FAQs

Queries about medication

CENTRAL NERVOUS SYSTEM DRUG

Narcotic analgesics

CODEINE C

SupplyiG30mg/Tab(CODEINER)
UseiGFor relief of mild to moderate pain and cough.
ContraindicationiGRespiratory depression, convulsive disorders.
Adverse effectiGDizziness, euphoria, dysphoria, nausea, vomiting, constipation, pruritus.
Usual dosageiGAdults: analgesic: 15-60mg Q4H, antitussive: 10-20g Q4-6H, do not exceed 120mg in 24 hours. Child: analgesic: 3mg/kg/day in 6 divided doses, antitussive: 2.5-10mg Q4-6H, do not exceed 60mg in 24 hours.

FENTANYL CITRATE C

SupplyiG25mg/Pkg(DUROGESICR), 50mcg/ml(FENTANYLR)
UseiG1. For analgesic action of short duration during the anesthetic periods, premedication, induction, maintenance and in the immediate post operative period. 2. Administration with droperidol as an anesthetic medication and induction.
ContraindicationiG1. Patient with known intolerance to the fentanyl and patient with asthma or myasthenia gravis. 2. In patients who have received MAO inhibitors within 14 days is not recommended.
Adverse effecti癒GRespiratory depression, apnea, muscular rigidity, bradycardia, hypotension, dizziness, blurred vision.
Usual dosageiGPremedication: 0.05-0.1mg IM. Induction: 0.05-0.1mg IV. Maintenance: 0.025-0.05mg IV or IM. Postoperative: 0.05-0.1mg IM.

MORPHINE B

SupplyiG10mg/ml(MORPHINER), 30mg/Tab(MORPHINER)
UseiGRelief of visceral pain, preanesthetic medication.
ContraindicationiGRespiratory depression, biliary colic, acute pancreatitis, asthma and increased intracranial pressure.
Adverse effectiGDizziness, sedation, euphoria, dysphoria, dry mouth, respiratory depression, weakness.
Usual dosageiGSC or IM : Adults: 5-20mg/70kg, child: 0.1-0.2 mg/kg/dose. IV : Adults: 2.5-15mg in 4-5ml water for injection, inject slowly over a 4-5 min period. Oral : peak serum level 2-3 hours.

PETHIDINE B

SupplyiG50mg/ml(DEMEROLR)
UseiGRelief of pain, preoperative medication anesthesia support.
ContraindicationiGHypersensitivity to meperidine, patient who have received MAO inhibitors within 14 days, increased intracranial pressure.
Adverse effectiGDizziness, sedation, euphoria, dysphoria, dry mouth, respiratory depression, weakness.
Usual dosageiGRelief of pain: Adults: 50-150mg IM or PO Q3-4H. Child: 1.1-1.8mg/kg IM, PO or SC up to adult dose Q3-4H. Preoperative medication: Adults: 50-100mg IM 30-90min before anesthesia. Child: 0.5-1mg/lb IM up to adult dose, 30-90min before anesthesia.

Non-narcotic analgesics

ACEMETACIN

SupplyiG60MG/CAP(ACEMETR, ACEOR)
UseiGPain & inflammation in rheumatic disease &other musculoskeletal disorders. Post-op analgesia.
ContraindicationiGHistory of hypersensitivity to aspirin or other NSAIDs. Renal, cardiac or hepatic impairment. Acutive peptic ulceration. Pregnancy. Child, elderly
Adverse effectiGGI disturbance, headache, dizziness, Symptoms of epilepsy. Parkinson’s disease &psychiatric disorders may be intensified.
Usual dosageiG1-2 cap tid
Special precautionsiGHistory of gastric or duodenal ulcers. May impair ability to drive or operate machinery.

DICLOFENAC SOD. B

SupplyiG12.5MG/SUPP(VALTAFENR),100MG/S.R.TAB(GROFENACR),
25MG/F.C.TAB(FLAMQUITR),50MG/E.M.CAP(VORENR),
50MG/2ML/AMP(VORENR)
UseiGAn analgesic, antipyretic, anti-inflammatory agent used in rheumatoid arthritis and related disorders.
ContraindicationiGPeptic ulcer and hypersensitivity to NSAIDs, asthma.
Adverse effectiGGI disturbance, diarrhea.
Usual dosageiGAdults: PO 100-150mg/daily, TID or QID. Child age 1 year or over should be given PO 0.5-3mg/kg/day in 2-3 doses. Suppositories: adult 75-100mg daily bid-tid. child 0.5-1 mg/kg/day.
Special precautionsiGAcute disease. Elderly, young child. Hepatic impairment, hypertension, fluid retention. Prepnancy laction. Prolonged use.

FLURBIPROFEN C

SupplyiG100mg,50mg/F.C.TAB(LEFENINER)
UseiGAnalgesic, anti-inflammatory in chronic articular rheumatism.
ContraindicationiGPeptic ulceration.
Adverse effectiGGI disturbance, rash, headach, sleepiness, fatigue.
Usual dosageiG150-200mg daily
Special precautionsiGElderly, pregnancy & lactation, child, peptic ulcer, blood disorder, hepatic & renal impairment, cardiac dysfunction.

IBUPROFEN B

SupplyiG20mg/ml120ml/Bot Susp.(SCONINR),600mg/Tab(RECLOFENR)
UseiGRA, osteoarthrosis
ContraindicationiGActive or severe peptic ulceration; asthma or alleragy provoked by aspirin or other NSAID
Adverse effectiGGI effects including ulceration; headache, nervousness; depression; drowsiness; insomnia; blurred vision; rashes; bronchospasm. Rarely, thrombopenia.
Usual dosageiGAdult Initially 1200 mg daily in divided doses. Maintenance: 600-1200 mg daily. May be increased to 1600 mg daily in divided doses. Childn 20 mg/kg body wt daily, 500mg daily
Special precautionsiGPregnancy. Bleeding disorders, CV disease. Renal failure.

KETOPROFEN B

SupplyiG50MG/TAB(KETOPROFENR)
UseiGAnalgesia, antipyresis, anti-inflammatory agent, Dysmenorrhea.
ContraindicationiGHypersensitivity.
Adverse effectiGGI disturbance, peptic ulceration, pruritus, tinnitus,drowsiness, dizziness, headache, anxiety, asthma, agranulocytosis, aplastic anemia, acute renal failure, nephrotic syndrome.
Usual dosageiGRheumatic disorder: PO 150-300mg daily in 3-4 divided doses. Dysmenorrhea, mild to moderate pain: 25-50mg Q 6-8 h as need; IM 50mg BID.
Special precautionsiGCV disease, peptic ulceration, renal failure; elderly

KETOROLAC

SupplyiG10MG/F.C.TAB(KETOR), 30MG/ML/AMP(KETOR)
UseiGFor the short-term management of moderate-sever acute pain, including pain following major abdominal, orthopedic & gynecological operative procedures.
ContraindicationiGHypersensitivity to aspirin or other NSAIDs
Adverse effectiGNausea, abdominal discomfort, peptic ulceration, GI bleeding, drowsiness, dizziness.
Usual dosageiGPO 1 tab 4-6 hrly. IM/IV 6hrly
Special precautionsiGImpaired renal/hepatic function, elderly, childn<16yr.

MELOXICAM

SupplyiG7.5MG/TAB(MOBICR)
UseiGMeloxicam has been effective in the treatment of rheumatoid arthritis and osteoarthritis, comparing well with several other nonstandard anti-inflammatory drugs
Place in therapy: Meloxicam has generally shown comparable efficacy and an improved gastrointestinal tolerability profile when compared to some other nonsteroidal antiinflammatory drugs (ie, diclofenac, piroxicam, naproxen).
ContraindicationiGActive peptic ulceration, severe hepatic insufficiency, non-dialysed severe renal insufficiency, child<15yr, pregnancy & lactation
Adverse effectiGThe adverse effect profile of meloxicam resembles that of other nonsteroidal anti-inflammatory agents but with less gastrointestinal toxicity compared to piroxicam, diclofenac, and naproxen.
Usual dosageiGOsteoarthritis 7.5 mg/day. May be increase to 15 mg/day. RA & ankylosing spondylitis 15 mg/day. May be reduced to 7.5 mg/day. Max: 15m/day
Pharmacokinetics: The oral bioavailability of meloxicam is 89%, and peak serum levels at steady-state occur 5 to 6 hours after administration. Meloxicam is metabolized extensively in the liver; metabolites are excreted in urine and bile. The elimination half-life of meloxicam is about 20 hours after oral doses.

MEPIRIZOLE

SupplyiG100MG/F.C.TAB(MEBRONR)
UseiGAntirheumatic, anti-inflammatory analgesic.
ContraindicationiGPeptic ulcers. Severe hematological abnormalities. Sever hepatic & renal disorder. Hypersensitivity.
Adverse effectiGGI disturbances, stomatitis, dizziness, headache, drowsiness, rash
Usual dosageiG150-450 mg in 2-4 divided doses.

NABUMETONE C

SupplyiG500MG/F.C.TAB(NO-TONR, RELIFEXR)
UseiGNabumetone is a prodrug and has little pharmacologic activity, the metabolite 6-methoxy-2-naphthylacetic acid (6-MNA) is similar to Naproxen. Nabumentone is used for anti-inflammatory and analgesic effects in the symptomatic treatment of acute and chronic osteoarthritis and rheumatoid arthritis.
ContraindicationiGHypersensitivity to Nabumetone, severe hepatic damage, peptic ulcer.
Adverse effectiGDiarrhea, abdominal pain, dyspepsia, nausea, vomiting, rash, headache, dizziness, sedation, peptic ulcer.
Usual dosageiGAdult initial dosage: 1g/daily before sleeping; maintenance dosage: 1~2g/daily, given single or 2 divided doses daily . Elderly: < 1g/daily before sleeping. Due to the extensive hepatic metabolism of nabumetone, no dosage adjusted in patients with renal insufficency is necessary but the inactive metabolites of nabumetone are excred renally. Monitoring of renal function is recommended.
Special precautionsiGHypersensitivity to aspirin, hepatic dysfunction.

NAPROXEN B

SupplyiG250MG/TAB(U-RITISR), 750MG/S.R.TAB(NAPROZENR)
UseiGAnalgesia, antipyresis, anti-inflammatory, acute gout.
ContraindicationiGHypersensitivity, pregnancy women.
Adverse effectiGGI upset, dizziness, headache, tinnitus, constipation, liver function impairment, jaundice, platelet dysfunction, renal function impairment.
Usual dosageiGAdults: initial dose 250mg BID then 500mg-1gm/daily, BID; maximum dose: 1.25g/day; for slow released tablet 750mg QD; acute gout: initial dose 750mg then 250mg Q8H. Childn (over 5 yrs): 10mg/kg/daily BID.
Special precautionsiGPatients with asthma or bronchospasm; bleeding disorders; CV disease; previous or recent peptic ulceration, renal failure or receiving coumarin anticoagulant.

PIROXICAM B

SupplyiG20MG/ML 2ML/AMP(TONMEXR), 20MG//TAB(FOGLUGENR)
UseiGAnalgesia, antipyresis and anti-inflammatory agent.
ContraindicationiGPeptic ulceration, hypersensitivity or sensitivity to aspirin or other NSAIDs, nursing mother.
Adverse effectiGPeptic ulceration, GI bleeding, decreased platelet aggregation and prolonged bleeding time, edema, liver dysfunction, headache, dizziness, drowsiness, fatigue.
Usual dosageiGRheumatic disorders: 10-30mg daily, usual dose 20mg daily. Acute gout: 40mg daily for 5-7 days.
Special precautionsiGImpaired renal function; CV disorders where edema may worsen the condition.

SALICYLAZO SULFAPYRIDINE B

SupplyiG500MG/TAB(SALAZOPYRINR)
UseiGMild to moderate ulcerative colitis , adjunctive therapy in severe ulcerative colitis.
ContraindicationiGHypersensitivity to sulfonamide or salicylates. In infants under 2 yrs, intestinal and urinary obstruction, patients with porphyria.
Adverse effectiGHeadache, blood dyscrasia, skin eruptions, Steven-Johnson syndrome, hypersensitivity reactions.
Usual dosageiGAdult: 3-4g/day divided into 4-8 doses, then 500mg QID (max 8gm/day). Childn: 40-60mg/kg/day in 3-6 divided doses, then 30mg/kg/day divided into 4 doses.
Special precautionsiGHepatic or renal impairment; blood dyscrasia; G6PD deficiency.

SULINDAC B

SupplyiG200MG/TAB(SOLIKYR)
UseiGSymptomatic treatment of acute and chronic rheumatoid arthritis, osteoarthritis and ankylosing spondylitis, acute gouty arthritis.
ContraindicationiGKnown hypersensitivity to the drug and in patients in whom asthma, rhinitis or urticaria is precipitated by aspirin or other NSAIDs.
Adverse effectiGGI pain, dyspepsia, nausea, vomiting, diarrhea and constipation, dizziness, headache, pruritus, sore or dry mucous membrane.
Usual dosageiG150-200mg BID.
Special precautionsiGImpaired hepatic, renal or cardiac function; GI hemorrhage or ulcers; pregnancy.

TENOXICAM

SupplyiG20MG/F.C.TAB(SUTONDINR, TENCAMR)
UseiGTenoxicam is a nonsteroidal anti-inflammatory agent structurally similar to piroxicam. Tenoxicam has been effective in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and nonarticular rheumatic conditions.
Place in therapy: Available studies have not indicated any significant advantage of tenoxicam over piroxicam (or other NSAIDs) with regard to clinical efficacy for any indication.
ContraindicationiGHypersensitivity , patients with a history of nasal polyps and angioedema or bronchospasm induced by aspirin or other anti-inflammatory agents, caution in patient with upper GI disease.
Adverse effectiGGastrointestinal complaints (nausea, epigastric pain); peptic ulceration has been reported. Other adverse reactions include headache, dizziness, edema, skin rash, and abnormalities in liver and renal function tests. The toxicity profile of tenoxicam is similar to that of piroxicam.
Usual dosageiG20mg IV or IM for 1-2 days then 20mg PO QD; bioavailablility of the drug is reported 100%. And no further accumulation of tenoxicam occurs after 6 months of continuous therapy.
Available one single-dose study suggested that dosage adjustments of tenoxicam are not required in renal insufficiency.
Special precautionsiGRenal disease; diabetes mellitus; liver cirrhosis; depletion. Pregnancy, lactation.

TIAPROFENIC ACID

SupplyiG200MG/CAP(SUFENR)
UseiGRheumatoid arthritis, osteoarthritis, ankylosing spondylitis, soft-tissue rheumatism, sport injuries or trauma.
ContraindicationiGPatients with gastroduodenal ulcer and with a recent history of asthma or urticaria following ingestion of aspirin or other NSAIDs.
Adverse effectiGGI disturbances, renal impairment, urinary disturbances, oedema and fatigue.
Usual dosageiGPO 200mg TID.

TOLFENAMIC ACID

SupplyiG100MG/CAP(CLOTANR)
UseiGAntirheumatic, Anti-inflammatory, Analgesics
Adverse effectiGSlight dysuria; GI complaints, erythema, headache.
Usual dosageiGRheumatic disorders 100-200mg tid. Acute attacks of migraine 200mg when 1st symptoms appear. Repeat after 2-3 hr if satisfactory effect is not obtained. Migrain prophylaxis 100mg tid. Dysmenorrhea 200 mg tid when 1st symptoms of menstruation appear.
Special precautionsiGPeptic & GI ulcers, reduced liver& kidney function.

TOLMETIN SOD. C

SupplyiG200MG/TAB(TOLECTINR)
UseiGRA & osteoarthritis.
ContraindicationiGTolerance. Sensitivity to aspirin & other NSAIDs. Pregnancy & nursing mothers
Adverse effectiGDyspepsia, GI distress, abdominal pain, diarrhea, flatulence, vomiting; headache; asthenia; elevated BP;edema; dizziness; wt gain & loss
Usual dosageiGStarting dose: 400 mg tid, for control: 600-1800 mg daily in divided doses. Control of osteoarthritis: 600-1600 mg daily in divided doses. Child>2yr starting dose:20mg/kg/day in divided doses, for control: 15-30 mg/kg/day
Special precautionsiGImpaired renal function. Compromised cardiac function. Liver dysfunction

GLUCOSAMINE SULFATE

SupplyiG314MG/TAB(VIARTRIL-SR)
UseiGAll form of degenerative osteoarticular disease. Primary & secondary osterarthrosis: cervical arthrosis, coxofemoral arthrosis, gonarthrosis, dorsal arthrosis, Iumbosacral arthrosis, scapulohumeral arthrosis, periarthritis, iumbago, fractures, osteoarticular dystrophies, chronic &subacute arthritis.
Usual dosageiGLight or moderate arthrosic symptoms 2 cap tid for at least 8 wk. Severe arthrosic symptoms Initial therapy:2 cap tid during the 1st 8 wk. Maintenance: 2 cap bid for 3-4mth. Repeat treatment every other 1 yr, depending on patient conditions.
Special precautionsiGVIARTRIL-S is a causal therapy and the therapeutic effect can only be seen after approx. 1 week from the beginning.
Therefore, in case of intense pains it is advisable to take an anti-inflammatory drug in addition during the first days of treatment with VIARTRIL-S

ACETAMINOPHEN C

SupplyiG500MG/TAB(ACETAMINOPHENR, DEPYRETINR, PANAMAXR),100MG/SUPP(ACETAR),24MG/ML60ML(ANTI-PHENR)
UseiGAnalgesic and antipyretic actions similar to aspirin, no anti-inflammatory properties.
ContraindicationiGHypersensitivity to acetaminophen, glucose-6-phosphate dehydrogenase deficiency, continued use in patients with anemia, or with cardiac, pulmonary, renal, or hepatic disease.
Adverse effectiGErythema or urticarial skin reaction, drowsiness, agranulocytosis, liver damage, renal tubural necrosis, methemoglobinemia.
Usual dosageiGAdults: 300-650mg Q4H, up to 1000mg QID, short-term therapy and long-term therapy up to 4g/day. Child: (7-12 yrs): 150-325mg TID or QID, don’t exceed 1.3g in 24 hours; (under 6 yrs): 120-200mg TID or QID, don’t exceed 480mg in 24 hours.
Special precautionsiGImpaired renal and hepatic function

Drugs used for hyperuricemia and gout

ALLOPURINOL C

SupplyiG100MG/TAB(SYNORIDR),300MG/TAB(APO-ALLOPURINOLR)
UseiGPrimary hyperuricemia of gout, secondary hyper-uricemia due to hematological disorders or antineoplastic therapy, and renal urate stone.
ContraindicationiGHypersensitivity to allopurinol, idiopathic hemochromatosis
Adverse effectiGRash, exfoliative, urticarial or purpuric lesions, nausea, vomiting, agranulocytosis, anemia, peripheral neuritis, diarrhea, headache.
Usual dosageiGInitial dose: 100mg/day PC, then increased by 100mg at weekly interval until serum uric level < 6mg/dl. Maximum dose: 300mg/dose, 800mg/day.
Special precautionsiGAcute gout, liver disease, renal impairment, pregnancy, lactation.

BENZBROMARONE

SupplyiG100MG/TAB(BENRONER, NOGOUTR), 100MG/CAP(BENZROR), 50MG/TAB(BENZONR), 50MG/CAP(NARCARICINR)
UseiGBenzbromarone is a uricosuric used to treat asymptomatic and symptomatic hyperuricemia, gout.
ContraindicationiGRenal dysfunction, glomerular filtration rate is less than 20ml/minute; Benzbromarone therapy should not be initiated during an acute attack of gout.
Adverse effectiGDiarrhea , rash; benzbromarone may precipitate an acute attack of gout and/or uric acid nephropathy. Ensure adequate fluid intake and maintenance of a relatively high urine pH to reduce the risk of nephrolithiasis.
Usual dosageiG40-120mg QD

COLCHICINE C

SupplyiG0.5MG/TAB(COLCHICINER)
UseiGAcute gouty arthritis, chronic sarcoid arthritis.
ContraindicationiGPregnancy, old or feeble patient with cardiac, renal, hepatic & GI disease.
Adverse effectiGNausea, vomiting, abdominal pain, hairless, bone marrow depression, myopathy, peripheral neuritis, burning threat pain, bloody diarrhea, shock, hematuria, oligouria.
Usual dosageiGProphylactic dose: 0.5mg QD-TID. Acute attack of gout: initial dose: 0.5-1mg then 0.5mg Q2H until pain is relieved or nausea, diarrhea appeared.

Drugs used for migraine

DIHYDROERGOTAMINE

SupplyiG5mg/Retard Cap(SEGLORR)
UseiGTreatment of vascular headaches including migraine and cluster headaches, postural hypotension.
ContraindicationiG Peripheral vascular disease, coronary heart disease, hypertension, impaired hepatic or renal function, pregnancy.
Adverse effectiGNausea. Localized edema, itching, transient tachycardia or bradycardia, weakness in the legs, dizziness.
Usual dosageiGPO 1 Cap BID with meals
Special precautionsiGAssociation with josamycin

Anxiolytics, Sedatives, Hypnotics

ALPRAZOLAM

SupplyiG0.25MG/TAB(GENDERGINR, 0.5MG/TAB(KINAXR,XANAXR), 1MG/TAB(KINAXR)
UseiGUsed for the management of anxiety disorder or for the short-term relief of symptoms of anxiety. Long term use (more than 4 months) has not been evaluated.
ContraindicationiGHypersensitivity, narrow angle glaucoma.
Adverse effectiGHeadache, insomnia, dizziness, sleepiness, nervousness, tremor, syncope, confusion, depression, nausea, vomiting, diarrhea, constipation, seizure, delirium and withdrawal symptoms have occured in some patients following rapid dosage reduction or abrupt discontinuance of alprazolam.
Usual dosageiGPO 0.5-4mg daily BID or TID
Patient informationiGAvoid alcohol and other CNS depressants; avoid activities needing good psychomotor coordination until CNS effects are known; drug may cause physical or psychological dependence; avoid abrupt discontinuation after prolonged use

BROMAZEPAM

SupplyiG3MG/TAB(LEXOTANR)
UseiGEmotional disturbance, functional disturbance in the cardiovascular and respiratory systems, psychosomatic disorders, emotional reactions to chronic organic disease.
ContraindicationiGMyasthenia gravis.
Adverse effectiGFatigue, drowsiness, muscle weakness.
Usual dosageiG1.5-3mg TID for outpatient therapy. 6-12mg BID or TID for severe cases.
Special precautionsiGElderly & debilitated patients. May impair ability to drive or operate machinery. Drug dependence. Withdrawal precaution.

BUSPIRONE HCL

SupplyiG10MG/TAB(BUSPR)
UseiGBuspirone is an anxiolytic agent chemically unrelated to benzodiazepines. Buspirone is indicated in the treatment of anxiety disorders.
Place in therapy: Studies have shown the drug to be equivalent in efficacy to diazepam on a mg-mg basis, while producing a lower degree of CNS side effects. Compared with diazepam, buspirone produces less sedation, less effect on psychomotor and psychologic function, and a lower propensity for interaction with ethanol and CNS depressants. Buspirone appears to lack the abuse liability of diazepam and other benzodiazepines.
ContraindicationiGHypersensitivity to buspirone or any of its inactive ingredients. Use with caution in patient with MAO inhibitor buspirone does not prevent the symptoms of benzodiazepine withdrawal. If buspirone is intended to replace long-term or chronic benzodiazepine therapy, gradually withdraw the patient from the first drug before initiating buspirone. Also use with caution in patietn with severe renal or hepatic impairment.
Adverse effectiGSide effects is minimal and include dizziness, nausea, headache, nervousness, lightheadedness, and excitement. Buspirone does not appear to be physically addicting.
Usual dosageiGPO 20 to 30 mg/day in divided doses started with initial 7.5 mg PO BID
Special precautionsiGSeizure disorder, renal or hepatic dysfunction.

FLUDIAZEPAM

SupplyiG0.25MG/TAB(ERISPANR)
UseiGFludiazepam is a short acting benzodiazepine with general properties similar to those of diazepam. It is used to treat anxiety disorder.
ContraindicationiGIn patient with narrow angle glaucoma, myasthenia gravis.
Adverse effectiGThe adverse effects similar to those of benzodiazepines: drowsiness (3.8%), dizziness (0.8%), and tiredness (0.8%). Other side effects include: GI symptoms, difficult in urine voiding.
Usual dosageiG1 Tab PO TID
Special precautionsiGResp depression; cardic, hepatic, renal disorder, organic disorder in the brain; infants; elderly; patients with physical weakness.

LORAZEPAM

SupplyiG1MG/TAB(ANXIEDINR, ATIVANR),
UseiGAnxiety, tension, agitation, irritability, insomnia with anxiety, neurosis or transient situational disturbances.
ContraindicationiGHypersensitive to the benzodiazepines, acute narrow angle glaucoma, psychotic reactions, primary depression disorders.
Adverse effectiGSedation, dizziness, weakness, unsteadiness, confusion, headache, sleep disturbance, slight hypotension.
Usual dosageiGUsual dose: 2-6mg/day, up to 10mg/day. Anxiety: 2-3mg/day BID or TID. Insomnia: 2-4mg HS. Elderly patients: 1-2mg/day TID.
Patient informationiGAdvise patient of potential for physical and psychological dependence with chronic use; advise patient of possible retrograde amnesia after I. V. or I.M. use; will cause drowsiness, impairment of judgment or coordination

NORDAZEPAM

SupplyiG5MG/S.C.TAB(CALMDAYR)
UseiGAnxiety &tension linked to functional & psychosomatic disturbances.
ContraindicationiGGlaucoma, myasthenia gravis, pregnancy, lactation.
Adverse effectiGAtaxia, drowsy walk, reduced resp capacity esp in newborn.
Usual dosageiG2 tab in the evening.
Special precautionsiGMay impair ability to drive or operate machinery.

OXAZEPAM

SupplyiG15M/TAB(ALEPAMR)
UseiGAnxiety, tension, irritability, agitation, psychoneurosis.
ContraindicationiGPsychoses; myasthenia gravis, acute narrow angle glaucoma, shock, coma or alcohol intoxication
Adverse effectiGTransient mild drowsiness. Idiosyncratic, allergic or hypersensitivity reactions; rarely leucopenia &hepatic dysfunction.
Usual dosageiGAdult Organic illness or emotional strain 15 mg tid. Severe anxiety &exaggerated stress reactions 15-30 mg 3-4 times daily. Geriatric patients suffering from anxiety 7.5-15 mg 2-3 times daily. Child >6yr0.5 mg/kg daily

BROTIZOLAM

SupplyiG0.25MG/TAB(LENDORMINR)
UseiGInsomnia
ContraindicationiGMyasthenia gravis
Adverse effectiGFatigue &reduced ability to concentrate after waking in patients sensitive to diazepines & following high doses.GI disorder; headache, dizziness; dryness of mouth; drop in BP in hypertensive patients.Tolerance &loss of memory.
Usual dosageiG1 tab at bedtime. Elderly & those decreased clearance 1/2 tab at bed time. In isolated cases, dose may be increased to 2 tab.

DIAZEPAM

SupplyiG2MG,5MG/TAB(VALIUMR)
UseiGTension, anxiety, moderate to severe psycho-neurotic state, acute alcohol withdrawal syndrome, tetanus, convulsive disorders, preoperative medication
ContraindicationiGHypersensitive to diazepam, acute narrow angle glaucoma, psychosis, shock, coma, alcohol intoxication.
Adverse effectiGDrowsiness, depression, confusion, fatigue, ataxia, hypoactivity, bradycardia, cardiovascular collapse.
Usual dosageiGAdults: 2-10mg BID-QID, IM or IV 2-10mg (start).
Child: 0.12-0.8mg/kg/day, IM or IV 1-2mg Q3-4H as needed.
Special precautionsiGCardioresp insufficiency; pregnancy, lactation; myasthenia gravis. May modify psychomotor performances. Dependence; withdrawal precautions.
Patient informationiGAvoid alcohol and other CNS depressants; avoid activities needing good psychomotor coordination until CNS effects are known; drug may cause physicial or psychological dependence; avoid abrupt discontinuation after prolonged use

FLUNITRAZEPAM

SupplyiG2MG/TAB(FLUZEPAMR, MODIPANOLR)
UseiGPreanesthetic medication, induction and maintenance of anesthesia, sleep disturbance.
ContraindicationiGMyasthenia gravis.
Adverse effectiGDrowsiness, hypotension, respiratory difficulty.
Usual dosageiGAdults: Premedication: IM or PO 1-2mg. Induction of anesthesia: slowly IV 1-2mg.
Child: Anesthesia induction: IV 0.03-0.04mg/kg,over 20-30 seconds
Special precautionsiGMay affect psychomotor performances; pregnancy, lactation.

LORMETAZEPAM

SupplyiG1MG/TAB(LORAMETR)
UseiGInsomnia.
ContraindicationiGPregnacy, lactation.
Usual dosageiG1-2 mg 30 mins before bedtime. Elderly 0.5 mg 30 mins before bedtime

NIMETAZEPAM

SupplyiG5MG/TAB(ERIMINR)
UseiGInsomnia.
ContraindicationiGAcute narrow angle glaucoma, serious myasthenia.
Adverse effectiGDependence, dizziness, drowsiness, headache, irritable excitation, confusion,hypotonia, skin rash, nervousness, tremor, tinnitus, dyslalia, increased GOT/GPT/AI-p, anorexia, nausea, vomiting, abdominal pain &discomfort, palpitation, diarrhea, chest pain, redness, stiffness of shoulders, diaphoresis, night sweat.
Usual dosageiG1 tab before retiring
Special precautionsiGResp depression; cardiac, hepatic, renal disorder, organic disorder in brain.

TRIAZOLAM

SupplyiG0.25MG/TAB(HALCIONR)
UseiGTransient & short-term insomnia, short-term adjunctive treatment in long-term insomnia.
Adverse effectiGDrowsiness, dizziness, lightheadedness, impaired coordination. Occasionally, anterograde amnesia, confusion, agitation.
Usual dosageiGadult 0.25 mg before retiring. Elderly & debilited patient 0.125-0.25 mg(therapy initiated at 0.125 mg) before retiring.

ZOLPIDEM

SupplyiG10MG/F.C.TAB(STILNOXR)
UseiGZolpidem is an imidazopyridine sedative-hypnotic that is structurally unrelated to the barbiturates and benzodiazepines. Zolpidem has been found to be effective for the short-term treatment of insomnia. Other applications have been investigated (eg, preoperative sedation), but further study is needed.
Place in therapy: A significant therapeutic advantage over the benzodiazepines due to its low incidence of adverse effects such as daytime sedation, amnesia, tolerance, dependence, and rebound insomnia upon withdrawal after therapeutic doses. Patients whose insomnia does not resolve after 7 to 10 days should be evaluated for other causes of sleep disturbance. Zolpidem has no anxiolytic properties, thus overuse is possible when used in anxious patients for sleep induction.
ContraindicationiGUse with caution in elderly or debilitated patients, patient with respiratory impairment, patient with hepatic impairment.
Adverse effectiGAdverse effects have been infrequent; anxiety, dizziness, drowsiness, fatigue, headache, irritability, diplopia, and muscle tremors have been reported
Usual dosageiGAdults: 10-20 mg PO QN immediate before sleep; Elderly patients and patients with hepatic impairment should be given an initial dose of 5 mg.
Special precautionsiGResp insufficiency, myasthenia gravis, hepatic & renal insufficiency.

ZOPICLONE

SupplyiG7.5MG/TAB(IMOVANER), 7.5MG/F.C.TAB(GENCLONER)
UseiGZopiclone is a short-acting non-benzodiazepine hypnotic agent. It is effective in the treatment of insomnina.
Place in therapy: In comparison with rapid eliminated benzodiazepines, it offers little or no advantage with regard to residual effects. Rebound insomnia has been reported.
ContraindicationiGHypersensitivity to Zopiclone; caution in patient with severe liver disease and elderly with moderate-to-severe liver disease. The drug should not be prescribed for longer than 28 days.
Adverse effectiGCommon adverse effects of zopiclone are dryness of the mouth and bitter taste, redisual sedation/psychomotor impairment, and rebound insomnia. Physical dependence, psychiatric reaction, including hallucinations, have been reported.
Usual dosageiG7.5 mg PO QN, prolong use should be avoided; dose adjustment are not required in renal insufficiency or in the elderly.
Special precautionsiGPregnancy & lactation. Child <15 yr.

Antipsychotics

CHLORPROMAZINE HCL

SupplyiG50MG/TAB(WINTERMINR)
UseiGSchizophrenia, acute psychoses and to control the manifestations of acute mania; moderate to severe agitation, hyperactivity or aggressiveness in disturbed children, pre-operative medication.
ContraindicationiGPatient with comatose states, bone marrow depression, hypersensitivity to phenothiazines, jaundice, hepatic damage.
Adverse effectiGCNS depression, somnolene, hypotension, extrapyramidal symptoms, agitation, restlessness, convulsion, fever, dry mouth.
Usual dosageiGAdults: PO 10mg TID-QID, or 25mg BID or TID. For promot control of severe symptoms, 25mg IM, repeated 1 hour later, if needed followed by 25-50mg orally TID. Child: PO 0.5mg/kg Q4-6H as needed; IM 0.5mg/kg Q6-8H as needed; maximum dose: 1 g/day
Patient informationiGDo not stop taking unless informed by your physician; do not take antacid within 1 hour of taking drug; avoid alcohol; avoid excess sun exposure (use sun block); may cause drowsiness, rise slowly from recumbent position; use of supportive stockings may help prevent orthostatic hypotension

CLOPENTHIXOL

SupplyiG10MG/TAB(CLOPIXOLR), 200mg/ml/AMP(CLOPIXOL-DEPOTR, 50MG/ML/AMP(CLOPIXOL-ACUPHASER)
UseiGAcute &chronic schizophrenia, psychoses, mania. Mental retardation associated psychomotor, excitation, agitation, violence &other behavioural disturbances.
ContraindicationiGAcute alcohol, barbiturate &opiate intoxication. Pregnancy.
Adverse effectiGExtrapyramidal syndrome; drowsiness, dry mouth, urinary retention, disturbed accommodation, tachycardia, postural hypotension, dizziness. Tardive dyskinesia.
Usual dosageiGChronic schizophrenia & other chronic psychoses 20-40 mg/day. Agitation & confusion in senile patients 2-6 mg/day, may be increase to 10-20 mg/day. Acute schizophrenia, psychoses, agitation, mania Amp 5-20 mg IM up to qid. Tab 10-50 mg/day.
Special precautionsiGHepatic or renal impairment, CV insufficiency, convulsive disorders; may impair ability to drive or operate machinery.

CLOZAPINE

SupplyiG25MG/TAB(CLOPINER,MEZAPINR), 100MG/TAB(CLOZARILR, MEZAPINR)
UseiGClozapine is an atypical antipsychotic agent and a tricyclic dibenzodiazepine derivative.
Place in therapy: The drug has demonstrated efficacy in the therapy of treatment-resistant schizophrenic patients. Because of the higher risk of agranulocytosis, clozapine should be reserved for those treatment-resistant patients who have not responded to adequate trials of other antipsychotic agents.
ContraindicationiGmyeloproliferative disorders, uncontrolled epilepsy, central nervous system depression, comatose state, and a history of clozapine-induced agranulocytosis
Adverse effectiGCommon adverse effects include sedation, dry mouth, nausea, constipation, and sialorrhea. Agranulocytosis is a serious adverse effect of clozapine; white blood cell counts should be monitored weekly for 6 months and every other week thereafter.
Usual dosageiGAdults: 300-600 mg/day; 50-900 mg/day have also been effective; Withdrawal schedule: Gradually reduce the dose over a 1-2 week period.
Child: Safety and effectiveness for use in child has not been established. But for 12-17 y/o as an initial dose of 12.5 -25 mg/day and increased every 4 days by one or two times the starting dose has been reported.

