FORMULARI UBAT-UBATAN HOSPITAL KEMAMAN (Pindaan 1/2020)

Generic Name Prescriber Indications Dosage Adverse Reaction Contraindications Interactions Precautions Category Abacavir Sulphate 600 mg and A* Antiretroviral combination therapy of HIV ADULTS & ADOLESCENT (> 12 years of Hypersensitivity, anorexia, headache, Hypersensitivity reaction to the active Co-trimoxazole, methadone, Close monitoring is required in patients Lamivudine 300 mg Tablet infection in adults and adolescents from age): Recommended dose is one tablet insomnia, cough, nasal symptoms, substance or to any excipients, severe ribavirin with mild and moderate hepatic 12 years of age with the following once daily. Not to be used in adults or nausea, vomiting, abdominal pain or hepatic impairment impairment. Discontinue treatment criteria: adolescents weigh less than 40kg. cramps, diarrhea, rash, alopecia, fever, immediately if hypersensitivity is i)Patients unsuitable or failed other CHILDREN : Not recommended lethargy, fatigue, malaise. suspected. Not recommended in patients HAART treatment ii)Patients who are at with creatinine clearance < 50ml/min high risk of renal impairment iii)Patients with osteoporosis or at high risk of bone loss Acetazolamide 250 mg Tablet B Reduction of intraocular pressure in open- 250mg 1-4 times a day, the dosage being Nausea, vomiting, diarrhoea, taste Hypokalaemia, hyponatraemia, Aspirin, cyclosporin, digitalis , Caution in patients with adrenal failure or angle glaucoma, secondary glaucoma titrated according to patient response disturbances, loss of appetite, hyperchloraemic acidosis, severe hepatic digoxin, lithium, phenytoin, Addisons disease; diabetis mellitus; and peri-operatively in angle-closure paraesthesia, flushing, headache, impairment, renal impairment, thiazide quinidine, topiramate hypokalemia, hyponatremia or other glaucoma dizziness, fatigue, irritability, depression, or sulphonamide hypersensitivity. Best electrolyte imbalance; respiratory or thirst, polyuria, reduced libido, metabolic avoided in the first trimester of hypochloraemic acidosis; hepatic or renal acidosis and electrolyte disturbances on pregnancy. Should not be used in chronic function impairment. Maintenance of long-term therapy noncongestive closed-angle glaucoma high fluid intake may be advisable, especially in patients with hypercalciuria or gout, to reduce the risk of renal calculi. Care should be taken if potassium supplementation is indicated. Caution in elderly, pregnancy and lactation, Stevens- Johnson syndrome, toxic epidermal necrosis, high-dose aspirin

Acetylsalicylic Acid 100 mg, Glycine B Prevention of myocardial infarct, stroke, 1 tablet daily Nausea, vomiting, dyspepsia, GI Bleeding disorders. Hypersensitivity to Alcohol, dipyridamole, Dyspepsia, gastric mucosal lesions, 45 mg Tablet vascular occlusion and deep vein ulceration, haematemesis, malaena. salicylate metoclopramide, metoprolol, haemorrhagic disorders, gout, intolerant thrombosis. Transient ischaemic attacks Occasionally hepatotoxicity carbonic anhydrase inhibitors, to aspirin, renal or hepatic impairment, corticosteroids, coumarin asthma and G6PD deficiency anticoagulants, sulphonylureas, methotrexate, phenytoin, valproic acid, probenecid, sulphinpyrazone

Acetylsalicylic Acid 300 mg Soluble C Initial treatment of cardiovascular 150mg to be taken daily. Use in children Gastric haemorrhage, hypersensitivity, Gastric and duodenal ulcers, Acetazolamide, Dipyridamol : Renal disorders, G6PD deficiency, Tablet disorders such as angina pectoris and under 16 years old is not recommended thrombocytopenia,GI disturbances; haemorrhagic diathesis, hypersensitivity salicylate toxicity (vomiting, pregnancy, patients with flu, chicken pox myocardial infection and for the prolonged bleeding time, rhinitis, to aspirin or other NSAIDs, children under tachycardia, hyperpnea, mental or haemorrhagic fever. History of peptic prevention of cardiovascular events in urticaria and epigastric discomfort; 12 years old.Hypersensitivity (attacks of confusion) or acetazolamide ulcer or those prone to dyspepsia and patients at risk. Other such uses include angioedema, salicylism, tinnitus; asthma, angioedema, urticaria or toxicity (fatigue, lethargy, those with gastric mucosal lesion; the treatment and prevention of bronchospasm rhinitis); pregnancy (third trimester); somnolence, confusion, asthma or allergic disorders; dehydrated cerebrovascular disorders such as stroke patients with haemophilia or hyperchloremic metabolic acidosis). patients; uncontrolled hypertension; haemorrhagic disorders; gout; severe Alendronate : GI distress. Antacids, impaired renal or hepatic function; renal or hepatic impairment; lactation calcium. Alcohol, corticosteroids, elderly phenylbutazone and oxyphenbutazone may increase risk of GI ulceration. Aspirin increases phenytoin levels. May antagonize actions of uricosurics and spironolactone Acyclovir 200 mg Tablet A/KK i) Mucocutaneous Herpes Simplex i) ADULT: initially 400 mg 5 times daily Skin rashes; GI effects; fatigue Patients known to be hypersensitivity to Increased mean half-life & plasma Patients with pre-existing neurologic, infection in immunocompromised and for 7 - 14 days. CHILD less than 2 years: acyclovir concentration with probenecid renal, or hepatic impairment, dehydrated AIDS patients 200 mg 4 times daily, CHILD more than 2 patient, elderly and lactation ii) Primary and recurrent Varicella Zoster years: 400 mg 4 times daily infection in immunocompromised and ii), iii) and iv) ADULT: 200 - 400 mg 4 AIDS patients times daily. CHILD: less than 2 years, half iii) Severe Kaposi Varicella Eruption adult dose; more than 2 years, adult (Eczema herpeticum) dose iv) Severe primary HSV infections (eg. v) ADULT: 800 mg 5 times daily for 7 days Neonatal herpes, encephalitis, eczema vi) ADULT: 20 mg/kg (maximum: 800 mg) herpeticum, genital herpes, gingival four times daily for 5 days, CHILD 6 stomatitis, vaginal delivery with maternal years: 800 mg four times daily. CHILD vulva herpes) less than 2 years; 400mg 4 times daily, v) Severe and complicated varicella more than 2 years; 800mg 4 times daily infection (eg. Encephalitis, purpura fulminans) vi) Severe zoster infection in paediatrics (eg. Encephalitis, purpura fulminans, immunocompromised patients and facial, sacral and motor zoster)

Acyclovir 800 mg Tablet A/KK i) Mucocutaneous Herpes Simplex i) ADULT: initially 400 mg 5 times daily for Skin rashes; GI effects; fatigue Patients known to be hypersensitivity to Increased mean half-life & plasma Patients with pre-existing neurologic, infection in immunocompromised and 7 - 14 days. CHILD less than 2 years: 200 acyclovir concentration with probenecid renal, or hepatic impairment, dehydrated AIDS patients ii) Primary and recurrent mg 4 times daily, CHILD more than 2 patient, elderly and lactation Varicella Zoster infection in years: 400 mg 4 times daily ii), iii) and iv) immunocompromised and AIDS patients ADULT: 200 - 400 mg 4 times daily. iii) Severe Kaposi Varicella Eruption CHILD: less than 2 years, half adult dose; (Eczema herpeticum) iv) Severe primary more than 2 years, adult dose v) ADULT: HSV infections (eg. Neonatal herpes, 800 mg 5 times daily for 7 days vi) encephalitis, eczema herpeticum, genital ADULT: 20 mg/kg (maximum: 800 mg) herpes, gingival stomatitis, vaginal four times daily for 5 days, CHILD 6 years: delivery with maternal vulva herpes) v) 800 mg four times daily. CHILD less than Severe and complicated varicella 2 years; 400mg 4 times daily, more than infection (eg. Encephalitis, purpura 2 years; 800mg 4 times daily fulminans) vi) Severe zoster infection in paediatrics (eg. Encephalitis, purpura fulminans, immunocompromised patients and facial, sacral and motor zoster)

Agomelatine 25 mg Tablet A* Major depression The recommended dose is 25mg once Headache, dizziness, somnolence, History of previous hypersensitivity to CYP2C9 & CYP1A2 inhibitors (eg Use in people with dementia or impaired daily at bedtime, maybe increased to insomnia, migraine; anxiety; nausea, the active ingredient or any of the fluvoxamine, ciprofloxacin, liver function, renal impairment, mania 50mg once daily at bedtime. diarrhea, constipation, upper abdominal excipients. Hepatic impairment (i.e. propranolol, grepafloxacin, or hypomania. Increased risk of suicidal pain; hyperhidrosis; back pain; fatigue; cirrhosis or active liver disease). Taking enoxacin), oestrogenS tendencies, lactose intolerance. Perform increased ALAT &/or ASAT. potent CYP1A2 inhibitors (e.g. liver function tests periodically. May fluvoxamine, ciprofloxacin) impair ability to drive or operate machinery. Pregnancy & lactation, elderly, children. Albendazole 200 mg Tablet C+ i) Single or mixed infestations of i)Child 12-24months: 200mg as a single Gastrointestinal discomfort, dizziness, Patients with hypersensitivity to Concurrent use with Discontinue therapy if liver function test intestinal parasites dose headache, erythema multiforme, Stevens- albendazole or to the benzimidazole drug dexamethasone may result in an elevations are significant, retinal lesions, ii) Strongyloides infection ii) Adult & Child above 2 years: 400mg Johnson syndrome, agranulocytosis, class, pregnancy (avoid pregnancy for at increased risk of albendazole cerebral hypertensive episodes, as a single dose for 3 consecutive days; aplastic anemia, leukopenia, least one month following therapy) adverse effects. pregnancy, hepatic disease, retinal Child 12 - 24months: 200mg as a single pancytopenia, thrombocytopenia, lesions dose for 3 consecutive days hepatotoxicity

Alendronate Sodium 70 mg and A* Osteoporosis in postmenopausal women 1 tablet once weekly [70mg/5600 IU]. Abdominal pain, dyspepsia, esophageal Abnornalities of the esophagus which If taken at the same time it is likely Discontinue in case of dysphagia, Cholecalciferol 5600 IU Tablet with a history of vertebral fracture and Patient should receive supplemental ulcer, dysphagia, abdominal distention, delay esophageal emptying such as that calcium supplements, antacids, odynophagia, retrosternal pain or new or whom oestrogen replacement therapy is calcium or vitamin D, if dietary vitamin D musculoskeletal (bone, muscle or joint) stricture or achalasia. Inability to stand or and other oral medications will worsening heartburn. Active upper contraindicated. Review treatment after inadequate. The tablet should be taken pain, constipation, diarrhea, flatulence, sit upright for at least 30 minutes. interfere with absorption of gastrointestinal problems (dysphagia, 2 years and if there is positive response, at least half and hour before the first headache, acid regurgitation, muscle Hypersensitivity to any component of the alendronate. Therefore, patients esophageal diseases, gastritis, duodenitis treatment may be continued up to 5 food, beverage, or medication of the day cramp, gastritis, gastric ulcer, urticaria, product. Hypocalcemia. must wait at least one-half hour or ulcers). CrCl less 35 ml/min. Correct years and then re-evaluate. Treatment with plain water only. To facilitate nausea, vomiting, esophagitis, after taking the hypocalcemia and other disorders should be stopped if there is no positive delivery to stomach and thus reduce the esophageal erosions, dizziness, vertigo, alendronate/cholecalciferol before affecting mineral metabolism (eg vit D response after 5 years. Otherwise, potential for esophageal irritation, it dysgeusia, rash, pruritis, alopecia. taking any other oral medication. deficiency) before starting therapy. patient needs to be given drug holiday should only be swallowed upon arising Monitor serum Calcium and urine. for 1 to 2 years and then continue for the day with a full glass of water and Children, pregnancy and lactation treatment shall the benefit outweigh the patient should not lie down for at least risk. 30 minutes and until after their first food of the day.

Alfacalcidol 0.25 mcg Capsule A/KK i) Renal osteodystrophy in patients on Initial dose ADULT and CHILD above Hypercalcaemia-stop immediately until Hypercalcaemia, metastatic calcification, Thiazide diuretics, calcium, Pregnancy, lactation, renal impairment, haemodialysis 20kg body weight : 1 mcg daily; serum calcium levels return to normal (in hyperphosphataemia (except when phosphates, carbamazepine, infants, elderly. Serum levels of calcium ii) Hypoparathyroidism and CHILD under 20kg body weight : 0.05 about one week) and then resumed at occurring with hypoparathyroidism), phenobarbitone should be monitor regularly (weekly to pseudohypoparathyroidism mcg/kg/day. half the previous dose. Anorexia, nausea, hypermagnesaemia, vitamin D monthly, depending in the progress of iii) Adjunct to the management of Maintenance dose : 0.25 mcg to 2 mcg vomiting, diarrhoea, lassitude, polyuria, overdose,known hypersensitivity to the patient) especially in children, renal tertiary hyperparathyroidism daily sweating, headache, thirst, vertigo, alfacalcidol, vitamin D or any of its impairment and patients receiving high iv) Rickets and osteomalacia pruritus, rash, urticaria,hypercalciuria analogues and derivatives. doses. Caution in hypercalciuria esp in v) Osteoporosis and ectopic calcification. In case of renal those with history of renal calculi and impairment, hyperphosphataemia. In patients being treated with cardioactive hypercalcaemic dialysis patients, glycosides or digitalis. possibility of calcium influx from the dialysate should be considered

Alfacalcidol 1 mcg Capsule A/KK i) Renal osteodystrophy in patients on Initial dose ADULT and CHILD above Hypercalcaemia-stop immediately until Hypercalcaemia, metastatic calcification, Thiazide diuretics, calcium, Pregnancy, lactation, renal impairment, haemodialysis 20kg body weight : 1 mcg daily; serum calcium levels return to normal (in hyperphosphataemia (except when phosphates, carbamazepine, infants, elderly. Serum levels of calcium ii) Hypoparathyroidism and CHILD under 20kg body weight : 0.05 about one week) and then resumed at occurring with hypoparathyroidism), phenobarbitone, should be monitor regularly (weekly to pseudohypoparathyroidism mcg/kg/day. half the previous dose. Anorexia, nausea, hypermagnesaemia, vitamin D monthly, depending in the progress of iii) Adjunct to the management of Maintenance dose : 0.25 mcg to 2 mcg vomiting, diarrhoea, lassitude, polyuria, overdose,known hypersensitivity to the patient) especially in children, renal tertiary hyperparathyroidism daily sweating, headache, thirst, vertigo, alfacalcidol, vitamin D or any of its impairment and patients receiving high iv) Rickets and osteomalacia pruritus, rash, urticaria,hypercalciuria analogues and derivatives. doses. Caution in hypercalciuria esp in v) Osteoporosis and ectopic calcification. In case of renal those with history of renal calculi and impairment, hyperphosphataemia. In patients being treated with cardioactive hypercalcaemic dialysis patients, glycosides or digitalis. possibility of calcium influx from the dialysate should be considered

Alfuzosin HCl 10 mg Tablet A* Treatment of functional symptoms 10 mg once a day pre bed Gastrointestinal disturbances, vertigo, Orthostatic hypotension, hepatic Alpha blockers and other Elderly, coronary insufficiency, related with benign prostatic malaise, dizziness, headache. Rarely insufficiency, severe renal insufficiency antihypertensives,potent CYP3A4 discontinue in the event of recurrence or hypertrophy (BPH) orthostatic hypotension, syncope, (CrCl less than 30 ml/min), intestinal inhibitors exacerbation of angina, may impair tachycardia, palpitations, chest pain, occlusion. Avoid use with potent CYP3A4 ability to drive or operate machinery asthenia, drowsiness, oedema, flushing, inhibitors (eg:ritonavir etc). dry mouth, rash, pruritis Allopurinol 300 mg Tablet A/KK i) Frequent and disabling attacks of gouty Initial dose : 100-300 mg daily. Skin rash, maculopapular, pruritic, Hypersensitivity to allopurinol, Oral anticoagulants, azathioprine, Renal/hepatic dysfunction, arthritis (3 or more attacks/year). Maintenance : 300-600 mg daily. Stevens-Johnson Syndrome, peripheral pregnancy, lactation, acute gout, antidiabetics, mercaptopurine.Use asymptomatic hyperuricaemia, ii) Clinical or radiographic signs of erosive Maximum: 900 mg daily neuritis, alopecia, GI upset, toxic asymptomatic hyperuricaemia only quarter of the usual dose of 6- Hypersensitivity and pregnancy gouty arthritis. epidermal necrolysis. Acute attack of mercaptopurine or azathioprine iii) The presence of tophaceous deposits. gouty arthritis in early stages of therapy. when given concurrently. Increases iv) Urate nephropathy. Skin reactions (discontinue immediately plasma half-life of adenine v) Urate nephrolithiasis. at first sign of rash). Very rarely, arabinoside. Effects decreased by vi) Impending cytotoxic chemotherapy or granulomatous hepatitis. Occasionally; uricosurics & large doses of radiotherapy for lymphoma or leukaemia thrombocytopenia, agranulocytosis, & salicylates aplastic anaemia in patients with impaired renal function

Alprazolam 0.5 mg Tablet A Anxiety disorders 0.25 - 0.5 mg 3 times daily (elderly or Drowsiness, blurred vision, coordination Hypersensitivity to benzodiazepines, Ketoconazole, fluconazole, Avoid operating vehicles or machinery, delibitated 0.25 mg 2-3 times daily), disorder, gastrointestinal disturbance, acute narrow angle glaucoma, itraconazole, contraceptives; abuse prone patient, pregnancy and increased if necessary to a total dose of 3 agitation, lightheadedness, dry mouth, concomitant use of ketoconazole/ increased alprazolam serum breastfeeding, renal or hepatic mg/day. Not recommended for children depression, headache, confusion, itraconazole, CNS depression concentrations and potential dysfunction, elderly patients, obesity, hypotension, syncope, tachycardia, alprazolam toxicity. Omeprazole, untreated open angle glaucoma, seizures, respiratory depression, coma, erythromycin, clarithromycin, impaired pulmonary function. Prolonged constipation, diarrhoea, nausea, cimetidine; benzodiazepine toxicity. use can lead to dependence vomiting, insomnia, nasal congestion, Sertraline; increased risk of rigidity, increased salivation, dermatitis, psychomotor impairment and sedation sedation. Fluoxetine; increased risk of alprazolam toxicity. Fluvoxamine; increased risk of CNS side effects. Ritonavir; increased plasma concentrations of alprazolam and enhanced alprazolam effects. Antihistamine/decongestant combinations, antipsychotic, ethanol, mirtazapine, phenothiazines, venlafaxine;increased risk of CNS depression, psychomotor impairment. Sedative/hypnotics, tricyclic antidepressants; CNS depression. Potentiates action of alcohol. Reduced concentration by 50% with cigarette smoking.

Amantadine HCl 100 mg Capsule B Parkinson's disease Initial dose: 100 mg daily and is increased Oedema of ankles, livedo reticularis, Hypersensitivity to amantadine products, Alcohol, methyldopa, Seizure disorder, psychiatry disorder, to 100 mg twice daily (not later than 4 depression, hallucination, nausea, pregnancy, lactation, epilepsy, history of metoclopramide, domperidone, recurrent eczema, gastric ulceration. p.m.) after a week. vomiting, dizziness, insomnia, blurred gastric ulceration, severe renal antipsychotic, antimuscarinics. Patients with cardiovascular or liver Elderly over 65 years: less than 100 mg vision, dry mouth. Seizures, psychosis, impairment Enhances the adverse effects of disease, impaired renal function. Elderly. or 100 mg at intervals of more than 1 day confusion, ataxia, heart failure, antimuscarinics and levodopa. Withdrawal of the drug should be depression, orthostatic hypotension, Central nervous system stimulants, gradual blood dyscrasias, urinary retention, drugs that raise urinary pH irritability, gastrointestinal disturbances Amiloride HCl 5 mg & B i) Diuretic as an adjunct to the i) Initially 1 - 2 tab daily adjusted Headache, fatigue, nausea, anorexia, Hypersensitivity to other sulfonamides. Angiotensin converting enzyme Diabetes mellitus. Electrolyte imbalance, Hydrochlorothiazide 50 mg Tablet management of oedematous states according to response. Max : 4 tabs daily. vomiting, arrhythmia, tachycardia, Hyperkalaemia, antikaliuretic therapy or inhibitors: postural hypotension concomitant use of other diuretics can ii) Hypertension ii) 1 -2 tabs daily as a single or divided orthostatic hypotension, dyspnoea, potassium supplementation, renal (first dose). Carbamazepine: result in hyponatraemia and dose elevated serum potassium levels. impairment. Children. hyponatraemia. Chlorpropamide: hypochloremia as well as increases in decreased chlorpropamide BUN levels. This is more frequent in effectiveness. Digitalis: digitalis patients with hepatic cirrhosis and toxicity (nausea, vomiting, ascites, metabolic alkalosis or those with arrhythmias). Corticosteroids: resistant oedema. Metabolic or hypokalaemia and subsequent respiratory acidosis. Pregnancy & cardiac arrhythmias. NSAIDs: lactation. decreased diuretic and antihypertensive efficacy. Propranolol: hyperglycaemia, hypertriglyceridemia. Cholestyramine and colestipol resins-absorption of hydrochlorothiazide is impaired in the presence of anion exchange resins.

Amiodarone 200 mg Tablet A* Arrhythmias 200 mg 3 times daily for 1 week, then Reversible corneal microdeposits; Cardiogenic shock, hypersensitivity to Antiarrhythmics, beta-blockers, Acute myocardial infarction, sino-atrio, reduced to 200 mg twice daily for colored halos. Hyper or hypothyroidism. amiodarone, second or third degree AV stimulating laxatives, diuretics block AV or other severe conduction another week. Maintenance dose, Rarely; photosensitization and block (if no pacemaker is present). inducing hypokalaemia, systemic disorder (unless the patient has a usually 200 mg daily or the minimum pigmentation. Reversible diffuse Severe sinus bradycardia and severe corticosteroids, tetracosactide, pacemaker),severe hypotension,severe required to control the arrhythmia interstitial pneumopathy or peripheral sinus-node dysfunction amphotericin B, digitalis, respiratory failure,bradycardia, neuropathy anticoagulants, phenytoin, general cardiomegaly, corneal microdeposits anaesthetics, ciclosporin (impaired vision)

Amisulpride 100 mg Tablet A* Treatment of psychoses, particularly Predominantly negative episodes: 50-300 Insomnia, anxiety, agitation, Hypersensitivity to amisulpride, Amiodarone; increased risk of Renal insufficiency (dose reductions), acute or chronic schizophrenia disorders mg once daily adjusted according to the extrapyramidal symptoms, galactorrhea, pheochromocytoma, prolactinomas and cardio toxicity (QT prolongation, epilepsy, Parkinson's disease; characterized by positive symptoms(e.g. patient's response. Mixed episodes with gynecomastia, amenorrhea, breast pain, breast cancer, pregnancy, lactation, torsades de pointes, cardiac arrest). concomitant use of dopamine agonists, delusion, hallucinations, thought positive and negative symptoms: 400- impotence, gastrointestinal disorder, children under 15 years of age If concurrent use cannot be previous hypersensitivity to other disorders) and/or negative 800 mg/day in 2 divided doses adjusted weight gain avoided, cautious dosing and benzamide derivatives (sulpiride, symptoms(e.g. blunted emotions, according to the patient's response. telemetric monitoring is advised . metoclopramide, tiapride, sultopride), emotional and social withdrawal) Should be taken on an empty stomach Amitriptyline, chloral hydrate, elderly patients (increased risk of adverse including when the negative symptoms (Preferably taken before meals) chloroquine, chlorpromazine, effects; reduced renal function may be predominate cisapride, clarithromycin, present requiring dose adjustment), erythromycin, fluconazole, coadministration with other agents fluoxetine, imipramine, isoflurane, which depress the central nervous mefloquine, octreotide, system or lower blood pressure prochlorperazine, sulfamethoxazole, thioridazine, trifluoperazine, trimethoprim and vasopressin; increased risk of cardio toxicity (QT prolongation, torsades de pointes, cardiac arrest) Amisulpride 400 mg Tablet A* Treatment of psychoses, particularly Predominantly negative episodes: 50-300 Insomnia, anxiety, agitation, Hypersensitivity to amisulpride, Amiodarone; increased risk of Renal insufficiency (dose reductions), acute or chronic schizophrenia disorders mg once daily adjusted according to the extrapyramidal symptoms, galactorrhea, pheochromocytoma, prolactinomas and cardio toxicity (QT prolongation, epilepsy, Parkinson's disease; characterized by positive symptoms(e.g. patient's response. Mixed episodes with gynecomastia, amenorrhea, breast pain, breast cancer, pregnancy, lactation, torsades de pointes, cardiac arrest). concomitant use of dopamine agonists, delusion, hallucinations, thought positive and negative symptoms: 400- impotence, gastrointestinal disorder, children under 15 years of age If concurrent use cannot be previous hypersensitivity to other disorders) and/or negative 800 mg/day in 2 divided doses adjusted weight gain avoided, cautious dosing and benzamide derivatives (sulpiride, symptoms(e.g. blunted emotions, according to the patient's response. telemetric monitoring is advised . metoclopramide, tiapride, sultopride), emotional and social withdrawal) Should be taken on an empty stomach Amitriptyline, chloral hydrate, elderly patients (increased risk of adverse including when the negative symptoms (Preferably taken before meals) chloroquine, chlorpromazine, effects; reduced renal function may be predominate cisapride, clarithromycin, present requiring dose adjustment), erythromycin, fluconazole, coadministration with other agents fluoxetine, imipramine, isoflurane, which depress the central nervous mefloquine, octreotide, system or lower blood pressure prochlorperazine, sulfamethoxazole, thioridazine, trifluoperazine, trimethoprim and vasopressin; increased risk of cardio toxicity (QT prolongation, torsades de pointes, cardiac arrest)

Amitriptyline HCl 25 mg Tablet B Depression Initially 25mg 3 times a day. Dry mouth, constipation, nausea, Hypersensitivity to drug/class. Barbiturate, phenytoin, Cardiac disease, hyperthyroidism, Maintenance: 25-100mg daily in divided vomiting, urinary retention, blurred Immediate recovery phase after carbamazepine, cimetidine, impaired hepatic and renal function, doses. Hospitalized patient: 100mg/day vision, drowsiness, dizziness, tachycardia, myocardial infarction, heart block, mania. amphetamines, antiarrhythmics, urinary retention, history of seizures, &gradually increase to 200-300mg/day. increased appetite, confusion, seizures, MAOI use within the last 14 days class Ia and III, anticholinergics, glaucoma, suicide risk, pregnancy, ADOLESCENT and ELDERLY: initially 20- myocardial infarction, stroke, antihistamines, beta 2 agonists, lactation, elderly, phaeochromocytoma, 30mg/day in divided doses w/ gradual agranulocytosis, thrombocytopenia, rash benzodiazepines, systemic carbonic history of mania, phychoses, angle- increments. and hypersensitivity reactions, blood anhydrase inhibitors, central alpha closure glaucoma, concurrent CHILD under 16 years are not sugar changes, endocrine side effects, 2 agonists, cholinergic agents, anticonvulsive therapy, anaesthesia recommended impotence, menstrual irregularities, bone clozapine, intranasal marrow depression decongestants, flumazenil, halothane, lithium, MAOIs, methylphenidate, metoclopramide, muscle relaxants, nitrates, opiates, antipsychotics, phenytoin, protease inhibitors, sedatives/hypnotics, SSRIs, indirect/mixed sympathomimetics, cimetidine, fluoxetine, clonidine

Amlodipine 10 mg Tablet B Hypertension 5 mg once daily. Max: 10 mg once daily Headache, dizziness, gingival hyperplasia, Hypersensitivity to amlodipine, Cyclosporin, sildenafil, vardenafil, Angina (exacerbation) during initiation of tachycardia, peripheral oedema symptomatic hypotension, persistent CYP3A4 inducers, CYP3A4 treatment; with dosage increases; during dermatologic reactions, congestive heart inducers(fluconazole, itraconazole, beta-blocker withdrawal; taper slowly failure ketoconazole) prior to calcium channel blocker therapy. Aortic stenosis (reduced myocardial oxygenation with drug-induced hypotension), congestive heart failure, pregnancy, hepatic impairment, lactation. Amlodipine 5 mg Tablet B Hypertension 5 mg once daily. Max: 10 mg once daily Headache, dizziness, gingival hyperplasia, Hypersensitivity to amlodipine, Cyclosporin, sildenafil, vardenafil, Angina (exacerbation) during initiation of tachycardia, peripheral oedema symptomatic hypotension, persistent CYP3A4 inducers, CYP3A4 treatment; with dosage increases; during dermatologic reactions, congestive heart inducers(fluconazole, itraconazole, beta-blocker withdrawal; taper slowly failure ketoconazole). prior to calcium channel blocker therapy. Aortic stenosis (reduced myocardial oxygenation with drug-induced hypotension), congestive heart failure, pregnancy, hepatic impairment, lactation.

Amlodipine 10 mg and Valsartan 160 A/KK Essential hypertension in patients whose Doses range from amlodipine besylate 5 Nasopharyngitis, flu, headache, oedema, Pregnancy and lactation, hypersensitivity Potassium supplement. Potassium- Risk of hypotension in sodium or volume mg Tablet blood pressure is not adequately mg/valsartan 160 mg to amlodipine peripheral oedema, fatigue, flushing, to amlodipine, valsartan, or any sparing diuretic, potassium depleted patient, beta blocker controlled by monotherapy besylate 10 mg/valsartan 320 mg ORALLY asthenia, vertigo, tachycardia, component of the product containing salt substitutes or other withdrawal should be gradual. Severe once daily, with dose titration occurring palpitations, orthostatic hypotension, drugs that may increase potassium renal impairment, dialysis. Unilateral/ every 1 to 2 weeks if necessary. MAX cough, pharyngolaryngeal pain, level bilateral renal stenosis, stenosis to a amlodipine besylate 10 mg/valsartan 320 gastrointestinal disturbances, rash, solitary kidney, after recent kidney mg erythema, joint swelling, back pain, transplantation, hepatic impairment, arthralgia. Rare: Hypersensitivity. biliary obstructive disorders. Aortic or Amlodipine: Gastritis, gingival mitral stenosis, obstructive hyperplasia, gynaecomastia, leucopaenia, hyperthrophic cardiomyopathy myalgia, pancreatitis, hepatitis, thrombocytopaenia, vasculitis. Valsartan: Neutropaenia, increases in creatinine, serum potassium and BUN

Amoxicillin 500 mg & Clavulanate A/KK Infections due to beta-lactamase ADULT & CHILD more than 12 years: Diarrhoea, indigestion, nausea, vomiting, Hypersensitivity to penicillins, possible Aminoglycosides, anticoagulants, Renal or hepatic impairment. Patients on 125 mg Tablet producing strain where amoxicillin alone Mild to moderate infections: 625 mg candidiasis, rash, pseudomembranous cross sensitivity with other β-lactams. probenecid, allopurinol, oral anticoagulation therapy. Prolonged use. is not appropriate. Respiratory tract, skin, twice daily. colitis, hepatitis, cholestatic jaundice, History of penicillin-associated contraceptive. Pregnancy. soft tissue, GUT infection, septicaemia, crystalluria, erythema multiforme, cholestatic jaundice/hepatic dysfunction peritonitis, post-operative infection & Stevens-Johnson syndrome, toxic osteomyelitis epidermal necrolysis, reversible leucopaenia, thrombocytopaenia, haemolytic anaemia, CNS disturbances

Amoxicillin 500 mg Capsule B Infections caused by susceptible strains ADULT: 250 - 500 mg 3 times daily. Diarrhoea, indigestion, urticarial or Hypersensitivity to penicillins Aminoglycosides, oral Hypersensitivity to cephalosporins, renal of gram positive and gram negative CHILD: 20 - 40 mg/kg/day in divided erythematous rash, hepatitis, cholestatic contraceptives or hepatic impairment, superinfection organisms doses 8 hourly jaundice

Amphotericin B 0.15% Eye Drops A Fungal infection of the cornea 1 drop hourly or 2 hourly Nausea and vomiting, anaemia, Hypersensitivity to Amphotericin B Cyclosporin, digitalis glycosides, Renal impairment thrombocytopenia non-depolarizing neuromuscular blockers

Amphotericin B 0.25% Eye Drops A Fungal infection of the cornea 1 drop hourly or 2 hourly Nausea and vomiting, anaemia, Hypersensitivity to Amphotericin B Cyclosporin, digitalis glycosides, Renal impairment thrombocytopenia non-depolarizing neuromuscular blockers

Ampicillin Sodium & Sulbactam A/KK Treatment of susceptible bacterial ADULT: 375-750mg twice daily CHILDREN GI disturbances, phlebitis, skin rashes, History of allergic reaction to any Allopurinol, Anticoagulants, Overgrowth of non-susceptible organism. Sodium 375 mg Tablet infections AND INFANTS: 25-50mg/kg/day in 2 itching, blood disorders, anaphylaxis and penicillins Bacteriostatic drugs, Estrogen- Check periodically for organ system divided doses, if ≥ 30kg use an adult dose superinfection containing oral contraceptives, dysfunction during prolong therapy Methotrexate, Probenecid Anastrozole 1 mg Tablet A* Hormonal therapy in breast cancer in 1 mg daily Hot flashes, asthenia, peripheral Hypersensitivity to anastrazole, Oestrogens, tamoxifen Hyperlipidemia, moderate to severe post-menopausal women if failed oedema, vaginal bleeding, deep vein pregnancy. Not indicated for hepatic impairment, severe impairment /contraindicated with Tamoxifen thrombosis, arthralgia, backpain, cough, premenopausal women of renal function (creatinine clearance dypsnea, headache, nausea, rash, less than 20 mL/min). Lowers circulating hypercholesterolaemia oestrogen levels which may cause a reduction in bone mineral density

Aripiprazole 10mg Tablet A* i) Treatment of acute episodes of Schizophrenia: 10 or 15 mg/day. Insomnia, restlessness, headache, Patients who are hypersensitive to Enhance effect of antihypertensive Suicide, tardive dyskinesia, neuroleptic schizophrenia and for maintenance of Maintenance dose: 15 mg/day. dizziness, akathisia, somnolence, aripiprazole or to any of the excipients. agents, alcohol, quinidine, malignant syndrome, seizure disorder, clinical improvement during continuation Bipolar mania: Starting dose: 15 or 30 sedation, tremor, extrapyramidal ketoconazole, carbamazepine diabetes mellitus, CV disease, therapy. mg/day. Dose adjustment should occur disorder, blurred vision, tachycardia, cerebrovascular disease, dementia- ii) Treatment of acute manic episodes at intervals of not less than 24 hour orthostatic hypotension, nausea, related psychosis and CV adverse events associated with bipolar I disorder vomiting, constipation, dyspepsia, in elderly. May disrupt body's ability to asthenia/fatigue, weight gain, anxiety increase/reduce core body temperature. diabetic ketoacidosis , neuroleptic Dysphagia, pregnancy & lactation. May malignant syndrome, seizure, peripheral impair ability to drive or operate oedema machinery. Safety and efficacy have not been established in children less than 13 years of age

Artificial tears/eye lubricant B Symptomatic relief of severe dry eye Instill 1-2 drops in affected eye(s) as Burning, stinging, allergic reactions, red Hypersensitivity to hypromellose or Unknown Avoid contamination of the applicator tip ophthalmic gel conditions and as lens lubricant during needed. Refer to product information eyes, blurred vision, raised intraocular carbomer through contact, self-prescribed use as ophthalmic diagnostic procedures leaflet. pressure, sticking of eyelids (discharge). an ocular lubricant should not exceed 3 days ,treat emergent elevations of intraocular pressure. Studies in children have not been performed

Ascorbic Acid 100 mg Tablet C+ Vitamin C deficiency ADULT: 100-250 mg once or twice daily In large doses, gastrointestinal History of hyperoxaluria Antacids, aspirin, contraceptives Use cautiously in patients with CHILD: 100 mg three times daily for one disturbances, renal calcium oxalate combination, cyanocobalamin, preexisting kidney stone disease, week followed by 100mg daily until calculi formation deferoxamine, gentamicin, erythrocyte G6PD deficiency, symptoms abate. haloperidol, iron, levodopa, haemochromatosis, thalassaemia or methotrexate, warfarin sideroblastic anaemia and avoid rapid intravenous injections

Asenapine 10mg Sublingual Tablet A* For second or third line treatment in i) Schizophrenia: - Acute treatment in Akathisia, oral hypoesthesia, Hypersensitivity to asenapine. Other centrally-acting drugs. May Cerebrovascular adverse events, adult for: adults: Recommended starting and somnolence, dizziness, extrapyramidal enhance the effect of certain dementia-related psychosis, neuroleptic i) Schizophrenia target dose of asenapine is 5mg given symptoms other than akathisia, weight antihypertensive agents. malignant syndrome, tardive dyskinesia, ii) Bipolar Disorder - Monotherapy: Acute twice daily. - Maintenance dose: 5mg gain, dysgeusia, oral hypoesthesia, Fluvoxamine. Co-administration hyperglycemia & diabetes mellitus. treatment of manic or mixed episodes twice daily. ii) Bipolar Disorder: - dystonia. with CYP2D6 substrates & Monitor weight regularly. associated with Bipolar I disorder. - Monotherapy: 10mg twice daily. inhibitors. Alcohol. Hypersensitivity reaction such as Adjunctive therapy: As adjunctive Adjunctive therapy: 5mg twice daily with anaphylaxis, angioedema, hypotension, therapy with either lithium or valproate lithium or valproate. Dose can be tachycardia, swollen tongue, dyspnea, for the acute treatment of manic or increased to 10mg twice daily based on wheezing and rash. Orthostatic mixed episodes associated with Bipolar I clinical response. hypotension, syncope & other Disorder. hemodynamic effects. Leukopenia, neutropenia & agranulocytosis. History of cardiac arrhythmias. Hyperprolactinemia, seizures. Conditions that may contribute to an elevation in core body temp. Suicide, dysphagia. Hepatic impairment. May impair ability to drive or operate machinery. Pregnancy & lactation. Children <18 yr, elderly. Asenapine 5mg Sublingual Tablet A* For second or third line treatment in i) Schizophrenia: - Acute treatment in Akathisia, oral hypoesthesia, Hypersensitivity to asenapine. Other centrally-acting drugs. May Cerebrovascular adverse events, adult for: adults: Recommended starting and somnolence, dizziness, extrapyramidal enhance the effect of certain dementia-related psychosis, neuroleptic i) Schizophrenia target dose of asenapine is 5mg given symptoms other than akathisia, weight antihypertensive agents. malignant syndrome, tardive dyskinesia, ii) Bipolar Disorder - Monotherapy: Acute twice daily. - Maintenance dose: 5mg gain, dysgeusia, oral hypoesthesia, Fluvoxamine. Co-administration hyperglycemia & diabetes mellitus. treatment of manic or mixed episodes twice daily. ii) Bipolar Disorder: - dystonia. with CYP2D6 substrates & Monitor weight regularly. associated with Bipolar I disorder. - Monotherapy: 10mg twice daily. inhibitors. Alcohol. Hypersensitivity reaction such as Adjunctive therapy: As adjunctive Adjunctive therapy: 5mg twice daily with anaphylaxis, angioedema, hypotension, therapy with either lithium or valproate lithium or valproate. Dose can be tachycardia, swollen tongue, dyspnea, for the acute treatment of manic or increased to 10mg twice daily based on wheezing and rash. Orthostatic mixed episodes associated with Bipolar I clinical response. hypotension, syncope & other Disorder. hemodynamic effects. Leukopenia, neutropenia & agranulocytosis. History of cardiac arrhythmias. Hyperprolactinemia, seizures. Conditions that may contribute to an elevation in core body temp. Suicide, dysphagia. Hepatic impairment. May impair ability to drive or operate machinery. Pregnancy & lactation. Children <18 yr, elderly.

