COMPOSITION
(Dicyclomine Hydrochloride I.P. 10 mg + Simethicone U.S.P. 40 mg)

Class: Antispasmodic and Antiflatulent
Dicyclomine Action: Relieves smooth muscle spasm of GI tract through anticholinergic effects and direct action on GI smooth muscle.
Simethocone : Relieves flatulence by dispersing and preventing formation of mucus-surrounded gas pockets in GI tract.

Absorption:
Rapidly absorbed. T max is 60 to 90 min (oral).
Distribution:
Vd approximately 3.65 L/kg.
Excretion:
79.5% excreted in the urine and 8.4% in feces. t ½ approximately 1.8 h.
Indications: Treatment of functional bowel/irritable bowel syndrome (eg, irritable colon, spastic colon, mucous colitis).
Indications:
Intestinal colic in children older than 6 months .
Relief of painful symptoms and pressure of excess gas in digestive tract; adjunct in treatment of many conditions in which gas retention may be problem, such as postoperative gaseous distention and pain, endoscopic examination, air swallowing, functional dyspepsia, peptic ulcer, spastic or irritable colon, diverticulosis.

Precautions: Pregnancy: Category B .

Lactation: Excreted in breast milk.

Children: Safety and efficacy have not been established. Contraindicated in infants younger than 6 mo. In infants, serious respiratory symptoms, seizures, syncope, pulse rate fluctuation, muscular hypotonia, coma, and death have been reported.
Elderly: Elderly patients may react with excitement, agitation, drowsiness, and other untoward manifestations to even small doses.
Special risk patients:Use with caution in patients with autonomic neuropathy, hyperthyroidism, hypertension, coronary heart disease, CHF, hiatal hernia, prostatic hypertrophy.
Anticholinergic psychosisReported in sensitive individuals and may include confusion, disorientation, short-term memory loss, hallucinations, dysarthria, ataxia, coma, euphoria, decreased anxiety, fatigue, insomnia, agitation and mannerisms, and inappropriate affect.
DiarrheaDiarrhea may be symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Treatment of diarrhea with drug is inappropriate and possibly harmful.
Gastric ulcer May delay gastric emptying rate and complicate therapy.
Heat prostration Can occur in presence of high environmental temperature.
Overdosage: Signs & symptomsCirculatory failure, vomiting, abdominal distention, muscle weakness, anxiety, stupor, blurred vision, photophobia, dilated pupils, urinary retention.

COMPOSOTION (Mefenamic Acid I.P. 250 mg + Dicyclomine HCl. I.P. 10 mg + Acetaminophen I.P. 350 mg)
Dicyclomine Action: Relieves smooth muscle spasm of GI tract through anticholinergic effects and direct action on GI smooth muscle.

Acetaminophen with analgesic, antipyretic properties.

Excellent coverage against gram positive like- Streptococcus, Staph. aureus.

Excellent gram negative coverage like E coli, H influenzae,M catarrhalis ,Salmonella, Shigella,Klebsiella,Proteus.

Stable against beta lactamases.

Safe, effective and has convenient dosage.
CLINICAL PHARMACOLOGY
Cefixime inhibits the third and final stage of bacterial cell wall synthesis by preferentially binding to specific penicillin-binding proteins (PBPs) that are located inside the bacterial cell wall. Like all beta-lactam antibiotics, cefixime's ability to interfere with PBP-mediated cell wall synthesis ultimately leads to cell lysis.
In general, third-generation cephalosporins are more active against gram-negative species than are the earlier generations of cephalosporins. They are less active, however, against the gram-positive species than are their first-generation counterparts.
Indications
Cefixime is indicated in the treatment of the following infections

• Typhoid fever
• Uncomplicated Urinary Tract Infections
• Otitis Media
• Pharyngitis and Tonsillitis,
• Acute Bronchitis and Acute Exacerbations of Chronic Bronchitis
• Uncomplicated gonorrhea
• Dosage And Administration
• Adults: The recommended dose of Cefixime is 400 mg daily. This may be given as 400 mg once daily or as 200 mg every 12 hours.
  For the treatment of uncomplicated cervical/urethral gonococcal infections, a single oral dose of 400 mg is recommended.
• Children: The recommended dose is 8 mg/kg/day of the suspension. This may be administered as a single daily dose or may be given in two divided doses, as 4 mg/kg every 12 hours. In Typhoid the dose is 20 mg/kg/day in two divided doses or as a single dose
  In the treatment of infections due to S. pyogenes , a therapeutic dosage of Cefixime should be administered for at least 10 days.

Composition : (Cyproheptadine HCl. I.P. 2 mg)

Action: Competitively antagonizes histamine at H 1 receptor sites. Also exhibits antiserotonin activity.

Metabolism:
The principal metabolite found in the urine is the quaternary ammonium glucuronide conjugate of cyproheptadine.

Excretion:
2% to 20% is excreted in the feces, of which 34% (5.7% of the dose) is unchanged drug. At least 40% is excreted in the urine.
Indications: Symptomatic relief of perennial and seasonal allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis; amelioration of allergic reactions to blood or plasma; management of allergic pruritic symptoms, mild skin manifestations of uncomplicated urticaria and angioedema, and cold urticaria; dermographism; adjunctive anaphylactic therapy.
Indications:
Prophylactic treatment of pediatric migraines; suppression of vascular headaches; appetite stimulation.

Precautions: Monitoring: Allergy symptomsWhen used for treatment of allergy symptoms, assess allergy symptoms (eg, cough; rhinitis; nasal congestion; sneezing; watery eyes; itching nose, throat, or eyes) before starting therapy and periodically during therapy. Notify health care provider if symptoms are not improving or are getting worse.
Dizziness/Drowsiness Monitor patient for dizziness and excessive drowsiness. If noted, hold therapy and notify health care provider.
Review therapyEnsure that therapy is periodically reviewed to determine if therapy needs to be continued without change or if a dose change (eg, increase, decrease, discontinuation) is indicated.
Pregnancy: Category B .

Lactation: Undetermined. Contraindicated in breast-feeding women.

Children: Safety and efficacy in children younger than 2 yr of age not established.

Elderly:Use with caution because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.
Sedatives/CNS depressants Avoid in patients with history of sleep apnea.

Overdosage: Signs & symptomsCNS depression, CV collapse, CV stimulation, seizures, hypotension, anticholinergic effects (eg, dilated pupils, dry mouth, flushing), hyperthermia (especially in children), dystonic reactions, dizziness, ataxia, blurred vision.

Description:
Digestive Enzymes are molecule catalysts located in abundance in the body. In fact, there are over 1,300 different types. Enzymes are considered as the "construction workers" that facilitate all the bodily functions.
Digestive enzymes are especially important, as exhaustion is one of the main reasons of accelerated aging. Plant enzymes assist in the digestion of food directly through the intestinal tract. Supplemental enzymes help prevent feelings of bloating and exhaustion after a big meal. We consume an average of two pounds of food per day or 20 tons over a lifetime. A smooth passage of food through the gastrointestinal tract is critical to avoid stasis of feces, which releases toxins. Digestive enzymes help in this respect together with a high soluble fiber diet.
Digestive enzymes also help other vitamins and minerals. For example, the fat-soluble vitamins A, D, E, and K require fat for absorption. Fat has to be broken down by an enzyme known as lipase. If lipase is not present in sufficient quantities, the fat will not be broken down. If the fat is not broken down, the vitamins will not be released. Therefore, you can spend a fortune on vitamin pills but if there is an absence of the proper enzymes to release the vitamins into the body's system, the vitamins will still be flushed out.
On an interesting note, one of the early signs of improving digestion after consuming digestive enzymes is an improvement in skin tone. This is because if the inner organs start to degenerate and fail to function properly, the stress will most likely be revealed on the face. Supplementation with digestive enzymes is therefore an important part of anti-aging treatment, in addition to consuming raw food and mineral supplements.

ContraIndications:
Cardiac failure, hypertension

Warning & Precautions :
History of allergy, impairment of hepatic or renal function, G6-PD deficiency. To get periodic blood check & liver function tests to be done.

Side Effects :
Prolonged use in patients ingesting low phosphate diet may cause osteomalacia. Nausea, vomiting, constipation.
Dosage: 1-2 teaspoonfuls to be taken after meal trice in a day.

Calcium Citrate +VITAMINS +Minerals

Calcium is an important component of a healthy diet. A deficit can affect bone and tooth formation, while overretention can cause kidney stones. Vitamin D is needed to absorb calcium. Dairy products, such as milk and cheese, are a well-known source of calcium. However, some individuals are allergic to dairy products and even more people, particularly those of non Indo-European descent, are lactose-intolerant, leaving them unable to consume dairy products. Others, such as vegans, avoid dairy products for ethical and health reasons. Fortunately, many other good sources of calcium exist. These include seaweeds such as kelp, wakame and hijiki; nuts and seeds (like almonds and sesame); blackstrap molasses; beans; oranges; amaranth; collard greens; okra; rutabaga; broccoli; dandelion leaves; kale; sardines; and fortified products such as orange juice and soy milk. The calcium content of most foods can be found in the USDA National Nutrient Database.[3]
Calcium is essential for the normal growth and maintenance of bones and teeth, and calcium requirements must be met throughout life. Long-term calcium deficiency can lead to osteoporosis, in which the bone deteriorates and there is an increased risk of fractures. Calcium has also been found to assist in the production of lymphatic fluids.
Recommended Adequate Intake by the IOM for Calcium:[4]
For more information about calcium in living nature, see calcium in biology and calcium metabolism.