FLUPENTHIXOL

SupplyiG1MG/TAB(FLUANXOLR), 3MG/TAB(FLUANXOL DRAGESSR) 20MG/1ML/AMP(FLUANXOL DEPOR)
UseiGAnxiety, behavior disorders, schizophrenia.
ContraindicationiGComatose patients, particularly those under the influence of alcohol, barbiturate, narcotics or other CNS depression, and in patients with bone marrow depression.
Adverse effectiGExtrapyramidal symptom, restlessness, insomnia, depressive reaction, urinary incontinence, weight gain.
Usual dosageiGAdults: PO 0.5-2mg/day for depression, 16-224mg/day for acute pschosis; IM 10mg/month to 100mg/week.
Child: PO 0.4-2mg/day for 6 months has been used in psychotic/aggressive children
Special precautionsiGHepatic disease, CV or resp disorders, pheochromocytoma, epilepsy, pregnancy, lactation.

HALOPERIDOL

SupplyiG0.5MG/TAB(HALDOLR), 2MG/TAB(ANINR)
UseiGAntidyskinetic (in Gilles de la Tourette’s disease), antipsychotic. Depot injection is for the maintenance treatment of psychosis.
ContraindicationiGPatient with severe toxic CNS depression or comatose states or parkinson’s disease or hypersensitivity to haloperidol. Neurologic disorders accompained with pyramidal or extrapyramidal symptoms.
Adverse effectiGExtrapyramidal reaction, tachycardia, hypotension, leukopenia, maculopapular and acne form skin reactions, anorexia, constipation.
Usual dosageiGAdults: PO 0.5-2mg BID or TID; for severe symptoms 3-5mg BID or TID, up to a maximum of 100mg/day; for prompt control of moderate to severe symptoms, IM 2-5mg Q1-8H. For Depot injection: IM 50-100mg and 150-200mg every 4 weeks is sufficient for mild and moderate conditions, higher dose 250-300mg for severe case is required.
Special precautionsiGChildren. Hyperthyroidism, hepatic dysfunction, CV disorders.

RISPERIDONE

SupplyiG2MG,3MG/CAP(RISPERDALR)
UseiGRisperidone is indicated for the management of the manifestations of psychotic disorders.
Place in therapy: In contrast to conventional neuroleptics, risperidone act mainly as dopamine antagonists, and blocks both 5-HT2 and dopamine D2 receptors. It may be less likely to cause extrapyramidal symptoms and tardive dyskinesias than other antipsychotics.
ContraindicationiGHypersensitivity to risperidone hyperpro-lactinemia, children and adolescents
Adverse effectiGSedation is the most prominent adverse effect; other infrequent effects include headache, dry mouth, constipation, blurred vision, and urinary retention. Palpitations, nervousness, and lumbalgia have also been reported.
Usual dosageiGPsychotic disorders: 4-8 mg/day PO beginning with 1 mg BID initially, with increases in increments of 1 mg BID on the second and third day, as tolerated, to a target dose of 3 mg BID by the third day.

SULPIRIDE

SupplyiG200MG/TAB(UISPANR), 200MG/F.C.TAB(DOGMATYLR)
UseiGSulpiride is a selective dopamine D2 antagonist with antipsychotic and antidepressant activity. It is used for tranquillization, antipsychotic, mood elevating, antiemetic, anti-gastrin secretion.
ContraindicationiGHypersensitivity, phaeochromocytoma, hypertension
Adverse effectiGPredominant adverse effects have been extra-pyramidal reactions and sedation. Tardive dyskinesia has been reported; similar to other neuroleptics, sulpiride has been associated with neuroleptic malignant syndrome and cholestatic jaundice. Other adverse effects are sleep disturbances, over-stimulation, and agitation
Usual dosageiG1. Schizophrenia: PO, initial: 200-400mg BID, increased if necessary, up to maximum 1.2g/day.
2. Child: 3-5mg/kg
3.Gastric and duodenal ulcers: 150-300mg daily

THIORIDAZINE HCL

SupplyiG25MG/F.C.TAB(MELLERILR)
UseiGSchizophrenia and acute psychosis.
ContraindicationiGPatient with extreme hypotensive or hypertensive heart disease or severe CNS depression or comatose states.
Adverse effectiGDrowsiness, pseudo-parkinsonism, extra-pyramidal symptoms, dry mouth, blurred vision, constipation, dermatitis, urticaria.
Usual dosageiGAdults: 50-100mg TID to start, followed by a gradual increase up to 800mg/day for control, then 200-800mg/day in 2-4 divided doses. Child (2-12 yr): 10mg BID or TID to start, followed by large doses until optimum responses is obtained or maximum dosage 3mg/kg/day is reached.
Patient informationiGOral concentrate must be diluted in 2-4 oz of liquid (water, fruit jiuice, carbonated drinks, milk, or pudding); do not take antacide within 1 hour of taking drug; avoid excess sun exposure; may cause drowsiness, restlessness, avoid alcohol and other CNS depressants; do not alter dosage or discontinu without consulting physician; yearly eye exams are necessary; might discolor urine(pink or reddish brown)

Drugs used for affective disorders

AMITRIPTYLINE HCL

SupplyiG25MG/CAP(SAROTEN RETARDR)
UseiGDepression, especially endogenous depression.
ContraindicationiGHypersensitivity, wait at least 14 days after discontinuing MAO inhibitors before initiating amitriptyline therapy.
Adverse effectiGHypotension, tachycardia, palpitations, arrhythmia, confusion, dry mouth, blurred vision, urinary retention, bone marrow depression, constipation.
Usual dosageiGQID to start, replace with oral therapy as soon as possible. Adults: PO 75mg/day divided to start, followed by increase in late-afternoon or bedtime dose, up to 150mg/day.
Special precautionsiGConvulsive disorders. Urinary retention. Advanced hepatic disease. Suicidal tendency. Attacks of intermittent blurring of vision, rainbow vision & ocular pain. Elder, child <5 yr

CITALOPRAM

SupplyiG20MG/TAB(CIPRAMR)
UseiGDepression.. Panic disorders.
Adverse effectiGDry mouth, nausea, increased sweating & tremor, somnolence
Usual dosageiGInitially 20 mg once a day. Max: 60 mg daily. Elderly > 65 yr 20mg daily, may be increased to a max of 40 mg daily.
Special precautionsiGPregnancy, lactation, mania.

FLUOXETINE

SupplyiG20MG/CAP(SINZACR, U-ZETR, PROZACR)
UseiGIt is an antidepressant that is a specific inhibitor of serotonin reuptake. It is as effective in the treatment of depression as amitriptyline, imipramine and doxepin but with lower degree of toxicity.
ContraindicationiGUse with cautison in patient with renal or hepatic disease. The washout period between use of fluoxetine and MAOI is 5 weeks.
Adverse effectiGNausea, hypotension, headache, anxiety, nervousness, insomnia, dry mouth, anorexia and visual disturbances, weight loss.
Usual dosageiG20 to 80mg/day, range from 5-60mg/day has been suggested.
Special precautionsiGControlled epilepsy, renal & hepatic impairment, insomnia if treatment in the evening.

IMIPRAMINE

SupplyiG10MG/TAB(TOFRANILR), 25MG/S.C.TAB(IMINER)
UseiGDepression, especially endogenous depression and childhood enuresis.
ContraindicationiGHypersensitivity to imipramine or other benzodiazepines; wait at least 14 days after discontinuing MAO inhibitors before initiating imipramine therapy, myocardial infarction during acute recovery phase.
Adverse effectiGDrowsiness, tachycardia, congestive heart failure, mydriasis, convulsion, hypotension, confusion, dry mouth, bone marrow depression, nausea, vomiting
Usual dosageiGAdults: PO 75mg/day to start, followed by up to 200mg/day if needed, usual maintenance dose: 50-150mg/day.
Special precautionsiGConcomitant administration with MAOIs. CV disturbances, AV block (grades I-III), arrhythmias, hypotersion. Narrow-angel glaucoma, disturbances of micturition, lowered convulsion threshold. Road users. Pregnancy, lactation.

LITHIUM CARBONATE

SupplyiG300MG/TAB(LIDINR), 300MG/CAP(LITHONATER), 400MG/F.C.TAB(CAMCOLIT-400R)
UseiGManic episodes of manic depressive illness.
ContraindicationiGPatient with renal impairment or cardiac disease.
Adverse effectiGDiarrhea, vomiting, drowsiness, arrhythmia, muscular weakness, hypotension, blurred vision, dry mouth.
Usual dosageiGAdults: For acute episode, 600mg TID; for maintenance 300mg TID or QID; maximum dose: 2.4 g/day
Special precautionsiGElderly. Diuretic therapy. Pregnancy. Pre-treatment & periodic routine clinical monitoring is essential.

MOCLOBEMIDE

SupplyiG150MG/F.C.TAB(AURORIXR, EUTAER)
UseiGMoclobemide is a selective and reversible inhibitor of monoamine oxidase-A. Moclobemide is effective in the treatment of endogenous and non-endogenous depression.
Place in therapy: In most comparative studies, moclobemide has been better tolerated than tricyclic antidepressants, particularly with regard to a lower frequency of anticholinergic effects. No interaction has been reported between moclobemide and tricyclic antidepressants.
ContraindicationiGPrevious hypersensitivity to moclobemide; in patients in an acute confusional state. The concomitant use of moclobemide with selective serotonin reuptake inhibitors, conventional MAO inhibitors, or tricyclic antidepressants is contraindicated. Moclobemide should not be used in combination with meperidine.
Adverse effectiGThe most frequent adverse effect of moclobemide is dry mouth (28%); other adverse effects include dizziness, headache, tremor, insomnia, constipation, nausea, blurred vision, hypotension, and tachycardia. Hypertensive responses as a result of tyramine interaction have been relatively rare.
Usual dosageiGAdults: 300 to 600 mg daily, in 3 divided doses; in patient with liver cirrhosis, a one-half to one-third dose reduction is suggested.
Special precautionsiGAcute confusional states. Pregnancy, lactation; ped age group. Depressive patients excitation or agitation as the predominant clinical feature should be treated in combination with a sedative.

SERTRALINE

SupplyiG50MG/F.C.TAB(ZOLOFTR)
UseiGSertraline is an antidepressant with selective inhibitory effects on presynaptic serotonin (5-HT) reuptake. It is effective in the treatment of depression, obsessive compulsive disorder (OCD), and panic disorder.
Place in therapy: Sertraline is unique among the antidepressants because it seems to cause less of the sedating, anticholinergic, and cardiovascular adverse effects common to other agents, possibly due to its high specificity for the serotonin receptor.
ContraindicationiGConcurrent use of monoamine oxidase inhibitor (MAOI) drugs. At least 2 weeks are required after ceasing a MAO inhibitor and then begin the drug, and.vis versa.
Adverse effectiGNausea and vomiting may occur, as may diarrhea and dry mouth.
Usual dosageiGInitial doses:50 mg PO QD; maximum doses are 200 mg PO QD
Special precautionsiGHepatic insufficiency; electroconvulsive therapy, unstable epilepsy; may impair ability to drive or operate machinery; pregnancy, lactation; children.

TRAZODONE HCL

SupplyiG50MG/TAB(MESYRELR), 100MG/TAB(TRAZONER)
UseiGTrazodone is used primarily in the treatment of mental depression or depression/anxiety disorder.
Place in therapy: Trazodone may be safely combined with MAOIs for refractory depression. Disadvantages of trazodone include a high incidence of priapism, orthostatic hypotension, and induction or exacerbation of atrial and ventricular arrhythmias. However, compared with the TCAs, trazodone is still considered less cardiotoxic.
ContraindicationiG1) Hypersensitivity to trazodone 2) Carcinoid syndrome 3) Trazodone is not recommended for use during initial recovery phase of myocardial infarction.
Adverse effectiGTrazodone has a low incidence of anticholinergic effects and cardiovascular effects. Adverse effects includes: ventricular arrhythmias, hypotension, heart block, drowsinness, weight gain, blurred vision, dizziness, and priapism.
Usual dosageiG50-600mg daily, usually response range between 100-300mg daily in single or divided dose.
Special precautionsiGPregnancy & lactation. Children <18yr

VENLAFAXINE

SupplyiG37.5MG/TAB(EFEXORR)
UseiGTreatment of depression, including depression associated with anxiety, in both hospitalized patients & outpatients.
ContraindicationiGConcomitant use in patient taking MAOIs. Pregnancy, lactation. Children <18yr.
Adverse effectiGDizziness, dry mouth, insomnia, nervousness, somnolence, anorexia, constipation, nausea, abnormal ejaculation/orgasm, sweating, asthenia.
Usual dosageiGUsually 75mg/day in 2 divided doses. Dose may be increased to 150mg/day in 2 divided doses.

Antiepileptic drugs

CARBAMAZEPINE C

SupplyiG200mg/Tab(TEGOLR), 200mg/F.C.Tab(TEGRETOL CRR)
UseiGFor relief of pain associated with trigeminal neuralgia and use to control grand mal and psychomotor or partial seizure.
ContraindicationiGPatients with previous bone marrow depression, hypersensitivity to carbamazepine and with a hisotry of cardiac, hepatic, or renal disease.
Adverse effectiGDizziness, ataxia, drowsiness, nausea, vomiting, agitation, tremor.
Usual dosageiGEpilepsy: initial dose 100-200mg, 1-2 times daily, gradually increased of 200mg/day to a usual maintenance dose of 0.8 to 1.2g daily in 2-4 divided doses up to 1.6g/day. Trigeminal neuralgia: initial dose 100mg BID, increased by 200mg daily up to 1.2g daily, usual maintenance dose 400-800mg daily in 2-4 divided doses.
Tegretol controlled release Tab can be divided into two parts but can not be crashed. For shifting from convensional tablet to controlled release form, increasing of 10-20% dose is recommended. For a 300 mg TID patient, 3 weeks are required for dose shifting to 500 mg CR BID.
Patient informationiGTake with food, may cause drowsiness, periodic blood test monitoring required; notify physician if you observe bleeding, bruising, jaundice, abdominal pain, pale stools, mental distrubances, fever, chills, sore throat, or mouth ulcers

CLONAZEPAM B

SupplyiG2mg/Tab(RIVOTRILR)
UseiGMajority of clinical forms of epileptic disease in infants & children esp typical or atypical petient mal epilepsy, tonic-clonic seizure, status epilepticus. Adult epilepsies & in focal seizures
Adverse effectiGTirdness, sleepiness, lassitude, muscular hypotonia, muscle weakness, dizziness, lightheadedness, ataxia, slowed reaction, poor conc., restlessness, confusion, disorientation; anterograde amnesia, depression. Increased production of saliva or of bronchial secretions in infants & young children
Usual dosageiGAdult 4-8 mg. Child >6 yr 3-6 mg, Small child 1.5-3 mg. Infant 0.5-1 mg. Divided into 3 or 4 doses daily.

PHENYTOIN D

SupplyiG100mg/Cap(DILANTINR), 250mg/5ml/Amp(ALEVIATINR)
UseiG1. Grand mal seizures and psychomotor seizures.
2. Ventricular tachycardia, paroxysmal atrial tachycardia.
3. Digitalis intoxication induced arrhythmias.
ContraindicationiGHypersensitivity to hydantoins, hemopoietic disorders, hepatic disease.
Adverse effectiGDrowsiness, ataxia, diplopia, GI disturbance, gingival hyperplasia, thrombocytopenia, agranulocytosis, osteomalacia.
Usual dosageiG1. Grand mal and psychomotor seizure: Adults: PO, initial dose 100mg TID, increase in dosage to a maximum of 600mg/day, usual maintenance dose: 300-400mg daily. IV, initial dose 150-200mg given at a rate not exceeding 50mg/min. Child: PO, initial dose 5mg/kg/day in 2-3 divided dose, maintenance dose 4-8mg/kg/day. IV, may be given 15-20mg/kg, at a rate not exceeding 1-3mg/kg/min.
2. Cardiac arrhythmias: IV, usual dose 3.5-5mg/kg, given at a rate not more than 50mg/min, electrocardiographic monitoring is recommended.

TOPIRAMATE

SupplyiG100mg/F.C.Tab(TOPAMAXR), 25mg/ F.C.Tab(TOPAMAXR)
UseiGAdjunctive therapy in adults & children greater than or equal to 2 yr with partial seizures, seizures associated with the Lennox-Gastaut Syndrome, as well as tonic-clonic
ContraindicationiGPregnancy
Adverse effectiGAtaxia, impaired conc, confusion, dizziness, faigue, paresthesia, somnolence, abnormal thinking. Less commonly, agintation, dizziness, fatigue, paresthesia, somnolence, abnormal thinking. Less commonly, agitation, amnesia, anorexia, aphasia, depression.
Usual dosageiGAdult 200-600 mg/day in 2 doses. Max:800 mg/day. Child greater than or equal to 2 yr 5-9 mg/kg/day in 2 doses.

VALPROIC ACID D

SupplyiG500mg/Cap(CONVULEXR)
UseiGGeneralized seizures, partial seizures
ContraindicationiGDisturbances of hepatic or pancreatic functions
Adverse effectiGNausea, vomiting, anorexia, increased appetite, weight gain, gastralgia, gastrospasm, diarrhea & constipation. Rarely, sedation, vertigo, headache, depressive deterioration, aggression, involuntary movements, hyperactivity, tonic cramps, ataxia, coordination disturbances, tremor, asterixis, dysarthria, nystagmus, diplopia.
Usual dosageiGInitially 15 mg/kg daily. Dosage should be increased by 5-10 mg/kg/wk, generally up to 30 mg/kg body wt daily.

SOD. VALPROATE

SupplyiG20%/40ml/Bot(DEPAKINER)
UseiGSimple and complex absence seizures, including petit mal.
ContraindicationiGHypersensitivity to valproic acid, hepatic or renal function impairment, blood dyscrasias.
Adverse effectiGNausea, vomiting, GI irritation, drowsiness, ataxia, transient alopecia, liver dysfunction.
Usual dosageiGAdult: Initial dose: 10-15mg/kg/day, increased by 5-10mg/kg daily at one week intervals until seizures are controlled, maximum recommended dosage is 60mg/kg/day. Child: 25-30 mg/kg/day of Depakin chron; Switch from Depakin to Deparkin chrono: in a three-day base from 1500 mg Deparkin to Chrono form, day 0: 500 mg QD of Deparkin, day 1: conventional form 1 Tab QD and chrono 1 Tab TID, day 2: chrono 1 Tab QD and 2 Tabs QN, day 3: chrono 3 Tab QD or QN.

VIGABATRIN

SupplyiG500mg/F.C.Tab(SABRILR)
UseiGVigabatrin is a derivative of gamma-aminobutyric acid that is used as an anticonvulsant. It is an effective adjunctive anticonvulsant for the treatment of multidrug-refractory complex partial seizures in adults. It is also effective in resistant partial seizures and infantile spasms in children and adolescents.
ContraindicationiGHypersensitivity to vigabatrin.
Adverse effectiGHeadache, ataxia, irritablility, behavior changes, anxiety, gastrointestinal disturbance, weight gain, and acute psychosis; psychosis has occurred upon abrupt withdrawal of vigabatrin.
Usual dosageiGAdults:for add-on therapy 2-3 g/day, increase to 4 g daily if necessary Child: 1-2 g/day.

Drugs used for parkinsonism

BIPERIDEN HCL C

SupplyiG2mg/Tab(AKINETONR)
UseiGArteriosclerotic, idiopathic postencephalitic parkin-sonism, drug-induced extrapyrimidal syndrome
ContraindicationiGClosed angle glaucoma, mechanic stenosis of the GI tract, hypersensitivity.
Adverse effectiGDry mouth, dizziness, fatigue, vertigo, gastric upset, mental confusion, transient postural hypotension.
Usual dosageiGPO 2mg TID or QID, PC.

*SINEMET25/250 C

ContentiGCARBIDOPA 25MG, L-DOPA 250MG
UseiGlisted in dosage
ContraindicationiGNarrow-angle glaucoma. Undiagosed skin lesions or history of melanoma. Hypersensitivity to any component of this product
Adverse effectiGDyskinesia including choreiform, dystonic & other involuntary movements. Mental changes including paranoid ideation & psychotic episodes; depression, development of suicidal tendencies;dementia; & GI disturbances.
Usual dosageiGSymptomatic treatment of Parkinsonism 1/2tab once or bid. Max:8 tab. Transfer from L-Dopa Stop L-Dopa therapy 12 hr befor Sinement 25/250 is started therapy

*MADOPAR

ContentiGCap:L-Dopa 100mg, Benserazide25mg
Tab: L-Dopa 200mg, Benserazide50mg
UseiGSymptomatic (postencephalitic, toxic or arterio-sclerotic) parkinsonism, except drug-induced parkinsonism, parkinson’s disease.
ContraindicationiGSeverely decompensated endocrine, renal, hepatic, cardiac disorders; psychosis and severe psychoneurosis; patient under 25 years old; pregnant women. No MAO inhibitors should be used concomitantly.
Adverse effectiGAnorexia, nausea, and vomiting, psychic disturbance.
Usual dosageiGInitial dose: 125mg TID then increased by 125mg weekly until the individual therapeutic dosage is reached up to 1.25g/day QID.
Pharmacokinetics: The bioavailablilty of Madopar HBS is 60% to those of conventional form. After ingestion HBS form need 3 hours to achieve serum peak concentration.
Note:The effects of levodopa are reduced or abolished by the concurrent use of vitamin B6 but no interaction occures with levodopa-carbidopa or levodopa-benserazide preperation.

PERGOLIDE B

SupplyiG50mcg/Tab(CELANCE 50R)
UseiGDopamine agonist, used as adjunct therapy with levodopa/carbidopa in long-term parkinsonian patients with clinical fluctuations. It is also effective in the treatment of hyperprolactinemia and acromegaly.
ContraindicationiGDisplayed hypersensitivity or idiosyncratic reactions to this drug or other ergot derivatives.
Adverse effectiGDyskinesias, dystonias, orthostatic hypotension, dizziness, confusion, somnolance, insomnia, nausea, constipation; CNS complain is most commonly hallucinations (8%) and confusion (2%) are the primary cause for drug withdrawal.
Usual dosageiGIn hyperprolactinemic and acromegalic patients: 0.025 to 0.5 mg/day, PO. In Parkinson’s disease: 2 to 3 mg, up to 10 mg/day in divided doses.

SELEGILINE C

SupplyiG5mg/Tab(SILTINR)
UseiGSelegiline is a monoamine oxidase (MAO) inhibitor that is specific for the MAO-B isozyme. It is effective in treating parkinsonian patients who develop fluctuations in response to chronic levodopa therapy and require maximum doses of the drug. The agent will allow lower doses of levodopa either alone or in combination with peripheral decarboxylase inhibitors. Selegiline may also be effective in delaying the need to initiate levodopa therapy in the early stage of Parkinson’s disease. Selegiline has also shown some benefit in the treatment of Alzheimer’s disease.
ContraindicationiGSelegiline is contraindicated for use with meperidine and patient with hypersensitivity to the drug.
Adverse effectiGSleep disturbances, psychosis, agitation, confusion, and dyskinesias, hypotension, anorexia, and increased libido; the adverse effects of agitation, confusion, and insomnia may occur more frequently in the elderly.
Usual dosageiGParkinsonism: PO 5-10mg QD; Depression: PO 5-30mg, QD. The doses should not exceed 10mg/day because of the risks associated with non-selective inhibition of monoamine oxidase (MAO).

TRIHEXYPHENIDYL HCL C

SupplyiG2mg, 5mg/Tab(BENZHEXOLR)
UseiGParkinsonism, extrapyramidal disorders due to reserpine & phenothiazine, muscle rigidity.
ContraindicationiGClosed angle galucoma, paralytic ileus or pyloric stenosis, prostatic enlargement.
Adverse effectiGDry mouth, fatigue, vertigo, gastric upset, psychotic disturbance
Usual dosageiGUsual dose 2mg TID or QID. Maximum dose: 15mg/day
Patient informationiGTake after meals or with food if GI upset occurs; do not discontinue drug abruptly; notify physician if adverse GI effects, rapid or pounding heartbeat, confusion, eye pain, rash, fever or heat intolerance occurs. Observe caution when performing hazardous takes or those that require alertness such as driving, as may cause drowsiness. Avoid alcohol and other CNS depressants. May cause dry mouth-adequate fluid intake or hard sugar free candy may relieve. Difficult urination or constipation may occur notify physician if effect persist; may increase susceptibility to heat stroke.

Skeletal muscle relaxants

BACLOFEN C

SupplyiG5mg/Tab(BACLOFENR)
UseiGTreatment of spasicity resulting from spinal crod & cerebral disease/injuries
Adverse effectiGSedation, dizziness, weakness, tiredness, CNS disturbances, hypotension. Rare resp difficulty, palpitations, chest pain, giddiness, GI disturbances, frequency of micturition. Skin reactions
Usual dosageiGInitially 5 mg tid for 3 days. Addition of 5 mg/dose every 3 days. Dose range:40-80 mg daily
Special precautionsiGRenal impairment. Pregnancy, lactation. Children <12yr. May impair ability to drive or operate machinery

CHLORMEZANONE

SupplyiG100mg/Cap(RELAXR)
UseiGAnxiety & tension states, musculoskeletal disorders associated with muscle spasm
ContraindicationiGPre-existting CNS depression or coma.
Adverse effectiGDrowsiness, rash, dizzines, flushing, nausea, depression, edema, urinary retention, weakness, excitement, tremor, confusion & headache. Rarely, serious skin reactions & cholestatic jaundice
Usual dosageiG1-2 tab tid
Special precautionsiGPregancy & lactation. Impaired liver, renal or resp function. Elderly, debilitated patients

MEPHENOXALONE C

SupplyiG200mg/Tab(DORSIFLEXR)
UseiGAll pain of vertebral origin or due to muscular spasm, which is often chronic.Torticollis, muscular rheumatism, muscular pain, cervical syndrome, pain due to extension, arthritis, spasm of the skeletal musculature.
Usual dosageiGAdults:1-2 tablets three times daily. Child of 6 to 15 years: 1/2 tablet three times with daily meal

ORPHENADRINE C

SupplyiG
MUSOLINR Orphenadrine25mg, Aspirin385mg, Caffeine30mg
SINSOLAXR Orphenadrine35mg, acetaminophen 450mg
UseiGReduces muscle rigidity, parkinsonism, extrapyra-midal dysfunction.
ContraindicationiGCardiospasm (mega-esophagus), tachycardia, glaucoma, urinary retention, myasthenia gravis, pyloric duodenal obstruction, bladder neck obstruction, stenosing peptic ulcer, prostatic hypertrophy.
Adverse effectiGDry mouth, blurred vision, dysurea, tachycardia, increasing ocular tension, nausea, vomiting, headache, rash.
Usual dosageiG1 Tab BID

PANCURONIUM C

SupplyiG2mg/ml 2ml/Amp(PAVULONR)
UseiGAn adjunct to anesthesia to induce skeletal muscle relaxation, to facilitate the management of patients undergoing mechanical ventilation.
ContraindicationiGHypersensitivity to the drug or to the bromide.
Adverse effectiGProfound and prolonged skeletal muscle relaxation resulting in respiratory insufficiency or apnea, slight increase in pulse rate; salivation, wheezing.
Usual dosageiGAdults: Initial IV dosage range is 0.04-0.1ml/kg, later increment dose starting at 0.01mg/kg may be used. For endotracheal intubation: 0.06-0.1mg/kg. Child: The same as for adults. Neonates: A test dose of 0.02mg/kg be given first to measure responsiveness.
Special precautionsiGPre-existing pulmonary, renal disease; pregnancy & neonate acidosis; severe electrolyte disturbances

TOLPERISONE HCL

SupplyiG150mg/Tab(MYDOCALMR)
UseiGSpastic paralysis due to sequelae of stroke, cerebral palsy, SMON, spastic spinal paralysis, amyotrophic lateral sclerosis, cerebrospinal degeneration, multiple sclerosis, cervical spondylosis, sequelae to injury and operation, ossification of the posterior longitudinal ligament.
ContraindicationiGHepatic disease, hypersensitivity, used with caution when administered in conjuction with methocarbamol.
Adverse effectiGHepatic dysfunction, chest distress, respiratory disorder, weakness, lassitude, dizziness, headache, drowsiness, anorexia, abdominal pain, gastric and abdominal discomfort, nausea, vomiting, diarrhea, thirst, constipation, meteorism, sensation of gastric and abdominal distension, gastric oppression and pyrosis.
Usual dosageiGAdults: PO 300mg daily, divided into 3 equal parts.

Antivertigo drugs

PROCHLORPERAZINE C

SupplyiG5mg/Tab(NOVAMINR)
UseiGNausea, vomiting, excessive anxiety, relatively mild psychiatric conditions & moderate to severe psychiatric conditions.
ContraindicationiGComa, drug-induced CNS depression, bone marrow depression.
Adverse effectiGExtrapyramidal symptoms, CNS depression, deep sleep, coma, agitation, convulsions, hypotension, restlessness.
Usual dosageiGNausea & vomiting Adult 1 tab 1-4 times daily. Schizophrenia Adult 3-9 tab in 3 divided doses.

DIPHENIDOL

SupplyiG25mg/S.C.Tab(SINPHADOLR)
UseiGDiphenidol is an antiemetic agent. It may be used to treat nausea and vomiting or vertigo.
ContraindicationiGPatient who has hypersensitivity to the drug. Use with caution to those patient with glaucoma, GI obstruction, or GU disease.
Adverse effectiGThe most serious side effects are hallucinations, confusion, and disorientation. Diphenidol should only be administered to patients in the institutional setting.
Usual dosageiG25-50mg Q4H; diphenidol should not be used in child weighing less than 23kg.

DOMPERIDONE

SupplyiG10mg/Tab(MOTILIUMR)
UseiGDomperidone is a peripheral dopamine antagonist. It has been used in delayed gastric emptying, nausea and vomiting, gastroesopageal reflux disease, and miscellaneous indications.
ContraindicationiGHypersensitivity.
Adverse effectiGGalactorrhea, seizures, and cardiac arrhythmias have been reported.
Usual dosageiGFor nausea and vomiting, oral 20-30mg TID to QID.
For postprandial dyspepsia, oral 10mg TID 15 to 30 minutes before meals.

MECLIZINE B

SupplyiG25mg/Tab(BONAMINER)
UseiGPrevention and treatment of motion sickness and for the relief of allergic states, postoperative vomiting, drug induced nausea and vomiting.
ContraindicationiGHypersensitivity to meclizine, pregnancy.
Adverse effectiGDry mouth, dizziness, blurred vision, fatigue.
Usual dosageiGFor motion sickness: 25-50 mg should be taken 1 hour before travel. For severe nausea and vomiting: 25-50 mg BID or TID.
Special precautionsiGGlaucoma or prostatic enlargement. Avoid driving a car or operating machinery. Pregnancy

Drugs used in anesthesia

MIDAZOLAM D

Supply:5mg/ml 1ml,3ml/Amp(DORMICUMR), 7.5mg/F.C.Tab(DORMICUMR)
Use:Midazolam is effective for anesthesia induction, as a preanesthetic medication, a hypnotic prior to short surgical procedures and in the treatment of insomnia.
Place in therapy: Midazolam produces a more rapid onset and less venous irritation of anesthesia induction than diazepam. It also can be considered as an alternative to thiopental although it has a slower onset of action. Midazolam appears to offer no advantage over triazolam as a hypnotics for insomnia.
Contraindication:Hypersensitivity to midazolam or other benzodiazepines. Patients with narrow angle glancoma.
Adverse effect:Respiratory depression, apnea, injection site pain and phlebitis(less than diazepam).
Usual dosage:For anesthesia: 0.15 to 0.3 mg/kg IV; doses of 0.1 mg/kg IM have been effective for anesthetic premedication. For conscious sedation: 0.05-0.1 mg/kg IV, maintenance of sedation in increament of 25% of initial dose may be given by slow titration; 1 mg/ml is recommended for titration, no more than 2.5 mg should be given over at least 2 minutes. DO NOT ADMINISTER AS A BOLUS DOSE. Maximal dose: some cases showed 0.3-0.85 mg/kg (20-55 mg/hr) without respiratory depression or hypnotic. Benzodiazepines equivalent: 3-4 times as potent per milligram as diazepam. For mild to moderate renal failure, no dose adjustments are required; for severe renal failure ( CrCl<10 ml/min) the dose should be decrease by 50%.

BUPIVACAINE C

Supply:0.5% 20ml, 4ml(MARCAINER)
Use:Peripheral nerve block, infiltration, sympathetic block, caudal or epidural block.
Contraindication:Hypersensitivity to marcaine.
Adverse effect:During prolonged epidural block, venous stasis and pressure sores may develop. Foetal bradycardia has been reported following paracervical block during labor and may require the administration of atropine sulfate intravenously.
Usual dosage:
1. Local infiltration: 0.25% solution .
2. Epidural block: 0.25% 0r 0.5% solution.
3. Caudal block: 0.25% or 0.5% solution
4. Peripheral nerve block: 0.25% or 0.5% solution.
5. Sympathetic block: 0.25% solution .
The maximum dose is 2mg/kg in any 4 hours period equivalent to 25-30ml of 0.5% solution.
Special precautions:Resuscitative equipment & drugs should be immediately available when local anaesth is used; do not administer if presence of blood is noted in attempting lumbar puncture.

ISOFLURANE C

Supply:250ml/Bot(FORANER)
Use:Inhalation on anesthesia.
Contraindication:Known sensitivity to forane or history of malignant hyperpyrexia.
Adverse effect:Arrhythmias, elevation of the white blood cell count, hypotension, respiratory depression.
Usual dosage:Vaporisers specially calibrated for forane should be used so that the concentration of anesthetic delivered can be accurately controlled. MAC values for forane diminish with age, falling from an average in oxygen of 1.28% in the mid-twenties to 1.15% in the mid-forties, to 1.05% in the mid-sixties age group.
Special precautions:Uterine curettage. Patients with increased intracranial pressure

LIDOCAINE C

Supply:1) Local anesthesics (Local use) : Inj 2% 20 ml/Vial,
2% with epinephrine (1:80,000) 20ml/Vial
2) Antiarrythmics (Inj for IV): 2% 5ml, 10% 10ml.
Use:Local anesthesia, acute management of cardiac arrhythmia.
Contraindication:Hypersensitivity to local anesthetics of the amide type, Adam’s-stokes syndrome, sinoatrial, atrioventricular or intraventricular heart block, hypovolemia.
Adverse effect:Less tolerant to local anesthetics, excitation of the CNS, arrhythmias and cardiac arrest may occur.
Usual dosage:1. Direct IV, adults : 50-100mg, rate 25-50mg/min, repeat if necessary, in one hour period 200-300mg. 2. IV infusion, adults : 20-50mg/kg/min, ECG monitoring. 3. Usual initial adult dose: without epinephrine not exceed 300mg, with epinephrine not exceed 500mg 4. Child, use of 0.5 or 1% solution.
Special precautions:Traumatised mucosa & sepsis

PROPOFOL B

Supply:10mg/ml 20ml/Amp(RECOFOLR)
Use:Inducing and/or maintaining general anesthesia, either in combination with other anesthetics or as the sole hypnotic agent.
Contraindication:Hypersensitivity to propofol or its inactive ingredients: soy-bean oil and egg phosphatide, should not receive this drug.
Adverse effect:Pain on injection, apnea, dose-related hypotension, headache, dizziness, twiching, bucking, jerking, throshing, seizure, heart block, temporary reduction in serum cortisol, porphyria, urine discoloration (green urine).
Usual dosage:Initial: 2-2.5mg/kg anesthesia, maintenance: 9-12 mg/kg/hr.

SEVOFLURANE B

Supply:250ml/Bot(ULTANER)
Use:Induction & maintenance of general anesthetics.
Contraindication:Known or suspected genetic susceptibility to malignant hyperthermia
Adverse effect:Dose-dependent cardio-resp depression, nausea, vomiting, hypotension.
Usual dosage:Induction: Individualized dosage
Special precautions:Coronary artery disease; renal or hepatic impairment; patients at risk for ICP elevations. Pregnancy, lactation.