Atenolol 100 mg Tablet B Hypertension, angina pectoris, Hypertension and arrythmias; 50 - 100 Chronic heart failure, AV block, Hypersensitivity to atenolol products, Clonidine, catecholamine-depleting Avoid abrupt withdrawal; gradual myocardial infarction and arrhythmias mg daily, bradycardia, bronchospasm, dizziness, bradycardia, 2nd and 3rd degree AV agents, beta-blockers withdrawal over a period of 1 to 2 weeks Angina; 100 mg daily, vertigo, nausea, fatigue, diarrhoea block overt cardiac failure, cardiogenic is recommended. Bronchospastic Myocardial infarction; individualised shock, metabolic acidosis, severe disease, congestive heart failure, peripheral circulatory disturbances, sick diabetes mellitus, sinus syndrome hyperthyroidism/thyrotoxicosis. Patients receiving clonidine - discontinue atenolol several days prior to withdrawal of clonidine. Peripheral vascular and renal disease

Atorvastatin 20 mg Tablet A/KK Hypercholesterolaemia and coronary 10 mg once daily. Maximum: 80 mg daily Gastrointestinal disturbances, headache, Liver disease, hypersensitivity to Risk of myopathy increased with Heavy alcohol use, history of liver heart disease intolerant or not myalgia, asthenia, insomnia, atorvastatin, pregnancy or lactation concurrent administration of disease. Discontinue therapy if serum responsive to other forms of therapy angioneurotic oedema, muscle cramps, cyclosporin, fibric acid derivatives, transaminase levels rise to 3 times upper myostitis, myopathy, cholestatic erythromycin, niacin or azole limit of normal and are persistent. This jaundice, peripheral neuropathy, antifungals. Decreased atorvastatin class of drug has been known to cause pruritus. Cognitive impairment (e.g. plasma concentration with oral myopathy and renal failure due to memory loss, forgetfulness, amnesia, antacid suspensions containing rhabdomyolysis. Concomitant memory impairment, confusion), magnesium and aluminium administration of fibrates, niacin, increase in HbA1c and fasting blood hydroxides and colestipol cyclosporin or erythromycin may glucose. increase the risk of myopathy Atorvastatin 40 mg Tablet A/KK Hypercholesterolaemia and coronary 10 mg once daily. Maximum: 80 mg daily Gastrointestinal disturbances, headache, Liver disease, hypersensitivity to Risk of myopathy increased with Heavy alcohol use, history of liver heart disease intolerant or not myalgia, asthenia, insomnia, atorvastatin, pregnancy or lactation concurrent administration of disease. Discontinue therapy if serum responsive to other forms of therapy angioneurotic oedema, muscle cramps, cyclosporin, fibric acid derivatives, transaminase levels rise to 3 times upper myostitis, myopathy, cholestatic erythromycin, niacin or azole limit of normal and are persistent. This jaundice, peripheral neuropathy, antifungals. Decreased atorvastatin class of drug has been known to cause pruritus. Cognitive impairment (e.g. plasma concentration with oral myopathy and renal failure due to memory loss, forgetfulness, amnesia, antacid suspensions containing rhabdomyolysis. Concomitant memory impairment, confusion), magnesium and aluminium administration of fibrates, niacin, increase in HbA1c and fasting blood hydroxides and colestipol cyclosporin or erythromycin may glucose. increase the risk of myopathy

Azathioprine 50 mg Tablet A i) Prophylaxis of rejection in organ and i) Adult: 1-5 mg/kg/day. Adjust dose Viral, fungal and baterial infections in Contraindicated to patient with known Allopurinol, neuromascular blocking Monitor complete blood count including tissue transplant according to clinical response and transplant patients receiving sensitivity to azathioprine, agents, warfarin, cytostatic or drug platelet, evidence of infection, ii) Auto-immune diseases haematological tolerance. Dose may also azathioprine in combination with other hypersensitivty to cyclophosphamide, which may have myelosuppressive unexpected bruising or bleeding or other iii) Rheumatoid arthritis be given via IV administration. immunosuppresants, depression of bone patient who are pregnant or likely to effects (eg. Penicillamine), manisfestations of bone marrow ii) Adult: 1-3 mg/kg/day. Discontinue marrow function; leucopenia, become pregnant and lactation. aminosalicylates derivate (eg depression. treatment if there is no improvement thrombocytopenia, nausea. olsalazine, mesalazine or after 12 week. sulfasalazine), frusemide, vaccines. iii) Adult: Initially, 1 mg/kg/day given in 1- 2 divided doses for 6-8 week, may increase by 0.5 mg/kg every 4 week until response or up to 2.5 mg/kg/day. Maintenance: Reduce dose gradually to achieve the lowest effective dose.

Azithromycin 250 mg Tablet A* Category of prescriber A/KK is only i) 1 g as a single dose; Nausea, abdominal discomfort, vomiting, Known hypersensitivity to azithromycin Antacids, ergot derivatives. Moderate or severe renal impairment, approved for indication (i): ii) 500 mg daily for 3 days; flatulence, diarrhoea & loose stools. or any of the macrolides Monitor patients on concurrent liver impairment, pregnancy & lactation (i) Adult treatment of uncomplicated iii) 1 g weekly Hearing impairment, interstitial nephritis, warfarin, digoxin or cIclosporin. genital infections due to Chlamydia acute renal failure, abnormal liver trichomatis or susceptible Neisseria function, dizziness & vertigo, convulsions, gonorrhoea. headache, somnolence. Cardiac The following indication is still under disorders: palpitations, arrhythmia, category of prescriber A*: supraventricular tachycardia, QT (ii) Treatment of complicated respiratory prolongation, torsades de pointes. Skin tract infection not responding to and subcutaneous tissue disorders: standard macrolides; allergic reactions, erythema multiforme, (iii) Prophylaxis against Mycobacterium Steven-Johnson Syndrome, toxic avium complex in patients with advanced epidermal necrolysis, drug reaction with HIV. eosinophilia and systemic symptoms (DRESS), Severe cutaneous adverse reactions (SCARs).

Baclofen 10 mg Tablet B Spasticity of the skeletal muscle ADULT: 5 mg 3 times daily. Max: 80 mg Daytime sedation, drowsiness, nausea Epilepsy and other convulsive conditions, Tricyclics and lithium enhance Pregnancy, patients suffering not only daily. CHILD: 0.75 - 2 mg/kg daily (more and other central nervous system corticol or subcorticol brain damage, muscle relaxant effect, ACE from spasticity but also from psychotic than 10 years, maximum: 2.5 mg/kg disorders, gastrointestinal disturbances, peptic ulceration, known hypersensitivity inhibitor, diuretics and disorders, schizophrenia or confusional daily) dysuria, frequency of micturition, to baclofen antihypertensives enhance states, epilepsy, cerebrovascular or enuresis or retention of urine, respiratory hypotensive effect. Sedative effect respiratory insufficiency. Central nervous depression enhanced with alcohol, anxiolytics system depressants, antihypertensives, and hypnotics. Excretion reduced levodopa. Caution in road users. Avoid by ibuprofen and possibly other abrupt discontinuation NSAIDs Benzhexol 2 mg Tablet B i) Parkinson's disease ii) Drug induced ADULT: Initially 1 mg daily, increase Severe mental disturbances, confusion, Children under 3 years, narrow-angle Alcohol and central nervous system Autonomic neuropathy, heart disease, parkinsonism iii) Dystonias gradually. Maintenance: 5 - 15 mg daily drowsiness, restlessness, hallucinations, glaucoma, closed-angle glaucoma, depressants may increase the hepatic or renal disease, in 3 - 4 divided doses. (Max 15mg/day) excitement, nausea and vomiting, dry tardive dyskinesias, prostatic sedative effect of benzhexol. hyperthyroidism, paediatric, elderly, mouth, blurring of vision, constipation, enlargement, paralytic ileus, chronic Delayed absorption of other oral potential for abuse, prostatic urinary retention, glaucoma pulmonary disease, sick sinus syndrome, drugs hypertrophy, glaucoma, obstructive thyrotoxicosis, cardiac failure with disease of gastrointestinal or tachycardia. genitourinary, pregnancy and lactation. Use with caution in patients with ileostomy or colostomy. Avoid driving or hazardous activities. Monitor intraocular pressure

Betahistine Dihydrochloride 24 mg A* i) Meniere's Syndrome as defined by the 24-48mg in divided doses daily Nausea and dyspepsia (indigestion), Hypersensitivity to the active substance Monoamino-oxidase (MAO It should be given with caution in Tablet following core symptoms: - Vertigo (with cutaneous (skin) and sub cutaneous or to any of the excipients. inhibitors) patients with phaeochromocytoma. nausea/vomiting). - Hearing loss (tissues under the skin) hypersensitivity Pregnancy, lactation. (Hardness of hearing). - Tinnitus (ringing (allergic) reactions have been reported, in the ears) ii)Symptomatic treatment of angioneurotic oedema, urticaria rash and vestibular vertigo pruritus, mild gastric complaints (eg. Vomiting, gastrointestinal pain, abdominal distension and bloating).

Bicalutamide 50 mg Tablet A* Androgen deprivation therapy in 50 mg once daily. (morning or evening), GI disturbances, hot flushes, pain, i. Females, children, pregnancy and Enhanced coumarin anticoagulants Moderate to severe hepatic impairment advanced prostate cancer in combination with or without food. Take on the same Nausea, vomiting, diarrhoea, asthenia, lactation ii. Hypersensitivity iii. effect, cimetidine, ketoconazole, with luteinising hormone-releasing time each day. Adult: When used with gynaecomastia, breast tenderness, Concomitant administration with cyclosporin and Ca-channel hormone (LHRH) analogue therapy or gonadorelin analogue: Usual dose: 50 mg pruritus, dry skin, alopecia, hirsutism, terfenadine, astemizole or cisapride. blockers surgical castration. once daily. May be started with or at decreased libido, impotence, weight gain least 3 days before starting gonadorelin analogue therapy.

Bisacodyl 5 mg Tablet C i) Constipation ii) Bowel preparation for i) ADULT and CHILD over 10 years 5-10 Rarely,electrolyte and fluid imblances, Ileus, intestinal obstruction, acute Milk, antacids, warfarin Prolonged use, abdominal pain, radiological procedures and surgery mg, CHILD 4-10 years 5 mg. To be taken abdominal discomfort, diarrhoea, rectal abdominal conditions, rectal bleeding, inflammatory bowel disease, sudden, at night for effect on the following burning, vomiting appendicitis persistent change in bowel habits morning ii) ADULT 10-20 mg the night before procedures, CHILD over 4 years 5 mg the night before procedures

Bisoprolol Fumarate 2.5 mg Tablet B Treatment of stable moderate to severe 1.25 mg once daily to 5 - 10 mg daily Arrythmia, bradycardia, chest pain, Hypersensitivity, cardiac failure, Prazosin, digoxin, amiodarone, Avoid abrupt withdrawal; gradual congestive cardiac failure in addition to oedema, hypotension, dizziness, pulmonary oedema, pregnancy, severe ACEI, antidiabetic agent, calcitriol, withdrawal over a period of 1 to 2 weeks ACEI's and diuretics headache, fatique, diarrhoea, nausea, asthma or severe chronic obstructive cholestyramine, clonidine is recommended. Bronchospastic impotency, cough, rhinitis pulmonary disease, hypotension disease, congestive heart failure, diabetes mellitus, hyperthyroidism/thyrotoxicosis. Peripheral vascular and renal disease

Bisoprolol Fumarate 5 mg Tablet B Treatment of stable moderate to severe 1.25 mg once daily to 5 - 10 mg daily Arrythmia, bradycardia, chest pain, Hypersensitivity, cardiac failure, Prazosin, digoxin, amiodarone, Avoid abrupt withdrawal; gradual congestive cardiac failure in addition to oedema, hypotension, dizziness, pulmonary oedema, pregnancy, severe ACEI, antidiabetic agent, calcitriol, withdrawal over a period of 1 to 2 weeks ACEI's and diuretics headache, fatique, diarrhoea, nausea, asthma or severe chronic obstructive cholestyramine, clonidine is recommended. Bronchospastic impotency, cough, rhinitis pulmonary disease, hypotension disease, congestive heart failure, diabetes mellitus, hyperthyroidism/thyrotoxicosis. Peripheral vascular and renal disease Bromhexine HCl 8 mg Tablet C Secretolytic therapy in acute and chronic Adult: 8-16 mg three times daily. Gastrointestinal ulceration Hypersensitivity to bomhexine May lead to higher antibiotic Gastrointestinal ulceration, pregnancy bronchopulmonary diseases associated Children: By body weight: 0.3 mg/kg/day concentration in lung tissue. Oral and lactation with abnormal mucous secretion and 8 hourly for 7 days, then 0.15 mg/kg/day anticoagulants impaired mucous transport. 8 hourly; or Based on age: 6-12 years – 4 Prescribing Restriction(s): Medical mg three times daily; 2-6 years – 2 mg Assistant in health settings without three times daily Medical Officer is allowed to prescribe this medicine for adult use only.

Bumetanide 1mg Tablet A* Oedema used in furosemide allergic Adult: 1mg in the early evening (up to Hypokalemia, hyperuricemia, muscle Hypersensitivity to bumetanide products, Angiotensin converting enzyme Alterations in glucose metabolism, blood patient. 5mg daily in severe case) cramps, arthralgias anuria, sesvere electrolyte imbalance, inhibitors: postural hypotension dyscrasias (thrombocytopenia), hepatic (Refractory fluid overload not hepatic coma (first dose). Digoxin: digoxin toxicity disease, hyperuricemia, hypokalemia, responding to Frusemide in CKD patient - (nausea, vomiting, cardiac hypovolemis, ototoxicity particularly Dr. Shahnon Only) arrhythmias). Gentamicin: potentiation of aminoglycoside ototoxicity. ototoxicity, coadministration not recommended

Cabergoline 0.5 mg Tablet A* i) Treatment of hyperprolactinaemic i)0.5mg per week given in 1 or 2 (one-helf Dizziness, vertigo, headache, nausea and Hypersensitivity to cabergoline, any Dopamine-antagonist (Eg Severe cardiovascular disease, Raynaud's disordersii) Prevention of puerperal of one 0.5mg tablet) doses per week abdominal pain, palpitation, epigastric other component of the product or any phenothiazines, butyrophenones, syndrome, peptic ulcer or lactation and suppression of lactation in ii) HIV mothers only : Prevent lactation 2 pain, somnolence, vomiting, syncope, ergot alkaloids. History of pulmonary, thioxanthenes, metoclopramide), gastrointestinal bleeding, or with a HIV infected mothers only tab first day after delivery. Interruption asthenia, hot flushes, breast pain, pericardial and retroperitoneal fibrotic macrolide antiboitics history of serious pyschotic, mental of laction : 0.25mg 12 hourly for 2 days fatigue, dyspepsia, gastritis, constipation, disorders, anatomical evidence of cardiac disorder, postural hypotension, fibrosis, breast pain, depression, paresthesia valvulopathy valvulopathy

Calcitriol 0.25 mcg Capsule A/KK i)Established postmenopausal i) 0.25 mcg 2 times daily Weakness; headache; somnolence; Hypercalcaemia; evidence of vitamin D Patients on digitalis, Monitor serum calcium, phosphorus, osteoporosis ii) Initial dose 0.25 mcg. In patients with nausea; vomiting; dry mouth; toxicity. Pregnancy (dose exceeding cholestyramine, colestipol, magnesium and alkaline phosphatase, ii) Renal osteodystrophy in patients on normal or only slightly reduced serum constipation; muscle pain; bone pain; RDA). Lactation. phenytoin, barbiturates, thiazide urinary calcium and phosphorus. Patients haemodialysis calcium levels, doses of 0.25 mcg every metallic taste; polyuria; polydipsia; diuretics. on digitalis. Pregnancy and lactation. iii)Hypoparathyroidism and rickets other day is sufficient anorexia; irritability; weight loss; Take care to ensure correct dose to iv)Secondary hyperparathyroidism in iii) 0.25 mcg/day given in the morning nocturia; mild acidosis; reversible infants, monitor plasma calcium and renal failure iv) ADULT and CHILD 3 years and older : azotemia; generalized vascular creatinine during dosage titration. Initially 0.25 mcg/ml. CHILD less than 3 calcification; nephrocalcinosis; Idiopathic hypercalcaemia, coronary years : 10 to 15 ng/kg/day conjunctivitis (calcific); pancreatitis; disease, renal function impairment and photophobia; rhinorrhoea; pruritus; arteriosclerosis, especially in the elderly, hyperthermia; decreased libido; elevated hypoparathyroidism and immobilized BUN; albuminuria; patients. Pediatric doses must be hypercholesterolaemia; elevated AST and individualised and monitored under close ALT; ectopic calcification; hypertension; medical supervision. cardiac arrhythmias.

Calcium Carbonate 500 mg Tablet B To be used only for: a) a) Hyperphosphatemia: i) Stage 3 to 5 Gastrointestinal irritation, constipation, Patients with calcium renal calculi or Co-administration with thiazide Renal impairment, hypercalcaemia- Hyperphosphatemia (phosphate binding chronic kidney disease, total dose flatulence, gastric hypersecretion and history of renal calculi, hypercalcaemia, diuretics or vitamin D may lead to associated disease eg, other activity) in patients with chronic renal of†elemental†calcium from all sources acid rebound, hypercalcaemia, alkalosis hypophosphataemia milk-alkali syndrome and malignancies, sarcoidosis, elderly failure b) Calcium supplementation (ie, dietary and calcium-based phosphate and renal dysfunction hypercalcaemia. Decreased binder) not to exceed 2,000 mg/day ii) absorption with corticosteroids. Stage 5 chronic kidney disease, total dose Decreases absorption of of†elemental†calcium from calcium- tetracyclines, atenolol, iron, based phosphate binder not to exceed quinolones, alendronate, natrium 1,500 mg/day b) Calcium fluoride, zinc and calcium-channel supplementation 1,000-2,500mg blockers. Enhances cardiac effects elemental calcium per day in divided of digitalis glycosides and may doses (500mg tablet contains 200mg precipitate digitalis intoxication elemental calcium) Calcium Lactate 300 mg Tablet C For prophylaxis of calcium deficiency and ADULT 1-5 g daily in divided doses Mild gastrointestinal disturbances, Ventricular fibrillation during cardiac Allopurinol, aspirin, chlorothiazide, Calcium enhances the effect of cardiac treatment of chronic hypocalcaemia bradycardia, arrhythmias resuscitation, hypercalcaemia, ciprofloxacin, digoxin, doxycycline, glycosides on the heart and may hypercalciuria, severe renal failure hydrochlorothiazide, itraconazole, precipitate arrhythmias. In large doses, ketoconazole, levothyroxine, monitor serum calcium concentration metolazone, minocycline, and kidney function weekly, renal norfloxacin, ofloxacin, impairment, history of renal stones oxytetracycline, pefloxacin, tetracycline, ticlopidine, verapamil, zalcitabine

Capecitabine 500 mg Tablet A* 1) Metastatic breast cancer; i) & ii) 1250 mg/m2 twice daily (morning Myelosuppression, oedema, fatigue, i. hypersensitivity to capecitabine, Warfarin, phenytoin, leucovorin Patient with bone marrow suppression, 2) Treatment of colorectal cancer in and evening) for 2 weeks, every 21 days fever, anaemia, abdominal pain, palmar- fluorouracil or any component of poor nutritional status, elderly patients adjuvant and metastatic setting; iii) Recommended for a total of 24 weeks plantar erythrodysesthesia, dermatitis, formulation (more than 80 years), hepatic or renal 3) Advanced oesophagogastric cancer in (8 cycles of 2 weeks of drug nausea and vomiting, stomatitis, ii. severe renal impairment dysfunction, pregnancy and lactation. combination with a platinum-based administration and 1 week rest period anorexia, diarrhoea, constipation, iii. pregnancy, lactation iv. regimen. iv) In combination with a platinum on day paraesthesia, conjunctivitis, eye contraindicated in patients with known 1, give capecitabine 1250 mg/m2 twice irritation. dihydropyrimidine dehydrogenase (DPD) daily for 14 days. Repeated every 3 deficiency. weeks for 8 cycles or optimum number of cycles

Captopril 25 mg Tablet B i) Hypertension i) Initially 12.5 mg twice daily. Rash, pruritus, flushing, angioedema, loss Angioedema induced by other May increase serum K with Kalium Anaphylaxis during lipid apheresis with ii) Congestive heart failure Maintenance: 25-50 mg 2 - 3 times daily, of taste perception, stomatitis, angiotensin converting enzyme (ACE) K-sparing diuretics. Hypotensive dextran sulfate membranes and during iii) Post-myocardial infarction may be increased to maximum 450 gastrointestinal irritation and abdominal inhibitors during prior exposure. Anuric effects enhanced by diuretics. hymenoptera desensitization, iv) Diabetic nephropathy mg/day in divided doses pain, leucopenia, persistent dry (non- renal failure during prior exposure to ACE Antihypertensive effect diminished angioedema; discontinue if laryngeal ii) Initially 6.25 - 12.5 mg 3 times daily, productive) cough, hypotension, inhibitors. Hypersensitivity to this or any by indomethacin, salicylates, stridor or angioedema of the face, increase after several days to 25 - 50 mg tachycardia, chest pain, palpitations, other ACE inhibitor. Pregnancy (second NSAIDs tongue, or glottis is observed, aortic 3 times daily pruritus, hyperkalaemia. Proteinuria; and third trimester pregnancy) stenosis, breast feeding period, cough, iii) Start 3 days after MI Initially 6.25 mg Potentially Fatal: Neutropenia, usually impaired renal function daily, gradually increased to 37.5 mg occurs within 3 mth of starting therapy daily in divided doses. May increase after especially in patients with renal several week to 150 mg/day in divided dysfunction or collagen diseases. doses if needed and tolerated Hyperkalaemia. Anaphylactic reactions. iv)75 - 100 mg daily in divided dose. Carbamazepine 200 mg CR Tablet A Epilepsy ADULT: Initial, 200 mg twice daily for the Rash, Stevens-Johnson Syndrome, Hypersensitivity to carbamazepine Plasma level is increased by Breast feeding, pregnancy, liver or kidney first week, may increase dosage by 200 nausea, drowsiness, dizziness, ataxia, products or tricyclic compounds, bone erythromycin, diltiazem, isoniazid, dysfunction, increased intraocular mg/day at weekly intervals until optimal blood dyscrasias, confusion, agitation, marrow suppression, porphyria. verapamil, fluoxetine, cimetidine pressure, history of cardiac damage, response is obtained. Maximum 1.6 visual disturbance, constipation or Concomitant MAOIs and decreased by other elderly patients, glaucoma, may g/day. CHILD: Usual maximum dosage diarrhoea, anorexia, leukopenia, blood antiepileptics and theophylline. exacerbate certain types of idiopathic 1000 mg/day in children 12-15 years of disorders, Syndrome of inappropriate May reduce alcohol tolerance and epilepsy. Initial and periodic complete age, 1200 mg/day in patients above 15 ADH (SIADH), cardiac conduction antagonise the effects of non- blood counts, liver function tests and years of age abnormalities, gynaecomastia. Allergic depolarising muscle relaxants. urinalysis. Monitor plasma levels. History skin reactions, vomiting, accommodation Cytochrome P450 3A4 inducers or haematological reactions. disorders, diplopia, raised liver enzymes, inhibitors, oral contraceptive Road/machinery users. Increased thrombocytopenia and hyponatraemia, intraocular pressure, latent psychosis, exfoliative dermatitis confusion, agitation. Mixed seizure disorders. Elderly. Avoid abrupt discontinuation. Neonatal withdrawal syndrome. Potential for an increase in risk of suicidal thoughts or behaviours

Carbamazepine 200 mg Tablet B i) Epilepsy i) ADULT: 100 - 200 mg 1 - 3 times daily Rash, Stevens-Johnson Syndrome, Hypersensitivity to carbamazepine Plasma level is increased by Breast feeding, pregnancy, liver or kidney ii) Trigeminal neuralgia increased gradually to usual dose of 0.8 - nausea, drowsiness, dizziness, ataxia, products or tricyclic compounds, bone erythromycin, diltiazem, isoniazid, dysfunction, increased intraocular 1.2 g daily in divided doses. blood dyscrasias, confusion, agitation, marrow suppression, porphyria. verapamil, fluoxetine, cimetidine pressure, history of cardiac damage, CHILD: Up to 1 year: 100 - 200 mg daily; 1 visual disturbance, constipation or Concomitant MAOIs, pregnancy and decreased by other elderly patients, glaucoma, may - 5 yrs: 200 - 400 mg daily; 5 - 10 years: diarrhoea, anorexia, leukopenia, blood antiepileptics and theophylline. exacerbate certain types of idiopathic 400 - 600 mg daily; 10 - 15 years: 0.6 - 1 g disorders, Syndrome of inappropriate May reduce alcohol tolerance and epilepsy. Avoid abrupt discontinuation. daily ADH (SIADH), cardiac conduction antagonise the effects of non- Neonatal withdrawal syndrome. ii) The initial dosage of 200 to 400mg abnormalities, gynaecomastia. Allergic depolarising muscle relaxants. Potential for an increase in risk of suicidal should be slowly raised daily until skin reactions, vomiting, accommodation Cytochrome P450 3A4 inducers or thoughts or behaviours freedom from pain is achieved (normally disorders, diplopia, raised liver enzymes, inhibitors, oral contraceptive at 200mg 3 to 4 times daily). The dosage thrombocytopenia and hyponatraemia, should then be gradually reduced to the exfoliative dermatitis lowest possible maintenance level. In elderly patients, an initial dose of 100mg twice daily is recommended.

Carbamazepine 400 mg CR Tablet A Epilepsy ADULT: Initial, 200 mg twice daily for the Rash, Stevens-Johnson Syndrome, Hypersensitivity to carbamazepine Plasma level is increased by Breast feeding, pregnancy, liver or kidney first week, may increase dosage by 200 nausea, drowsiness, dizziness, ataxia, products or tricyclic compounds, bone erythromycin, diltiazem, isoniazid, dysfunction, increased intraocular mg/day at weekly intervals until optimal blood dyscrasias, confusion, agitation, marrow suppression, porphyria. verapamil, fluoxetine, cimetidine pressure, history of cardiac damage, response is obtained. Maximum 1.6 visual disturbance, constipation or Concomitant MAOIs, pregnancy and decreased by other elderly patients, glaucoma, may g/day. CHILD: usual maximum dosage diarrhoea, anorexia, leukopenia, blood antiepileptics and theophylline. exacerbate certain types of idiopathic 1000 mg/day in children 12-15 years of disorders, Syndrome of Inappropriate May reduce alcohol tolerance and epilepsy. Initial and periodic complete age, 1200 mg/day in patients above 15 ADH (SIADH), cardiac conduction antagonise the effects of non- blood counts, liver function tests and years of age abnormalities, gynaecomastia. Allergic depolarising muscle relaxants. urinalysis. Monitor plasma levels. History skin reactions, leukopenia, vomiting, Cytochrome P450 3A4 inducers or haematological reactions. accommodation disorders, diplopia, inhibitors, oral contraceptive Road/machinery users. Increased raised liver enzymes, thrombocytopenia intraocular pressure, latent psychosis, and hyponatraemia, exfoliative confusion, agitation. Mixed seizure dermatitis disorders. Elderly. Avoid abrupt discontinuation. Neonatal withdrawal syndrome. Potential for an increase in risk of suicidal thoughts or behaviours

Carbimazole 5 mg Tablet B Hyperthyroidism ADULT: Initially, 10-60mg daily in divided Skin rashes, nausea, headache, Blood dyscrasias, hypersensitivity, Concurrent use of digoxin and Liver disorders, pregnancy (discontinue 3- doses given 8 hourly. Maintenance: 5 to gastrointestinal disturbances, hepatic tracheal obstruction carbimazole may result in 4 weeks before delivery), lactation 20mg daily. disorders, neutropenia, agranulocytosis. decreased peak serum levels of CHILDREN > 6 years: Initially 15mg daily Rarely, pancytopenia / aplastic anaemia, digoxin. Antithyroid drugs, by in divided doses. CHILDREN 1-6 years: haemolytic anaemia reducing the extent of Initially 7.5mg daily in divided doses hyperthyroidism, decrease the metabolism of clotting factors and thus reduce the effects of oral anticoagulants Carvedilol 6.25 mg Tablet A/KK Treatment of stable moderate to severe 3.125 mg twice daily for 2 weeks, then Bradycardia, syncope, Dizziness, Hypersensitivity to carvedilol, asthma, Hypotensive effects potentiated by Avoid abrupt withdrawal, gradual congestive cardiac failure in addition to 6.25 mg twice daily for 2 weeks, then headache, tiredness, gastrointestinal bradycardia, 2nd and 3rd degree AV adrenergic neurone-blocking drugs, withdrawal over a period of 1 to 2 weeks ACEI's and diuretics 12.5 mg twice daily for 2 weeks then 25 disorders, flu-like symptoms block, cardiogenic shock overt cardiac catecholamine depletors, central is recommended. Bronchospastic mg twice daily (titrated up to the highest failure, obstructive airway disease, nervous system depressants, disease, congestive heart failure, tolerated level). Max: <85 kg: 25 mg bid; severe chronic heart failure and hepatic diuretics and vasodilators. Action diabetes mellitus >85 kg: 50 mg bid. impairment decreased by rifampicin. Concurrent administration with cardiac glycosides may cause a sharp drop in heart rate

Cefuroxime Axetil 125 mg Tablet A/KK Upper and lower respiratory tract, genito- ADULT: 250 mg twice daily ;UTI: 125 mg GI disturbances occasionally Hypersensitivity to cephalosporins Drugs which reduce gastric acidity, Anaphylactic reaction to penicillins, urinary tract, skin & soft tissue and twice daily. pseudomembraneous colitis, such as proton pump inhibitors and Severe renal impairment; pregnancy, urinary tract infections (UTI) CHILD:30 mg/kg/day in 2 divided doses, hypersensitivity reactions, eosinophilia, H2 antagonists lactation up to 500 mg daily headache, superinfection

Celecoxib 200 mg Capsule A i) Osteoarthritis ii) Rheumatoid Arthritis i) ADULTS: 200 mg once daily. May GI disorders, flatulence, insomnia, Hypersensitivity to celecoxib, allergic- Diuretics, anti-coagulants, Hypertension, cardiac conditions, iii) Acute pain iv) Ankylosing Spondylitis increase to 200 mg bid, if necessary. pharyngitis, sinusitis, dizziness, vertigo, type reaction to sulphonamides, aspirin sulphonylureas, captopril, liver/renal dysfunction, elderly, fluid CHILD not recommended ii) 100mg twice hearing disturbance, photosensitivity, or other nonsteroidal anti-inflammatory phenytoin, digoxin, fluconazole, retention, children, asthmatic, daily, increased if necessary to 200 mg 2 blood disorder, fluid retention, renal agents, ischaemic heart disease and lithium, antacids, aspirin, coagulation defects, pregnancy (third times daily; CHILD not recommended iii) failure, hepatic impairment, Steven- stroke patient glucocorticoids, warfarin trimester) 400mg as a single dose on first day Johnson syndrome, allergic reactions, followed by 200mg once daily on chest pain, oedema, hot flushes, flu-like subsequent days iv) Initial, 200 mg once symptoms. Gastric side effects are lesser daily or 100 mg twice daily; if no effect with this drug as compared to other after 6 weeks, may increase to max. 400 NSAIDs. mg daily in 1-2 divided doses. If no response following 2 weeks of treatment with 400 mg/day, consider discontinuation and alternative treatment

Cephalexin Monohydrate 250 mg B i) Respiratory tract infection, urinary tract i) 250 mg 6 hourly ii) 250 - 500 mg 6 GI disturbances, overgrowth of non- Hypersensitivity to cephalosporins Concurrent treatment with high Hypersensitivity to penicillins, renal Capsule infection ii) Complicated, recurrent or hourly iii) 1 - 1.5 g 3 times daily or 4 times susceptible organisms, hypersensitivity doses of cephalosporins& impairment, superinfection. Pregnancy chronic infections, bronchitis iii) daily. Maximum: 6 g/day Child: 25-100 reactions, reversible neutropenia aminoglycosides or potent diuretics and lactation Pneumonia mg/kg daily in divided doses. Max: 4 g may adversely affect renal function. daily. Probenecid may increase or prolong plasma level& toxicity of cephalosporins. Isolated reports of cephalexin decreasing the efficacy of oestrogen-containing oral contraceptives

Cetirizine HCl 10 mg Tablet B Urticaria, allergic dermatoses (insect ADULT and CHILD over 6 years:10 mg Somnolence, fatigue, headache and dry Hypersensitivity to cetirizine or Decreased cetirizine clearance Activities requiring mental alertness. bites, atopic eczema), perennial rhinitis, daily or 5 mg twice daily. Child 2-6 years: mouth, pharyngitis, abdominal pain, hydroxyzine, not to be used in children resulting in elevated cetirizine Concurrent use of central nervous allergic rhinitis 5 mg once daily or 2.5 mg twice daily coughing, diarrhoea, epistaxis, less than 2 years of age. serum concentrations and possibly system depressants. Renal insufficiency bronchospasm, nausea, vomiting, cetirizine toxicity with theophylline or hepatic dysfunction, elderly. To be used with caution and doctor's advice in children 2 to 6 years of age. Charcoal, Activated 250 mg Tablet C i) Diarrhoea and food poisoning ii) i) ADULT 0.5-1 g given 3-4 times daily. Black stools and gastrointestinal An unprotected airway, gastrointestinal Acarbose, carbamazepine, digoxin, Aspiration of charcoal, hydrocarbons, Reduce absorption of drugs, plant, CHILD half adult dose. ii) Need to be disturbances tract not anatomically intact frusemide, olanzapine, phenytoin; corrosive, imaging of gastroesophageal. inorganic poison and chemicals in dissolved in liquid (slurry consistency). decreased effectiveness of these Caution in patient at risk of poisoning cases ADULT and CHILD over 12 years: initial 30- drugs, reduce absorption of oral gastrointestinal obstruction 100 g or 1-2 g/kg; repeat initial dose as therapy and render their soon as possible or 20-50 g every 2-6 effectiveness, simultaneous oral hours. CHILD over 1-12 years, 25-50 g or therapy should be avoided. Clear 1-2 g/kg; may repeat half the initial dose activated charcoal from stomach every 2-6 hour as needed. CHILD to 1 /avoid its usage if methionine year of age, 1 g/kg; may repeat half the (specific oral antidote) is to be used initial dose every 2-6 hours as needed. For maximum efficacy administer within 1 hour after ingestion of toxic compound

Chlorpheniramine Maleate 4 mg C Symptomatic treatment of allergic ADULT : 4 mg every 4 - 6 hours. Drowsiness, dizziness, hypotension, CNS Hypersensitivity to chlorpheniramine, not Alcohol, CNS depressants, MAOIs, Prophyria, pregnancy, asthma, glaucoma Tablet conditions responsive to antihistamines Maximum 24 mg daily. CHILD 2 - 5 years : stimulation, tinnitus, blurred vision, to be used in children less than 2 years of anticholinergics drugs avoid operating vehicles or machinery, to 1 mg every 4 - 6 hours (maximum 6 mg irritability, lassitude age. be used with caution and doctor's advice daily) 6 - 12 years : 2 mg every 4 - 6 hours in children 2 to 6 years of age. (maximum 12 mg daily)

Chlorpromazine HCl 100 mg Tablet B Psychosis mania and agitation ADULT : Initial dose - 25 mg 3 times daily Postural hypotension, akathisia, tardive Hypersensitivity to chlorpromazine Alcohol, CNS depressant, Pregnancy and lactation, elderly, epilepsy according to response up to 1 g daily. dyskinesia, arrhythmias, constipation, products, phenothiazines, anticholinergic, tramadol, or history of seizure, impaired kidney and PAEDIATRIC: Up to 5 years: 0.5 mg/kg haematologic effects, agranulocytosis, myelosuppression, coma, severe CNS phenobarbitone, beta-blockers liver function, Parkinson's disease, severe body weight every 4 - 6 hours (Maximum aplastic anaemia, thrombocytopenia, depression, bone marrow depression (metoprolol, atenolol, propranolol), hypotension, hypothyroidism, cardiac 40 mg daily). CHILD 6 - 12 years: A third neuroleptic malignant syndrome, captopril,norepinephrine, failure, phaeochromocytoma, to half adult dose (Maximum 75 mg jaundice, agitation, insomnia, procyclidine, warfarin, epinephrine, myasthenia gravis & prostate daily) parkinsonism symptoms, drowsiness, cimetidine, ethanol, adrenaline, hypertrophy. Avoid in patient convulsion and tachycardia, acute antacids, amphetamine, hypersensitive to phenothiazines, history dystonia, leukopenia, angioedema, amiodarone, bumetamide, of narrow-angle glaucoma or bronchospasm, urticaria, chlorothiazides, clarithromycin, agranulocytosis. Monitor BP & complete hyperprolactinemia, eye, cardiac, skin & erythromycin, frusemide, blood count. Avoid exposure to sunlight subcutanoues tissue disorders, dry phenytoin, antiarrhythmics, mouth, respiratory depression, antidepressants & other neuroleptic malignant syndrome. Rarely antipsychotics, carbamazepine agranulocytosis, priapism

Chlorpromazine HCl 25 mg Tablet B Psychosis mania and agitation ADULT : Initial dose - 25 mg 3 times daily Postural hypotension, akathisia, tardive Hypersensitivity to chlorpromazine Alcohol, CNS depressant, Pregnancy and lactation, elderly, epilepsy according to response up to 1 g daily. dyskinesia, arrhythmias, constipation, products, phenothiazines, anticholinergic, tramadol, or history of seizure, impaired kidney and PAEDIATRIC: Up to 5 years: 0.5 mg/kg haematologic effects, agranulocytosis, myelosuppression, coma, severe CNS phenobarbitone, beta-blockers liver function, Parkinson's disease, severe body weight every 4 - 6 hours (Maximum aplastic anaemia, thrombocytopenia, depression, bone marrow depression (metoprolol, atenolol, propranolol), hypotension, hypothyroidism, cardiac 40 mg daily). CHILD 6 - 12 years: A third neuroleptic malignant syndrome, captopril,norepinephrine, failure, phaeochromocytoma, to half adult dose (Maximum 75 mg jaundice, agitation, insomnia, procyclidine, warfarin, epinephrine, myasthenia gravis & prostate daily) parkinsonism symptoms, drowsiness, cimetidine, ethanol, adrenaline, hypertrophy. Avoid in patient convulsion and tachycardia, acute antacids, amphetamine, hypersensitive to phenothiazines, history dystonia, leukopenia, angioedema, amiodarone, bumetamide, of narrow-angle glaucoma or bronchospasm, urticaria, chlorothiazides, clarithromycin, agranulocytosis. Monitor BP & complete hyperprolactinemia, eye, cardiac, skin & erythromycin, frusemide, blood count. Avoid exposure to sunlight subcutanoues tissue disorders, dry phenytoin, antiarrhythmics, mouth, respiratory depression, antidepressants & other neuroleptic malignant syndrome. Rarely antipsychotics, carbamazepine agranulocytosis, priapism Ciclosporin 25 mg Capsule A* Only for: i) Patients in whom donor i & ii) Initially 12.5 - 15 mg/kg/day, Nephrotoxicity, hepatotoxicity, gum Hypersensitivity to ciclosporin or any Etoposide, statins, vaccines, History of allergic reactions, pregnancy, specific transplantation cannot be carried beginning on the day before transplant. hyperplasia, hypertension, neurotoxicity, other component, rheumatoid arthritis or immunosuppressive drugs except monitor BP, serum electrolytes, renal and out and in young children to minimise Maintenance approx 12.5 mg/kg/day for convulsions, increased malignancy risk, psoriasis patients with abnormal renal corticosteroids, live vaccines, hepatic function, hypertension & side-effects of steroids ii) Follow-up cases 3 - 6 months before being tapered off to tremor, paraesthesia, hypertrichosis, function, uncontrolled hypertension, nephrotoxic drugs, NSAIDs, hepatic malignancies. Neoral and Sandimmun are of bone marrow transplant iii) Patients zero by 1 year of transplantation iii) 3 facial oedema, acne, gingival malignancies, uncontrolled infections in enzyme inducers. Increased not bioequivalent - dosage adjustments with severe rheumatoid arthritis not mg/kg/day in 2 divided doses for first 6 hypertrophy, hyperkalaemia, fluid rheumatoid arthritis patients, primary or ciclosporin level by diltiazem, and increased monitoring needed. responding to other second line drugs iv) weeks. May increased gradually to retention, increased susceptibility to secondary immunodeficiency in doxycycline, erythromycin, Increased risk for opportunistic infections Patients with idiopathic nephrotic maximum 5 mg/kg. Treatment infections, gastrointestinal symptoms rheumatoid arthritis patients, psoriasis ketoconazole, nicardipine, such as activation of latent viral syndrome who are steroid toxic or poor withdrawn if no response after 3 months patients receiving PUVA (psoralen plus verapamil, oral contraceptives. infections including BK virus -associated response to cyclophosphamide v) Severe iv) ADULT: 5 mg/kg/day in 2 divided ultraviolet A) or UVB (ultraviolet B) Drugs which reduce ciclosporin nephropathy aplastic anemia, pure red cell aplasia vi) doses. CHILD: 6 mg/kg/day in 2 divided therapy, methotrexate or other level are carbamazepine, isoniazid, Cases of recalcitrant psoriasis and atopic doses. Patients with permitted levels of immunosuppressants, coal tar, radiation phenobarbitone, phenytoin and eczema vii) Treatment of chronic ocular kidney failure, the starting dose must not therapy & lactation rifampicin. Increased risk of inflammatory disorders/uveitis more than 2.5 mg/kg/day v) 12 convulsion when used concurrently mg/kg/day vi) 2.5 mg/kg/day in 2 divided with high-dose methylprednisolone doses increasing if there is no improvement after 4 weeks by 0.5 -1 mg/kg/month up to maximum 5 mg/kg/day vii) 5 mg/kg/day in 2 divided doses, may increase to 7 mg/kg/day in resistant cases. Maintenance: Less than 5 mg/kg/day especially during remission Cinacalcet Hydrochloride 25mg A* Secondary hyperparathyroidism in The starting dose for adults is 25mg once Common: Digestive symptoms; nausea/ Patients with a history of hypersensitivity - Azole antifungals, macrolide Patients with hypocalcaemia, seizure or a tablet patients undergoing maintenance dialysis daily to be administered orally. Depends vomiting, gastric discomfort. Other: to any ingredients in cinacalcet. antibiotics, amiodarone history of seizure and gastrointestinal with hypercalcaemia. Restriction(s): For on the serum parathyroid hormone (PTH) Anorexia, abdominal distention, hydrochloride - Tricyclic haemorrhage and/or gastrointestinal treatment of refractory secondary and calcium levels, the dose may be hypocalcaemia/ decreased serum antidepressants, butyropherone ulcer or a history of gastrointestinal hyperparathyroidism in patients with end- adjusted within a range of 25-75mg once calcium and prolonged QT interval. antipsychotics, flecalnide, haemorrhage and/or gastrointestinal stage renal disease (including those with daily. If no improvement in PTH, the dose vinblastine - Calcitonin, ulcer. calciphylaxis) only in those: i) who have may be increased up to 100 mg once bisphosphonates, corticosteroids - 'very uncontrolled' plasma levels of intact daily. Dose can be increased by 25mg at Digoxin, diazepam, etc. parathyroid hormone (defined as greater a time at intervals of at least 3 weeks. than 85pmol/L [800 pg/mL] that are The safety of cinacalcet in low birth refractory to standard therapy, and an weight infants, newborns, sucklings, adjusted serum calcium level at upper infants and children has not been limit of normal or high, despite established. Caution when cinacalcet is appropriate adjustment of phosphate administered to patients aged 65 years binders including non-calcium based or older. It is recommended not to use phosphate binders. ii) in whom surgical cinacalcet in pregnant women or in parathyroidectomy is contraindicated in women who may possibly be pregnant. that the risks of surgery are considered Cinacalcet should be avoided in nursing to outweigh the benefits, or if there is mothers. likely to be a significant delay for surgery. Response to treatment should be monitored regularly and treatment should be continued with dose escalation as appropriate. If a reduction in the plasma levels of intact parathyroid hormone of 30% or more is not seen within 4 months of treatment, then consideration should be given to stopping treatment.