Calcium supplements are used to prevent and to treat calcium deficiencies. There are conflicting recommendations about when to take calcium supplements. However, most experts agree that no more than 500 mg should be taken at a time because the percent of calcium absorbed decreases as the amount of calcium in the supplement increases.[4] It is recommended to spread doses throughout the day, with the last dose near bedtime. Recommended daily calcium intake varies from 1000 to 1500 mg, depending upon the stage of life.
" Calcium citrate is more easily absorbed (bioavailability is 2.5 times higher than calcium carbonate), easier to digest and less likely to cause constipation and gas than calcium carbonate. It also has a lower risk of contributing to the formation of kidney stones. Calcium citrate is about 21% elemental calcium. 1000 mg will provide 210 mg of calcium. It is more expensive than calcium carbonate and more of it must be taken to get the same amount of calcium.

COMPOSITION :

• Ceftriaxone - 1 000 MG
• ceftriaxone - 250mg
• Ceftriaxone is a sterile, semisynthetic, broad-spectrum cephalosporin antibiotic for intravenous or intramuscular administration.
• ???Broad spectrum third generation cephalosporin protected with the broad spectrum beta-lactamase inhibitor]
• ???Ceftriaxone shows lower MICs than Cefotaxime for several gram-negative organisms. Increased sensitivity when combined with sulbactam.
• ??Superior action against anaerobes, salmonella
• ???Lower resistance development
• ???Safe even in children
  
  
• CLINICAL PHARMACOLOGY
• Ceftriaxone:
• Ceftriaxone is a third generation cephalosporin antibiotic with a broad-spectrum activity which includes gram positive and gram negative aerobic and anaerobic bacteria.
• Ceftriaxone has a high degree of stability in the presence of beta lactamases, both penicillinases and cephalosporinases of gram-negative and positive bacteria. The bactericidal activity of ceftriaxone sodium results from inhibition of cell wall synthesis.
• INDICATIONS AND USAGE
• Avezone is indicated for the treatment of the following infections:
• o Lower Respiratory Tract infections
• o Acute Bacterial Otitis Media
• o Skin and Skin Structure infections
• o Urinary Tract infections (complicated and uncomplicated)
• o Pelvic inflammatory Disease
• o Bacterial Septicemia
• o Bone and joint infections
• o Intra-Abdominal infections
• o Meningitis
• o Resistant typhoid
• o Sexually transmitted diseases
• o Surgical Prophylaxis
• CONTRAINDICATIONS
• Avezone is contraindicated in patients with known allergy to penicillin or any other ingredients of the combination.
• of BUN, headache, dizziness, vaginitis, flatulence, dyspepsia, palpitations and epistaxis.
• DOSAGE AND ADMINISTRATION
• Avezone may be administered intravenously or intramuscularly.
• Adults:
• The usual adult daily dose (in terms of Ceftriaxone) is 1-2 grams given once a day (or in equally divided doses twice a day) depending on the type and severity of infection. The total daily dose should not exceed 4 grams.
• For the treatment of uncomplicated gonococcal infections, a single intramuscular dose of 250 mg is recommended.
• For preoperative use (surgical prophylaxis), a single dose of 1 gram administered intravenously ½ to 2 hours before surgery is recommended.
• In the treatment of meningitis, it is recommended that the initial therapeutic dose be 100 mg/kg (not to exceed 4 grams). Thereafter, a total daily dose of 100 mg/kg/day
• (not to exceed 4 grams daily) is recommended. The daily dose may be administered once a day (or in equally divided doses every 12 hours). The usual duration of therapy is 7 to 14 days.
• GenerallyAvezone therapy should be continued for at least 2 days after the signs and symptoms of infection have disappeared. The usual duration of therapy is 4 to 14 days; in complicated infections, longer therapy may be required.
• When treating infections caused by Streptococcus pyogenes, therapy should be continued for at least 10 days.
• No dosage adjustment is necessary for patients with impairment of renal or hepatic function, however, blood levels should be monitored in patients with severe renal impairment (eg, dialysis patients) and in patients with both renal and hepatic dysfunctions.

COMPOSOTION
Avecold susp: (Cetirizine 2.5 mg + Phenylpropanolamine mg 12.5 + Paracetamol 125 mg)
Avecold tablets: (Dextromethorphan 10 mg + Paracetamol 500 mg + Cetirizine 10 mg + Phenylpropanolamine 25 mg + Caffeine Anhydrous 30 mg
It is a combination of anti- tussive and anti -histaminic.

CLINICAL PHARMACOLOGY
Cetrizine Symptomatic relief of symptoms (eg, nasal, nonnasal) associated with seasonal and perennial allergic rhinitis; treatment of uncomplicated skin manifestations of chronic idiopathic urticaria.
Cetirizine is a highly potent long-acting peripheral H1-receptor antagonist which acts both on the early and late allergic response.
Phenylpropanolamine is an orally active sympathomimetic amine and exerts a decongestant action on the nasal mucosa.
Paracetamol is an acetaminophen derivative with analgesic, antipyretic properties.

Dextromethorphan hydrobromide acts centrally to elevate the threshold for coughing. It has no analgesic or addictive properties. The onset of anti-tussive action occurs in 15 to 30 minutes after administration and is of long duration.
Phenylpropanolamine hydrochloride is a sympathomimetic drug, which is readily absorbed from the gastrointestinal tract and produces nasal vasoconstriction (decongestion). Phenylpropanolamine stimulates both alpha and beta adrenergic receptors, similar to ephedrine. Part of its peripheral action is indirect and is due to the displacement of norepinephrine from storage sites, but it also has a direct effect on the adrenergic receptors.

Caffeine acts through multiple mechanisms involving both action on receptors and channels at the cell membrane, as well as intracellular action on Calcium and cAMP pathways. By virtue of its purine structure it can act on some of the same targets as adenosine related nucleosides and nucleotides, like the cell surface P1 GPCRs for adenosine, as well as the intracellular Ryanodine receptor which is the physiological target of cADPR (cyclic ADP ribose), and cAMP-phosphodiesterase (cAMP-PDE). Although the action is agonistic in some cases, it is antagonistic in others. Physiologically, however, caffeine action is unlikely due to increased RyR opening, as it requires plasma concentration above lethal dosage. The action is most likely through adenosine receptors

INDICATIONS AND USAGE
Dextromethorphan HBr and Phenylpropanolamine HCl Liquid is indicated for the relief of coughs and upper respiratory symptoms, including nasal congestion, associated with allergy or the common cold.

ADVERSE REACTIONS
The most frequent adverse reactions to Dextromethorphan HBr and Phenylpropanolamine HCl Liquid include sedation, dryness of the mouth, nose and throat, thickening of bronchial secretions, and dizziness.
DOSAGE AND ADMINISTRATION
Children:

• 6 to 12 years, 1 teaspoonful every 4 hours
• 2 to 6 years 1/2 teaspoonful every 4 hours
• Do not exceed six doses in a 24 hour period
• Children under 2 years consult a physician

AVECOLD TABLETS
Adults and children (12 years and above):
One tablet twice daily. The recommended dosage should not be exceeded.

Class: Antibiotic Cephalosporin

Action: Inhibits mucopeptide synthesis in bacterial cell wall.

Absorption:
IV IV - C max is 45 to 90 mcg/mL (500 mg and 1 ? g doses).
IM IM - C max is 17 to 39 mcg/mL (500 mg and 1 ? g doses). T max is about 1 h.
Distribution:
Ceftazidime is less than 10% protein bound. It is excreted in human milk in low concentrations.
Excretion:
The t ½ is about 1.9 to 2 h. About 80% to 90% is excreted unchanged by the kidneys. Renal Cl is about 100 ? mL/min. Plasma Cl is about 115 ? mL/min.

Special Populations:
Renal Function Impairment - The t ½ is significantly prolonged. Dosage adjustments are recommended.

Indications: Treatment of infections of lower respiratory tract, skin and skin structures, urinary tract, bone and joint; treatment of gynecological infections; treatment of intra-abdominal infections; treatment of septicemia and CNS infections including meningitis caused by susceptible strains of specific microorganisms; concomitant antibiotic therapy.

Precautions: Monitoring: Response to therapy Monitor patient's response to therapy. Notify health care provider if infection does not appear to improve or worsens.
Adverse reactions Monitor patient for GI, DERM, and general body adverse reactions, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.

Pregnancy: Category B .

Lactation: Excreted in breast milk.

Hypersensitivity:Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.

Renal function impairment: Use drug with caution in patients with renal function impairment. Dosage adjustment based on renal function may be required.

Superinfection: May result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Pseudomembranous colitis Consider in patients in whom diarrhea develops.

Overdosage: Signs & symptomsNeuromuscular excitability, asterixis, seizures, encephalopathy.

Class: Antacid and ntiflatulent
Action: Neutralizes gastric acid, thereby increasing pH of stomach and duodenal bulb. Increases lower esophageal sphincter tone and inhibits smooth muscle contraction and gastric emptying.
Relieves flatulence by dispersing and preventing formation of mucus-surrounded gas pockets in GI tract.
magaldrate provide cytoprotective action on gastric mucosal cells
addition to its neutralizing capacity as an antacid, magaldrate contributes to the cytoprotective activity of the mucosa by stimulating endogenous PGE2 synthesis.
Simethicone is an oral anti-foaming agent reduces bloating, discomfort and pain caused by excess gas in the stomach or intestinal tract

Indications: Symptomatic relief of upset stomach associated with hyperacidity, including heartburn, gastroesophageal reflux, acid indigestion and sour stomach; relief of hyperacidity associated with peptic ulcer, gastritis, peptic esophagitis, gastric hyperacidity and hiatal hernia.
For symptomatic relief of hyperacidity associated with

peptic ulcer
gastritis
peptic esophagitis
gastric hyperacidity
hiatal hernia
postoperative gas pain

COMPOSOTION : (Omeprazole & Domperidone Capsules)
Omeprazole is a substituted benzimidazole that suppresses gastric acid secretion by specific inhibition of the H + /K + -ATPase enzyme system (proton pump) at the secretory surface of the gastric parietal cell thus blocking the final step of acid production.