THIAMYLIL

Supply:300mg/Amp(CITOSOLR)
Use:Anaesth for diagnostic & surgical procedures; induction of anaesth or to supplement low potency agent
Contraindication:Liver disease
Adverse effect:Induced-asthma
Usual dosage:Individualised dosage
Special precautions:Shock condition

THIOPENTAL SOD. C

Supply:2.5mg/Vial(PENTOTHALR)
Use:Anesthetic agent for brief surgical procedures, induction of anesthesia, control of convulsive states.
Contraindication:Complete absence of suitable veins for IV administration, hypersensitive to barbiturates, status asthmaticus, latent or manifest porphyria.
Adverse effect:Coughing, sneezing, hypersensitivity, respiratory depression, cardiac arrhythmia.
Usual dosage:Induction anesthesia, usual dose: IV 50-75mg (2-3ml of a 2.5% solution) at intervals of 20-40 seconds depending on the reaction of the patient. Use in convulsive states: IV 75-125mg (3-5ml of a 2.5% solution) should be given as soon as possible after the convulsion begins.
Special precautions:Moderate hypertension; excessive premed, hepatic dysfunction, increased blood urea, severe anemia; severe CV diseases, raised intracranial pressure, asthma, myasthenia gravis, severe uremia. Elderly.

CARDIOVASCULAR DRUGS

DIGOXIN C

Supply:0.25MG/TAB(LANOXINR)
Use:Congestive heart failure, atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia, cardiogenic shock.
Contraindication:Ventricular fibrillation, digitalis intoxication.
Adverse effect:GI disturbance, anorexia (the earliest symptom of digoxin overdose), cardiac arrhythmia, and conduction defect.
Usual dosage:Adults : Oral : rapid digitalization: 0.75-1.5mg, maintenance dose: 0.125-0.25mg; IV: rapid digitalization: 0.75mg initially, 0.25mg Q2-4H, maximum dose: 1.0-1.5mg. Infants and Child: 10-20mg/kg/day by mouth or by injection.
Patient information:Do not discontinue medication medication without checking with physician; notify physician if loss of appetite or visual changes occur
Mechanism:
Congestive heart failure : Inhibition of the sodium/potassium ATPase pump which acts to increase the intracellular sodium-calcium exchange to increase intracellular calcium leading to increased contractility
Supraventricular arrhythmias: Direct suppression of A-V node conduction to increase effective refractory period and decrease condu ction velocity-positive inotropic effect, enhanced vagal tone, and decreased ventricular rate to fast atrial arrhythmias. Atrial fibrillation may decrease sensitivity and increase tolerance to higher serum digoxin concentrations.

DOBUTAMINE C

Supply:12.5MG/ML,20ML(UTAMINER)
Use:Used to increase cardiac output in the short-term treatment of patients with cardiac decompensation caused by depressed contractility from organic heart disease or cardiac surgical procedures.
Contraindication:Patients with idiopathic hypertropic subaortic stenosis
Adverse effect:Ectopic heartbeats, increased heart rate, angina, chest pain, palpitation, and elevations in blood pressure.
Usual dosage:The rate of infusion needed to increase cardiac output is 2.5-10mg/kg/min. On rare occasions infusion rates up to 40mg/kg/min have been required to obtain the desired effect.

DOPAMINE C

Supply:200MG/5ML(INTROPINR)
Use:Shock, cardiac disorders
Contraindication: Pheochromocytoma, uncorrected tachycardias, or ventricular fibrillation, Parkinson’s disease
Adverse effect:Nausea, vomiting, ectropic beats, palpitation tachycardia, angina pain, dyspnea, headache, excessive vasoconstriction, hypertension.
Usual dosage:IV drip 5-10mg/kg/min as needed, do not add to alkali solution.
Special precautions:During anaesth with cyclopropane, halothane &other halogenated anaesth

AMIODARONE D

Supply:200MG/TAB(CORDARONER)
Use:Amiodarone is effective for the treatment of life-threatening recurrent ventricular fibrillation and tachycardia that has been unresponsive to adequate dose of other antiarrhythmic agents. It is also effective in refractory supraventricular arrhythmias.
Contraindication:Bradycardia, impairment of A-V conduction, heart failure, patient with iodine sensitivity, disorders of the thyroid gland, exposure to sunlight.
Adverse effect:Benign yellowish-brown corneal microdepositis, photosensitivity, severe bradycardia, conduction disturbances, severe hypotension, hypo- or hyperthyroidism, peripheral neuropathy, extrapyramidal effects, nausea, vomiting, metallic taste, nightmares, vertigo, headache, sleeplessness and fatigue. The most common adverse effects requiring discontinuance of oral amiodarone are pulmonary infiltrates or fibrosis, paroxysmal ventricular tachycardia, congestive heart failure, and elevations of serum hepatic enzyme concentrations.
Usual dosage:Initial dose: 800-1600mg PO daily for 1-3 weeks. After adeqate control: 600-800mg daily for one month then 400mg daily. IV loading dose: 150mg at rate of 15mg/min over 10 min, then 360mg at rate of 1mg/min (over 6 hrs). IV maintenance dose: 540mg at rate of 0.5mg/min (over 18 hrs), after first 24 hrs the maintenance infusion rate of 0.5mg/min (720mg over 24 hrs) should be continued.
Patient information:Take with food; use sunscreen or stay out of sun to prevent burns; skin discoloration is reversible; photophobia may make sunglasses necessary; do discontinue abruptly; regular blood work for thyroid function tests and ophthalmologic exams are necessary; notify physician if persistent if persistent dry cough or shortness of breath occurs
Mechanism: Class III antiarrhythmic agent which inhibits adrenergic stimulation, prolongs the action potential and refractory period in myocardial tissue; decreases A-V conduction and sinus node function

MEXILETINE C

Supply:100MG/CAP(MEXITILR)
Use:Prevention and treatment of ventricular arrhythmia.
Contraindication:Sinus node dysfunction; conduction defect; bradycardia, hypotension; cardiac, renal or hepatic failure.
Adverse effect:Nausea, vomiting, indigestion, unpleasant taste, hiccups, lightheadedness, drowsiness, confusion, dizziness, diplopia, blurred vision, nystagmus, dysarthria, ataxia, tremor, paraesthesia, convulsions, sinus bradycardia, hypotension, atrial fibrillation, palpitations.
Usual dosage:PO initial: 400-600mg, followed by 200-250mg TID-QID, starting 2 hrs after the loading dose. maintenance: 600-800 mg/day in divided dose.
*Note:
1. Absorption may be delayed by concurrent use of anticholinergics or opiates.
2. Absorption may be enhanced by concurrent use of metoclopramide.

Sympatholytic drugs

ACEBUTOL B

Supply:100MG/CAP(SECTRALR), 400MG/TAB(SECTRALR)
Use:Acebutolol is effective in angina pectoris, hypertension and ventricular arrhythmias.
Place in therapy: All currently available b-blockers appear to be equally effective for the treatment of hypertension, however, b-blockers with cardioselectivity (i.e. atenolol, acebutolol) may be particularly effective in hypertension with asthma or diabetes. Since acebutolol has intrinsic sympathomimetic activity, it does not increase serum triglyceride levels or decrease HDL cholesterol, acebutolol may be useful in patients with dyslipidemia.
Contraindication:Persistently severe bradycardia, second degree and third degree heart block, overt cardiac failure, cardiogenic shock, avoid use with verapamil concomitantly.
Adverse effect:Hypotension, bradycardia, congestive heart failure, fatigue, headache, GI toxicity, decrease in FEV-1 in asthmatics, lupus-like reactions appear more commonly than with other b-blockers.
Usual dosage:Hypertension: 400-800mg QD or divided to BID use, Stable angina: 600-1600mg daily.
Patient information:Do not discontinue abruptly; consult pharmacist or physician before taking with other adrenergic drugs9eg. Cold medications); take at the same time each day; use with the caution while driving or performing takes requiring alertness
Special precautions:Abroupt withdrawal of beta-blockers may result in an exaggerated cardiac beta-adrenergic responsivenessSymptomatalogy has included reports of tachycardia, hypertension, ischemia, agina, myocardial infarction, and sudden death; abrupt withdrawal of the drug should be avoided; drug should be discontinued over 1-2 weeks

ATENOLOL C

Supply:50MG/F.C.TAB(ATENOLOLR), 50MG/TAB(MIROBECTR), 100MG/TAB(ATENOR, TENORMINR), 100MG/F.C.TAB(ATENOLOLR)
Use:Treatment of hypertension, alone or in combination with other agent; management of angina pectoris, postmyocardil infarction patients
Contraindication:Sinus bradycardia, cardiac shock, symptomatic CHF.
Adverse effect:Cold extremeties, muscular fatigue
Usual dosage:50-100mg QD.
Patient information:Adhere to dosage regimen; watch for postural hypotension; abrupt withdrawal of the drug should be avoided; take at the same time each day; use with the caution while driving or performing takes requiring alertness
Special precautions:abrupt withdrawal of the drug should be avoided; drug should be discontinued over 1-2 weeks; may potenitate hypoglycemia in a diabetic patient and mask signs and symptons; modify dosage in patients with reneal impairment

*SHPYNJA C

Content:Atenolol 100mg, chlorthalidone 25mg

CARVEDILOL C

Supply:25MG/TAB(DILATRENDR)
Use:Listed in Dosage.
Contraindication:Decompensated heart failure requiring IV inotropic support; asthma; COPD with bronchospastic component; clinically manifested liver dysfunction; 2nd & 3rd degree AV block; severe bradycardia(<50bpm); cardiogenic shock; sick sinus syndrome; severe hypotension (systolic BP<85 mmHg); pregnancy & lactation.
Adverse effect:Dizziness, headaches, fatigue, bradycardia, postural hypotension, hypotension, GI disturbances, flu-like symptoms, resp effects
Usual dosage:Essential hypertension Adult 12.5 mg once daily for the 1st 2 days. Thereafter 25 mg once daily. Max: 50 mg daily. CHF 3.125mg bid for 2 wks. Dosage may be increased at intervals of not <2 weeks, to 6.25 mg bid, followed by 12.5 mg bid thereafter 25 mg. Adult<85kg Max 25 mg bid, 85kg Max 50mg bid

LABETALOL HCL C

Supply:200MG/F.C.TAB(LABTALR), 5MG/ML,5ML/AMP(TRANDATER)
Use:All grades of hypertension.
Contraindication:Patients with digitalis resistant heart failure or atrioventricular block, asthma and prone to bronchospasm.
Adverse effect:Postural hypotension, scalp tingling, insomnia, GI discomfort, nasal stiffness, vivid dreams.
Usual dosage:PO : 200-400mg BID; IV : initial dose 50mg , if necessary, doses of 50mg may be repeated at 5 minutes interval until a satisfactory response occurs.
Patient information:Do not stop medication without aid of physician; may mask signs and symptoms of diabetes
Special precautions:Paradoxical increase in blood pressure has been reported with treatment of pheochromocytoma or clonidine withdrawal syndrome; use with caution in patients with hyper-reactive airway disease, congestive heart failure, diabetes mellitus, hepatic dysfunction; orthostatic hypotension may occur with I.V. administration

METOPROLOL

Supply:100MG/TAB(BETALOCR)
Use:Hypertension angina pectoris, cardiac arrhythmias, maintenance treatment of MI, functional heart disorders with palpitation. Migraine prophylaxis.
Contraindication:AV block II & III, uncompensated cardiac failure, cardiogenic shock & marked bradycardia
Adverse effect:Exertional tiredness, GI disturbances, slleep patterm disturbances. Cold extremities.
Usual dosage:100-200mg daily as a single dose

PROPRANOLOL C

Supply:10MG/TAB(INDERALR), 40MG/TAB(CARDOLOLR)
Use:Hypertension, angina pectoris, cardiac arrhythmia, prophylaxis of migraine, hypertrophic subaortic stenosis.
Contraindication:Second to third degree heart block, bronchial asthma, cardiogenic shocks, sinus bradycardia, allergic rhinitis during the pollen season, hypoglycemia, metabolic acidosis.
Adverse effect:Severe bradycardia, congestive heart failure, hypotension, bronchospasm
Usual dosage:PO 10-40mg TID or QID, maintenance dose: 160-480mg/day. For emergency of cardiac arrhythmia: IV 1-3mg (less than 1mg/min), maximum dose: 10mg.
Patient information:Do not discontinue abruptly; notify physician if CHF symptoms become worse or side effects develop; take at the same time each day; use with the caution while driving or performing takes requiring alertness
Special precautions:Administer very cautiously to patients with CHF, asthma, diabetes mellitus, hyperthyroidism. Abrupt withdrawal of the drug should be avoided, drug should be discontinued over 1-2 weeks; may potentiate hypoglycemia in a diabetic patient and mask signs and symptoms
Mechanism: Nonselective beta-adrenergic blocker(class II antiarrhythmic); competitively blocks response to beta1- and beta2-adrenergic stimulation

Angiotensin-I converting enzyme inhibitors

CAPTOPRIL

Supply:12.5MG/TAB(CAPTOPRIR), 25MG/TAB(CABUDANR, CAPOMILR)
Use:Severe hypertension, renovascular hypertension, congestive heart failure.
Contraindication:Patients with severe autoimmune disease, impaired renal function
Adverse effect:Skin rash, pruritus, taste disturbance, proteinuria (renal disease history); serum potassium concentration may be raised.
Usual dosage:Adults: Usual dose: 25-150mg TID, 1 hour AC; maximum dose: 450 mg/day. Child: Usual dose: 1mg/kg/day; maximum dose: 6 mg/kg/day.
Special precautions:Use with caution and decrease dosagein patients with reanal impairment(especially renal artery stenosis), sever congestive heart failure, or with coadministered diuretic therapy; experience in children is limited.
Patient Information:Take 1 hour befor meals; do not stop therapy except under prescriber advice; notify physician if you develop sore throat, fever, swelling, rash, difficult breathing, irregular heartbeats, chest pain,or cough. May cause dizziness, fainting, and lightheadedness, especially in first week of therapy; sit and stand up slowly

CILAZAPRIL

Supply:2.5MG/TAB(INHIBACER)
Use:Listed in Dosage
Contraindication:Patients with ascites. Pregnancy.
Adverse effect:Headache, dizziness. Fatigue, hypotension, dyspepsia, nausea, coughing. Rarely, angioneurotic edema.
Usual dosage:Essential hypertension,severe heart failure First 2 days half 2.5 mg tab omce daily, then 2.5-5 mg once daily. Renovascular hypertension Initially 0.5 mg or less. Heart failure Initially 1 mg up to 5 mg daily.
Special precautions:Symptomatic hypotension, liver cirrhosis, impaired renal function, surgery, anesth.

DOXAZOSIN MESYLATE

Supply:2MG/TAB(DOXABENR), 4MG/TAB(GENZOSINR)
Use:Doxazosin is a selective long-acting a-1-adrenergic antagonist, with a similar structure to prazosin. Once daily dose is effective alone or in combination with other antihypertensive agents in controlling mild to moderate essential hypertension.
Contraindication:Hypersensitivity to quinazolines such as prazosin and terazosin
Adverse effect:Orthostatic hypotension, dizziness, vertigo, and headaches are the most common adverse effects.
Usual dosage:Initial: 1mg daily and slowly titrated up to a maximum of 16mg QD or until blood pressure is adequately controlled. No dosing adjustments are required in elderly or renal failure patients.

ENALAPRIL MALEATE

Supply:5MG/TAB(RENITECR, SINTECR), 10MG/TAB(PERISAFER), 20MG/TAB(RENITECR, SYNBOTR)
Use:Enalapril is an angiotensin converting enzyme inhibitor. It has been used in hypertension, chronic heart failure. Theoretically, enalapril has advantages over captopril with respect to increase potency, longer duration of action, and possibly a reduction in side effects due to a lack of sulfhydryl moeity.
Contraindication:Hypersensitivity to enalapril or enalaprilat and other ACE inhibitors.
Adverse effect:The most frequent adverse effects are headache (4.8%), dizziness (4.6%), and fatigue (2.8%). Other adverse effects include diarrhea, rash, hypotension, cough, nausea, and orthostasis.
Usual dosage:Usual dosage:Hypertension: 5mg QD, blood pressure control: 10-40 mg daily; the dosage should be adjusted in patients with renal failure; maximum dose: 40mg/day
Dosage adjustment : according to CrCl (ml/min)
> 30 : 2.5mg QD
< 30 : initial dose 0.625mg
Patient Information:Notify physican if vomiting, diarrhea, excessive perspiration, or dehydration should occur; also if swelling of face, lips, tongue, or difficulty in breathing occurs or if persisten cough develops

HYDRALAZINE HCL C

Supply:25MG/S.C.TAB(APRESLOINER)
Use:Moderate to severe hypertension.
Contraindication:Coronary artery disease, hypersensitivity, mitral valve rheumatic heart disease.
Adverse effect:GI disturbance, anorexia, palpitation, tachycardia, angina pectoris, headache.
Usual dosage:PO : Adults: 10-50mg QID, up to 300mg/day may need, Child: 187.5-250mg/kg QID. IM, IV : Adults: 20-40mg, repeated as needed Q4-6H. Child: 425mg/kg QID.

INDAPAMIDE B

Supply:1.25MG/TAB(MILIXR), 2.5MG/F.C.TAB(NAKAMIDER, NATRILIXR)
Use:Essential hypertension
Contraindication:Anuria, hypersensitivity to sulfonamides, severe hepatis failure, recent cerebral vascular accidents.
Adverse effect:Orthostatic hypotension, allergic manifestations, fatigue.
Usual dosage:1.25-5 mg daily.
Special precautions:Hypokalemia, gout, pregnancy, lactation.

IRBESARTAN D

Supply:150MG/TAB(APROVELR)
Use:Treatment of essential hypertension
Contraindication:Pregnancy, lactation.
Adverse effect:Resp infection, headache, musculoskeletal pain, trauma, dizziness, fatigue, diarrhoea
Usual dosage:150mg once daily

LISINOPRIL D

Supply:10MG/TAB(GENOPRILR, ZESTRILR), 20MG/GENOPRILR)
Use:Lisinopril is effective in reducing blood pressure in patients with essential or renovascular hypertension, and is indicated as adjunctive therapy in patients with congestive heart failure.
Contraindication:Hypersensitivity, history of angioedema induced by other ACE inhibitors and pregnancy.
Adverse effect:Blood dyscrasias, hypotension, headache, fatigue, insomnia, hyperkalemia, nausea, diarrhea, taste disturbances, renal dysfunction, dry cough.
Usual dosage:5-10mg daily ; max. 80mg/day.
Dosage adjustment : according to CrCl (ml/min)
> 30 : initial dose 10 mg/day
10 – 30 : initial dose 5mg/day
< 10: initial dose 2.5 mg/day
depending on blood pressure response

METHYLDOPA B

Supply:250MG/TAB(ALDOMETR)
Use:Moderate to severe hypertension.
Contraindication:Active hepatic disease, eg: acute hepatitis, active cirrhosis, phaeochromocytoma.
Adverse effect:Drowsiness, sedation, headache, dizziness, asthenia, weakness, bradycardia, abnormal liver function tests.
Usual dosage:Initial dose: 250mg BID or TID, maintenance dose: 0.5-2.0g/day, maximum daily dose: 3g
Supply:10MG/TAB(LONITENR)
Use:Severe hypertension.
Contraindication:Pheochromocytoma.
Adverse effect:Sodium and water retension, hypertrichosis.
Usual dosage:Adults:Initial dose: 5mg/day to start, may be increase to 50 mg/day(QD or BID); usual maintenance dose: 10-40mg/day; maximum dose: 100mg/day. Child:Initial dose: 0.2mg/kg/ day, maximum dose: 1mg/kg/day

PERINDOPRIL D

Supply:4MG/TAB(ACERTILR)
Use:Severe hypertension.
Contraindication:Pheochromocytoma.
Adverse effect:Sodium and water retension, hypertrichosis.
Usual dosage:Adults:Initial dose: 5mg/day to start, may be increase to 50 mg/day(QD or BID); usual maintenance dose: 10-40mg/day; maximum dose: 100mg/day. Child:Initial dose: 0.2mg/kg/ day, maximum dose: 1mg/kg/day
Special precautions:Renal failure; renovascular hypertension; surgery/anesth; elderly. Hemodialysis: avoid combination with highly permeable membranes (polyacrylonitrile).

PHENOXYBENZAMINE HCL C

Supply:10MG/CAP(DIBENYLINER, LIMYR)
Use:Used to control or prevent paroxysmal hypertension and sweating in patients with pheochromocytoma.
Contraindication:Patients with marked cerebral or coronary arteriosclerosis or renal damage, and decrease in blood pressure is undesirable.
Adverse effect:Nasal congestion, miosis, postural hypotension with dizziness and tachycardia.
Usual dosage:PO, initial adult dosage: 10mg BID, then increased every other day, usually to 20-40mg 2 or 3 times daily, until an adequate response is achieved.
Special precautions:Elderly; ischaemic heart disease; marked arteriosclerosis; renal damage.

PRAZOSIN HCL C

Supply:1MG,2MG/TAB(MINIPRESSR)
Use:All grades of hypertension.
Adverse effect:Dizziness, headache, drowsiness, lack of energy, weakness, palpitations, postural hypotension, nasal congestion.
Usual dosage:Initial: 0.5-1.0mg BID or TID. Maximum dose: 20mg/day.
Note: Adrenaline should not be given to antagonize the hypotensive effects of prazosin in overdosage.

RAMIPRIL D

Supply:2.5MG/CAP(TRITACER)
Use:Hypertension
Adverse effect:Nausea, dizziness &headache, dry cough. Hypersensitivity reactions including pruritus, rash &fever.
Usual dosage:2.5 mg once daily. Patients on diuretics or with impaired renal function Initially 1.25 mg once a day. Usual dosage range: 2.5-10 mg

TERAZOSIN C

Supply:2MG/TAB(TERASRINR, TEZOPINR)
Use:Hypertension, benign prostatic hypertrophy, and heart failure.
Place in therapy: All of the available selective a-1-receptor blockers appear to be equally effective for the treatment of hypertension. Since a -1-adrenergic blockers may be safely used in patients with diabetes, congestive heart failure, asthma, and hyperlipidemia, they may be preferred initial agents.
For benign prostatic hyperplasia, surgical (transurethral prostatectomy) treatment is associated with an 85% improvement in symptoms, a-blockers reduce symptoms by 51%, and treatment with the 5-a-reductase inhibitor finasteride improves symptoms by 31%.
Contraindication:Hypersensitivity.
Adverse effect:The first-dose syncope and postural hypotension frequently occur. Other adverse effects include dizziness, faintness, fatigue and headache; tachycardia has also been observed.
Usual dosage:Adults: Initial dose 1mg PO HS, then titrate to 5mg PO QD; some patients may require 10-20mg PO QD. Dosing adjustments are not required in elderly patients but escalation should be slower.
Special precautions:Orthostatic hypotension

VALSARTAN D

Supply:80MG/CAP(DIOVANR)
Use:Hypertension
Contraindication:Pregnancy &lactation.
Adverse effect:Headache, dizziness, viral infection, upper resp tract infection, coughing, diarrhea, faigue, rhinitis, sinusitis, back pain, abdominal pain, nausea, pharyngitis, arthralgia.
Usual dosage:80 mg once daily. May be increased to 160 mg daily.
Special precautions:Severely Na-depleted vol-depleted patients, renal artery stenosis, severely impaired renal function, severe hepatic impairment, biliary obstruction.

Calcium antagonists

AMLODIPINE

Supply:5MG/TAB(NORVASCR)
Use:Traetment of hypertension and angina(chronic stable or Prinzmetal’s)with or without other therapy
Contraindication:Hypersensitivity to amlodipine
Adverse effect:Dose related peripheral edema; headache, flushing, palpitations and GI disturbances
Usual dosage:5 to 10mg QD. Dose reductions may be indicated in the elderly or those with hepatic failure, but are not necessary in renal impairment.
Special precautions:Use with caution and titrate dosages for patient with impaired renal or hepatic function; use caution when treating patients with congestive heart failure, sick-sinus syndrome, sever left ventricular dysfunction, hypertrophic cardiomyopathy
Patient information:Do not discontinue abruptly; report any dizziness, shortness of breath, palpitation or, edema
Mechanism: Inhibits calcium ion from entering the’ slow channels’or select voltage-sensitive areas of vascula smooth muscle and myocardium during depolarization, producing a relaxation of coronary vascular smooth muscle andcoronary vasodilation; increases myocardial oxygen delivery in patients with vasospastic angina

DILTIAZEM

Supply:30MG/TAB(ANGELTENSIONR, CARTILR), 60MG/TAB(CARTILR)
Use:Treatment of coronary artery spasm, angina pectoris, essential hypertension, supraventricular arrhythmia.
Contraindication:Severe hypotension or second and third degree heart block except with a functioning pacemaker; hypersensitivity to diltiazem; sick sinus syndrome, acute myocardial infarction, and pulmonary congestion
Adverse effect:A-V nodal block, hypotension, headache, and GI disturbance.
Usual dosage:30-50mg TID, maximum dose: 360 mg/day in 3-4 doses.
Patient information:Sustained release products should be taken in the morning; do not crush or chew, limit caffeine intake; avoid alcohol; notify phyician if angina pain is not reduced when taking this drug

FELODIPINE

Supply:5MG/TAB(PLENDILR)
Use:Felodipine is effective as monotherapy in mild to moderate hypertension. It may be useful in angina, congestive heart failure, and pulmonary hypertension.
Place in therapy: Felodipine produces less disruption of left ventricular function than do verapamil and diltiazem and may be preferred in patients with concomitant sinus bradycardia, conduction disturbances and compromised cardiac function. As monotherapy, response was seen in 60% to 65% of patients on felodipine 5 to 10mg daily or nifedipine 10mg twice daily.
Contraindication:Hypersensitivity to calcium channel antagonist, symptomatic hypotension, any degree of A-V block, use caution in patient with previous left ventricular dysfunction.
Adverse effect:Dizziness, headache, peripheral edema (worse than with verapamil and diltiazem), flushing, rash, and gingival hyperplasia.
Usual dosage:Adults: Initial PO 5 mg QD; adjusted at 2 week intervals; 20mg QD has been used; for elderly and impaired liver function, should not receive more than 10mg/day.
Child: PO 0.18 to 0.56mg/kg QD were used to control hypertension or renal artery stenosis.

NICARDIPINE

Supply:20MG/S.C.TAB(COPONENTR)
Use:Hypertension
Contraindication:Incomplete hemostasis following intracranial hemorrhage, acute apoplexy, elevated intracranial pressure.
Adverse effect:Infrequentyl, anorexia, nausea, vomiting, flushing, palpitation, headache. Rarely granulocytopenia, dry mouth, constipation, peripheral edema, rash.
Usual dosage:10-20 mg tid
Special precautions:Liver or kidney impairment, hypotension, glaucoma, pregnancy.

NIFEDIPINE

Supply:5MG/SOFT.CAP/(AJULATER, ADALATR), 10MG/SOFT.CAP(AJULATER, RONIANR), 20MG/CAP(CORACTENR), 30MG/OROS.TAB
Use:Treatment and prophylaxis of angina pectoris, hypertension
Adverse effect:Transient headache, flushing bradycardia, hypotension, palpitation, tachycardia, chest pain.
Usual dosage:10mg TID
Patient education: Sustained release products should not be crushed or chewed; AdalatR CC should be taken on an empty stomach; limit caffeine intake; avoid alcohol; notify phyician if angina pain is not reduced when taking this drug
Special precautions:The routine use of short-acting nifedipine capsule in hypertensive emergencies and pseudoemergencies is not recommended

NISOLDIPIN

Supply:5MG/F.C.TAB(SYSCOR 5R)
Use:Nisoldipine is a dihydropyridine calcium channel blocking agent similar in structure to nifedipine.
Place in therapy: At present, available data do not suggest significant clinical advantages of the drug over nifedipine.
Contraindication:Hypersensitivity to this or other calcium channel antagonists.
Adverse effect:Dizziness, headache, peripheral edema (worse than with verapamil and diltiazem), flushing, rash, and gingival hyperplasia are the most common adverse events.
Usual dosage:Hypertension: 5-10 mg PO QD, titrate to response, range between 20-40 mg; stable angina: 10-20 mg daily, divide into two doses.
Dosage adjustment: 1. No adjustment in patient with renal failure 2. Dose reductions are suggested in liver dysfunction, with initial doses limited to 10 mg or less 3. No dose adjustment is recommended with hemodialysis.

VERAPAMIL

Supply:120/S.R.CAP(VERELANR)
Use:Control of supraventricular arrhythmia, angina pectoris, chronic coronary insufficiency, hypertension.
Contraindication:Hypotension, associated with cardiac shock, patients in digitalis intoxication, marked bradycardia, partial of complete A-V block, acute myocardial infarction, concomitant use with ��-blockers and cardiac depressants.
Adverse effect:Severe hypotension, bradycardia, constipation, flushing, bronchospasm.
Usual dosage:PO : 40-120mg TID AC, maximal dose 480mg /day ; IV infusion : 75-150mg/kg in normal saline or dextrose solution at a rate of 5-10mg/hr.

DIPYRIDAMOLE B

Supply:10MG/2ML/AMP(PERSANTINR), 25MG/F.C.TAB(PERSANTINR), 50MG/F.C.TAB(SANCINR)
& Fibrinolytics
Use:Management of chronic angina pectoris, thrombo-embolic disease.
Contraindication:Acute myocardial infarction
Adverse effect:Headache, dizziness, nausea, skin rash.
Usual dosage:As antithrombotics: 400-600mg/day AC.
For angina pectories: 50mg TID, maximum dose: 400mg/day
Special precautions:Rapidly progressing angina; subvalvular aortic stenosis; hemodynamic instability eg associated recent MI

ISOSORBIDE 5 MONONITRATE C

Supply:20MG/TAB(ISMO-20R)
Use:Long-term treatment of circulation disorders of the coronary blood vessels and for preventing attacks of angina pectoris, post-myocardial infarction therapy.
Contraindication:Patients with marked low blood pressure, circulatory collapse, states of shock and acute myocardial infarction with low filling pressure.
Adverse effect:Nitrate headaches, decrease blood pressure, slight states of dizziness, increase of the heart rate, temporary reddening of the face, weakness, nausea, vomiting.
Usual dosage:1 Tab BID.
Special precautions:Not suitable for treating attacks of angina pectoris. Pregnancy &lactation. May impair ability to drive or operate machinery.
Patient information:Dispense drug in easy-to open container; do not change brands without consulting your pharmacist or physician, extended release tablets should not be chewed or crushed and should be swallowed together with a half-glassful of fluid; headaches are sometimes a marker of the activity of the drug. the antianginal efficacy of tables can be maintained by carefully following the prescribed schedule of dosing(2 doses taken 7 hours apart)
Mechanism: Decreasing preload as measured by pulmonary capillary wedge pressure and left ventricular end diastolic volume and pressure; the average reduction in left ventricular end diastolic volume is 25% at rest, with a corresponding increase in ejection fraction of 50% to 60%. This effect improves congestive symptoms in heart failure and improves the myocardial perfusion gradient in patient with coronary artery disease

ISOSORBIDE DINITRATE C

Supply:5MG/SUBLINGUAL.TAB(ISODILR),10MG/TAB(ISORDILR), 10MG/10ML/AMP(ISOKETR)
Use:Prevention and treatment of angina pectoris; for congestive heart failure
Contraindication:Severe anemia, closed-angle glaucoma, postural hypotension, cerebral hemorrhage, head trauma
Adverse effect:Headache, transient dizziness, weakness, cutaneous flushing.
Usual dosage:2.5-10mg sublingual or oral with food Q2-6H for prompt relief or prophylaxis, 10-60mg TID-QID in patient with congestive heart failure.
Patient information:Do not chew or crush sublingual or sustained release physician; if no relief from sublingual tablet after 15 minutes, report to nearest emergency room or seek emergency help
Pharmacodynamics
Dosage form Onset of action Duration
Sublingual tab 2-10 min 1-2 h
Chewable tab 3 min 0.5-2 h
Oral tab 45-60 min 4-6 h
Sustained release tab 30 min 6-12 h

NICORANDIL

Supply:5MG/TAB(SIGMARTR)
Use:Anginal pectoris
Adverse effect:Palpitations, facial flash; throbbing headache, dizziness; rash; GI disturbances; increase in liver enzymes; cervical pain; diplopia.
Usual dosage:Usually 5 mg tid
Special precautions:Hepatic disorders; glaucoma; child elederly; pregnancy.

NITROGLYCERIN SUBLINGUAL C

Supply:0.6MG/SUBLINGUAL.TAB(NITROGLYCERINR)
Use:Prophylatic treatment and management of angina pectoris.
Contraindication:Patient with marked anemia, head trauma, or cerebral hemorrhage.
Adverse effect:Headache, vertigo, weakness, palpitation, dizziness, flushing, nausea, vomiting. tachycardia, postural hypotension.
Usual dosage:1 Tab sublingual every 5 minutes prn
Patient information: Go to hospital if no relief after 3 sublingual doses; do not swallow or chew sublingual form; take oral nitrates on an empty stomach; keep tightly closed; keep tablets and capsules in original container; a treatment-free interval of 8-12 hours is recommended each day; take 3 times/day rather than every 8 hours
Mechanism: Reduces cardiac oxygen demand by decreasing left ventricular pressure and systemic vascular resistance; dilates coronary arteries and improves collateral flow to ischemic regions

BUMETANIDE C

Supply:0.5MG/ML/4ML(BURINEXR), 1MG/TAB(BURINEXR)
Use:Edema associated with Chf, liver cirrhosis, renal disease. Acute pulmonary edema, drug-induced fluid retention, drug-poisoning that can be treated by forced diuresis. Hypertension.
Contraindication:Hepatic coma, severe electrolyte depletion, concurrent administration with lithium, anuria.
Adverse effect:Hypokalemia & hypochloremic alkalosis (long-term therapy); muscular cramps in patients with sever chronic renal failure; asymptomatic hyperuricemia. Rarely, skin rashes, depression of formed elements in the blood; abdominal discomfort.
Usual dosage:Amp Usually 1-2 mg IV or IM
Special precautions:Hepatic cirrhosis; patients on digitalis therapy; diabetes, electrolyte disturbances, prostatic hypertrophy; impaired micturition; renal insufficiency.

FUROSEMIDE C

Supply:20MG/2ML/AMP(LASIXR), 40MG/TAB(LASIXR)
Use:Hypertension, acute pulmonary edema, edema due to congestive heart failure, hepatic cirrhosis and renal disease.
Contraindication:Anuria, hypersensitive to furosemide.
Adverse effect:Dehydration, hypokalemia, glucose intolerance, hypochloremic alkalosis, hyperuricemia.
Usual dosage:40-500mg/day, maximum daily dose: 600mg.
Patient information:May be taken with food or milk; rise slowly from a lying or sitting position to minimize dizziness, lightheadeness, or fainting; also use extra care when exercising, standing for long periods of time, and during hot weather; take last dose of day early in the evening to prevent nocturia

HYDROCHLOROTHIAZIDE B

Supply:AnjalR(Triamterene50mg, hydrochlorothiazide25mg)
AmitonR(amiloride5mg, hydrochlorothiazide50mg)
Use:All forms of edema, hypertension, congestive heart failure, hepatic cirrhosis with ascites.
Contraindication:Anuria, hypersensitivity to hydrochlorothiazide.
Adverse effect:Thirst, epigastric pain, anorexia, nausea, vomiting, headache, hypokalemia.
Usual dosage:50-150mg/day
Patient information:May be taken with food or milk; take early in day to avoid nocturia; take the last dose of mulitple doses no later than 6 PM unless instructed otherwise. A few people who take this medication become more sensitive to sunlight and may experience skin rash, redness, itching, or severe sunburn, especially if sun block SPF?15 is not used on exposed skin areas. May increase blood glucose levels in diabetics.