Cinnarizine 25 mg Tablet B Vestibular disorders Adult: One tablet 3 times daily Gastrointestinal disturbances, epigastric Avoid in porphyria Alcohol, CNS depressants Pregnancy, Parkinson's disease. May pain, nausea and vomiting, tinnitus, lupus affect ability to drive or operate erythematosus machinery

Ciprofloxacin 250 mg Tablet A Treatment of infections due to ADULT: 125-750 mg twice daily. Acute Nausea, diarrhoea, vomiting, dyspepsia, Hypersensitivity to ciprofloxacin or other Suggest: Drugs metabolised by Epilepsy, CNS disorder, liver damage, susceptible bacterial strains gonorrhoea: a single dose of 250 mg abdominal pain, flatulence, anorexia, quinolones. Children, adolescents, CYP1A2 (e.g Theophylline, renal impairment. Avoid prolonged dizziness, headache, tiredness, agitation, pregnancy & lactation Clozapine, Tizanidine) Oral Anti- exposure to sunlight trembling, insomnia, peripheral coagulants NSAIDs Phenytoin, paralgesia, sweating, unsteady gait, Cyclosporin, Glibenclamide, convulsions, increase in intracranial Methotrexate, Probenecid and pressure, anxiety states, nightmares, other prokinetic drugs confusion, depression, hallucinations, impaired taste & smell, visual disturbances, tinnitus, transitory impairment of hearing, especially at high frequencies, skin reactions Ciprofloxacin HCl 0.3% Ophthalmic A* Treatment of bacterial infections caused i) 2 drops every 15 minutes for the first 6 Local burning or ocular discomfort, History of hypersensitivity to Specific drug interaction studies Prolonged use may result in overgrowth Solution by susceptible strains in i) corneal ulcers hours, then 2 drops every 30 minutes for itching, foreign body sensation,lid margin ciprofloxacin or other quinolones or any have not been conducted with of nonsusceptible organisms. Discontinue ii) bacterial conjunctivitis the rest of the first day. Second day : 2 crusting,crystals/scales, conjunctival other component of the medication ophthalmic ciprofloxacin use at first appearance of skin rash or drops every hour. Subsequent days (3rd - hyperaemia and bad taste following other signs of hypersensitivity reactions. 14th day) : 2 drops every 4 hours. instillation. Corneal staining, keratitis, Appropriate therapy should be initiated if Treatment may be continued after 14 allergic reactions, lid oedema, tearing, super-infection occurs. Pregnancy & days if corneal re-epithelialization has photophobia, corneal infiltrates, nausea lactation not occured ii) 1 - 2 drops every 2 hours and decreased vision. Hypersensitivity into the conjunctival sac while awake for reactions. In patients with corneal ulcer 2 days and 1-2 drops every 4 hours while and frequent administration of the drug, awake for the next 5 days white precipitates have been observed which resolved after continuous application of the eye drops.

Clindamycin HCl 300 mg Capsule A* i) Skin and soft tissue infections, bone& i) ADULT: 150 - 300 mg every 6 hours; up Diarrhoea occasionally with acute colitis Hypersensitivity to clindamycin or Neuromuscular blockers, History of GI disease, especially joint infections ii) Cerebral toxoplasmosis to 450 mg every 6 hours in severe (discontinue), abdominal pain, GI upsets, lincomycin erythromycin colitis.Discontinue immediately if iii) Children less than 8 years infections; Max: 1.8g/day CHILD: 3 - 6 skin reactions, jaundice, hematopoietic diarrhoea or colitis develops. Renal or old:Treatment and prophylaxis of malaria mg/kg every 6 hours. Children weighing changes, pseudomembranous hepatic impairment. Perform periodic in combination with quinine, as an <10 kg should receive at least 37.5 mg enterocolitis, pruritus, vaginitis liver and kidney function tests with alternative to doxycline every 8 hr. ii) 600 mg 6 hourly for 6 prolonged therapy and in neonates and weeks iii) 10mg/kg twice a day, in infants. Pregnancy and lactation. combination with quinine. The Superinfection. combination to be given for 7 days

Clobazam 10 mg tablet A* As adjunctive therapy in patients with The initial dose in adults and adolescents Drowsiness, dizziness, tiredness, fatigue, Myasthenia gravis. Severe respiratory May interact with medication for Monitor respiratory function in patients epilepsy not adequately stabilised with >15 yr should be low (5 to15mg daily), if loss of coordination, or nausea may insufficiency, sleep apnoea syndrome. depression, narcotic pain relievers, with chronic or acute respiratory their basic medication. necessary, increased gradually to a occur. Severe liver impairment. History of drug sleeping pills, tranquilizers, insufficiency. Preexisting muscle maximum daily dose of about 80mg. or alcohol dependence. Children 6 antihistamines, other seizure weakness, renal or hepatic impairment, Doses of up to 30mg may be taken as a months to 3 yr. Pregnancy (especially medications. history of alcohol or drug abuse. Avoid single dose in the evening. The initial first trimester) & lactation. abrupt withdrawal. Pregnancy & dose in children from 3 to15 yr is lactation. Investigate possible organic normally 5mg. A maintenance dose of 0.3 cause in psychovegetative & to 1.0mg/kg body weight daily is usually psychosomatic disorders. May impair sufficient. ability to drive or operate machinery. Risk of habituation & dependence.

Clostridium Botulinum Toxin Type A A* i) Focal dystonias ii) Hemifacial spasm iii) 20 - 200 units 3 months once Misplaced injections may paralyse Generalised disorders of muscle activity Effects enhanced by Anaphylaxis and corneal 100 units Spasticity including cerebral palsy nearby muscle groups and excessive eg. myasthenia gravis, bleeding aminoglycosides and non- exposure.Subclinical or clinical evidence doses may paralyse distant muscle, disorders, pregnancy and breast feeding depolarizing muscle relaxant of marked defective neuromuscular influenza-like syndrome. Exacerbation of transmission existing eyelid abnormalities, ptosis, diplopia, spread of the paralytic effect to mid-facial muscles, keratitis, dry eyes, minor bruising, lid swelling, burning sensation, dysphagia Clostridium botulinum Type A toxin A* i) Focal dystonias ii) Hemifacial spasm iii) Initially 20 U/kg divided between both Inj site reactions, ptosis, dysphagia; Hypersensitivity. Pregnancy & lactation Effects enhanced by Subclinical or clinical evidence of marked haemagglutinin complex 500U/vial Spasticity including cerebral palsy calf muscles. May be titrated 10-30 U/kg weakness of adjacent muscle to area of aminoglycosides and non- defective neuromuscular transmission. powder for injection up to max of not >1000 U/patient. Should inj, eye & eyelid oedema, compensatory depolarizing muscle relaxant Patients with underlying neurological only be used in children > 2 years of age. sweating, diplopia, dry eyes, tearing, disorders eg swallowing difficulties; Repeat injections given not less than 3 arm, facial, leg & neck muscle weakness, history of dysphagia & aspiration. months from previous injection. dysphonia, accidental injury, abnormal gait, urinary incontinence, diarrhoea, vomiting, generalized weakness, fatigue, flu-like syndrome, pain/bruising at inj site.

Clomiphene Citrate 50mg Tablet A Anovulatory infertility 50 mg daily from 2nd - 6th or 5th - 9th Blurred vision, vasomotor flushing, Pregnancy, uncontrolled thyroid or Danazol can results in inhibition of Pelvic examination prior to initial day of menstrual cycle. Increase dose abdominal pain and ovarian enlargement adrenal dysfunction, liver disease, response to clomiphene. Ethinyl treatment, ophthalmological evaluation gradually by increments of 50 mg if there (which may be part of the ovarian abnormal uterine bleeding, ovarian cysts, estradiol can results in suppression in patients developing visual symptoms, is no response until a dosage of 200 mg hyperstimulation syndrome) organic intracranial lesion of response to ethinyl estradiol. multiple pregnancies can occur, ovarian daily is achieved (starting as early as 30 When used concomitantly with hyperstimulation syndrome and days afer the previous course). Further gonadorelin acetate abnormal ovarian enlargement may treatment may not be recommended if gonadotrophins (FSH), it may occur pregnancy has not occurred after a total increase the risk of ovarian of 6 treatment cycles. hyperstimulation syndrome (OHSS)

Clonazepam 2 mg Tablet B i) Epilepsy ii) Non-epileptic myoclonus i) & ii) ADULT: Initial dose should not Drowsiness, ataxia, aggravation of Hypersensitivity to clonazepam products Phenytoin, phenobarbital, Avoid abrupt withdrawal, renal exceed 1.5mg/day divided into 3 doses, seizure, fatigue, dizziness. Tiredness, and benzodiazepines, severe liver carbamazepine and valproate may insufficiency, respiratory disease, acute may be increased in increments of 0.5mg sleepiness, lassitude, muscular disease, narrow angle glaucoma, increase the clearance of intermittent porphyria, uncontrolled every 3 days until seizures are controlled. hypotonia, muscle weakness, light- respiratory depression, acute pulmonary clonazepam. Combination with open angle glaucoma, elderly, pregnancy, Maintenance dose: 3-6mg/day. headedness, ataxia, slowed reaction, insufficiency valproate may cause petit mal lactation, may exacerbate tonic seizures. Maximum: 20mg/day. CHILD up to 10 poor concentration, restlessness, status epilepticus. Enhanced effects Patients with spinal or cerebellar ataxia, years: initial dose 0.01-0.03 mg/kg/day in confusion, agitation, excitability, on sedation, respiration and acute alcohol or drug intoxification, 2-3 divided doses, increased by no more irritability, disorientation, anterograde hemodynamics when co- severe liver damage, sleep apnoea, renal than 0.25-0.5mg every third day, amnesia, depression. Increased administered with any central and hepatic diseases. History of maximum 0.2mg/kg/day. CHILD 10-16 production of saliva or bronchial acting depressants including depression and or suicide attempts. years: initial dose 1-1.5mg/day in 2-3 secretions in infants and young children, alcohol Simultaneous use of other anti-epileptics. divided dose, may be increased by 0.25- coordination disturbances, vertigo, Avoid driving and operating machinery 0.5mg every third day until individual anorexia, visual disturbances, libido maintenance dose of 3-6mg/day is changes reached. Clopidogrel 75 mg Tablet A* Secondary prevention of 75 mg once daily GI bleeding, purpura, bruising Active pathological bleeding such as Cytochrome P450 effect. Avoid for first few days after MI and for 7 atherothrombotic events in: haematoma, epistaxis, haematuria, peptic ulcer & intracranial haemorrhage, Amiodarone, cisapride, ciclosporin, days after ischaemic stroke; not i) Adult patients suffering from ocular haemorrhage, intra cranial breast feeding diltiazem, irbesartan, losartan, oral recommended in unstable angina, myocardial infarction (from a few days bleeding, abdominal pain, dyspepsia, hypoglycemics, paclitaxel, coronary artery bypass grafting and until less than 35 days), ischaemic stroke gastritis & constipation, rash, pruritus phenytoin, quinidine, sildenafil, percutaneous transluminal coronary (from 7 days until less than 6 months) or tamoxifen, verapamil, warfarin, angioplasty; patients at risk of increased established peripheral arterial disease. aspirin, heparin, thrombolytics, bleeding from trauma, surgery or other Prescribing restriction: as second/third NSAIDs, atorvastatin, erythromycin, pathological conditions; discontinue 7 line treatment in patients who are clarithromycin. Concomitant use of days before elective surgery if sensitive or intolerant to acetylsalicylic the drugs that inhibit CYP2C19 antiplatelet effect not desirable, liver acid and/or ticlopidine). should be discouraged impairment, renal impairment, ii) Adult patients suffering from acute pregnancy. Based on literature data, coronary syndrome: • Non-ST segment patients with genetically reduced elevation acute coronary syndrome CYP2C19 function (intermediate or poor (unstable angina or non-Q-wave metabolisers) have lower systemic myocardial infarction), including patients exposure to the active metabolite of undergoing a stent placement following clopidogrel and diminished antiplatelet percutaneous coronary intervention. • ST responses, and generally exhibit higher segment elevation acute myocardial cardiovascular events rates following infarction, in combination with myocardial infarction than do patients acetylsalicylate acid (ASA) in medically with normal CYP2C19 function treated patients eligible for thrombolytic therapy.

Cloxacillin Sodium 500 mg Capsule B Treatment of susceptible bacterial ADULT: 250 - 500 mg every 6 hours. Occasional rashes, GI upsets, anaphylaxis Hypersensitivity to cloxacillin Allopurinol, chloramphenicol. History of asthma or allergic-type infections, notably penicillinase- Child: 50-100 mg/kg in divided doses products/penicillins Probenecid impairs renal excretion. reactions to other medications, producing staphylococci every 6 hr. Anticoagulant effect is decreased. overgrowth of nonsusceptible organisms. Tetracycline, oestrogen-containing Pregnancy and lactation.Renal oral contraceptives. Antiperistalstic impairment. antidiarrhea(opiates, diphenoxylate, atropine) Clozapine 100 mg Tablet A Treatment of resistant schizophrenia Initial dose : 12.5 mg ( once or twice ) Hyperglycemia, agranulocytosis, Severe hepatic and renal impairment, Tramadol, carbamazepine, Patients who are elderly, cachectic, or daily, increase slowly in steps of 25 - 50 sedation, salivation, cardiovascular myeloproliferative disorders, fluoxetine, sertraline, fluvoxamine, have serious underlying medical mg up to 300 mg daily within 2 - 3 weeks. effects, dizziness / vertigo, seizures, uncontrolled epilepsy, pregnancy, erythromycin, phenobarbitone, illnesses; cardiovascular and or Maximum 900 mg/day drowsiness, confusion, blurred vision, dry lactation, coma, hypersensitivity to phenytoin, rifampicin, cimetidine, pulmonary disease; discontinue mouth, jaundice, leucopenia, neuroleptic clozapine products, myocarditis with benzodiazepines, other treatment if myocarditis is suspected; malignant syndrome, anticholinergic clozapine history, agranulocytosis with antipsychotics, tricyclic history of seizures; history of neuroleptic toxicity, hepatitis, hypotension, syncope, clozapine history (except due to previous antidepressants, valproic acid malignant syndrome; rapid escalation of constipation, tremor, weight gain, chemotherapy), WBC less than 3500, derivatives. Alcohol, MAOIs, CNS dose, prostatic hypertrophy, tachycardia, hypersalivation. GI/GU obstruction, narrow angle depressants, narcotics, hypotension, impaired renal or liver Eosinophilia, ketoacidosis, hyperosmolar glaucoma, CNS depression antihistamines, anticholinergic function, seizure disorder, hyperglycemia coma, convulsions, ECG changes, drugs, antihypertensive agents, and diabetes mellitus. WBC & absolute circulatory collapse, arrhythmias, adrenaline, drugs with resp neutrophil counts (weekly during the 1st myocarditis, cardiomyopathy, depressant effects, omeprazole, 18 week, at least monthly thereafter) can thromboembolism, aspiration of ingested cimetidine, carbamazepine, SSRIs, be performed, eosinophilia, food, intestinal obstruction, ileus, faecal lithium, azole antimycotics, thrombocytopenia. Concurrent use of impaction, hepatitis, pancreatitis, protease inhibitors, caffeine, drugs with a substantial potential to fulminant hepatic necrosis, interstitial nicotine depress bone marrow function & of long- nephritis, neuroleptic malignant acting depot antipsychotics should be syndrome, unexplained sudden death avoided. Caution when patients drive vehicles or operate machinery. Narrow- angle glaucoma, chronic constipation, , lactation, pregnancy. Monitoring of standing & supine BP is necessary during the 1st few week of treatment in patients with Parkinson's disease

Clozapine 25 mg Tablet A Treatment of resistant schizophrenia Initial dose : 12.5 mg ( once or twice ) Hyperglycemia, agranulocytosis, Severe hepatic and renal impairment, Tramadol, carbamazepine, Patients who are elderly, cachectic, or daily, increase slowly in steps of 25 - 50 sedation, salivation, cardiovascular myeloproliferative disorders, fluoxetine, sertraline, fluvoxamine, have serious underlying medical mg up to 300 mg daily within 2 - 3 weeks. effects, dizziness / vertigo, seizures, uncontrolled epilepsy, pregnancy, erythromycin, phenobarbitone, illnesses; cardiovascular and or Maximum 900 mg/day drowsiness, confusion, blurred vision, dry lactation, coma, hypersensitivity to phenytoin, rifampicin, cimetidine, pulmonary disease; discontinue mouth, jaundice, leucopenia, neuroleptic clozapine products, myocarditis with benzodiazepines, other treatment if myocarditis is suspected; malignant syndrome, anticholinergic clozapine history, agranulocytosis with antipsychotics, tricyclic history of seizures; history of neuroleptic toxicity, hepatitis, hypotension, syncope, clozapine history (except due to previous antidepressants, valproic acid malignant syndrome; rapid escalation of constipation, tremor, weight gain, chemotherapy), WBC less than 3500, derivatives. Alcohol, MAOIs, CNS dose, prostatic hypertrophy, tachycardia, hypersalivation. GI/GU obstruction, narrow angle depressants, narcotics, hypotension, impaired renal or liver Eosinophilia, ketoacidosis, hyperosmolar glaucoma, CNS depression antihistamines, anticholinergic function, seizure disorder, hyperglycemia coma, convulsions, ECG changes, drugs, antihypertensive agents, and diabetes mellitus. WBC & absolute circulatory collapse, arrhythmias, adrenaline, drugs with resp neutrophil counts (weekly during the 1st myocarditis, cardiomyopathy, depressant effects, omeprazole, 18 week, at least monthly thereafter) can thromboembolism, aspiration of ingested cimetidine, carbamazepine, SSRIs, be performed, eosinophilia, food, intestinal obstruction, ileus, faecal lithium, azole antimycotics, thrombocytopenia. Concurrent use of impaction, hepatitis, pancreatitis, protease inhibitors, caffeine, drugs with a substantial potential to fulminant hepatic necrosis, interstitial nicotine depress bone marrow function & of long- nephritis, neuroleptic malignant acting depot antipsychotics should be syndrome, unexplained sudden death avoided. Caution when patients drive vehicles or operate machinery. Narrow- angle glaucoma, chronic constipation, , lactation, pregnancy. Monitoring of standing & supine BP is necessary during the 1st few week of treatment in patients with Parkinson's disease Colchicine 0.5 mg Tablet B i) Acute gout and prophylaxis of i) Initial dose, 0.5-1.2 mg, then 0.5-0.6 mg Bone marrow depression with aplastic Serious GI, renal, hepatic & cardiac Reversible malabsorption of Vit Pregnancy, lactation, children and recurrent gout. ii) Leucocytoclastic every hour until relief of pain is obtained anaemia, peripheral neuritis, myopathy, disorders and those with blood B12, action inhibited by acidifying elderly, GI disease, cardiac, renal and Vasculitis either cutaneous or systemic or vomiting or diarrhoea occurs hair loss, gastrointestinal disturbances, dyscrasias, hypersensitivity to colchicine, agents & enhanced by alkalinizing hepatic impairment. Prolonged therapy involvement, Behcet's syndrome, (Maximum : 8 mg). The course should epigastric pain, diarrhoea, nausea, children under 2 years old, pregnancy, agents, cyclosporin, erythromycin. not recommended Urticarial vasculitis, Systemic sclerosis, not be repeated within 3 days. vomiting, myelosuppression, abdominal debilitated patients, SC/IM Response to CNS depressants and Sweet's syndrome and severe Prevention of attacks during initial pain, diarrhoea, gastrointestinal administration sympathomimetics may increase recalcitrant aphthous stomatitis treatment with allopurinol or uricosuric haemorrhage, rashes, renal and hepatic when used concurrently with drugs: 0.5 mg 1-3 times daily. ii) 0.5 mg 1- damage in excessive doses. Rarely colchicine. Increased risk of 3 times daily depends on disease and peripheral neuritis, myopathy, alopecia myopathy when used concurrently severity, up to a maximum of 3 mg/day and with chronic therapy blood disorders with simvastatin. Potential risk of like agranulocytosis, aplastic anaemia severe drug interactions, including death in certain patients treated with colchicine and concomitant P- glycoprotein or strong CYP3A4 inhibitors such as clarithromycin, ciclosporin, erythromycin, calcium channel antagonists (verapamil, diltiazem), telithromycin, ketoconazole, itraconazole, HIV protease inhibitors and nefazodone. P-glycoprotein or strong CYP3A4 inhibitors are not to be used in patients with renal or hepatic impairment who are taking cochicine. A dose reduction or interruption of colchicine treatment should be considered in patients with normal renal and hepatic function if treatment with a P- glycoprotein or a strong CYP3A4 inhibitors required. Avoid consuming grapefruit and grapefruit juice while using colchicine

Conjugated Estrogens 0.625 mg & A Management of moderate to severe 1 tablet daily Breast pain, breakthrough bleeding, Pregnancy, known or suspected cancer of St John's Wort , phenorbarbital, Myocardia infarction, stroke, breast, Medroxyprogesterone Acetate 2.5 vasomotor symptoms associated with dysmenorrhea, spotting, breast the breast and estrogen dependent phenytoin, carbamazepine, endometrial and ovarian cancer, mg Tablet menopause, prevention and tenderness or enlargement, discharge, neoplasia, undiagnosed abnormal genital rifampicin and dexamethasone may pregnancy, gallbladder disease, retinal management of postmenopausal arthralgias, leg cramp, depression, bleeding, active thrombophlebitis or reduce plasma concentrations of vascular thrombosis, proptosis, diplopia, osteoporosis, atropic vaginitis and vaginitis, weight changes thromboembolic disorders, liver estrogens. Erythromycin, migraine, hypercalcaemia, fluid atropic urethritis in post menopausal dysfunction or disease. Active or recent clarithromycin, ketoconazole, retention, hypertriglyceridemia, hepatic woman with intact uterus arterial thromboembolic disease itraconazole, ritonavir and impairment, past history of cholestatic grapefruit may increase jaundice, elevated blood pressure, concentration of estrogens asthma, epilepsy, hypocalcaemia, hypothyroidism, abnormal uterine bleeding, depression Conjugated Oestrogens 0.625 mg A i) Osteoporosis associated with i) 0.3 - 0.625 mg daily ii) 0.3- 1.25mg daily Nausea, endometrial cancer Known or suspected or past breast St John's Wort , phenorbarbital, Hypertriglyceridemia, fluid retention, , Tablet oestrogen deficiency ii) Female for 3weeks, then off for 1 week iii) & iv) (postmenopausal), oedema, weight cancer, estrogen -dependent neoplasia, phenytoin, carbamazepine, impaired liver function, patient with pre- hypoestrogenism iii) Vasomotor 0.3mg-1.25mg daily changes, breast changes, headache pregnancy, undiagnosed abnormal rifampicin and dexamethasone may existing hypertension, asthma, epilepsy, symptoms associated with oestrogen migraine, steepening of corneal uterine bleeding, active or history of reduce plasma concentrations of migraine, porphyria, systemic lupus deficiency iv)atrophic vaginitis and curvature, changes in libido, change in confirmed thromboembolic and disorder, estrogens. Erythromycin, erythematosus, hypothyroidm, urethritis menstrual flow, vomiting, aggravation of liver dysfunction. clarithromycin, ketoconazole, hypocalcemia, patients who have risk porphyria, cholestatic jaundice, alopecia, itraconazole, ritonavir and factors for thrombotic disorder, patients breakthrough bleeding, spotting, grapefruit may increase who have been treated for endometrial amenorrhoea, bloating, dizziness concentration of estrogens carcinoma, increase risk of ovarian and breast cancer and gallbladder disease.

Cyclophosphamide 50 mg Tablet A i) Solid tumours, leukaemia, lymphoma, i) ADULT: 50 - 100 mg/day. Monitor full i) Reproductive system: Carcinogenesis, Hypersensitivity to cyclophosphamide. Doxorubicin, cimetidine, thiazide Myelosuppression, renal/hepatic autoimmune disorders, autoimmune blood count (FBC), liver function, urine mutagenesis, impairment of fertility ii) Pregnancy, lactation. Bladder diuretics. Radiotherapy, live impairment, elderly patients. Monitor bullous diseases, connective tissue microscopy and renal function. CHILD, up Digestive system: nausea and vomiting, haemorrhage. Patients with bone- vaccines. Succinyl choline, haematological profile and presence of disease, pyoderma gangrenosum ii) For to 1 year: 10 - 20 mg daily, 1 - 5 years: 30 - anorexia, diarrhoea, haemorrhagic colitis, marrow aplasia, acute infection, drug- or halothane, nitrous oxide. Increased RBCs in urine regularly. Maintain severe lupus nephritis (Class III & IV), 50 mg daily, 6 - 12 years: 50 - 100 mg oral mucosal ulceration, jaundice iii)skin radiation-induced urothelial toxicity. bone marrow depression with adequate hydration and frequent systemic vasculitis and steroid daily ii) 2 mg/kg/day for 3 - 4 months iii) 1 and its structure: alopecia, rash, very rare Porphyria. Contraindicated for continued allopurinol, barbiturates, micturition to reduce the risk of cystitis. resistant/dependent nephrotic syndrome - 1.5 mg/kg/day orally in divided doses reports of Stevens-Johnson syndrome use in patients with severely depressed phenytoin, corticosteroids, iii) Systemic lupus erythematosus (SLE), and toxic epidermal necrolysis. bone marrow function. chloramphenicol, interferon alfa rheumatoid arthritis, polyarteritis iv)Hematopoietic system: dose related nodosa, wegener granulomatosis leukopenia, neutropenia, thrombocytopenia, fever iv) urinary system: haemorrhagic ureteritis, renal tubular necrosis, cystitis and urinary bladder fibrosis. v) Infections vi) Carcinogenesis vii)Respiratory system: Interstitial pneumonitis Dabigatran Etexilate 110 mg Capsule A* i) Prevention of venous thromboembolic i) Following total knee replacement: Bleeding, anaemia, haematoma, Hypersensitivity to the active substance Heparins, fondaparinux, desirudin, Patients at risk for bleeding, recent events in patients who have undergone Initially ADULT 110mg (ELDERLY, 75 mg) haemorrhage, haematuria, decreased or to any of the excipients, severe renal thrombolytic agents, GPIIb/IIIa biopsy or major trauma, spinal & epidural total knee replacement or total hip within 1- 4 hours after surgery, then 220 haemoglobin, wound secretion, post- impairment (CrCl less than 30 ml/min), receptor antagonists, clopidogrel, anaesthesia, lumbar puncture, pregnancy replacement surgery. ii) Reduction of the mg (ELDERLY, 150 mg) once daily procedural discharge active clinically significant bleeding, ticlopidine, dextran, sulfinpyrazone, & lactation, children risk of stroke and systemic embolism in thereafter for 6-10 days Following total organic lesion at risk of bleeding, vitamin K antagonists, amiodarone, patients with non-valvular atrial hip replacement: Initially ADULT 110 mg spontaneous or pharmacological quinidine, NSAIDs, sibutramine fibrillation (AF). iii) Treatment of deep (ELDERLY, 75 mg) within 1- 4 hours after impairment of haemostasis, hepatic vein thrombosis (DVT) and pulmonary surgery, then 220 mg (ELDERLY, 150 mg) impairment or liver disease expected to embolism (PE) and prevention of once daily thereafter for 28-35 days ii) have any impact on survival, concomitant recurrent DVT and PE in adults. Recommended daily dose is 300mg taken treatment with quinidine, concomitant orally as 150mg hard capsule twice daily. treatment with systemic ketoconazole Therapy should be continued lifelong. iii) Recommended daily dose is 300mg taken as one 150mg capsule BD following treatment with a parenteral anticoagulant for at least 5 days. The duration of therapy should be individualized after careful assessment of the treatment benefit against the risk for bleeding. ii) & iii) For the following groups, the recommended daily dose is 220 mg taken as one 110mg capsule twice daily: - Patients aged 80 years or above -Patients who receive concomitant verapamil Special patient population for renal impairment : Renal function should be assessed by calculating the creatinine clearance (CrCl) prior to initiation of treatment with Dabigatran to exclude patients for treatment with severe renal impairment (i.e. CrCl < 30 ml/min). Dabigatran Etexilate150 mg Capsule A* i) Reduction of the risk of stroke and i) Recommended daily dose is 300mg Bleeding, anaemia, haematoma, History of serious hypersensitivity Heparins, fondaparinux, desirudin, Bleeding, significant and sometimes fatal, systemic embolism in patients with non- taken orally as 150mg hard capsule twice haemorrhage, haematuria, decreased reaction (eg anaphylactic reaction or thrombolytic agents, GPIIb/IIIa may occur; increased risk with labour and valvular atrial fibrillation (AF). ii) daily. Therapy should be continued haemoglobin, wound secretion, post- anaphylactic shock) to dabigatran/ any receptor antagonists, clopidogrel, delivery and concomitant use of drugs Treatment of deep vein thrombosis (DVT) lifelong. ii) Recommended daily dose is procedural discharge components of the product, severe renal ticlopidine, dextran, sulfinpyrazone, that increase bleeding risk (eg. and pulmonary embolism (PE) and 300mg taken as one 150mg capsule BD impairment (CrCl less than 30 mL/min), rivaroxaban, prasugrel, vit K Antiplatelet agents, heparin, fibrinolytic prevention of recurrent DVT and PE in following treatment with a parenteral active bleeding, organic lesion at risk of antagonists, amiodarone, therapy, chronic use of NSAIDS). adults. anticoagulant for at least 5 days. The bleeding, spontaneous or verapamil, clarithromycin, Concomitant use with p-glycoprotein duration of therapy should be pharmacological impairment of quinidine, aspirin, NSAIDs, inducers (eg rifampin); reduced individualized after careful assessment of haemostasis, hepatic impairment or liver itraconazole, tacrolimus, dabigatran exposure: avoid concomitant the treatment benefit against the risk for disease. Concomitant treatment with cyclosporine, ritonavir, tipranavir, use. Interruption of therapy for active bleeding. For the following groups, the quinidine & systemic ketoconazole. nelfinavir, saquinavir, ketoconazole, bleeding, elective surgery, or invasive recommended daily dose is 220 mg taken rifampicin, St. John's wort, procedures, increased risk of stroke as one 110mg capsule twice daily: - carbamazepine. Patients aged 80 years or above -Patients who receive concomitant verapamil Special patient population for renal impairment : Renal function should be assessed by calculating the creatinine clearance (CrCl) prior to initiation of treatment with Dabigatran to exclude patients for treatment with severe renal impairment (i.e. CrCl < 30 ml/min).

Dapsone 100 mg Tablet B i)Leprosy i) ADULT: 6 - 10 mg/kg weekly/ 1.4mg/kg Nausea, vomiting, anorexia; fever, Hypersensitivity to dapsone products, Rifampicin increases plasma Cardiac, pulmonary, hepatic or renal ii) Dermatitis herpetiformis daily (around 50 - 100 mg daily). malaise, headache; dizziness, severe anaemia, G6PD deficiency clearance of dapsone. Excretion disease, pregnancy, lactation. Persons CHILD: 1 - 2 mg/kg/day. Maximum: 100 tachycardia, nervousness, insomnia, skin decreased by probenecid. deficient in glucose-6-phosphate mg/day disorders, agranulocytosis, peripheral Pyrimethamine may increase the dehydrogenase are more susceptible to ii) ADULT: 50 - 300 mg daily neuritis, psychosis, haemolysis, likelihood of haematologic the hemolytic effects of dapsone. methaemoglobinemia; hypersensitivity reactions reactions

Deferasirox 125 mg Dispersible A* Treatment of chronic iron overload due Initial 20 mg/kg/day. Starting dose can Rash, urticaria, abdominal pain, Hypersensitivity to deferasirox or to any Aluminium containing antacids Increased risk of potentially fatal acute Tablet to blood transfusions (transfusional also be based on transfusion rate and diarrhoea, nausea, vomiting, backache, component of the product renal failure, concomitant use of haemosiderosis) in adult and pediatric existing iron burden. In patients not headache, cough, bronchitis, fever, medicines that depress renal function, patients aged 2 years and above. adequately controlled with doses of influenza, cytopenia, drug-induced elderly, haematologic disorders 30mg/kg/day (e.g serum ferritin levels hepatitis, increased liver enzyme, (including neutropenia, persistently above 2,500 microgram/L anaphylaxis, hypersensitivity disorder, thrombocytopenia and agranulocytosis), and not showing a decreasing trend over arthralgia, cataract, retinal disorder, acute renal failure with advanced-stage time), doses up to 40mg/kg/day may be raised intraocular pressure, hearing loss, disorders renal conditions considered. infection of ear, fatigue, acute renal failure

Deferasirox 500 mg Dispersible A* Treatment of chronic iron overload due Initial 20 mg/kg/day. Starting dose can Rash, urticaria, abdominal pain, Hypersensitivity to deferasirox or to any Aluminium containing antacids. Increased risk of potentially fatal acute Tablet to blood transfusions (transfusional also be based on transfusion rate and diarrhoea, nausea, vomiting, backache, component of the product. renal failure, concomitant use of haemosiderosis) in adult and pediatric existing iron burden. In patients not headache, cough, bronchitis, fever, medicines that depress renal function, patients aged 2 years and above. adequately controlled with doses of influenza, cytopenia, drug-induced elderly, haematologic disorders 30mg/kg/day (e.g serum ferritin levels hepatitis, increased liver enzyme, (including neutropenia, persistently above 2,500 microgram/L anaphylaxis, hypersensitivity disorder, thrombocytopenia and agranulocytosis), and not showing a decreasing trend over arthralgia, cataract, retinal disorder, acute renal failure with advanced-stage time), doses up to 40mg/kg/day may be raised intraocular pressure, hearing loss, disorders renal conditions. considered. infection of ear, fatigue, acute renal failure. Deferiprone 500 mg Tablet A* Treatment of iron overload in patients 25 mg/kg 3 times a day for total daily Genotoxicity, neutropenia, Severe liver dysfunction, existing Aluminium containing antacids. In case of persistent arthropathy, with thalassemia major for whom dose of 75 mg/kg. Doses greater 100 agranulocytosis, tachycardia, vasculitis, neutropenia, agranulocytosis, pregnancy Due to the risk of additive toxicity, deferiprone therapy should be desferrioxamine therapy is mg/kg are not recommended weight gain, zinc deficiency, abdominal and lactation use with drugs that may cause discontinued. Monitor neutrophil counts contraindicated or inadequate. Add on pain, urine discoloration, hepatotoxicity, neutropenia or agranulocytosis is weekly. Interrupt therapy if patient therapy to desferrioxamine for visual impairment, joint problems, not recommended develops an infection thalassemia patients with cardiac ototoxicity and skin rash complication

Desloratadine 5 mg Tablet A* Allergic rhinitis and chronic idiopathic Adults and Adolescents (12 years of age Fatigue, headache and dry mouth Hypersensitivity to desloratadine or Amphetamines, alcohol, Phenylketonuric patient, severe renal or urticaria and older): 5mg once a day regardless of loratadine. betahistine, CNS depressants, hepatic failure; elderly, epilepsy, mealtime. acetylcholinesterase Inhibitors pregnancy and lactation

Desloratadine 2.5mg/5ml syrup A* Allergic rhinitis and chronic idiopathic For children only: 1-5 yrs: 2.5ml once a Fatigue, headache and dry mouth Hypersensitivity to desloratadine or Amphetamines, alcohol, Phenylketonuric patient, severe renal or urticaria. Prescribing Restriction(s): For day (with or without meal) 6-11 yrs: 5ml loratadine. betahistine, CNS depressants, hepatic failure; elderly, epilepsy, use in children 1-2 years old only. once a day (with or without meal) acetylcholinesterase Inhibitors pregnancy and lactation

Desmopressin 0.2 mg Tablet A i)Central diabetes insipidus ii)Primary i)ADULT and CHILD : 0.1-0.2mg 3 times Nausea, hypertension, hypotension, Hypersensitivity to desmopressin; Tricyclic antidepressants, Avoid fluid overload in the very young & nocturnal enuresis iii)Treatment of daily, up to 0.1-1.2mg daily ii) ADULT & palpitation, anaphylaxis, transient hyponatremia or a history of chlorpromazine and the elderly, conditions characterised by nocturia associated with nocturnal Child≥5 yr 0.2-0.4mg at night iii)Initially headache, stomach pain, epistaxis , hyponatremia; moderate-to-severe renal carbamazepine, indomethacin fluid & or electrolyte imbalance & those polyuria in adult 0.1 mg at night. May be increased to 0.2 fatigue, transient fall in BP with reflex impairment at risk for increased intracranial pressure. mg and then to 0.4 mg by means of tachycardia and facial flushing Caution in renal concentration capacity weekly increase testing for children less than 1 year

Dexamethasone 0.5 mg Tablet A i) Prophylaxis and management of 0.5mg to 10mg daily is given for oral Fluid and electrolyte disturbances, Hypersensitivity, administration of live Barbiturates, phenytoin, rifampin Discontinue treatment by reducing the nausea and vomiting in cancer administration, depending upon the muscle weakness, peptic ulcer vaccines and systemic fungal infection. may decreases dexamethasone dosage gradually. Patients with ocular chemotherapy, post-operation and disease being treated. Up to 15 mg daily effects; dexamethasone decreases herpes simplex, psychic derangements, palliative care, ii) Treatment of in severe disease. effect of salicylates, vaccines, gastric duodenal ulcer, congestive heart adrenocortical function abnormalities, iii) toxoids. Increased effect: failure, hypertension, diabetes mellitus, Any other treatment requiring Salmeterol: The addition of chronic renal failure, uremia and elderly. corticosteroid therapy. salmeterol has been demonstrated Unless considered life saving, the use of to improve response systemic administration of corticosteroids is contraindicated in patients with osteoporosis, psychoses or severe psychoneurosis.

