POTASSIUM CITRATE Manufacturer Distributor Contents Indications San Marino New Marketlink K citrate Alkalinizing agents which includes

correction of metabolic acidosis, alkalinization of the urine and as antacids. It has been used as alternative to sodium bicarbonate in treating chronic metabolic acidosis resulting from renal disorders. Initial Treatment: 30 mEq (3 tab) daily in 3 divided doses. Severe Treatment: 60 mEq (6 tab) in 3 divided doses daily. Administration: Take each dose without crushing, chewing or diluting the tablet. Should be taken with food (May be taken w/ or 30 min after meals or bedtime snack.). K-Cit should not be given to patients with metabolic or respiratory alkalosis, hypocalcemia or hypochlorhydria. It should be administered with considerable care to patients with renal or adrenocortical insufficiency, cardiac disease or other conditions that may predispose to hyperkalemia. Excessive administration of K-Cit may lead to hypokalemia and metabolic alkalosis, especially in patients with renal function. Symptoms include mood changes, tiredness, shortness of breath, muscle weakness and irregular heartbeat. Muscle hypertonicity, twitching and tetany may develop, especially in hypocalcemia. Click to view ADR Monitoring Website It is recommended that the patients in treatment with K-Cit follow a diet without salt and increase the intake of fluids. Potassium-Sparing Diuretics (Triamterene, Spirinolactone or Amyloride): Concomitant administration should be avoided since the simultaneous administration of these agents can produce severe hyperkalemia. View more drug interactions with K-Cit TRIMETAZIDINE Therapharma Manufacturer Distributor Contents Indications Dosage Overdosage Administration Contraindications Special Precautions Therapharma Trimetazidine Treatment of angina pectoris. Long-term treatment of coronary insufficiency. Adult: Usual Dose: 1 tab at mealtime in the morning and evening. The tablet must be swallowed whole with a glass of water. Do not chew, crush or bite the tablet. The physician should be consulted immediately in the event of trimetazidine overdosage. Should be taken with food Hypersensitivity to any component of Vestar. Pregnancy. In the event of an angina attack, the physician should be informed. Tests may be required and treatment regimen may be modified. Use in pregnancy: Trimetazidine should be avoided particularly during the 1st trimester of pregnancy except when absolutely required. Nevertheless, none of the animal studies have shown any embryotoxicity or teratogenicity. Use in lactation: In the absence of data on excretion of trimetazidine in breast milk, breastfeeding is not recommended during treatment. A decision should be made whether to stop breastfeeding or discontinue Vestar. Occasionally, minor GI disturbances (eg, nausea, vomiting) Click to view ADR Monitoring Website Since non-interaction with monoamine oxidase inhibitors (MAOIs) has not been established, trimetazidine should not be co-administered with these agents. No other drug interactions have been reported. View more drug interactions with Vestar Store at temperatures not exceeding 30C. Shelf-Life: 24 months. Pharmacology: Pharmacodynamics: Findings from in vitro and ex vivo studies of myocardial ischemia have demonstrated that trimetazidine limits intracellular acidosis, limits sodium and calcium accumulation, maintains intracellular ATP levels and reduces creatinine phosphokinase release, preserves mitochondrial function, reduces myocardial fatty acid metabolism and increases myocardial glucose metabolism, protects against oxygen-free radical-induced membrane damage and inhibits neutrophil infiltration. By inhibiting fatty acid metabolism and secondarily stimulating glucose metabolism, trimetazidine optimizes cardiac metabolism and thus protects the heart against the harmful effects of ischemia. However, the definitive mechanism of action of trimetazidine has yet to be determined. Anti-Anginal Drugs C01EB15 - Trimetazidine ; Belongs to the class of other cardiac preparations. Rx Tab 35 mg (modified-release) x 60's.

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Pregnancy Category (US FDA) Category A: Controlled studies in women fail to demonstrate a risk to the foetus in the 1st trimester (and there is no evidence of a risk in later trimesters), and the possibility of foetal harm remains remote. Store at temperatures not exceeding 30C. Shelf-Life: 24 months. Each tablet of K-Cit contains potassium citrate 10 mEq equivalent to 1080 mg. Pharmacokinetics: Potassium citrate is absorbed and in the absence of a deficit of bicarbonate in the plasma, its ion are excreted in the urine, which is rendered alkaline and there is an accompanying diuresis. It is metabolized, after absorption, to bicarbonate. Other Drugs Acting on the Genito-Urinary System A12BA02 - Potassium citrate ; Belongs to the class of potassium-containing preparations. Used as dietary supplements. Coated tab 10 mEq 30's.