METOLAZONE B

Supply:0.5MG/TAB(MYKROXR)
Use:Metolazone is an effective diuretic for edema and essential hypertension. It has been used in patients with renal failure and nephrotic syndrome.
Place in therapy: The only apparent advantage over other thiazides is its usefulness in patient with a decreased glomerular filtration rate.
Contraindication:Thiazide diuretics are contraindicated in patient with anuria, hypersensitivity to other thiazide diuretics, or sulfonamides and in use in pregnant women.
Adverse effect:Anemia, orthostatic hypotension, hypokalemia, hyperuricemia, and hyponatremia.
Usual dosage:Adults: Initial oral dose 2.5-10 mg/day, a lower range has been recommended (1.25-5 mg/day). Child: 0.2-0.4 mg/kg/day

SPIRONOLACTONE D

Supply:25MG/TAB(SPIRONOLACTONER)
Use:Hypertension, edema due to congestive heart failure, hepatic cirrhosis, or nephrotic syndrome.
Contraindication:Anuria, acute renal insufficiency, hyperkalemia.
Adverse effect:Hyperkalemia, hyponatremia, dehydration, GI syndrome, cramping, ataxia, skin rash, headache, drowsiness.
Usual dosage:Adults: 25-200mg/day, divided into 2-4 doses. Child: 3.3mg/kg/day

*ALDACTIDE 25 D

Content: Per tabSPIRONOLACTONE 25MG, HYDROFLUMETHIAZIDE 25MG
TRICHLORMETHIAZIDE C
Supply:2MG/TAB(FLUITRANR)
Use:Hypertension, edema due to congestive heart failure, hepatic cirrhosis, chronic renal disease and corticosteroid therapy.
Contraindication:Anuria, hypersensitivity to trichlormethiazide.
Adverse effect:Nausea, flushing of face, hypokalemia, hyponatremia, hypochloremic alkalosis.
Usual dosage:2-4mg/day.
Special precautions:Electrolyte imbalances; hepatic or renal impairment; pregnancy &lactation.

PENTOXIFYLLINE C

Supply:100mg/Amp(PENTOXILLINER, TRENTALR), 100mg/Tab(TRENTAL DRAGEER), 400mg/Tab(TRENTAL DRAGEER) 400mg/S.R.Tab(FORFLOWR), 400mg/S.R.F.C.Tab(PERILAXR, FYLIN RETARDR, IPENTOLR)
Use:Treatment of peripheral vascular circulatory disorder.
Contraindication:Recent myocardial infarction, severe hemorrhage
Adverse effect:Nausea, dizziness, flushing, headache
Usual dosage:PO initial dose: 200mg TID when improvement is seen reduce to 100mg TID. IV initial dose 100mg in 250-500ml N/S given over 1.5-3 hours, increased by 50mg every day until a daily dose of 300mg is reached.

BUFLOMEDIL HCL

Supply:150mg/F.C.Tab(LOFTYLR, LOMEDILR)
Use:Buflomedil is a vasoactive drug and seems to improve nutritional blood flow in ischemic tissue of patients with peripheral or cerebral vascular disease.
Contraindication:Woman in postpartum, severe arterial hemorrhage.
Adverse effect:GI disturbance, headache, nausea, dizziness, itching, flushing.
Usual dosage:PO 300-600mg/day
Special precautions:Impaired renal function; low body weight

DIHYDROERGOCRISTINE

Supply:3mg/Cap(DIERTINAR)
Use:Cerebrovascular, peripheral vascular & coronary disorders. Arterial hypertension
Adverse effect:Nausea, vomiting, headache, blurred vision, skin rashes, nasal stuffiness, flushing, orthostatic hypotension, sinus bradycardia.
Usual dosage:1 cap bid

DIHYDROERGOTOXINE

Supply:1.5mg/Tab(SCAMINR, TRIROGINR)
Use:Confusion, dizziness, mood-depression, unsociability.
Contraindication:Hypersensitivity and in patient with acute or chronic psychosis regardless of etiology.
Adverse effect:Ergotism, sinus bradycardia, orthostatic hypotension, flushing, porphyria, transient nausea, nasal stuffiness, blurred vision.
Usual dosage:PO 1mg TID

FLUNARIZINE

Supply:5mg/Cap(SIBELIUMR, SUFUNIR), 10mg/Cap(FORKNOWR)
Use:Migraine, prophylaxis and treatment of vertigo and peripheral vascular disease.
Contraindication:Patient hypersensitive to flunarizine.
Adverse effect:Drowsiness, headache, insomnia, nausea, dry mouth.
Usual dosage:Migraine, headache prophylaxis and peripheral vascular disease: PO 10mg daily as a single dose.
Vertigo: PO 20mg TID.
Special precautions:Pregnancy

NICAMETATE

Supply:50mg/Tab(EUCLIDANR)
Use:Treatment of peripheral vascular disorders.
Contraindication:Peptic ulcer, severe hypotension, atrial hemorrhage, hepatic dysfunction, hyperuricemia.
Adverse effect:Transient palpitation, flushing of face.
Usual dosage:300mg/day

NICERGOLINE

Supply:5mg/Tab(SERMIONR)
Use:Intellective, affective, behavioural & somatic symptoms associated with cerebral decary (include dementia & Parkinsonism), memory disorders, reduced vigilance & conc, mood depression, apathy, unsociability, indifference to surroundings, loss of self-care, asthenia, anorexia and tinnitus. Adjuvant to neurological rehabilitation in after-stroke hemiplegic patients
Adverse effect:Slight GI disturbances; flushing; drowsiness; insomnia
Usual dosage:5-10 mg tid.

MIDODRINE HCL

Supply:2.5mg/Tab(GUTRONR)
Use:Orthostatic circulatory regulation disturbance & dysregulation, constitutional & symptoms hypotension. Management of side effects produced by hypnotics & urinary incontinence, psychotropic drugs, antihypertensives
Contraindication:Raised BP, severe organic heart diseases, acute nephritis, thyrotoxicosis, pheochromocytoma
Adverse effect:Bradycardia
Usual dosage:Adult & adolescent 1/2 tab. To be taken once or bid.
Special precautions:Impaired liver function

NOREPINEPHRINE BITARTRATE

Supply:2.3mg/ml 4ml/Amp(LEVOPHEDR)
Use:Hypotension, cardiac arrest and profound hypotension.
Contraindication: Hypotension with blood volume deficiency, mesenteric or peripheral vascular thrombosis, pregnancy, patient under cyclopropane anesthesia.
Adverse effect:Anxiety, transient headache, palpitation, respiratory difficulty, bradycardia, photophobia, sweating, vomiting, retrosternal pain, cardiac arrhythmia
Usual dosage:IV drip 8-12mg/min, according to the patient’s blood pressure.
Special precautions:Hypertension, extravasation. Should be given into a large vein

METABOLIC & NUTRIENT AGENT

MAGNESIUM SULFATE

Supply:10% 20ml//Amp(MAGNESIUM SULFATER)
Use:Prevention or control seizures in severe pre-eclampsia or eclampsia and in convulsions associated with epilepsy, glomerulonephritis and hypothyroidism; used to prevent or correct magnesium deficiency in TPN.
Contraindication:Heart block, myocardial damage, serious renal impairment.
Adverse effect:Safe in mothers’ infusion for eclampsia immediately before, during, and after delivery. The milk/plasm ratio is 1.9. No adverse effect to nursing infant reported.
Usual dosage:Flushing, sweating, depressed reflexes, hypo-tension, circulatory collapse, cardiac and CNS depression.

POTASSIUM CHLORIDE A

Supply:15% 5ml/Amp(POTASSIUM CHLORIDER)
Use:Potassium depletion, corticosteroid therapy, hypokalemia in digitalis intoxication.
Contraindication:Addison’s disease, acute dehydration, acute or chronic renal disease, hyperkalemia, severe renal impairment with azotemia or oligouria.
Adverse effect:Hyperkalemia, flaccid paralysis, mental confusion, cardiac depression, cardiac arrhythmias.
Usual dosage:Prevention of hypokalemia (20mEq/day) Potassium depletion (40-100mEq/day).

POTASSIUM GLUCONATE

Supply:595mg/Tab(Radi-kR)
Use:Hypokalemia
Contraindication:Hyperkalemia
Usual dosage:3-8 tab daily in 2-3 divided doses
Special precautions:Impaired renal function.

SODIUM BICARBONATE C

Supply:7% 20ml/Amp(SODIUM BICARBONATER)
DEXTROSE
Supply:10% 500ml/Bag(DEXTROSER), 5% 500ml/Bot(DITROSER), 5% 500ml(GLUCOSER), 0.33% 500ml(
Use:Sodium depletion, hypertonic used for shock, anti-ketogenic action used for acidosis, provide calories (5%, 10%, 20%, 50% infusion), 50 % dextrose for insulin hypoglycemia.
Contraindication:Intracranial or intraspinal hemorrhage; diabetic coma, glucose-galactose malabsorption syndrome.
Adverse effect:Thrombophlebitis, hyperglycemia, glycosuria.
Usual dosage:IV depend on the age, weight and clinical condition. The maximum rate is 0.5g/kg/hr.

GELAFUNDIN

Supply:500ml/Bot(GELAFUNDINR)
Use:Primary vol replacement in hypovolaemia & shock due to acute blood or fluid loss, burn & sepsis; prophylaxis of hypotension during epidural or spinal anaesth; haemodilution & autologous transfusion; extracorporeal circulation
Contraindication:Hypervolaemia, hyperhydration, severe cardiac disturbances
Adverse effect:all colloidal vol substitutes, allergic, (anaphylactic or anaphylactoid) reactions of varying severity can occur after infusion of Gelafundin/Gelofusine.
Usual dosage:Prophylaxis & treatment of hypovolaemia & hypotension 500-1000 ml. Severe hypovovlaemia 1000-2000ml. Haemodilution Max 20 ml/kg body wt/day

GLYCEROL C

Supply:250ml/Bot(FRUCEOLR)
Use:Treatment of intracranial edema, and increased intracranial pressure, reduction of brain or eyeball volume during brain or eye surgery.
Contraindication:Patients with hereditary fructose intolerance.
Adverse effect:Occult blood in urine, hemoglobinuria, headache.
Usual dosage:Usual adult dose: 200-500mg QD or Q12H IV infusion for 2-3 hours, duration of administration: 1-2 weeks.

GLYCEROSTERIL C

Supply:10% 250ml/Bot(GLYCEROSTERILR)
Use:Treatment of cerebral oedema
Contraindication:Hyperosmolar coma, haemolytic anaemia lowered osmotic RBC resistance, decompensated cardiac insufficiency, impaired renal function(oliguria, anuria), general fluid losses (dehydration conditions)
Usual dosage:40 drops/min or 125 ml/hr/70 kg body wt. Max: 500ml/day/70 kg body wt.

RINGER

Supply: Inj 500ml/Bot
Each 100ml contains:
Sodium Chloride 860 mg
Potassium Chloride 30 mg
Calcium Chloride anhydrous 33 mg
Electrolyte content given in meq/L

Each 100ml contains

Each 100ml contains
Na K Ca Cl
147 4 5 156

Use:Sodium deficiency, potassium deficiency, acidosis, alkalosis, renal failure, maintenance fluid therapy.
Contraindication:Circulatory overload, edema due to sodium excess.
Usual dosage:500ml/day.
SODIUM CHLORIDE
Supply: 0.45% 500 ml/Bot, 20 ml/Amp (77 mEq of NaCl/L, 154 mOsm/L), 3 % 500ml/Bot (513 mEq of NaCl/L, 1026 mOsm/L), 0.9% 500 ml/Bot (Plastic bag/Glass bot)
Use:Hypotonic sodium chloride solution (0.45%): fluid replacement when fluid losses exceed electrolyte depletion. Isotonic solution(0.9%): water and sodium retention. Hypertonic solution (3%): hyponatremia, hypochloremia.
Contraindication:Congestive heart failure, severe renal impairment, edema with sodium retention.
Usual dosage:Dose in dependent on age, weight and clinical condition of patient : 6-10g/day.

CALCIUM SALTS

Supply:CALCIUM CARBONATE: 250mg/Cap(OS-CALR), 500mg/Tab(CALCIUM CARBONATER), 1250mg/Tab(CALCIUM FROM OYSTER SHELLR) 500mg/Tab equiv to elemental Ca200mg
CALCIUM CITRATE:950mg/Tab(CALBOR)equiv to elemental Ca200mg CALCIUM GLUCONATE:10% 10ml/Vial(CALGLONR) equiv to elemental Ca89.2mg
Use:Calcium salts are useful in treating a variety of conditions including hypocalcemia, osteoporosis, tetany, and leg cramps.
Place in therapy: Oral calcium supplementation, in conjunction with estrogen therapy, is effective in preventing postmenopausal bone loss.
Contraindication:Patient with hypercalcemia, renal failure or GFR<50 ml/min
Adverse effect:One of the more common side effects of calcium is constipation; hypercalcemia may result in nephrolithiasis, anorexia, nausea, vomiting, and ocular toxicity.
Usual dosage:500mg bid
Special precautions:Hypercalciuria; renal impairment, previous renal calculi
Pharmacokinetics: Following absorption, 99% of calcium is deposited in bone and about 40% to 45% of serum calcium is bound to plasma proteins.

CALCIUM PHOSPHATE

Supply:300mg/Tab(BIO-CALR)
Tab contains
Calcium phosphate 802 mg (calcium 300mg)
Cholecalciferol 62.5IU(1.56mcg)
Note: It consists of a variable mixture of hydrous and anhydrous calcium phosphates. Each g of hydrated calcium phosphate represents approximately 9.7-10 mmol of calcium. Hydrated calcium phosphate 2.51-2.58 g is approximately equivalent to 1 g of calcium.
Use:Calcium salts are useful in treating a variety of conditions including hypocalcemia, osteoporosis, tetany, and leg cramps.
Place in therapy: Oral calcium supplementation, in conjunction with estrogen therapy, is effective in preventing postmenopausal bone loss.
Contraindication:Patient with hypercalcemia, renal failure or GFR<50 ml/min
Adverse effect:One of the more common side effects of calcium is constipation; hypercalcemia may result in nephrolithiasis, anorexia, nausea, vomiting, and ocular toxicity.
Usual dosage:1-2 Tab PO BID

CALCIUM FOLINATE C

Supply:30mg/Amp(ANTREXR), 50mg/5ml/Vial(LEUCOVORINR)
Use:Cellular rescue from the adverse effects of high-dose methotrexate therapy.
Contraindication:It is an improper therapy for pernicious anemia secondary to lack of Vitamin B12, because hemologic remission may occur while neurologic mainifestations remain progress.
Adverse effect:Allergic sensitization.
Usual dosage:Rescue of methotrexate therapy: 10mg/m2 IM or IV every 6 hours until methotrexate serum levels are below 10-8 M.

*FURSULTIAMINE

Supply:50mg/S.C.Tab(ALINAMIN-F50R), 50mg/20ml/Amp(ALINAMIN-F50R)
Use:Neuralgia, neuritis, eye’s fatigue, nervous cystitis; post-op intestinal paralysis, vit B1 deficiency.
Adverse effect:Rarely, nausea, vomiting & rumbling; shock, hypersensitivity, headache or pollakiuria (decrease dose or stop use)
Usual dosage:Amp 20ml once-bid slow IV. Tab 1-3 tab daily.

PYRIDOXAL PHOSPHATE

Supply:30mg/Tab(PYRIDOXALR)
Use:Acute eczema, atopic dermatitis, hyperemesis gavidarum peripheral nerve disorders.
Adverse effect:Long term use may result in paresthesia, somnolence and low serum folic acid levels.

PYRIDOXINE HCL

Supply:10mg/Tab(VIT B6)
Use:1. For pyridoxine deficiency, 2. For treatment of irradiation sickness and nausea and vomiting of pregnancy.
Contraindication:Sensitivity to pyridoxine.
Adverse effect:Paresthesia, somnolence and low serum folic acid level.
Usual dosage:Prophylactic: 1-2mg, QD. Therapeutic: 30-150mg. QD.

FOLIC ACID

Supply:5mg/Tab(FOLIC ACIDR)
Use:For megaloblastic anemias, anemias of nutritional origin, pregnancy, infancy or childhood.
Contraindication:It is an incomplete therapy for pernicious anemia, it should not be employed because of the menace of neurological complications various types of leukemias.
Adverse effect:Allergic sensitization
Usual dosage:10-30mg in divided doses.

MECOBALAMIN

Supply:1000mcg/Amp(MECOBALR),
250mcg, 500mcg/Tab(YOUCOBALR)
Use:Pernicious anemia and related macrocytic anemias.
Contraindication:Hypersensitivity to cyanocobalamine.
Adverse effect:Anaphylactic shock, itching, peripheral vascular thrombosis, polycythemia vera, etc.
Usual dosage:Nutritional deficiency: 10-250mg QD. Vit B12 deficiency: 1000mg QD, PO; IM, 30mg QD, for 5-10 days, followed 10-200mg monthly.

ACIPIMOX

Supply:250mg/Cap(OLBETAMR)
Use:Type IIa (elevated plasma levels of cholesterol), IIb, III, IV (elevated plasma levels of triglycerides), V(elevated plasma levels of cholesterol and triglycerides) hyperlipoproteinemia.
Place in therapy: Acipimox is a derivative of niacin. It has a longer duration of action and greater hypolipidemic activity than niacin, and it is better tolerated than niacin with a low incidence of adverse effects. It is most valuable in the treatment of Type IV hyperlipoproteinemia, which is primarily manifest as hyper-triglyceridemia.
Contraindication:Peptic ulcer, hypersensitivity.
Adverse effect:Flushing, gastric upset, headache, vomiting, hypotension, heartburn, loose stools, itching, rash, tingling of the extremities, cutaneous blisters.
Usual dosage:Adults: PO 250mg BID or TID, or 500mg QD.

BEZAFIBRATE

Supply:200mg/Tab(BEZALIPR), 400mg/Tab(BEZALIP RETARDR)
Use:For treatment of hypertriglyceridaemia and hyper-cholesterolaemia.
Contraindication:Liver and gall bladder disease, cholelithiasis, severe renal impairment, pregnancy and lactation.
Adverse effect:GI distubance, pruritus, urticaria, muscular pain, and weakness.
Usual dosage:200mg TID PC.

ETOFIBRATE

Supply:500mg/(LIPO-MERZ RETARDR)
Use:Severe primary & secondary hyperlipidemia
Contraindication:Liver disease (expect fatty liver beging a frequent concomitant symdrome in hypertriglyceridemia),gallbladder diseases, severe renal insufficiency, decompensated heart failure, acute cardiac infarct, acute bleedings. Pregnancy & lactation.
Adverse effect:Flush syndrome & reactions to flush, GI disorders
Usual dosage: 1 cap daily

FENOFIBRATE C

Supply:100mg/Cap(FENOFIBRATER, LIPOLINR, SYNPIDR)
Use:Hyperlipidemia
Contraindication:Liver & renal impairment, pregnancy, lactation. Hyperlipidaemia Type I.
Adverse effect:Elevation of transaminases, muscular pains, GI disturbances, skin reactions, headache.
Usual dosage:1 cap tid

FLUVASTATIN SOD.

Supply:20mg/Cap(LESCOLR)
Use:Primary HYPERcholesterolaemia & mixed dyslipidaemia
Contraindication:Active liver disease, unexplained persistent elevations in serum transaminases; lactation, pregnancy
Adverse effect:Dyspepsia, nausea, insomnia, abdominal pain, headache.
Usual dosage:20-40 mg once daily

GEMFIBROZIL C

Supply:300mg/Cap(GEMBITR, GEMNPIDR, URAGEMR), 600mg/F.C.Tab(GEMBRILR)
Use:Hyperlipoproteinemia. It decreases the level of LDL and VLDL, and elevates HDL cholesterol of patients with hyperlipoproteinemia.
Place in therapy: It is an effective antihyperlipidemic agent in type IV and V hyperlipidemia, and for type IIb patient without history or symptoms of existing coronary heart disease.
Contraindication:Patient with hepatic or severe renal dysfunction, or pre-existing gall bladder disease.
Adverse effect:The common adverse effects with genfibrozil are gastrointestinal effects: epigastric pain, dry moth, constipation, diarrhea, and flatulence. Other side effects include : CNS ( fatigue, vertigo, headache, paresthesias, hypesthesia ), ophthalmic( blurred vision ), dermatologic ( eczema, rash ), hematologic ( slight decrease in hemoglobin, hematocrit and leukocyte count ) and atrial fibrillation.
Usual dosage:900-1500mg/day( usually 1200mg ) BID, AC( 30 min before the morning and evening meal).

LOVASTATIN

Supply:20mg/Tab(DELIPICR)
Use:Lovastatin is an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase, the rate limiting enzyme in cholesterol synthesis. In some patients, combination therapy with colestipol, bile-acid binding resins, or ileal bypass may be necessary to reduce cholesterol levels to 240mg/dL or lower.
Contraindication:Patient with hypersensitivity to lovastatin and those with active liver disease should not receive the drug.
Adverse effect:Lovastatin is well tolerated. But there are some case reported Adverse effect: insomnia, headache, diarrhea, cholestatic jaundice, elevated liver enzymes, blurred vision, myopathy.
Usual dosage:Initial dose: 20mg QD; the maximum recommended daily dose is 80mg/day.

PRAVASTATIN X

Supply:5mg/Tab(MEVALOTINR)
Use:Pravastatin is a competitive inhibitor of HMG-CoA reductase. Treatment of familial and non-familial hyper-cholesterolemia; clinical studies have suggested that pravastatin, simvastatin, and lovastatin are similar in efficacy and toxicity. Fluvastatin appears to be slightly less effective than pravastatin when equipotent doses are used.
Place in therapy: The HMG-CoA reductase inhibitors, including pravastatin, are recommended for treatment of patient with primary hypercholesterolemia. Its lipid-lowering effect shows dose-dependence.
Contraindication:Previous hypersensitivity to pravastatin. Active liver disease, or persistent, unexplained liver function enzyme elevations. Pravastatin is specifically contraindicated in pregnant or lactating females.
Adverse effect:Reversible elevations in liver enzymes have been reported rarely; other adverse effects have included gastrointestinal disturbances, headache, weakness.
Usual dosage:Initial dose: PO 10- 20mg QN; elderly and patients with significant renal or hepatic disease: 10mg QN; maintenance dose: 10-40mg QN. Once daily dosing at bedtime is marginally more effective than once daily dosing in the morning, possibly because peak hepatic cholesterol synthesis occurs between midnight and 3 AM.

SIMVASTATIN X

Supply:20mg/F.CTab(ZOCORR)
Use:Simvastatin is an HMG-CoA reductase inhibitor that is structurally related to lovastatin. Simvastatin is indicated for primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Frederickson types IIa and IIb). Simvastatin is also indicated for patients with coronary heart disease and hypercholesterolemia to reduce the risk of coronary death, nonfatal myocardial infarction, myocardial revascularization procedures, and stroke.
Place in therapy: Simvastatin is superior to fibrates, cholestyramine and probucol in lowering total and LDL cholesterol levels; however, it does not appear to offer any advantage over lovastatin. Simvastatin had similar activity and adverse-effect profile compared to lovastatin.
Contraindication:Simvastatin is contraindicated in patient with active liver disease, unexplained elevations of serum transaminases, hypersensitivity, pregnancy, and lactation.
Adverse effect:Common adverse effects include headache and gastrointestinal complaints. Elevations in transaminases greater than 3 times the upper limit of normal were reported in 1% of patients. Elevations in creatine phosphokinase have also been reported.
Usual dosage:Adults: 5-40 mg PO QD, administered in the evening
Pharmacokinetics: Simvastatin is administered as a prodrug, which is hydrolyzed in the liver to its active form. Peak serum levels of active drug occur 1 to 2 hours after oral administration; excretion is primarily via the biliary tract.

AMINOL-V

Supply:5% 500ml/Bot(AMINOLR)
Total amino acid: 5%, Sorbitol: 5%.
Total nitrogen content: 8.39 mg/ml.
Na+: 30 mEq/Liter, K+: 25 mEq/Liter, Cl-: 55 mEq/Liter,
pH: 4.8 (3.5-6.5).

Each liter contains

Each liter contains
l-Isoleucine 1.4 g l-Alanine 17.1 g
l-Leucine 2.2 g l-Proline 3.5 g
l-Lysine 1.6 g l-Malic acid 3.5 g
l-Methionine 2.2 g l-Ornithine- l-Aspartate 0.5 g
l-Phenylalanine 2.2 g Nicotinamide 15.0 mg
l-Threonine 3.09 g Riboflavine-5′-Phosphate-Na 2.0 mg
l-Tryptophan 0.5 g Panthenol 10.0 mg
l-Valine 1.6 g Pyridoxine HCl 2.0 mg
l-Arginine 5.0 g Rutin 240 mg
l-Histidine 1.2 g Sorbitol 50.0 g
Glycine 10.0 g Sodium Chloride 1.753 g
Potassium Chloride 1.864 g

Use:Supply of amino acids, nutrition and water
Contraindication:Hypersensitivity to those components, hepatic coma, renal insufficiency.
Adverse effect:Fever, flushing, allergic reaction, convulsion, hypotension, thrombosis.
Usual dosage:500-1000ml/day; IV infusion rate: 150ml/hr.

AMINOPOLY-H

Supply:500ml/Bot(AMINOPOLY-HR)
pH: 6.8-7.8, total amino acid content: 7.11%, total nitrogen content: 12.1 g/L, branch chain amino acid content: 2.755%, Na: 15-16 mEq/L, Cl: 0 mEq/L

Each liter contains

Each liter contains
l-Isoleucine 9.2 g l-Tryptophan 0.70 g
l-Leucine 9.45 g l-Valine 8.90 g
l-Lysine monoacetate 3.95 g l-Arginine 9.20 g
l-Methionine 0.65 g l-Histidine 3.10 g
l-Cysteine 0.20 g l-Alanine 8.40 g
l-Phenylalanine 0.30 g l-Proline 5.30 g
l-Threonine 3.00 g l-Serine 2.60 g
l-Tyrosine 0.60 g l-Aspartic acid 0.20 g
Amino acetic acid 5.40 g

Use:Aminopoly H, a branch chain amino acid is used in parenteral nutrition. It is used in patient with hepatic encephalopathy. But this type of therapy is controversial.
Contraindication:Anuria, congenital defect in metabolism of branch chain amino acids: maple syrup urie disease, isovaleric acidemia.
Adverse effect:BUN imbalance, diluted hypocalcemia, fever, thrombophlebitis.
Usual dosage:500ml mixed with 50% dextrose 80ml through central vein infusion.

ALFA-CALCIDOL B

Supply:0.25mcg/Cap(ALFACALCIDOLR), 0.5mcg/Tab(LONPRYLR)
Use:1a-hydroxyvitamin D3 is and analog of vitamin D. It can be used in familial hypophosphatemia, hypoparathyroidism, and vitamin D resistant rickets. It is also effective in chronic renal failure patients.
Contraindication:Hypersensitivity, and evidence of vitamin D toxicity or hypercalcemia .
Adverse effect:Execessive doses will result in hypercalcemia or hypercalciuria.
Usual dosage: 0.5 to 1.0mg/day.

CLODRONATE

Supply:60mg/ml 5ml/Amp(BONEFOSR)
Use:Clodronate is effective in the treatment of cancer-related hypercalcemia, Paget’s disease, hyperparathyroidism, and osteolytic bone metastases.
Contraindication:Previous hypersensitivity to clodronate.
Adverse effect:Gastrointestinal disturbances are the primary adverse effects following oral doses; hypocalcemia, nephrotoxicity, leukemia has been observed rarely, unlike etidronate, clodronate does not impair the mineralization of bone.
Usual dosage:Doses of 300mg IV daily for 5 consecutive days (infused over at least 2 hours) or 800 to 3200mg/day PO are usually indicated in the treatment of cancer-associated hypercalcemia; in Paget’s disease, oral doses of 800 to 1600mg/day have been effective.
Administration: Diluted in 500ml of NS and given as an IV infusion over a minimum of 2 hours (generally 2-3 hours), to minimize the risk of renal toxicity

RALOXIFENE

Supply:60mg/Tab(EVISTAR)
Use:Treatment & prevention of osterporosis in postmenopausal women.
Contraindication:Pregnancy & lactation, women with child bearing potential; active or history of venous thromboembolic events; severe hepatic impairment.
Adverse effect:Hot flushes, leg cramps, peripheral edema, venous thromboembolic events
Usual dosage:1 tab daily
CALCITONINA SALMMON C
Supply:1400IU/ml(CALCITONAINA SPRAY NASALE ARMOURR),
50IU/Amp(STEOCINR)
Use:Postmenopausal osteoporosis, Paget’s disease of bone, hypercalcemia
Contraindication:Pregnancy. Lactation. Chronic rhinitis.
Adverse effect:Nausea; flushing(transient); occasionally, hypersensitivity.
Usual dosage:100 IU daily

Hepatic Protectors

RE-LIVER R(Cap) Ext.Cardui marianae Siccum87.5mg
Thiamine Hcl 4mg
Riboflavin 4mg
Pyridoxine Hcl 4mg
Nicotinamide 12mg
Calcium Pantothenate 8mg
Cyanocobalamin 1.2ug
PLEXINA R(3ml/Amp) L-Citrulline 20mg
L-Ornithine HCL 30mg
L-Arginine HCL 100mg
JETEPAR R(Tab) Betaine glucuronate 150mg
diethanolamine glucuronate 30mg
nicotinamide ascorbate 20mg
JETEPAR R(10ml/Amp) Betaine glucuronate 750mg
diethanolamine glucuronate 200mg
nicotinamide ascorbate 100mg
BILIEPA R-300R Ursodeoxycholic Acid 300mg

HEMATOLOGICAL DRUG

FERROUS SALT A

Supply:Ferric hydroxide polymaltose contains 100mg of elemental iron/Tab (FERRUM HAUSMANN CHEWABLER)
Ferro sulfate 324mg contains 65mg of elemental iron/S.C.Tab (FERROUS SULFATER)
Ferrous fumarate50mg/S.C.Tab(BLOODFULLR)
Fe150mg/Cap(NIFEREX-150R)
Ferrous sulfat 160mg, Folic acid 400 mg contains 50 mg of element iron /Tab (SLOW-FE FOLICR)
Use:Iron deficiency due to chronic blood loss, pregnancy, premature babies, severe pernicious anemia.
Contraindication:Patients receiving repeated blood transfusions or with anemias not produced by iron deficiency; with iron-storage or iron-absorption diseases, haemoglobinopathies, or exisitng GI disease.
Adverse effect:Therapeutic dose may cause mild GI discomfort, diarrhea, vomiting; side effect is reduced by taking it with or immediately after food; constipation (large dose > 180mg iron/day), irritant and corrosive effects on GI mucosa, and necrosis and perforation may occur.
Usual dosage:1. Usual therapeutic dosage : Adults: PO 50-100mg of elemental iron TID; child: elemental iron 4-6mg/kg/day in 3 divided doses. 2. Prevent iron deficiency: pregnant women: 30mg of iron, not breast-fed infants: 1mg/kg/day, max 10mg/day; low-birth-weight infants: 2mg/kg/day for 2 months, max 15mg/day; more than 10-year old child: male : 2mg/day, female 5mg/day.

ACETYLSALICYLIC ACID C

Supply:100mg/Tab(TAPALR), 100mg/E.M.Cap(BOKEYR
Use:Muscular and vascular pains, headache, dentalgia, arthritis, bursitis, rheumatoid arthritis, rheumatic fever, inflammatory joints condition. Fever and discomfort of cold, and as an anticoagulant (anti-thrombotic action).
Contraindication:Hypersensitivity to salicylate, active peptic ulceration, hemophilia, severe hepatic damage and pregnancy women.
Adverse effect:Gastric ulceration, dyspepsia, heartburn, hemorrhage, skin eruptions, tinnus, decreased hearing and vertigo.
Usual dosage:Adults: analgesia & antipyresis: 0.6gm Q4H or 0.3g Q3H. anti-inflammatory: 4 gm/daily. Anticoagulant: 325mg TID or QID. Child: 50-75mg/kg/day.

ENOXAPARIN SOD. C

Supply:100mg/ml 0.6ml/Bot(CLEXANER)
Use:Prophylactic treatment of venous thromboembolic disease, particularly in orthopaedic & general surgery. Treatment of established DVT. Prevention of thrombosis in extracorporeal circulation during haemodialysis. Unstable angina, Non-Q-wave myocardial infarction
Contraindication:History of thrombocytopenia during enoxaparin therapy. Hemorrhagic tendencies, organic lesion with tendency to bleed, major blood clotting disorder. Acute infectious endocarditis, hemorrhagic stroke syndrome, acute GI ulcer.
Adverse effect:Hemorrhagic symptoms, thrombocytopenia (rare), hematomas & skin necrosis at inj site; skin allergies or systemic allergic reactions

HEPARIN C

Supply:1000U/ml 5ml/Amp(SODIUM HEPARINR)
5000U/5ml/Vial(HEPARIN LEOR)
Use:Low doses for prophylaxis of postoperative venous thrombosis, high doses to treat established thrombosis.
Contraindication:Tendency of bleeding, in the presence of active peptic ulceration, or severe indigestion, in severe renal or heaptic disease. Hypertension, increases the risk of cerebral haemorrhage. In subacute bacterial endocarditis, embolism is not prevented, and may be accompanied by haemorrhage, especially in the brain.
Adverse effect:Bleeding (after surgery), transient alopecia, allergy (rare), mild thrombocytopenia.
Usual dosage:SC, intermittent IV infusion, continuous IV infusion. Established thrombosis: IV 5000 IU, followed by either 1500 IU per hour given by constant rate infusion pump or alternatively 35000 IU in one liter N/S (stable for 24 hours) infused over 24 hours. i.e. a daily dose of about 4000 IU or 10000 IU through an indwelling IV cannula Q6H. Prevention of thrombosis: 5000 IU SC 2 hours before operation, repeated Q8-12H until patient is ambulatory.

TICLOPIDINE B

Supply:100mg/F.C.Tab(LICODINR), 250mg/Tab(TICLOPIDINER)
Use:Ticlopidine is an antiplatelet drug with a mechanism of action different from that of aspirin or other nonsteroidal antiinflammatory drugs. Ticlopidine decreases platelet aggregation, circulating platelet aggregates, and prolongs bleeding time. It may be useful in the prevention of thromboembolic disorders, cardiovascular mortality, stroke, myocardial infarction, and vaso-occlusive sickle cell crisis. The drug may also be useful in maintaining graft patency or access sites for hemodialysis.
Contraindication:Hypersensitivity, active bleeding disorders, neutropenia or thrombocytopenia, severe liver impairment. Ticlopidine should be discontinued if the absolute neutrophil count falls below 1200/mm3 or if the platelet count falls below 80,000/mm3.
Adverse effect:Neutropenia, thrombocytopenia, leukopenia, agranulocytosis, pancytopenia, thrombocytopenic purpura, hemorrhage, ecchymosis, epostaxis, menorrhagia, gastro-intestinal bleeding, dizziness, nausea, vomiting, abdominal cramps, dyspepsia, flatulence, anorexia, liver damage, rash, urticaria.
Usual dosage:PO 250mg BID, maintain patency in patients on hemodialysis: 200mg QD, duration ranged from 9 days (post-operative thrombosis) to 6 months.

WARFARIN SOD. D

Supply:5mg/Tab(COUMADINR)
Use:Venous thrombosis or pulmonary embolism, and in patients with atrial fibrillation, prosthetic heart valves, rheumatic valvular disease and transient ischaemic attacks, prevention of postoperative deep vein thrombosis.
Usual dosage:PO: Initial daily dosage is 40-60mg; the average maintenance dose is 2-10mg daily, based on the patient’s prothrombin time response.