Diclofenac 50 mg Tablet B Pain and inflammation in rheumatic ADULTS: Initial dose of 150 mg daily. Mild Epigastric pain, GI disturbances, slight Hypersensitivity, rhinitis, urticaria, Increases plasma concentration of Patients w/ known CV disease or risk disease or long term: 75 - 150 mg daily in 2 to 3 dizziness, hypersensitivity, oedema, asthma or allergic reactions to aspirin or warfarin, lithium and factors for CV disease, fluid retention or divided doses after food. Maximum nephrotoxicity, abnormal liver function, other anti-inflammatory agents methotrexate. May reduce effects heart failure, SLE, HTN, history of GI 200mg/day. PAEDS more than 6 months : headache, neurological, haematological of diuretics & beta blockers. May disease. Patients who may be adversely 1 - 3 mg/kg body weight daily in divided and dermatological side effects. alter plasma concentration of affected by prolongation of bleeding doses. Maximum 3mg/kg/day (Max sulfonylureas. Aspirin, warfarin, time. Hepatic and renal impairment. 150mg/day). digoxin, methotrexate, ciclosporin Elderly. Lactation. Dienogest 2mg tablet A/KK Treatment of endometriosis One tablet daily. Treatment can be Increased weight; depressed mood, sleep Hypersensitivity; Active venous CYP3A4 inducers or inhibitors may Serious uterine bleeding; Circulatory started on any day of menstrual cycle. disorder, nervousness, loss of libido, thromboembolic disorder, past or alter therapeutic effects; disorders; discontinue use if any Tablets must be taken continously altered mood; headache, migraine; GI present arterial & CV disease (eg MI, phenytoin, barbiturates, primidone, symptoms of arterial or venous without regard to vaginal bleeding. disorders; acne, alopecia; back pain; CVA, ischemic heart disease); DM with carbamazepine, rifampicin, thrombotic events occur; Breast cancer, breast discomfort, ovarian cyst, hot vascular involvement; presence or oxcarbazepine, topiramate, liver tumors; Osteoporosis; History of flushes, uterine/vaginal bleeding history of severe hepatic disease & liver felbamate, griseofulvin, nevirapine depression; Hypertension; Discontinue including spotting; asthenic conditions, tumors; known or suspected sex & St. John's wort containing- use upon recurrence of cholestatic irritability. hormone-dependent malignancies; products may increase clearance of jaundice &/or pruritus which occured 1st undiagnosed vaginal bleeding. Pregnancy sex hormones; azole antifungals, during pregnancy or previous use of sex & lactation. Children. cimetidine, verapamil, macrolides, steroids; DM especially gestational DM; diltiazem, protease inhibitors, chloasma (especially chloasma antidepressants & grapefruit juice gravidarium); Rare hereditary problems may increase plasma levels of of galactose intolerance, Lapp lactose progestogens deficiency or glucose-galactose malabsorption; Persistent ovarian follicles; Regular physical & gynecological examination should be performed during use.

Digoxin 0.25 mg Tablet B Heart failure , with atrial fibrillation, Rapid digitalisation: 0.75 -1.5 mg in Nausea, vomiting, anorexia, diarrhoea, Digoxin is contraindicated in intermittent Plasma concentration increased by Acute myocardial infarction, acute supraventricular arrhythmias divided doses over 24 hours; less urgent abdominal pains, salivation, sweating; complete heart block or second degree quinidine, verapamil, nifedipine, myocarditis, amyloid cardiomyopathy, AV (particularly, atrial fibrillation) digitalisation, 250 mcg-500 mcg daily headache, facial pain, malaise, fatigue, atrioventcular block,especially if there is amiodarone. Hypokalaemia may be block. Chronic constrictive pericarditis, (higher dose may be divided). drowsiness, depression, disorientation, a history of Stokes-Adams attacks. associated with diuretics, lithium, electrolyte imbalance (eg. hypokalaemia, Maintenance : 62.5mg -500 mcg daily mental confusion, delirium, hallucination, Contraindicated in arrhythmias caused by carbenoxolone, corticosteroids. hypocalcaemia or hypercalcaemia, (higher dose may be divided) according visual disturbance.Hypokalaemia. cardiac glycoside Antacids, neomycin may reduce hypomagnesaemia), hypothyroidism, to renal function and , in atrial fibrillation, Ventricular premature contractions, atrial intoxication,supraventricular arrhythmias serum level of digoxin hypoxia, idiopathic hypertrophic on heart rate response; usual range, 125- or ventricular arrhythmias and as in the Wolff-Parkinson-White subaortic stenosis. Renal disease, severe 250 mcg daily (lower dose may be conduction defects syndrome,ventriculartachycardia,hypertr bradycardia, severe heart failure and appropriate in elderly) ophic cardiomyopathy, and pulmonary disease, ventricular hypersensitivity to digoxin. tachycardia and Wolff-Parkinson-White syndrome

Digoxin 62.5 mcg Tablet B Heart failure, with atrial fibrillation, Rapid digitalisation: 1-1.5 mg in divided Nausea, vomiting, anorexia, diarrhoea, Digoxin is contraindicated in intermittent Plasma concentration increased by Acute myocardial infarction, acute supraventricular arrhythmias doses over 24 hours; less urgent abdominal pains, salivation, sweating; complete heart block or second degree quinidine, verapamil, nifedipine, myocarditis, amyloid cardiomyopathy, AV (particularly, atrial fibrillation) digitalisation, 250 mcg-500 mcg daily headache, facial pain, malaise, fatigue, atrioventcular block,especially if there is amiodarone. Hypokalaemia may be block. Chronic constrictive pericarditis, (higher dose may be divided). drowsiness, depression, disorientation, a history of Stokes-Adams attacks. associated with diuretics, lithium, electrolyte imbalance (eg. hypokalaemia, Maintenance: 62.5 - 500 mcg dailly mental confusion, delirium, hallucination, Contraindicated in arrhythmias caused by carbenoxolone, corticosteroids. hypocalcaemia or hypercalcaemia, (higher dose may be divided) according visual disturbance. Ventricular premature cardiac glycoside Antacids, neomycin may reduce hypomagnesaemia), hypothyroidism, to renal fuction, and in atrial fibrillation, contraction intoxication,supraventricular arrhythmias serum level of digoxin hypoxia, idiopathic hypertrophic on heart-response; usual range :125 - 250 as in the Wolff-Parkinson-White subaortic stenosis. Renal disease, severe mcg daily (lower doses may be syndrome,ventriculartachycardia,hypertr bradycardia, severe heart failure and appropriate in the elderly) ophic cardiomyopathy, and pulmonary disease, ventricular hypersensitivity to digoxin. tachycardia and Wolff-Parkinson-White syndrome

Dihydrocodeine Tartrate 30 mg B For the control of moderate to severe ADULT: 30 - 60 mg every 4 - 6 hours. GI disturbance, headache, vertigo, Respiratory depression, obstructive Naltrexone : precipitation of opioid Hypothyroidism, chronic hepatic or Tablet chronic pain PAED, over 4 yrs: 0.5 - 1 mg/kg body respiratory depression airway disease, acute alcoholism, acute withdrawal symptoms. MAOIs, adrenocortical disease, renal weight every 4-6 hours asthmatic attack, hypersensitivity phenothiazines, CNS depressants, insufficiency, elderly, lactation. cimetidine, other narcotic analgesics, anti-cholinergic agents. Diltiazem HCl 30 mg Tablet B Treatment of angina pectoris in the Initially 30mg tds, may increase to 60mg Headache, dizziness, peripheral oedema, Acute myocardial infarction with Aspirin, beta-adrenergic blockers, AV block (first degree), combination following cases: i) inadequate response tds (elderly initially twice daily; increased gingival hyperplasia, AV block, pulmonary congestion, atrial fibrillation carbamazepine, cimetidine, therapy with beta-blockers (with left or intolerance to beta-blockers and if necessary to 360 mg daily. bradycardia or flutter (IV dose forms): i) Accessory cisapride, cyclosporin, digitoxin, ventricular dysfunction), congestive Isosorbide Dinitrate ii) contraindication bypass tract (Wolff-Parkinson-White, digoxin, enflurane, lithium, heart failure, gastrointestinal to beta-blockers iii) coronary artery Lown-Ganong-Levine) ii) Short PR lovastatin, methylprednisolone, hypermotility (extended release dose spasm syndromes. Hypersensitivity to this or midazolam, nifedipine, oral forms), gastrointestinal obstruction other calcium channel blocker, patients anticoagulants, phenytoin, (extended release dose forms), with sick sinus syndrome , 2nd- or 3rd- quinidine, rifampin, saquinavir, hypotension, impaired liver function degree AV block; pregnancy, lactation simvastatin, clonidine, CYP3A4 (reduced metabolism, enhanced inducer response). Impaired renal function. Paroxysmal supraventricular tachycardia conversion, persistent dermatologic reactions induced by calcium antagonists have progressed to erythema multiforme or exfoliative dermatitis

Diosmin 450 mg and Hesperidin 50 A/KK i) Haemorrhoids ii) Chronic venous i) Acute attack: 6 tablets daily for the first Minor gastrointestinal disturbances, Hypersensitivity to any component of Not known Lactation mg Tablet insufficiency 4 days, then 4 tablets daily in 2 divided neurovegetative disorders preparation doses for 3 days and 2 tablets thereafter. Chronic: 2 tablets daily ii) 2 tab daily with meals

Diphenoxylate HCl 2.5mg with B Acute diarrhoea ADULT initially 4 tablet followed by 2 Euphoria, paraesthesia, central nervous Hypersensitivity to diphenoxylate Barbiturates, tranquilizers, alcohol, Advanced hepatorenal disease, abnormal Atropine Sulphate 0.025mg Tablet tablet 4 times daily until diarrhoea is system effects, anoneurotic oedema and hydrochloride or atropine, jaundice, MAOIs liver function, Down Syndrome controlled other allergic reactions, toxic megacolon, acute diarrhoeal conditions like antibiotic paralytic ileus, gastrointestinal associated diarrhoea, disturbance. Atropine effects: pseudomembranous enterocolitis, acute Hyperthermia, tachycardia, urinary ulcerative colitis and infective diarrhoeas. retention, flushing, dry skin and mucous Paralytic ileus and a ganglionosis. Not membranes. At therapeutic dose- recommended for use in children dryness of the mouth, difficulty in swallowing, thirst, reduce bronchial secretion, mydriasis with cycloplegia

Domperidone 10 mg Tablet B Nausea, vomiting, dyspepsia, gastro- Chronic dyspepsia ADULT 10 mg 3 times Mild abdominal cramps, raised serum Known hypersensitivity to domperidone MAOIs, antacids, antisecretory Dosage adjustment may be necessary in esophageal reflux daily. Acute and subacute conditions prolactin level or any of the excipients. Prolactin- drugs, azole antifungals, macrolide patients who are receiving domperidone (particularly nausea and vomiting):ADULT releasing pituitary tumour(prolactinoma.) antibiotics, HIV protease inhibitors, concomitantly with 20 mg 3-4 times daily Should not be used when stimulation of anticholinergic drugs, CYP3A4 cimetidine,pregnancy, lactation gastric motility could be harmful: gastro- inhibitors. Antacids or antisecretory intestinal haemorrhage, mechanical agents should be taken after meals obstruction or perforation when used concomitantly

Donepezil HCl 10 mg Tablet A Treatment of mild to moderate dementia 5 - 10 mg once daily at bedtime. Diarrhoea, muscle cramps, nausea, Hypersensitivity to donepezil Has the potential for synergistic Gastrointestinal disease or history of in Alzheimer's disease, as well as in Maximum 10 mg daily vomiting, insomnia, fatigue, dizziness, hydrochloride and piperidine derivatives. activity with concurrent ulcer disease, asthma or obstructive patients with severe Alzheimer's disease. hallucination, agitation, loss of appetite Pregnancy and lactation succinylcholine, other pulmonary disease or seizures or those [psychiatrists and neurologists only] neuromuscular blocking agents or receiving concurrent NSAIDs, pregnancy, cholinergic agonist. Has the cardiac conduction abnormalities, potential to interfere with drugs anaesthesia with succinylcholine having anticholinergic activity. Muscle relaxants drugs, suxamethonium Donepezil HCl 5 mg Tablet A Treatment of mild to moderate dementia 5 - 10 mg once daily at bedtime. Diarrhoea, muscle cramps, nausea, Hypersensitivity to donepezil Has the potential for synergistic Gastrointestinal disease or history of in Alzheimer's disease, as well as in Maximum 10 mg daily vomiting, insomnia, fatigue, dizziness, hydrochloride and piperidine derivatives. activity with concurrent ulcer disease, asthma or obstructive patients with severe Alzheimer's disease. hallucination, agitation, loss of appetite Pregnancy and lactation succinylcholine, other pulmonary disease or seizures or those neuromuscular blocking agents or receiving concurrent NSAIDs, pregnancy, cholinergic agonist. Has the cardiac conduction abnormalities, potential to interfere with drugs anaesthesia with succinylcholine having anticholinergic activity. Muscle relaxants drugs, suxamethonium

Dorzolamide HCl 2% Ophthalmic A* All glaucoma patients where beta- Monotherapy : 1 drop 3 times daily. Burning, stinging, conjunctivitis, eyelid Patients who are hypersensitive to any High dose of salicylate therapy. Patients with severe renal Solution blockers are contraindicated and when Adjunctive therapy with an ophthalmic inflammation, eye itching, eyelid component of this product Potential additive effect with oral (CRcl<30ml/min) or hepatic impairment. intraocular pressure is not well controlled beta-blocker : 1 drop 2 times daily. When irritations, headache, bitter taste, carbonic anhydrase inhibitors Pregnancy and lactation. Children. by other drugs substituting for another ophthalmic nausea, itching, fatigue/asthenia, blurred Remove contact lens prior to antiglaucoma agent with this product, vision, tearing. Rarely, iridocyclitis and administration and do not reinsert 15 discontinue the other agent after proper rash. Angioedema, bronchospasm, minutes after use. Acute angle glaucoma, dosing on one day and start Trusopt on urticaria, pruritis, dizziness, paraesthesia, sensitivity to sulfonamide, concomitant the next day. If more than 1 topical transient myopia (resolve upon use of oral carbonic-anhydrase inhibitors, ophthalmic drug is used, the drugs discontinuation) and superficial punctate conjunctivitis and lid reactions reported should be administered at least 10 mins keratitis with chronic administration, ocular apart infection or inflammation, recent ocular surgery, reports of bacterial keratitis associated with the use of multiple dose containers of ophthalmic products

Dothiepin HCl 25 mg Capsule A Depression of any aetiology Initially 75 mg (ELDERLY 50-75 mg) daily Drowsiness, extrapyramidal symptoms, Concomitant use of MAOIs, recovery Alcohol, barbiturate, tranquilliser, May activate latent schizophrenia, in divided doses or single dose at tremor, confusional state, disorientation, phase of myocardial infarction, hepatic MAOIs, anticholinergic, exaggerate paranoid delusions, renal or bedtime, increased gradually as dizziness, anticholinergic effects, failure, epilepsy antihistamine, sympathomimetics, hepatic impairment, Pregnancy, lactation necessary to 150 mg daily (ELDERLY 75 paraesthesia, hypotension, tachycardia, 5 HT agonist, benzodiazepines, and children less than 16 years mg may be sufficient), up to 225 mg daily palpitations, arrhythmias, conduction carbamazepine, clozapine, in some circumstances. CHILD is not defects, libido changes, nausea, vomiting, cyclosporine, digoxin, haloperidol, recommended constipation, rash, pharyngitis, phenytoin, linezolid, impotence, anemia metoclopramide, ritonavir, tramadol, lithium, NSAIs, thioridazine, warfarin

Doxazosin Mesilate 4 mg CR Tablet A* Benign Prostatic Hyperplasia 4 mg once daily to maximum 8mg/day Postural hypotension, vertigo, headache, Hypersensitivity to doxazosin and other In patients currently on beta Gastrointestinal disorders, pregnancy, fatigue, dizziness, oedema and asthenia quinazolines blockers, the first dose response lactation, history of gastrointestinal (marked initial drop in blood obstruction, oesophageal obstruction pressure, particularly on standing) to an alpha-1 adrenergic blocking drug may be exaggerated, tadalafil, sildenafil, vardenafil

Doxycycline 100 mg Capsule B Infections due to susceptible organisms ADULT: 200 mg on the first day followed GI distress, anorexia, maculopapular and Hypersensitivity to Anticoagulants, penicillin, antacids, Lactation, myasthenia gravis, hepatic or by 100 mg daily. Severe infections: 200 erythematous rash, tooth discolouration tetracyclines/doxycycline, porphyria, ferum, acitretin, isotretinoin, renal impairment mg daily in children pregnancy, lactation, children less than methotrexate 12 years Duloxetine 30 mg Capsule A* Major depressive disorder, diabetic ADULT: 60 mg once daily up to a Gastrointestinal disorders, excessive Concomitant use with MAOIs, potent Drugs metabolised by CYP2D6 (eg History of mania/hypomania, seizures, peripheral neuropathic pain maximum dose of 120mg/day (in divided sweating, CNS disorders (eg headache, CYP1A2 inhibitors, hepatic or severe flecainide, vinblastine, renal impairment, elderly, liver doses) CHILD and ADOLESCENT under 18 dizziness, fatigue, insomnia, somnolence, renal impairment, uncontrolled narrow- carbamazepine, tricyclic transaminase elevations, pregnancy and years not recommended blurred vision, dysuria, tremor), angle glaucoma, hypersensitivity to antidepressants), potent CYP1A2 lactation, suicidal ideation and behavior hepatotoxicity, suicidal thought, duloxetine or any other component of inhibitors/inducers, CNS-active or worsening depression, bleeding increased urinary frequency, increased the product, uncontrolled hypertension. drugs (eg diazepam, imipramine, abnormalities, hyponatremia, controlled libido, palpitation, decrease appetite, phenytoin, haloperidol, alcohol) narrow-angle glaucoma, diabetes; may blurred vision, flushing, tinnitus. worsen glycemic control, hepatic impairment; increased risk of liver injury and aggravation of pre-existing liver disease, hepatic insufficiency; risk of drug toxicity. avoid abrupt discontinuation

Duloxetine 60 mg Capsule A* Major depression, diabetic peripheral ADULT: 60 mg once daily up to a Gastrointestinal disorders, excessive Concomitant use with MAOIs, potent Drugs metabolised by CYP2D6 (eg History of mania/hypomania, seizures, neuropathic pain maximum dose of 120mg/day (in divided sweating, CNS disorders (eg headache, CYP1A2 inhibitors, hepatic or severe flecainide, vinblastine, renal impairment, elderly, liver doses) CHILD and ADOLESCENT under 18 dizziness, fatigue, insomnia, somnolence, renal impairment, uncontrolled narrow- carbamazepine, tricyclic transaminase elevations, pregnancy and years not recommended blurred vision, dysuria, tremor), angle glaucoma, hypersensitivity to antidepressants), potent CYP1A2 lactation, suicidal ideation and behavior hepatotoxicity, suicidal thought, duloxetine or any other component of inhibitors/inducers, CNS-active or worsening depression, bleeding increased urinary frequency, increased the product, uncontrolled hypertension. drugs (eg diazepam, imipramine, abnormalities, hyponatremia, controlled libido, palpitation, decrease appetite, phenytoin, haloperidol, alcohol) narrow-angle glaucoma, diabetes; may blurred vision, flushing, tinnitus. worsen glycemic control, hepatic impairment; increased risk of liver injury and aggravation of pre-existing liver disease, hepatic insufficiency; risk of drug toxicity. avoid abrupt discontinuation

Dutasteride 0.5 mg Capsule A* Benign prostatic hyperplasia in men with 0.5 mg daily Impotence, decrease libido, ejaculation Severe hepatic impairment, women, child Verapamil, diltiazem, cimetidine, Concurrent use of CYP3A4 enzyme an enlarged prostate gland disorders, gynaecomastia, breast and adolescent ciprofloxacin, ketoconazole, inhibitors (e.g. ritonavir), capsules should tenderness, allergic reactions including ritonavir not be handled by women who are rash, prutitus, urticaria and localized pregnant or who may become pregnant edema. due to the possibility of absorption of dutasteride through the skin and the potential risk of a fetal anomaly

Dydrogesterone 10 mg Tablet A/KK i) Dysmenorrhoea ii) Endometriosis iii) i) 10 mg bd from day 5 - 25 of cycle ii) 10 Breakthrough bleeding, altered liver Breast and genital cancers, abnormal Enzyme inducing drugs such as Pregnancy, liver disease, history or Dysfunctional uterine bleeding (to arrest mg bd - tds from day 5 - 25 of the cycle or function, angioedema, haemolytic vaginal bleeding, breastfeeding carbamazepine, griseofulvin, currently suffer from porphyria. and to prevent bleeding) iv) Threatened continuously iii) To arrest bleeding :10 anaemia phenobarbitone, phenytoin and abortion v) Habitual abortion vi) Post mg bd with an oestrogen once daily for 5 - rifampicin may enhance the menopausal complaints (hormone 7 days, To prevent bleeding : 10 mg bd clearance of progesterone. replacement therapy in combination with with an oestrogen once daily from day 11 Progesterone may inhibit oestrogen) - 25 of the cycle iv) 40 mg at once, then ciclosporin metabolism leading to 10mg 8hrly until symptoms remit v) 10 increased plasma-ciclosporin mg bd until 20th week of pregnancy vi) 10-20 mg daily during last 12-14 days of each cycle Efavirenz 200 mg Capsule A* Combination therapy for HIV infections ADULT: 600 mg once daily. ADOLESCENT Dizziness, nausea, headache, fatigue, Hypersensitivity, concomitant Amprenavir, indinavir, ritonavir, Must not be used as a single agent to with a protease inhibitor and or & CHILD less than 17 years, more than 40 rash including erythema multiforme & terfenadine, cisapride, midazolam, saquinavir, rifamycins, treat HIV or added on as a sole agent to a Nucleoside Reverse Transcriptase kg: 600 mg once daily, 32.5 - less than 40 Stevens-Johnson Syndrome, allergic triazolam ergot derivatives and clarithromycin, oral contraceptives, failing regimen. Monitor psychiatric Inhibitors (NRTIs) kg: 400 mg once daily, 25 - less than 32.5 reaction, abnormal coordination, ataxia, voriconazole (adjusted dose for both anticonvulsants, methadone, St. adverse experiences, nervous system kg: 350 mg once daily, 20 - less than 25 confusion, stupor, vertigo, vomiting, voriconazole and efavirenz are needed) John's wort, sertraline, cetirizine, symptoms and cholesterol. Caution use kg: 300 mg once daily, 15 - less than 20 diarrhoea, hepatitis, impaired lorazepam. Other compounds that in patient with liver disease, history of kg: 250 mg once daily, 13 - less than 15 concentration, insomnia, anxiety, are substrates of CYP3A4 may have seizures, known or suspected history of kg: 200 mg once daily. No studies in abnormal dreams, somnolence, decreased plasma concentration hepatitis B or C infections and in patients children less than 3 years or less than 13 depression, abnormal thinking, agitation, when coadministered with with other medications associated with kg. Formulation unsuitable for children amnesia, delirium, emotional liability, efavirenz liver toxicity. May affect ability to drive less than 40 kg euphoria, hallucination and psychosis or operate machinery. Pregnancy should be avoided in women receiving efavirenz.†

Efavirenz 600 mg Tablet A/KK Combination therapy for HIV infections ADULT: 600 mg once daily. ADOLESCENT Dizziness, nausea, headache, fatigue, Hypersensitivity, concomitant Amprenavir, indinavir, ritonavir, Must not be used as a single agent to with a protease inhibitor and or & CHILD less than 17 years, more than 40 rash including erythema multiforme & terfenadine, cisapride, midazolam, saquinavir, rifamycins, treat HIV or added on as a sole agent to a Nucleoside Reverse Transcriptase kg: 600 mg once daily, 32.5 - less than 40 Stevens-Johnson Syndrome, allergic triazolam and ergot derivatives and clarithromycin, oral contraceptives, failing regimen. Monitor psychiatric Inhibitors (NRTIs) kg: 400 mg once daily, 25 - less than 32.5 reaction, abnormal coordination, ataxia, voriconazole (adjusted dose for both anticonvulsants, methadone, St. adverse experiences, nervous system kg: 350 mg once daily, 20 - less than 25 confusion, stupor, vertigo, vomiting, voriconazole and efavirenz are needed) John's wort, sertraline, cetirizine, symptoms and cholesterol. Caution use kg: 300 mg once daily, 15 - less than 20 diarrhoea, hepatitis, impaired lorazepam. Other compounds that in patient with liver disease, history of kg: 250 mg once daily, 13 - less than 15 concentration, insomnia, anxiety, are substrates of CYP3A4 may have seizures, known or suspected history of kg: 200 mg once daily. No studies in abnormal dreams, somnolence, decreased plasma concentration hepatitis B or C infections and in patients children less than 3 years or less than 13 depression, abnormal thinking, agitation, when coadministered with with other medications associated with kg. Formulation unsuitable for children amnesia, delirium, emotional liability, efavirenz liver toxicity. May affect ability to drive less than 40 kg euphoria, hallucination and psychosis or operate machinery. Pregnancy should be avoided in women receiving efavirenz.

Empagliflozin 10mg tablet A* Indicated in the treatment of type 2 Starting dose is 10 mg once daily. In Hypoglycaemia (when used with SU or Hypersensitivity to the active substance Diuretics may add to the diuretic Should not be used in patients with type diabetes mellitus to improve glycaemic patient with eGFR ≥60 ml/min/1.73m2 insulin), vaginal moniliasis, vulvovaginitis, or to any of the excipients in tablet core effect & increase the risk of 1 diabetes mellitus or for the treatment control in adults as: Add-on combination who need tighter glycaemic control, the balanitis and other genital infection, and film coating. dehydration and hypotension. of diabetic ketoacidosis. Use with therapy: In combination with other dose can be increased up to 25 mg once urinary tract infection, pruritus Insulin and insulin secretagogues cautions in patients with renal glucose–lowering medicinal products daily (maximum). (generalised), increase urination. may increase the risk of impairment, hepatic impairment, including insulin, when these, together hypoglycaemia. pregnancy & lactation, diabetic with diet and exercise, do not provide ketoacidosis, urinary tract infections, adequate glycaemic control. Prescribing cardiac failure patients at risk for volume Restriction: Patients must meets all the depletion & patients who are lactose following criteria: 1. HbA1c not more intolerance. than 8.5% on dual combination anti- diabetic therapy; 2. BMI: 30kg/m2 and above; 3. Creatinine clearance 45ml/min or EGFR 45ml/min/1.73m2 and above. Empagliflozin 25mg tablet A* Indicated in the treatment of type 2 Starting dose is 10 mg once daily. In Hypoglycaemia (when used with SU or Hypersensitivity to the active substance Diuretics may add to the diuretic Should not be used in patients with type diabetes mellitus to improve glycaemic patient with eGFR ≥60 ml/min/1.73m2 insulin), vaginal moniliasis, vulvovaginitis, or to any of the excipients in tablet core effect & increase the risk of 1 diabetes mellitus or for the treatment control in adults as: Add-on combination who need tighter glycaemic control, the balanitis and other genital infection, and film coating. dehydration and hypotension. of diabetic ketoacidosis. Use with therapy: In combination with other dose can be increased up to 25 mg once urinary tract infection, pruritus Insulin and insulin secretagogues cautions in patients with renal glucose–lowering medicinal products daily (maximum). (generalised), increase urination. may increase the risk of impairment, hepatic impairment, including insulin, when these, together hypoglycaemia. pregnancy & lactation, diabetic with diet and exercise, do not provide ketoacidosis, urinary tract infections, adequate glycaemic control. Prescribing cardiac failure patients at risk for volume Restriction: Patients must meets all the depletion & patients who are lactose following criteria: 1. HbA1c not more intolerance. than 8.5% on dual combination anti- diabetic therapy; 2. BMI: 30kg/m2 and above; 3. Creatinine clearance 45ml/min or 45ml/min/1.73m2 and above.

Enalapril 10 mg Tablet B i) Hypertension ii) Congestive heart i) Initially 5 mg daily, (ELDERLY 2.5 mg Dizziness, headache, diarrhoea, fatigue, Angioedema induced by other May have additive effects with Symptomatic hypotension likely to occur failure once daily), usual maintenance dose 10 - asthenia, cough, orthostatic hypotension, angiotensin converting enzyme (ACE) other antihypertensives, potassium in volume depleted patients eg. by 20 mg daily. Maximum: 40 mg/day in 1 - hyperkalaemia, angioneurotic oedema inhibitors. Hypersensitivity to this or any supplement, potassium-sparing diuretic therapy, dietary salt restriction, 2 divided doses ii) Initially 2.5 mg daily, (discontinue therapy) other angiotensin converting enzyme diuretics or potassium-containing dialysis, diarrhoea or vomiting, patients usual maintenance dose 20 mg daily in 1 - inhibitor. Pregnancy (second and third salt substitutes. Increased lithium with heart failure with or without 2 divided doses; maximum: 40 mg/day trimesters particularly) level associated renal insufficiency. Caution in severe heart failure, especially ischemic heart or cerebrovascular disease. Patients with obstruction in the outflow tract of the left ventricle. Renal impairment patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. Dosage reduction and or discontinuation of the diuretic and or enalapril may be required. Serum potassium should be monitored. Not recommended during pregnancy. Lactation. Children Enalapril 20 mg Tablet B i) Hypertension ii) Congestive heart i) Initially 5 mg daily, (ELDERLY 2.5 mg Dizziness, headache, diarrhoea, fatigue, Angioedema induced by other May have additive effects with Symptomatic hypotension likely to occur failure once daily), usual maintenance dose 10 - asthenia, cough, orthostatic hypotension, angiotensin converting enzyme (ACE) other antihypertensives, potassium in volume depleted patients eg. by 20 mg daily. Maximum: 40 mg/day in 1 - hyperkalaemia, angioneurotic oedema inhibitors. hypersensitivity to this or any supplement, potassium-sparing diuretic therapy, dietary salt restriction, 2 divided doses ii) Initially 2.5 mg daily, (discontinue therapy) other angiotensin converting enzyme diuretics or potassium-containing dialysis, diarrhoea or vomiting, patients usual maintenance dose 20 mg daily in 1 - inhibitor. Pregnancy (second and third salt substitutes. Increased lithium with heart failure with or without 2 divided doses; maximum: 40 mg/day trimesters particularly) level associated renal insufficiency. Caution in severe heart failure, especially ischemic heart or cerebrovascular disease. Patients with obstruction in the outflow tract of the left ventricle. Renal impairment patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. Dosage reduction and or discontinuation of the diuretic and or enalapril may be required. Serum potassium should be monitored. Not recommended during pregnancy. Lactation. Children

Enalapril 5 mg Tablet B i) Hypertension ii) Congestive heart i) Initially 5 mg daily, (ELDERLY 2.5 mg Dizziness, headache, diarrhoea, fatigue, Angioedema induced by other May have additive effects with Symptomatic hypotension likely to occur failure once daily), usual maintenance dose 10 - asthenia, cough, orthostatic hypotension, angiotensin converting enzyme (ACE) other antihypertensives, potassium in volume depleted patients eg. by 20 mg daily. Maximum: 40 mg/day in 1 - hyperkalaemia, angioneurotic oedema inhibitors. Hypersensitivity to this or any supplement, potassium-sparing diuretic therapy, dietary salt restriction, 2 divided doses ii) Initially 2.5 mg daily, (discontinue therapy) other angiotensin converting enzyme diuretics or potassium-containing dialysis, diarrhoea or vomiting, patients usual maintenance dose 20 mg daily in 1 - inhibitor. Pregnancy (second and third salt substitutes. Increased lithium with heart failure with or without 2 divided doses; maximum: 40 mg/day trimesters particularly) level associated renal insufficiency. Caution in severe heart failure, especially ischemic heart or cerebrovascular disease. Patients with obstruction in the outflow tract of the left ventricle. Renal impairment patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney. Dosage reduction and or discontinuation of the diuretic and or enalapril may be required. Serum potassium should be monitored. Not recommended during pregnancy. Lactation. Children

Entacapone 200 mg Tablet A Parkinson's Disease. An adjunct to 200 mg to be taken with each daily dose Nausea, vomiting, abdominal pain, Pregnancy and breast-feeding, hepatic Entacapone and ferrous product Levodopa-induced orthostatic standard levodopa/benserazide or of levodopa/dopa-decarboxylase constipation, diarrhoea, urine may be impairment, phaeochromocytoma, should be taken at least 2 - 3 hours hypotension may be aggravated. Abrupt levodopa/carbidopa for use in patients inhibitor. Max 2g daily. May be taken coloured reddish-brown, dry mouth, history of neuroleptic malignant apart. Dosage of levodopa and withdrawal with parkinson's disease and end of dose with or without food dyskinesia, dizziness, anaemia, rarely syndrome or non-traumatic other antiparkinson drugs may motor fluctuations, who cannot be elevated liver enzymes, gastrointestinal rhabdomyolysis. Concomitant use with need to be adjusted when initiating stabilised on those combinations symptoms, insomnia, hallucinations, selective and nonselective MAO-A and entacapone. Effects of medicinal confusion, paroniria, aggravated MAO-B inhibitors products metabolised by catechol- parkinsonism, dizziness, dystonia, O-methyl transferase (COMT) may hyperkinesia, fatigue, increased be potentiated. MAO-A inhibitors, sweating, fall. Extremely rare (potentially tricyclic antidepressants, serious adverse reactions): Hepatitis, noradrenaline reuptake inhibitors, sudden sleep onset episodes, neuroleptic medicinal products metabolized by malignant syndrome, rhabdomyolysis COMT, selegiline, warfarin

Entecavir 0.5 mg Tablet A* First line treatment of Chronic Hepatitis B 0.5-1mg once daily. Renal Dose Swelling, erythema, pruritus, rash, Hypersensitivity to entecavir or to any Drugs that reduce renal function or Monitor hepatic function after treatment in patients who satisfy the criteria for Adjustment: 0.5-1mg every 48hours (30- stinging of skin, burning sensation component of the product compete for active tubular discontinuation. Co-infection with HIV. treatment and require long-term therapy 49ml/min); 0.5-1mg every 72hours (10- secretion may increase serum Patient with renal impairment. Liver or have a very high baseline viral load 29ml/min); 0.5mg-1mg every 5-7 days concentration of either entecavir or transplant recipients. Pregnancy and (<10ml/min; HD or CAPD). co-administered drug Lactation. Children <16 yr. Eperisone HCl 50 mg Tablet A Myotonic symptoms associated with 50 mg 3 times daily Weakness, dizziness, insomnia, Not known Methocarbamol, tolperisone HCl Hepatic disorders, drug hypersensitivity cervical syndrome, periarthritis of drowsiness, numbness or trembling in shoulder and lumbago spastic paralysis the extremities, hepatic and renal dysfunction/ haematological changes, rashes, GI disturbances, urinary disorders

Erythromycin Ethylsuccinate 400 mg B Treatment of susceptible bacterial Adult 400 mg 6 hrly or 800 mg 12 hrly. Rash, urticaria; nausea, vomiting, GI Hypersensitivity; porphyria; hepatic May antagonise therapeutic effects Hepatic& renal impairment, myasthenia Tablet infections Max: 4 g/day. Childn 30-50 mg/kg in discomfort; ototoxicity; central impairment; pregnancy. lincomycin and clindamycin. gravis divided doses. Childn 2-8 yr 1 g/day in neurotoxicity; agranulocytosis; Concurrent usage may lead to divided doses in severe cases. Infant & arrhythmias; pancreatitis. Potentially increased absorption of alcohol. childn ≤2 yr 500 mg/day in divided doses. Fatal: Hepatotoxicity, cholestatic Potentially Fatal: May potentiate jaundice; raised serum transaminases; actions of neuromuscular blockers, eosinophilia. Severe cutaneous adverse oral anticoagulants, ciclosporin, reactions (SCARs). theophylline. Terfenadine, astemizole, cisapride toxicity increased.

Escitalopram 10 mg Tablet A* i) Major depression ii) Treatment of panic i) 10 mg once daily; may be increased to Dizziness, headache, nausea, sweating, Concurrent use of MAOIs or within 14 MAOI, selegiline, lithium, Paradoxical anxiety, seizures, mania, disorder with or without agoraphobia max 20 mg daily. ii) Panic disorder with somnolence, insomnia, constipation, days of discontinuing MAOS treatment tryptophan, agents that may lower diabetes, suicidal tendencies, or without agoraphobia :Initially 5 mg for diarrhoea, increase or decreased seizure threshold, St John's Wort, hyponatraemia, haemorrhage, the first week, thereafter increased to 10 appetite, sexual dysfunction, fatigue, omeprazole, high doses of electroconvulsive therapy, reversible mg daily. Max 20 mg daily, ELDERLY pyrexia, sinusitis, yawning, rash, Steven cimetidine, drugs metabolised by selective MAO-A inhibitors, serotonin initially half the adult dose, lower Johnson Syndrome, rhinitis, blurred CYP2D6 and CYP2C19 enzymes, syndrome, St John's Wort, lactation, maintenance dose may be sufficient. vision, nasal congestion, prolactinemia, alcohol, aspirin, NSAIDs, warfarin, renal and hepatic function impairment, CHILD and ADOLESCENT under 18 years dry mouth, decrease prothrombin, carbamazepine, ketoconazole, abnormal bleeding, avoid abrupt not recommended hepatic failure, hypoglycemia, linezolid, tramadol, metoprolol, 5 discontinuation, may activate hypomania hypokalemia, suicidal ideation, HT agonist, gingko, lamotrigine or mania, concomitant use of NSAIDs, diaphoresis, Syndrome of inappropriate work requiring mental alertness. antidiuretic hormone secretion (SIADH), ear ache, urinary tract infection, urinary frequency.