Indications
Domicap is indicated for short-term treatment of active duodenal ulcer, short-term treatment (4-8 weeks) of active benign gastric ulcer, treatment of heartburn and other symptoms associated with GERD, short-term treatment (4-8 weeks) of erosive esophagitis, Maintenance of Healing of Erosive Esophagitis and for the long-term treatment of pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome).
Domperidone is a derivative of benzimidazole that possesses both prokinetic and antiemetic properties due to its inhibitory action at dompamine D 2 receptors.
Omeperazole : Suppresses gastric acid secretion by blocking acid (proton) pump within gastric parietal cell.
Domperidone
Domperidone is a dopamine antagonist with anti-emetic properties, Domperidone does not readily cross the blood-brain barrier. In domperidone users, especially in adults, extrapyramidal side effects are very rare, but domperidone promotes the release of prolactin from the pituitary. Its anti-emetic effect may be due to a combination of peripheral (gastrokinetic) effects and antagonism of dopamine receptors in the chemoreceptor trigger zone, which lies outside the blood-brain barrier in the area postrema. Animal studies, together with the low concentrations found in the brain, indicate a predominantly peripheral effect of domperidone on dopamine receptors. Studies in man have shown oral domperidone to increase lower oesophaegeal pressure, improve antroduodenal motility and accelerate gastric emptying. There is no effect on gastric secretion.

Dosage and Administration
Domicap capsules should not be opened, chewed or crushed and should be swallowed whole. The capsule should be taken before meals.
Duodenal ulcers
20 mg once daily for four weeks.
Gastric ulcers
20 mg once daily for eight weeks. In severe cases it can be increased to 40 mg once daily.
Gastroesophageal reflux disease
20 mg-40 mg daily for 4-8 weeks.
GERD, long-term management
10 mg once daily,dose maybe increased to 20 mg once daily if symptoms return.

COMPOSOTION :Nimesulide 100 mg + Paracetamol 500 mg Tablets
Nimesulide is a sulfonanilide non-steroidal anti-inflammatory drug whose anti-inflammatory analgesic and antipyretic activities have been demonstrated in several widely used animal experimental models2. At the recommended dose of 100 mg b.i.d., it is as effective an analgesic and anti-inflammatory agent as classical NSAIDs, and a well-tolerated drug with fewer side effects as evidenced by a number of controlled and non-controlled comparative trials3. Nimesulide is a unique NSAID, not only due to its chemical structure but also because of its specific affinity to inhibit Cyclooxygenase-2 thus exerting milder effects on the gastrointestinal mucosa.
Nimesulide appears to exert its therapeutics effects through a variety of mechanisms viz4:

• Selective Cyclooxygenase-2 inhibitor
• Reduced generation of superoxide anions by stimulated polymorphonuclear leucocytes
• Inhibition of platelet aggregation factor synthesis by activated cells
• Scavenger of inactivation of alpha1-protease inhibitor
• Inhibition of histamine release
• Inhibition of protein kinase C through inhibition of phosphodiesterase type IV
• Reduced degradation of cartilage matrix through inhibition of metalloprotease synthesis
• Potent inhibition of induced platelet aggregation
• Prevention of bradykinin/cytokine induced hyperalgesia of nerves (inhibiting release of TNF- alpha)

Paracetamol is a peripherally acting analgesic and is well absorbed orally. Paracetamol produces analgesia by elevation of he pain threshold and antipyresis through action on the hypothalamic heat regulating center. Paracetamol is equal to aspirin in analgesic and antipyretic effectiveness.

Indications:
Pain, Fever and Inflammatory symptoms of:
Soft tissues and oral cavity inflammation
Dysmenorrhoea
Urogenital disease
Chronic arthritis (Osteoarthritis)
Respiratory tract infections
ENT diseases
Postoperative pain states
Sports injuries.

Composition: (Domperidone B.P. 1 mg)
Domperidone
Domperidone is a dopamine antagonist with anti-emetic properties, Domperidone does not readily cross the blood-brain barrier. In domperidone users, especially in adults, extrapyramidal side effects are very rare, but domperidone promotes the release of prolactin from the pituitary. Its anti-emetic effect may be due to a combination of peripheral (gastrokinetic) effects and antagonism of dopamine receptors in the chemoreceptor trigger zone, which lies outside the blood-brain barrier in the area postrema. Animal studies, together with the low concentrations found in the brain, indicate a predominantly peripheral effect of domperidone on dopamine receptors. Studies in man have shown oral domperidone to increase lower oesophaegeal pressure, improve antroduodenal motility and accelerate gastric emptying. There is no effect on gastric secretion.

Indications
Jasdom is indicated for

• Symptomatic treatment of migraine.
• Any medical condition with concomitant nausea/vomiting and fever/pain.

Dosage And Administration
Jasdom drops should be given as soon as a migraine attack has started or is imminent.

• Children (under 12 years)
• Jasdom Drops : As recommended by the physician.

Contraindications

• Hypersensitivity to paracetamol, domperidone or any of the other constituents of the drugs.

Absorption:
Rapidly absorbed following oral administration. T max is 1.3 h for loratadine and 2.5 h for its metabolite. Food increases bioavailability (AUC) about 40%; however, T max is delayed 1 h. Steady state is reached by about the fifth dosing day.

Distribution:
97% protein bound.

Metabolism:
Metabolite is descarboethoxyloratadine. Metabolized by CYP-450 3A4 and P450 2D6. Undergoes extensive first-pass metabolism.
Excretion:
About 80% equally distributed between urine and feces in the form of metabolic products within 10 days. The t ½ for loratadine is 8.4 h (3 to 20 h). The t ½ for descarboethoxyloratadine is 28 h (8.8 to 92 ? h).
Onset:
Rapid.

Special Populations:
Renal Function Impairment - With CrCl less than 30 mL/min, AUC and C max are increased approximately 73% for loratadine and 120% for its metabolite.
Hepatic Function Impairment - AUC and C max doubled for loratadine; t ½ is 24 h (loratadine) and 37 h (metabolite).
Elderly - AUC and C max are increased approximately 50%, and t ½ ranged from 6.7 to 37 h.

Indications: Temporarily relieves symptoms caused by hay fever or other upper respiratory allergies (runny nose, sneezing, itchy/watery eyes, itching of the nose or throat); treatment of chronic idiopathic urticaria.

Overdosage: Signs & symptoms Somnolence, tachycardia, headache, extrapyramidal signs, palpitations

JASBON TAB/SUSPENSION

COMPOSITION

• Calcium carbonate -500 MG
• Alfacalcidol 0.25 mcg

DESCRIPTION
Calcium Carbonate is the most widely used salt in the category for the following reasons:

Higher proportion of elemental calcium (40% of elemental Calcium)

Better tolerability profile, fewer incidences of gastrointestinal side effects (Bloating & Flatulence) Improved patient compliance, less dose & more tolerable.

Alfacalcidol is a form of vitamin D3. It is converted rapidly in the liver to the active metabolite, 1,25-dihydroxycholecalciferol (calcitriol).
In the normal situation it controls the intestinal absorption of calcium and phosphate and plays an important part in the regulation of bone mineralisation. In chronic renal failure, the kidneys produce insufficient calcitriol and this leads to abnormalities of calcium and phosphate metabolism.

CLINICAL PHARMACOLOGY
CALCIUM Calcium is the major constituent found in various parts of human body, e.g. bones, teeth etc. The normal human man & woman possess about 1300 & 1000 gm of Calcium respectively, of which £ 90% is in bones. Calcium is essential for many important physiological processes such as bone growth & development, development of skeletal structure, cell division, neuronal excitability, neurotransmitter realease, muscle contraction, membrane integrity, blood coagulation etc.
The body's requirement for Calcium increases with increasing age.

ALFACALCIDOL
Oral administration of alfacalcidol to patients with chronic renal failure compensates for the reduced production of calcitriol. Consequently, intestinal malabsorption of calcium and phosphate and the resulting hypocalcaemia (low blood calcium levels) are improved, thereby reversing the signs and symptoms of bone disease.
Alfacalcidol is also given to provide a more rapid increase in active vitamin D and hence calcium, in people with various bones diseases. As this form of vitamin D only requires one conversion to become calcitriol, it provides a quicker response than giving normal dietary vitamin D. supplements.
INDICATIONS AND USAGE
As a vital Calcium supplement in :

• Osteoporosis. ???Pregnancy & Lactation. ???Adolescents.
• Hypocalcaemia (low blood calcium level) in the neonate.
• Low parathyroid function (hypoparathyroidism).
• Over activity of the parathyroid glands (hyperparathyroidism).

.
DOSAGE AND ADMINISTRATION
1 tablet twice daily till pregnancy, or as directed by the physician.

Memory Disorders:
Complaints of declining memory are common with advancing age. Memory disorders are associated with difficulty in learning and retaining new information. Dementia is defined as an insidious decline in a number of mental functions resulting in the loss of personal and social independence in a previously competent individual. Even though the most common component of dementia is memory loss, isolated defects in memory or in language do not qualify as dementia, which is usually associated with defective reasoning, decision making and judgment.
Dementia occurs when several of the cerebral systems that support learning, memory, language, emotion and reason are dysfunctional. Dementia can be self-limited (e.g., damage from head trauma or cardiac arrest) or progressive (e.g., dementia associated with Alzheimer's Disease).