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MIMS Class ATC Classification [?] Poison Schedule Presentation/Packing

CALCIUM CARBONATE Indication & Dosage

FENOFIBRATE Indication & Dosage

Oral
Hyperacidity Adult: Per tablet contains 500 mg calcium carbonate: Take 1-2 tablets as needed, up to a max of 16 tablets/day. May suck or chew tablets. Pregnant women: 1-2 tablets as needed, up to a max of 7 tablets in 24 hr. CrCl (ml/min) <25 Dosage Recommendation Dosage adjustments may be needed depending on serum calcium levels.

Oral
Hyperlipidaemias Adult: Dose depends on the formulation used. For standard micronised formulations: Initially, 67 mg tid or 200 mg once daily, may reduce to 67 mg bid or increase to 67 mg 4 times daily. For non-micronised formulations: Initially, 200-300 mg daily in divided doses. Usual range: 200-400 mg daily. For formulations with improved bioavailability, doses between 40-160 mg daily may be used. Child: 5 mg/kg daily. Renal impairment: Dose reduction is necessary. Should be taken with food. Hypersensitivity; severe hepatic and renal impairment. Unexplained persistent liver function abnormality and primary biliary cirrhosis; preexisting gall bladder disease. Pregnancy, lactation. Renal or hepatic impairment. Monitor LFTs and blood counts regularly. Increased risk of cholelithiasis, pancreatitis, skeletal muscle effects. Withdraw treatment if no adequate response after 2 mth of treatment at max recommended dose. Headache, dizziness, asthaenia, fatigue, arrhythmia, photosensitivity, eczema, dizziness, vaginitis, paraesthesia, rhinitis, cough, sinusitis, allergic pulmonary alveolitis, polyuria, myopathy, myositis, arthralgia, myalgia, myasthenia. Potentially Fatal: Hepatitis, cholecystitis. Resins impede the absorption of fenofibrate. May increase ciclosporin concentration and associated nephrotoxicity when used together. Potentially Fatal: Statins increase the risk of rhabdomyolysis and myopathy with renal failure. May increase the effects of oral anticoagulants. Click to view more fenofibrate Drug Interactions Food increases the bioavailability of fenofibrate. Increased creatinine and gamma glutamyl transpeptidase.

Oral
Hyperphosphataemia in patients with chronic renal failure Adult: Initially, 2.5 g daily, given in divided doses, may increase up to 17 g daily in divided doses if needed. CrCl (ml/min) <25 Administration Contraindications Special Precautions Dosage Recommendation Dosage adjustments may be needed depending on serum calcium levels.

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May be taken with or without food. (Take w/ meals for better absorption. Avoid taking w/ large amt of fibre-rich food.) Patients with Ca renal calculi or history of renal calculi; hypercalcaemia; hypophosphataemia. Patients with suspected digoxin toxicity. Renal impairment, hypoparathyroid disease, hypercalcaemia-associated diseases. Calcium absorption is impaired in achlorhydria; use an alternate salt and take with food. Caution when used in patients with a history of kidney stones. Constipation, flatulence; hypercalcaemia; metabolic alkalosis; milk-alkali syndrome, tissue-calcification. Gastric hypersecretion and acid rebound (with prolonged use). Co-administration with thiazide diuretics or vit D may lead to milk-alkali syndrome and hypercalcaemia. Decreased absorption with corticosteroids. Decreases absorption of tetracyclines, atenolol, iron, quinolones, alendronate, Na fluoride, Zn and calciumchannel blockers. Enhances cardiac effects of digitalis glycosides and may precipitate digitalis intoxication. Absorption may be increased with food. Decreased absorption with bran, foods high in oxalates and whole grain cereals. Calcium may reduce iron absorption.