Esomeprazole 20 mg Tablet A* i)Gastro-oesophageal reflux disease ii)H. i)20mg daily for 4-8 weeks ii)40mg daily Abdominal pain , constipation , diarrhoea Hypersensitivity to esomeprazole, in Citalopram, imipramine, Exclude gastric malignancy prior to pylori eradication for 10 days in combination with , dyspepsia , flatulence , nausea , patients with known hypersensitivity to clomipramine, phenytoin, treatment. Severe renal or hepatic amoxicillin 1g twice daily or dizziness, headache erythema any component of the formulation diazepam, ketoconazole , insufficiency. Pregnancy; lactation clarithromycin 500mg twice daily multiforme , Stevens-Johnson syndrome, itraconazole, warfarin, effects on (discontinue). Long-term treatment toxic epidermal necrolysis, dermatitis absorption, effects on hepatic should be kept under regular metabolism/cytochrome P-450 surveillance. Fructose intolerance, pathways,clarithromycin and glucose-galactose malabsorption or amoxicillin (increase esomeprazole sucrase-isomaltase insufficiency. and 14-hydroxyclarithromycin Monitoring when initiating and ending plasma level) concomitant treatment with warfarin.Severe liver impairment, Hypersensitivity reactions e.g., angioedema and anaphylactic reaction/shock have been reported Esomeprazole 40 mg Tablet A* i)Gastro-oesophageal reflux disease ii)H. i)20mg daily for 4-8 weeks ii)40mg daily Abdominal pain , constipation , diarrhoea Hypersensitivity to esomeprazole, in Citalopram, imipramine, Exclude gastric malignancy prior to pylori eradication for 10 days in combination with , dyspepsia , flatulence , nausea , patients with known hypersensitivity to clomipramine, phenytoin, treatment. Severe renal or hepatic amoxicillin 1g twice daily or dizziness, headache erythema any component of the formulation diazepam, ketoconazole , insufficiency. Pregnancy; lactation clarithromycin 500mg twice daily multiforme , Stevens-Johnson syndrome, itraconazole, warfarin, effects on (discontinue). Long-term treatment toxic epidermal necrolysis, dermatitis absorption, effects on hepatic should be kept under regular metabolism/cytochrome P-450 surveillance. Fructose intolerance, pathways,clarithromycin and glucose-galactose malabsorption or amoxicillin (increase esomeprazole sucrase-isomaltase insufficiency. and 14-hydroxyclarithromycin Monitoring when initiating and ending plasma level) concomitant treatment with warfarin.Severe liver impairment, Hypersensitivity reactions e.g., angioedema and anaphylactic reaction/shock have been reported

Essential Phospholipids, A/KK Nutritional supplement in liver disorders Please refer to product leaflet Gastrointestinal disorders; allergic Hypersensitivity. Children < 12 years old. Anticoagulants May provoke severe allergic reactions. nicotinamide, cyanocobalamine, reactions (rare) Pregnancy & lactation. tocopheryl, pyridoxine, thiamine, riboflavine capsule

Estradiol 1 mg & Estradiol 1 mg with A* Hormone Replacement Therapy for One tablet daily without pill-free interval, Breast tenderness, nausea, headache, Known or suspected carcinoma of the Phenobarbital, carbamazepine, Periodic general and gynaecological Dydrogesterone 10 mg women with disorders due to natural or starting with 1 mg of Estradiol for first 14 oedema, breakthrough bleedings, skin breast, endometrial carcinoma or other phenytoin, St John's Wort may exam and mammogram should be surgically induced menopause with intact days, followed by 1mg Estradiol with 10 reactions hormone dependent neoplasia. Acute or increase metabolism of estrogens. instituted. Patients in the uterus. mg Dydrogestrone daily for the next 14 chronic liver disease. History of liver perimenopausal phase are advised to days disease where the liver function tests take non-hormonal contraceptive have not returned to normal. History of precautions. Interruption of HRT 1 month venous thromboembolic diseases (e.g. before surgery should be considered. deep venous thrombosis or pulmonary Epilepsy, migraine, cardiac failure, embolism). Abnormal genital bleeding. hypertension, porphyria, Known or suspected pregnancy haemoglobinopathies, otosclerosis, uterine leiomyomata, endometriosis, lactation

Estradiol Valerate 1 mg Tablet A* Oestrogen replacement therapy - only 1 mg daily continuously or 21 day Headache, nausea, hypertension, Severe liver disease, breast cancer Barbiturates, phenylbutazone, Associated with adverse lipoprotein those who cannot tolerate Premarin regimen with 1 week of tablet free myocardia infarction, thromboembolism, (except metatastic disease), oestrogen hydantoins, rifamcipin and metabolism, impairment of glucose interval vaginal bleeding, breast tension, increase dependent neoplasia, known or ampicillin may impair action of the tolerance, possible enhancement of in body weight suspected pregnancy, undiagnosed drug. Requirements for oral mitotic activity in breast epithelial tissue. abnormal vaginal bleeding, antidiabetics and insulin can Hypercoagulability, familial thromboembolic disorders change as a result of glucose hyperlipoproteinaemia, fluid retention, intolerance. uterine bleeding and mastodynia, impaired liver function and aspirin hypersensitivity (tartazine dye) Estradiol Valerate 2 mg and B Pre and post menopausal syndrome, Start on the 5th day of menstrual cycle - Changes in vaginal bleeding pattern, Known or suspected pregnancy, including Rifampicin, barbiturates, phenytoin, Asthma, epilepsy, migraine, Norgestrel 500 mcg with Estradiol primary and secondary amenorrhea, 1 tab daily for 21 days then stop for 7 change in amount of cervical secretion, use for missed abortion or as a diagnostic rifampicin, phenylbutazone, hypertension, cardiac or renal Valerate 2 mg Tablet menstrual irregularities. Deficiency days. If patient forgets dose at usual premenstrual-like-syndrome, cystitis-like- test for pregnancy. Oestrogen or ampicillin. Requirements for oral dysfunction, endometrial hyperplasia, symptoms after oophorectomy or time, it should be taken within following syndrome, increase in size of uterine progestin may cause foetal harm when antidiabetics and insulin can metabolic bone diseases, endometrial radiological castration for 12 hours leiomyomata, vaginal candidiasis, administered to a pregnant woman. change cancer, breast cancer, gall bladder noncarcinomatous disease amenorrhoea, changes in cervical Known or suspected cancer of the breast. disease, pancreatitis, lactation, surgery, erosion, nausea, cholestatic jaundice, Known or suspected oestrogen - liver disorders, enlargement of uterine changes in appetite, vomiting, abdominal dependent neoplasm, severe liver fibromyomata cramps, bloating, increased incidence of dysfunction, jaundice or severe pruritus gall bladder disease, pancreatitis. during a previous pregnancy, previous or Headache, dizziness, mental depression, existing liver tumours, existing or nervousness, migraine. Increase or suspected hormone-dependent tumours decrease in weight, oedema, changes in of uterus or mammae. Severe diabetes libido, fatigue, backache, reduced with vascular changes, previous or carbohydrate tolerance, aggravation of existing thromboembolic processes, porphyria, pyrexia, anaphylactoid endometriosis, disturbances of reactions lipometabolism, a history of herpes gestationis, otosclerosis with deterioration during previous pregnancies, Dubin-Johnson syndrome, Rotor syndrome, sickle-cell anemia

Ethambutol HCl 400 mg Tablet B Tuberculosis Adult: 15-25mg/kg daily (max 1200mg) or Generally well tolerated but may Optic neuritis; history of previous Aluminium hydroxide, ethionamide Reduced visual acuity. Reduced dosage in 50mg/kg biweekly (max2000mg). provoke reversible retrobulbar neuritis adverse effects with ethambutol. impaired renal function. May precipitate Children: 15-25mg/kg daily or 50 mg/kg with a reduction of visual acuity, central Lactation. attack of gout. Ocular examination is twice weekly. scotoma& green-red colour blindness, recommended allergic rashes, GI disturbances, jaundice, peripheral neuritis, confusion, hallucinations, joint pain, fever, malaise, headache, dizziness, anorexia& abdominal pain

Etoricoxib 120 mg Tablet A* i)Acute and chronic treatment of signs i) OA: 60 mg once daily. RA: 90 mg once Small increase in blood pressure, Patients who experienced asthma, Warfarin, ACEIs, lithium, Bleeding disorders, liver disease, renal and symptoms of osteoarthritis (OA) and daily ii & iii) Acute gouty arthritis and increased risk of thrombotic urticaria or allergic type of reaction after methotrexate, oral contraceptives, impairment , hypertension, recent rheumatoid arthritis (RA) ii)Acute gouty acute pain: 120 mg once daily (Given the complication, headache, dizziness, taking aspirin or NSAIDs, acute peptic rifampicin, aspirin, SSRIs myocardial infarct, cardiovascular arthritis iii)Acute pain exposure to COX-2 inhibitors, doctors are fatigue, insomnia, nausea, vomiting, ulcer, severe renal or hepatic disease, hyperlipidaemia, diabetes, advised to use the lowest effective dose diarrhoea, heartburn, taste disturbance, disease,ischaemic heart disease and smoking, peripheral arterial disease for the shortest possible duration of decreased appetite and flatulence stroke, hypertensive patient whose treatment) blood pressure is not under control

Etoricoxib 90 mg Tablet A* i)Acute and chronic treatment of signs i) OA: 60 mg once daily. RA: 90 mg once Small increase in blood pressure, Patients who experienced asthma, Warfarin, ACEIs, lithium, Bleeding disorders, liver disease, renal and symptoms of osteoarthritis (OA) and daily ii & iii) Acute gouty arthritis and increased risk of thrombotic urticaria or allergic type of reaction after methotrexate, oral contraceptives, impairment , hypertension, recent rheumatoid arthritis (RA) ii)Acute gouty acute pain: 120 mg once daily (Given the complication, headache, dizziness, taking aspirin or NSAIDs, acute peptic rifampicin, aspirin, SSRIs myocardial infarct, cardiovascular arthritis iii)Acute pain exposure to COX-2 inhibitors, doctors are fatigue, insomnia, nausea, vomiting, ulcer, severe renal or hepatic disease, hyperlipidaemia, diabetes, advised to use the lowest effective dose diarrhoea, heartburn, taste disturbance, disease,ischaemic heart disease and smoking, peripheral arterial disease for the shortest possible duration of decreased appetite and flatulence stroke, hypertensive patient whose treatment) blood pressure is not under control Ezetimibe 10 mg & Simvastatin 20 A* Primary hypercholesterolemia Usual starting dose: 10/20 mg/day Myalgia, headache, upper respiratory Hypersensitivity to ezetimibe or Itraconazole, ketoconazole, Unexplained muscle pain, tenderness or mg Tablet infection, hepatotoxicity, anaphylaxis, simvastatin or any of its components. erythromycin, clarithromycin, HIV weakness, heavy alcohol use, past angioedema drug-induced myopathy, Active liver disease or unexplained protease inhibitors, gemfibrozil, history of liver disease or current rhabdomyolysis, abdominal pain, persistent elevations in serum niacin, cyclosporine, danazol, moderate to severe hepatic insufficiency, diarrhoea, fatigue, thrombocytopenia, transaminases, pregnancy, lactation amiodarone, verapamil, major surgery, renal insufficiency hepatitis, hypersensitivity reactions cholestyramine, diltiazem, fibrates, including rash and angioedema, grapefruit juice, coumarin pancreatitis, nausea, anaemia, derivatives, antacids constipation, asthenia, jaundice, muscle cramps, dizziness, paresthesia, peripheral neuropathy, alopecia, pruritus

Ezetimibe 10 mg Tablet A* i) Co-administration with statins for 10 mg once daily. Not recommended for Abdominal pain, arthralgia, back pain, Avoid co-administration with fibrates. Cholestyramine, fibrates, Children under 10 years old, moderate to patients who have chronic heart disease children less than 10 years old cough, diarrhoea, fatigue, headache, Hypersensitivity to ezetimibe, active liver cyclosporin severe hepatic insufficency, myopathy, or are chronic heart disease equivalent or sinusitis disease or persistently elevated liver pregnancy and lactation familial hypercholesterolaemia with enzymes target LDL-C not achieved by maximum dose of statins ii) Monotherapy in patients with documented biochemical intolerance to statins

Felodipine 10 mg Extended Release A/KK Hypertension Initiate at 5 mg once daily. Usual dose, 5 - Peripheral oedema, asthenia, headache, Unstable angina pectoris, cardiogenic Plasma levels increased by CYP3A4 Patients with heart failure, hypertrophic Tablet 10 mg once daily in the morning dizziness, fatigue, tachycardia, shock, aortic stenosis inhibitors (e.g. cimetidine, azole cardiomyopathy with outflow tract palpitation, flushing, rash, nausea, antifungals, erythromycin, obstruction. Hepatic impairment. Elderly. dyspepsia, constipation, upper resp ritonavir) and reduced CYP3A4 by Pregnancy and lactation. infection, ankle swelling, gingival inducers (e.g. phenytoin, hyperplasia. carbamazepine, barbiturates). May increase concentration of tacrolimus.

Felodipine 5 mg Extended Release A/KK Hypertension Initiate at 5 mg once daily. Usual dose, 5 - Peripheral oedema, asthenia, headache, Unstable angina pectoris, cardiogenic Plasma levels increased by CYP3A4 Patients with heart failure, hypertrophic Tablet 10 mg once daily in the morning dizziness, fatigue, tachycardia, shock, aortic stenosis inhibitors (e.g. cimetidine, azole cardiomyopathy with outflow tract palpitation, flushing, rash, nausea, antifungals, erythromycin, obstruction. Hepatic impairment. Elderly. dyspepsia, constipation, upper resp ritonavir) and reduced CYP3A4 by Pregnancy and lactation. infection, ankle swelling, gingival inducers (e.g. phenytoin, hyperplasia. carbamazepine, barbiturates). May increase concentration of tacrolimus. Fenofibrate 145 mg tablet A* Category of prescriber A/KK is approved 145mg once daily, with or without food Gastrointestinal disorders, moderately Gallbladder disease, history of Oral anticoagulants, cyclosporin, Reduce dose in renal impairment. for the following indications ONLY: As elevated serum transaminase levels. hypersensitivity to fenofibrate, including HMG-CoA reductase inhibitors & Monitor transaminase & creatinine levels second line therapy after failed severe skin rashes, hypersensitivity to other fibrates. every 3 months at the initiation of gemfibrozil in patients: i) fenofibric acid, the active metabolite of treatment. Discontinue if AST & ALT Hypercholesterolemia and fenofibrate, liver disease, active, levels more than 3 times/upper limit of hypertriglyceridemia alone or combined including primary biliary cirrhosis and normal. Pancreatitis. Hypoalbuminemia. [type IIa,IIb,III and V dysplipidemias] in unexplained persistent liver function Patients with predisposing factors for patients unresponsive to dietary and abnormality, nursing mothers, renal myopathy/rhabdomyolysis. other non-pharmacological measures impairment especially when there is evidence of associated risk factors ii) Treatment of secondary hyperlipoproteinemias if hyperlipoprotenemia persists despite effective treatment of underlying disease iii) Dyslipidemia in Type 2 Diabetes Mellitus Category of prescriber A* is approved for the following indication: Diabetic retinopathy Indicated for the reduction in the progression of diabetic retinopathy in patients with type 2 diabetes and existing diabetic retinopathy. Prescribing Restriction: To be initiated by endocrinologists and ophthalmologists only.

Ferrous controlled release 500 mg, A/KK Anemia due to iron deficiency, One tablet daily Rare, occasionally with nausea, vomiting, Patients with hypersensitivity to any of Magnesium trisilicate and antacid Folic acid alone is improper therapy in Vitamin B1, Vitamin B2, Vitamin B6, megaloblastic anemia where there is an constipation or diarrhea, gastric pain at the ingredients of this drug, patients with which contains carbonate will the treatment of pernicious anemia and Vitamin B12, Vitamin C, Niacinamide, associated deficiency of Vitamin C and high doses thalassemia, sideroblastic anemia, inhibit the absorption of iron. other megaloblastic anemia where Calcium Pantothenate, Folic Acid 800 Vitamin B-complex particularly in hemochromatosis, and hemosiderosis. Ferrous sulfate affects tetracycline vitamin B12 is deficient. There is the mcg Tablet pregnancy. In primary health clinic, the Should not be used in paediatric patients absorption. Levodopa may produce possibility of dark feces. Not suitable to indication is restricted to anemia due to and also contraindicated in the rare reversed effect due to pyridoxine. patients who received repeated blood iron deficiency in pregnant women ONLY. instance of hypersensitivity to folic acid Administration with milk or egg transfusion or non-iron deficiency may inhibit the absorption of iron. anemia. Long-term usage may cause iron accumulation. Use in the elderly: Elderly people who have tendency of vitamin B12 deficiency must have regular monitoring of vitamin B12 serum concentration while taking this drug.

Ferrous Fumarate 200 mg Tablet C+ Prevention and treatment of iron- Adult: Usual dose range: Up to 600 mg Abdominal cramps, nausea, vomiting, Haemochromatosis, haemolytic anaemia, Oral absorption of iron may be Avoid in patients with peptic ulcer, deficiency anaemias daily. May increase up to 1.2 g daily if diarrhoea or constipation, dark stools, known hypersensitivity to iron salts increased when taken with ascorbic enteritis, receiving frequent blood necessary. Child: As syrup containing 140 heartburn, temporary teeth staining and acid. May reduce the absorption of transfusions or ulcerative colitis. mg(45 mg iron)/5ml. Preterm neonate: discolouration of urine quinolones and tetracyclines when Administration of iron for more than 6 0.6-2.4 ml/kg daily; up to 6 years old: 2.5- taken concurrently via the oral months should be avoided except in 5ml twice daily route. Concurrent admin with patients with continuous bleeding or antacids may reduce the menorrhagia absorption of ferrous fumarate from the GI tract. May reduce the absorption of penicillamine in the gut when taken concurrently. Finasteride 5 mg Tablet A* Treatment and control of benign 5 mg a day as a single dose. Clinical Reduce libido, premature ejaculation, Hypersensitivity to finasteride products, Not known Patients should be screened for prostatic prostatic hyperplasia responses occur within 12 weeks - 6 breast tenderness or enlargement known or suspected pregnancy carcinoma, hepatic dysfunction, patients months of initiation of therapy. Long- with a large residual urinary volume or a term administration is recommended for severely diminished urinary flow rate maximal response should be monitored for obstructive uropathy and may not be candidates for finasteride therapy, crushed tablets should not be handled by a woman when she is pregnant or may potentially be pregnant because of the possibility of absorption and the subsequent potential risk to the male foetus

Flecainide Acetate 100mg Tablet A* i) Sustained monomorphic ventricular Ventricular arrhythmias: 100 mg twice Giddiness, dizziness, lightheadedness, Preexisting second- or third-degree AV Amiodarone; increased flecainide Congestive heart failure (CHF), patients tachycardias ii) Preexcited atrial daily, maximum 400 mg/day (usually visual disturbances, nausea and block; right bundle branch block when plasma levels; reduce dose of with a left ventricular ejection fraction fibrillation associated with Wolff- reserved for rapid control or in heavily vomiting. Proarrhythmia may occur in associated with a left hemiblock (unless a flecainide (LVEF) less than 40% may be particularly Parkinson White Syndrome iii) built patients), reduced after 3 - 5 days if patients with structural heart disease pacemaker is present); presence of 50%.Cimetidine;increased susceptible to the adverse cardiac effects Reciprocating Atrio-Ventricular possible. Supraventricular arrhythmias: and or significant left ventricular cardiogenic shock; hypersensitivity to the bioavailability and half-life of (ie, worsening CHF, proarrhythmia). tachycardias (AVT) associated with Wolff- 50 mg twice daily, increased if required impairment drug flecainide.Cisapride, disopyramide, Elderly patients. Electrolyte imbalance Parkinson White Syndrome iv) to maximum of 150 mg twice daily verapamil;has negative inotropic (eg, hypo- or hyperkalemia) . Hepatic Supraventricular tachycardias due to effects; administer with flecainide disease, increased mortality; flecainide Intra-Atrio Ventricular Nodul Reentry only if benefit outweighs the risks. should not be initiated in post- Coadministration with flecainide is myocardial infarction patients with not recommended because of the asymptomatic or minimally symptomatic increased risk of life-threatening non-life threatening ventricular cardiac arrhythmias. Increased pacemaker arrhythmias.Digoxin;Increased threshold, proarrhythmic events; new or digoxin plasma levels.Drugs that worsened arrhythmias, primarily at high inhibit CYP2D6 (eg, quinidine, serum levels . Renal disease . Sick sinus ritonavir);Flecainide plasma syndrome (Bradycardia-Tachycardia concentrations may be elevated, syndrome) and slowing of cardiac increasing the risk of conduction toxicity.Propranolol;levels of either drug may be increased, additive negative inotropic effects. Smoking;increased dosage may be required.Urinary acidifiers;effects of flecainide may be decreased. Urinary alkalinizers;effects of flecainide may be increased Fluconazole 100 mg Capsule A i) Oropharyngeal candidiasis, atrophic i) Oropharyngeal candidiasis: 50 - 100 mg Nausea, abdominal pain, diarrhoea, Known hypersensitivity to fluconazole or Warfarin, oral sulfonylureas, Pregnancy, lactation, renal impairment oral candidiasis associated with dentures, daily for 7 - 14 days (Maximum 14 days) flatulence; rash, headache to related azole compounds, co- phenytoin, rifampicin, cyclosporin, other candidal infections of mucosa ii) except in severely immunocompromised administration of terfenadine theophylline, cisapride Tinea pedis, corporis, cruris, versicolor patients, treatment can be continued for and dermal candidiasis iii) Invasive longer periods. Atrophic oral candidiasis candidal & cryptococcal infections associated with dentures: 50 mg daily for (including meningitis) iv) Prevention of 14 days. Other candidal infections of relapse of cryptococcal meningitis in mucosa: 50 - 100 mg daily for 14 - 30 AIDS patients after completion of days. CHILD: 3 - 6 mg/kg on first day then primary therapy v) Prevention of fungal 3 mg/kg daily (every 72 hours in infections in immunocompromised NEONATE up to 2 weeks old, every 48 patients considered at risk as a hours in NEONATE 2 - 4 weeks old) ii) 50 consequence of HIV infections or mg daily for 2 - 4 weeks, maximum 6 neutropenia following cytotoxic weeks iii) 400 mg initially then 200 - 400 chemotherapy, radiotherapy or bone mg daily for 6 - 8 weeks. CHILD: 6 - 12 marrow transplant mg/kg daily (every 72 hours in NEONATE up to 2 weeks old, every 48 hours in NEONATE 2 -4 weeks old) iv) 100 - 200 mg daily v) 50 - 400 mg daily. CHILD: 3 - 12 mg/kg daily (every 72 hours in NEONATE up to 2 weeks old, every 48 hours in NEONATE 2 - 4 weeks old)

Fludrocortisone Acetate 0.1 mg A As an adjunct to glucocorticoids in the Adrenocorticoid insufficiency (chronic): Fluid& electrolyte disturbances, muscle Hypersensitivity to fludrocortisone, Spironolactone- result in a Cirrhosis, diabetes mellitus, Tablet management of primary adrenocortical ADULT 1 tablet daily. Salt-losing weakness, peptic ulcer, oedema, uncontrolled bacterial infection, viral or paradoxical dose-related increase hypertension, hypothyroidism. Glaucoma insufficiency in Addison's disease and adrenogenital syndrome: ADULT 1 - 2 urticaria, headache, glycosuria systemic fungal infections, psychotic in urinary potassium excretion. can also occur with prolonged use. treatment of salt-losing adrenogenital tablets daily. CHILD and INFANT 0.5 - 1 tendencies, osteoporosis, acute Loop diuretic- excessive potassium Discontinue treatment by reducing the syndrome tablet daily glomerulonephritis, chronic nephritis loss. Risk of tendon rupture may be dosage gradually increased in patients receiving concomitant fluoroquinolones and corticosteroids

Flunarizine HCl 5 mg Capsule B i) Migraine prophylaxis ii) Maintenance i) ADULT: 5 - 10 mg daily preferably at Drowsiness, fatigue, asthenia, Hypersensitivity to flunarizine or Excessive sedation can occur with Hepatic insufficiency, elderly, depression, treatment of vestibular disturbances and night. ELDERLY more than 65 years: 5 mg depression, headache, porphyria, cinnarizine, history of depressive illness, alcohol, hypnotics or tranquilizers. pregnancy, breast feeding, may impair of cerebral and peripheral disorders at night. Maintenance 5-day treatment dizziness, insomnia, tremor, pre-existing symptoms of Parkinson's Amiodarone, beta blockers, ability to drive or operating machinery at the same daily dose ii) 5 - 10 mg at extrapyramidal effects, nausea, vomiting, disease or other extrapyramidal carbamazepine, NSAIDs, night. If no improvement after 1 month, dry mouth, gastric pain, weight gain disorders anticoagulants, rifampin, discontinue treatment sumatriptan, hypnotics or tranquilisers, diclofenac, ibuprofen, phenytoin, valproate. Fluoxetine HCl 20 mg Capsule A i) Depression ii) Obsessive-compulsive i) 20 mg once daily increased after 3 Tremor, asthenia, gastrointestinal Present or recent treatment with MAOIs, Drugs metabolised by cytochrome History of seizure, elderly, volume disorder weeks if necessary, usual dose 20 - 60 mg disorder, inappropriate secretion of hypersensitivity to fluoxetine P450, CNS active drugs, drugs depletion, diabetes, cardiac disease, (ELDERLY 20 - 40 mg) once daily max 80 adrenocortical hormone, nervousness, highly bound to protein plasma. pregnancy and breastfeeding, impaired mg once daily (ELDERLY max 60 mg once insomnia, headache, anorexia, anxiety, Benzodiazepines, caffeine, renal/liver function, abnormal bleeding, daily). ii) Initially 20 mg once daily dry mouth, decreased libido, delayed ergotamine, clozapine, lithium, suicidal ideation, anxiety and insomnia, increased after 2 weeks if necessary, ejaculation, anorgasmia, sweating and MAOIs, phenytoin, antipsychotics, hyponatremia, rash, avoid abrupt usual dose 20 - 60 mg (ELDERLY 20 - 40 serotonin syndrome propranolol, warfarin. withdrawal mg) once daily, max 80 mg (ELDERLY max 60 mg) once daily, discontinue if no improvement within 10 weeks. CHILD and ADOLESCENT under 18 years are not recommended

Flutamide 250 mg Tablet A* Androgen deprivation therapy in 250 mg 3 times daily Diarrhoea, cystitis, hot flushes, Hypersensitivity to flutamide, severe Warfarin Monitor liver function, aniline toxicity, advanced prostate cancer in combination hepatotoxicity, drowsiness, confusion, hepatic impairment, pregnancy use in women with luteinising hormone-releasing depression, anxiety, decreased libido, hormone (LHRH) analogue therapy or impotence, gynaecomastia, surgical castration. discolouration of urine, hypertension, myocardial infarction, peripheral edema

Fluvoxamine 100 mg Tablet B Depression For depression, initially 50 - 100 mg daily Blurred vision, dry mouth, tremor, Use of MAOI within 14 days, Warfarin, phenytoin, theophyline, Concomitant use with MAOIs, hepatic in the evening, increased if necessary to gastrointestinal disturbances, coadministration of terfenadine, propanolol, lithium, insufficiency, children, epilepticus, 300 mg daily (over 150 mg in divided somnolence, constipation, headache, astemizole or cisapride, may cause benzodiazepines, caffeine, geriatric, pregnancy, lactation, doses); usual maintenance dose 100 mg insomnia, vomiting, dizziness, agitation, increased plasma concentrations of these ergotamine, MAOIs, sildenafil, cardiovascular disease, avoid abrupt daily. CHILD and ADOLESCENT under 18 extrapyramidal effects, bradycardia, drugs and an increased incidence of side statins, heparin, NSAIDs, aspirin, withdrawal, elderly, abnormal bleeding, years not recommended seizures, hepatotoxicity, withdrawal effects, hypersensitivity to fluvoxamine carbamazepin, clozapin, hyponatremia, may activate mania or syndrome, Steven Johnson Syndrome, haloperidol, proton pump inhibitor, hypomania, history of seizure, suicidal anphylactic reaction, abnormal tricyclic antidepressants, grapefruit, ideation, worsening depression. ejaculation, hepatitis, asthenia, abnormal St. John wort, dilatiazem, bleeding, hyponatremia, seizure, metoclopramide, serotonergic serotonin syndrome, worsening drugs, linezolid, tramadol, celecoxib depression, hypomania, mania (rare), suicidal thoughts

Fluvoxamine 50 mg Tablet B Depressive disorder For depression, initially 50 - 100 mg daily Blurred vision, dry mouth, tremor, Use of MAOI within 14 days, Warfarin, phenytoin, theophyline, Concomitant use with MAOIs, hepatic in the evening, increased if necessary to gastrointestinal disturbances, coadministration of terfenadine, propanolol, lithium, insufficiency, children, epilepticus, 300 mg daily (over 150 mg in divided somnolence, constipation, headache, astemizole or cisapride, may cause benzodiazepines, caffeine, geriatric, pregnancy, lactation, doses); usual maintenance dose 100 mg insomnia, vomiting, dizziness, agitation, increased plasma concentrations of these ergotamine, MAOIs, sildenafil, cardiovascular disease, avoid abrupt daily. CHILD and ADOLESCENT under 18 extrapyramidal effects, bradycardia, drugs and an increased incidence of side statins, heparin, NSAIDs, aspirin, withdrawal, elderly, abnormal bleeding, years not recommended seizures, hepatotoxicity, withdrawal effects, hypersensitivity to fluvoxamine carbamazepin, clozapin, hyponatremia, may activate mania or syndrome, Steven Johnson Syndrome, haloperidol, proton pump inhibitor, hypomania, history of seizure, suicidal anphylactic reaction, abnormal tricyclic antidepressants, grapefruit, ideation, worsening depression. ejaculation, hepatitis, asthenia, abnormal St. John wort, dilatiazem, bleeding, hyponatremia, seizure, metoclopramide, serotonergic serotonin syndrome, worsening drugs, linezolid, tramadol, celecoxib depression, hypomania, mania (rare), suicidal thoughts Folic Acid 5 mg Tablet C+ i) For the prevention and treatment of i) ADULT initially 10-20mg mg daily for 14 GI disturbances, hypersensitivity Undiagnosed megaloblastic anaemia; Antiepileptics, oral contraceptives, Treatment resistance may occur in folate deficiency states ii) For the days or until haematopoietic response reactions; bronchospasm. pernicious, aplastic or normocytic anti-TB drugs, alcohol, aminopterin, patients with depressed haematopoiesis, prevention of neural tube defect in the obtained. Daily maintenance: 2.5 mg- anaemias. methotrexate, pyrimethamine, alcoholism, deficiencies of other foetus 10mg .CHILD up to 1 year:250 mcg/kg trimethoprim and sulphonamides vitamins. Large doses of folic acid may daily; 1 to 5 years:2.5mg/day;6-12 years: may result to decrease in serum lower the blood concentration of vitamin 5mg/day ii) 5 mg daily starting before folate contrations. Decreases B12.Folate dependent tumours, those pregnancy and continued through the serum phenytoin concentrations. with phenytoin,neonates.Should not be first trimester given until the diagnosis of pernicious anaemia has been ruled out.

Frusemide 40 mg Tablet B Pulmonary oedema ADULT: Initial 40 - 80 mg on morning if Hyponatremia Anuria, hypersensitivity to furosemide, Activated charcoal, amikacin, Alterations in blood glucose and glucose required, can be increased to a max of 1 hepatic coma and pre-coma. Severe gentamicin, kanamycin, angiotensin tolerance tests. Diabetes mellitus, g/day in certain cases especially in hypokalaemia, severe hyponatraemia, converting enzyme inhibitors, electrolyte imbalance (eg, hypokalaemia, chronic renal failure. CHILD : 1 - 3 mg/kg hypovolaemia with or without aspirin, chloral hydrate, digoxin hyponatraemia), fluid imbalance, daily concomitant hypotension steroids, NSAIDs dehydration, blood volume reduction with circulatory collapse and possible vascular thrombosis and emboli may occur with excessive diuresis especially in elderly patients. Gout or hyperuricaemia. Hepatic disease (cirrhosis and ascites). Hypersensitivity to sulfonamides. Ototoxicity (hearing loss, tinnitus), systemic lupus erythematosus

Fusidate, Sodium 250 mg Tablet A* Treatment of infections caused by ADULT: 500 mg 3 times daily, skin and Gastrointestinal disturbances (dyspepsia, Hypersensitivity to fusidic acid and or its Hepatotoxicity and increased Hepatic insufficiency. Pregnancy and susceptible organisms especially soft tissue infection: 250 - 500 mg twice nausea, vomiting) salts plasma concentrations of fusidic lactation Staphylococcal infections including daily acid and ritonavir. An increased risk Methicillin Resistant Staphylococcus of myopathy or rhabdomyolysis aureus (MRSA) with simvastatin Gabapentin 300 mg Capsule A* i) Add-on therapy for intractable partial ADULT & CHILD > 12 yrs: 900- Somnolence, dizziness, ataxia, weight Hypersensitivity to gabapentin Antacid like Maalox reduced the Renal insufficiency, patients less than 12 epilepsy, refractory to standard anti- 3600mg/day. Therapy may be initiated gain, fatigue, nystagmus, tremor, bioavailability of gabapentin years old, diabetes, pregnancy, lactation, epileptic drugs ii) Treatment of various by administered 300mg TDS on day 1, or diplopia, amnesia, dyspepsia, asthenia, elderly, renal impairment, haemodialysis, types of neuropathic pain, both by titrating the dose as: 300mg once on leukopenia, headache, myalgia absence seizures. Avoid abrupt peripheral (which includes diabetic day 1, 300mg BD on day 2, 300mg TDS on withdrawal. Discontinuation of neuropathy, post-herpetic neuralgia, day 3. Thereafter, may be increased in 3 gabapentin and or addition or trigeminal neuralgia) in adult more than equally divided doses up to max substitution of alternative therapy should 18 years 3600mg/day.CHILD 3-12 yr: Initially 10-15 be gradual, over a minimum of 1 week. mg/kg/day in 3 divided dose. Effective May affect ability to drive or operate dose: CHILD 3 to less than 5 yrs: machinery. Potential for an increase in 40mg/kg/day in 3 divided doses, CHILD 5- risk of suicidal thoughts or behaviours 12 yrs: 25-35mg/kg/day in 3 divided doses ii) ADULT: 900mg/day in 3 equally divided doses. Max 3600mg/day

Gemfibrozil 300 mg Capsule A/KK Treatment of hyperlipoprotinaemias ADULT: 1200 mg/day in 2 divided doses, Myositic syndrome, cholelithiasis, GI Hypersensitivity to gemfibrozil, severe Co-admin with repaglinide may Cholelithiasis, concomitant use of (TYPES IIA, IIB, III, IV, V) 30 minutes before breakfast and dinner. disturbances, rash, headache, blood hepatic or renal dysfunction, gall stones, lead to an increase in the serum anticoagulants and Dose range from 0.9-1.5 g daily dyscrasias, myalgia. Impotence, painful neonates, children, pregnancy, lactation levels of repaglinide. May enhance hydroxymethylglutaryl coenzyme A extremities, blurred vision; pruritus, the effects of oral anticoagulants. (HMG-CoA) reductase inhibitor (statin) urticaria; impotence; dizziness; May also increase the plasma risk of rhabdomyolysis. Diabetes, cholestatic jaundice. Potentially Fatal: concentrations of ciclosporin and hypothyroidism, not recommended for Bone marrow hypoplasia; intracranial associated nephrotoxicity when patients with type IIa hyperlipidemia haemorrhage; nephrotoxicity; peripheral used concurrently (low-density lipoproteins cholesterol neuritis. elevations only)

Gliclazide 30 mg Modified Release B Diabetes mellitus type 2 Initially, 30mg daily at breakfast time, Hypoglycemia, gastrointestinal Known hypersensitivity to gliclazide, Alcohol (causing disulfiram-like Low calorie diets, prolonged or strenuous Tablet may increase in successive steps to 60, disturbances, skin and subcutaneous excipients and other sulphonylureas and reaction) Drugs that potentiate exercise, alcohol intake, combination of 90 or 120mg daily at 1 month intervals. tissue disorders, raised liver enzymes, sulphonamides. Type 1 diabetes, diabetic hypoglycaemic effect: Coumarins, hypoglycaemic agents, malnutrition, Max daily dose: 120mg transient visual disturbances, precoma and coma, diabetic sulphonamides, salicylates, irregular mealtimes, skipping meals, hematologic disturbances. ketoacidosis, severe renal or hepatic phenylbutazone, beta blockers, periods of fasting & dietary changes, insufficiency, treatment with miconazole, MAOIs, ketoconazole, miconazole renal or hepatic insufficiency, thyroid pregnancy and lactation. Drugs that diminish hypoglycaemic disorders, hypopituitarism and adrenal effect: Thiazide diuretics, insufficiency, paediatric. corticosteroids and oestrogens Gliclazide 60 mg Modified Release B Diabetes mellitus type 2 Initially, 30mg daily at breakfast time, Hypoglycemia, gastrointestinal Known hypersensitivity to gliclazide, Alcohol (causing disulfiram-like Low calorie diets, prolonged or strenuous Tablet may increase in successive steps to 60, disturbances, skin and subcutaneous excipients and other sulphonylureas and reaction) Drugs that potentiate exercise, alcohol intake, combination of 90 or 120mg daily at 1 month intervals tissue disorders, raised liver enzymes, sulphonamides. Type 1 diabetes, diabetic hypoglycaemic effect: Coumarins, hypoglycaemic agents, malnutrition, (except in patients whose blood glucose transient visual disturbances, precoma and coma, diabetic sulphonamides, salicylates, irregular mealtimes, skipping meals, level was not reduced after 2 weeks of hematologic disturbances ketoacidosis, severe renal or hepatic phenylbutazone, beta blockers, periods of fasting & dietary changes, treatment). Max daily dose: 120mg insufficiency, treatment with miconazole, MAOIs, ketoconazole, miconazole renal or hepatic insufficiency, thyroid pregnancy and lactation Drugs that diminish hypoglycaemic disorders, hypopituitarism and adrenal effect: Thiazide diuretics, insufficiency, paediatric corticosteroids and oestrogens

Gliclazide 80 mg Tablet B Diabetes mellitus type 2 Initially 40-80mg daily. A single dose Nausea, vomiting, heartburn, anorexia, Type 1 diabetes mellitus, pregnancy and Alcohol (causing disulfiram-like Paediatric, excessive exercise, severe should not exceed 160mg and when diarrhoea, metallic taste, increased lactation, diabetic ketoacidosis, diabetics reaction) Drugs that potentiate diarrhoea, severe gastroparesis, higher doses are required, a twice daily appetite, weight gain, skin rashes, undergoing surgery, diabetic coma, hypoglycaemic effect: Coumarins, intestinal obstruction, prolonged split dosage is advised and should be pruritus, hypoglycemia, hypersensitivity. diabetic precoma, hyperosmolar sulphonamides, salicylates, vomiting, hyperglycaemia, divided. Maximum daily dose: 320mg. Infrequently, SIADH nonketotic coma, after severe burns or phenylbutazone, beta blockers, hyperthyroidism, hypoglycaemia, For elderly, starting dose should be 40mg trauma, or during infections, MAOIs, ketoconazole, miconazole hypothyroidism, renal impairment, twice daily. hypersensitivity, severe renal or hepatic Drugs that diminish hypoglycaemic hepatic impairment, intercurrent insufficiency, treatment with miconazole effect: Thiazide diuretics, infections, traumas, shock, after corticosteroids and oestrogens anaesthesia, major surgery

Glyceryl Trinitrate 0.5 mg Sublingual C Prophylaxis and treatment of angina and 0.5-1 mg sublingually may be repeated Flushing, dizziness,throbbing headache, For sublingual:Severe anaemia, early Imipramine, atropine, nitrates and Severe hepatic , renal impairment, Tablet left ventricular failure every 5 minutes until relief is obtained. vomiting, restlessness, blurred myocardial infarction, increased sildenafil hypothyroidism, malnutrition, Seek physician if the pain persists after a vision,tachycardia,bradycardia , intracranial pressure, symptomatic hypothermia. Cerebrovascular disease, total of 3 tablets in a 15 minutes period. hypotension (which can be severe), hypotension, hypersensitivity to organic lung disease or cor pulmonale, syncope, and cyanosis nitrates pregnancy, lactation, glaucoma, mitral rarely),methaemoglobinaemia, valve prolapse, cardiac tamponade, respiratory impairment syncope. Avoid prolonged excessive hypotension. Nitrate-free interval is recommended in patients on continuous treatment with nitrates to reduce the risk of tolerance

Granisetron HCl 1 mg Tablet A Prevention and treatment of nausea and ADULT 1 mg twice daily or 2 mg once Headache, asthenia, fever, pain, Hypersensitivity to granisetron and other Cytochrome P450 effect (minor). Subacute intestinal obstruction, vomiting associated with chemotherapy daily with the first dose to be bradycardia, constipation, nausea, 5-HT3 receptor antagonists Apomorphine combination can pregnancy and lactation, liver disease. and radiotherapy administered within 1 hour prior to leukopenia, thrombocytopenia, cause profound hypotension and May mask paralytic ileus/gastric cytostatic therapy and can be given for hypersensitivity reaction, transiet loss of consciousness. distension. Cardiac co-morbidities, on up to 1 week following radiotherapy. increases in liver enzymes, rash Coadministration with drugs that cardio-toxic chemotherapy and/or Maximum 9 mg/day can prolong QT interval may result concommitant electrolyte abnormalities in serious arrythmias

Griseofulvin (Ultramicrosize 125 mg B Dermatophyte infections of the skin, ADULT: 500 mg daily up to 1 g daily in Oral thrush; GI distress, taste perversion; Established porphyria, hepatocellular Antagonises oral anticoagulants Lactation; ability to drive or operate = 250 mg Microsize) Tablet scalp, hair and nails, where topical divided doses, 2-8 wk in hair and skin dizziness, confusion, headache, failure, SLE and related conditions, and oral contraceptives. Decreased machinery may be impaired; avoid therapy has failed or inappropriate infections, 6 mth in fingernail infections depression, insomnia, fatigue; peripheral pregnancy GI absorption with phenobarbital. exposure to intense sunlight or artificial and 12 mth or more for toenail neuritis, photosensitivity; skin rashes, Reduced plasma concentrations light. May damage sperm cells - male infections. CHILD: 10 mg/kg daily in urticaria, erythema multiforme; with enzyme inducers e.g. should not father children within 6 divided doses or as a single dose leucopenia, proteinuria. Hepatotoxicity; phenylbutazone and hypnotics. month of treatment angioedema. Enhances effects of alcohol and causes disulfiram-like reaction. Haloperidol 1.5 mg Tablet B Schizophrenia and other psychoses Adult:†0.5-5 mg bid/tid, may increase up Extrapyramidal symptoms (EPS), tardive Parkinson's disease, severe CNS Tramadol, fluoxetine, fluvoxamine, Concomitant anticoagulant use, to 100 mg daily in severe or resistant dyskinesia, sedation, hypotension, depression, bone marrow suppression, carbamazepine, concomitant CNS depressant use cases. Usual maintenance: 3-10 mg tachycardia, insomnia, anxiety, weight severe cardiac or hepatic disease, cisapride,dicoumarol, procyclidine, (anaesthetics, opiates, and alcohol), daily.†Child: >3 yr: Initially, 25-50 mcg/kg changes, anticholinergic effects, comatose states, hypersensitivity to methyldopa, olanzapine, rifampicin, history of convulsive disorders, known daily in 2 divided doses, increased gynaecomastia, galactorrhoea, menstrual haloperidol. Lactation lithium, tricyclic antidepressants. allergies or allergic reactions to drugs, gradually if necessary. Max: 10 mg/day. irregularities, neuroleptic malignant May increase the plasma levels of manic patients, neuroleptic malignant syndrome, arrhythmias, seizure, haloperidol when used with syndrome, elderly patients, impaired jaundice, hyperpyrexia. Anxiety, clozapine or chlorpromazine liver function, CV disease, thyrotoxicosis. depression, anorexia, leukopaenia Parkinsonism, angle-closure glaucoma, benign prostatic hyperplasia; severe cardiac or hepatic disease, presence of acute infections or leucopaenia; hyperthyroidism; pregnancy, elderly, children. Patients receiving anticoagulants. Discontinue treatment upon signs of neurological toxicity in patients taking lithium. Temperature regulation: Impaired core body temperature regulation may occur