Epidemiological studies indicate that approximately 15% of patients greater than 65 years old suffer from some form of dementia, while the incidence increases to 23% in patients 75 to 84 years old and 48% in patients greater than 85 years old. Objective assessment of memory loss and cognitive impairment is done by using neuropsychological testing

Ginkgo Biloba

Background: Ginkgo biloba is obtained from the Ginkgo biloba Linne tree. Threatened with extinction during the ice age, the ginkgo tree survived in China, and it is believed to be the oldest living tree species. The ginkgo tree has been introduced in Europe and North America as an ornamental tree, and it can be found along city streets and in parks. Ginkgo biloba is one of the most widely used and studied herbal products, and in Germany and China, it is the most commonly prescribed herbal medication. Because of the Dietary Supplement Health and Education Act of 1994, the United States Food and Drug Administration (FDA) does not regulate dietary supplements, including herbs, for safety or efficacy. Therefore, unlike prescription and non-prescription drugs approved by the FDA, there is no guarantee of strength, purity or safety of dietary supplements that contain Ginkgo biloba.

Chemical Composition: Ginkgo biloba leaf extract contains flavonol and flavone glycosides, lactone derivatives (ginkgolides), bilobalide, ascorbic acid, catechin, iron-based superoxide, 6-hydroxykinuretic acid, protocatechuic acid, shikimic acid, sterols and vanilic acid. The major classes of active ingredients are the ginkgolides and bilobalides (also known as terpenes) and the flavonoids. The ginkgo seeds contain a potentially toxic substance, ginkgotoxin (4-O-methoxypyridoxine), which has anti-vitamin B6 activity and inhibits GABA formation, which can potentially lead to convulsions and loss of consciousness. The ginkgo tree roots have a greater concentration of the active ingredients. Commercial manufacturers use the Ginkgo biloba leaves to extract the active ingredients. The standardization of Ginkgo biloba leaf extract products is done by the active ingredients: flavones, ginkgolides and bilobalides.

Pharmacology: Even though the chemical components of the ginkgo leaf have distinctive intrinsic pharmacological properties, they work synergistically to produce more potent pharmacological effects For example,. the ginkgo leaf extract protects the neurons from oxidative damage potentially preventing the progression of tissue degeneration in patients with dementia. Additionally, Ginkgo biloba leaf extract improves blood flow throughout the body, and it restores the balance between prostacyclin and thromboxane A2 resulting in improved vasoregulation. Vascular contraction and improvement in the venous tone are thought to be the result of phosphodiesterase inhibition and release of catecholamines. The beneficial effects of Ginkgo biloba leaf extract in Alzheimer's Disease might also be due to the inhibition of toxicity and cell death induced by beta-amyloid peptides. It has been proposed that Ginkgo biloba leaf extract 1) inhibits monoamine oxidase A and B, 2) inhibits catechol-O-methyl transferase (an enzyme that breaks down adrenergic transmitters), and 3) increases the number of alpha-adrenoreceptors in the brain as there is a decline in alpha-adrenoreceptors with age.

Other proposed mechanisms of action for the Ginkgo biloba leaf extract include possible effects on the benzodiazepine receptors, a possible decrease in glucocorticoid biosynthesis, and a possible increase in pancreatic beta-cell function in response to glucose loading. The pharmacological properties of the Ginkgo biloba seeds are the result of cyanogenic glycosides and ginkgotoxins. The cyanogenic glycosides have antibacterial and antifungal effects, while the ginkgotoxins can cause seizures, loss of consciousness and even death.

Reported Uses: Since ancient times, Ginkgo biloba has been used for medicinal purposes. In the oldest Chinese Materia Medica (2800 B.C.), Ginkgo biloba was recommended for asthma, swelling of the hands and feet, coughs, vascular disorders, aging and for the brain. Since 1965, Gingko biloba has been used in Europe for the treatment of cerebral insufficiency and peripheral vascular disease.

Clinical Efficacy: Ginkgo biloba has been clinically studied for the following conditions: peripheral vascular disease, claudication, dementia, cerebral insufficiency, ischemic stroke, tinnitus, memory impairment, asthma, and vertigo.

Ginkgo biloba leaf extract is possibly effective when used for Alzheimer's vascular or mixed dementia. Studies report that Ginkgo biloba leaf extract can stabilize or improve several measures of cognitive function and social functioning. Outcome studies have not yet verified Ginkgo's effect on disease progression, and it has not been directly compared to conventional dementia treatment. Clinical improvements in patients treated with Ginkgo biloba leaf extract appear to be similar to clinical improvement in patients treated with donepezil and tacrine. German practitioners consider Ginkgo biloba leaf extract to be the treatment of choice for dementia and for age-related memory dysfunction.

Description:
Role of vitamins and minerals, it helps to understand a little bit about the chemistry of your body. Living organisms rely on highly complex processes to perform and regulate those internal functions that are necessary to maintain life. Processes are in place to -

• Build the cells that make up your body's structures
• Meet the separate needs of different types of cells
• Permit each of these different cell types to carry out its own specific functions
• Help maintain cellular structure and performance
• Alter the type and degree of cellular activity in the face of changing circumstances
• Communicate and coordinate each cell's activity with the activity of other cells and organs in the body
• Adjust cellular behavior, as needed, in ways that will permit a coordinated response of the whole organism to its environment
• Dispose of waste products
• Govern the disposal of cells when their job is done

Dosage: As per the physician's advice.

COMPOSITION : (Mecobalamin -1000 mcg + Vitamins)

Mecobalamin (or methylcobalamin)
Methylcobalamin is a type of Vitamin B12. Vitamin B12 comes in several kinds including hydroxy-, cyano-, and adenosyl-, but only the methyl form is used in the central nervous system. Deficiency states are fairly common and vitamin B12 deficiency mimics many other disease states of a neurological or psychological kind, and it causes anemia. Cyanocobalamin (the kind in vitamin supplements) is converted by the liver into methylcobalamin but not in therapeutically significant amounts. Vitamin B12 deficiency is caused by a wide range of factors including low gastric acidity (common in older people,) use of acid blockers such as Prilosec™ or excessive laxative use, lack of intrinsic factor, poor aborption from the intestines, lack of Calcium, heavy metal toxicity, or excessive Vitamin B12 degradation.

• Vitamin B-12 is involved in numerous important body functions, including red blood cell formation and control of pernicious anemia; synthesis and function of nerve tissue, such as myelin; metabolism of carbohydrates, fats, and proteins (for example, Vitamin B-12 is necessary for the conversion of methylmalonate to succinic acid, an important Krebs cycle intermediate in energy production).
• Vitamin B-12 also is involved in the synthesis or transfer of single carbon units (e.g., allowing the interconversion of serine and glycine and the conversion of homocysteine to methionine); and serves as a coenzyme in the biosynthesis of methyl groups.
• Methylcobalamin is one of two coenzyme forms of B-12 (along with adenosylcobalamin) and can be used directly by the body without metabolic conversion.
• Applications of methylcobalamin include eliminating pernicious anemia; treatment of sprue; reduction of homocysteine (used in conjunction with folate and Vitamin B-6); improvement of mental dysfunction in the elderly; treatment of asthma and sulfite sensitivity; treatment of depression (i.e., supporting the production of serotonin and melatonin).
• Other applications of methylcobalamin include prevention and reversal of peripheral nerve damage in conditions including diabetes, multiple sclerosis, and those caused by chemotherapy (daily dosages up to 60 mg may be needed); detoxification, especially of brain tissue; treatment of tinnitis; supportive treatment in AIDS; and treatment of low sperm

Methylcobalamin is a kind of endogenous coenzyme vitamin B 12 . It is well transported to nerve cell organelles and promotes nucleic acid and protein synthesis. Mecobalamin is the only neuro active form of Vit B12 which is 130-150 times more potent than B12 and help in the formation of myelin sheath, promotes growth and regeneration of nerve cells. Mecobalamin helps in the formation of myelin sheath, promotes growth and regeneration of nerve cells. Improves microcirculation. Also mecobalamin is a cofactor in the enzyme methionine synthetase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine.

Description:
Role of vitamins and minerals, it helps to understand a little bit about the chemistry of your body. Living organisms rely on highly complex processes to perform and regulate those internal functions that are necessary to maintain life. Processes are in place to -

• Build the cells that make up your body's structures
• Meet the separate needs of different types of cells
• Permit each of these different cell types to carry out its own specific functions
• Help maintain cellular structure and performance
• Alter the type and degree of cellular activity in the face of changing circumstances
• Communicate and coordinate each cell's activity with the activity of other cells and organs in the body
• Adjust cellular behavior, as needed, in ways that will permit a coordinated response of the whole organism to its environment
• Dispose of waste products
• Govern the disposal of cells when their job is done

Dosage: As per the physician's advice.

Description
Jascobal is a dietary supplement containing a combination of Alpha Lipoic acid, Methylcobalamin, Folic Acid, Pyridoxine Hydrochloric (B6) , Mecobalamin (or methylcobalamin)

Alpha Lipoic Acid
Alpha lipoic acid is a fat and water soluble antioxidant that traps free radicals in the body and thus prevents cell damage. Alpha Lipoic Acid supplementation results in increased levels of glutathione that protects the brain from damage caused by free radicals. Widely used in the treatment of various diseases caused by free radicals such as Dementia, Stroke, Parkinsons and Alzheimer's.

Mecobalamin helps in the formation of myelin sheath, promotes growth and regeneration of nerve cells. Improves microcirculation. Also mecobalamin is a cofactor in the enzyme methionine synthetase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine.

Folic acid and cobalamin Reduces homocysteine by metabolizing it to methionine.
Pyridoxine Facilitates breakdown of homocysteine to cysteine and other byproducts.

Dosage And Administration
One soft gel capsule once daily with water and food.

JASOCALM

COMPOSITION : (Clonazepam U.S.P. 0.5 mg)

Class: Benzodiazepine

Action: Potentiates action of GABA, inhibitory neurotransmitter, resulting in increased neuronal inhibition and CNS depression, especially in limbic system and reticular formation.

Absorption:
Rapidly absorbed. About 90% bioavailable. T max is 1 to 4 h.
Distribution:
About 85% protein bound.
Metabolism:
Highly metabolized in the liver; CYP-450, including CYP3A4, may play a major role in oxidation and reduction of clonazepam.
Excretion:
The t ½ is 30 to 40 h. Less than 2% is excreted in urine as unchanged drug.