DESMOPRESSIN B

Supply:0.1mg/Tab(MINIRINR)
Use:Central (neurogenic) diabetes insipidus, for urine concentration test. In addition, desmopressin may be useful in increasing plasma levels of factor VIII activity in patients with hemophilia A or von Willebrand’s disease.
Contraindication:Hypersensitivity to desmopressin, patients with coronary insufficiency and or hypertension.
Adverse effect:Adverse effects include hypotension, headache, psychosis, seizures, water retention and hyponatremia, abdominal cramps, vulval pain, nasal congestion, rhinitis, flushing, local dermatologic effects following injection, and hypersensitivity reactions.
Usual dosage: The initial oral dose is 0.05 mg twice daily titrated to clinical response; the usual range is 0.1 to 0.8 mg daily.

TRANEXAMIC ACID B

Supply:250mg/Cap(TRANSAMINR),
50mg/ml 20ml/Amp(TRANEXAMICR)
Use:Antiplasmin (antifibrinolytic) agent. Used in haemorrhage caused by administration of plasminogen activators (streptokinase, urokinase), obstetric complications, and in hyperplasminaemic states.
Contraindication:In the presence of an underlying thrombosing state.
Adverse effect:Diarrhea, headache, hypotension, heartburn, dizziness, pruritus, erythema, skin rash , nausea, nasal stuffiness, diuresis, muscle pain, weakness, intrarenal obstruction.
Usual dosage:PO 1-1.5gm BID-TID, dosage reduced in renal failure.
IV, usual dose is 0.5 to 1g (10 to 15mg/kg) given 2 to 3 times daily, starting immediately after surgery; and after a few days, 1 to 1.5g orally 3 to 4 times daily.

PHYTOMENADIONE(VITAMIN K1) C

Supply:10mg/1ml/Amp(KATIMIN “1”R)
Use:Hypoprothrombinaemia due to oral anticoagulants, antibacterials and salicylates; hemorrhagic disease of the newborn.
Adverse effect:Severe reactions (flushing, dyspnea, chest pain) and occasionally deaths have occurred after IV, possibly due to emulsifier; inject site allergy.
Usual dosage:IM, SC is preffered; in emergency, direct IV push not exceeding 1mg/min, or IV infusion. Dose, route, duration of therapy are dependent on patient’s requirements and regulated by repeated determinations of prothrombin time. Newborns: 0.5-1.0mg IM or SC, to correct excessively long prothrombin time. In adults: 2.5-25mg or up to 50mg given initially, subsequent doses be individualized on the basis of response.

HORMONES &DRUGS AFFECTING HORMONAL MECHANISM

ACARBOSE B

Supply:50mg/Tab(GLUCOBAYR)
Use:Acarbose is an inhibitor of intestinal a-glucosidases. It is indicated as monotherapy or in combination with sulfonylureas for treating patients with non-insulin dependent diabetes mellitus.
Place in therapy: It acts via competitive inhibition of a-glucosidases which delays absorption of monosaccharides and reduces post-prandial blood glucose.
Contraindication:1.Hypersensitivity. 2.Diabetic ketoacidosis. 3. Cirrhosis. 4.Digestive diseases associated with marked problems in absorption or digestion. 5.Conditions which may worsen as a result of increased intestinal gas. 6.Partial bowel obstruction or predisposition to bowel obstruction. 7.Inflammatory bowel disease. 8.Colon ulcerations.
Adverse effect:GI disturbances include flatulence, meteorism, abdominal pain and distention, diarrhea, and borborygmi are the main adverse effects. Isolated cases of elevated liver enzymes have been reported.
Usual dosage:Initial 25 mg TID with meal, maintenance dose 50-100 mg TID
Pharmacokinetics: Approximately 0.7 to 2% is absorbed from GI tract. Acarbose is not metabolized systemically, but it may be degraded by the influence of intestinal bacteria and the degradation products are absorbed.

GLIBENCLAMIDE C

Supply:5mg/Tab(GLIBENR)
Use:Mild or moderately severe uncomplicated non-insulin dependent diabetes mellitus.
Contraindication:Patients complicated by fever, trauma or gangrene, and with impaired renal or hepatic functions or serious impairment of thyroid or adrenal function, insulin-dependent diabetes mellitus.
Adverse effect:GI disturbances, dizziness, jaundice, skin rashes and blood disorders.
Usual dosage:Initial dose 5mg/day, may be gradually increased if necessary, up to 20mg daily.

GLICLAZIDE

Supply:80mg/Tab(DIAMICRONR, GLIZIDER)
Use:All types of maturity onset diabetes.
Contraindication:Patients complicated by fever, trauma or gangrene, and with impaired renal or hepatic functions or serious impairment of thyroid or adrenal function, insulin-dependent diabetes mellitus.
Adverse effect:Skin reaction, headache, GI disturbances.
Usual dosage:Initial dose 40-80mg/day, gradually increased if necessary up to 320mg/day.

GLIPIZIDE

Supply:5mg/Tab(MINIDIABR)
Use:Non-insulin dependent diabetes mellitus (Type II) patients whose hyperglycemia cannot be controlled by diet alone.
Contraindication:Patients complicated by fever, trauma or gangrene, and with impaired renal or hepatic functions or serious impairment of thyroid or adrenal function, insulin-dependent diabetes mellitus.
Adverse effect:Nausea, anorexia, vomiting, pyrosis, gastralgia, diarrhea, constipation, allergic skin reaction, dizziness, drowsiness, headache.
Usual dosage:PO 2.5mg to 20mg QD, administered approximately 30 minutes before meals; maximum dose: 40mg/day

GUAR GUM

Supply:5gm/Sachet(GUAREM GRANULESR)
Use:Listed in dosage
Contraindication:Patients with esophageal or intestinal obststion
Adverse effect:GI disturbances
Usual dosage:Diabetes 1 sachet tid with meals. Hypercholesterolemia 1 sachet 2-5 times

METFORMIN HCL

Supply:250mg/F.C.Tab(GLUCOMINR), 500mg/F.C.Tab(GLUCOFITR, GLUBINR, GLUCOMINR), 500mg/Tab(GLUCOPHAGER), 850mg/Tab(METFORMINR)
Use:May be used as insulin or sulfonylurea replacement or supplement in severe as well as mild adult diabetes. Because of toxicity (lactacidosis) use severely restricted.
Contraindication:Diabetic coma and ketoacidosis; renal impairment; chronic liver disease; cardiac failure & recent MI; alcoholism; hypoxemia; history of lactic acidosis; hypersensitivity; shock.
Adverse effect:GI disturbances, skin rash, and lactacidosis.
Usual dosage:0.75-1.5g daily.
Special precautions:Pregnancy, lactation, stop therapy 2-3 days before surgery, conditions which may cause dehydration, patients with serious infection or trauma. Regular renal monitoring is needed

INSULIN(RECOMBINANT DNA) B

Supply:Human NPH insulin 100 IU/ml, 10 ml/Vial;
Human RI 100 IU/ml, 10 ml/Vial
MIXTARD Humulin 70/30 Inj 100U/ml, 10ml/Vial, 70% Human insulin isophans, 30% Human insulin
Use:Treatment of insulin-dependent diabetic patients.
Contraindication:Hypoglycemia.
Adverse effect:Lipodystrophy, insulin resistance and hypersensitivity reaction have rarely been reported.
Usual dosage:1. Humulin R: SC, IM, IV; onset of action occurs at approximately 30 minutes with a duration of 5 to 7 hours and peak activity at 1 to 3 hours.
2. Humulin N: SC, IM; onset of action occurs at approximately 1 hour with a duration of 18 to 20 hours and peak activity at 2 to 8 hours may be given as a single dose before breakfast.
Special precautions:Psychic stress, infection or other disease that increase insulin requirement. Pregancy.

Thyroid hormones

THYROXIN SOD. B

Supply:100mcg/Tab(ELTROXINR)
Use:Hypothyroidism.
Contraindication:Thyrotoxicosis.
Adverse effect:Anginal pain, cardiac arrhythmia, tachycardia, diarrhea, flushing, sweating, and muscular weakness.
Usual dosage:50-300mg/day.
Special precautions:Elderly; those with myocardial insufficiency or ECG evidence of MI; diabetes mellitus or insipidus. Initiate corticosteroid therapy befors giving thyroxine to patients with panhypopituitarism or other cause predisposing to adrenal insufficiency, pregnancy, lactation.

Antithyroid drugs

CARBIMAZOLE

Supply:10mg/Tab(NEWMAZOLER)
Use:Hyperthyroidism.
Contraindication:Patient in treated with radioactive iodine.
Adverse effect:Headache, rash, and GI upsets.
Usual dosage:5-10mg TID or QID.

METHIMAZOLE D

Supply:5mg/Tab(TAPAZOLER)
Use:Treatment of hyperthyroidism
Contraindication:Pregnancy & lactation
Adverse effect:Skin rash, urticaria, nausea, vomiting, epigastric distress, hair loss, myalgia, edema, janudice, sialadenopathy, lymphadenopathy & much less frequency of inhibition of myelopoiesis.
Usual dosage:Adult Mild hyperthyroidism 15 mg daily in 3 divided doses 8 hrly. Maintenance: 5-15 mg daily
Special precautions:Agranulocytosis

PROPYLTHIOURACIL D

Supply:50mg/Tab(PROCILR)
Use:Hyperthyroidism
Contraindication:Patients with hypersensitive to the drug.
Adverse effect:Skin disorder, agranulocytosis, thrombocytopenia, jaundice, edema.
Usual dosage:Initial 50-100mg TID, maintenance 100-150mg TID.

OXYTOCIN X

Supply:10IU/1ml/Amp(PITON-SR)
Use:Used in induction of labor, uterine inertia, postpartum bleeding.
Contraindication:Toxemia abruption placenta, undilated cervix over distended uterus, abnormal presentation, and cardiovascular or renal disease.
Adverse effect:Nausea, vomiting, cardiac arrhythmia, fetal bradycardia, postpartum hemorrhage, afibrinogenemia, pelvic hematoma, water intoxication.
Usual dosage:Dosage is determined by uterine response:
Induction of labor: IV infusion: 10 unit diluted with 1000ml isotonic saline or dextrose and staring at 0.01 unit per minute. the dosage can be doubled every 30-45 minutes. IM: initial dose 0.1 unit increasing to 0.2, 0.4, 0.8 unit etc every 30 minutes intervals.Control postpartum bleeding: 20-40 unit diluted with 1000ml isotonic saline or dextrose IV infusion. Stimulation of lactation 2 iu IM.Treatment of incomplete abortion 2-5 iu IM every 30-60 mins or IV infusion in adequate dose.
Special precautions:Careful monitoring essential. Existence of scars of the uterus & cervix. Hypotension.

RITODRINE CHL B

Supply:10mg/Tab(YUTOPARR), 10mg/ml/Amp(ANPOR)
Use:Premature labour (after 20th week), prevention of premature labour after gynecological operations, acute fetal distress during labour if caused by hypermotility of the uterus or compression of the umbilical cord.
Contraindication:Patients with heavy blood loss per vaginam, maternal cardiac disease, chorioamnionitis.
Adverse effect:Palpitation, increase maternal pulse rate, tachycardia, flushing, sweating, tremor, nausea, vomiting.
Usual dosage:Premature labor: IV, initial dose 0.05mg/min to be gradually increased according to the results by 0.05mg/min every 10 minutes. The effective dosage: 0.15-0.35mg/min. The infusion should be continued for 12 to 48 hours after the uterine contraction have ceased. Tab 1-2 tab 2-6 hrly. Max: 120mg daily. Usually 80-120 mg equally divided over the day
Special precautions:Patients with potential cardiac risk & cardiac abnormalities. Careful monitorong of patients with suspected cardiac disorders. Occult cardiac disease may be unmasked. Diabetic patients or those receiving K-depleting diuretics.Monitor patient’s state of hydration, avoid fluid overload. IV treatment for greater than or equal to 2-3 wk may lead to leucopenia &/or agranulocytosis with complete recovery after discontinuation of treatment

DEXAMETHASONE PHOSPHATE C

Supply:5mg/ml/Amp(METHASONER)
Use:Rheumatic arthritis, certain leukemia, lymphoma, soft tissue inflammation, head injury, hemolytic anemia and other collagen diseases.
Contraindication:Systemic fungal infections.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:PO, 0.75-9mg/day.

HYDROCORTISONE SODIUM SUCCINATE C

Supply:100mg/Vial(SOLU-CORTEFR)
Use:Cortisone is used for replacement therapy in chronic adrenocortical insufficiency, salt-losing forms of congenital adrenal hyperplasia syndromes, and as an anti-inflammatory agent.
Contraindication:Systemic fungal infection.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:20-240mg/day, IM or IV.

METHYLPREDNISOLONE SODIUM SUCCINATE C

Supply:4mg/Tab(MEDNINR), 125mg/Vial(MEDASONR), 40mg/Vial(STERILE SOLU-MEDROLR)
Use:Endocrine disorders, severe shock, collagen disease, bronchial asthma and dermatologic disease.
Contraindication:Systemic fungal infections.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:Usual dose 4-48mg/day IV over one to several minutes; high dose therapy, 30mg/kg IV over 10-20 minutes, may be repeated Q4H or Q6H for 48 hours.

PREDNISOLONE B

Supply:5mg/Tab(PRECONINR)
Use:Endocrine and rheumatic disorders; collagen, dermatological ophthalmic, respiratory and GI disease, exacerbation of multiple sclerosis, trichinosis associated with neurological or myocardial involvement.
Contraindication:Systemic fungal infection.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:5-60mg/day, maximum dose: 250mg/day.

METHYLTESTOSTERONE X

Supply:10mg/Cap(METHYLTESTOSTERONER)
Use:Eunuchism, eunuchoidism, male climacteric or impotence, postpubertal cryptorchidism with evidence of hypogonadism, postpartum breast pain and engorgement, advanced inoperable androgen after having stopped medication.
Contraindication:Male breast carcinoma, hypercalcemia, easily stimulated patients carcinoma of the prostate, hepatic impairment, cardiac, hepatic or renal decompensation, prepubertal males.
Adverse effect:Skin reactions, anaphylactoid reactions; acne, decreased ejaculatory volume, cholestatic jaundice, edema, hypercalcemia.
Usual dosage:PO, 10-40mg/day for eunuchism, 30mg/day for postpubertal cryptochidism, 80mg/day for 3-5 days for postpartum breast pain and engorgement, 200mg/day for advanced inoperable androgen responsive breast cancer in females.

CYPROTERONE ACETATE

Supply:50mg/Tab(ANDROCURR)
Use:Cyproterone acetate is an antiandrogen with progestogenic activity. Use alone or in combination with estrogens has demonstrated some degree of efficacy in a variety of conditions, including advanced prostatic carcinoma, hypersexual behavior disorders, endometriosis, hirsutism, acne, post-orchiectomy hot flashes, and lupus erythematosus; low doses of the drug with estrogen have been evaluated in postmenopausal replacement therapy.
Contraindication:It should not be used in patient previous hypersensitivity to cyproterone acetate, malignant diseases other than prostatic carcinoma, patients with a history of thromboembolic disorders, acute liver disease. Other precautions include: patient with severe chronic depression or immature youth (potential for delayed bone maturation and testicular development). Don’t use with alcohol.
Adverse effect:Skin reaction, weight change , headache, anaemia, gynaecomastia, abnormal spermatozoa, nausea, hair pattern, infertility, gastrointestinal disturbance, decrease renal function.
Usual dosage:50mg BID, if necessary after 4 weeks, increase to 200-300mg/day

*ESTANDROM PROLONGATUMR X

Content:per ml Estradiol benzoate 1 mg, estradiol phenylpropionate 4 mg, testosterone propionate 20mg, testosterone phenylpropionate 40mg, testosterone isocaproate 40 mg
Use:Estrogen deficiency symptoms associated with natural or surgical menopause
Adverse effect:GI upsets; BP rise, thrombosis; erythema nodosum, acne, hirsutism; headache, migraine, mood changes; breast tendermess, pain, enlargement & secretions; body weight changes; intermenstrual bleeding, enlarged clitoris.
Usual dosage:1 ml every 3-4 week or longer interval, depending on the clinical need. By IM inj only

CONJUGATED ESTROGEN X

Supply:0.625mg/Tab(PREMARINR)
Use:Severe vasomotor symptoms associated with the menopause; primary ovarian failure; atrophic vaginitis.
Contraindication:Breast cancer; estrogen dependent neoplasia, pregnancy, active thrombophlebitis, or thromboembolic disorders, abnormal vaginal bleeding.
Adverse effect:Breast tenderness, enlargement and secretion; melasma, erythema multiforme erythema nodosum, migraine, dizziness, mental depression and chorea.
Usual dosage:

  1. Moderate to severe vasmotor symptoms associated with the menopause: 1.25mg/day. If the patient is menstruating, begin administration on day 5 of bleeding.
  2. Atrophic vaginitis and kraurosis vulvae: 0.3 to 1.25mg or more per day.
  3. Female hypogonadism: 2.5-7.5mg/day, TID for 20 days, followed by a rest period of 10 days.
  4. Female castration and primary ovarian: 1.25mg/day.
  5. Mammary carcinoma (for palliation): 10mg TID for at least 3 months.
  6. Prevention of postpartum breast engorgement: 3.75mg Q4H for 5 doses or 1.25mg Q4H for 5 days.

DANAZOL X

Supply:200mg/Cap(CYCLOLADYR)
Use:Endometriosis, fibrocystic breast disease, menorrhagia.
Contraindication:Abnormal genital bleeding; impaired hepatic, renal or cardiac function; pregnancy and breast feeding.
Adverse effect:Acne, edema, mild hirsutism, decrease in breast size, weight gain and testicular atrophy.
Usual dosage:Endometriosis: make sure the patient is not pregnancy, administer 800mg/day BID for 3-6 months, up to 9 months. Fibrocystic breast disease: 100-400mg BID.

DYDROGESTERONE

Supply:5mg/Tab(DUPHASTONR)
Use:Dysmenorrhea, endometriosis, infertility, threatened abortion, secondary amenorrhoes and functional uterine bleedings.
Adverse effect:GI disturbances and mild leukocytosis. Breakthrough bleeding (increase dosage)
Usual dosage:Infertility 10 mg bid from day 11-25 of the cycle. Duration:3 mouth. Threatened abortion 40mg at once then 10 mg 8 hrly until symptom remit. Habitul abortion 10 mg bid until the 20th wk of pregnancy. Duration:3 mouth.Primary dysmenorrhea 10 mg bid from day 5-25 of the cycle. Duration:3-6 mouth. Endometriosis 10mg bid-tid from day 5-25 of the cycle or continuously. Duration:3-9 mouth Premenstrual syndrome 10 mg bid from day 11-25 of the cycle.Duration:3-6 mouth. Secondary amenorrhea An estrogen once daily from day 1-25 of the cycle with 10 mg dydrogesterone bid from day 11-25 of the cycle. Duration: 3 mouth.Dysfunctional uterine bleeding To stop bleeding :10mg bid with an estrogen once daily for 5-7 days. To prevent bleeding:10mg bid with an estrogen once daily from day 11-25 of the cycle. Duration:3 mouth
Warning:Breakthrough bleeding may occur in a few patients. It can be prevented by increasing the dosage.

OESTROGEL

Supply:Cream 30g/Tube, each gram content 17-�� estradiol 0.6mg
Use:Oestrogel is indicated in estrogen deficiency following the decrease in ovarian activity, vaginal dryness and atrophy.
Contraindication:Malignant tumors of the breast or uterus, pituitary tumors, avoid in women with past or present thromboembolic disease.
Adverse effect:Increase the risk of endometrial cancer, nausea, high dose may produce hypertension
Usual dosage:Topical 2.5g QD over the largest area of both arms, or forearms, or shoulder, but avoiding the area of the breast and vulvar mucosa.

*COVINA X

Content:estradiol 2mg, norethisterone 1mg
Use:Estrogen deficiency syndrome, prevention of bone mineral content loss, in post menopausal women at increased risk of developing fractures.
Adverse effect:Breast tenderness, nausea, headache, edema.
Usual dosage:1 tab daily

*SEVINA X

Content:12 blue tab each containing estradiol 2 mg,10 white tab each containing estradiol 2mg, noresthisterone acetate 1mg. 6 orange tab each containing estradiol 1 mg
Use:Estrogen deficiency. Prevention of menopausal osteoporosis.
Adverse effect:Unscheduled bleeding. Alopecia, skin hypersensitivity, visual disturbances
Usual dosage:1 tab daily. Women on hormone replacement therapy or menstruating 1 tab from day 5 of the cycle

MEDROXYPROGESTERONE ACETATE D

Supply:5mg/Tab(ProveraR)
Use:Treatment of secondary amenorrhea and abnormal uterine bleeding caused by hormonal imbalance in patients without underlying organic pathology such as fibrosis or uterine cancer.
Contraindication:Patients with thrombophlebitis, thromboembolic disorders, cerebral apoplexy, undiagnosed vaginal bleeding, missed abortion.
Adverse effect:Changes in menstrual flow, spotting, amenorrhea, changes in cervical erosion and secretions, edema, weight gain or loss, cholestatic jaundice, breast tenderness, gastrointestinal disturbances, galactorrhea, and dermatologic effects.
Usual dosage:Treatment of secondary amenorrhea and abnormal uterine bleeding, usual oral dosage is 5-10mg daily for 5-10 days.
Mammary carcinoma, prostate carcinoma, renal carcinoma: 100-1000mg/day in 2-3 divided doses, may be combined with other antineoplastic agents.

NORETHISTERONE ACETATE

Supply:5mg/Tab(NORETONER, PRIMOLUT-NORR)
Use:Primary and secondary amenorrhoea, premenstrual syndrome, uterine hypoplasia, progressive carcinoma of the breast.
Contraindication:Pregnancy, severe liver disease, Dubin-Johnson syndrome, Rotor syndrome.
Adverse effect:Cholestatic liver changes (in high dose).
Usual dosage:10-20mg/day.

*ESTROMON

Content:Conjugated estrogens
Use:Primary ovarian failure, primary amenorrhea, management of menopause syndrome
Adverse effect:Fluid & salt retention, edema; weight gain; breast tenderness, gynecomastia; altered liver function, jaundice; depression; GI upsets, dizziness, chloasma, rash, urticaria, erythema multiforme; endometrial hyperplasia
Usual dosage:1 tab daily

  • DIANE-35
    Content:Cyproterone acetate 2 mg, ethinylestradiol 35µg
    Use:Androgen-dependent disease in women
    Adverse effect:Headache; gastric upset; nausea; breast tension; changes in body weight & libido; intermenstrual bleeding; depressive moods; chloasma; rarely, poor tolerance of contact lenses, fluid retention.
    Usual dosage:1 tab daily for 21 days, starting on the 1st day of the cycle, then 7 tab-free days

ANTIHISTAMINES AND ANTIALLERGIC DRUG

CETIRIZINE DIHYDROCHLORIDE

Supply:10MG/F.C.TAB(CETIZINER, ZYRTECR) Use:Cetirizine, a metabolite of hydroxyzine, is a H1-receptor antagonist with minimal anticholinergic or central nervous system activity. It has been used in allergic rhinitis, perennial allergic rhinitis, and chronic urticaria.
Place in therapy: Drugs that inhibit cytochrome P-450 enzymes (i.e., azithromycin, ketoconazole, and erythromycin) do not interfere with the pharmacokinetic disposition of cetirizine. The reduced propensity of arrhythmias associated with cetirizine will likely favor the selection of this drug over other second generation antihistamines.
Contraindication:Hypersensitivity to cetirizine or hydroxyzine; Avoid concurrent use of central nervous system depressants or patient with renal insufficiency or hepatic dysfunction.
Adverse effect:Generally, cetirizine is well tolerated, but somnolence, fatigue, and dry mouth are the common side effects. Doses greater than 10 milligrams may be associated with a higher frequency of side effects, especially sedation.
Usual dosage:Adults: 10 mg PO QD
Special precautions:Pregnancy

CHLORPHENIRAMINE MALEATE

Supply:4MG/TAB(CHLORPHENIRAMINER)
Use:Rhinitis, pruritus and urticaria, hay fever, contact dermatitis, drug sensitization.
Contraindication:Lower respiratory tract disease, newborn or premature infants, nursing mother.
Adverse effect:Nausea, headache, drowsiness, dizziness and irritablity, disturbance of vision.
Usual dosage:Adults: 4mg TID or QID, maximum dose 24mg/day
Child: 6-12 yrs, 2mg TID or QID.
2- 6 yrs, 1mg TID or QID.
maximum pediatric dose: 12mg/day
CONAMIN
Content:CHLORPHENIRAMINE MALEATE 2MG+CAFFEINE ANHYDROUS 30MG

CYPROHEPTADINE

Supply:4MG/TAB(CYPROHR)
Use:Pruritus, eczema, urticaria, appetite stimulant, migraine headache.
Contraindication:Patient with glaucoma; it should not be prescribed for elderly debilitated.
Adverse effect:Dry mouth, dizziness, drowsiness, nausea and irritability.
Usual dosage:Allergy: Adults: 4mg TID (Max. 32mg/day).
Child: 2- 6 yrs, 2mg BID or TID (Max. 12mg/day)
7-14 yrs, 4mg BID or TID (Max. 16mg/day)
Stimulation of appetite: Adults: 2-4mg TID or QID.
Child: 2-6 yrs, 2mg BID or TID(Max. 8mg/day)
Migraine: initially 4mg, not to exceed 8mg within 4-6 hours.

DIPHENHYDRAMINE HCL

Supply:30MG/AMP(VENALINR)
Use:Symptomatic relief of allergic symptoms caused by histame release which include nasal allergies and allergic dematosis;can be used for mild nighttime sedation;prevention of motion sickness and as an antitussive;has antinauseant and topical anesthetic properties;treatment of phenothiazine-induced dystonic reactions
Contraindication:Hypersensitivity to diphenhydramine or any component; should not be used in acute attacks of asthma
Adverse effect:Dry mouth. sedation, dizziness, irritability, thickening of bronchial secretions.
Usual dosage:PO, usual dose 25-50mg TID or QID.
IM or IV, usual adult dose is 10-50mg, maximum adult dosage
is 400mg daily.
Patient information:Maycause drowsiness;swallow whole,do not crush or chew sustained release product; avoid alchol, may impair coordination and judgment
Special precautions:Diphenhydramine has high sedative and anticholinergic properties,so it may not be considered the antihistamine of choice for prolonged use in the elderly. Use with caution in patient with angle-closure glaucoma, pepticulcer, urinary tract obstruction, hyperthyroidism; some preparation contant sodium bisulfite;syrup contant alcohol

HISTAP-P

Cotent:BROMPHENIRAMINE MALEATE 4MG + PHENYLPR 5MG

LORATADING

Supply:10MG/TAB(CLARITYLINER, GENADINER, LORAR)
Use:Loratadine is a long-acting, non-sedating antihistamine. It is an antihistamine with very little sedative and anticholinergic properties. It is an effective antihistamine for the treatment of allergic rhinitis.
Contraindication:Hypersensitivity, caution in patients who are at risk for drowsiness, asthma, or syncope.
Adverse effect:Loratadine is well tolerated. The most common side effects reported in clinical trials are headache and nausea. Other side effects includes sedation, dizziness, dry mouth, fatigue. When coadministrate with erythromycin, cimetidine or ketoconazole, the serum level of these drugs are elevated but no QT interval prolongation observed.
Drug interaction:CYP2D6 and 3A3/4 enzyme substrate
Increase plasme concertration of loratadine and its active metabolite with ketoconazole; erythromycin increase the AUC of loratadine and its activity metabolite
Usual dosage:Adult: 10 mg PO QD Child: for 6-11 years of age 10 mg PO QD.
Patient Information:Drink plenty of water; may cause dry mouth; sedation; drowsiness, and can impair judgment and coordination
Special precautions:Patients with liver impairment should should start with a low dose; safety in child

MEQUITAZINE

Supply:5MG//TAB(PRIMALANR)
Use:Mequitazine, a phenothiazine derivative, is an antihistamine with antimuscarinic and mild central sedative properties. Mequitazine is used for the symptomatic relief of hypersensitivity reactions.
Contraindication:Hypersensitivity to this drug.
Adverse effect:Dry mouth, disturbance of visual accommodation
Drug interaction:CNS depressant, antichlolinergic, TCA, MAOIs, alcohol
Usual dosage:Adults: 5 mg PO, BID
Special precautions:Hepatic disease, glaucoma, prostatic hypertropic, epilepsy. May impair ability to dirve or operate machinery.

RESPIRATORY TRACT DRUGS

ANTITUSSIVE DRUGS EXPECTORANTS & MUCOLYTIC DRUGS

ANTITUSSIVE DRUGS EXPECTORANTS & MUCOLYTIC DRUGS
ACETIN R ACETYLCYSTEINE 66.67 MG/GM 1.50gm MUCOLYTIC AGENTS
BISOLVON R BROMHEXINE HCL 8mg MUCOLYTIC AGENTS
AMBROXOL R AMBROXOL HYDROCHLORIDE 30mg EXPECTORANTS
DESPUTUM R IODOPROPYLIDENE GLYCEROL 30mg EXPECTORANTS
KODERLIN R GUAIACOL GLYCERYL ETHER 88mg CODEINE PHOSPHATE 4.8mg DL-METHYLEPHEDRINE HCL 20mg EXPECTORANTS COMPOSITE
MUCOSOLVAN R AMBROXOL HYDROCHLORIDE 30mg EXPECTORANTS
MUSCO R AMBROXOL HYDROCHLORIDE 30mg EXPECTORANTS
SAPONAL R 0.7g EXPECTORANTS
BENSAU R BENZONATATE 100mg ANTITUSSIVES
BECANTEX R SODIUM DIBUNATE 30mg ANTITUSSIVES
COLIN R CHLORPHENIRAMINE MALEATE 120ml ANTITUSSIVES
KOSONIN R SYRUP CODEINE PHOSPHATE 120ml ANTITUSSIVES
MEDICON-A R DEXTROMETHORPHANE HBR 20mg POTASSIUM CRESOLSULFONATE 90mg LYSOZYME CHLORIDE 20mg ANTITUSSIVES
PACOMIN R OXELADIN CITRATE 20mg ANTITUSSIVES
REGROW R DEXTROMETHORPHAN HBR 60mg ANTITUSSIVES
EPHEDRINE R EPHEDRINE HCL 40mg/ml1ml SYMPATHOMIMETIC or ADRENERGIC
KODAPIN R ORCIPRENALINE SULFATE 5mg BROMHEXINE HYDROCHLORIDE 8mg DOXYLAMINE SUCCINATE 7.5mg SYMPATHOMIMETIC or ADRENERGIC
ISON R CARBINOXAMINE MALEATE PHENYLPROPANOLAMINE HCL20mg CAFFEINE ANHYDROUS 30mg COMMON COLD PREPARATIONS
HUSCOL R CHLOPERASTINE HCL 20mg POSTASSIUM GUAIACOL SULFONATE 80mg DL-METHYLEPHEDRINE HCL 16.6mg CHLORPHENIRAMINE MALEATE 2.5mg COMMON COLD PREPARATIONS
V-COME R Acetaminophen 325mg Chlorpheniramine maleate 2mg Pseudoephedrine HCL 30mg Dextromethorphan HBR 15mg COMMON COLD PREPARATIONS

GASTROINTESTINAL DRUGS

TOPAAL

Content :Silica hydrated 130 mg, colloidal Al(OH)3 30mg, Mg bicarbonate 40 mg, alginic acid 200 mg
Use:Heartburn, hiatal hernia, peptic esophagitis, gastritis, peptic ulcer, gastroesophageal reflux.
Adverse effect:Diarrhea, constipation.
Usual dosage:2 tab bid-tid
Special precautions:Renal insufficiency; low phosphate diet.

ALDIOXA

Supply:100MG/TAB(ALUSAR, PEIWETSUR)
Use:Peptic & duodenal ulcer.
Contraindication:Hypophosphatemia.
Adverse effect:Constipation
Usual dosage:1 tab tid

DIMETHICONE

Supply:40MG/TAB(SIMETHICONER)
Use:Antiflatulent, relief GI gas pain.
Contraindication:Infant colic.
Adverse effect:None
Usual dosage:Tab: 1-2 Tabs QID, PC & HS. Drops: 2ml QID, PC & HS (shake well before using).

MAGALDRATE

Supply:200MG/TAB(MAGACIDR)
Use:Over-secretion of gastric acid.
Usual dosage:2-4 tab qid

MAGALDRATE
BOWCON R PIPERILATE 3MG+MAGNESIUM ALUMINUM 295MG
SPAGASTROL R BUTINOLIN PHOSPHATE 600MGBISMUTH 150MG
BALUNAR DIHYDROXYALUMINUM SODIUM CARBONATE 350MG
LEDERSCONER ALUMINUM HYDROXIDE DRIDE GEL334MG ANTIFOAM AF EMULSION 36.7MG
ULSTALR OXETHAZAINE 0.95MG/MLMAGNESIU 20MG/ML
MIXANATER PIPETHANATE 1.5MGALUMINUM MAGNESIUMS 147.5MG
SIMEGELR SIMETHICONE EMULSION 20MGMAGNESIUM HYDROXIDE 128MG
STOMACHICR DIASTASE 110MG SCOPOLIA 5MGBELLADONNA 5MG
STACAINER SULCAIN(ETHYL-P-PIPERIDYLACETYLAMINOBENZOATE
SUPERGELR ALUMINUM HYDROXIDE DRIED GEL 200MG SIMETHICONE 20MG
HOMALINR ALUMINUM HYDROXIDE 299MG
WELLPINR ALUMINUM HYDROXIDE MAGNESIUM CARBONATE CO-DRIDE GEL 282MGSIMETHICONE 25MG

CIMETIDINE B

Supply:300MG/2ML/AMP(TAGAMETR),400MG/F.C.TAB(TAGAMETR)
Use:Gatric and duodenal ulcer, gastroesophageal reflux, pathological hypersecretory conditions (eg. Zollinger-Ellison
syndrome) , stress related mucosal damage.
Adverse effect:Dizziness, headache, confusional states, diarrhea, rash, gynecomastia, impotence, thrombocytopenia, muscular pain, cardiac arrhythmia.
Usual dosage:Adults: 300mg Q6-8H (IV, IM), 300mg QID (PO) and treated continuously for 4-6 weeks. Max. dose: 2.4gm/day, 12gm/day in hypersecretory condition. Oral 400mg HS for prophylaxis of recurrent ulcer.
Child: 20-40mg/kg/day (Tab, Inj) in divided doses, four times a day.
Dosage adjustment : according to CrCl (ml/min)
> 50 : 300mg Q6H or 300mg QID
20 – 50 : 300mg Q8H or 300mg TID
< 20 : 300mg Q12H or 300mg BID
Special precautions:Impaired renal function; gastric malignancy; hemodialysis; pregnancy, lactation; elderly.

RANITIDINE B

Supply:150MG/F.C.TAB(QUICRANR, WEIDOSR), 25MG/ML/2ML/AMP(VESYCAR), 50MG/5ML/AMP(GETWAYR)
Use:Similar to cimetidine
Contraindication:
Adverse effect:Dizziness, insomnia, rash, arthragia
Usual dosage:Adults: IV, IM : 50mg Q6-8H; PO : 150mg BID or 300mg HS for treatment of duodenal or gastric ulcer; maximum dose: IV 400mg/day, PO 6gm/day; PO 150mg HS for prophylaxis of recurrent ulcer.
Child: Oral, 2-4mg/kg, two times a day up to a maximam dose of 300mg/day. IV, 2-4 mg/kg/day, in divided doses.
Dosage adjustment : according to CrCl (ml/min)
> 50 : 50 mg Q6-8H or 150 mg BID
20 – 50 : 50 mg Q12H or 150 mg HS
< 20 : 50 mg Q24H or 150 mg HS
Special precautions:Renal & hepatic impairment, gastric malignancy.