Haloperidol 5 mg Tablet B Schizophrenia and other psychoses Adult:†0.5-5 mg bid/tid, may increase up Extrapyramidal symptoms (EPS), tardive Parkinson's disease, severe CNS Tramadol, fluoxetine, fluvoxamine, Concomitant anticoagulant use, to 100 mg daily in severe or resistant dyskinesia, sedation, hypotension, depression, bone marrow suppression, carbamazepine, concomitant CNS depressant use cases. Usual maintenance: 3-10 mg tachycardia, insomnia, anxiety, weight severe cardiac or hepatic disease, cisapride,dicoumarol, procyclidine, (anaesthetics, opiates, and alcohol), daily.†Child: >3 yr: Initially, 25-50 mcg/kg changes, anticholinergic effects, comatose states, hypersensitivity to methyldopa, olanzapine, rifampicin, history of convulsive disorders, known daily in 2 divided doses, increased gynaecomastia, galactorrhoea, menstrual haloperidol. Lactation lithium, tricyclic antidepressants. allergies or allergic reactions to drugs, gradually if necessary. Max: 10 mg/day. irregularities, neuroleptic malignant May increase the plasma levels of manic patients, neuroleptic malignant syndrome, arrhythmias, seizure, haloperidol when used with syndrome, elderly patients, impaired jaundice, hyperpyrexia. Anxiety, clozapine or chlorpromazine liver function, CV disease, thyrotoxicosis. depression, anorexia, leukopaenia Parkinsonism, angle-closure glaucoma, benign prostatic hyperplasia; severe cardiac or hepatic disease, presence of acute infections or leucopaenia; hyperthyroidism; pregnancy, elderly, children. Patients receiving anticoagulants. Discontinue treatment upon signs of neurological toxicity in patients taking lithium. Temperature regulation: Impaired core body temperature regulation may occur Hydrochlorothiazide 25 mg Tablet B Diuretic, hypertension ADULT: Diuretics; 25-200 mg daily. Metabolic disturbances, electrolyte Anuria, concurrent lithium therapy, renal May enhance toxicity of digitalis Renal or hepatic impairment, pregnancy Hypertension 12.5-25 mg daily CHILD: imbalance, anorexia, gastrointestinal decompensation glycosides, neuromuscular-blocking and lactation, elderly, debilitated Oedema and hypertension; Adjunct; 1 to disturbances, headache, dizziness, action of competitive muscle patients, syndrome lupus erythematous. 2 mg/kg ORALLY daily in single or two postural hypotension, paresthesia, relaxants, effect of Monitor fluid and electrolytes, bronchial divided doses; Children 2-12 years old impotence, yellow vision, antihypertensives. Increased risk of asthma MAX dose, not to exceed 100 mg ORALLY hypersensitivity. Rarely cholestatic postural hypotension with alcohol, daily; Infants less than 6 months old, may jaundice, pancreatitis, blood dyscrasias barbiturates, opioids. Potassium- require doses up to 3 mg/kg ORALLY daily depleting effect enhanced by in two divided doses, Infants up to 2 yrs corticosteroids, ACTH, old: MAX dose, not to exceed 37.5 mg carbenoxolone ORALLY daily

Hydrochlorothiazide 50 mg Tablet B Diuretic, hypertension ADULT: Diuretics; 25-200 mg daily. Metabolic disturbances, electrolyte Anuria, concurrent lithium therapy, renal May enhance toxicity of digitalis Renal or hepatic impairment, pregnancy Hypertension 12.5-25 mg daily CHILD: imbalance, anorexia, gastrointestinal decompensation glycosides, neuromuscular-blocking and lactation, elderly, debilitated Oedema and hypertension; Adjunct; 1 to disturbances, headache, dizziness, action of competitive muscle patients, syndrome lupus erythematous. 2 mg/kg ORALLY daily in single or two postural hypotension, paresthesia, relaxants, effect of Monitor fluid and electrolytes, bronchial divided doses; Children 2-12 years old impotence, yellow vision, antihypertensives. Increased risk of asthma MAX dose, not to exceed 100 mg ORALLY hypersensitivity. Rarely cholestatic postural hypotension with alcohol, daily; Infants less than 6 months old, may jaundice, pancreatitis, blood dyscrasias barbiturates, opioids. Potassium- require doses up to 3 mg/kg ORALLY daily depleting effect enhanced by in two divided doses, Infants up to 2 yrs corticosteroids, ACTH, old: MAX dose, not to exceed 37.5 mg carbenoxolone ORALLY daily

Hydrocortisone 10 mg Tablet B Glucocorticoid replacement therapy in ADULT: 20 - 30 mg daily in divided doses. Fluid and electrolyte disturbances, Hypersensitivity, systemic fungal Concurrent use of barbiturates, Discontinue treatment by reducing the primary or secondary adrenal CHILD: 10 - 30 mg daily in divided doses muscle weakness, peptic ulcer infection carbamazepine, phenytoin, dosage gradually insufficiencies and long term primidone or rifampicin may management of congenital adrenal enhance the metabolism and hyperplasia in children reduce the effects of systemic corticosteroids. Oral contraceptives or ritonavir may increase plasma concentrations of corticosteroids

Hydroxychloroquine Sulphate 200 A i) SLE and mixed connective tissue i) Initially 400 mg daily in divided dose. Gastrointestinal disturbances, nausea, Pre-existing maculopathy, pregnancy, Digoxin - increase level, metoprolol Liver disease, alcoholism or concurrent mg Tablet disease for skin, joint and serosa ii) Maintenance : 200 - 400 mg daily ii) vomiting and diarrhea, headache, skin hypersensitivity to 4-aminoquinoline administration with known hepatotoxic Second line therapy for acute ADULT : 400 - 600 mg daily. reactions, bleaching of hair, alopecia, compound, long-term use in children, drugs. G6PD deficiency, renal impairment rheumatoid arthritis Maintenance: 200 - 400 mg daily. CHILD : blurred vision, difficulty in focusing, blood retinal or visual field changes from prior 4- or metabolic acidosis, patients with up to 6.5 mg/kg daily (maximum 400mg dyscrasias, drug-induced myopathy, aminoquinoline compound psoriasis or porphyria, haematologic daily) disorder of cornea, cardiovascular: disorders. If patient develops pigmentary Torsades de pointes, agranulocytosis, abnormality or visual field defect, retinopathy, ototoxicity (rare) discontinue drug Hydroxyurea 500 mg Capsule A i)Solid tumours ii) Chronic myelocytic i)Intermittent therapy : 80 mg/kg orally i. Psychoneural system: rarely headache, Severe bone marrow depression , Potentiated myelosuppressive Hydroxyurea is mutagenic and leukaemia and myeloproliferative as a single dose every 3rd day. dizziness, disorientation, hallucinations, pregnancy, lactation, hypersensitivity to activity by previous or concomitant clastogenic. Bone marrow function is disease iii)Severe psoriasis eg. Extensive Continuous therapy : 20 - 30 mg/kg orally and convulsions may be caused. ii. hydroxyurea products. radiotherapy or cytotoxic therapy. markedly depressed, patients who have plaque psoriasis, erythrodermic psoriasis, as a single dose dly. Concomitant therapy Gastrointestinal: stomatitis, inappetance, Leukopenia and/or previously received rediotherapy of pustular psoriasis -as third line therapy. with irradiation : 80 mg/kg orally as a nausea, vomiting, diarrhea, and thrombocytopenia effects of cytotoxic cancer chemotherapeutic single dose every 3rd day.(administration constipation may occur. iii. Hematologic: hydroxyurea may be increased by agents, exacerbation of postirradiation of hydroxyurea should be started at least Primarily, bone marrow depression concurrent or recent therapy of erythema, marked renal dysfunction, 7 days before initiation of irradiation and (leukopenia, anemia, thrombocytopenia). ""blood dyscrasia-causing impairment of fertility, elderly patients. continued during radiotherapy as well). Megaloblastic erythropoiesis seen early medications cause the same Correct anemia prior to initiating ii)Continuous therapy (20 - 30 mg/kg in the course of therapy. iv. Urogenital effects. Concurrent use with live therapy. orally as a single dose daily, therapy system: Dysuria occur very rarely, virus vaccine may potentiate the should be interrupted if the white blood temporary impairment of renal tubular replication of the vaccine virus, may cell count drops below 2500/mm3, or the function accompanied by elevations in increase the adverse effects of the platelet count below 100,000/mm3. iii) serum uric acid, BUN, and creatinine vaccine virus, and/or may decrease 500 mg tds. levels. v. Central nervous system: At the the patient's antibody response to higher dose, general lethargy state may the vaccine. be caused, and flush, chill, malaise have been reported. vi. Dermatologic: Occasionally, maculopopular rash, facial erythema may occur. vii. Hepatic: Abnormal BSP retention, elevation of hepatic enzymes have been reported. viii. Other: very rare alopecia may be caused

Hyoscine N-Butylbromide 10 mg C Gastrointestinal tract and genito-urinary ADULT 10-20mg, 3-4 times a day. CHILD 6-Xerostomia, dyshidrosis, tachycardia, Obstructive disease of the Intensifies anticholinergic effects of Geriatric and pediatric patients, Tablet tract spasm, dyskinesia of the biliary 12 years old: 10mg 3 times a day. urinary hesistancy and retention, allergic gastrointestinal or urinary tract, narrow- tricyclic antidepressants, pregnancy, breastfeeding, intestinal system reactions, skin reactions, confusions, angle glaucoma, cardiac antihistamines, quinidine, atony, paralytic ileus and ulcerative excitement, constipation, paralytic ileus tachyarrhythmias, myasthenia gravis, amantadine and disopyramide. colitis, coronary artery diseases, prostatic hypertrophy with urinary Enhances tachycardic effects of arrhythmias , heart failure, hypertension, retention beta-adrenergic agents. Dopamine xerostomia, hiatal hernia with reflux antagonist eg metoclopramide esophagitis, prostatic hypertrophy. reduces effects of both drugs on gastrointestinal tract

Ibuprofen 200 mg Tablet B Pain and inflammation in rheumatic Dosage: ADULT : 200 - 400 mg 3 times Peptic ulceration, GI bleeding, headache, Hypersensitivity. Treatment of Coumarin-type anticoagulants, Bleeding disorders, CV disease. Infants disease daily after food, maximum 3.2 g daily. dizziness, nervousness, skin rash, perioperative pain in the setting of CABG aspirin or NSAIDs, digitalis with increased total bilirubin. Premature CHILD : 30-50 mg/kg body weight daily in pruritus, tinnitus, oedema depression, surgery. Patient whom asthma, urticaria glycosides, lithium, methotrexate, neonates with existing or at risk of divided doses, maximum 2.4g daily. drowsiness, insomnia, blurred vision, or other allergic-type reaction are diuretics, cefoperazone, valproic infection. Hepatic and renal impairment. Lowest effective dose for the shortest hypersensitivity, impairment of renal precipitated by aspirin or other NSAIDs. acid, ciclosporin, gold compound, Elderly (avoid chronic use). possible duration. function, dyspepsia, thrombocytopaenia, Active or history of peptic ulcer; history other nephrotic medications, visual disturbances, nausea, vomiting, of GI bleeding. Neonates with congenital probenecid. Moclobemide epigastric pain, heartburn, jaundice, heart disease, suspected necrotising enhances effects of ibuprofen. hepatitis, depression enterocolitis, and impaired renal Increased risk of gastrointestinal function. 3rd trimester of pregnancy, and bleeding with warfarin. Lost of BP lactation. response with ACEI Imatinib Mesylate 400 mg Tablet A* i) ADULT and CHILD: Philadelphia positive i) ADULT: Chronic phase chronic myeloid Myelosuppression, anorexia, Hypersensitivity to imatinib or any Alfuzosin, aprepitant, Hepatic or severe renal impairment. (Ph+) chronic myeloid leukaemia in leukemia: 400 mg once daily. Accelerated insomnia,headache, dizziness, component of the product. Avoid carbamazepine, dexamethasone, Severe fluid retention may occur. It is chronic phase and in early acceleration phase or blast crisis chronic myeloid paraesthesia, taste disturbance, pregnancy and lactation ketoconazole, levothyroxine, recommended that patients be weighed after failure of interferon therapy ii) leukemia: 600 mg once daily. CHILD more hypoaesthesia, ocular disorders, flushing, phenobarbital, phenytoin, rifampin, regularly. History of cardiac disease. Treatment of patients with unresectable than 2 years, chronic and advanced Dyspnoea, epistaxis, cough, simvastatin, St John's Wort, Monitor thyroid-stimulating hormone and/or metastatic malignant phase chronic myeloid leukemia: 340 gastrointestinal disorders, Periorbital warfarin, ciclosporin and (TSH) levels.Gastrointestinal and intra- gastrointestinal stromal tumours (GIST) mg/m2 daily. Max: 800 mg/day ii) ADULT oedema, dermatitis, eczema, rash, paracetamol tumoural haemorrhages have been who are positive for CD117/c-kit : 400mg/day musculoskeletal pain, fluid retention. reported. Possible occurence of tumour lysis syndrome. Regular monitoring of complete blood counts and liver function tests. Close monitoring of growth in children under imatinib. Women of childbearing potential must be advised to use effective contraception during treatment. Pregnancy, lactation (avoid)

Indomethacin 25 mg Capsule B Pain and inflammation in rheumatic 50 - 200 mg daily in divided doses, with Gastrointestinal disturbances and Active GI ulcer or recurrent history of GI Salicylates, anticoagulant drugs, Active or previous history of disease food. Child not recommended. bleeding, headache, vertigo, depression, ulcer; hypersensitivity, rhinitis, urticaria, probenecid, methotrexate, gastrointestinal ulceration, bleeding, or epigastric disease, dizziness, somnolence, asthma or allergic reactions to aspirin or ciclosporin, lithium, digoxin, beta- perforation. History of renal/liver depression & fatigue, anxiety, psychic other anti-inflammatory agents; proctitis; blockers, captopril, heparin or dysfunction. Hypertension or cardiac disturbances including psychotic pregnancy & lactation. thrombolytic agents, conditions aggravated by fluid retention episodes, mental confusion, tinnitus, aminoglycosides, digitalis and oedema. May aggravate corneal deposits, retinal disturbances, glycosides. antihypertensives, depression/psychiatric disorders such as oedema, weight gain, flushing, sweating, diuretics especially triamterene, epilepsy, mental depression, thrombocytopenia, rash, pruritus & diflunisal, other salicylates, Parkinsonism. Patients with coagulation urticaria cefamandole, cefoperazone, defects. Renal impairment. Retinal cefotetan, plicamycin, valproic acid, disturbances. Elderly. Pregnancy and gold compound, other nephrotoxics lactation & zidovudine

Isoniazid 100 mg Tablet B i) Tuberculosis ii)Tuberculous meningitis i) & ii) ADULT 5-8mg/kg daily (Max Peripheral neuropathy and Acute liver disease, hypersensitivity to Inhibits metabolism of Increased risk of hepatitis in severe renal 300mg) or 15-20mg/kg biweekly (max hepatotoxicity, psychiatric sign or isoniazid antiepileptics (carbamazepine, dysfunction, chronic liver disease, daily 1200mg) symptom, agranulocytosis, anaemia, ethosuximide and phenytoin) and users of alcohol, increased risk of fatal megaloblastic anaemia, diazepam, reduced plasma hepatitis in females thrombocytopenia, systemic lupus concentration of ketoconazole and erythematosus, seizure increased theophylline plasma concentration

Isosorbide Dinitrate 10 mg Tablet B Prophylaxis and treatment for: i) Angina i) 30 - 120 mg daily in divided doses ii) 40 - GI disturbances, headache, hypotension, Hypersensitivity to organic nitrates, Hypotensive effects may be Acute myocardial infarction,cerebral ii) Left ventricular failure 160 mg, up to 240 mg if required tachycardia anaemia, symptomatic hypotension enhanced by alcohol, beta-blocker, hemorrhage,congestive heart failure, calcium channel blocker, glaucoma, hyperthyroidism,hypertrophic, antihypertensive, sildenafil, tricyclic cardiomyopathy, antidepressant hypotension,methemoglobinemia, recent head trauma, severe anemia, volume depletion

Isosorbide-5-Mononitrate 30 mg SR A Prophylaxis and treatment of angina Initiate at 30 mg for 1st 2-4 days to avoid "Hypotension, tachycardia, flushing, Hypersensitivity to organic nitrates, Hypotensive effects may be Serious cerebrovascular disease, Tablet pectoris headache. Usual dose: 60 mg once daily, headache, dizziness, palpitation, anaemia, symptomatic hypotension, not increased when used with alcohol increased intracranial pressure, aortic may be increased to 120 mg once daily syncope, confusion. Nausea, vomiting, recommended in pregnancy & lactation. or vasodilators. Concurrent use stenosis, mitral stenosis & hypertrophic abdominal pain. Restlessness, weakness with calcium channel blockers may obstructive cardiomyopathy, anaemia, and vertigo. Dry mouth, chest pain, back lead to marked orthostatic hypoxaemia, hypothyroidism. May pain, oedema, fatigue, abdominal pain, hypotension. Potentially Fatal: impair ability to drive or operate constipation, diarrhoea, dyspepsia and Significant hypotension may occur machinery. Pregnancy & lactation flatulence. Potentially Fatal: Severe when used with phosphodiesterase- hypotension and cardiac failure." 5 inhibitors" Itopride HCl 50 mg Tablet A* Treatment of gastrointestinal symptoms 50 mg 3 times daily before meal Leukopenia, thrombocytopenia, Gastrointestinal haemorrhage, Reduced effect with anticholinergic Enhances the action of acetylcholine and of functional, non-ulcer dyspepsia anaphylactic reaction, dizziness, mechanical obstruction or perforation drugs may produce cholinergic side effects. (chronic gastritis) i.e sensation of headache, tremor, gastrointestinal Pregnancy and lactation, elderly, renal bloating, early satiety, upper abdominal disturbance, jaundice, rash, redness, and hepatic impairement, mental pain or discomfort, anorexia, heartburn, itching, acute dystonic reaction, depression nausea and vomiting abdominal pain

Itraconazole 100 mg Capsule A/KK i) Dermatomycosis including pityriasis i) 200 mg once daily for 7 days ii) 100 mg Rash, hypokalemia, diarrhoea, nausea Hypersensitivity to azole antifungals; Rifampicin& phenytoin reduce oral Lactation, history of liver or renal versicolor ii) Oral candidiasis iii) Palmar daily for 15 days iii) 200 mg twice daily and vomiting, Stevens-Johnson pregnancy and lactation; hepatic disease. bioavailability of itraconazole. disease, children, decreased gastric tinea manus and plantar tinea pedis iv) for 7 days iv) 200mg twice daily for 1 syndrome, neutropenic disorder, CYP3A4 metabolized substrates acidity. Patients with risk factors for Fingernail onychomycosis v) Toenail week per month for 2 months v) 200 mg hepatotoxicity, anaphylaxis that can prolong the QT-interval congestive heart failure such as onychomycosis vi) Vulvovaginal twice daily for 1 week per month for 3 e.g; astemizole, cisapride, ischaemic and valvular cardiac disease candidiasis months vi)200 mg morning and evening quinidine, terfenadine, HMG-CoA for 1 day or 200 mg once daily for 3 days reductase inhibiotrs, triazolam, oral midazolam, ergot alkalaoids, warfarin, digoxin, cyclosporin, oral contraceptives.

Ivabradine 5 mg Tablet A* i) Symptomatic treatment of chronic Initial dose 5 mg twice daily. May Luminous phenomena (phosphenes), Resting heart rate below 60 beats per QT-prolonging drugs, CYP3A4 Mild heart failure including stable angina pectoris in patients with increase dose after 3-4 weeks to 7.5 mg blurred vision, bradycardia, first degree minute prior to treatment, cardiogenic inhibitors (eg azole antifungals, asymptomatic left ventricular normal sinus rhythm, who have a twice daily depending on response. AV block, ventricular extrasystoles, shock, acute myocardial infarction, macrolides, HIV protease inhibitors, dysfunction, atrial fibrillation or other contraindication or intolerance to beta ELDERLY, initial dose 2.5 mg twice daily muscle cramps, eosinophilia, dyspnoea, severe hypotension (less than 90/50 nefazodone, diltiazem & verapamil) arrythmias, second degree AV-block, blockers ii) Treatment of coronary artery and titrate to a maximum of 7.5 mg twice palpitation, hyperuricaemia, raised mmHg), severe hepatic insufficiency, sick & inducers (eg rifampicin, CHF, stroke, retinitis pigmentosa, disease. Symptomatic treatment of daily plasma-creatinine concentration sinus syndrome, sino-atrial block, severe barbiturates, phenytoin, St. John's galactose intolerance, hypotension, chronic stable angina pectoris in coronary heart failure, pacemaker-dependent, wort), grapefruit juice congenital QT syndrome, moderate artery disease patients with normal sinus unstable angina, AV-block of third hepatic insufficiency, severe renal rhythm. Ivabradine is indicated : - in degree, combination with strong insufficiency, elderly patients unable to tolerate or with a cytochrome P450 3A4 inhibitors, contraindication to the use of beta- pregnancy & lactation blockers - or in combination with beta- blockers in patients inadequately controlled with an optimal beta-blocker dose and whose heart rate is > 60 bpm. Treatment of chronic heart failure. Ivabradine is indicated in chronic heart failure NYHA II to IV class with sinus rhythm and whose heart rate is ≥75bpm, in combination with standard beta- blocker therapy or when beta- blocker therapy is contraindicated or not tolerated. Ivabradine 7.5 mg Tablet A* i) Symptomatic treatment of chronic Initial dose 5 mg twice daily. May Luminous phenomena (phosphenes), Resting heart rate below 60 beats per QT-prolonging drugs, CYP3A4 Mild heart failure including stable angina pectoris in patients with increase dose after 3-4 weeks to 7.5 mg blurred vision, bradycardia, first degree minute prior to treatment, cardiogenic inhibitors (eg azole antifungals, asymptomatic left ventricular normal sinus rhythm, who have a twice daily depending on response. AV block, ventricular extrasystoles, shock, acute myocardial infarction, macrolides, HIV protease inhibitors, dysfunction, atrial fibrillation or other contraindication or intolerance to beta ELDERLY, initial dose 2.5 mg twice daily muscle cramps, eosinophilia, dyspnoea, severe hypotension (less than 90/50 nefazodone, diltiazem & verapamil) arrythmias, second degree AV-block, blockers ii) Treatment of coronary artery and titrate to a maximum of 7.5 mg twice palpitation, hyperuricaemia, raised mmHg), severe hepatic insufficiency, sick & inducers (eg rifampicin, CHF, stroke, retinitis pigmentosa, disease. Symptomatic treatment of daily plasma-creatinine concentration sinus syndrome, sino-atrial block, severe barbiturates, phenytoin, St. John's galactose intolerance, hypotension, chronic stable angina pectoris in coronary heart failure, pacemaker-dependent, wort), grapefruit juice congenital QT syndrome, moderate artery disease patients with normal sinus unstable angina, AV-block of third hepatic insufficiency, severe renal rhythm. Ivabradine is indicated : - in degree, combination with strong insufficiency, elderly patients unable to tolerate or with a cytochrome P450 3A4 inhibitors, contraindication to the use of beta- pregnancy & lactation blockers - or in combination with beta- blockers in patients inadequately controlled with an optimal beta-blocker dose and whose heart rate is > 60 bpm. Treatment of chronic heart failure. Ivabradine is indicated in chronic heart failure NYHA II to IV class with sinus rhythm and whose heart rate is ≥75bpm, in combination with standard beta- blocker therapy or when beta- blocker therapy is contraindicated or not tolerated.

Labetalol HCl 100 mg Tablet B Hypertension (including in pregnancy) ADULT: 100 mg daily with food, increased Hypotension, bradycardia, nausea, Hypersensitivity to labetalol products, Alpha-1 adrenergic blockers, Anaesthesia/surgery, including when at intervals of 14 days to usual dose of vomiting bradycardia, asthma/obstructive airway amiodarone, cimetidine, clonidine, used in cases to control bleeding 200 mg twice daily, up to 800 mg twice disease, cardiogenic shock, heart block digoxin, dihydropyridine, calcium (myocardial depression). Avoid abrupt daily (3 - 4 divided doses if higher dose). overt cardiac failure channel blockers, diltiazem, withdrawal; gradual withdrawal over a Max: 2.4 g daily enflurane, epinephrine, flunarizine, period of 1 to 2 weeks is recommended. halothane, hypoglycemic agents, Bronchospastic disease, congestive heart imipramine, isoflurane, lidoflazine, failure, diabetes mellitus. The methyldopa, verapamil bioavailability and half-life of labetalol are increased in the elderly. In addition, the hypotensive response is greater in this age group following oral or i.v. administration. Therefore, lower doses of labetalol are likely to be required in elderly patients.

Lamivudine 100 mg Tablet A* Management of chronic hepatitis B Adult:†100 mg once daily. For patients Nausea, vomiting, diarrhoea, abdominal Hypersensitivity. Lactation. Trimethoprim, interferon alfa, Moderate to severe renal impairment, infection associated with evidence of with concomitant†HIV†infection: 300 mg pain, cough; headache, fatigue, insomnia, ribavirin, sulfamethoxazole, Pancreatitis, lactic acidosis or severe hepatitis B viral replication and active once daily or in 2 divided doses.†Child: malaise, fever, rash, alopecia, muscle zalcitabine hepatomegaly with steatosis. advanced liver inflammation >2 yr: 3 mg/kg once daily. Max: 100 disorders, peripheral neuropathy, cirrhotic liver disease, pregnancy, chronic mg/day. pancreatitis, neutropenia, anaemia, hepatitis B or C thrombocytopenia and red-cell aplasia, lactic acidosis, raised liver enzymes and serum amylase, hepatomegaly

Lamivudine 150 mg Tablet A/KK HIV infection in combination with other ADULT: 150 mg twice daily or 300 mg Nausea, vomiting, diarrhoea, abdominal Hypersensitivity. Lactation. Trimethoprim, interferon alfa, Moderate to severe renal impairment, antiretroviral agents once daily. INFANT under 1 month: 2 pain, cough; headache, fatigue, insomnia, ribavirin, sulfamethoxazole, Pancreatitis, lactic acidosis or severe mg/kg twice daily. CHILD 3 month or malaise, fever, rash, alopecia, muscle zalcitabine hepatomegaly with steatosis. advanced over: 4 mg/kg twice daily. Maximum 300 disorders, peripheral neuropathy, cirrhotic liver disease, pregnancy, chronic mg daily pancreatitis, neutropenia, anaemia, hepatitis B or C thrombocytopenia and red-cell aplasia, lactic acidosis, raised liver enzymes and serum amylase, hepatomegaly Lamotrigine 100 mg Tablet A i) Adjunctive or monotherapy for partial i) Up to 200 mg daily in single or divided Dizziness, fatigue, headache, Hypersensitivity to lamotrigine products Metabolism is increased by Concomitant use of other antiepileptics, seizures and generalised tonic-clonic dosage ii) 25- 200 mg daily hypersensitivity reactions, rashes, carbamazepine, phenobarbital, discontinue therapy at the first sign of seizures not satisfactorily controlled with malaise, leukopenia, thrombocytopenia, phenytoin and primidone, rash, renal, hepatic or cardiac other antiepileptic drugs ii) Prevention of photosensitivity, blurred vision, decreased by valproate. Central impairment, pregnancy, lactation. Closely mood episodes in adult 18 years and conjunctivitis, drowsiness, insomnia, nervous system events occur with monitor and consider withdrawal if above with bipolar disorder, ataxia, nausea. Irritability, drowsiness, carbamazepine. Rifampicin, hypersensitivity syndrome develops. predominately by preventing depressive insomnia, tremor, nystagmus, ataxia, ethinyloestradiol/levonorgestrel Avoid abrupt withdrawal (reduce dosage episodes diplopia, blurred vision, gastrointestinal combination enhances the stepwise over a period of 2 week) unless disturbances, arthralgia, pain including metabolism of lamotrigine. Sodium serious skin reaction occurs. Significant back pain. Rarely, severe skin reactions valproate reduces the metabolism hepatic or renal impairment. Monitor including Stevens-Johnson syndrome and of lamotrigine. Possible and adjust dose if necessary in women toxic epidermal necrolysis interference with folate who are starting or stopping hormonal metabolism during long-term contraceptives during Lamictal therapy. therapy Close supervision of patients at high risk of suicide in bipolar disorder. Potential of an increase in risk of suicidal thoughts or behaviours

Lamotrigine 5 mg A Management of seizures in children aged a) Add-on therapy in patients not taking Fatigue, headache, hypersensitivity Hypersensitivity to lamotrigine products, Central nervous system events Concomitant use of other antiepileptics, Dispersible/Chewable Tablet 2 - 12 years Valproate: week 1 and 2: 2 mg/kg/day reactions, rashes, malaise, leukopenia, hepatic impairment occur with carbamazepine. discontinue therapy at the first sign of twice daily, week 3 and 4: 5 mg/kg/day thrombocytopenia, photosensitivity, Phenytoin, carbamazepine, rash, renal, hepatic or cardiac twice daily. Maintenance: 5 - 15 blurred vision, conjunctivitis, nausea, phenobarbital, primidone, impairment, pregnancy, lactation. Closely mg/kg/day twice daily b) Add-on therapy irritability, drowsiness, insomnia, rifampicin, monitor and consider withdrawal if in patients taking Valproate or other anti- dizziness, tremor, nystagmus, ataxia, ethinyloestradiol/levonorgestrel hypersensitivity syndrome develops, epileptic drugs, week 1 and 2: 0.2 diplopia, blurred vision, gastrointestinal combination enhance the avoid abrupt withdrawal (reduce dosage mg/kg/day as a single dose (children less disturbances, arthralgia, pain including metabolism of lamotrigine. Sodium stepwise over a period of 2 week) unless than 25 kg may take 5 mg on alternate back pain. Rarely, severe skin reactions valproate reduces the metabolism serious skin reaction occurs. Significant days), week 3 and 4: 0.5 mg/kg/day as a including Stevens-Johnson syndrome and of lamotrigine. Possible hepatic or renal impairment. Monitor single dose. Maintenance dose: 1 -5 toxic epidermal necrolysis interference with folate and adjust dose if necessary in women mg/kg/day once daily or twice daily metabolism during long-term who are starting or stopping hormonal therapy contraceptives during lamictal therapy. Close supervision of patients at high risk of suicide in bipolar disorder. Potential for an increase risk of suicidal thoughts or behaviours

Latanoprost 0.005% Eye Drops A* Reduction of elevated intraocular The recommended dosage is one drop Slight discomfort, mild to moderate Known hypersensitivity to any Effects additive to beta-adrenergic Inflammatory, neovascular, angle closure pressure in patients with open-angle (1.5 µg) in the affected eye(s) once daily conjunctival hyperaemia, transient component of the products antagonist, adrenergic agonists, or congenital glaucoma, open angle glaucoma in the evening. If more than one topical punctate ephitelial erosions, increased carbonic anhydrase inhibitors and glaucoma of pseudophakic patients, ophthalmic drug is being used, the drugs pigmentation of iris, rash cholinergic agonists. Other eye pigmentary glaucoma, acute attacks of should be administered at least five (5) preparation containing thiomersal closed angle glaucoma, pregnancy and minutes apart lactation. Contact lens users

Letrozole 2.5 mg Tablet A* i) Treatment of hormone responsive 2.5 mg once daily Headache, nausea, fatigue, arthralgia, Hypersensitivity to letrozole, pregnancy, Inhibitors of the cytochrome P450 Impaired liver function. Only to be used metastatic or locally advance breast musculoskeletal pain, hot flushes, facture lactation enzymes, tamoxifen in postmenopausal women. Cirrhosis and cancer after failure of tamoxifen ii) of bone, heart failure, myocardial severe hepatic dysfunction, risk of drug Adjunct for node positive infarction toxicity pregnancy, potential for maternal postmenopausal women with early and fetal malformations breast cancer (positive or unknown oestrogen or positive progesterone receptor status / receptor status) who have received 5 years of adjuvant tamoxifen therapy Leucovorin Calcium (Calcium A i) Treatment of folic acid antagonist i) 15 mg every 6 hours for the next 48 - Nausea, vomiting, mucosal toxicity, Hypersensitivity to leucovorin, pernicious May diminish the effect of anti- Pregnancy, lactation, seizure disorder Folinate) 15 mg Tablet overdose; ii) Leucovorin (folinic acid) plus 72 hours; diarrhoea anaemia or megaloblastic anaemia epileptic substances such as tegafur-uracil combination therapy is ii) Adjuvant setting - Leucovorin Calcium where vitamin B12 is deficient phenobarbitone, phenytoin. When indicated for the treatment of colorectal 75 mg/day, Day 1-28, rest 7 days for 5 calcium folinate is given in cancer in: a) Metastatic stage, b) cycles; Concurrent setting - Leucovorin conjunction with a folic acid Adjuvant setting, c) Concurrent setting. Calcium 25 mg /day, D8- D36, for 4 antagonist (e.g. cotrimoxazole, weeks; Metastatic stage - Leucovorin pyrimethamine) the efficacy of the Calcium 75 mg/day, Day 1-28, rest 7 days folic acid antagonist may either be for 5 cycles. reduced or completely neutralised. Concomitant administration with 5- fluorouracil may enhance the efficacy and toxicity of 5- fluorouracil

Levetiracetam 500 mg Tablet A* i) Monotherapy therapy in the treatment i) Monotherapy ADULTS and Asthenia, somnolence/fatigue, Hypersensitivity to levetiracetam Evening primrose, ginkgo Avoid abrupt discontinuation, renal of partial onset seizures with or without ADOLESCENT (from 16 years) : Starting hematological or GI disturbances, products impairment, severe hepatic impairment, secondary generalization in patients from dose: 250 mg twice daily, Increase dose paresthesia, amnesia, ataxia, convulsion, pregnancy, lactation, elderly. May affect age 16 years of age with newly to 500 mg twice daily after 2 week. Dose dizziness, headache, hyperkinesia, ability to drive or operate machinery. diagnosed epilepsy ii) Adjunctive can be further increased by 250 mg twice tremor, balance disorder, attention Potential for an increase in risk of suicidal treatment in partial onset seizures with daily every 2 week depending upon the disturbance, memory impairment, thoughts or behaviours or without secondary generalization in clinical response. Max: 1500 mg twice psychiatric disorders, anorexia, increased adults and children from 4 years of age daily. ii) ADULT more than 18 years and wt, vertigo, diplopia, blurred vision, with epilepsy; juvenile myoclonic ADOLESCENT (12-17 years) more than or myalgia, accidental injury, infection, epilepsy and idiopathic generalized tonic equal to 50 kg: Initially 500 mg twice nasopharyngitis, increased coughing, clonic epilepsy from 12 years of age daily may be increased up to 1500 mg eczema, pruritus, rash. twice daily. Dose changes can be made in 500 mg twice daily increments or decrements 2-4 weekly. CHILD (4-11 years) and ADOLESCENT (12-17 years) less than 50 kg : Initially 10 mg/kg twice daily, may be increased up to 30 mg/kg twice daily. Dose changes should not exceed increments or decrements of 10 mg/kg twice daily every 2 weeks. CHILD more than or equal to 50 kg: Adult dose

Levocetirizine Dihydrochloride 5 mg A* Symptomatic treatment of allergic Children above 12 years and adults: 5 mg Asthenia, somnolence, nasopharyngitis, Hemodialysis patients, hypersensitivity Ritonavir; increased exposure of Concurrent alcohol use; should be Tablet rhinitis (including persistent allergic orally once daily (Swallow whole, do not pharyngitis, xerostomia, fatigue, fever to levocetirizine, cetirizine, or any levocetirizine avoided due to potential increase in CNS rhinitis) and chronic idopathic urticaria chew/crush). component of the product, end-stage depression and sedation, concurrent use renal disease, (CrCl less than 10 mL/min), of other central nervous system renally impaired pediatric patients depressants; should be avoided due to between 6 months and 11 years old potential increase in CNS depression and sedation, renal function, impaired; increased risk of adverse reactions, dosage adjustment required Levodopa 100 mg and Carbidopa 25 B Parkinson's disease Patients not receiving Levodopa before, Central nervous system: Anxiety, Hypersensitivity to this drug. Patient on Hypertensive crisis with MAOIs, Not recommended for treatment of drug- mg Tablet initially 100 - 125 mg 3 - 4 times daily confusion, nervousness, mental MAOIs therapy or 2 weeks prior to increased hypotensive effect with induced extrapyramidal reactions. The adjusted according to response. depression, psychotic symptoms. initiating therapy. May be administered antihypertensives, antagonism occurrence of dyskinesias in patients Maintenance: 0.75 - 2 g in divided doses. Anorexia, nausea and vomiting, concomitantly with or an MAOI with or effect of antipsychotic, reduced previously treated with levodopa alone In patients previously treated with diarrhoea, insomnia, agitation, postural selectivity for MAO type B (eg selegiline absorption by iron, plasma may require dosage reduction. All Levodopa the dose should be about 20 - hypotension, dizziness, chest pain, HCl). Narrow-angle glaucoma with concentration increased by patients should be observed carefully for 25% of the dose previously being taken tachycardia, arrhythmias, reddish compensated endocrine, renal or hepatic metoclopramide. Linezolid, the development of depression with discoloration of urine and other body function, cardiac disorders, psychiatric clonidine, anticholinergics, tricylic concomitant suicidal tendencies. fluid. Dyskinesia, muscle twitching and diseases or closed-angle glaucoma, antidepressant, phenothiazines, Cardiovascular disease or pulmonary blepharospasm may be taken as early undiagnosed skin lesion, melanoma, phenytoin, papaverine, selegiline disease, bronchial asthma. Hepatic signs to consider dosage reduction. pregnancy and high protein diet impairment, renal impairment, endocrine Gastrointestinal bleeding, development disease, chronic wide-angle glaucoma. of duodenal ulcer, dark saliva, Observe carefully when the dosage is leukopenia, hemolytic and non-hemolytic reduced abruptly or discontinued, anaemia, thrombocytopenia, especially if the patient is receiving agranulocytosis, angioedema, urticaria, neuroleptics. Pregnancy, women of pruritus, paraesthesia, increased libido, childbearing potential. Not dyspnoea, alopecia, rash, dark sweat, recommended in patients less than 18 dark urine years

Levodopa 200 mg, Benserazide 50 B Parkinson's Disease Initial: 100/25 mg 1-2 times/day, increase Anorexia, nausea and vomiting, Hypersensitivity to this drug. Patient on Hypertensive crisis with MAOIs, Open-angle glaucoma, depression, mg Tablet every 3-4 days until therapeutic effect, diarrhoea, insomnia, agitation, cardiac MAOIs therapy with decompensated increased hypotensive effect with diabetes, severe cardiovascular disease, optimal dosage: 400/100 mg to 800/200 arrhythmias, postural hypotension (rarely endocrine, renal or hepatic function, antihypertensives, antagonism bronchial asthma, renal, hepatic or mg/day divided into 4-6 doses. Dose: labile hypertension), dizziness, cardiac disorders, psychiatric diseases or effect of antipsychotic, reduced endocrine disease, history of psychoses 200/50 mg used only when maintenance tachycardia, arrhythmias, reddish closed-angle glaucoma. Pregnancy. absorption by iron, plasma or convulsion. Lactation. Perform liver therapy is reached and not to exceed discoloration of urine and other body Patients less than 25 years. Lactation. concentration increased by function and blood count tests during levodopa 1000-1200 mg/benserazide 250- fluid, rarely hypersensitivity, abnormal Combination with MAOIs (except metoclopramide. Tricylic treatment. Discontinue 12-48 hours 300 mg per day involuntary movement. Lost or change of selegiline) antidepressant, phenothiazines, before surgery requiring general taste. Abnormal involuntary movements. phenytoin, pyridoxine. Potentiates anaesthesia. If patient must undergo Rarely, skin reactions, haemolytic effects of sympathomimetics. surgery without Madopar having been anaemia, mild, transient leukopenia and Neuroleptics, opioids, withdrawn, avoid anaesthesia with thrombocytopenia. Agitation, anxiety, antihypertensives containing cyclopropane or halothane insomnia, hallucination, delusion and reserpine, antacid, protein-rich temporal disorientation in the elderly meal

Levodopa 250 mg and Carbidopa 25 B Parkinson's disease Patients not receiving Levodopa before, Central nervous system: Anxiety, Hypersensitivity to this drug. Patient on Hypertensive crisis with MAOIs, Not recommended for treatment of drug- mg Tablet initially 100 - 125 mg 3 - 4 times daily confusion, nervousness, mental MAOIs therapy or 2 weeks prior to increased hypotensive effect with induced extrapyramidal reactions. The adjusted according to response. depression, psychotic symptoms. initiating therapy. May be administered antihypertensives, antagonism occurrence of dyskinesias in patients Maintenance: 0.75 - 2 g in divided doses. Anorexia, nausea and vomiting, concomitantly with or an MAOI with or effect of antipsychotic, reduced previously treated with levodopa alone In patients previously treated with diarrhoea, insomnia, agitation, postural selectivity for MAO type B (eg selegiline absorption by iron, plasma may require dosage reduction. All Levodopa the dose should be about 20 - hypotension, dizziness, chest pain, HCl). Narrow-angle glaucoma with concentration increased by patients should be observed carefully for 25% of the dose previous being taken tachycardia, arrhythmias, reddish compensated endocrine, renal or hepatic metoclopramide. Linezolid, the development of depression with discoloration of urine and other body function, cardiac disorders, psychiatric clonidine, anticholinergics, tricylic concomitant suicidal tendencies. fluid. Dyskinesia, muscle twitching and diseases or closed-angle glaucoma, antidepressant, phenothiazines, Cardiovascular disease or pulmonary blepharospasm may be taken as early undiagnosed skin lesion, melanoma, phenytoin, papaverine, selegiline disease, bronchial asthma. Hepatic signs to consider dosage reduction. pregnancy and high protein diet impairment, renal impairment, endocrine Gastrointestinal bleeding, development disease, chronic wide-angle glaucoma. of duodenal ulcer, dark saliva, Observe carefully when the dosage is leukopenia, hemolytic and non-hemolytic reduced abruptly or discontinued, anemia, thrombocytopenia, especially if the patient is receiving agranulocytosis, angioedema, urticaria, neuroleptics. Pregnancy, women of pruritus, paresthesia, increased libido, childbearing potential. Not dyspnea, alopecia, rash, dark sweat, dark recommended in patients less than 18 urine years Levofloxacin 500 mg Tablet A* Community acquired pneumonia 500 mg daily for 7 - 14 days Diarrhoea, nausea, headache, blurred Hypersensitivity to quinolones, Antacids, sucralfate, divalent Fluoroquinolone are associated with an vision, hypoglycemia, tendinitis, pregnancy & lactation. Children and cations, multivitamin, theophylline, increased risk of tendinitis and tendon anaphylactic reactions, Stevens-Johnson growing adolescents less than 18 years warfarin, NSAIDS, antidiabetic rupture in all the age; especially older syndrome old agents, amiodarone, patients, patient taking corticosteroid chlorpromazine, cortisone, drugs and patient with kidney, heart or dexamethasone, diclofenac, lung transplants. Caution in infusion rate, disopyramide, ibuprofen, a rapid or bolus IV may result indomethacin, iron, ketoprofen, hypotension. Renal impairment (CrCl less ketorolac, mefenamic acid, than 50 mL/minute), CNS disorders, meloxicam, naproxen, predisposition to seizures, lowered phenylbutazone, piroxicam, convulsion threshold, diabetes mellitus, prednisolone, prochlorperazine, conditions predisposing to torsade de quinidine pointes, significant bradycardia, cardiomyopathy, G6PD deficiency. Ensure adequate hydration. Avoid excessive sun exposure. May affect ability to drive or operate machinery.