Indications: Treatment of Lennox-Gastaut syndrome; management of akinetic and myoclonic seizures and absence seizures unresponsive to succinimides; panic disorders.

Indications: Unlabeled use(s):
Treatment of restless legs syndrome, parkinsonian dysarthria, acute manic episodes of bipolar affective disorder, multifocal tic disorders and neuralgias; adjunctive therapy for schizophrenia.

Precautions: Monitoring: CBC Ensure that CBC with differential and liver enzymes are evaluated periodically in patient on prolonged therapy.
Response to treatment Frequently assess patient for response to treatment. Notify health care provider if condition does not appear to improve or worsens.
Review therapyEnsure that therapy is periodically reviewed to determine if it needs to be continued without change or if a dose change (eg, increase, decrease, discontinuation) is indicated.

Pregnancy: Category D .

Lactation: Excreted in breast milk.

Children: Panic disorder Safety and efficacy not established.
Seizure disordersInitial dose should be small and gradually increased. Long-term use may cause adverse effects such as possibly delayed mental or physical development.
Renal function impairment: Use drug with caution to avoid accumulation.
Hepatic function impairment: Use drug with caution to avoid accumulation.

Overdosage: Signs & symptomsSomnolence, confusion, diminished reflexes, coma.

Serratiopeptidase exerts anti-inflammatory action and promotes healing of injured tissues by the following mechanisms:
1.Antiinflammatory:

• Inhibition of vascular permeability is due to scald or injury.
• Inhibition of inflammatory edema.
• Excellent neutralization of bradykinin.
• Strong dissolution of fibrin of clots to enhance blood flow.

2.Action to promote the lysis and discharge of debris, sputum and pus:

• Decreased pus and viscosity of secretions
• Helps dissolution of dead tissues.

3.Action to promote transfer of antibiotics and other drugs to the focal site.

Absorption:
Bioavailability is approximately 50% because of first-pass metabolism (oral doseforms). Food decreases T max and C max .

Distribution:
More than 99% protein bound (albumin). Vd is approximately 1.4 L/kg.
Metabolism:
Undergoes first-pass metabolism; metabolized to inactive metabolites.
Excretion:
Approximately 65% is excreted in urine and 35% in the bile. The t ½ is 1 to 2 h. Plasma elimination t ½ after application of topical patch is approximately 12 h.

DOSAGE AND ADMINISTRATION
The maximum recommended dose one tablet b.i.d. for minimum 7-10 days.

JASOMYCIN

COMPOSITION

Cefoperazone - 0.5 MG

Sulbactam - O.5 MG
DESCRIPTION
Cefoperazone, introduced some years back, had truly extensive spectrum including high activity against pseudomonas, anaerobes apart from other gram-negative and gram-positive bacteria. The only limitation was its susceptibility to beta-lactamase produced by some gram-negative bacteria and pseudomonas. Addition of Sulbactam, an antibiotic with property of protecting co-administered antibiotic from beta-lactamase produced by bacteria, helps further extend the spectrum of Cefoperazone to beta-lactamase producing bacteria including pseudomonas, extended-spectrum beta-lactamase producing klebsiella and MRSA. Sulbactam by itself also has action against Acinetobacter and some anaerobic bacteria.

• Sulbactam reduces the MICs of Cefoperazone by 4 fold
• High sensitivity against tough pathogens
• Lower resistance levels against pseudomonas
• Excellent even as monotherapy in anaerobes

CLINICAL PHARMACOLOGY
Jasomycin is a combination of cefoperazone, a third generation cephalosporin and sulbactam, a ?-lactamase inhibitor.
Cefoperazone is a bactericidal agent, with broad spectrum of activity against most of the gram positive & gram-negative pathogens. It also shows a good activity against the difficult to treat pathogens such as B. fragilis, C. difficile and pseudomonas.
Sulbactam is a ?-lactamase inhibitor, which confers the following advantages:

1. It inhibits ?-lactamases produced by bacteria & protects Cefoperazone
2. Enhances the bactericidal activity, by a synergistic action with Cefoperazone
3. Decreases the MIC values of organisms susceptible to Cefoperazone, due to increased affinity to PBPs.
4. Cefoperazone resistant bacteria becomes susceptible, by addition of Sulbactam Thus,
Jasomycin is a unique combination with extensive spectrum of activity.

INDICATIONS AND USAGE
For the treatment and management of:

• Respiratory tract infections (Upper & Lower)
• Urinary tract infections (Upper & Lower)
• Intra - abdominal infections, Peritonitis, Cholecystitis etc
• Septicemia
• Infections in Burns & Wounds
• Skin & Soft tissue infections
• Bone & Joint Tissue Infections
• Pelvic Inflammatory Disease, Endometritis, Gonorrhoea & Other Infections of genital tract
• Infections in Immunocompromised patients
• Febrile neutropenic

For Prophylaxis:

• Laparoscopic surgery
• Cholecystectomy & other colorectal surgery
• Plastic surgery
• Multiple fractures & complicated orthopaedic surgery

DOSAGE AND ADMINISTRATION
In Adults
The usual adult dose of Jasomycin is 2-4 g per day (i.e., 1-2g of cefoperazone activity per day) given intravenously or intramuscularly in equally divided doses 12 hourly.
In severe or refractory infections, the daily dosage may be increased to 8 gm Jasomycin (4g of cefoperazone) given IV. Additional cefoperazone may be administered separately if required, as the recommended maximum daily dose of sulbactam is 4g (8g of Jasomycin )

Indications and Usage for Nandrolone
Nandrolone decanoate is indicated for the management of the anemia of renal insufficiency and has been shown to increase hemoglobin and red cell mass. Surgically induced anephric patients have been reported to be less responsive.
Contraindications
1. Male patients with carcinoma of the breast or with known or suspected carcinoma of the prostate.
2. Carcinoma of the breast in females with hypercalcemia: androgenic anabolic steroids may stimulate osteolytic resorption of bones.
3. Pregnancy, because of masculinization of the fetus.
4. Nephrosis or the nephrotic phase of nephritis.

Drug interactions
Anticoagulants. Anabolic steroids may increase sensitivity to oral anticoagulants. Dosage of the anticoagulant may have to be decreased in order to maintain the prothrombin time at the desired therapeutic level. Patients receiving oral anticoagulant therapy require close monitoring, especially when anabolic steroids are started or stopped.

Nandrolone Dosage and Administration
Nandrolone decanoate injection is intended for deep intramuscular injection only, into the gluteal muscle preferably.
Dosage should be based on therapeutic response and consideration of the benefit to risk ratio. Duration of therapy will depend on the response of the condition and the appearance of adverse reactions. If possible, therapy should be intermittent.
Nandrolone decanoate should be regarded as adjunctive therapy and adequate quantities of nutrients should be consumed in order to obtain maximal therapeutic effects. For example, when it is used in the treatment of refractory anemia, adequate iron intake is required for a maximal response.

Anemia of Renal Disease
A dose of 50 to 100 mg per week is recommended for women and 100 to 200 mg per week for men. Drug therapy should be discontinued if no hematologic improvement is seen within the first six months. For children from 2 to 13 years of age, the average dose is 25 to 50 mg every 3 to 4 weeks.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever the solution and container permit.

JASLOC-P

COMPOSITION
Each film-coated tablet contains:

• Aceclofenac BP - 100mg
• Paracetamol IP - 500mg
  

Paracetamol compliment the action of Aceclofenac in controlling pain & fever. The powerful combination aceclofenac and paracetamol provides superior analgesic and antipyretic action in moderate to severe painful and inflammatory conditions associated with fever. The combination controls pain faster, longer & stronger.

CLINICAL PHARMACOLOGY
Conditions of moderate to severe pain and conditions of chronic pain of osteoarthritis, rheumatoid arthritis and spondyloarthritis which have pain as the foremost symptom need better analgesic effect which is stronger and for longer duration.
We know that pain as a symptom has peripheral as well as central components. Aceclofenac heading the list of peripherally acting NSAIDs

Jasloc-P provides superior anti-inflammatory action and analgesia by following mechanisms:

• Inhibition of production of inflammatory mediators IL-1? and tumor necrosis factor (TNF).
• Inhibition of basal and stimulated prostaglandin E2 production by tissue and blood cells.
• Reduction of stimulated generation of reactive oxygen species after 15 days of treatment.
• Dramatic decrease of L selectin expression and decrease in adhesion molecules expression.
• It blocks PGE2 production via cyclooxygenase, COX-2 inhibition in human rheumatoid synovial and other inflammatory cells.
• It inhibits neutrophil adhesion & accumulation at the inflammatory site thus blocking the pro-inflammatory actions of neutrophils.

Addition of paracetamol provides additional central mechanism of action by inhibiting brain cyclo-oxygenase and controlling pain as well as fever at the central level.

INDICATIONS AND USAGE
Conditions of moderate to severe pain and inflammatory conditions associated with pain and fever or as co-prescription to antibiotics and other groups of drugs.

CONTRAINDICATIONS

• Active Peptic Ulcer.
• Bleeding from the stomach or intestines.
• Moderate to severely decreased kidney function.
• People in whom aspirin or other medicines in this class (NSAIDs) cause attack of asthma, itchy rash (urticaria) or nasal inflammation (rhinitis).
• Suspected peptic ulcer.

PRECAUTIONS
Aceclofenac should be used with caution in the following: elderly people, history of peptic ulcer, Crohn's disease, blood disorders, people at increased risk of bleeding, decreased heart function, people who have recently had major surgery, type of life long inherited blood disease caused by a defect in the liver (hepatic porphyria).