NIZATIDINE C

Supply:150MG/CAP(TAZAC PULVULESR)
Use:Duodenal ulcers, gastroesophageal reflux disease.
Contraindication:Patients who have a hypersensitivity to other H2-antagonists, should not receive nizatidine since a cross-sensitivity has been observed with this class of drugs.
Adverse effect:Headache is the most common side effect followed by gastrointestinal effects and dizziness.
Usual dosage:150mg BID or 300mg HS
Special precautions:Symptomatic response to nizatidine dose not preclude gastric malignancy; moderate to severe renal insufficiency; pregnancy & lactation.

FAMOTIDINE B

Supply:20MG/F.C.TAB(FAMODINER, VOKERR, WEIMOKR), 20MG/AMP(FORGASR), 40MG/F.C.TAB(WEIMOKR)
Use:Similar to cimetidine.
Contraindication:Hypersensitivity to famotidine or other H2-antagonists
Adverse effect:Headache, dizziness, diarrhea, constipation, arthralgia, somnolence, rash.
Drug interaction:Decreased effect of ketoconazole, itraconazole
Usual dosage:Adults: IV 20mg Q12H, PO 20mg BID or 40mg HS for treatment of duodenal or benign gastric ulcer. PO 20-40mg BID for treatment of GERD. Oral max. dose: 640mg/day. Oral 20 mg HS for prophylaxis of recurrent ulcer. Child: For BW > 10kg : PO 1-2mg/kg/day, in two divided doses. For BW < 10kg : PO 1-2mg/kg/day, in three divided doses.
Dosage adjustment : according to CrCl (ml/min)
> 50 : 20 mg Q6-8H or 20-40 mg BID
20 – 50 : 20 mg Q12H or 20 mg BID
< 20 : 20 mg Q24H or 20 mg HS
Special precautions:Modify dose in patients with renal impairment

CETRAXATE HCL

Supply:200MG/CAP(NEUERR)
Use:Peptic ulcer.
Adverse effect:Thirst, GI disturbances, fullness in abdomen, exanthema, hypersensitivity.
Usual dosage:200 mg tid-qid.
Special precautions:Thrombosis, consumption coagulopathy;pregnancy.

SUCRALFATE B

Supply:500MG/TAB(WEIZIPR), 1GM/SUSP.PKG(SUCRATE GELR), 1GM/SACHET.PKG(YUWAN-SR)
Use:Short-term management of duodenal ulcers
Unlabeled use: Gastric ulcers maintenance of duodenal ulcers; suspension may be used topically for treatment of stomatitis due to cancer chemotherapy and other cause of esophagel and gastric erosions; GERD, esophagitis; treatment of NSAID mucosal damage; prevention of stress ulcers; postsclerotherapy for esophageal variceal bleeding
Adverse effect:Dizziness, dry mouth, constipation may occur after prolong use.
Usual dosage:Weizip 2 tab tid-qid before meals. Sucrate 1 sachet bib, Maintenance:1 sachet daily. Yuwan-s 1g qid or 2g bid
Patient information:Take before meals or on empty stomach; do not take antacid 30 minutes befor or after taking sucralfate
Mechanism: Forms a complex by binding with positively charged proteins in exudates, forming a viscouse paste-like, adhesive substance. This selectively form a protective coating that protects the lining against peptic acid, pepsin, and bile salts

ALVERINE

Supply:60NG/CAP(SPASMONALR)
Use:Dysmenorrhea & pre-menstrual pain; selsctive muscle spasmolytic in conditions eg. Irritable bowel syndrome, painful diverticular disease of the colon.
Contraindication:Paralytic ileus.
Usual dosage:Adult & elderly 1 or 2 cap once-tid.
Special precautions:1st trimester of pregnancy.

CEFATROPIN

Contect: atropine sulfate 0.01 mg , Complex silver compound 0.1 mg, gelsemine extr 0.08 mg
Use:Gastric & duodenal ulcer, gastritis, indigestion, heartburn, pressure, spastic pain in the stomach region.
Usual dosage:1-2 tab tid before meals.

ATROPINE SULFATE

Supply:1MG/1ML(ANTOPINR)
Use:Antisecretory, antispasmodics, treatment of acute poisoning of parasympathomimetic agents.
Contraindication:Prostatic enlargement, paralytic ileus, pyloric stenosis, glaucoma, tachycardia.
Adverse effect:Tachycardia, increasing ocular tension, pupils dilatation, dry mouth, blurred vision, dysurea, headache, weakness, nausea, vomiting, restlessness, rash.
Usual dosage:Anticholinergic: 0.4-0.6mg IV, SC. Preanesthetic medication: 0.3-0.6mg, SC, IM or IV. Antidote of cholinesterase inhibitor: 2-4mg IV then 2mg, every 5-10min, IM, until muscarinic symptoms disappear or atropine toxicity appear.

HYOSCINE-N-BUTYLBROMIDE

Supply:10MG/S.C.TAB(BUSCOPANR), 20MG/1ML(KOSCOPANR)
Use:Gastric & duodenal ulcer, intestinal & cholelithic colic.
Contraindication:Hypersensitivity, glaucoma, tachycardia, GI obstructive, megacolon, ulcerative colitis, myasthenia gravis.
Adverse effect:Dry mouth, urinary hesitancy, blurred vision, constipation, tachycardia, drowsiness, dizziness, nausea, vomiting, headache, flushing.
Usual dosage:IM, SC or IV 10-20mg QD, POAdult & child >6yr 1-2 tab 3-5 times daily.

METHSCOPOLAMINE METHYISULFATE

Supply:1MG/F.C.TAB(DAIPINR)
Use:Spasms & hypermotility of GIT, biliary & renal tract dyskinesia
Contraindication:Dysuria due to prostatic enlargement; paralytic ileus; glaucoma; severe heart diseases.
Adverse effect:Dry mouth, dysphagia thirst; mydriasis with cycloplegia & photophobia; flushing; urinary urgency, difficulty & retention. Occasionally, vomiting, giddiness, staggering.
Usual dosage:Adult 1-2 tab tid-qid

PINAVERIUM BROMIDE

Supply:50MG/F.C.TAB(DICETELR)
Use:Pinaverium is a calcium channel blocking agent (spasmolytic) used for the treatment of gastrointestinal disorders.
Place in therapy: No convincing evidence of the efficacy of pinaverium in treatment of irritable bowel syndrome. And the drug offered no clinically significant advantage over anticholinergics. The efficacy of pinaverium in biliary functional disorders requires further evaluation.
Contraindication:Hypersensitivity to pinaverium bromide or bromides
Adverse effect:The adverse effects of pinaverium include epigastric pain and/or fullness, heartburn, constipation, abdominal distention, dry mouth, headache, and drowsiness.
Usual dosage:Irritable bowel syndrome: 50 mg PO TID; Give with food to minimize irritation of esophageal mucosa.
Special precautions:Pregnancy

PIPETHANATE ETHOBROMIDE

Supply:10MG/S.C.TAB(PETHOR)
Use:Acute gastritis, gastric hypermotility, spasms of urinary tract.
Contraindication:Prostatic enlargement may lead to urinary retention, paralytic ileus; pyloric stenosis; closed-angle glaucoma.
Adverse effect:Dry mouth with difficulty in swallowing & talking; thist; mydriasis with cycloplegia & photophobia; flushing & dry skin; transient bradycardia; occasionally vomiting, giddiness, staggering.
Usual dosage:1-2 tab tid-qid
Special precautions:Diarrhea; myasthenia gravis; fever; tachycardia, cardiac surgery; may cause mental confusion.

PIPOXOLAN

Supply:10MG/F.C.TAB/(ROWAPRAXINR)
Use:Pipoxolan is used as a smooth muscle relaxant.
Contraindication:glaucoma; prostest cancer with urine retention; pregnant women
Adverse effect:No atropine-like toxicity reported. No further data available.
Usual dosage:Adults: vascular type headache: 1 tab PO TID; urinary spasm: 1-3 tab PO TID
Child: age above 6: 1-3 tab PO QD to BID; child age under 6: not recommended

BISMUTH SUBCARBONATE

Supply:324MG/TAB(bismuth subcarbonateR)
Use:Enteritis, dysentery and colitis with diarrhea, astringent.
Contraindication:Renal and hepatic disease, septic-condition of the mouth.
Adverse effect:GI disturbance,anorexia, headache, malaise, skin reaction, discoloration of mucous membranes.
Usual dosage:1-2 Tabs, TID or QID.

POLYCARBOPHIL

Supply:500mg/Tab(MITROLANR)
Use:Calcium polycarbophil is a hydrophilic resin for use in both diarrhea and constipation. Calcium polycarbophil is effective in both constipation and diarrhea and may be useful in sodium-restricted patients
Place in therapy: Calcium polycarbophil is equally effective as psyllium and more effective than kaolin-pectin.
Contraindication:Intestinal obstruction or fecal impaction or swallowing difficulties
Adverse effect:The only significant side effects have been abnormal fullness and flatulence.
Usual dosage:Adult: 2 tab (chewed) PO QID; 250 ml of water is given in constipation;
Child: 3 to 6 y/o: 1 tab PO BID chewed and swallowed with 250 ml of water or other fluid; 6 to 12 y/o: 1 tab PO TID chewed and swallowed with 250 ml of water or other fluid three times

ANTIBIOPHILUS

Content:Per g Lactobacillus acidophilus Lyophillised Lactobacillus casei variety rhamnosus 1.0×108
Use:Prevention of antibiotic-induced diarrhea; symptomatic treatment of diarrhea of a non-organic origin in infant < 2yr: as a complement to rehydration, >2yr:treatment dose not exempt from rehydration if necessary.
Usual dosage: Preventive treatment 2 cap/day. Intestinal transit disorders 4-8 cap/day.

BISACODYL

Supply:5MG/E.C.TAB(DULCOLAXR)
Use:All type of functional constipation, preparation for surgery and some intestinal examination.
Contraindication:Acute abdominal pain or cramps, intestinal obstruction.
Adverse effect:Severe abdominal cramps, irritation, excessive purgation.
Usual dosage:PO 2-3 Tabs HS.
Special precautions:Child; pregnancy.

LACTULOSE

Supply:667MG/ML 300ML(DUPHALAC LIQUIDR)
Use:Constipation, hepatic encephalopathy.
Contraindication:Patients on a galactose-free diets, with intestinal obstruction, abdominal pain, nausea, or vomiting.
Adverse effect:Nausea, diarrhea, flatulence, hypernatraemia.
Usual dosage:Constipation: Adult, 15ml BID, Child(5-10 yr.), 10ml BID; Child(less than 5 yr.), 5ml BID; Infant, 2.5ml BID. Hepatic encephalopathy: 30-50ml TID.

PSYLLIUM HYDROPHILIC MUCILLOID

Supply:1GM/PG(KONSYLR)
Use:Treatment of constipation or non-specific diarrhea.
Usual dosage:Adult 1 sachet 1-3 times daily. Child greater than or equal to 6 yr 1/2 the adult dose or less.

*NORMACOL PLUS GRANULES 7GM GR.

Content:STERCULIA 62%, FRANGULA 8%
Use:Treatment of constipation, particularly hypotonic or slow transit constipation resistant to bulk alone .The initiation and maintenance of bowel action after rectal surgery and after haemorrhoitectomy
Contraindication:Intestinal obstruction, fecal impaction, and total atony of the colon.
Adverse effect:Abdominal distention. Intestinal obstruction is possible if the product is taken in overdosage or is not adequately washed down with fluid.
Usual dosage:Adults : 1 or 2 sachets once or twice daily after meals. Child(6-12 years):A reduced amount may be given at the discretion of the physician.
Special precautions:Ulcerative colitis. Not to be taken immediately before retiring. Adequate fluid intake required. Not to be taken for > 4 days if there has been no movement of the bowels.

LACTOBACTERIA

Supply:BIOFERMINR
Use:ional intestinal disorder and nutritional disturbance in children. Nonspecific ingestion & nonspecific enteritis with diarrhea, funct
Usual dosage:1-3 Tabs TID with meal

PANZYNORM

Supply:PANZYNORMR
Use:Deficient enzymatic secretion of the pancreas, stomach and intestine digestive disturbance with putrefactive and fermentative process, enteritis, gastritis, disease of gallbladder and liver.
Contraindication:Hypersensitivity to any component, biliary obstruction.
Adverse effect:Slight stool looseness or nausea.
Usual dosage:1-2 Tabs TID with meal. Don’t crush or chew.

ALCOS-ANAL OINT: Supply

ALCOS-ANAL OINT: Supply
Ointment20gm Sodium oleate100mgPistocainR 20mg, chlorocarvacrol1mg Haemorrhoid
Suppositories Sodium oleate200mg, PistocainR 20mg, chlorocarvacrol 1mg Haemorrhoid

FAKTU

Content:Policresulen 100mg, cinchocaine hydrochloride 2.5mg
Use:Hemorrhoids esp those associated with inflammatory conditions; anal fissures & rhagades; anal pruritus & eczema; wound treatment following proctologic surgery.
Adverse effect:Mild local discomfort
Usual dosage:1 supp bid-tid after defecation; maintenance:1 supp daily

XYLMOL B

Content:each gm of Lidocaine 50mg, Aluminal acetate 35mg,
Zinc Oxide 180mg, hydrocortisone acetate 2.75mg
Use:Hemorrhoids, anal rhagades & inflammatory conditions, perianal abscess, proctoptosis.
Usual dosage:Insert 1 supp in the morning, evening & after evacuation

CISAPRIDE C

Supply:5,10mg/Tab(AsamoxR), 5mg/Tab(CisaR), 5mg/Tab(Cisap)
Use:Treatment of nocturnal symptoms of gastroesophageal reflux disease (GERD), also demonstrated effectiveness for gastroparesis, refractory constipation, and nonulcer dyspepsia
Contraindication:Hypersensitivity, and cases as gastrointestinal hemorrhage, obstruction, and perforation
Adverse effect:Abdominal cramps, dyspepsia, epigastric pain, flatulence, diarrhea, nausea, and dry mouth, dizziness, and sleep disturbances.
Usual dosage:Initial: 10mg 4 times/day at least 15 minutes befor mealss and at bedtime; in some patients the dosage will need to be increased to 20 mg to obtain a satisfactory result
Mechanism: Enhances the release of acetylcholine at the myenteric plexus. In vitro studies have shown cisapride to have serotonin-4 receptor agonistic properties which may increase gastrointestinal motility and cardiac rate; increase lower esophageal sphincter pressure and lower esophageal peristalsis; accelerates gastric emptying of both liquids and soilds

METOCLOPRAMIDE B

Supply:10mg/2ml/Amp(PRIMPERANR), 5mg/Tab(PRIPRAMR, PASPERTASER)
Use:Symptomatic treatment of diabetic gastric stasis, gastroesophageal reflux. Stimulate gastric emptying, significant relief of nausea, vomiting, anorexia & abdominal fullness, prevention of cancer chemotherapy-induced emesis
Contraindication:GI hemorrhage, mechanical obstruction or perforation, pheochromocytoma, current use of MAO inhibitors, tricyclic antidepressants or sympathomimetic drug cause extrapyramidal reaction
Adverse effect:Constipation, diarrhea, drowsiness, lassitude, extrapyramidal reaction, galactorrhea, dizziness, anxiety, periorbital oedema & skin rash.
Usual dosage: PO 5-10mg TID-QID AC, maximum dose: 0.5mg/kg.
For the prevention of cancer chemotherapy-induced emesis, IV infusion 2mg/kg is given initially 30 minutes before administration of a highly emetogenic drug and repeated twice at 2 hour intervals following the initial dose.
Patient information:May impair mental altertness or physical coordination; avoid alcohol, barbiturates or other CNS depressants; take 30 minutes before 30 minutes before meals; notify physician if involuntary movements occur
Mechanism: Blacks dopamine receptors in chemoreceptor trigger zone of the CNS; enhances the response to acetylcholin of tissue in upper GI tract causing enhances motility and accelerated gastric emptying without stimulating gastric, biliary, or pancreatic secretions

OMEPRAZOLE C

Supply:20MG/CAP(LOSECR), 40MG/AMP(OMEZOLLYOR, LOSECR)
Use:Omeprazole suppresses gastric acid secretion by binding to the proton pump of the parietal cell.
Contraindication:Hypersensitivity; symptomatic response to omeprazole therapy does not preclude the presence of gastric malignancy.
Adverse effect:It is well tolerated but elevations of liver enzymes have been reported in patients with pre-existing liver disease. Long-term safety has not been established. In most cases drug therapy should be limited to short-term (less than 8 weeks) treatment.
Usual dosage:Duodenal, gastric, jejunal or esophageal ulcers: 20-30mg QD; 2 to 4 weeks for duodenal ulcers, 4-8 weeks for gastric ulcers or duodenal ulcer’s patients who smoke.
Special precautions:Exclude malignancy if gastric ulcer is suspected.

PANTOPRAZOLE

Supply:40MG/ GASTRO-RESISTANT TAB(PANTOLOC R)
Use:Pantoprazole is a proton pump inhibitor. Gastric and duodenal ulcers, moderate and severe reflux esophagitis; acute treatment only, not indicated for maintenance therapy.
Place in therapy: Pantoprazole is a potent inhibitor of gastric acid secretion. Animal and in vitro studies have demonstrated it to be comparable to or more potent than omeprazole, with less potential for interactions with P450 cytochromes and better acid stability.
Contraindication:Hypersensitivity to pantoprazole; Severe hepatic insufficiency; Cirrhosis
Adverse effect:headache (1.3%), diarrhea (1.5%), dizziness (0.7%), pruritis (0.5%), and asthenia (0.3%)
Usual dosage:Adults: gastric ulcer, duodenal ulcer and reflux esophagitis: 40 mg PO QD; Dosage reductions are not necessary for patients with renal insufficiency or on dialysis; the maximum daily dose: 40 milligrams.

ANTIMICROBIAL DRUGS

AMPICILLIN SOD. B
Supply:500MG/VIAL(AMPICILLINR)
Use:Bactericidal against gram positive organisms, including Streptococcus faecalis, Streptococcus pneumoniae, Haemophilus influenzae, Salmonella, E. coli, Neisseria gonorrhoeae, Neisseria meningitides, Proteus mirabilis, Brucella spp, Shigella.
Contraindication:Not to be used in patients sensitive to penicillins. Reduced doses in patients with impaired renal function.
Adverse effect:Allergic reaction, skin rashes, urticaria, maculopapular, diarrhea, nausea, vomiting, raised serum aminotransferase, pseudomembranous colitis, superinfections with Pseudomonas and Candida.
Usual dosage:Normal Dosage: Infection due to gram positive organisms & Haemophilis influenzae: 250 – 500 mg Q6H. GI and urinary tract infection due to G(-) organisms: 500 – 750 mg Q6 – 8H. Enteric infection: 1 – 2 g Q6H.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
> 30 : 1.5 – 3 g Q6-8H
15 – 29 : 1.5 – 3 g Q12H
5 – 14 : 1.5 – 3 g Q24H

Patient information:Food decrease rate and extent of absorption; take oral on an empty stomach, if possible(ie, 1 hour prior to, or 2 hours after meals); report diarrhea promptly; entire course of medication should be taken to ensure eradication of organism; females should report onset of symptoms of candidal vaginitis; may interfere with the effects of oral contraceptives

AMOXICILLIN B

Supply:500MG/CAP(AMOXICILLINR),
1.5GM/60ML/POWDER FOR ORAL SUSP.(AMOLINR)
Use:Same as ampicillin, bactericidal slightly more active than ampicillin against some Streptococci and Salmonella spp, but less active agaisnt Shigella spp.
Contraindication:Same as ampicillin.
Adverse effect:Same as ampicillin.
Usual dosage:Usual dosage:Adults: PO 250 – 500 mg Q8H; maximum daily dose: 4.5 g.
Child: under 20 kg, 20 – 40 mg/kg/day in 3 divided doses.
Patient information:Report diarrhea promptly; entire course of medication (10-14days) should be taken to ensure eradication of organism; may interfere with oral contraceptive; females should report symptoms of vaginitis; pediatric drops may be placed on child’s tongue or added to formula, milk

BENZATHIN PENICILLIN G B

Supply:2,400,000IU/VIAL(RETARPENR)
Use:Streptococcal infections (group A without bacteremia), mild to moderate infections of the upper respiratory tract. Venereal infections, prophylaxis of rheumatic fever and/or chorea, also prophylactic therapy for rheumatic heart disease and acute glomerulonephritis.
Contraindication:Hypersensitivity to penicillins.
Adverse effect:Hypersensitivity reactions, rash, leukopenia, hemolytic anemia, thrombocytopenia, neuropathy, nephropathy.
Usual dosage:IM only. For URI, adults: 1,200,000 U as a single dose. Child(> 27.3kg) : 900,000 U as a single dose, child & infants(< 27.3kg) : 300,000-600,000 U as a single dose.
For syphilis, adult: 2,400,000 U as a single dose for early syphilis, 2,400,000-3,000,000 U once a week for 2-3 weeks; congential syphilis: Infants & child up to 2 yrs of age, 50,000 U/kg as a single dose, chldren 2-12 yrs of age , adjust dosage on the basis of usual adult dose.
Streptococcal prophylaxis: 1,200,000 U/month, or 600,000 U/2 weeks.
Special precautions:Diabetes. Must not be inj SC, IV or intralumbarly or into body cavities. Trivial infection should not be treated with Retarpen. Impaired renal function. Infants, elderly. Hypersensitiyity to cephalosporins.

OXACILLIN B

Supply:0.5gm/Vial(Prostaphlin)
Use:Active against most gram positive organisms and Neisseria spp. activity is less than other penicillins. Effective to those infection caused by penicilln-resistant Staphylococci and Streptococci.
Contraindication:Hypersensitivity to penicillins, used with caution in jaundiced neonates.
Adverse effect:As for benzyl penicillin, increased serum SGOT and SGPT. Neutropenia, Haematuria, albuminuria and uraemia occured in infants.
Usual dosage: Adult, IM or IV 0.25-1 g Q4-6H; maximum dose: 6 g/day
Newborn and premature infants: 25 mg/kg/day in divided doses.
Patient information:Take orally on an empty stomach 1 hour before or 2 hours after meals; finish all medication; do not skip doses

PIPERACILLIN B

Supply:2gm/Vial(Pitamycin)
Use:Bone, joint, skin, soft tissue, O&G, intraabdominal, resp tract infection; UTI; septicemia; endocarditis; gonorrhea.
Contraindication:Hypersensitivity to penicillins. Infectious mononucleosis
Adverse effect:Allergic reactions; GI disturbances; pseudomembranous colitis; rarely hemolytic anemia, leukopenia; superinfection.
Usual dosage:Mild infection 100-200 mg/kg body wt. Severe infection 200-300 mg/kg body wt. Daily by IM or IV

TALAMPICILLIN

Supply:250MG/CAP(TALACINR)
Use:Resp tract & enteric infections, UTI, gonorrhea, meningitis, septicemia, bacillary dysentery, shigellosis, salmonellosis
Contraindication:Hypersensitivity to penicillins. Infectious monoucleosis
Adverse effect:Allergic reactions, GI disturbances, pseudomembranous colitis, hemolytic anemia. Leukopenia.
Usual dosage:Adult 250 mg tid or qid

CEFACLOR B

Supply:250MG/CAP(U-CLORR)
Use:Cefaclor is a second-generation oral cephalosporin. Cefaclor is more active than cephalexin and cephradine, in vitro, against a number of gram-negative and gram-positive organisms. It is effectively in infection of respiratory tract, urinary tract, skin and soft tissues, and for otitis media.
Contraindication:Hypersensitivity to cefaclor or cephalosporin antibiotics.
Adverse effect:Nausea and diarrhea; CNS reactions (headache, lassitude) have occurred rarely, as have elevations in hepatic function tests and cholestatic jaundice; skin reactions have been reported, including a syndrome of pruritic rash, arthralgia and joint swelling in SLE patients.
Usual dosage:250 mg Q8H, with 500 mg Q8H suggested in severe infections, maximum dose: 4 g/day

CEFADROXIL

Supply:500MG/CAP(CEFADROXILR), 1.5GM/60ML SYRUP/BOT(UCEFAR)
Use:Infections due to gr+ve & gm-ve organisms
Contraindication:Hypersensitivity to penicillins, severe renal impairment.
Adverse effect:Nausea, diarrhea, dysuria, rashes, urticaria, angioedema& other hypersensitivity reactions
Usual dosage:1-2gm daily in 1-2 doses
Special precautions:Hypersensitivity to penicillin, severe renal impairment

CEFAZOLIN B

Supply:1GM/VIAL(CEFAZOLLINR, VETERINR,WINZOLINR), 500MG/VIAL(WINZOLINR,VETERINR)
Use:Cefazolin is a first-generation cephalosporin. Active against Staphylococci, Streptococci, Neisseria, Salmonella, Shigella spp, Bordetella pertussis, Klebsiella pneumoniae, Proteus mirabilis and some strains of E.coli and Haemophilus influenzae.
Contraindication:Use with great care in patients allergic to penicillin and taking anticoagulants.
Adverse effect:Allergic reaction, elevated SGOT, increased prothrombin time, neurological disturbances, superinfection, acute and potentially fatal renal failure.
Usual dosage:Usual dosage:Normal Dosage: Adult 0.5 – 2g Q6-12H, in severe infections 6 g/day; maximum daily dose: 6 – 12g. Child: 25 – 50 mg/kg/day in divided doses.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
> 55 : 1 g Q6-8H
35 – 54 : 1 g Q8-12H
11 – 34 : 1 g – 500 mg Q12H
< 10 : 1 g – 500 mg Q24H

CEFEPIME B

Supply:500MG/VIAL(MAXIPIMER)
Use:Cefepime is considered to be a fourth generation cephalosporin antibiotic because it has good gram negative coverage similar to third generation cephalosporins but better gram positive coverage.
Place in therapy: Cefepime has been useful in the treatment of respiratory tract infections, skin and soft tissue infections, and urinary tract infections. It is particularly effective against infections involving gram-negative bacilli and Pseudomonas spp. Cefepime is most closely resembles ceftazidime in its spectrum of activity, with possibly increased activity against many enterobacter species and gram-positive organisms. It is not useful against methicillin-resistant staphylococcus species enterococcal species and has poor activity against anaerobic organisms. Cefepime may prove useful as an alternative to existing third-generation cephalosporins.
Contraindication:Hypersensitivity to cefepime or other cephalosporin antibiotics. In patient with renal dysfunction; dosage adjustment may be required.. Use cautiously in patients with history of colitis and patient with hypersensitivity to penicillins.
Adverse effect:Phlebitis may occur and resolves upon discontinuation of therapy. Headache, blurred vision, lightheadedness, dyspepsia, and antibiotic-associated diarrhea may occur. Although transient elevations in serum transaminases may occur, no clinical hepatotoxicity has been reported.
Usual dosage:Adults: 1 g IV Q12H; maximum recommended dose: 2 g BID for severe and very severe infecti

Cr Clearance Mild Infection Moderate Infection Severe Infection

Recommended Doses

Recommended Doses
>60 ml/min 500mg Q12H 1g Q12H 2g Q12H
30-60 ml/min 500mg Q24H 1g Q24H 2g Q24H
11-29 ml/min 500mg Q24H 500mg Q24H 1g Q24H
?10 ml/min 250mg Q24H 250mg Q24H 500mg Q24H

CEFOPERAZONE

Supply:1GM/VIAL(SHINFOMYCINR)
Use:Cystic fibrosis; UTI, skin, soft tissue, resp tract, abdominal, bone & joint infection; peritonitis; septicemia.
Contraindication:Hypersensitivity to cephalosporins
Adverse effect:Allergic reactions; eosinophilia; anaphylaxis; occasionally neutropenia, leukopenia, thrombopenia; hemolytic ansmia, hypoprothrombinemia, nephrotoxicity. Rarely, GI effects.
Usual dosage:2-4 gm daily in 2 divided doses.

CEFOTAXIME

Supply:250MG/VIAL(CLAFORANR), 1GM/VIAL(CETAXR), 2GM/VIAL(CLAFORANR)
Use:Resp tract, GUT, ENT, abdominal infections, skin & soft tissue, bone & joint infection; septicemia, gonorrhea
Contraindication:Hypersensitivity to cephalosporins
Adverse effect:Transient pain at inj site, diarrhea, candidiasis, hypersensitivity reactions, eosinophilia, leucopenia, thrombopenia. Raraly, phlebitis, superinfection
Usual dosage:1 gm 12 hrly IV or IM

CEFTAZIDIME

Supply:500MG/VIAL(KEFADIMR)
Use:Ceftazidime is a third-generation cephalosporin. Treatment of lower respiratory tract, skin, urinary tract, bone and joint infections; gynecologic infection, intra-abdominal infection, septicemia and CNS infection.
Contraindication:Patients with known hypersensitivity to cephalosporins
Adverse effect:Allergic reaction, diarrhea, nausea, vomiting, abdominal pain and metallic taste, eosinophilia, thrombo-cytosis.
Usual dosage:Normal Dosage: The adult dosage range is 1-6g/day: for instance, 500 mg, 1 g or 2 g given 12 or 8 hourly by IV or IM injection. Child age over two months is 30 to 100 mg/kg/day given as 2 or 3 divided doses Child age over 2 months under 1 year is 25 to 50 mg/kg twice daily. Neonate and infants up to 2 month of age is 25 to 60 mg/kg/day given as two divided doses.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
> 50 : 1 – 2 g Q8-12H
31 – 50 : 1 g Q12H
16 – 30 : 1 g Q24H
6 – 15 : 500 mg Q24H
< 5 : 500 mg Q48H

CEFTRIAXONE

Supply:1GM/VIAL(CEFINR), 500MG/VIAL(ROCEPHINR)
Use:Ceftriaxone is a third-generation cephalosporin. Treatment of respiratory tract infections, particularly pneumonia and ear, nose and throat infections, renal and urinary tract infections, meningitis.
Contraindication:Hypersensitivity to cephalosporins.
Adverse effect:Diarrhea, nausea, vomiting, allergic dermatitis, eosinophilia, hematoma or bleeding, thrombocytopenia, leukopenia.
Usual dosage:The usual dosage for adult and child over 12 years old is 1 – 2 g once daily. The maximum adult dosage is 4 g daily. Infants and young child may receive 50 – 75 mg/kg (not to exceed 2 g) daily given in equally divided doses every 12 hours.

CEFUROXIME

Supply:250MG/VIAL(ZINACEFR)
Use:Resp tract, GUT, ENT, abdominal infections, skin & soft tissue, bone & joint infection; septicemia, gonorrhea
Contraindication:Hypersensitivity to cephalosporins
Adverse effect:Hypersensitivity, GI disturbances including very rarely pseudomembranous colitis. Haematological changse. Superinfection. Transient pain at IM inj site Occasionally, thrombophlebitis
Usual dosage:Adult 750 mg tid Imor IV. Severe infection: 1.5 g tid IV. Child 30-100 mg/kg/day in 3 or 4 divided doses. Neonate 30-100 mg/kg/day in 2 or 3 divided doses

CEPHALEXIN B

Supply:250MG/CAP(KEFLEXR, KIDOLEXR, LONFLEXR), 500MG/CAP(ULEXR), 1GM/VIAL(ROLESR)
Use:Cephalexin is a first-generation cephalosporin. Against both gram positive and negative organisms, but less potent.
Contraindication:Use with great care in patients allergic to penicillin and taking anticoagulants.
Adverse effect:Nausea, vomiting, diarrhea and abdominal discomfort. Skin rashes, eosinophilia and neutropenia, rise in serum aminotransferases, superinfection (particularly candida).
Usual dosage:Adults: 250-500 mg Q6H, maximum dose up to 12 g/day. Child: 25-100 mg/kg/day divided into 4 doses, maximum dose up to 4 g/day.

CEPHALOTHIN B

Supply:1GM/VIAL(KEFLINR, ULOTHIN NEUTRALR)
Use:Infection of the resp tract, GIT, GUT, skin & skin structure, bone & joint
Contraindication:Hyperseneitivity
Adverse effect:Diarrhea, allergic reactions, neutropenia, thrombocytopenia, hemolytic anemia, pseudomembranous colitis, local reactions eg thrombophlebitis
Usual dosage:1-2 gm IV prior to surgery; 1-2gm during surgery; 1-2 gm 6-hrly post-op for 14 hr.

CEPHAPIRIN SOD.

Supply:1GM/VIAL(CEPHAZERR)
Use:Infection of upper & lower resp tract, skin & soft tissue, GUT & others due to susceptible microorganisms
Contraindication:Hypersensitivity to cephalosporins
Adverse effect:Nausea, vommiting, diarrhea & abdominal discomfort; skin rash, urticaria; eosinophilia; angioedema ; anaphylaxis; leukopenia, anemia, neutropenia; superinfection; pseudomembranous colitis
Usual dosage:500mg-1gm 4-6 hrly

CEPHRADINE B

Supply:1GM/VIAL(CEPINR, CEKODIN-AR), 500MG/CAP(LACEFR, CEPONINR)
Use:GUT, GI, resp tract, skin & soft tissue infections
Contraindication:Hypersensitivity to Cephalosporins
Adverse effect:GI intolerance. Hypersensitivity reactions. Rarely, glossitis, diasshea, superinfection, pseudomembranous colitis, transient eosimphilia, leukopenia, neutropenia, thrombophlebitis.
Usual dosage:Adult 1 tab hrly

MINOCYCLINE D

Supply:100MG/CAP(MENOCINR),100MG/PELLET-FILLED CAP(MINOCINR), 100MG/VIAL(MINOCINR)
Use:Treatment of susceptible bacterial infections of both gram-positive organisms; acne, meningococcal carrier state
Contraindication:Hypersensitivity to minocycline, other tetracyclines; childrean <8 years of age
Adverse effect:GI disturbance, nausea, vomiting, diarrhea, hypersensitivity reactions, superinfection, discoloration of teeth in child, renal damage.
Usual dosage:PO or IV 200mg initially, then 100mg Q12H (IV should not exceed 400mg in 24 hours).
Patient information:Avoid unnecessary exposure to sunlight; do not take with antacids, iron products; finish all medication; do not skip doses; take 1 hour before or 2 hours after meals

AMIKACIN SULFATE C

Supply:250MG/2ML/VIAL(AMINFECR), 500MG/2ML(AMIKIN PARENTERALR)
Use:Antimicrobial activity similar to gentamicin, and effective against organisms resistant to gentamicin, tobramycin and kanamycin.
Contraindication:Hypersensitivity to amikacin or other amino-glycosides antibiotics. It should be given with care to patient with impaired renal function.
Adverse effect:Ototoxicity, nephrotoxicity, neurotoxicity.
Usual dosage: Normal Dosage: IM or IV 15-20 mg/kg/day in divided doses Q8H or Q12H, maximum dose 1.5 g/day.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
Any CrCl-initial dose : 7.5 mg/kg
75 – 100 : 7.5 mg/kg Q8-12H
50 – 75 : 7.5 mg/kg Q16-24H
< 50 : 7.5 mg/kg Q24H or more

Patient information:Report loss of hearing, ringing or roaring in the ears, or feeling of fullness in head

GENTAMICIN C

Supply:80mg/2ml/vial(GentamicinR), 140mg/ml/vial(GantaR)
Use:Bactericidal against many strains of gram negative including E. coli, Klebsiella, Enterobacter, Serratia, Shigella, Pseudomonas aeruginosa, and some Proteus. Among gram positive organisms: Staphylococcus aureus is high sensitive.
Contraindication:Hypersensitivity or toxic reaction to gentamicin. It should be given with care to patients with impaired renal function or with ototoxicity symptoms occur.
Adverse effect:Nephrotoxicity, ototoxicity (vestibular damage is more common than hearing loss), allergy reaction.
Usual dosage:Usual dosage:Normal Dosage: Usual daily dose : 3 mg/kg in divided doses, IM or IV. Usual dose range: 1-5 mg/kg/day.,maximum dose: 8 mg/kg/day.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
Any CrCl : initial dose 1.5-2.5 mg/kg
75 – 100 : 1.5 – 2.5 mg/kg Q 8-12H
50 – 75 : 1.5 – 2.5 mg/kg Q16-24H
< 50 : 1.5 – 2.5 mg/kg Q24H or more

NETILMICIN SULFATE D

Supply:150mg/1.5ml/vial(NETROMYCINR)
Use:Active against aerobic gram-negative bacilli, Staphylococcus aureus, Staphylococcus epidermidis, against gentamicin and tobramycin-resistant organisms.
Contraindication:Hypersensitivity, cross-allergenicity among aminoglycosides has been demonstrated. Use cautiously when patients are also receiving anesthetics, neuromuscular blocking agents (succinylcholine, tubocurarine), or massive transfusions of citrate-anticoagulated blood
Adverse effect:Nephrotoxicity, ototoxicity, liver enzyme elevation, neuromuscular blockade (when combined with tubocurarine)
Usual dosage:Adults: 4 – 6.5 mg/kg/day IM or IV in 2 – 3 divided doses, 7 – 14 days; maximum dose: 7.5 mg/kg/day, 12 mg/kg/day in cystic fibrosis. Infants older than 6 weeks and child less than 12 years: recommended dose is 5.5 – 8 mg/kg/day IM or IV

TOBRAMYCIN SULFATE D

Supply:80MG/2ML/VIAL(TOPRAMYCINR)
Use:Treatment of infections caused by susceptible gm+ve & gm-ve bacteria.
Contraindication:Hypersensitivity
Adverse effect:Nephrotoxicity, ototoxicity & neuromuscular blockade. Hypersensitivity reactions, visual disturbances.
Usual dosage:Adult Pyelonephritis cystitis 120 mg/day IM/IV in 2 divided doses. Other infections 180 mg/day IM/IV in 3 divided doses. Child 3mg/kg IM/IV in 2-3 divided doses.