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Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus. Calcium carbonate can neutralise gastric acid rapidly and effectively. However, it may adversely activate Ca dependent processes, leading to secretion of gastric and hydrochloric acid. It can induce rebound acid secretion and, prolonged high doses may cause hypercalcemia, alkalosis and milk-alkali syndrome. Absorption: Converted to calcium chloride by gastric acid. Some of the calcium is absorbed in the intestines. Calcium is absorbed in soluble, ionized form; solubility of calcium is increased in an acidic environment. Distribution: Crosses placenta, enters breast milk. Excretion: Mainly in the faeces as unabsorbed calcium; urine (20%). Antacids, Antireflux Agents & Antiulcerants / Calcium/with Vitamins / Electrolytes

MIMS Class ATC Classification

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus. Oral: Store at 25C. Fenofibrate lowers plasma TG by activating lipoprotein lipase thus increasing catabolism of very low-density lipoprotein with consequent increase in high-density lipoprotein levels. Absorption: Readily absorbed from the GI tract (oral); reduced if taken after an overnight fast. Distribution: >99% bound to plasma albumin. Metabolism: Rapidly via hydrolysis; converted to fenofibric acid. Excretion: Urine (60% metabolite, glucuronide conjugate); faeces (25%); 20 hr (elimination half-life). Dyslipidaemic Agents C10AB05 - Fenofibrate ; Belongs to the class of fibrates. Used in the treatment of hyperlipidemia.

SAMBONG Manufacturer Distributor Marketer Contents Indications Pascual Zuellig Altermed Sambong (Blumea balsamifera) powd leaves As an anti-urolithiasis in patients w/ urinary tract stones w/ normal kidney function. As a diuretic in patients w/ mild to moderate CHF & edema. Dosage Administration Special Precautions Anti-urolithiasis 4 tabs or 2 forte tabs tid. Diuretic 2 tab or 1 forte tab tid. May be taken with or without food (Take before or after meals.). Patients w/ excretory urogram showing signs of renal obstruction. Pregnancy & lactation. MIMS Class ATC Classification Poison Schedule [?] Other Drugs Acting on the Genito-Urinary System G04BX - Other urologicals ; Non-Rx

PARACETAMOL Indication & Dosage

Oral
Mild to moderate pain and fever Adult: 0.5-1 g 4-6 hrly as necessary. Max: 4 g daily. Child: Neonate 28-32 wk post menstrual age: 20 mg/kg as a single dose then 10-15 mg/kg 8-12 hrly (max 30 mg/kg daily in divided doses); neonate >32 wk post menstrual age: 20 mg/kg as a single dose then 10-15 mg/kg 6-8 hrly (max 60 mg/kg daily in divided doses); child 1-3 mth: 30 mg 8 hrly (max 60 mg/kg daily in divided doses); 3 mth-1 yr: 60-120 mg 4-6 hrly (max 4 doses in 24 hr); 1-5 yr: 120-250 mg 4-6 hrly (max 4 doses in 24 hr); 6-12 yr: 250-500 mg 4-6 hrly (max 4 doses in 24 hr). May be taken with or without food. Overdosage: Consult local protocols. Early symptoms: nausea and vomiting (normally settle within 24 hr of ingestion). After 24 hr symptoms may include right subcostal pain and tenderness, usually indicates development of hepatic necrosis. Liver damage is greatest 3-4 days after ingestion and may lead to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema and death. Treatment: based on plasma concentration. Acetylcysteine protects the liver if administered within 24 hr after ingestion (most effective if given within 8 hr). Dose: 140 mg/kg orally (loading) followed by 70 mg/kg every 4 hr for 17 doses. Parenteral acetylcysteine is given to those unable to take oral dosing. Activated charcoal may be given if paracetamol is 150 mg/kg or 12 g (whichever is smaller) if it is thought that the paracetamol has been ingested within the previous hr. Renal or hepatic impairment; alcohol-dependent patients; G6PD deficiency. Nausea, allergic reactions, skin rashes, acute renal tubular necrosis. Potentially Fatal: Very rare, blood dyscrasias (e.g. thrombocytopenia, leucopenia, neutropenia, agranulocytosis); liver damage. Reduced absorption of cholestyramine within 1 hr of admin. Accelerated absorption with metoclopramide. Decreased effect with barbiturates, carbamazepine, hydantoins, rifampicin and sulfinpyrazone. Paracetamol may increase effect ofwarfarin. Potentially Fatal: Paracetamol increases the risk of liver damage in chronic alcoholics. Increased risk of toxicity with other hepatotoxic drugs or drugs which induce microsomal enzymes e.g. barbiturates, carbamazepine, hydantoins,rifampicin and sulfinpyrazone. St John's Wort may decrease effect. May produce false-positive test results for 5-hydroxyindoleacetic acid.

