitagliptin 50
mg bid + metformin
already taken. Patients
inadequately controlled on
sitagliptin monotherapy 50
mg/500 mg tab bid. May be
titrated up to 50 mg/1,000
mg tab bid. Patients
switching from sitagliptin
co-administered w/
metformin Initiate w/ dose
of sitagliptin & metformin
already being
taken. Patients
inadequately controlled on
dual combination therapy
w/ any 2 of the following 3
antihyperglycemic agents:
Sitagliptin, metformin or
sulfonylurea Sitagliptin 50
mg bid + metformin dose
based on glycemic control
level. Patients currently on
or initiating sulfonylurea
may require lower doses of
sulfonylurea doses to
reduce the risk of
sulfonylurea-induced
hypoglycemia. Gradual
dose escalation to reduce
GI effects associated w/
metformin. Patients
inadequately controlled on
dual combination therapy
w/ any 2 of the following 3
chronic metabolic
acidosis including
diabetic
ketoacidosis, w/ or
w/o coma. Lactic
acidosis.
Discontinue
treatment in
patients undergoing
radiologic studies.
Type 1 diabetes.
Pregnancy &
lactation.
antihyperglycemic agents:
Sitagliptin, metformin or
insulin Sitagliptin 50 mg bid
+ metformin dose based on
glycemic control level &
current dose (if any) of
metformin. Gradual dose
escalation to reduce the GI
side effects associated w/
metformin should be
considered. Patients
currently on or initiating
insulin therapy may require
lower doses of insulin to
reduce the risk of
hypoglycemia. Patients
inadequately controlled on
dual combination therapy
w/ any 2 of the following 3
antihyperglycemic agents:
Sitaglipin, metformin or a
PPaR- agonist Usual
starting dose of Janumet
should provide sitagliptin
dosed as 50 mg bid (100
mg total daily dose). In
determining the starting
dose of the metformin
component, the patient's
level of glycemic control &
current dose (if any) of
metformin should be
considered.Patients
inadequately controlled on
dual combination therapy