CLARITHROMYCIN C

Supply:250mg/Tab(KLARICIDR)
Use:It has a similar spectrum of activity as erythromycin. It is effective for the treatment of upper and lower respiratory tract infections. It is also approved for use in skin and skin structure infections, and infections caused by Mycobacterium avium complex.
Contraindication:Hypersensitive to erythromycin and use with caution in patients with marked renal or hepatic impairment.
Adverse effect:Eosinophilia (2.6%), prolong prothrombin time (1%), decreased white blood cell (<1%), thrombocytopenia, headache, epigastritis, nausea, vomiting, diarrhea, taste disturbance (3%), hemauria, proteinuria, rash urticaria.
Usual dosage:Adults: 250 to 500 mg BID for most infections. Child: 5 to 10 mg/kg/day.The specific guidelines are not provided, it is recommended that the dose of clarithromycin be decreased or the dosage interval be prolonged in the presence of renal impairment.

ERYTHROMYCIN B

Supply:250mg/Cap(ERYTHROMYCIN ESTOLATER)
Use:Active against most gram positive and some negative bacteria, including Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Hemolytic Streptococci, Diphtheria bacillus are sensitive; used in conjunction with neomycin for decontaminating the bowel; treatment of gastroparesis
Contraindication:Pregnancy and hypersensitivity, use with caution to patient with pre-existing liver disease.
Adverse effect:Allergic reaction, GI upsets, cholestatic hepatitis.
Usual dosage: Adults: 250 – 500 mg Q6H, up to 4 g/day.
Child: PO 30 – 50 mg/kg/day Q6H, IV 15 – 20 mg/kg/day ,up to 4 g/day.
Patient information:Refrigerate after reconstitution, take until gone, do not skip doses; report to physician if persistent diarrhea occurs; discard any unused portion after 10 days; absorption of estolate, ethylsuccinate, and base in a delayed release form are unaffected by food; take stearate salt and nondelayed release base preparation 2 hours befor or after meals

SPIRAMYCIN C

Supply:1.5 M.U.I/Tab(ROVAMYCINR)
Use:Toxoplasmosis; non-gonococcal urethritis; upper & lower rewp tract, skin & soft tissue infections
Contraindication:Hypersensitivity
Adverse effect:GI upsets. Rarely, allergic skin reactions, paraesthesia
Usual dosage:Adult 3 MIU 8-12 hrly. Child 0.15 MIU/kg body wt/day in 2-3 divided doses.

ALFUZOSIN

Supply:2.5mg/F.C.Tab(XatralR)
Use:Treatment of certain functional symptoms of benign prostatic hypertrophy, when surgery has to be delayed
Contraindication:History of oryhostatic hypotension
Adverse effect:More frequently: GI disturbances, lipothymic events & headache. Less frequently: dry mouth, tachycardia chest pain, asthenia, drowsiness, rash, pruritus & flushes.Palpitation, orthostatic hypotension & edema.
Usual dosage:Xatral 1 tab tid. Xatral XL 10mg qd

ALPROSTADIL

Supply:20mcg/Vial(CAVERJECTR)
Use:Patent ductus arteriosus, Buerger’s disease, arteriosclerosis obliterans, pulmonary atresia, Raynaud’s disease, peripheral vascular disease, ischemic leg ulcer due to chronic arterial occlusion.
Contraindication:Neonates with respiratory distress syndrome.
Adverse effect:Flushing, hypotension, bradycardia, apnea, fever, seizures, tachycardia, diarrhea.
Usual dosage:Raynaud’s phenomenon: 6-10ng/kg/min IV for 12-72 hours. Angina: 5-30ng/kg/min IV for 24-72 hours. Dilation of ductus arteriosus: 0.05-0.1mg/kg/min.

FINASTERIDE X

Supply:5MG/TAB(PROSCARR)
Use:Benign prostatic hyperplasia. Finasteride causes a decrease in serum prostate-specific antigen, a marker commonly used for the detection of prostatic carcinoma. Patients should be screened for prostatic carcinoma by other methods (digital rectal exam) prior to and during finasteride therapy.
Place in therapy: Finasteride is an 5-a reductase inhibitor; it inhibits the conversion of testosterone to dihydrotestosterone. But several weeks of therapy are often required before any benefit is noted by the patient. Combination therapy with finasteride and an alpha-blocker may provide optimal medical management.
Contraindication:Hypersensitivity to finasteride and pregnancy; It is not indicated for use in women or children.
Adverse effect:Finasteride interferes the marker of prostatic carcinoma PSA (prostate-specific antigen). Caution in patients with hepatic dysfunction.
Usual dosage:5 mg PO QD; urinary excretion of metabolites are decreased in patients with chronic renal insufficiency. However, an increased fecal excretion occurs in these patients. No dosage adjustment is necessary in patients with chronic renal insufficiency

OXYBUTYNIN CHLORIDE B

Supply:2.5MG/TAB(BLASECR)
Use:Used as an antispasmodic in patients with uninhibited neurogenic or reflex neurogenic bladder for the relief of symptoms associated with voiding, such as urgency, urge incontinence, frequency, nocturia and incontinence.
Contraindication:Patients with glaucoma, myasthenia gravis, partial or complete obstruction of the GI tract, adynamic ileus, megacolon, severe colitis or ulcerative colitis when megacolon is present.
Adverse effect:Dry mouth, decreased sweating, urinary hesitancy and/or retention, hot flushes, fever, tachycardia, palpitation, transient blurred vision, mydriasis, cycloplegia or increased ocular tension.
Usual dosage:The usual adult dosage is 5g 2 or 3 times daily with a maximum of 5mg 4 times daily. Child older than 5 years of age is 5mg twice daily with a maximum of 5mg 3 times daily.

PHENAZOPYRIDINE HCL X

Supply:100MG/S.C.TAB(UROPYRINR)
Use:Treatment &control of benign prostatic hyperplasia (BPH) to cause regression of enlarged prostate, improve urine flow& improve the symptoms of BPH
Contraindication:Women & pead patients
Adverse effect:Impotence, decreased libido & vol of ejaculate
Usual dosage:5 mg daily

TAMSULOSIN HCL

Supply:0.2MG/CAP(HARNALIDGER)
Use:Urinary dysfunction caused by prostatic hyperplasia
Adverse effect:Dizziness, GI discomfort, allergy, impaired hepatic function, nasal congestion, peripheral edema, asthenia
Usual dosage:0.2mg once daily
Special precautions:Orthostatic hypotension. May impair ability to drive or operate machinery

TERAZOSIN C

Supply:2MG/TAB(HYTRINR)
Use:Hypertension, benign prostatic hypertrophy, and heart failure.
Place in therapy: All of the available selective a-1-receptor blockers appear to be equally effective for the treatment of hypertension. Since a -1-adrenergic blockers may be safely used in patients with diabetes, congestive heart failure, asthma, and hyperlipidemia, they may be preferred initial agents.
For benign prostatic hyperplasia, surgical (transurethral prostatectomy) treatment is associated with an 85% improvement in symptoms, a-blockers reduce symptoms by 51%, and treatment with the 5-a-reductase inhibitor finasteride improves symptoms by 31%.
Contraindication:Hypersensitivity.
Adverse effect:The first-dose syncope and postural hypotension frequently occur. Other adverse effects include dizziness, faintness, fatigue and headache; tachycardia has also been observed.
Usual dosage:Adults: Initial dose 1mg PO HS, then titrate to 5mg PO QD; some patients may require 10-20mg PO QD. Dosing adjustments are not required in elderly patients but escalation should be slower.

U-CITRA

Supply:K-CITRATE GRANULESR
Use:Citrate and citric acid solutions are systemic and urinary alkalinizing agents. Used to correct the acidosis of certain renal tubular disorders, to treat metabolic acidosis, for long-term urine alkalinization, for prevention and treatment of uric acid and calcium kidney stones, and as non-particulate neutralizing buffers.
Contraindication:Severe renal impairment with oliguria, azotemia, or anuria; Addison’s disease; adynamic episodica hereditaria; acute dehydration; heat cramps; severe myocardial damage; hyperkalemia. Caution should be used in patients with low urinary output or reduced glomerular filtration rates.
Adverse effect:It is well tolerated in usually dosage and in normal renal function patient. Excess amount or patient with renal dysfuction may induced metabolic alkalosis or hyperkalemia.
Usual dosage:For urine alkalization: 15 to 30mL, child: 5 to 15mL, diluted with water, PC and HS.
For treatment of calcium and uric acid stones: potassium citrate 30-60mEq/day PO in 3 or 4 doses with meals or within 30 minutes after meals.

NALIDIXIC ACID B

Supply:500MG/TAB(WINPECONR)
Use:Urinary infection produced by susceptible gm-ve.Intestinal infection, diasshea & dysentery.
Adverse effect:GI reaction. Neurological effects. Intracranial hypertension. Photosensitivity reactions. Rarely, cholestatic jaundice, thrombopenia, leukopenia, hemolytic anemia.
Usual dosage:Adult 4-6 tab daily. Child 50 mg/kg body wt daily in 3-4 divided doses.

*BAKTAR

Content :sulfamethoxazle 400mg, trimethoprim 80mg
Use:It is used for the treatment of urinary tract infections caused by susceptible strains of E. coli, Proteus (indole positive or negative) Klebsiella, Enterobacter, Haemophilus influenzae, Streptococcus pneumoniae, Shigella spp. and also active against Pneumocystis carinii.
Contraindication:Pregnancy, infants younger than 2 months, lactation, hypersensitivity to sulfonamides or trimethoprim, patients with impaired renal or hepatic function.
Adverse effect:Agranulocytosis, aplastic and megaloblastic anemia, nausea, erythema multiforme, headache, and mental depression.
Usual dosage:Adults: 2 tab Q12H for 10-14 days in urinary tract infection, 8mg/kg trimethoprim and 40mg/kg sulfamethoxazole daily, give in 2 divided dose Q12H.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
> 30 10-20mg/kg/d n 2-3 div. doses
15 – 30 5-10 mg/kg/d n 2-3 div. Doses
< 15 n 2-3 div. no recommended

The usual IV dosage is 8-10mg/kg/day in 2-4 equally divided doses every 6, 8 or 12 hours for 5 days or up to 14 day for severe UTIs.
For all IV doses of cotrimoxazole, the drug in 100ml of D5W per 5ml vial over 30 minutes is recommended. If fluid restriction is required, each 5ml ampule can be added to 75ml D5W and should be administered within 2 hours.

CIPROFLOXACIN C

Supply:250mg/F.C.Tab(SUPEROCINR), 100mg/50ml/Bot(CIPROXINR)
Use:Ciprofloxacin is effective in multi-resistant strains. Ciprofloxacin is active in vitro against most gram-negative aerobic bacteria, including Enterobacteriaceae and Psudomonas aeruginosa, and many gram-positive aerobic bacteria: penicillinase producing, nonpenicillinase producing, methicillin-resistant Staphylococci. It has indicated in skin and bone infections due to gram-negative organisms, gastrointestinal infections in patients with multiple-resistant organisms, complicated urinary tract infections, gram-negative nosocomial pneumonia, sexually transmitted diseases, febrile neutropenia, gram-negative meningitis, and hepatobiliary infections.
Place in therapy: Ciprofloxacin should not be used as empiric therapy due to the increasing development of resistance. It should be reserved for targeted indications where there is culture and sensitivity data guiding appropriate therapy. Resistance has been observed in numerous reports, especially to strains of Pseudomonas aeruginosa especially when the drug is used as a single agent.
Contraindication:Hypersensitivity to the drug or patients with known hypersensitivity to nalidixic acid, oxolinic acid, cinoxacin, or other quinolone antibiotics. Ciprofloxacin can cause arthropathy in immature animals, the manufacturer states that the drug should not be used in children or adolescents ( younger than 16-18 years of age).
Adverse effect:The main adverse effects of PO doses are gastrointestinal disturbances; CNS side effects, including seizures, have occurred with ciprofloxacin therapy. Several studies have documented increase in transaminases associated with ciprofloxacin and in some cases severe and fatal hepatitis have developed. Additionally, hematuria and anaphylactic reactions have been described.
Usual dosage:200-400mg IV Q12H; 250-750mg PO Q12H, usual duration: 7-14 days, bone and joint infection: 4-6 weeks or longer. Oral dosage is used after injection form only in our hospital.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
> 30 200-400 mg Q12H
5 – 29 200-400 mg Q18-24H

Special precautions:Renal dysfunctio

NORFLOXACIN C

Supply:200mg/F.C.Tab(N.F.S.R)
Use:Treatment of complicated urinary tract infections caused by susceptible Citrobacter freundii, Enterobacter cloacae, E. coli, Klebsiella pneumoniae, Morganella morganii, Proteus mirabilis, P. vulgaris, Providencia rettgeri or Pseudomonas aeruginosa and also for the treatment of gonorrhea.
Contraindication:Patients with a history of hypersensitive to the drugs or to other quinolone anti-infective agents.
Adverse effect:Nausea, abdominal pain, diarrhea, vomiting, anorexia, dyspepsia, dysphagia, headache, dizziness, eosinophilia.
Usual dosage:PO, should be given 1 hour before or 2 hours after a meal. Usual dosage 400mg BID for 7-10 days in the uncomplicated UTI and 10-21 days for complicated UTI. Maximum dose: 1.2g/day
Special precautions:Renal failure. Patients with CNS damage.

OFLOXACIN C

Supply:100mg, 200mg/F.C.Tab(OXACINR)
Use:Ofloxacin is a broad spectrum oral fluoroquinolone antibiotics. It has been successful in treating: urinary and respiratory tract infections, gonorrhea, nongonococcal urethritis (Chlamydia), otitis media, and sinusitis. Ofloxacin and other quinolones will not replace beta lactam as drug of choice. It is useful for pyelonephritis, nosocomial UTIs, and hospital acquired gram-negative pneumonias.
Contraindication:Hypersensitivity to the drug or to other members of quinolone group: nalidixic acid, oxalinic acid, norfloxacin, and ciprofloxacin
Adverse effect:Nausea, vomiting, diarrhea, abdominal pain, headache, dizziness, insomnia, hallucinations, skin reaction, blood dyscrasias, hypersensitivity, photoonycholysis. It should be avoided in prepubertal children since animal studies have demonstrated erosions of the cartilage and weight bearing joints.
Usual dosage:PO 200-400 mg BID, single dose ranging from 100-600 mg have been used to treat gonorrhea. Or 400 mg IV Q12H is usually used. It should be avoided in prepubertal child.
Special precautions:Renal dysfunction, convulsions, elderly

CLOTRIMAZOLE B

Supply:10MG/GM 5GM/TUB(CANESTENR)
Use:Dermatomycoses, pityriasis versicolor, erythrasma, Candida vulvitis.
Adverse effect:Skin reaction (rare)
Usual dosage:Apply thinly bid-tid to the affected area

KETOCONAZOLE C

Supply:200MG/TAB(KETONAR)
Use:Treatment of superficial & deep mycoses, maintenance treatment to prevent recurrence in systemic mycotic infect & in chronic mucocutaneous candidosis.Vaginal candidosis. Onychomycoses.
Contraindication:Liver disease, recovery phase of hepatitis
Adverse effect:GI disturbances, pruritus, elevated liver function tests. Rarely, acute Allergic reactions, hepatitis, gynecomastia
Usual dosage:Adult 1 tab once daily. Child 3.3-6.6 mg/kg/day

MICONAZOLE

Supply:2%CREM/DAFRIN-H(DAFRIN-HR)
Use:Vag infections due to candida, vaginitis due to gm+ve bacterias.
Usual dosage:1 tabinserted deeply into vag nightly

TERBINAFINE B

Supply:250MG/TAB(LAMISILR)
Use:Oral terbinafine has been used for the treatment of onychomycosis and moccasin-type tinea pedis, cutaneous candidiasis.
Place in therapy: Terbinafine appears to be as effective as griseofulvin for the treatment of tinea crucis and corporis, but is more effective for onychomycosis, and moccasin-type tinea pedis.
Contraindication:Previous hypersensitivity to terbinafine or naftifine. For patients with pre-existing liver disease or renal impairment, the use of terbinafine is not recommended. Liver function tests are recommended in patients who have received terbinafine for more than 6 weeks.
Adverse effect:Fatigue, headache, dizziness, gastrointestinal disturbances, skin rash, pruritus, alopecia, and elevation of hepatic function tests .
Usual dosage:Superficial mycosis: 125 mg PO BID or 250 mg PO QD, Systemic mycosis: 250 – 500 mg PO QD; dose adjustments would appear indicated in those patients with renal insufficiency or liver dysfunction.>

ETHAMBUTOL B

Supply:400MG/TAB(MYAMBUTOLR)
Use:Bacteriostatic and is active against organsims of Mycobacterium tuberculosis, M. bovis, M. marinum and some strains of M. kansasii, M. avium,M. fortuiturn and M. intracellulare.
Contraindication:Hypersensitivity, pregnancy, optic neuritis, ocular defects and patients with impaired renal functions.
Adverse effect:Decrease in visual acuity, hyperuricemia.
Usual dosage:Initial treatment: 15mg/kg/day in a single dose. (range 500mg-1.5g), continued treatment: 25mg/kg/day for 60 days then 15mg/kg/day.(range: 900mg-2.5g)
Patient information:Report any visual changes or rash to physician; may cause stomach upset, take with food; do not take within 2 hours of aluminum-containing antacids

*RIFATER C

Content:Rifampicin 120mg, INH 80 mg, pyrazinamide 250mg
Use:Initial intensive phase treatment (usually 2 mth) for short course chemotherapy of TB. When indicated other anti-TB drugs may be added. After the intensive phase treatment, therapy should be continue with Rifinah for a further 4 mth min
Contraindication:
Adverse effect:Staining of contact lenses, reddish coloration of urine, sputum & lachrymal fluid. Irregular dosing may result in immunological side effects eg ‘flu syndrome’
Usual dosage:Single daily dose, 1 tab/10kg body wt, not exceeding 5 tab daily. Alternatively, patient>50kg 5 tab, 40-49kg 4 tab, 30-39kg 3 tab

RIFAMPICIN

Supply:450MG/CAP(RIFAMPICINR)
Use:Bactericidal and active against Mycobacterium tuberculosis, M. bovis, M. marinum, M. kansasii, and gram positive and negative bacteria including Neisseria, Staphylococcus aureus, Haemophilus influenzae, Legionella pneumophilia.
Contraindication:Hypersensitivity, pregnancy, lactation, liver disease.
Adverse effect:GI disturbances, hypersensitivity reaction, headache, drowsiness, fatigue, ataxia, visual disturbances, mental confusion.
Usual dosage:PO 1 hour before or 2 hour after meals. For treatment of tuberculosis, use in combination with at least one other antituberculosis agent, usual adult dose: 600mg/day as a single dose. Child > 5 years, 10-20mg/kg/day, daily dose should not exceed 600mg.
Patient information:May discolor urine, tears, sweat, or other body fluids to a red-orange color; take 1 hour befor or 2 hours after a meal on an empty stomach; soft contact lenses may be permanently stained; report to physician any sever or persistent flu-like symptoms, nausea, vomiting, dark urine or pale stools, or unusual bleeding or bruising; utilize an alternate form from oral/other systemic contraceptives during therapy; compliance and completion with course of therapy is very important; if you are a diabetic taking oral medications or if you regularly take oral anticoagulant therapy, your medication may need special and careful adjustment.

*RINA C

Content:Rifampicin 300mg, Isoniazide 150mg
Use:Pulmonary & extrapulmonary TB
Contraindication:Hypersensitivity. Janudice
Adverse effect:Skin reactions, GI intolerance; hepatitis; thrombocytopenia; flu syndrome; red discoloration of urine, sputum, tears, staining of contact lenses; polyneuritis.
Usual dosage:Adult 2 cap daily

ACYCLOVIR C

Supply:200MG/TAB(ZOVIRAXR)
Use:Treatment of herpes simplex infections in immuno-compromised patients.
Contraindication:Hypersensitivity, use with caution in patients with abnormal renal function.
Adverse effect:Severe inflammation sometimes leading to ulceration has resulted from accidental infusion into the tissue extravascularly.
Usual dosage: PO 200 mg 5 times daily at approximately 4 hours intervals.
Five days treatment is usually adequate in acute infection.

INTERFERON ALFA-2B

Supply:3,000,000U/VIAL(INTRON AR)
Use:Interferon alfa-2b is indicated for the treatment of multiple myeloma, Kaposi’s sarcoma in patients with acquired immune deficiency syndrome, malignant melanoma, hairy cell leukemia and laryngeal papillomatosis.
Place in therapy: Alfa-interferon is the most effective treatment currently available for the treatment of chronic hepatitis B and C; at best 50% of patients will have a good response of treatment.
Contraindication:It is contraindicated in patients with known hypersensitivity to the drug or any ingredients in the formulation.
Adverse effect:Neutropenia and thrombocytopenia occur frequently. Neutropenia is one of the most common reasons for discontinuation of therapy. Flu-like syndrome occurring 30 – 120 minutes after administration and persist for several hours is also common. Tolerance to these effects generally occurs within the first few weeks of therapy. Cardiovascular adverse effects occur in 15% of patients. Nausea, diarrhea, fatigue, headache, malaise, proteinuria are also common.
Usual dosage:Chronic hepatitis B: 5 million IU daily or 10 million IU 3 times/week, for 16 weeks, IM or SC; or low dose regimen: 3 million IU 3 times/week SC, for 4 months. Chronic hepatitis C: 3 million IU 3 times/week IM or SC, patient response with a decrease ALT levels, continue for 6 months; If no response is observed after 16 weeks, discontinue therapy.
Hair cell leukemia, and Multiple myeloma: 2 million IU/m2, IM or SC 3 times a week, for 1-2 months. AIDS-related Kaposi’s sarcoma: 50 million IU/m2 daily, IM or SC, for 5 day then escape 9 days before next 5-days regimen.

*CURAMR B

Content:Amoxicillin 500mg, Clavulanic acid 125mg
Use:Upper & lower resp tract infections, skin & soft tissue infections, genitourinary tract infections
Contraindication:Hypersenstivity to amoxicillin, clavulanic acid or penicillin; concomitant use of alcohol.
Adverse effect:Headache, rash, urticaria, nausea, vomiting pseudomembranous colitis, vaginal candidiasis, diarrhea (9%).
Usual dosage:Adults: PO 1 Tab Q8H; double amoxicillin dose in severe case; maximum dose: 2 g/day.
Child<40kg : 20 – 40 mg (amoxicillin component)/kg/day divided into 3 doses.

Dosage adjustment : according to CrCl (ml/min)

15 – 30 Q12- 18H
5 – 15 Q24- 36H
< 5 Q 48 H

Special precautions:Periodic monitoring of renal, hepatic & blood parameters. Pregnancy & lactation

*TIENAMR C

Content:Imipenem 500mg, Cilastatin 500gm
Use:Imipenem is indicated in treating severe infections due to multi-resistant organisms. Alone, or in combination with an aminoglycoside, it can be used for serious mixed infections including pulmonary, intra-abdominal and soft-tissue infections. Imipenem is more potent than third generation cephalosporins against Pseudomonas aeruginosa. Cilastatin reduces imipenem metabolism by inhibiting dehydropeptidase.
Contraindication:Use with caution in patients with a history of hypersensitivity reaction to penicillins.
Adverse effect:Increment in hepatic function tests occur commonly; but no reports of definite liver damage have been observed.
Usual dosage:Normal Dosage: 0.25 – 1 g Q6H or Q8H, maximum adult dosage: 50 mg/kg or 4 g/day.

Dosage adjustment : according to CrCl (ml/min)

Dosage adjustment : according to CrCl (ml/min)
> 70 500mg-1 g Q6-8H
30 – 70 500 mg Q6-8H
20 – 30 500 mg Q8-12H
< 20 250-500 mg Q12H

*TAZOCINR B

Supply:Per 2.25g vial Piperacillin 2 g, tazobactam 250mg
Use:Piperacillin/tazobactam is a combination of piperacillin, extended spectrum penicillin, and tazobactam, a b-lactamase inhibitor. Piperacillin sodium/tazobactam sodium has a wide spectrum of activity to against many gram-positive, -negative and anaerobic bacteria. In vitro studies, piperacillin sodium/tazobactam sodium dose not result in synergism against Pseudomonas aeruginosa and that the currently recommended dosage generally are too low to be effective in the treatment of Pseudomonas aeruginosa.
Place in therapy: It has been successfully used in the treatment of infections such as cellulitis, appendicitis, community-acquired pneumonia, and gynecologic infections. It is ineffective against MRSA and does not offer any major advantages in the treatment of gram positive organisms.
Contraindication:Patients with a prior history of hypersensitivity to beta-lactam antibiotics or to b-lactamase inhibitors.
Adverse effect:The most frequent adverse effects reported are GI effects (diarrhea, nausea, constipation, 11%), headache (7-8%), and dermatologic reactions (rash, pruritus, fever, 4%). In some cases, leukopenia and neutropenia occurred after 21 days of therapy.
Usual dosage:Adults: 12 g-15 g/day IV in divided doses of 3.375 grams Q6H. Dosage reduction is recommended in patients with renal failure:

CrCl(ml/min) Dosage

CrCl(ml/min) Dosage
20-40 2.25 g Q6H
<20 2.25 g Q8H

*ANSULLINAR, *UNASYNR

Content:Per 750mg vial Sulbactam 250mg, Ampicillin 500mg
Use:Unasyn is an antibiotic combination, comprised of ampicillin and a beta-lactamase inhibitor-sulbactam. Besides the inhibition effects of ampicillin sensitive microorganisms, the resistant strains: S. aureus, S. epidermidis, H. influenzae, Moraxella catarrhalis, N. gonorrhea, Klebsiella spp. E coli, E aerogenes, Proteus spp, and Acinetobacter calcoaceticus are inhibited.
Contraindication:Severe hypersensitivity to penicillin.
Adverse effect:Similar to those seen with ampicillin alone, the most common of which are diarrhea and maculopapular rash.
Usual dosage:Adults: 1.5-12 g/day, in divided Q6-8H. Child: 150 mg/kg/day, in divided Q6-8H
Special precautions:Overgrowth of non-susceptible organism. Check periodically for organ system dysfunction during prolonged therapy.

CLINDAMYCIN B

Supply:150mg, 300mg/Cap(CLINDAMYCINR), 300mg/2ml/Vial(EUDAMYCINR, B.B.R)
Use:Antimicrobial spectrum similar to lincomycin but activity is greater.
Contraindication:Hypersensitivity, diarrheal states
Adverse effect:Diarrhea, Pseudomembranous colitis, hyper-sensitivity reactions, agranulocytosis, thrombocytopenia.
Usual dosage:Adults: 150-300mg Q6H PO, severe infection: 450mg Q6H PO, 0.6-2.7g/day in divided doses IM or slow IV. Child: 8-16mg/kg/day in 4 divided dose up to 20 mg/kg/day PO, 15-40 mg/kg/day in divided doses IM or slow IV, maximum dose: 2.7-4.8g/day

COLISTIN

Supply:1,000,000Unit/Cap(COLISTINR)
Use:Gm-ve infections
Adverse effect:Dizziness, ataxia, sensory disturbances, paresthesia, neuromuscular blockade, nephrotoxicity, ototoxicity.
Usual dosage:Adult 1-2 MU bid or qid. Child 75,000-150,000 u/kg/day.
Special precautions:Impaired renal function. Myasthenia gravis.

LINCOMYCIN

Supply:300mg/ml 10ml/Vial(LINCOCINR)
Use:Resp tract, skin & soft tissue, bone & joint infection, septicemia & endocarditis, bacillary dysentery.
Contraindication:Hypersensitivity to lincomycin or clindamycin
Adverse effect:GI disturbances, hematopoietic effects, pruritus, skin rashes, liver jaundice, renal dysfunction
Usual dosage:IMAdult 600mg 24hrly or 12 hrly. Child 10mg/kg 24 hrly or 12 hrly. IV Adult 600 mg-1g 8-12 hrly. Child 10-20 mg/kg/day in 2-3 doses at 8-12 hrly
Special precautions:GI disease esp colitis

MEROPENEM B

Supply:250mg/Vial(MEPEMR)
Use:Meropenem has demonstrated efficacy comparable to that of imipenem/cilastatin in intraabdominal and soft tissue infections; it has also shown usefulness in febrile neutropenia, urinary tract infections, and Pseudomonas meningitis.
Place in therapy: In vitro, meropenem is more active than imipenem against many gram-negative pathogens; it has shown activity against strains of Enterobacteriaceae and Pseudomonas aeruginosa resistant to imipenem, aminoglycosides, quinolones, and third-generation cephalosporins. the primary indications for meropenem will be for the treatment of mixed infections usually requiring antibiotic combinations (eg, intraabdominal infections, pulmonary infections) and infections caused by multidrug-resistant gram-negative pathogens, including Pseudomonas aeruginosa.
Contraindication:Hypersensitivity to meropenem; use with caution to patient with renal impairment or epileptic patients and patients with neurological disorders or liver dysfunction (possible hepatotoxic effects)
Adverse effect:Headache, nausea, abdominal pain, diarrhea, and liver function test abnormalities have been reported with meropenem; there is some evidence that meropenem may be less likely than imipenem to induce seizures.
Usual dosage:Adults: 0.5-1 g IV Q8H; for meningitis 2 g IV Q8H
Child: IV 20 mg/kg Q8H intra-abdominal infections; 40 mg/kg Q8H for meningitis.

SODIUM FUSIDATE

Supply:250mg/Tab(FUCIDINR)
Use:Treatment of infections caused by susceptible organisms esp Staph eg osteomyelitis, septicaemia, endocarditis, pneumonia, cutaneous infections, surgical & traumatic wound infections. Also other Staph infections including MRSA.
Adverse effect:GI disturbances
Usual dosage:Adult 2 tab tid. Skin & soft tissue infection 1-2 tab bid
Special precautions:Hepatic insufficiency. Pregnancy & lactation

SPECTINOMYCIN DIHCL.

Supply:2gm/Vial(TOGAMYCINR)
Use:Acute gonorrheal urethritis/cervicitis & proctitis in male& femalw.
Contraindication:
Adverse effect:Local pain, urticaria, dizziness, nausea, chills, fever, reduction in urine output; rarely, anaphylaxis.
Usual dosage:2 g as a single dose IM
Special precautions:Serologic test for syphilis before & after treatment

TEICOPLANIN

Supply:200mg/Vial(TARGOCIDR)
Use:Teicoplanin is a glycopeptide antibiotic, similar to vancomycin. It is used in the treatment of serious gram-positive infections. It has been used empirically in neutropenic patients.
Place in therapy: Compared to vancomycin, teicoplanin possesses an extended elimination half-life and can be dosed once daily. Additionally, the severe pain and necrosis that is associated with intramuscular injections of vancomycin have not been reported with teicoplanin. Teicoplanin should be a suitable alternative to vancomycin for gram-positive infections.
Contraindication:Patient has hypersnsitivity to this drug.
Adverse effect:Pain on injection, thrombophlebitis, neutropenia, rash, bronchospasm, eosinophilia, and rare cases of ototoxicity.
Usual dosage:Adults: loading dose of 400 to 800mg , maintenance doses of 200 to 600mg QD; IM as maintenance doses of 200 to 600mg following an intravenous loading dose.
Child: 3-6mg/kg/day.
Teicoplanin dose in patients with renal insufficiency has been proposed:

Creatinine Clearance

Creatinine Clearance
>80 mL/min 30-80 mL/min <10 mL/min
Constant Interval 400 mg Q24H 200 mg Q24H 133 mg Q24H
Constant Dose 400 mg Q24H 400 mg Q48H 400 mg Q72H

Special precautions:Serologic test for syphilis befor & after treatment

VANCOMYCIN C

Supply:500mg/Vial(VANCOR)
Use:Treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (��-lactamase-resistant) Staphylococci. Oral form of vancomycin for treatment of antibiotic associated pseudomembranous colitis produced by Clostridium difficile.
Contraindication:Patients with known hypersensitivity to the drug.
Adverse effect:Ototoxicity, nephrotoxicity, rapid infusion may develop anaphylactoid reactions, including red man syndrome, hypotension, urticaria, reversible neutropenia.
Usual dosage:Normal Dosage: Adults IV 2g/day divided either as 500mg every 6 hours or 1g every 12 hours. Each gram should be administered over a period of at least 60 minutes. The usual child daily IV dosage is 40mg/kg, can be divided and incorporated into the child’s 24 hour fluid requirement. In neonates and infants, an initial dose of 15mg/kg is suggested followed by 10mg/kg every 12 hours for neonates in the first week of life and every 8 hours thereafter up to the age of one month. Treatment of antibiotic-associated pseudomembranous colitis, the usual adult daily dosage is 500mg to 2g given in 3 or 4 divided doses for 7 to 10 days, the total daily dosage should not exceeded 2g.

Dosage adjustment : according to CrCl (ml/min)

> 60 : 1 gm Q12H or 500 mg Q6H
< 60 : may lengthen interval to keep trough < 10

ANTIPARASITIC DRUG

METRONIDAZOLE B

Supply:500mg/100ml/Bot(MEDAZOLER), 250mg/Tab(METRODINR)
Use:It has bactericidal, amebicidal and trichomonacidal action, active against most obligately anaerobic bacteria, trichomonas vaginalis, Entamoeba histolytic, Giardia lamblia.
Contraindication:Pregnancy, hypersensitivity, patients with blood dyscrasia, severe hepatic impairement.
Adverse effect:GI discomforts , headache, anorexia, dry mouth, dizziness. vertigo, peripheral neuropathy, reversible leukopenia, skin rash
Usual dosage:For trichomoniasis: PO 2g as a single dose or 250mg TID for 7 days. For amebiasis: adults: PO 750mg TID for 5-10 days; Child: PO 35-50mg/kg/day in 3 divided dose for 5-10 days, maximum dose 2.4g/day. For giardiasis: adults: 250mg TID for 5-7 days, child: 15mg/kg/day in 3 divided dose for 5 days. For anaerobic infection: PO or IV, initial dose 15mg/kg, followed by maintenance dose 7.5mg/kg/Q6H, maximum dose 4g/day.