No laboratory test is required if used for short term but in case of long-term use liver function and kidney function test is recommended.
There is no evidence that the dose of Aceclofenac needs to be modified in patients with mild renal impairment.
Drugs Like Methotrexate,Diuretics,Anticoagulant, Aspirin, Quinolone may potentiate the action of Aceclofenac and hence dose adjustment is required.

PREGNANCY
The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by the physician.

LACTATING MOTHERS
It is not known if this medicine passes into breast milk. It is not recommended for use during breastfeeding unless considered essential by the physician.

PEDIATRICS
The safety and efficacy in children and adolescents has not been established.

GERIATRICS
Aceclofenac pharmacokinetics are not altered in elderly patient hence no dose adjustment is required.

DOSAGE AND ADMINISTRATION
The maximum recommended dose one tablet OF ACECLOFENAC b.i.d. for 3-5 days or as directed by the physicians.

JASLOC-PS

COMPOSITION
Each film-coated tablet contains

• Aceclofenac 100mg
• Paracetamol 500mg
• Serratiopeptidase 15mg

CLINICAL PHARMACOLOGY
Aceclofenac is a peripherally acting NSAIDs which provides superior anti-inflammatory action and analgesia by following mechanisms:

• Inhibition of production of inflammatory mediators IL-1? and tumor necrosis factor (TNF).
• Inhibition of basal and stimulated prostaglandin E2 production by tissue and blood cells.
• Reduction of stimulated generation of reactive oxygen species after 15 days of treatment.
• Dramatic decrease of L selectin expression and decrease in adhesion molecules expression.
• It blocks PGE2 production via cyclooxygenase, COX-2 inhibition in human rheumatoid synovial and other inflammatory cells.
• It inhibits neutrophil adhesion & accumulation at the inflammatory site thus blocking the pro-inflammatory actions of neutrophils,

Serratiopeptidase exerts anti-inflammatory action and promotes healing of injured tissues by the following mechanisms:
1.Antiinflammatory:
a) Inhibition of vascular permeability is due to scald or injury.
b) Inhibition of inflammatory edema.
c) Excellent neutralization of bradykinin.
d) Strong dissolution of fibrin of clots to enhance blood flow.

2.Action to promote the lysis and discharge of debris, sputum and pus:
a) Decreased pus and viscosity of secretions
b) Helps dissolution of dead tissues.

3.Action to promote transfer of antibiotics and other drugs to the focal site.

CONTRAINDICATIONS

• Active Peptic Ulcer.
• Bleeding from the stomach or intestines.
• Moderate to severely decreased kidney function.
• People in whom aspirin or other medicines in this class (NSAIDs), asthma, itchy rash (urticaria) or nasal inflammation (rhinitis).
• Suspected peptic ulcer.
  PRECAUTIONS
• Aceclofenac should be used with caution in the following: elderly people, History of peptic ulcer, Crohn's disease, Blood disorders, people at increased risk of bleeding, decreased heart function, people who have recently had major surgery, a type of life long inherited blood disease caused by a defect in the liver (hepatic porphyria).

No laboratory test is required if used for short term but in case of long-term use liver function and kidney function test is recommended.
There is no evidence that the dose of Aceclofenac needs to be modified in patients with mild renal impairment.
Drugs Like Methotrexate,Diuretics,Anticoagulant , Aspirin, Quinolone may potentiate the action of Aceclofenac and hence dose adjustment is required.
The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by the physician.
The study in rats suggest no evidence of teratogenic effect.
It is not known if this medicine passes into breast milk. It is not recommended for use during breastfeeding unless considered essential by the physician.

The safety and efficacy in children and adolescents has not been established.
Aceclofenac pharmacokinetics are not altered in elderly patient hence no dose adjustment is required.
DOSAGE AND ADMINISTRATION
The maximum recommended dose one tablet b.i.d. for minimum 7-10 days.

JASLOC -MR

COMPOSITION
Each film-coated tablet contains

• Aceclofenac 100mg
• Paracetamol 500mg
• Chlorzoxazone Tabs

Paracetamol compliment the action of Aceclofenac in controlling pain & fever. The powerful combination aceclofenac and paracetamol provides superior analgesic and antipyretic action in moderate to severe painful and inflammatory conditions associated with fever. The combination controls pain faster, longer & stronger.
Chlorzoxazone Skeletal muscle relaxant, centrally acting.Its Action may be related to its sedative properties or to inhibition of reflex arcs at spinal cord and subcortical levels of brain.

CLINICAL PHARMACOLOGY
Conditions of moderate to severe pain and conditions of chronic pain of osteoarthritis, rheumatoid arthritis and spondyloarthritis which have pain as the foremost symptom need better analgesic effect which is stronger and for longer duration.
We know that pain as a symptom has peripheral as well as central components. Aceclofenac heading the list of peripherally acting NSAIDs

Jasloc-P provides superior anti-inflammatory action and analgesia by following mechanisms:

• Inhibition of production of inflammatory mediators IL-1? and tumor necrosis factor (TNF).
• Inhibition of basal and stimulated prostaglandin E2 production by tissue and blood cells.
• Reduction of stimulated generation of reactive oxygen species after 15 days of treatment.
• Dramatic decrease of L selectin expression and decrease in adhesion molecules expression.

Addition of paracetamol provides additional central mechanism of action by inhibiting brain cyclo-oxygenase and controlling pain as well as fever at the central level.

JASMOB

COMPOSITION (The Cartilage Vitalizer)

JASONEX

Composition (Protein Powder)- Chocolate Flavour

Absorption:
T max is 2.6 h; C max is 131 ng/mL (tablets). T max is 2 h; C max is 88 ng/mL (orally disintegrating tablet [ ODT ] ). T max is 1 h; C max is 118 ng/mL (suspension). Administration with a high-fat meal decreased AUC and C max by 21% and 20%, respectively (tablets), 40% and 60%, respectively (ODT), and 30% to 47%, respectively (suspension).
Distribution:
60% to 70% is bound to plasma proteins. The drug does not cross the blood-brain barrier.
Metabolism:
Approximately 5% is eliminated by hepatic metabolism.
Excretion:
Mean t ½ is 14.4 h. Approximately 80% is excreted in the feces and 11% in the urine.
Onset:
1 h.
Peak:
2 to 3 h.

Duration:
8 to 12 h.
Indications: Symptomatic relief of symptoms associated with seasonal allergic rhinitis; treatment of uncomplicated skin manifestations of chronic idiopathic urticaria.

Indications: Symptomatic relief of symptoms associated with seasonal allergic rhinitis; treatment of uncomplicated skin manifestations of chronic idiopathic urticaria. Overdosage: Signs & symptomsDizziness, drowsiness, dry mouth.

Indications:
Chronic heated phlegm [green, yellow, dark in color]
Clinical relief of cough
Temporarily relieves cough due to minor throat and bronchial irritation occurring with a cold, and nasal congestion due to the common cold, hay fever or other upper respiratory allergies Temporarily relieves these symptoms due to hay fever (allergic rhinitis):
runny nose sneezing itchy watery eyes
itching of the nose or throat

ORANT 200 ORANT -OD

Composition

orant -200Each film-coated tablet contains Ofloxacin USP 200 mg.
Orant -ODEach film-coated tablet contains Ofloxacin 400 mg
Oflaxacin Action: Interferes with microbial DNA synthesis.

Indications
Orant is indicated for the treatment of the following bacterial infections if these are due to Ofloxacin-sensitive pathogens. To treat diarrhea and dysentery of Protozoal, Bacterial & Mixed origin

• Acute, chronic or recurrent respiratory tract infections (bronchitis):
  Caused by Haemophilus influenzae or other Gram-negative or multi-drug resistant pathogens, as well as Staphylococcus aureus. Pneumonias, especially if caused by pathogens such as Escherichia coli, Enterobacter, Proteus, Pseudomonas, Legionella or Staphylococcus.
• Chronic and recurrent infections of ear, nose and throat:
  Especially if caused by Gram-negative pathogens including Pseudomonas or by Staphylococcus (not recommended for treatment of acute tonsillitis).
• Skin and skin structure infections:
  Infections of the abdominal cavity (e.g. bacterial infections of gastrointestinal tract, the biliary duct, peritonitis).
• Infections of the kidneys, urinary tract and genital organs, gonorrhoea.
• MDR-TB (Multi-drug resistant tuberculosis).

Dosage And Administration
The dose of orant is determined by the type and severity of the infection.

• Adults: 200 mg to 800 mg daily. Up to 400 mg as a single dose should be given in the morning. Larger doses should be given as two divided doses. The doses are 5-10 mg/kg body weight/day.
• In Renal Impairment:

Dosage And Administration
The dose of orant is determined by the type and severity of the infection.

ORANT-OZ

COMPOSOTION : (Ofloxacin & ornidazole tablets)

Combination of Antibiotic Fluoroquinolone and antimicrobial agent
Oflaxacin Action: Interferes with microbial DNA synthesis.

Ornidazole is a nitroimidazole which has antimicrobial action against microaerophilic Protozoa¸ Giardia lamblia, Entamoeba histolytica and Trichomonas vagin ali s and against obligate anaerobic bacteria.

The overall benefits of the combination of ofloxacin and ornidazole include:

1. Broad spectrum coverage of both bacteria and protozoa in a variety of infections.
2. Combination of one of the most potent fluoroquinolones against gram-negative enteric organisms and gram-positive aerobic organisms
3. Since the combination is in a fixed dose, it ensures that the patient gets both the drugs against bacteria and protozoa.
4. Significant improvement in compliance since the number of pills to be taken by the patient is reduced by half.
5. There are no interactions between the two drugs.
6. Both the drugs are well tolerated and have been used for several years.