Levonorgestrel 1.5 mg Tablet A* Emergency contraception within 72 1.5 mg as a single dose as soon as Acne, weight gain, abdominal pain, Genital bleeding of unknown etiology, Effectiveness is reduced by enzyme Not effective in terminating an existing hours of unprotected sexual intercourse possible after coitus [preferably within 12 nausea, dizziness, headache, depression, pregnancy, severe hepatic insufficiency inducing drugs such as pregnancy, not recommended for routine for the female victim of sexual violence hours but no later than after 72 hours] breast tenderness, cyst of ovary, fatigue barbiturates, phenytoin, use as a contraceptive and in patients to prevent unwanted pregnancy pelvic inflammatory disease, sepsis, carbamazepine, St. John's Wort, with severe hepatic dysfunction menstrual irregularities rifampicin, ritonavir and griseofulvin Levonorgestrel 150 mcg and C+ Contraception 1 tablet daily for 21 days from first day of Thromboembolic disease, hypertension, Thromboembolic disorders, Effectiveness may be reduced by Age, smoking, gall bladder disease, Ethinyloestradiol 30 mcg Tablet the cycle, followed by 7 tab free days gall bladder disease, nausea, vomiting, cardiovascular disease, breast or antibiotics, phenytoin, diabetes, hypertension, epilepsy, migraine endometrial cancer, oestrogen carbamazepine, barbiturates, migraine, cardiac or renal dysfunction, dependent neoplasia, undiagnosed rifampicin history of depression, uterine fibroids, abnormal vaginal bleeding, cholestatic lactation. Gastrointestinal disease jaundice of pregnancy, hepatic adenomas (impaired absorption of oral or carcinomas, known or suspected contraceptive steroids in the small bowel pregnancy due to inflammatory disease)

Levothyroxine Sodium 100 mcg B Hypothyroidism Start at low dose and increase at 2-4 Nervousness, excitability, tremor, muscle Hypersensitivity, untreated adrenal Reduced absorption with iron, Elderly, CHD, severe or long existing Tablet weeks interval. Adult: Initially, 50-100 weakness, cramps, sweating, flushing, insufficiency, acute myocardial infarction, cholestyramine, colestipol, hypothyroidism. Coronary failure, angina mcg/day may increase by 25-50 mcg at heat intolerance, headache, insomnia, acute myocarditis, acute pancarditis. aluminium- and magnesium- pectoris, arteriosclerosis, hypertension, approximately 3 to 4 weeks intervals tachycardia, palpitations, angina pectoris, containing antacids, calcium pituitary or adrenal insufficiency, cardiac until the thyroid deficiency is corrected. excessive weight loss, menstrual carbonate, simethicone, sucralfate. insufficiency or tachycardic arrhythmias. Maintenance: 100-200 mcg/day. CHILD; 0 irregularities, diarrhoea, vomiting, May alter requirements of Not suitable for weight reduction. - 3 months: 10 - 15 mcg/kg/day; 3 - 6 convulsions, cardiac arrhythmia, heart antidiabetic drugs. Reduced Galactose intolerance, Lapp lactase months: 8 - 10 mcg/kg/day; 6 - 12 failure, coma, myocardial infarction, efficacy of thyroid replacement deficiency, glucose-galactose months: 6 - 8 mcg/kg/day; 1 - 5 years: 5 - osteopenia, pseudotumor cerebri, therapy with imatinib. Reduced tri- malabsorption, pregnancy and lactation. 6 mcg/kg/day; 6 - 12 years: 4 - 5 seizure iodothyronine serum levels with mcg/kg/day; more than 12 years: 2 -3 amiodarone. Reduced serum levels mcg/kg/day of thyroxine with carbamazepine, phenytoin, phenobarbital, rifampicin, oestrogens. May change hypoprothrombinaemic response to warfarin and other oral anticoagulants. Increased risk of significant hypertension and tachycardia with ketamine Levothyroxine Sodium 25 mcg Tablet B Hypothyroidism Start at low dose and increase at 2-4 Nervousness, excitability, tremor, muscle Untreated hyperthyroidism; uncorrected Antidiabetics, coumarins, protease Angina, heart failure; diabetes mellitus; weeks interval. Usual recommended weakness, cramps; sweating, flushing, adrenal failure; recent myocardial inhibitors, phenytoin, diabetes insipidus; elderly; long-standing dose for i) Treatment of benign euthyroid heat intolerance, headache, insomnia, infarction cholestyramine, colestipol, hypothyroidism; adrenal insufficiency; goitre: 75-200mcg. ii) Prophylaxis of tachycardia, palpitations, angina pectoris, aluminium, iron and calcium myxoedema. Do not use for treatment of relapse after surgery for euthyroid goitre: excessive weight loss; menstrual carbonate containing drugs, obesity or for weight loss. Pregnancy, 75-200mcg iii) Substitution therapy in irregularities; diarrhoea, vomiting, salicylates, dicumarol, frusemide, lactation hypothyroidism: ADULT Initially, 25- convulsions, cardiac arrhythmia, heart clofibrate, sevelamer, tyrosine 50mcg/day. Maintenance: 100- failure, coma,myocardial infarction, kinase inhibitors, propylthiouraacil, 200mcg/day. CHILDREN Initially 12.5- osteopenia, pseudotumor cerebri, glucocorticoids, beta 50mcg/day, Maintenance: 100- seizure sympatholytics, amiodarone and 150mcg/m2 body surface area iv) iodine containing contrast media, Concomitant supplementation during sertraline, chloroquine/proguanil, anti-thyroid drug treatment of oestrogens, soy-containing hyperthyroidism: 50-100mcg v) compounds Suppression therapy in thyroid cancer: 150-300mcg

Lignocaine, Aluminium Acetate, Zinc B Anorectal pain, pruritis, inflammation 1 suppository to be used once or twice Dry skin, pruritus, irritation, transient Hypersensitivity to local anaesthetics or With large doses of lidocaine, risk Children less than 12 years old, Oxide and Hydrocortisone and irritation daily. Not for prolonged use burning/stinging and atrophy of anal skin to other components of the product of additional systemic toxicity in traumatised mucosa, sepsis in anorectal Suppository patients receiving other local region or suspected herpes simplex anaesthetics infection

Lopinavir 100 mg and Ritonavir 25 A As second line protease inhibitor if Adult: (Therapy-naive patients) 400/100 Dyslipidemia, hyperglycaemia, Hypersensitivity to lopinavir or ritonavir, Drugs metabolized by CYP3A4 eg DM, hyperglycemia; history of mg Tablet intolerant to indinavir/ ritonavir as part mg bd or 800/200 mg once daily; hypercholesterolemia, increased concomitant use with drugs that are dihydropyridine Ca channel pancreatitis; hepatic impairment, of HAART regimen. (Therapy-experienced patients): 400/100 triglycerides, diarrhoea, nausea, highly dependent on CYP3A or CYP2D6 blockers, HMG-CoA reductase hepatitis B or C, marked elevations in mg bd. Concomitant therapy (efavirenz, headache, pain, insomnia. for clearance. inhibitors, immunosuppressants; transaminases; haemophilia type A & B; nevirapine, amprenavir, fosamprenavir or tenofovir, indinavir, fentanyl, underlying structural heart disease, nelfinavir) 400/100 mg bd. Children >40 digoxin, dasatinib, nilotinib, preexisting conduction system kg or w/ BSA >1.4 m2 as adult dose. vincristine, vinblastine, warfarin, abnormalities, patients receiving drugs bupropion, trazodone, phenobarb, that prolong PR interval. Perform phenytoin, carbamazepine, triglyceride & cholesterol testing prior to ketoconazole, itraconazole, therapy & periodically thereafter. voriconazole, clarithromycin, Children, elderly. Pregnancy & lactation. rifabutin, rifampin, atovaquone, dexamethasone, fluticasone propionate, tadalafil, vardenafil, sildenafil, St. John's wort, methadone, oral contraceptives.

Lopinavir 200 mg and Ritonavir 50 A As second line protease inhibitor if Adult: (Therapy-naive patients) 400/100 Dyslipidemia, hyperglycaemia, Hypersensitivity to lopinavir or ritonavir, Drugs metabolized by CYP3A4 eg DM, hyperglycemia; history of mg Tablet intolerant to indinavir/ ritonavir as part mg bd or 800/200 mg once daily; hypercholesterolemia, increased concomitant use with drugs that are dihydropyridine Ca channel pancreatitis; hepatic impairment, of HAART regimen (Therapy-experienced patients): 400/100 triglycerides, diarrhoea, nausea, highly dependent on CYP3A or CYP2D6 blockers, HMG-CoA reductase hepatitis B or C, marked elevations in mg bd. Concomitant therapy (efavirenz, headache, pain, insomnia for clearance inhibitors, immunosuppressants; transaminases; haemophilia type A & B; nevirapine, amprenavir, fosamprenavir or tenofovir, indinavir, fentanyl, underlying structural heart disease, nelfinavir) 400/100 mg bd. Children >40 digoxin, dasatinib, nilotinib, preexisting conduction system kg or w/ BSA >1.4 m2 as adult dose. vincristine, vinblastine, warfarin, abnormalities, patients receiving drugs bupropion, trazodone, phenobarb, that prolong PR interval. Perform phenytoin, carbamazepine, triglyceride & cholesterol testing prior to ketoconazole, itraconazole, therapy & periodically thereafter. voriconazole, clarithromycin, Children, elderly. Pregnancy & lactation rifabutin, rifampin, atovaquone, dexamethasone, fluticasone propionate, tadalafil, vardenafil, sildenafil, St. John's wort, methadone, oral contraceptives Loratadine 10 mg Tablet B Allergic rhinitis and allergic dermatoses ADULT and CHILD over 6 years 10 mg Headache, drowsiness, fatigue, sedation, Hypersensitivity to loratadine. Not to be Cimetidine, erythromycin, Hepatic and renal impairment. Elderly. once daily. CHILD 2 - 6 years: 5 mg once nervousness, hyperkinesia, dysphonia, used in children less than 2 years of age. ketoconazole and other hepatic Pregnancy and lactation. To be used with daily malaise, wheezing, upper resp tract enzyme inhibitors caution and doctor's advice in children 2 infection, dry mouth, epistaxis, to 6 years of age. pharyngitis, abdominal pain, diarrhoea, stomatitis, tooth disorder, conjunctivitis, earache, influenza-like symptoms, viral infections and rash.

Loratadine 5 mg and A/KK For treatment of allergic rhinitis and ADULT and CHILD over 12 years 1 tablet Headache, nervousness, dizziness, Narrow-angle glaucoma, urinary Loratadine is metabolised by Avoid in hepatic insufficiency, renal Pseudoephedrine Sulphate 120 mg allergic dermatoses twice daily tachycardia, rhinitis, pruritis, acne, retention, severe coronary artery cytochrome P450 isoenzymes insufficiency (use lower initial dose), Tablet insomnia, fatigue, pharyngitis, disease, severe hypertension, CYP3A4 and CYP2D6. Therefore pregnancy, hypertension, diabetes somnolence, nausea, palpitations, concomitant therapy with MAOIs or concomitant administration of mellitus, ischaemic heart disease, tachycardia within 10 days of continuing such other drugs that inhibit or are increased intraocular pressure, treatment, hyperthyroidism, hepatic and metabolised by these hepatic hyperthyroidism, prostatic hypertrophy, renal impairment, hypersensitivity to enzymes may result in changes in stenosing peptic ulcer, elderly, lactating, loratadine or pseudoephedrine plasma concentrations of either prostatic hypertrophy drug, bromocriptine, hydrocodone, selegiline

Lorazepam 1 mg Tablet A/KK i) Severe anxiety ii) Insomnia i) 1 - 4 mg increase to 10 mg daily in Fatigue, hypotension, ataxia, respiratory Respiratory depression, acute pulmonary Theophylline, decreased Concomitant use of central nervous divided doses. ELDERLY (or delibitated) depression, sedation, confusion, insufficiency, sleep apnoea syndrome, benzodiazepine effectiveness. system drugs such as phenothiazines, half adult dose ii) 1 - 2 mg at bedtime Not depression, headache, nausea, tremor, severe hepatic impairment, myasthenia Valproic acid, increased lorazepam narcotic analgesics, barbiturates, recommended in children urinary retention, vertigo, withdrawal gravis, phobic or obsessional states, concentrations. Clozapine, alcohol antidepressants, scopolamine and syndrome, bradycardia, dependence or depression or anxiety with depression, or central nervous system MAOIs; elderly and debilitated patients, abuse acute narrow-angle glaucoma, depressants, will give additive patients with a limited pulmonary hypersensitivity to benzodiazepines central nervous system depression reserve, doses exceeding 2 mg/day in effect. Contraceptive, decreased geriatric patients or debilitated patients, lorazepam effect. Rifampicin, not recommended in patients with decreased effect of lorazepam. primary depressive disorder or psychosis. Digoxin, increased serum digoxin Potential for drug abuse, impaired concentrations liver/renal function

Losartan 50 mg Tablet B Patients intolerant of ACE inhibitors, only Hypertension: Usual starting and Angioedema, headache, dizziness, cough Hypersensitivity to losartan, pregnancy Fluconazole, lithium, rifampicin Angioedema: intravascular volume in the treatment of i) Hypertensive maintenance dose: 50 mg once daily. depletion (eg those treated with high- patient with left ventricular hypertrophy Maximum increasing the dose to 100 mg dose diuretics), electrolyte imbalance: ii) Hypertension in diabetics with once daily. Patients with intravascular lower dose should be considered for proteinuria or nephropathy volume-depletion starting dose of 25 mg patients with a history of hepatic once daily. Renal protection in Type 2 impairment, changes in renal function diabetic patients with proteinuria and including renal failure may occur in hypertension, starting dose: 50 mg once susceptible individuals. Blood urea and daily, may be increased to 100 mg once serum creatinine may be increased in daily based on blood pressure response patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney, lactation, children

Losartan Potassium 100 mg Tablet B Patients intolerant of ACE inhibitors, only Usual starting dose: 50 mg once daily. Angioedema, headache, dizziness, cough Hypersensitivity to losartan, pregnancy Fluconazole, lithium, rifampicin Angioedema: intravascular volume in the treatment of: i) Hypertensive May be increased to 100 mg once daily. depletion (eg those treated with high- patient with left ventricular hypertrophy dose diuretics), electrolyte imbalance: ii)Hypertension in diabetics with lower dose should be considered for proteinuria or nephropathy patients with a history of hepatic impairment, changes in renal function including renal failure may occur in susceptible individuals. Blood urea and serum creatinine may be increased in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney, lactation, children Magnesium Trisilicate Tablet C Heartburn, dyspepsia ADULT 1-2 tablet to be chewed up to 6 Diarrhoea Hypersensitivity to antacids, Tetracyclines, ketoconazole, Renal impairment times a day before meals. CHILD over 6 hypophosphataemia itraconazole, dipyridamole, years one tablet to be taken 3-4 times a quinolones, captopril, iron and day aspirin

Mebeverine HCl 135 mg Tablet B Irritable bowel syndrome 135 mg 3 times daily Dizziness, headache, nausea, peritonitis, Cystic fibrosis, porphyria, paralytic ileus, Not known Hypersensitivity to mebeverine HCl, skin reactions hypersensitivity to any component of severe hepatic insufficency, porphyria formulation

Meclozine HCl 25 mg and Pyridoxine B Nausea and vomiting of pregnancy Optimum dosing: 1 to 2 tablets OD. Drowsiness, dry mouth, blurred vision, Hypersensitivity to meclozine May enhanced sedative effect of Use with caution in prostatic 50 mg Tablet Maximum dosing: 4 tablets/day. headache, gastrointestinal disturbance central depressants including hyperthrophy, urinary retention, alcohol glaucoma and pyloroduodenal obstruction, hepatic disease, severe heart failure, asthma. Avoid operating vehicles and machinery. Meclozine may inhibit lactation Mecobalamin 500 mcg Tablet B Peripheral neuropathies 1 tablet 3 times daily. The dosage should †Anorexia, nausea, vomiting and Not known Not known Discontinue medication if there is no be adjusted according to age of patient diarrhoea response after taking orally for several and severity of symptoms months

Medroxyprogesterone Acetate 5 mg B i) Secondary amenorrhoea ii) Abnormal i) 5-10 mg daily for 5-10 days started Gastrointestinal distress, oedema, Thromboembolic disorders, liver disease, Aminoglutethimide and enzyme- Depressions, diabetes, epilepsy, Tablet uterine bleeding due to hormonal anytime during cycle ii) 5-10 mg daily for menstrual disorders, dermatologic known or suspected malignancy of breast inducing drugs (e.g. migraine, asthma imbalance 5-10 days on day 16-21 of menstrual effects, nausea, fatique, depression, or genital organs, undiagnosed abnormal carbamazepine, griseofulvin, cycle. Optimum secretory transformation acne, hirsutism, breast tenderness, vaginal bleeding, known or suspected phenobarbital, rifampicin, 10 mg daily for 10 days from day 16 of thromboembolic phenomena, pregnancy, hypersensitivity to phenytoin) may reduce plasma the cycle galactorrhoea, decreased glucose medroxyprogesterone products concentrations leading to reduced tolerance, anaphylaxis, corticoid like efficacy reaction (high doses)

Mefenamic Acid 250 mg Capsule C Mild to moderate pain ADULT: 250 - 500 mg 3 times daily after Diarrhoea, skin rash, allergic, Gastrointestinal ulceration or Alendronate, ACEIs, antacids, beta- Elderly, renal impairment, asthmatic meals. CHILD over 6 months: 6.5 - 25 glomerulonephritis, non-oliguric renal inflammatory bowel disease, adrenergic blockers, calcium sensitive to NSAIDs or salicylates, mg/kg daily 3 - 4 times daily for not failure, thrombocytopenia, reversible renal/hepatic impairment channel blocker, ciclosporin, pregnancy, increased risk of serious longer than 7 days except in juvenile haemolytic anaemia, hypertension, diuretics, methotrexate, cardivascular thrombotic events, arthritis oedema, myocardial infarction sulphonylureas, warfarin myocardial infarction

Meloxicam 7.5 mg Tablet A/KK Only for patients not responding to other i) initially 7.5 mg daily. May be increased Dyspepsia, nausea, abdominal pain, Active peptic ulceration, pregnancy, NSAIDs, salicylates, oral History of gastrointestinal disease, liver NSAIDs in the treatment of i) painful to 15 mg daily ii) initially 15 mg daily. pruritis, skin rash, constipation. Vomiting, lactation, hypersensitivity to NSAIDs or anticoagulants, ticlopidine, heparin, cirrhosis, dehydration. Chronic heart osteoarthritis ii) rheumatoid arthritis May be reduced to 7.5 mg daily. flatulence, diarrhoea, anaemia, pruritus, aspirin, severe hepatic insufficiency, non- thrombolytics, lithium, failure, nephrotic syndrome, overt renal Maximum 15 mg daily. Child under 12 lightheadedness, headache, oedema dialysed severe renal insufficiency. methotrexate, IUD, diuretics, disease, recent major surgical years not recommended Children less than 15 year antihypertensives, cholestyramine, procedures. Withdraw if peptic ciclosporin ulceration or gastrointestinal bleeding occurs. Concomitant anticoagulant or diuretic treatment. Elderly Memantine HCI 10 mg Tablet A* As monotherapy or as adjunctive therapy Adult Initially 5 mg/day on the 1st week, Hypertension, constipation, dizziness, Hypersensitivuty to either memantine L-dopa, dopaminergic agonists, Severe renal impairment, epilepsy, co- with cholinesterase inhibitors for the 5mg twice a day on the 2nd week, then somnolence, headache, pain, Stevens- hydrochloride or any components of the anticholinergics, barbiturates, administration with N-methyl-D- symptomatic treatment of patients with 15 mg/day (10mg in the morning and Johnson syndrome, deep venous tablet, renal impairment (CrCl <50 neuroleptics, antispasmodic agents aspartate (NMDA) antagonists (eg moderate to severe Alzheimer?s disease. 5mg in the evening) on the 3rd week. thrombosis, hepatitis, liver failure, mL/min), current or history of seizures. (dantrolene or baclofen), amantadine, ketamine or From the 4th week on, continue cerebral infarction, cerebrovascular phenytoin, cimetidine, ranitidine, dextromethorphan), patients with treatment with maintenance dose of 20 accident, grand mal seizure, intracranial procainamide, quinidine, quinine, factors that may raise urine pH, recent mg/day (10mg twice a day). Max: 20 hemorrhage, seizure, transient ischemic nicotine, hydrochlorothiazide. myocardial infarct, uncompensated mg/day. attack, acute renal failure, neuroleptic Avoid administration with congestive heart failure, uncontrolled malignant syndrome amantadine, ketamine & hypertension, pregnancy and lactation, dextromethorphan. children. May impair ability to drive or operate machinery.

Memantine HCl 20 mg Tablet A* As monotherapy or as adjunctive therapy Adult Initially 5 mg/day on the 1st week, Hypertension, constipation, dizziness, Hypersensitivuty to either memantine L-dopa, dopaminergic agonists, Severe renal impairment, epilepsy, co- with cholinesterase inhibitors for the 5mg twice a day on the 2nd week, then somnolence, headache, pain, Stevens- hydrochloride or any components of the anticholinergics, barbiturates, administration with N-methyl-D- symptomatic treatment of patients with 15 mg/day (10mg in the morning and Johnson syndrome, deep venous tablet, renal impairment neuroleptics, antispasmodic agents aspartate (NMDA) antagonists (eg moderate to severe Alzheimer?s disease. 5mg in the evening) on the 3rd week. thrombosis, hepatitis, liver failure, (dantrolene or baclofen), amantadine, ketamine or From the 4th week on, continue cerebral infarction, cerebrovascular phenytoin, cimetidine, ranitidine, dextromethorphan), patients with treatment with maintenance dose of 20 accident, grand mal seizure, intracranial procainamide, quinidine, quinine, factors that may raise urine pH, recent mg/day (10mg twice a day). Max: 20 hemorrhage, seizure, transient ischemic nicotine, hydrochlorothiazide. myocardial infarct, uncompensated mg/day. attack, acute renal failure, neuroleptic Avoid administration with congestive heart failure, uncontrolled malignant syndrome amantadine, ketamine & hypertension, pregnancy and lactation, dextromethorphan. children. May impair ability to drive or operate machinery.

Mesalazine 500mg MR Tablet A Inflammatory bowel disease of ulcerative ADULT: 250 - 500 mg 3 - 4 times daily for Allergic exanthema, drug fever, Severe hepatic and renal function Sulfonylureas, coumarins, Pregnancy, lactation, elderly, impaired colitis and Crohn's disease. 3 - 6 weeks. CHILD up 2 years with bronchospasm, lupus erythematosus-like disorders, active peptic ulcer, blood methotrexate, probenecid, hepatic function, pulmonary function Crohn's disease: 20 - 30 mg/daily in syndrome, hepatitis, pancreatitis, hair clotting abnormalities, salicylate sulfinpyrazone, frusemide, disorders especially asthma need close divided doses loss hypersensitivity, babies and infants rifampicin, azathioprine, 6- monitoring. In patients with mercaptopurine hypersensitivity to sulfasalazine, treatment may be started under close medical supervision and if signs of intolerance such as spasms, acute abdominal pain, fever, severe headache and skin rashes, treatment must be discontinued immediately.

Mesalazine 6.67% w/w Enema A Inflammatory bowel disease of ulcerative 60 ml (4g) at bedtime, retained Allergic exanthema, drug fever, Hypersensitivity to mesalazine, Sulfonylureas, coumarins, Pregnancy, lactation, elderly, patients (1gm/100ml) colitis and Crohn's disease. overnight, approximately 8 hours bronchospasm, lupus erythematosus-like salicylates and sulfasalazine. Severe methotrexate, probenecid, predisposed to pericarditis or syndrome, hepatitis, pancreatitis, hair impaired renal (CrCl < 20 ml/min) or sulfinpyrazone, frusemide, myocariditis, impaired hepatic and renal loss hepatic function. Children less than 2 rifampicin, azathioprine, 6- function, pulmonary function disorders years old. mercaptopurine, lactulose. especially asthma need close monitoring. In patients with hypersensitivity to sulfasalazine, treatment may be started under close medical supervision and if signs of intolerance such as spasms, acute abdominal pain, fever, severe headache and skin rashes, treatment must be discontinued immediately. Metformin 500 mg and B As second-line therapy when diet, Initial dose:1.25 mg/250 mg ORALLY once Hypoglycemia, lactic acidosis, cobalamin Renal disease or renal dysfunction, Cationic drugs that are eliminated Adrenal or pituitary insufficiency elderly, Glibenclamide 2.5 mg Tablet exercise and initial treatment with daily; titrate in increments of 1.25 deficiency, abdominal pain, diarrhoea, chronic heart failure requiring by renal tubular secretion. Thiazide debilitated or malnourished patients, sulphonylurea or metformin do not result mg/250 mg per day every 2 weeks,2.5 nausea and vomiting, dizziness pharmacologic treatment, acute or and other diuretics, corticosteroids, excessive alcohol intake, hypoxic states in adequate glycemic control in patients mg/500 mg to 5 mg/500 mg ORALLY chronic metabolic acidosis, including phenothiazines, thyroid products, due to shock, acute chronic heart failure with type 2 diabetes mellitus twice daily; titrate in increments of 5 diabetic ketoacidosis with or without estrogens, oral contraceptives, or acute myocardial infarction, lactic mg/500 mg up to MAX 20 mg/2000 mg coma, hypersensitivity to metformin or phenytoin, nicotinic acid, acidosis, severe metabolic complication once daily glibenclamide sympathomimetics, calcium due to accumulation of metformin, liver channel blockers and isoniazid may or renal disease, peripheral vascular produce hyperglycaemia and lead disease, pulmonary disease, pregnancy to loss of glycaemic control. The or lactation, stress caused by infection, hypoglycaemic action of fever, trauma or surgery sulphonylureas may be potentiated by NSAIDs and other highly protein- bound drugs, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, MAOIs, β- blockers, ciprofloxacin, oral miconazole

Metformin HCl 500 mg Extended A/KK Diabetes mellitus who experienced 500 mg once daily. Maximum dose 2000 Gastrointestinal disorders, taste Hypersensitivity, diabetic ketoacidosis, Alcohol, iodinated contrast agents, Renal failure (risk of lactic acidosis), Release Tablet gastrointestinal side effects with normal mg once daily with evening meal disturbance/metallic taste. Rarely, diabetic precoma, renal failure (CrCl < glucocorticoids, beta-2 agonists, administration of iodinated contrast metformin decreased vitamin B12 absorption, lactic 60ml/min), acute conditions with diuretics, ACEIs agent (discontinue prior to radiologic acidosis, skin reactions, liver function potential to alter renal function (e.g. exam and restart 48 hours afterwards), tests abnormalities dehydration, severe infection, shock), surgery (discontinue 48 hours prior to acute or chronic disease which may surgery and restart 48 hours afterwards), cause tissue hypoxia (e.g. cardiac or pregnancy respiratory failure, recent myocardial infarction), hepatic insufficiency, alcohol, lactation

Metformin HCl 500 mg Tablet B Diabetes mellitus Initial: 500mg orally twice daily with Gastrointestinal disorders, taste Hypersensitivity, diabetic ketoacidosis, Alcohol, iodinated contrast agents, Renal failure (risk of lactic acidosis), food. Maintenance: Titrate in 500mg disturbance/metallic taste. Rarely, diabetic precoma, renal failure (CrCl < glucocorticoids, beta-2 agonists, administration of iodinated contrast increments weekly, doses up to 2000 mg decreased vitamin B12 absorption, lactic 60ml/min), acute conditions with diuretics, ACEIs. agent (discontinue prior to radiologic daily may be divided into 2 equal doses. acidosis, skin reactions, liver function potential to alter renal function (e.g. exam and restart 48 hours afterwards). tests abnormalities. dehydration, severe infection, shock), May need to discontinue treatment in acute or chronic disease which may patients with stress-related states e.g. cause tissue hypoxia (e.g. cardiac or fever, trauma, infection or surgery. respiratory failure, recent myocardial Elderly; monitor renal function regularly. infarction), hepatic insufficiency, alcohol, May impair ability to drive or operate lactation. machinery.

Methadone 5mg/ml Syrup A/KK Detoxification treatment or maintenance Initial 10-20mg per day, increasing by 10- Constipation, nausea, vomiting, asthenia, Hypersensitivity to methadone, severe Buprenorphine, didanosine, May cause dependence on prolonged treatment of narcotic addiction. 20mg per day until there are no signs of dizziness, somnolence, cardiac arrest, hepatic impairment, respiratory efavirenz, fluconazole, fluvoxamine, use. Avoid alcoholic beverages, effects withdrawal or intoxication. Usual dose 40- disease of cardiovascular system, shock, depression, obstructive airways disease, naltrexone, nevirapine, rifampin, on ability to drive or operate machine. 60mg/day respiratory arrest, respiratory ulcerative colitis, concomitant risperidone, ritonavir, voriconazole, Methadone, even in low doses is a depression, diaphoresis, constipation, administration with monoamine oxidase zidovudine special hazard for children, non- sedation inhibitors (MAOIs) or within 2 weeks of dependent adults are also at risk of discontinuation toxicity and dependent adults are at risk if tolerance is incorrectly asessed during induction Methotrexate 2.5 mg Tablet A i) Acute lymphoblastic leukaemia and i) ADULT: 20 mg/m2 weekly. CHILD: 20 - Myelosuppression, nausea, vomiting, Pregnancy, lactation, severe Alcohol, aminophenazone, Impaired renal function, pleural effusion, acute promyelocytic leukemia 30 mg/m2 weekly according to protocol diarrhoea, mucositis, transient myelosuppression, serious renal and liver amiodarone, amitriptyline, ascitis, poor nutritional status, (maintenance) ii) Extensive plaque ii) Relapsed acute lymphoblastic abnormalities in serum levels of liver impairment, increase risk of toxicity in antibiotics, cisplatinum, ciclosporin, myelosuppression, acute or chronic psoriasis, erythrodermic psoriasis, leukaemia (ALL): 100 mg/m2/day for 5 enzymes, acute hepatocellular injury (not the presence of third space fluid (pleural cytosine arabinoside, diclofenac, hepatotoxicity (elevated transaminases, pustular psoriasis, Reiter's syndrome, days 6 weekly according to protocol iii) common at standard dose), effusion, ascites) etoposide, etretinate, 5- fibrosis, cirrhosis), pulmonary toxicity connective tissue disease Dose used by dermatologist: 5 - 25 mg erythematous rash, pruritis, pigmentary fluorouracil, NSAIDs, salicylates, (dry cough, pneumonitis), nephrotoxicity weekly. Liver biopsy after cumulative changes, photosensitivity, acute renal nephrotoxic drugs, sulfonamides, with high-dose therapy, patients with a dose of 1.5 gram and repeat liver biopsy failure (high dose), headache, tetracyclines, teniposide, warfarin, creatinine clearance of less than 60 with additional gram received. Maximum drowsiness, dizziness, acute confusion folic acid ml/minute should not receive high-dose cumulative dose is 4 gram. Monitor full (high dose), interstitial pneumonitis, methotrexate, high-dose or intrathecal blood count (FBC), renal and liver myelosuppression, interstitial methotrexate therapy must not be function iv) Rheumatoid arthritis, pneumonitis formulated with diluents containing psoriatic arthropathy: dose used by preservatives, women of child-bearing rheumatologist: 2.5 mg/week orally potential, gastrointestinal toxicity starting dose, increasing to 7.5 - 20 (vomiting, diarrhoea, stomatitis), tumour mg/weekly lysis syndrome in patients with rapidly growing tumors, severe and sometimes fatal skin reactions, potentially fatal infections (especially Pneumocystis carinii pneumonia), neurotoxicity (leukoencephalopathy, seizures), high- dose methotrexate therapy will generally require the use of leucovorin rescue, care should be taken in handling the body fluids of persons receiving antineoplastic agents

Methyldopa 250 mg Tablet B Hypertension Adult: 250 mg 2 - 3 times daily, gradually Sedation, headache, weakness, dizziness, Hypersensitivity to methyldopa, history Antihypertensive drugs, lithium, Avoid abrupt withdrawal, congestive increased at intervals of 2 or more days, parkinsonism, bradycardia, orthostatic of hepatitis, autonomic dysfunction, monoamine oxidase inhibitors heart failure, dialysis patients (risk of maximum; 3 g/day. Elderly: initially 125 hypotension, GI symptoms, hepatic bilateral cardiovascular disease (MAOIs) hypertension following procedure), mg twice daily, increased gradually, impairment, impotence oedema, haemolytic anaemia, maximum; 2 g daily. Child: Initially, 10 hypotension, liver disease, severe mg/kg or 300 mg/m2 daily in 2-4 divided bilateral cerebrovascular disease (risk of doses; increase as necessary. Max: 65 choreoathetotic movements) mg/kg, 2 g/m2 or 3 g daily, whichever is least.