TINIDAZOLE

Supply:500mg/100ml/Bot(FLUGENR)
Use:Prophylaxis & treatment of post-op anaerobic infection
Contraindication:Blood dyscrasias. Active CNS disease
Adverse effect:Thrombophlebitis; nausea, fatigue, vomiting
Usual dosage:800mg/day by IV infusion

MEBENDAZOLE C

Supply:100mg/Tab(VERMOXR)
Use:It is an anthelmintic agent, effect agaisnt threadworm (pinworm) (Enterobius), roundworm(Ascaris), whipworm (Trichuris), hookworms (Ancylostoma and Necator).
Contraindication:Hypersensitivity, and pregnancy.
Adverse effect:Nausea,vomiting, abdominal pain and diarrhea.
Usual dosage:Threadworm: 100mg in a single dose, repeated in 2-3 weeks. Hookworm, whipworm: 100mg BID for 3 days, maximum dose: 200mg/kg/day

CYCLOPHOSPHAMIDE D

Supply:500mg/Vial(SYKLOFOSFAMIDR), 50mg/Tab(ENDOXAN-ASTAR)
Use:Acute leukemia, lymphomas, Hodgkin’s disease, endometrial carcinoma, breast cancer, sarcomas.
Contraindication:Hemorrhagic cystitis, diabetes mellitus, renal and hepatic failure.
Adverse effect:Leukopenia, thrombocytopenia, alopecia, cystitis, nausea, vomiting, pulmonary fibrosis, cardiotoxicity, skin rash.
Usual dosage:Initial: IV 2.5mg/kg/day; maintenance: 2.5mg/kg twice week, oral 2.5mg/kg/day.
Stability: Cyclophosphamide 100mg/L or 3.1g/L in D5W, 1.5% or less cyclophosphamide decomposition in 8 hours at 24 to 27 ? or 6 days at 5 ?. Cyclophosphamide 4g/L in Sodium Chloride 0.9%, 3.5% cyclophosphamide decomposition in 24 hours at room temperature and 1% decomposition in 4 weeks under refrigeration.
Special precautions:Patients of reproductive age should use contraceptives throughout therapy & for not <6 mth afterwards.Diabetes melliyus; elderly & debilitated patients; renal & hepatic failure

CISPLATIN D

Supply:0.5mg/ml 10mg/vial(PLATINOLR)
Use:Ovarian carcinoma, squamous cell carcinoma of head and neck, lymphoma.
Contraindication:Patients with renal and hearing impairment.
Adverse effect:Severe nausea, vomiting, renal failure, peripheral neuropathy, ototoxicity, hypomagnesaemia.
Usual dosage:100mg/m2 IV infusion over 12 hours, alternative schedule 20mg/m2/day for 5 days every 3 week for 3 courses, in combination with bleomycin & vinblastine.
Special precautions:Perform audiometric testing & neurologic exam. Momitor peripheral blood counts & liver function
Stability: D5W with cisplatin 50mg/L, reconstituted in sterile water for injection, stated to have a utility time of 8 hours at 25? or 24 hours at 4? in a glass container under fluorescent light. NS with cisplatin 1.25mg/mL is stable for 48 hours in polyvinylchloride containers.

DACARBAZINE C

Supply:200mg/Vial(DTIC-DOMER)
Use:Malignant melanoma, Hodgkin’s disease, combine of other antineoplastic agents.
Contraindication:Hypersensitivity to dacarbazine.
Adverse effect:Hemopoietic toxicity, hepatotoxicity, anaphylactic reactions, alopecia, anorexia, nausea, vomiting.
Usual dosage:
1. Recommended Dosage: 2-4.5mg/kg/day IV for 10 days, repeated at 4-week intervals.
2. Alternate recommended Dosage: 250mg/m2/day IV for 5 days, repeated every 3 weeks.
Special precautions:Local pain, burning sensation & irritation at the site of inj may be relieved by locally applied hot packs
Stability: Dacarbazine, reconstituted, may be diluted in D5W (or NS) and may be stored for 72 hours at 4 ? or for 8 hours at 25? and under normal light.

EPIRUBICIN

Supply:10mg/Vial(PHARMORUBICINR)
Use:Breast carcinoma, malignant lymphomas, soft tissue sarcomas, gastric and ovarian carcinomas.
Contraindication:Myelodepression, severe heart disease, previous treatments with maximal cumulative doses of adriamycin or daunoblastin.
Adverse effect:Cardiac toxicity, alopecia, mucositis, gastro-intestinal disorders, hematologic toxicity.
Usual dosage:The recommemded dose for single agent in adult is 75-90mg/m2 body surface, as 3-5 minutes IV injections 3 weekly when compatible with extent bone marrow function.
Special precautions:Liver impairment. Previous extensive radiotherapy. Bone infiltration by tumor

FLUORO-URACIL C

Supply:250mg/5ml/Vial(FLUORO-URACILR)
Use:Antifungal agent, inhibits Cryptococcus neoformans and Candida spp, Phialophora pedrosoi, Phialophora verrucosa, Cladosporium carrionii and Torulopsis glabrata.
Contraindication:Patients with renal or hepatic impairment or blood disorders.
Adverse effect:Bone marrow depression, agranulocytosis, aplastic anemia.
Usual dosage:150 mg/kg/day in 4 divided doses.
Dosage adjustment: according to CrCl (ml/min)

CrCl Dosage Interval

CrCl Dosage Interval
20-40 12.5-37.5 mg/kg Q12H
10-20 12.5-37.5 mg/kg Q24H
<10 12.5-37.5 mg/kg Q24-48H

Special precautions:GI ulceration, bleeding or hemorrhage. DPD deficiency.

FLUTAMIDE D

Supply:250mg/Tab(FUGERELR)
Use:Flutamide is a nonsteroidal nonhormonal antiandrogenic.
Place in therapy: In treating prostate cancer, flutamide compares favorably to DES and leuprolide monotherapy. Flutamide represents a less toxic alternative to DES or surgical orchiectomy and provides additional benefit when used in combination with leuprolide in patients with carcinoma of the prostate and as such will be a useful formulary addition.
Contraindication:Hypersensitivity to flutamide; severe hepatic impairment
Adverse effect:Gynecomastia and galactorrhea are the most frequently reported adverse effects. Other adverse effects include diarrhea, which has resulted in non-compliance, nausea, vomiting and transient serum transaminase elevations.
Usual dosage:250 mg PO TID; Doses of 1.5 g/day have also been effective, without increased toxicity.
Special precautions:Periodic liver function test & sperm count determinations may be considered in patients on long-term treatment

GEMCITABINE HCL D

Supply:200mg/Vial(GEMZARR)
Use:Gemcitabine is a cytotoxic agent structurally related to cytarabine. It can be used in advanced breast cancer, non-small-cell lung cancer, pancreatic carcinoma, and ovarian carcinoma.
Place in therapy: A greater intracellular accumulation of active metabolites is achieved with gemcitabine relative to cytarabine, and it may process superior antitumor activity than cytarabin.
Contraindication:Hypersensitivity to gemcitabine; use carefully in patient with hepatic dysfunction, myelosuppression, pregnancy, renal impairment, and avoid infusion times longer than 60 minutes. Monitor CBC prior to each dose.
Adverse effect:The adverse effects include: myelosuppression (dose limiting), flu-like symptoms (occasionally dose-limiting), fatigue, fever, peripheral edema, proteinuria, cutaneous reactions, and gastrointestinal effects.
Usual dosage:Pancreatic cancer: 1000 mg/m2 IV once weekly for 7 consecutive doses non-small-cell lung cancer: 1000 mg/m2 IV for 3 consecutive doses per cycle
Infusion time more than 30 min may induce further adverse effects. Dosage adjustment according to the mornitoring of the platelet, WBC and agranulocytosis:

Dosage adjustment according to the mornitoring of the platelet, WBC and agranulocytosis

Other Department
Agranulaocyte (x 106/L) Platelet count (x 106/L) % of Total Dose
>1000 And >100000 100
500-1000 Or 50000-100000 75
<500 Or <50000 Hold

Special precautions:Monitor platelet, leukocyte & granulocyte counts. Pregnancy, lactation, child, Impaired renal function or hepatic insufficiency. May impair ability ability to drive or operate machinery
Stability: The reconstituted solution is prepared with 5 ml NS. The maximum concentration of reconstituted solution is 40 mg/ml. The further diluted solution is stable for 24 hours at 15-30?.

IRINOTECAN

Supply:100mg/5ml/Vial(CAMPTOR)
Use:2nd -line treatment for metastatic colorectal cancer in patients failing an established 5-fluorouracil containing treatment regimen
Contraindication:Chronic inflammatory bowel disease &/or bowel obstruction; pregnancy or lactation; bilirubin > 1.5 times the ULN of normal range; severe bone marrow failure; WHO performance status> 2
Adverse effect:Delayed diarrhea, neutropenia; nausea, vomiting; acute cholinergic syndrome; dyspnea, muscle cramp, paresthesia, asthenia; alopecia, constipation, anorexia, abdominal pain, mucositis, cutaneous reactions; allergy, infusion site reaction
Usual dosage:350 mg/m2 , IV over a 30-90 mins period every 3 week.

METHOTREXATE X

Supply:50mg/Vial(METHOTREXATER)
Use:Low dose therapy: choriocarcinoma, lymphotic leukemia, breast carcinoma. High dose therapy: malignant melanoma, osteogenic sarcoma, epidermoid carcinoma of neck and head, small cell carcinoma of lung.
Contraindication:Psoriatic patients with severe renal or hepatic disorder, blood dyscrasia, pregnant women.
Adverse effect:Nausea, vomiting, leukopenia, thrombocytopenia, stomatitis, diarrhoea, hepatic and lung fibrosis.
Usual dosage:2.5-5mg/day or 15-50mg/m2 every 1-2 weeks, IM, IT, PO; 12mg/m2 twice weekly, IT.
Stability: D5W with methotrexate 50mg/L is compatible for 24 hours in glass or polyolefin containers; conditions not specified. Methotrexate 50mg/mL in Sodium Chloride 0.9%, chemically is stable for at least 1 week at 22 to 25?.

MITOMYCIN-C

Supply:2mg/Vial(MITOMYCIN-CR)
Use:Adenocarcinoma of stomach, pancrease, colon and breast; head and neck cancers, advanced biliary ovarian, lung and cervical, squamous cell carcinomas, transitional cell carcinoma of the urinary bladder.
Contraindication:Thrombocytopenia, coagulation disorders.
Adverse effect:Nausea, vomiting, thrombocytopenia, leukopenia, stomatitis, alopecia.
Usual dosage:10mg/m2 IV, every 3-4 weeks.
Special precautions:Monitor patient frequently with lab tests. Infectious disease, bleeding tendency.
Stability: D5W with mitomycin 20 to 40mg/L is stable for 3 hours at room temperature. Mitomycin 40mg/L in NS is reported less than 10% mitomycin loss reported in 24 hours at 25?.

PACLITAXEL D

Supply:30mg/5ml/Vial(TAXOLR)
Use:It can be used in refractory ovarian and breast cancer; activity has also been demonstrated in acute leukemia, lung cancer, malignant melanoma, and a variety of other malignancies.
Place in therapy: Besides overay carcinoma, paclitaxel also has activity against other malignancies, including malignant melanoma and acute leukemia.
Contraindication:1.Previous hypersensitivity to paclitaxel or cremophor EL (polyoxyethylated castor oil). 2.Patients with baseline neutropenia of less than 1500 cells/mm3.
Adverse effect:The major adverse effect is neutropenia. Other adverse effects include hypersensitivity reactions, mucositis, alopecia, neuropathies, myalgias, arthralgias, gastrointestinal disturbances, and arrhythmias.
Usual dosage:Refractory ovarian cancer: 135 mg/m2 over 24 hours repeated every 3 weeks; diluted with D5W, NS to a final concentration of 0.3-1.2 mg/ml before injection. A prophylactic antiallergic regimen of dexamethasone, diphenhydramine, and cimetidine or ranitidine may be used previous injection of praclitaxol.
Stability: Concentrations of 0.3 to 1.2 milligrams/milliliter is stable for 27 hours at 25? in D5W or NS. No Polyvinyl chloride (PVC) container or tubing should be used for a leaching of diethylhexyl phthalate (DEHP) from bags may occur.
Special precautions:Cardiac conduction abnormalities

TAMOXIFEN D

Supply:10mg/Tab(TADEXR)
Use:Advanced breast cancer.
Contraindication:Hypersensitivity to tamoxifen, patients with leukopenia or thrombocytopenia , pregnancy.
Adverse effect:Peripheral edema, reduced hemoglobulin, gynecological problems (vaginal bleeding, menstrual irre-gularities).
Usual dosage:10-20mg BID.
Special precautions:May be given to premenopausal women only after through exam has excluded the possibility of pregnancy.

TOREMIFENE CITRATE D

Supply:60mg/Tab(FARESTONR)
Use:Metastatic breast cancer in postmenopausal patients
Contraindication:Pre-exisiting endometrial hyperplasia, severe hepatic failure.
Adverse effect:Hot flush, sweating, nausea, leucorrhea, dizziness, oedema, pain, vomiting, vag bleeding, fatigue, skin discoloration, insomnia, dyspnea, pruritus, anorexia, reversible cornea, verticillata, asthenia. Thromboembolic events, endometrial hypertrophy
Usual dosage:60 mg daily
Special precautions:Non-compensated cardiac insufficiency, severe angina pectoris, hypercalcaemia, severe thromboembolic disease, hepatic impairment

VINBLASTINE SULFATE D

Supply:10mg /Vial(VINBLASTINER)
Use:Generalized Hodgkin’s disease, lymphocytic lymphoma, histocytic lymphoma, mycosis fungoides, advanced carcinoma of the testis, Kaposi’s sarcoma, choriocarcinoma, Letterer-Siwe disease, carcinoma of breast.
Contraindication:Patients with leukopenia of bacterial infection, should not be used during the first trimester of pregnancy.
Adverse effect:Nausea, vomiting, constipation, vesiculations of the mouth, ileus, diarrhea, anorexia, abdominal pain, rectal bleeding, pharyngitis, hemorrhagic enterocolitis bleeding, numbness, parethesias, peripheral neuritis, mental depressions, loss of deep tendon reflexes, headache, convulsions, malaise, weakness, dizziness, pain tumor site, vesiculation of skin.
Usual dosage:Adults: IV initially 0.1mg/kg/week, increased by 0.05 mg/kg/week, until falls WBC to 3000/mm3, the tumor regresses or maximal dose of 0.5mg/kg is reached (usually 0.15-0.2mg/kg). Child: IV, 0.1-0.2mg/kg/week or 3-6mg/m2/week.
Stability: D5W or NS with vinblastine 20mg/L is less than 5% vinblastine decomposition in 3 weeks at 4 or 25? in the dark.
Special precautions:Toxicity may be enhanced in the presence of hepatic insufficiency

POLICRESULEN

Supply:90mg/Vag.Supp.(ALBOTHYLR)
Use:Local treatment of inflammation or infection and tissus damage of vaginal and cervix (e.g. dischage due to bacterial, trichomonal and fungal infections; pressure sares from pessaries), condylomata acuminata etc.
Contraindication:Concomitant use of other topical agents in treating the affected areas
Adverse effect:Occasionally, mild local discomfort at beginning of treatment which disappears on discontinuation
Usual dosage:1 to be inserted on alternate days
Special precautions:1st trimester of pregnancy. Avoid deep intracervical application of the concentrate

CLOTRIMAZOLE B

Supply:200mg/Vag.Tab(FASTINR)
Use:Clotrimazole is effective against a broad spectrum of fungi. Vaginal clotrimazole 500 mg as a single dose is considered a treatment of choice in uncomplicated vulvovaginal candidiasis
Place in therapy: Due to the elimination of a compliance problem, single-dose clotrimazole vaginal tablets may be a treatment of choice in uncomplicated and possibly recurrent vulvovaginal candidiasis.
Contraindication:Hypersensitivity to clotrimazole; If clotrimazole vaginal treatment fails, appropriate microbiological studies should be done to confirm the diagnosis and rule out other pathogens
Adverse effect:Local irritation and contact dermatitis may occur with topical administration of clotrimazole.
Usual dosage:a single 500-mg intravaginal dose.

CONJUGATDED ESTROGENS

Supply:42.5gm/Vag.Crem(PREMARINR)
Use:Atrophic vaginitis. Post-menopausal atrophic urethritis.
Contraindication:Known or suspected breast cancer, estrogen-dependent neoplasia, active thromboembolic disease, undiagnosed abnormal genital bieeding. Known or suspected pregnancy
Adverse effect:Rarely nausea, vomiting. Breakthrough bleeding, spotting, change in menstrual flow, amenorrhea. Breast tenderness, enlargement, secretion. GI effects, cholestatic jaundice. Chloasma or melasma. Steepening of the cormeal curvature; intolerance to contact lenses. Headache, migraine, dizziness; chorea. Weight changes; edema; changes in libido.
Usual dosage:Intravaginally or topically, 0.5-2 g daily depending on severity of condition. Max: 4g/day. Cyclic administration (3 wk on &1 wk off) should be used
Special precautions:Systemic absorption may occur. Warning & precautions associated with oral Premarin should be considered

FENTICONAZOLE NITRATE

Supply:200mg/Vag.Supp(LOMEXINR)
Use: Vaginal: Genital candidiasis
Adverse effect:Transient burning
Usual dosage:1 supp at bedtim

Antiprotozoal drugs

METRONIDAZOLE B

Supply:500mg/100ml/Bot(MEDAZOLER), 250mg/Tab(METRODINR)
Use:It has bactericidal, amebicidal and trichomonacidal action, active against most obligately anaerobic bacteria, trichomonas vaginalis, Entamoeba histolytic, Giardia lamblia.
Contraindication:Pregnancy, hypersensitivity, patients with blood dyscrasia, severe hepatic impairement.
Adverse effect:GI discomforts , headache, anorexia, dry mouth, dizziness. vertigo, peripheral neuropathy, reversible leukopenia, skin rash
Usual dosage:For trichomoniasis: PO 2g as a single dose or 250mg TID for 7 days. For amebiasis: adults: PO 750mg TID for 5-10 days; Child: PO 35-50mg/kg/day in 3 divided dose for 5-10 days, maximum dose 2.4g/day. For giardiasis: adults: 250mg TID for 5-7 days, child: 15mg/kg/day in 3 divided dose for 5 days. For anaerobic infection: PO or IV, initial dose 15mg/kg, followed by maintenance dose 7.5mg/kg/Q6H, maximum dose 4g/day.

TINIDAZOLE

Supply:500mg/100ml/Bot(FLUGENR)
Use:Prophylaxis & treatment of post-op anaerobic infection
Contraindication:Blood dyscrasias. Active CNS disease
Adverse effect:Thrombophlebitis; nausea, fatigue, vomiting
Usual dosage:800mg/day by IV infusion

MEBENDAZOLE C

Supply:100mg/Tab(VERMOXR)
Use:It is an anthelmintic agent, effect agaisnt threadworm (pinworm) (Enterobius), roundworm(Ascaris), whipworm (Trichuris), hookworms (Ancylostoma and Necator).
Contraindication:Hypersensitivity, and pregnancy.
Adverse effect:Nausea,vomiting, abdominal pain and diarrhea.
Usual dosage:Threadworm: 100mg in a single dose, repeated in 2-3 weeks. Hookworm, whipworm: 100mg BID for 3 days, maximum dose: 200mg/kg/day

ANTINEOPLASTIC AGENTS

CYCLOPHOSPHAMIDE D

Supply:500mg/Vial(SYKLOFOSFAMIDR), 50mg/Tab(ENDOXAN-ASTAR)
Use:Acute leukemia, lymphomas, Hodgkin’s disease, endometrial carcinoma, breast cancer, sarcomas.
Contraindication:Hemorrhagic cystitis, diabetes mellitus, renal and hepatic failure.
Adverse effect:Leukopenia, thrombocytopenia, alopecia, cystitis, nausea, vomiting, pulmonary fibrosis, cardiotoxicity, skin rash.
Usual dosage:Initial: IV 2.5mg/kg/day; maintenance: 2.5mg/kg twice week, oral 2.5mg/kg/day.
Stability: Cyclophosphamide 100mg/L or 3.1g/L in D5W, 1.5% or less cyclophosphamide decomposition in 8 hours at 24 to 27 ? or 6 days at 5 ?. Cyclophosphamide 4g/L in Sodium Chloride 0.9%, 3.5% cyclophosphamide decomposition in 24 hours at room temperature and 1% decomposition in 4 weeks under refrigeration.
Special precautions:Patients of reproductive age should use contraceptives throughout therapy & for not <6 mth afterwards.Diabetes melliyus; elderly & debilitated patients; renal & hepatic failure

CISPLATIN D

Supply:0.5mg/ml 10mg/vial(PLATINOLR)
Use:Ovarian carcinoma, squamous cell carcinoma of head and neck, lymphoma.
Contraindication:Patients with renal and hearing impairment.
Adverse effect:Severe nausea, vomiting, renal failure, peripheral neuropathy, ototoxicity, hypomagnesaemia.
Usual dosage:100mg/m2 IV infusion over 12 hours, alternative schedule 20mg/m2/day for 5 days every 3 week for 3 courses, in combination with bleomycin & vinblastine.
Special precautions:Perform audiometric testing & neurologic exam. Momitor peripheral blood counts & liver function
Stability: D5W with cisplatin 50mg/L, reconstituted in sterile water for injection, stated to have a utility time of 8 hours at 25? or 24 hours at 4? in a glass container under fluorescent light. NS with cisplatin 1.25mg/mL is stable for 48 hours in polyvinylchloride containers.

DACARBAZINE C

Supply:200mg/Vial(DTIC-DOMER)
Use:Malignant melanoma, Hodgkin’s disease, combine of other antineoplastic agents.
Contraindication:Hypersensitivity to dacarbazine.
Adverse effect:Hemopoietic toxicity, hepatotoxicity, anaphylactic reactions, alopecia, anorexia, nausea, vomiting.
Usual dosage:
1. Recommended Dosage: 2-4.5mg/kg/day IV for 10 days, repeated at 4-week intervals.
2. Alternate recommended Dosage: 250mg/m2/day IV for 5 days, repeated every 3 weeks.
Special precautions:Local pain, burning sensation & irritation at the site of inj may be relieved by locally applied hot packs
Stability: Dacarbazine, reconstituted, may be diluted in D5W (or NS) and may be stored for 72 hours at 4 ? or for 8 hours at 25? and under normal light.

EPIRUBICIN

Supply:10mg/Vial(PHARMORUBICINR)
Use:Breast carcinoma, malignant lymphomas, soft tissue sarcomas, gastric and ovarian carcinomas.
Contraindication:Myelodepression, severe heart disease, previous treatments with maximal cumulative doses of adriamycin or daunoblastin.
Adverse effect:Cardiac toxicity, alopecia, mucositis, gastro-intestinal disorders, hematologic toxicity.
Usual dosage:The recommemded dose for single agent in adult is 75-90mg/m2 body surface, as 3-5 minutes IV injections 3 weekly when compatible with extent bone marrow function.
Special precautions:Liver impairment. Previous extensive radiotherapy. Bone infiltration by tumor

FLUORO-URACIL C

Supply:250mg/5ml/Vial(FLUORO-URACILR)
Use:Antifungal agent, inhibits Cryptococcus neoformans and Candida spp, Phialophora pedrosoi, Phialophora verrucosa, Cladosporium carrionii and Torulopsis glabrata.
Contraindication:Patients with renal or hepatic impairment or blood disorders.
Adverse effect:Bone marrow depression, agranulocytosis, aplastic anemia.
Usual dosage:150 mg/kg/day in 4 divided doses.
Dosage adjustment: according to CrCl (ml/min)

CrCl Dosage Interval

CrCl Dosage Interval
20-40 12.5-37.5 mg/kg Q12H
10-20 12.5-37.5 mg/kg Q24H
<10 12.5-37.5 mg/kg Q24-48H

Special precautions:GI ulceration, bleeding or hemorrhage. DPD deficiency.

FLUTAMIDE D

Supply:250mg/Tab(FUGERELR)
Use:Flutamide is a nonsteroidal nonhormonal antiandrogenic.
Place in therapy: In treating prostate cancer, flutamide compares favorably to DES and leuprolide monotherapy. Flutamide represents a less toxic alternative to DES or surgical orchiectomy and provides additional benefit when used in combination with leuprolide in patients with carcinoma of the prostate and as such will be a useful formulary addition.
Contraindication:Hypersensitivity to flutamide; severe hepatic impairment
Adverse effect:Gynecomastia and galactorrhea are the most frequently reported adverse effects. Other adverse effects include diarrhea, which has resulted in non-compliance, nausea, vomiting and transient serum transaminase elevations.
Usual dosage:250 mg PO TID; Doses of 1.5 g/day have also been effective, without increased toxicity.
Special precautions:Periodic liver function test & sperm count determinations may be considered in patients on long-term treatment

GEMCITABINE HCL D

Supply:200mg/Vial(GEMZARR)
Use:Gemcitabine is a cytotoxic agent structurally related to cytarabine. It can be used in advanced breast cancer, non-small-cell lung cancer, pancreatic carcinoma, and ovarian carcinoma.
Place in therapy: A greater intracellular accumulation of active metabolites is achieved with gemcitabine relative to cytarabine, and it may process superior antitumor activity than cytarabin.
Contraindication:Hypersensitivity to gemcitabine; use carefully in patient with hepatic dysfunction, myelosuppression, pregnancy, renal impairment, and avoid infusion times longer than 60 minutes. Monitor CBC prior to each dose.
Adverse effect:The adverse effects include: myelosuppression (dose limiting), flu-like symptoms (occasionally dose-limiting), fatigue, fever, peripheral edema, proteinuria, cutaneous reactions, and gastrointestinal effects.
Usual dosage:Pancreatic cancer: 1000 mg/m2 IV once weekly for 7 consecutive doses non-small-cell lung cancer: 1000 mg/m2 IV for 3 consecutive doses per cycle
Infusion time more than 30 min may induce further adverse effects. Dosage adjustment according to the mornitoring of the platelet, WBC and agranulocytosis:

Dosage adjustment according to the mornitoring of the platelet, WBC and agranulocytosis

Other Department
Agranulaocyte (x 106/L) Platelet count (x 106/L) % of Total Dose
>1000 And >100000 100
500-1000 Or 50000-100000 75
<500 Or <50000 Hold

Special precautions:Monitor platelet, leukocyte & granulocyte counts. Pregnancy, lactation, child, Impaired renal function or hepatic insufficiency. May impair ability ability to drive or operate machinery
Stability: The reconstituted solution is prepared with 5 ml NS. The maximum concentration of reconstituted solution is 40 mg/ml. The further diluted solution is stable for 24 hours at 15-30?.

IRINOTECAN

Supply:100mg/5ml/Vial(CAMPTOR)
Use:2nd -line treatment for metastatic colorectal cancer in patients failing an established 5-fluorouracil containing treatment regimen
Contraindication:Chronic inflammatory bowel disease &/or bowel obstruction; pregnancy or lactation; bilirubin > 1.5 times the ULN of normal range; severe bone marrow failure; WHO performance status> 2
Adverse effect:Delayed diarrhea, neutropenia; nausea, vomiting; acute cholinergic syndrome; dyspnea, muscle cramp, paresthesia, asthenia; alopecia, constipation, anorexia, abdominal pain, mucositis, cutaneous reactions; allergy, infusion site reaction
Usual dosage:350 mg/m2 , IV over a 30-90 mins period every 3 week.

METHOTREXATE X

Supply:50mg/Vial(METHOTREXATER)
Use:Low dose therapy: choriocarcinoma, lymphotic leukemia, breast carcinoma. High dose therapy: malignant melanoma, osteogenic sarcoma, epidermoid carcinoma of neck and head, small cell carcinoma of lung.
Contraindication:Psoriatic patients with severe renal or hepatic disorder, blood dyscrasia, pregnant women.
Adverse effect:Nausea, vomiting, leukopenia, thrombocytopenia, stomatitis, diarrhoea, hepatic and lung fibrosis.
Usual dosage:2.5-5mg/day or 15-50mg/m2 every 1-2 weeks, IM, IT, PO; 12mg/m2 twice weekly, IT.
Stability: D5W with methotrexate 50mg/L is compatible for 24 hours in glass or polyolefin containers; conditions not specified. Methotrexate 50mg/mL in Sodium Chloride 0.9%, chemically is stable for at least 1 week at 22 to 25?.

MITOMYCIN-C

Supply:2mg/Vial(MITOMYCIN-CR)
Use:Adenocarcinoma of stomach, pancrease, colon and breast; head and neck cancers, advanced biliary ovarian, lung and cervical, squamous cell carcinomas, transitional cell carcinoma of the urinary bladder.
Contraindication:Thrombocytopenia, coagulation disorders.
Adverse effect:Nausea, vomiting, thrombocytopenia, leukopenia, stomatitis, alopecia.
Usual dosage:10mg/m2 IV, every 3-4 weeks.
Special precautions:Monitor patient frequently with lab tests. Infectious disease, bleeding tendency.
Stability: D5W with mitomycin 20 to 40mg/L is stable for 3 hours at room temperature. Mitomycin 40mg/L in NS is reported less than 10% mitomycin loss reported in 24 hours at 25?.

PACLITAXEL D

Supply:30mg/5ml/Vial(TAXOLR)
Use:It can be used in refractory ovarian and breast cancer; activity has also been demonstrated in acute leukemia, lung cancer, malignant melanoma, and a variety of other malignancies.
Place in therapy: Besides overay carcinoma, paclitaxel also has activity against other malignancies, including malignant melanoma and acute leukemia.
Contraindication:1.Previous hypersensitivity to paclitaxel or cremophor EL (polyoxyethylated castor oil). 2.Patients with baseline neutropenia of less than 1500 cells/mm3.
Adverse effect:The major adverse effect is neutropenia. Other adverse effects include hypersensitivity reactions, mucositis, alopecia, neuropathies, myalgias, arthralgias, gastrointestinal disturbances, and arrhythmias.
Usual dosage:Refractory ovarian cancer: 135 mg/m2 over 24 hours repeated every 3 weeks; diluted with D5W, NS to a final concentration of 0.3-1.2 mg/ml before injection. A prophylactic antiallergic regimen of dexamethasone, diphenhydramine, and cimetidine or ranitidine may be used previous injection of praclitaxol.
Stability: Concentrations of 0.3 to 1.2 milligrams/milliliter is stable for 27 hours at 25? in D5W or NS. No Polyvinyl chloride (PVC) container or tubing should be used for a leaching of diethylhexyl phthalate (DEHP) from bags may occur.
Special precautions:Cardiac conduction abnormalities

TAMOXIFEN D

Supply:10mg/Tab(TADEXR)
Use:Advanced breast cancer.
Contraindication:Hypersensitivity to tamoxifen, patients with leukopenia or thrombocytopenia , pregnancy.
Adverse effect:Peripheral edema, reduced hemoglobulin, gynecological problems (vaginal bleeding, menstrual irre-gularities).
Usual dosage:10-20mg BID.
Special precautions:May be given to premenopausal women only after through exam has excluded the possibility of pregnancy.

TOREMIFENE CITRATE D

Supply:60mg/Tab(FARESTONR)
Use:Metastatic breast cancer in postmenopausal patients
Contraindication:Pre-exisiting endometrial hyperplasia, severe hepatic failure.
Adverse effect:Hot flush, sweating, nausea, leucorrhea, dizziness, oedema, pain, vomiting, vag bleeding, fatigue, skin discoloration, insomnia, dyspnea, pruritus, anorexia, reversible cornea, verticillata, asthenia. Thromboembolic events, endometrial hypertrophy
Usual dosage:60 mg daily
Special precautions:Non-compensated cardiac insufficiency, severe angina pectoris, hypercalcaemia, severe thromboembolic disease, hepatic impairment

VINBLASTINE SULFATE D

Supply:10mg /Vial(VINBLASTINER)
Use:Generalized Hodgkin’s disease, lymphocytic lymphoma, histocytic lymphoma, mycosis fungoides, advanced carcinoma of the testis, Kaposi’s sarcoma, choriocarcinoma, Letterer-Siwe disease, carcinoma of breast.
Contraindication:Patients with leukopenia of bacterial infection, should not be used during the first trimester of pregnancy.
Adverse effect:Nausea, vomiting, constipation, vesiculations of the mouth, ileus, diarrhea, anorexia, abdominal pain, rectal bleeding, pharyngitis, hemorrhagic enterocolitis bleeding, numbness, parethesias, peripheral neuritis, mental depressions, loss of deep tendon reflexes, headache, convulsions, malaise, weakness, dizziness, pain tumor site, vesiculation of skin.
Usual dosage:Adults: IV initially 0.1mg/kg/week, increased by 0.05 mg/kg/week, until falls WBC to 3000/mm3, the tumor regresses or maximal dose of 0.5mg/kg is reached (usually 0.15-0.2mg/kg). Child: IV, 0.1-0.2mg/kg/week or 3-6mg/m2/week.
Stability: D5W or NS with vinblastine 20mg/L is less than 5% vinblastine decomposition in 3 weeks at 4 or 25? in the dark.
Special precautions:Toxicity may be enhanced in the presence of hepatic insufficiency

GYNEOLOGICAL PREPARATIONS

POLICRESULEN

Supply:90mg/Vag.Supp.(ALBOTHYLR)
Use:Local treatment of inflammation or infection and tissus damage of vaginal and cervix (e.g. dischage due to bacterial, trichomonal and fungal infections; pressure sares from pessaries), condylomata acuminata etc.
Contraindication:Concomitant use of other topical agents in treating the affected areas
Adverse effect:Occasionally, mild local discomfort at beginning of treatment which disappears on discontinuation
Usual dosage:1 to be inserted on alternate days
Special precautions:1st trimester of pregnancy. Avoid deep intracervical application of the concentrate

CLOTRIMAZOLE B

Supply:200mg/Vag.Tab(FASTINR)
Use:Clotrimazole is effective against a broad spectrum of fungi. Vaginal clotrimazole 500 mg as a single dose is considered a treatment of choice in uncomplicated vulvovaginal candidiasis
Place in therapy: Due to the elimination of a compliance problem, single-dose clotrimazole vaginal tablets may be a treatment of choice in uncomplicated and possibly recurrent vulvovaginal candidiasis.
Contraindication:Hypersensitivity to clotrimazole; If clotrimazole vaginal treatment fails, appropriate microbiological studies should be done to confirm the diagnosis and rule out other pathogens
Adverse effect:Local irritation and contact dermatitis may occur with topical administration of clotrimazole.
Usual dosage:a single 500-mg intravaginal dose.

CONJUGATDED ESTROGENS

Supply:42.5gm/Vag.Crem(PREMARINR)
Use:Atrophic vaginitis. Post-menopausal atrophic urethritis.
Contraindication:Known or suspected breast cancer, estrogen-dependent neoplasia, active thromboembolic disease, undiagnosed abnormal genital bieeding. Known or suspected pregnancy
Adverse effect:Rarely nausea, vomiting. Breakthrough bleeding, spotting, change in menstrual flow, amenorrhea. Breast tenderness, enlargement, secretion. GI effects, cholestatic jaundice. Chloasma or melasma. Steepening of the cormeal curvature; intolerance to contact lenses. Headache, migraine, dizziness; chorea. Weight changes; edema; changes in libido.
Usual dosage:Intravaginally or topically, 0.5-2 g daily depending on severity of condition. Max: 4g/day. Cyclic administration (3 wk on &1 wk off) should be used
Special precautions:Systemic absorption may occur. Warning & precautions associated with oral Premarin should be considered

FENTICONAZOLE NITRATE

Supply:200mg/Vag.Supp(LOMEXINR)
Use: Vaginal: Genital candidiasis
Adverse effect:Transient burning
Usual dosage:1 supp at bedtim