INDICATIONS

ORANT OZ is indicated for the treatment of a wide variety of infections caused by susceptible gram-positive and gram-negative organisms
Respiratory Tract Infections like lung abscess, aspiration pneumonia, empyema and bronchiectasis

ENT Infections like chronic sinusitis, chronic suppurative otitis media, cholesteatoma and mastoiditis

Dermatological Infections like cellulitis, breast and other cutaneous abscesses, gangrene, diabetic and decubitus ulcers

Gynaecological Infections including PID
Orofacial and Dental Infections
Surgical Wound Infections

DOSAGE AND ADMINISTRATION
One tablet of ofloxacin and one tablet of Ornidazole taken once daily for 5 - 10 days.

Absorption:
Rapid. C max is 2.5 mcg/mL (oral) and 5.52 mcg/mL (IV); bioavailability is approximately 77% (oral). T max is 2.5 h. Oral administration with food may delay absorption up to 2 h or longer.

Distribution:
Pantoprazole distributes mainly in extracellular fluid. Vd is 11 to 23.6 L. Protein binding is approximately 98%, mainly albumin.

Metabolism:
Pantoprazole is extensively metabolized in the liver through CYP-450. The main metabolic pathway is demethylation by CYP2C19 and oxidation by CYP3A4. No evidence of metabolites with pharmacologic activity. CYP2C19 displays genetic polymorphism because of deficiency in some populations (3% of white and black patients, 17% to 23% of Asian patients); these patients are known to be slow metabolizers of pantoprazole.

Excretion:
Urine (71%), feces (18%); no renal excretion of unchanged drug. The t ½ is 1 h, and 3.5 to 10 h in slow metabolizers. Total Cl is 7.6 to 14 L/h.

Duration:
More than 24 h.

Indications: OralShort-term (no more than 8 wk) treatment in the healing and symptomatic relief of erosive esophagitis associated with gastroesophageal reflux disease (GERD); long-term treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome; maintenance of healing of erosive esophagitis.

IVShort-term (7- to 10-day) treatment of GERD, as an alternative to oral therapy in patients unable to continue oral pantoprazole; hypersecretory conditions associated with Zollinger-Ellison syndrome or other neoplastic conditions.

PEPNORM -D

COMPOSITION (Pantoprazole 40 mg + Domperidone 10 mg)

Combination of Proton Pump Inhibitor pantoprazole and Domperidone, the
only prokinetic with anti-emetic action.

Domperidone has the characteristic features of:

• Selective CTZ blocker.
• Anti-dopaminergic agent, competitively inhibits the D2 receptors.
• Acts in two ways:
  
  Prevents the messages from reaching the Emesis center in the brain.
  
  They increase the gastric emptying rate, by stimulating the rate & force of intestinal contractions and clearing the region of the residual food.
• Thus, it removes the cause of emesis.
• It is also termed as 'PROKINETIC.'
• It does not cross the blood brain barrier, hence shows lower incidences of extrapyramidal side effects.

INDICATIONS AND USAGE
- Nausea & vomiting of various etiologies, e.g. Drug-induced.

RADICLAV 625 RADICLAV DS
Composition
RADICLAV 625 Amoxycillin 500 mg+ Clavulanic Acid 125 mg)

Pharmacodynamics
RADICLAV is a formulation of amoxycillin and clavulanic acid. Amoxycillin has a broad spectrum of bactericidal activity against many gram-positive and gram-negative microorganisms. Amoxycillin is, however, susceptible to degradation by (beta)-lactamases, and therefore, the spectrum of activity does not include organisms which produce these enzymes. The formulation of amoxycillin and clavulanic acid in protects amoxycillin from degradation by (beta)-lactamase enzymes and effectively extends the antibiotic spectrum of amoxycillin to include many bacteria normally resistant to amoxycillin and other (beta)-lactam antibiotics.
Amoxycillin/clavulanic acid has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections.

Pharmacokinetics
Combining clavulanic acid with amoxycillin causes no appreciable alteration of the pharmacokinetics of either drug compared with their separate administration. After oral administration, both components achieve maximum plasma concentration in about an hour. Absorption is unaffected by food, milk, ranitidine or pirenzepine. The tissue and body fluid distribution of both components is generally adequate to achieve antibacterial levels, although the concentrations may be somewhat low in bronchial secretions and cerebrospinal fluid. The pharmacokinetic profile of amoxycillin and clavulanic acid in children parallels that in adults.

INDICATIONS
RADICLAV is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the conditions listed below:
Lower Respiratory Tract Infections - caused by (beta)-lactamase producing strains of H. influenzae and M. catarrhalis
.
Otitis Media - caused by (beta)-lactamase producing strains of H. influenzae and M. catarrhalis.
Sinusitis - caused by (beta)-lactamase producing strains of H. influenzae and M. catarrhalis .
Skin and Skin Structure Infections - caused by (beta)-lactamase producing strains of S. aureus, E. coli and Klebsiella spp.
Urinary Tract Infections - caused by (beta)-lactamase producing strains of E. coli, Klebsiella spp. and Enterobacter spp.
Bone and Joint Infections
Other infections e.g. intra-abdominal sepsis and dental infections

Oral Administration
Tablets should be swallowed whole without chewing. If required, tablets may be broken in half and swallowed without chewing. To minimize potential gastrointestinal intolerance, administer at the start of a meal. The absorption of RADICLAV is optimized when taken at the start of a meal. Treatment should not be extended beyond 14 days without review.

ADVENT Tablets
Adults and Children over 12 years

Usual dosages for the treatment of infection.

Mild to Moderate Infections One 625 mg tablet twice a day.
Severe Infections One 1 g tablet twice a day.

Dentoalveolar abscess one ADVENT 625 mg tablet twice a day for five days.

RADICLAV 625mg and 1g tablets are not recommended in children of 12 years and under.

RADICLAV Syrup
Usual dosages for the treatment of infection.
Patients aged 12 weeks (3 months) and older.
Mild to Moderate infections 25/3.6 mg/kg/day b.i.d
Severe Infections and Otitis media, sinusitis, lower respiratory infections 45/6.4 mg/kg/day b.i.d
For infants with immature renal function RADICLAV Syrup 228 mg/5 mL is not recommended.

Instructions for use/handling
At the time of dispending, the dry powder should be reconstituted to form an oral suspension. To make up to 30 mL first shake the bottle to loosen powder. Add water to 2/3 of fill-mark on bottle. Replace the cap, and shake the bottle until all of the powder is suspended. Add more water until the level of the fill line is attained, and shake again. When first reconstituted, allow to stand for 5 minutes to ensure full dispersion. After reconstitution, keep in a refrigerator when not in use. Use the reconstituted syrup within 7 days.

CONTRAINDICATIONS
ADVENT is contraindicated in patients with a history of allergic reactions to any penicillin. Attention should be paid to possible cross-sensitivity with other beta-lactam antibiotics , e.g. cephalosporins. It is also contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with amoxycillin- clavulanate.

UNDESIRABLE EFFECTS
Amoxycillin- clavulanate is generally well tolerated. The majority of side effects observed in clinical trials were of a mild and transient nature and less than 3% of patients discontinued therapy because of drug-related side effects. From the original premarketing studies, where both paediatric and adult patients were enrolled, the most frequently reported adverse effects were diarrhoea/loose stools (9%), nausea (3%), skin rashes and urticaria (3%), vomiting (1%) and vaginitis (1%). The overall incidence of side effects, and in particular diarrhoea, increased with the higher recommended dose. Other less frequently reported reactions include: Abdominal discomfort, flatulence, and headache.

OVERDOSAGE
Following overdosage, patients have experienced primarily gastrointestinal symptoms including stomach and abdominal pain, vomiting, and diarrhoea. Rash, hyperactivity, or drowsiness have also been observed in a small number of patients.

RABED

COMPOSITION
Each capsule Repral D contains:

• RABEPRAZOLE : 20 mg
• DOMPERIDONE : 10mg

DESCRIPTION
Rabeprazole is a proton pump inhibitor and belongs to the class of anti-secretory compounds (substituted benzimidazole), commonly known as 'PROTON PUMP' and Domperidone is a potent prokinetic with anti-emetic action.

• Novel combination of most potent PPI- Rabeprazole and Domperidone, the only prokinetic with anti-emetic action.
• Once daily dosage compliance.
• Unique 4 dimensional action that effectively controls symptoms such acid reflux, bloating, epigastric pain and also offers G.I protection.

CLINICAL PHARMACOLOGY
RABED - D is an unique combination of RABEPRAZOLE & Domperidone. Rabeprazole is an:

• Unique PPI
• Shows fastest anti-secretory action, better than other PPIs, shows almost 95% inhibition in 5 minutes

- Reaches these levels rapidly
- Only PPI to give improved GI protection, via increased mucin synthesis
- Sustains high level of antisecretory effect through day and night
- Sustains this level predictably
- Low potential for drug interactions and well tolerated
- Highly effective for GERD, maintenance and healing of duodenal ulcers and hypersecretory conditions

Whereas, Domperidone has the characteristic features of:

• Selective CTZ blocker.
• Anti-dopaminergic agent, competitively inhibits the D2 receptors.
• Acts in two ways:
  • Prevents the messages from reaching the Emesis center in the brain.
  • They increase the gastric emptying rate, by stimulating the rate & force of intestinal contractions and clearing the region of the residual food.
• Thus, it removes the cause of emesis.
• It is also termed as 'PROKINETIC.'
• It does not cross the blood brain barrier, hence shows lower incidences of extrapyramidal side effects.

INDICATIONS AND USAGE

- Nausea & vomiting of various etiologies, e.g. Drug-induced.
- Post surgical convalescence - Relief in conditions of Reflux esophagitis,
dyspepsia,etc.
- Relief in conditions of Reflux esophagitis, dyspepsia,etc.

CONTRAINDICATIONS
Contraindicated in individuals with known hypersensitivity to either of the active ingredients, and substituted benzimidazoles.