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Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters). Intravenous: Do not store above 30C; do not freeze or refrigerate; if parenteral solution is diluted: use within an hr (infusion time included). Oral: Do not store above 30C; do not freeze or refrigerate; if parenteral solution is diluted: use within an hr (infusion time included). Rectal: Do not store above 30C; do not freeze or refrigerate; if parenteral solution is diluted: use within an hr (infusion time included). Paracetamol exhibits analgesic action by peripheral blockage of pain impulse generation. It produces antipyresis by inhibiting the hypothalamic heat-regulating centre. Its weak anti-inflammatory activity is related to inhibition of prostaglandin synthesis in the CNS. Analgesics (Non-Opioid) & Antipyretics

HYDROXYZINE Indication & Dosage

CETIRIZINE

Oral
Pruritus in acute and chronic urticaria and dermatosis Adult: Initially, 25 mg at night increased if required up to 25 mg 3-4 times daily. Child: 6 mth-6 yr: 5-15 mg daily, increased to 50 mg/day in divided doses; >6 yr: Initially, 15-25 mg/day, increased up to 50-100 mg/day. Renal impairment: Moderate-severe impairment: Reduce dose by 50%. Hepatic impairment: Reduce total daily dose by 33%. May be taken with or without food. Excessive sedation, hypotension (rare). Symptomatic and supportive treatment. Empty stomach immediately by inducing emesis or by gastric lavage. IV fluids and norepinephrine or metaraminol (do not use epinephrine) if hypotension. Haemodialysis or peritoneal dialysis is probably not effective. Porphyria, neonates, pregnancy, lactation. Renal and hepatic impairment; narrow-angle glaucoma; epilepsy; prostatic hypertrophy; bladder neck obstruction; asthma; COPD. May impair ability to drive or operate machinery. CNS depression, paradoxical CNS stimulation, dry mouth, thickened respiratory secretions, constipation, blurring of vision, tachycardia, GI disturbances, headache, hypotension, tinnitus. Masks ototoxicity of aminoglycoside antibiotics. Potentially Fatal: Potentiates CNS depression by barbiturates, hypnotics, opioid analgesics, sedatives and neuroleptics. MAOIs, atropine, and TCAs potentiate antimuscarinic effects. Click to view more hydroxyzine Drug Interactions Increased CNS depression with alcohol.

Indication & Dosage

Oral
Allergic conditions Adult: 10 mg once daily or 5 mg bid. Child: 6 mth-2 yr: 2.5 mg once daily (up to 2.5 mg bid in children 12 mth) ; 2-5 yr: 5 mg once daily or 2.5 mg bid; >6 yr: 10 mg once daily or 5 mg bid.

Administration Overdosage

Elderly: Renal impairment: Half the usual dose. Hepatic impairment: Half the usual dose.
Contraindications Special Precautions Adverse Drug Reactions Drug Interactions Hypersensitivity; lactation. Hepatic or renal impairment; elderly; tasks requiring mental alertness eg, driving or operating heavy machinery; pregnancy. Somnolence, insomnia, malaise, headache, dizziness; GI discomfort, dry mouth, abdominal pain, diarrhoea, nausea, vomiting; occasional hypersensitivity; epistaxis, pharyngitis, bronchospasm. Risk of increased INR and epistaxis when taken together with warfarin. Potentially Fatal: CNS depressants and anticholinergics may potentiate CNS depression of cetirizine. Click to view more cetirizine hydrochloride Drug Interactions Oral: Store at 20-25C. Syr: Can also refrigerate at 2-8C. Cetirizine is a potent and highly selective antagonist of the peripheral histamine H 1receptor on effector cells in the GI tract, blood vessels and respiratory tract. Absorption: Absorbed rapidly from the GI tract (oral); peak plasma concentrations after 1 hr. Rate, but not extent, of absorption altered by food. Distribution: Enters breast milk; crosses the blood-brain barrier (insignificant amounts). Protein-binding: Highly bound. Excretion: Via the urine (as unchanged); 10 hr (elimination half-life). Antihistamines & Antiallergics

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MIMS Class Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus. Intramuscular: Store at 15-30C. Oral: Store at 15-30C. Hydroxyzine blocks histamine H1-receptors on effector cells of the GI tract, blood vessels and respiratory tract; a sedating anihistamine with antimuscarinic and significant sedative properties. It also possesses skeletal muscle relaxing, bronchodilator, antiemetic and analgesic properties. Absorption: Absorbed rapidly from the GI tract (oral). Metabolism: Converted to cetirizine (has antihistaminic properties). Excretion: 20 hr (elimination half-life). Anxiolytics / Antihistamines & Antiallergics N05BB01 - Hydroxyzine ; Belongs to the class of diphenylmethane derivatives anxiolytics. Used in the management of anxiety, agitation or tension.

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