PRECAUTIONS
Not recommended for continuous use or routine prophylaxis
Should be used with caution in patients with risk of arrhythmias

ADVERSE REACTIONS
In general, Rabed- D is well tolerated. However, few transient effects such as skin rash, allergic reactions, galactorrhoea, conjunctivitis etc. may be observed.

DOSAGE AND ADMINISTRATION
One capsule per day OR as directed by the physician

RAPILAX

Sodium Picosulfate
This belongs to the group of medicines known as stimulant laxatives.
Sodium Picosulfate is used to treat constipation and is sometimes used to clear the bowel before medical examinations that require the bowel to be empty.

Constipation can be caused by a poor diet, not drinking enough water and not going to the toilet as soon as you feel you need to. Pregnancy, a lack of exercise or movement (such as being ill in bed) and some medicines, including some pain killers, can also cause constipation.

Sodium Picosulfate works by encouraging the bowel to contract and move the waste products along the bowel helping you to go to the toilet.

Sodium Picosulfate is available in oral liquid and capsule form.
Sodium Picosulfate is sometimes spelt Sodium Picosulphate.
It is also sometimes known as: Laxoberal; Dulco-lax. You may notice the use of any of these names on the packaging of your medicine.

• What is it used for?
• Emptying the bowel prior to surgery, childbirth or radiological investigation
• Short term management of constipation
• Warning!
• As with all laxatives, this medicine should not be taken on a continuous daily basis for long periods. If laxatives are needed on a daily basis you should consult your doctor.
• This medicine should not be given to children under 10 years of age, unless onmedical advice.
• Not to be used in
• Blockage of the gut (intestinal obstruction)
• Obstruction of the intestines due to loss of intestinal movement or physical blockage (ileus)
• Severe dehydration
• Sudden abdominal conditions requiring surgery, such as appendicitis
• Sudden attacks of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease
• This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than the possible risk to the foetus, particularly in the first trimester. Seek medical advice from your doctor.
• The use of this medicine during breastfeeding is not recommended. Seek medical advice from your doctor.

Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Diarrhoea
• Abdominal discomfort

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?

Broad spectrum antibiotics, such as amoxicillin, may reduce the laxative action of this medicine.

RADICLOX S

COMPOSITION : (Amoxycillin + Cloxacillin + Serratiopeptidase + LB Caps)

Indications
RADICLOX S is a combination of two beta-lactam antibiotics, amoxycillin and cloxacillin and Serratiopeptidase + LB Cap.They exert their bactericidal action by inhibition of cell wall synthesis.
Amoxycillin is active against a wide range of gram positive and gram negative pathogens, and cloxacillin acts against penicillinase producing gram positive pathogens.

Indications
RESPIRATORY TRACT INFECTIONS
Tonsillar abscess, otitis media, suppurative sinus infection, acute and chronic bronchitis, bronchi-ectasis, bronchopneumonia, pleurisy, empyema, lung abscess, emphysema, bronchiolitis.

GYNAECOLOGICAL INFECTIONS
Septic abortion, puerperal infections, caesarean sections and other gynaecological surgeries.

URINARY TRACT INFECTIONS
Acute and chronic pyelonephritis, cystitis, urethritis.

SKIN AND SOFT TISSUE INFECTIONS
Recurrent boils, carbuncles, impetigo, cellulitis and other infected dermatoses.

BONE INFECTIONS
Osteomyelitis and septic arthritis.

SERIOUS INFECTIONS
Septicaemia, bacterial endocarditis, brain abscess and bacterial meningitis.

IMPAIRED RENAL FUNCTION
If creatinine clearance is between 10 and 30 ml/minute the dose should be reduced to one tablet daily.

Dosage and Administration
RADICLOX S Capsules
The dosage differs depending on the type, site and severity of infections.
Adults
One capsule three to four times daily.

SINADAY Tablets

Composition
(Alprazolam 0.5 mg + Sertraline Hydrochloride. 50 mg)

Indications

• SINADAY is indicated for the treatment of moderate to severe depression associated with insomnia and anxiety disorders like Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder and Phobic Anxiety Disorders, where moderate to severe anxiety is part of the clinical picture.

Dosage And Administration

• For the treatment and prevention of recurrence of depression associated with anxiety and insomnia, an initial dosage of one tablet SINADAY once daily after lunch is recommended. Upward titration to SINADAY (at intervals of at least 1 week.) to a maximum 3-4 tablets/day of SINADAY may be advised in patients who do not respond.
• For treatment of patients with Obsessive-Compulsive Disorder or severe anxiety disorder, SINADAY can be added to sertraline 50 mg or 100 mg.

Special population
Elderly Patients
Although dosage adjustments are not required in elderly patients caution is advised.
Patients with renal or hepatic impairment
Restyl Forte should be administered with caution in patients with renal or hepatic impairment.

Contraindications

• SINADAY is contraindicated in patients hypersensitive to any of the constituents and in patients with acute narrow-angle glaucoma.
• SINADAY is indicated for the treatment of moderate to severe depression associated with insomnia and anxiety disorders like Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder and Phobic Anxiety Disorders, where moderate to severe anxiety is part of the clinical picture.

TRAMAPOR TRAMAPAR-D

Tramadol Injection

Tramadol (INN) (IPA: [?træm??d?l]) is an atypical opioid which is a centrally acting analgesic, used for treating moderate to severe pain. It is a synthetic agent, as a 4-phenyl-piperidine analogue of codeine,[1][2] and appears to have actions on the GABAergic, noradrenergic and serotonergic systems. Tramadol was developed by the German pharmaceutical company Grünenthal GmbH and marketed under the trade name Tramadol is usually marketed as the hydrochloride salt (tramadol hydrochloride) and is available in both injectable (intravenous and/or intramuscular) and oral preparations (e.g.

Dosages vary depending on the degree of pain experienced by the patient. Tramadol is approximately 10% as potent as morphine, when given by the IV/IM route. Oral doses range from 50-400 mg daily, with up to 600 mg daily when given IV/IM.

The 'combination' pills each contain 37.5 mg of tramadol and 325 mg of paracetamol, with the recommended dose being one or two pills every four to six hours.

Unlike most other opioids, Tramadol is not considered a controlled substance in many countries (U.S. and Canada, among others), and is available with a normal prescription. Tramadol is available over-the-counter without prescription in a few countries.[3]
Uses
Tramadol is often used to treat moderate and severe pain and most types of neuralgia, including trigeminal neuralgia.
It is suggested that tramadol could be effective for alleviating symptoms of depression and anxiety because of its action on GABAergic, noradrenergic and specifically serotonergic systems. However, health professionals have not yet endorsed its use on a large scale for disorders such as this.

[diabetic neuropathy[4][5]

• postherpetic neuralgia[6][7]
• fibromyalgia[8]
• estless legs syndrome[9]
• opiate withdrawal management[10][11]
• migraine headache[12]
• " obsessive-compulsive disorder[13]

ULBEN

Ulben Tablets
Each tablet contains Albendazole 400 mg.

Indications

• Hookworm ( Ancyclostoma, Necator ), Roundworm ( Ascaris ), Threadworm ( Strongyloides ), Whipworm ( Trichuris ), Tapeworm ( Taenia species), Opisthorchis , Hydatid disease ( Echinococcus ), Neurocysticercosis, Mixed helminthic infestations.
• It is also indicated in giardiasis in children over two years of age.

Dosage And Administration

• Adults and children over two years: 1 tablet or 10 ml suspension (400 mg) as a single dose. In strongyloides or H. nana infestations, 1 tablet or 10 ml suspension once daily for 3 days. If the patient is not cured after 3 weeks, second course of treatment is indicated.
• Children (1-2 years) : One half tablet or 5 ml suspension (200 mg) as a single dose. The tablet must be chewed, swallowed or crushed and mixed with food. No special procedures such as fasting or purging are required.

Giardiasis:
400 mg once daily for 5 days.

• Hydatid disease:
  Patient weight > 60 kg: 400 mg b.i.d. with meals. 28-day cycle followed by a 14-day albendazole free interval for a total of 3 cycles.
  Patient weight <60 kg: 15 mg/kg/day given in divided doses b.i.d. with meals (maximum total dose - 800 mg).
• Neurocysticercosis:
  Patient weight > 60 kg: 400 mg b.i.d. with meals 8-30 days.
  Patient weight < 40 kg: 15 mg/kg/day given in divided doses b.i.d. with meals (maximum total daily dose: 800 mg).

Contraindications

• Hypersensitive to the derivatives of benzimidazoles.

VIMOTIN TABLETS/SUSPENSION

COMPOSITION : (Antioxidont + Vitamins Tablets)

ZANTHOCIN

COMPOSITION
Each film coated tablet contains:
Azithromycin USP - 250 mg

DESCRIPTION
Zanthocin contains the active ingredient azithromycin, an azalide, a subclass of macrolide antibiotics, for oral administration.

• Broad spectrum antibiotic
• New macrolide antibiotic with high tissue concentration and long half-life
• Advantage of short treatment regimen
• Well-tolerated and safer than Erythromycin & Doxycycline
• Dosage flexibility due to Pulse therapy
• High patient compliance

CLINICAL PHARMACOLOGY
Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis.

Following oral administration, azithromycin is rapidly absorbed and widely distributed throughout the body. Rapid distribution of azithromycin into tissues and high concentration within cells result in significantly higher azithromycin concentrations in tissues than in plasma or serum.

Small amount of aziythromycin are demethylated in liver, and is excreted in bile as unchanged and metabolites.
The terminal elimination half-life is in excess of 68 hours.
Azithromycin is excreted in faeces in unchanged form.

INDICATIONS AND USAGE
In Acne and uncomplicated skin and soft tissue Infections like cellulitis, erysipelas, impetigo, folliculitis, and furuncles and carbuncles.
Updated as on 14 October 2005 Page 2 of 2 www.elderindia.com

DOSAGE AND ADMINISTRATION
Pulse therapy in acne