Methylphenidate HCl 10 mg Tablet A Attention deficit hyperactivity disorder CHILD over 6 years, initially 5 mg 1 - 2 Nervousness, insomnia, decreased Anxiety and tension states, agitation, Pressor agents, MAOIs, May exacerbate behavioral disturbance (ADHD) times daily, increased if necessary at appetite. Occasionally headache, tics, tics in siblings, familial history or anticoagulants, anticonvulsants, and thought disorder in psychotic weekly intervals by 5 - 10 mg daily to drowsiness, dizziness, dry mouth, diagnosis of Tourette's syndrome, tricyclic antidepressants, patients. Not for severe depression, maximum of 60 mg daily in divided tachycardia, palpitations, arrhythmias, glaucoma, hyperthyrodism, cardiac phenylbutazone, guanethidine suicidal tendency, chronic abuse can lead doses; discontinue if no response after 1 changes in blood pressure and heart rate. arrythmias, severe angina pectoris, to marked tolerance and psychic month, also suspend periodically to Gastrointestinal disturbances, skin hypersensitivity to drug/class, children dependence. Epilepsy and hypertension. assess child's condition (usually finally reactions, fever, arthralgia. Rare: blurred less than 6 years of age, MAOIs use Monitor blood count during long-term discontinued during or after puberty) vision, moderately reduced weight gain within 14 days treatment. Careful supervision during and minor growth retardation in children, drug withdrawal. Children less than 6 seizures, dependency, and leucopenia. years. Pregnancy and lactation. Caution Methylphenidate was reported to cause in road/machinery users. Cardiovascular prolonged and painful erections disease, hypertension, alcohol/drug Methylphenidate HCl 36 mg A* Attention deficit hyperactivity disorder CHILD over 6 years: Individualize dosage, Loss of appetite, slurred speech, Marked anxiety, tension, agitation, Pressor agents, MAOIs, Onset or exacerbation of motor and Extended-release Tablet (ADHD) to be taken once daily in the morning. abnormal behavior, restlessness, glaucoma, Tourette's syndrome. anticoagulants, anticonvulsants, verbal tics, growth suppression with long- Dose may be adjusted in increments to a hypertension, tachyarrhythmia, Treatment with MAOIs or within a tricyclic antidepressants, term therapy, preexisting maximum of 54 mg/day, at weekly thrombocytopenia, hallucinations. minimum of 14 days following phenylbutazone, guanethidine gastrointestinal narrowing or with interval. Patient new to Methylphenidate was reported to cause discontinuation of a MAOI. Child less dysphagia, severe depression and methylphenidate: starting dose 18 mg prolonged and painful erections than 6 year fatigue, may exacerbate symptoms of once daily; adults 18mg or 36mg once (priapism), sometimes requiring surgical behavior disturbance and thought daily. Patient currently using intervention, in both pediatric and adult disorder in psychotic patients, patients methylphenidate: 18 - 36 mg. Maximum patients. It was reported to develop whose underlying conditions may be 54 mg/day. Discontinue if no response more often subsequent to an increase in compromised by increases in blood after 1 month dose. Priapism has also appeared during pressure or heart rate, history of drug a period of drug withdrawal (drug dependence or alcoholism and seizures, holidays or during discontinuation). visual disturbances, periodic hematologic monitoring during prolonged therapy. Pregnancy and lactation. May impair ability to drive or operate machinery

Metoclopramide HCl 10 mg Tablet B i) Dyspepsia, flatulence, hiatus hernia, i) ADULT over 20 years: 10 mg 3 times Extrapyramidal effects (especially in Concomitant therapy with drugs which Increased absorption of aspirin and Hepatic and renal impairment, elderly, peptic ulceration, reflux oesophagitis, daily. ADULT between 12 - 20 years: 5 mg children and young adults), are likely to cause extrapyramidal paracetamol; opioid analgesics and young adults and children; may mask gastritis, duodenitis, cholelithiasis, 3 times daily. CHILD under 12 years: 0.12 hyperprolactinaemia, tardive dyskinesia, reactions, epileptics, gastrointestinal antimuscarinics antagonise effect underlying disorders such as cerebral nausea, vomiting ii) Promote bowel mg/kg/dose 6 - 12 hourly ii) Single dose 5 drowsiness, restlessness, anxiety, haemorrhage, obstruction (mechanical), on gastro-intestinal activity, irritation; avoid for 3 - 4 days following transit during diagnostic procedures - 10 minutes before examination; ADULT drowsiness, fatigue, akathisia, insomnia, or perforation, hypersensitivity to antipsychotics (increased risk of gastro-intestinal surgery, may cause and CHILD over 15 years: 10 - 20 mg; depression, neuroleptic malignant metoclopramide, pheochromocytoma. extrapyramidal effects). Decrease acute hypertensive response in CHILD less than 15 years: 0.12 syndrome, diarrhoea, bronchospasm and Immediately after GI surgery where absorption of digoxin phaeochromocytoma; pregnancy and mg/kg/dose 6 - 12 hourly cardiac conduction abnormalities, stimulation of GI tract motility might be breast feeding; porphyria. Use cautiously galactorrhea, gynaecomastia dangerous. in patients with depression, Parkinson's disease or hypertension

Metoprolol Tartrate 100 mg Tablet B Hypertension, angina, myocardial Hypertension: Initially 100 mg to Lassitude, gastrointestinal and sleep Hypersensitivity to metoprolol products, Alpha-1 adrenergic blockers, Pregnancy, lactation infarction, arrhythmias maximum 400 mg daily, Angina: 50 mg - pattern disturbances; rarely, non-specific bradycardia, 2nd and 3rd degree AV amiodarone, chlorpromazine, 100 mg in 2 - 3 times daily. Myocardial skin reactions and coldness of block overt cardiac failure, cardiogenic chlorprothixene, cimetidine, infarction: 200 mg daily in divided doses. extremities shock, obstructive pulmonary disease clonidine, digoxin, dihydropyridine, Arrythmias: 50 mg - 300 mg in 2 - 3 times calcium channel blockers, daily flunarizine, fluoxetine, fluvoxamine, hydralazine, hypoglycemic agents, lidocaine, methyldopa Metronidazole 200 mg Tablet B Anaerobic infection Anaerobic bacterial infections Adult: GI disturbances e.g. nausea, unpleasant History of hypersensitivity to Acute psychoses or confusion with Patients with CNS diseases; History of Initially, 800 mg followed by 400 mg 8 hly metallic taste, vomiting, diarrhoea or metronidazole or other nitroimidazole disulfiram. Additive/synergistic seizure disorder. Evidence or a history of for about 7 days. Other recommended constipation. Furred tongue, glossitis, derivatives. Pregnancy (1st trimester) effect with other antimicrobials. blood dyscrasias; perform total and doses: 500 mg 8 hrly or 7.5 mg/kg 6 hrly and stomatitis due to overgrowth of and lactation. Effects reduced with phenobarbital differential leukocyte counts before and (max: 4 g in 24 hr). Child: 7.5 mg/kg 8 Candida. Rarely, antibiotic-associated or phenytoin. Potentially Fatal: after treatment. Severe hepatic hrly. Elderly: Use lower end of adult dose colitis. Weakness, dizziness, ataxia, Disulfiram-like reaction with impairment; monitor plasma levels. recommendations. Do not admin as a headache, drowsiness, insomnia, alcohol. Increased risk of adverse Prolonged use may result in fungal or single dose. Prophylaxis of postoperative changes in mood or mental state. effects of coumarin anticoagulants, bacterial superinfection. anaerobic bacterial infections Adult: 400 Numbness or tingling in the extremities, phenytoin, lithium, ciclosporin, mg by mouth 8 hrly in the 24 hr prior to epileptiform seizures (high doses or fluorouracil. Increased risk of surgery followed postoperatively by IV or prolonged treatment). Transient neurological effects with rectal admin until oral therapy is leucopenia and thrombocytopenia. cimetidine. possible. Other sources recommend that Hypersensitivity reactions. Urethral oral doses be initiated only 2 hr prior to discomfort and darkening of urine. surgery and that number of doses for all Raised liver enzyme values, cholestatic admin routes be limited to a total of 4. hepatitis, jaundice. Thrombophlebitis Elderly: Dose reduction may be (IV). Potentially Fatal: Anaphylaxis. necessary. Tab: Should be taken with food.

Midazolam 7.5 mg Tablet A/KK Pre and post-operative sedation ADULT: Usually 7.5 - 15 mg at bedtime; Muscle stiffness, induration of veins, Acute narrow angle glaucoma, Neuroleptics, tranquilizer, Elderly, COPD, congestive heart failure, or for premedication, 30 - 60 minutes pain, redness, headache, apnoea, hypersensitivity to midazolam products, antidepressant, hypnotics, respiratory failure, severe electrolyte and before the procedure. For ELDERLY, nausea, coughing, vomitting, drowsiness, acute alcohol intoxication, shock, analgesics, anaesthetics, fluid disturbances, pregnancy and debilitated or impaired liver/kidney respiratory depression, phlebitis, lactation antipsychotics, anxiolytics, lactation, hepatic and renal impairment, function: 7.5 mg gastrointestinal disturbances, increased antiepiletics, antihistamines, labor and delivery, prolonged use and appetite, jaundice, hypotension, erythromycin, clarithromycin, abrupt withdrawal, moderate lowering of bronchospasm, pain at the site of cimetidine, omeprazole, diltiazem, intraocular pressure in ophthalmic. injection efavirenz, indinavir, nelfinavir, Children under 15 kg not to exceed 1 ritonavir, saquinavir, fluvoxamine, mg/ml halothane, sevoflurane, thiopental, itraconazole, theophylline, atorvastatin

Mirtazapine 15 mg Orodispersible A* Major depression Initially 15 mg daily at bedtime increased Agranulocytopenia, neutropenia, mania, Hypersensitivity to mirtazapine or Clonidine, monoamine oxidase Heart disease, hypotension, epilepsy, Tablet according to response up to 45 mg daily dizziness, increase appetite & weight, GI component of formulation, MAOIs, inhibitors, ethanol, warfarin, diabetes, hepatic and renal impairment, as a single dose at bedtime or in 2 disturbance,hypotensiom, somnolence. procarbazine, selegiline carbamazepine, phenytoin, pregnancy, mania and hypomania, divided doses. CHILD and ADOLESCENT Patients should be advised to report any ketoconazole, cimetidine, hyponatremia, bone marrow depression under 18 years not recommended fever, sore throat, stomatitis or other methadone, rifampicin, antivirals, (granulocytopenia), jaundice, signs of infection during treatment. St. John's wort, diazepam, hypersensitivity to other anti-depressant, Blood count should be performed and fluoxetine, fluvoxamine, linezolid, suicidal ideation and behavior or the drug to be stopped immediately if olanzapine, tramadol, venlafaxine worsening depression; increased risk in blood dyscrasia suspected, raised serum children and adolescents. cholesterol and serum triglycerides, raised ALT (SGPT) level, asthenia, dizziness, dream disorder, agranulocytosis, neutropenia, seizure, worsening depression, suicidal ideation, dry mouth. Mirtazapine 30 mg Orodispersible A* Major depression Initially 15 mg daily at bedtime increased Agranulocytopenia, neutropenia, mania, Hypersensitivity to mirtazapine or Clonidine, monoamine oxidase Heart disease, hypotension, epilepsy, Tablet according to response up to 45 mg daily dizziness, increase appetite & weight, GI component of formulation, MAOIs, inhibitors, ethanol, warfarin, diabetes, hepatic and renal impairment, as a single dose at bedtime or in 2 disturbance,hypotensiom, somnolence. procarbazine, selegiline carbamazepine, phenytoin, pregnancy, mania and hypomania, divided doses. CHILD and ADOLESCENT Patients should be advised to report any ketoconazole, cimetidine, hyponatremia, bone marrow depression under 18 years not recommended fever, sore throat, stomatitis or other methadone, rifampicin, antivirals, (granulocytopenia), jaundice, signs of infection during treatment. St. John's wort, diazepam, hypersensitivity to other anti-depressant, Blood count should be performed and fluoxetine, fluvoxamine, linezolid, suicidal ideation and behavior or the drug to be stopped immediately if olanzapine, tramadol, venlafaxine worsening depression; increased risk in blood dyscrasia suspected, raised serum children and adolescents, cholesterol and serum triglycerides, raised ALT (SGPT) level, asthenia, dizziness, dream disorder, agranulocytosis, neutropenia, seizure, worsening depression, suicidal ideation, dry mouth,

Montelukast Sodium 10 mg Tablet A/KK Chronic treatment of asthma and relief of CHILD more than 15 years and ADULT: 10 Abdominal pain, headache ,thirst, Hypersensitivity to any component of Phenobarbitone Should not be used for treatment of symptoms of seasonal allergic rhinitis for mg daily at bedtime diarrhea, hyperkinesia, flu-like montelukast acute asthma attacks. Should not be children more than 15 years and adults symptoms, eczematous dermatitis and abruptly substituted for inhaled or oral rash corticosteroids. Pregnancy and lactation. Patients with known aspirin sensitivity should continue avoidance of aspirin or NSAIDs while taking montelukast. Paediatric less than 6 month

Montelukast Sodium 4 mg Oral A* Asthmatics, not controlled on high dose 12 months - 5 years: 1 packet of 4mg oral Abdominal pain, headache ,thirst, Hypersensitivity to any component of Phenobarbitone Should not be used for treatment of Granules inhaled corticosteroids more than 1600 granules daily at bedtime diarrhea, hyperkinesia, flu-like montelukast acute asthma attacks. Should not be mcg/day and with co-morbid allergic symptoms, eczematous dermatitis and abruptly substituted for inhaled or oral disorders. Chronic treatment of asthma rash corticosteroids. Pregnancy and lactation. Patients with known aspirin sensitivity should continue avoidance of aspirin or NSAIDs while taking montelukast. Paediatric less than 6 month

Montelukast Sodium 5 mg Tablet A* Asthmatics, not controlled on high dose CHILD 6 - 14 years: One 5 mg chewable Abdominal pain, headache ,thirst, Hypersensitivity to any component of Phenobarbitone Should not be used for treatment of inhaled corticosteroids more than 1600 tablet daily at bedtime diarrhea, hyperkinesia, flu-like montelukast acute asthma attacks. Should not be mcg/day and with co-morbid allergic symptoms, eczematous dermatitis and abruptly substituted for inhaled or oral disorders. Chronic treatment of asthma rash corticosteroids. Pregnancy and lactation. Patients with known aspirin sensitivity should continue avoidance of aspirin or NSAIDs while taking montelukast. Paediatric less than 6 month Mycophenolate Mofetil 500 mg A* i) Prophylaxis of acute organ rejection in i) Renal transplant rejection: ADULT: 1 g Myelosuppression, hypertension, Hypersensitivity to mycophenolate Antacids, cholestyramine, Full blood count weekly for 4 weeks, then tablet patients receiving allogenic renal, cardiac twice daily. CHILD (3 months and older): infection, diarrhoea, nausea / vomiting, mofetil and mycophenolic acid, decreased mycophenolate mofetil twice a month for 2 months, then and hepatic transplant ii) Used with 600 mg/m(2)/dose, twice daily; constipation, abdominal pain, dyspepsia, pregnancy efficacy. Iron decreased monthly in the first year. Elderly, active steroids for induction and maintenance maximum daily dose, 2 g/10 mL. Cardiac dizziness, insomnia, headache, tremor, mycophenolate mofetil efficacy. serious gastro-intestinal disease, delayed of severe lupus nephritis resistant or transplant rejection: 1.5 g twice daily. leucopenia, anaemia, thrombocytopenia, Azathioprine, drugs which interfere graft function. Avoid exposure to intolerant to cyclophosphamide therapy Hepatic transplant rejection: 1.5 g twice leucocytosis, polycythaemia, electrolyte with enterohepatic recirculation, sunlight. Bone marrow suppression. daily ii) Induction phase: 2 - 3 g/day for imbalances aciclovir, ganciclovir Monitor neutrophil count. If neutropenia up to 6 months. Maintenance phase: develops, stop treatment or reduce dose. dose gradually tapers to 1 g/day Perform relevant diagnostic tests as necessary & complete blood counts weekly. Severe active digestive diseases, severe chronic renal failure. Pregnancy & lactation. Increased risk for opportunistic infections such as activation of latent viral infections including BK virus - associated nephropathy

Naproxen Sodium 275 mg Tablet A i) Rheumatic arthritis, osteoarthritis and 550 mg- 1100 mg in two divided doses Abdominal discomfort, epigastric Hypersensitivity, active or history of Probenecid, oral anticoagulants, Active or previous history of alkylosing spondylitis ii) Acute gout iii) distress, gastrointestinal reactions, peptic ulceration. Patients whom aspirin thiazide diuretics, ACEIs, beta- gastrointestinal ulceration, bleeding or Muscular skeletal disorder and peptic ulceration, skin rash, pruritus, & other NSAIDs induced symptoms of blockers, methotrexate, lithium, perforation. History of renal or liver dysmenorrhoea insomnia, visual disturbance, headache, asthma, rhinitis, urticaria or other allergic aspirin, other NSAIDs dysfunction or coagulation defects. nausea, peripheral oedema, tinnitus, reactions Hypertension or cardiac conditions vertigo. Prolongs bleeding time aggravated by fluid retention and oedema, dehydration, diuretics, pregnancy and lactation

Nevirapine 200 mg Tablet A/KK Treatment of HIV-1 infection in Combined with other antiretrovirals: 200 Hepatitis, hepatic failure (life Hypersensitivity to nevirapine or any Methadone, rifampicin, Pregnancy. Interrupt treatment if severe combination with other antiretroviral mg once daily for the 1st 14 days; up to threatening), hepatotoxicity, severe skin component of the formulation, breast ketoconazole, other antivirals such hepatotoxicity or life-threatening skin agents 200 mg twice daily if rash does not reaction, headache, fatique, diarrhoea, feeding, severe hepatic impairment as saquinaxir, indinavir, St. John's reactions develop. Renal or hepatic develop. Re-introduce at a lower dose for nausea, rash wort, warfarin insufficiency. Monitor liver function the 1st 14 days if treatment is periodically. Avoid use in patients with interrupted for >7 days,necessitate CD4 cell counts more than 250 cells/mm3 reintroduction at a lower dose for the in adult women and 400 cells/mm3 in first 14 days. adult men.

Nifedipine 10 mg Tablet B Hypertension Initial dose of 10 mg twice daily. Usual Dizziness, flushing, headache, Cardiogenic shock, acute unstable Other antihypertensives, Patients with hypotension, poor cardiac range 10 - 30 mg 3 times daily. hypotension, peripheral oedema, angina, use wthin one month of aldesleukin, and antipsychotics, reserve, heart failure, severe aortic Maximum: 120 - 180 mg per day. Elderly: tachycardia, palpitations, nausea, myocardial infarction. Treatment of fentanyl, insulin, benazerpril, stenosis, diabetes melitus, underlying Dose reduction may be necessary. constipation, other gastrointestinal angina attack in chronic stable angina or coumarin anticoagulants, CYP3A4 severe gastrointestinal narrowing disturbances, increased micturition acute reduction of blood pressure in inhibitors . (extended-release tablet). Avoid abrupt frequency, lethargy, eye pain, visual adults. Concomitant use with strong withdrawal as it may casue rebound disturbances, syncope, vertigo, migraine, CYP3A4 inducers. angina. Hepatic impairment. Elderly. mood disturbances, rashes (including Pregnancy and lactation. erythema multiforme), liver function abnormalities (including cholestasis), pruritus, gingival hyperplasia, myalgia, gynaecomastia, tremor, impotence, fever. Paradoxical increase in ischaemic chest pain during initiation of treatment.

Ofloxacin 100 mg Tablet A i) As second-line treatment of leprosy ii) i) 400 mg/day ii) 400 mg twice daily iii) Rash, GI discomfort, insomnia, dizziness, Hypersensitivity to quinolones. Antacids, sucralfate, oral CNS disorders or other risk factors that As second-line treatment for tuberculosis 200 mg twice daily rash, pruritus, headache, Pregnancy, lactation antidiabetics, warfarin, may predispose to seizures or lower the and multidrug resistant tuberculosis photosensitivity, diarrhoea, nausea, theophylline, probenecid, seizure threshold. Renal or hepatic (MDR-TB) iii) Sequential therapy for UTI vomiting, cardiac dysrhythmia, QT aminoglycosides, beta-lactam impairment, diabetes. Avoid exposure to and pyelonephritis prolongation, immune hypersensitivity antibiotics direct sunlight. Children less than 18 reaction, traumatic or non-traumatic years rupture of tendon, peripheral neuropathy, seizure Olanzapine 10 mg Disintegrating A* i) Acute and maintenance treatment of i) 5 - 10 mg once daily, increase to 10 mg Somnolence, agitation, dizziness, Hypersensitivity to olanzapine products, Carbamazepine, ciprofloxacin, History of neuroleptic malignant Tablet schizophrenia and other psychoses once daily within 5 - 7 days, adjust by 5 - constipation, drowsiness, weight gain, narrow angle glaucoma, lactation fluvoxamine, levodopa, haloperidol, syndrome, patients with liver disease, where positive and or negative 10 mg/day at 1 week intervals, maximum peripheral oedema, dry mouth, postural activated charcoal, ethanol, central seizure disorder, pneumonia, narrow symptoms are prominent ii) Short-term 20 mg/day ii) 10 - 15 mg once daily, hypotension, elevated liver alpha-2 agonists, cimetidine, angle glaucoma, pregnancy, use for acute mania episodes associated increase by 5 mg/day at intervals of not transaminases, hyperglycaemia, diabetic epinephrine, muscle relaxants, cardiovascular disease, history of breast with Bipolar 1 disorder less than 24 hours. Maintenance 5 - 20 ketoacidosis, weight gain, dizziness, tricyclic antidepressants. May cancer, tardive dyskinesia, mg/day; maximum 20 mg/day increased appetite, orthostatic antagonise the effects of dopamine gastrointestinal obstruction, paralytic hypotension, dry mouth, constipation, agonist. Other centrally-acting ileus, cerebrovascular disease, elderly, tardive dyskinesia Very rare: Skin and drugs including alcohol. Activated hypotension, hypovolaemia, subcutaneous tissue disorders - drug charcoal dehydration, risk of aspiration reaction with eosinophilia and systemic pneumonia, hyperglycemia and diabetes symptoms (DRESS) mellitus. Elevated ALT and or AST, hepatic impairment, limited hepatic functional reserve, seizures, low leukocyte/neutrophil counts, history or existing bone marrow depression, hypereosinophilic conditions, myeloproliferative disease; prostatic hypertrophy, paralytic ileus. Pregnancy and lactation. May impair ability to drive or operate machinery

Olanzapine 10 mg Tablet A* i) Acute and maintenance treatment of i) 5 - 10 mg once daily, increase to 10 mg Somnolence, agitation, dizziness, Hypersensitivity to olanzapine products, Carbamazepine, ciprofloxacin, History of neuroleptic malignant schizophrenia and other psychoses once daily within 5 - 7 days, adjust by 5 - constipation, drowsiness, weight gain, narrow angle glaucoma, lactation fluvoxamine, levodopa, haloperidol, syndrome, patients with liver disease, where positive and or negative 10 mg/day at 1 week intervals, maximum peripheral oedema, dry mouth, postural activated charcoal, ethanol, central seizure disorder, pneumonia, narrow symptoms are prominent ii) Short-term 20 mg/day ii) 10 - 15 mg once daily, hypotension, elevated liver alpha-2 agonists, cimetidine, angle glaucoma, pregnancy, use for acute mania episodes associated increase by 5 mg/day at intervals of not transaminases, hyperglycaemia, diabetic epinephrine, muscle relaxants, cardiovascular disease, history of breast with Bipolar 1 disorder less than 24 hours. Maintenance 5 - 20 ketoacidosis, weight gain, dizziness, tricyclic antidepressants. May cancer, tardive dyskinesia, GI mg/day; maximum 20 mg/day increased appetite, orthostatic antagonise the effects of dopamine obstruction, paralytic ileus, hypotension, dry mouth, constipation, agonist. Other centrally-acting cerebrovascular disease, elderly, tardive dyskinesia Very rare: Skin and drugs including alcohol. Activated hypotension, hypovolaemia, subcutaneous tissue disorders - drug charcoal dehydration, risk of aspiration reaction with eosinophilia and systemic pneumonia,hyperglycemia and diabetes symptoms (DRESS) mellitus. Elevated ALT &/or AST, hepatic impairment; limited hepatic functional reserve; seizures; low leukocyte/neutrophil counts; history or existing bone marrow depression; hypereosinophilic conditions; myeloproliferative disease; prostatic hypertrophy, paralytic ileus. Pregnancy & lactation. May impair ability to drive or operate machinery Olanzapine 5 mg Tablet A* i) Acute and maintenance treatment of i) 5 - 10 mg once daily, increase to 10 mg Somnolence, agitation, dizziness, Hypersensitivity to olanzapine products, Carbamazepine, ciprofloxacin, History of neuroleptic malignant schizophrenia and other psychoses once daily within 5 - 7 days, adjust by 5 - constipation, drowsiness, weight gain, narrow angle glaucoma, lactation fluvoxamine, levodopa, haloperidol, syndrome, patients with liver disease, where positive and or negative 10 mg/day at 1 week intervals, maximum peripheral oedema, dry mouth, postural activated charcoal, ethanol, central seizure disorder, pneumonia, narrow symptoms are prominent ii) Short-term 20 mg/day ii) 10 - 15 mg once daily, hypotension, elevated liver alpha-2 agonists, cimetidine, angle glaucoma, pregnancy, use for acute mania episodes associated increase by 5 mg/day at intervals of not transaminases, hyperglycaemia, diabetic epinephrine, muscle relaxants, cardiovascular disease, history of breast with Bipolar 1 disorder less than 24 hours. Maintenance 5 - 20 ketoacidosis, weight gain, dizziness, tricyclic antidepressants. May cancer, tardive dyskinesia, GI mg/day; maximum 20 mg/day increased appetite, orthostatic antagonise the effects of dopamine obstruction, paralytic ileus, hypotension, dry mouth, constipation, agonist. Other centrally-acting cerebrovascular disease, elderly, tardive dyskinesia Very rare: Skin and drugs including alcohol. Activated hypotension, hypovolaemia, subcutaneous tissue disorders - drug charcoal dehydration, risk of aspiration reaction with eosinophilia and systemic pneumonia,hyperglycemia and diabetes symptoms (DRESS) mellitus. Elevated ALT &/or AST, hepatic impairment; limited hepatic functional reserve; seizures; low leukocyte/neutrophil counts; history or existing bone marrow depression; hypereosinophilic conditions; myeloproliferative disease; prostatic hypertrophy, paralytic ileus. Pregnancy & lactation. May impair ability to drive or operate machinery

Olanzapine 5mg Disintegrating A* i) Acute and maintenance treatment of i) 5 - 10 mg once daily, increase to 10 mg Somnolence, agitation, dizziness, Hypersensitivity to olanzapine products, Carbamazepine, ciprofloxacin, History of neuroleptic malignant Tablet schizophrenia and other psychoses once daily within 5 - 7 days, adjust by 5 - constipation, drowsiness, weight gain, narrow angle glaucoma, lactation fluvoxamine, levodopa, haloperidol, syndrome, patients with liver disease, where positive and or negative 10 mg/day at 1 week intervals, maximum peripheral oedema, dry mouth, postural activated charcoal, ethanol, central seizure disorder, pneumonia, narrow symptoms are prominent ii) Short-term 20 mg/day ii) 10 - 15 mg once daily, hypotension, elevated liver alpha-2 agonists, cimetidine, angle glaucoma, pregnancy, use for acute mania episodes associated increase by 5 mg/day at intervals of not transaminases, hyperglycaemia, diabetic epinephrine, muscle relaxants, cardiovascular disease, history of breast with Bipolar 1 disorder less than 24 hours. Maintenance 5 - 20 ketoacidosis, weight gain, dizziness, tricyclic antidepressants. May cancer, tardive dyskinesia, mg/day; maximum 20 mg/day increased appetite, orthostatic antagonise the effects of dopamine gastrointestinal obstruction, paralytic hypotension, dry mouth, constipation, agonist. Other centrally-acting ileus, cerebrovascular disease, elderly, tardive dyskinesia Very rare: Skin and drugs including alcohol. Activated hypotension, hypovolaemia, subcutaneous tissue disorders - drug charcoal dehydration, risk of aspiration reaction with eosinophilia and systemic pneumonia, hyperglycemia and diabetes symptoms (DRESS) mellitus. Elevated ALT and or AST, hepatic impairment, limited hepatic functional reserve, seizures, low leukocyte/neutrophil counts, history or existing bone marrow depression, hypereosinophilic conditions, myeloproliferative disease, prostatic hypertrophy, paralytic ileus. Pregnancy and lactation. May impair ability to drive or operate machinery

Omeprazole 20 mg Capsule A/KK Only for : i)Reflux oesophagitis ii)For i)20 - 80 mg 1 - 2 times daily up to 8 - 12 Gastrointestinal effects such as Hypersensitivity to omeprazole or to any May prolong elimination of Proton pump inhibitors reduce gastric eradication of Helicobacter pylori weeks ii)20 mg twice daily in diarrhoea, nausea and constipation, of its components diazepam, warfarin and phenytoin. acidity and increase the risk of infection iii)Benign peptic ulcer not combination with any of the 2 antibiotics headache, cough, upper respiratory tract Increases plasma concentration of gastrointestinal infections. It may mask responding to conventional therapy (clarithromycin 500 mg twice daily, infection, rash clarithromycin, ketoconazole symptoms of gastric cancer (exclude iv)Zollinger-Ellison Syndrome amoxicillin 1 g twice daily or malignancy in suspected gastric ulcers) metronidazole 400 mg twice daily)for 1 - 2 weeks iii) 20 mg once daily for 4 - 6 weeks iv) ADULT: 20 - 120 mg once daily adjusted according to the patient's response. CHILD 0.4 - 0.8 mg/kg/day Oxycodone HCl 10 mg Prolonged A* Management of moderate to severe ADULT, ELDERLY and CHILDREN more GI and CNS disturbances, bronchospasm, Hypersensitivity to opioids, acute Anticholinergics, antihypertensives, History or tendency for drug abuse. Risk Release Tablet chronic cancer pain non-responsive to than 18 years, opioid-naive patients: 10 dyspnoea, pharyngitis, voice alteration, respiratory depression, cor pulmonale, CNS depressants including of criminal diversion similar to morphine; morphine (in accordance with WHO step- mg 12 hourly. Renal or hepatic orthostatic hypotension, rash, sweating, cardiac arrhythmias, acute asthma or sedatives or hypnotics, general obstructive pulmonary disease or cor wise ladder of chronic pain management) impairment: 5 mg 12 hourly. Titrate dose pruritus, fever and chills, constipation, other obstructive airways disease, anaesthetics, phenothiazines, other pulmonale, substantial decrease in [Initiated by Chronic Pain Specialist only] carefully, as frequently as once a day if xerostomia, asthenia, dizziness, sedated, paralytic ileus, suspected surgical tranquillizers, alcohol, other opioids respiratory reserve, hypoxia, necessary, to achieve pain relief apnoea, respiratory arrest, respiratory abdomen, severe renal impairment, & neuroleptics; muscle relaxants, hypercapnia, pre-existing respiratory depression delayed gastric emptying, acute coumarin derivatives, depression or kyphoscoliosis associated alcoholism, brain tumour, increased metoclopramide, MAOIs, with respiratory depression (increased cerebrospinal or intracranial pressure, neuromuscular blockers, opioid risk for respiratory depression); head injury, severe CNS depression, analgesics, drugs that involve circulatory shock, hypovolemia, convulsive disorders, delirium tremens, cytochrome P450 enzyme system concurrent use with other drugs which hypercarbia. Concurrent MAOIs (or eg CYP3A4, CYP2D6 may decrease blood pressure; within 2 weeks of discontinuation). Pre- concomitant administration with central operative or within 24 hours post- nervous system depressants; elderly or operative. Lactation debilitated patients (greater risk of respiratory depression); head injury, increased intracranial pressure, central nervous system depression or coma; acute abdominal conditions; acute alcoholism, delirium tremens; Addison?s disease; iliary tract disease, including acute pancreatitis. Hypothyroidism, biliary tract disease, pancreatitis, inflammatory bowel disorders, prostatic hypertrophy, adrenocortical insufficiency; renal/hepatic disease; 24 hours prior to cordotomy or other pain relieving surgery; abdominal surgery, chronic non-malignant pain. Avoid abrupt cessation of prolonged use & therapy. May impair ability to drive or operate machinery. Pregnancy Oxycodone HCl 5 mg Immediate A* i)As a second line drug in the Initially 5 mg every 4 to 6 hours, GI and CNS disturbances, bronchospasm, Hypersensitivity to opioids, acute Anticholinergics, antihypertensives, History or tendency for drug abuse. Risk Release Capsules management of opioid responsive, increased if necessary according to dyspnoea, pharyngitis, voice alteration, respiratory depression, cor pulmonale, CNS depressants including of criminal diversion similar to morphine; moderate to severe chronic cancer pain severity of pain, usual max. 400 mg daily, orthostatic hypotension, rash, sweating, cardiac arrhythmias, acute asthma or sedatives or hypnotics, general obstructive pulmonary disease or cor ii)As a step-down analgesic drug in post- but some patients may require higher pruritus, fever and chills, constipation, other obstructive airways disease, anaesthetics, phenothiazines, other pulmonale, substantial decrease in operative procedures (Initiated by doses xerostomia, asthenia, dizziness, sedated, paralytic ileus, suspected surgical tranquillizers, alcohol, other opioids respiratory reserve, hypoxia, palliative medicine physicians, apnoea, respiratory arrest, respiratory abdomen, severe renal impairment, & neuroleptics; muscle relaxants, hypercapnia, pre-existing respiratory oncologists, anaesthesiologists, depression delayed gastric emptying, acute coumarin derivatives, depression or kyphoscoliosis associated haematologists and pain specialists only) alcoholism, brain tumour, increased metoclopramide, MAOIs, with respiratory depression (increased cerebrospinal or intracranial pressure, neuromuscular blockers, opioid risk for respiratory depression); head injury, severe CNS depression, analgesics, drugs that involve circulatory shock, hypovolemia, convulsive disorders, delirium tremens, cytochrome P450 enzyme system concurrent use with other drugs which hypercarbia. Concurrent MAOIs (or eg CYP3A4, CYP2D6 may decrease blood pressure; within 2 weeks of discontinuation). Not concomitant administration with central recommended for pre-operative use. nervous system depressants; elderly or Pregnancy and Lactation. Children less debilitated patients (greater risk of than 18 years old. respiratory depression); head injury, increased intracranial pressure, central nervous system depression or coma; acute abdominal conditions; acute alcoholism, delirium tremens; Addison?s disease; iliary tract disease, including acute pancreatitis. Hypothyroidism, biliary tract disease, pancreatitis, inflammatory bowel disorders, prostatic hypertrophy, adrenocortical insufficiency; renal/hepatic disease; 24 hours prior to cordotomy or other pain relieving surgery; abdominal surgery, chronic non-malignant pain. Avoid abrupt cessation of prolonged use & therapy. May impair ability to drive or operate machinery. Pregnancy Oxycodone Hydrochloride 10mg A* Management of moderate to severe Adults, elderly and children over 12 Bradycardia, chest pain, palpitations, ST Hypersensitivity to opioids, acute Anticholinergics, antihypertensives, Use with caution in opioid-dependent Prolonged Release chronic cancer pain non-responsive to years: Usual starting dose for opioid- depression, supraventricular tachycardia, respiratory depression, cor pulmonale, CNS depressants including patients and in patients with morphine in accordance with WHO step- naive patients or patients presenting tinnitus, vertigo, miosis, visual cardiac arrhythmias, acute asthma or sedatives or hypnotics, general hypotension, hypovolaemia, diseases of wise ladder of chronic pain management. with moderate to severe pain impairment, nausea, vomiting, other obstructive airways disease, anaesthetics, phenothiazines, other the biliary tract, pancreatic, inflammatory (Initiated by palliative medicine uncontrolled by weaker opioids constipation, asthenia, fatigue, chills, paralytic ileus, suspected surgical tranquillizers, alcohol, other opioids bowel disorders, prostatic hypertrophy, physicians, oncologists, (especially if they are receiving fever, hepatobiliary disorders, immune abdomen, severe renal impairment, & neuroleptics; muscle relaxants, adrenocortical insufficiency, toxic anaesthesiologists, haematologists and concurrent sedatives, muscle relaxants or system disorders, decreased appetite, delayed gastric emptying, acute coumarin derivatives, psychosis, chronic pulmonary, renal or pain specialists only) other CNS medicines) is 10mg 12 hourly. dizziness, headache and somnolence, alcoholism, brain tumour, increased metoclopramide, MAOIs, hepatic disease, myxedema and The dose should then be carefully broncospasm, dyspnea, pharyngitis, cerebrospinal or intracranial pressure, neuromuscular blockers, opioid debilitated elderly of infirm patients. titrated with longitudinal patient voice alteration, pruritus head injury, severe CNS depression, analgesics, drugs that involve Patients who undergo cordotomy or monitoring, assessing whether the pain is convulsive disorders, delirium tremens, cytochrome P450 enzyme system other pain-relieving surgical procedures opioid responsive and providing the hypercarbia. Concurrent MAOIs (or eg CYP3A4, CYP2D6 should not receive Oxycontin tablets for patient significant pain relief. Patients within 2 weeks of discontinuation). Pre- 24 hours before surgery. with renal or hepatic impairment: The operative or within 24 hours post- recommended adult starting dose should operative. Lactation be reduced by 1/3 to 1/2, and each patient should be titrated to adequate pain control according to their clinical situation.

Paliperidone 100 mg Prolonged A* Second or third line treatment of acute Initiation: Deltoid IM 150 mg eq on Day1, Insomnia, headache, agitation, Moderate to severe renal impairment, Centrally acting drugs, alcohol, Neuroleptic malignant syndrome, Release Injection and maintenance treatment of followed by deltoid IM 100 mg eq on one somnolence, sedation, dizziness, dementia-related psychosis, lactation levodopa & other dopamine congenital long QT syndrome, tardive schizophrenia in adults week later. Maintenance: Monthly dose injection site pain, akathisia, agonists, carbamazepine. Drugs dyskinesia, hyperglycemia & diabetes of 75 mg eq ( this can be increased or extrapyrimidal disorder, constipation, known to prolong QT interval mellitus, hyperprolactinemia, decreased based on individual patient?s nausea, vomiting, nasopharyngitis, cardiovascular or cerebrovascular disease tolerability and/or efficacy). These bradycardia, bundle branch block, or conditions predisposing to monthly maintenace dose can be postural orthostatic tachycardia hypotension. Monitor complete blood administered in either the deltoid or syndrome, tachycardia, blood cholesterol count regularly. History of seizures & gluteal muscle increased, blood glucose increased, cardiac arrhythmias, risk for aspiration convulsion, dizziness postural, drooling, pneumonia. Conditions that contribute dysarthria, dyskinesia, dystonia, to core body temperature elevation or hypertonia, lethargy, neuroleptic dehydration. Parkinson's disease, malignant syndrome, oromandibular dementia with Lewy bodies. Pregnancy. dystonia, parkinsonism, psychomotor Elderly. Adolescents & children. May hyperactivity, syncope, oculogyric crisis, impair ability to drive or operate eye rolling, vision blurred, amenorrhea, machinery erectile dysfunction, galactorrhea, gynecomastia, menstruation irregular, sexual dysfunction

Paliperidone 150 mg Prolonged A* Second or third line treatment of acute Initiation: Deltoid IM 150 mg eq on Day1, Insomnia, headache, agitation, Moderate to severe renal impairment, Centrally acting drugs, alcohol, Neuroleptic malignant syndrome, Release Injection and maintenance treatment of followed by deltoid IM 100 mg eq on one somnolence, sedation, dizziness, dementia-related psychosis, lactation levodopa & other dopamine congenital long QT syndrome, tardive schizophrenia in adults week later. Maintenance: Monthly dose injection site pain, akathisia, agonists, carbamazepine. Drugs dyskinesia, hyperglycemia & diabetes of 75 mg eq ( this can be increased or extrapyrimidal disorder, constipation, known to prolong QT interval mellitus, hyperprolactinemia, decreased based on individual patient?s nausea, vomiting, nasopharyngitis, cardiovascular or cerebrovascular disease tolerability and/or efficacy). These bradycardia, bundle branch block, or conditions predisposing to monthly maintenace dose can be postural orthostatic tachycardia hypotension. Monitor complete blood administered in either the deltoid or syndrome, tachycardia, blood cholesterol count regularly. History of seizures & gluteal muscle increased, blood glucose increased, cardiac arrhythmias, risk for aspiration convulsion, dizziness postural, drooling, pneumonia. Conditions that contribute dysarthria, dyskinesia, dystonia, to core body temperature elevation or hypertonia, lethargy, neuroleptic dehydration. Parkinson's disease, malignant syndrome, oromandibular dementia with Lewy bodies. Pregnancy. dystonia, parkinsonism, psychomotor Elderly. Adolescents & children. May hyperactivity, syncope, oculogyric crisis, impair ability to drive or operate eye rolling, vision blurred, amenorrhea, machinery erectile dysfunction, galactorrhea, gynecomastia, menstruation irregular, sexual dysfunction Paliperidone 3 mg Extended A* Second or third line treatment of ADULT 6 mg once daily in the morning, Headache, tachycardia, akathisia, sinus Lactation, hypersensitivity to Centrally acting drugs, alcohol, Neuroleptic malignant syndrome, tardive Released Tablet schizophrenia adjusted if necessary; usual range 3 -12 tachycardia, extrapyramidal disorder, Paliperidone, Risperidone or to any levodopa, dopamine agonists, dyskinesia (discontinue use), diabetes mg daily. Renal impairment (creatinine somnolence, dizziness, sedation, tremor, product component itraconazole mellitus, cerebrovascular disease or clearance between 10-50 mL/min) 3 mg hypertonia, dystonia, orthostatic conditions predisposing to hypotension, once daily. Avoid if creatinine clearance hypotension & dry mouth. Menstrual seizure, Parkinson's disease, conditions less than 10mL/min disturbances, erectile dysfunction, that contribute to core body galactorrhoea and gynaecomastia temperature elevation or dehydration, pregnancy, adolescent and children. May impair ability to drive or operate machinery

Paliperidone 6 mg Extended A* Second or third line treatment of ADULT 6 mg once daily in the morning, Headache, tachycardia, akathisia, sinus Lactation, hypersensitivity to Centrally acting drugs, alcohol, Neuroleptic malignant syndrome, tardive Released Tablet schizophrenia adjusted if necessary; usual range 3 -12 tachycardia, extrapyramidal disorder, Paliperidone, Risperidone or to any levodopa, dopamine agonists, dyskinesia (discontinue use), diabetes mg daily. Renal impairment (creatinine somnolence, dizziness, sedation, tremor, product component itraconazole mellitus, cerebrovascular disease or clearance between 10-50 mL/min) 3 mg hypertonia, dystonia, orthostatic conditions predisposing to hypotension, once daily. Avoid if creatinine clearance hypotension & dry mouth. Menstrual seizure, Parkinson's disease, conditions less than 10mL/min disturbances, erectile dysfunction, that contribute to core body galactorrhoea and gynaecomastia temperature elevation or dehydration, pregnancy, adolescent and children. May impair ability to drive or operate machinery

Paliperidone 75 mg Prolonged A* Second or third line treatment of acute Initiation: Deltoid IM 150 mg eq on Day1, Insomnia, headache, agitation, Moderate to severe renal impairment, Centrally acting drugs, alcohol, Neuroleptic malignant syndrome, Release Injection and maintenance treatment of followed by deltoid IM 100 mg eq on one somnolence, sedation, dizziness, dementia-related psychosis, lactation levodopa & other dopamine congenital long QT syndrome, tardive schizophrenia in adults week later. Maintenance: Monthly dose injection site pain, akathisia, agonists, carbamazepine. Drugs dyskinesia, hyperglycemia & diabetes of 75 mg eq ( this can be increased or extrapyrimidal disorder, constipation, known to prolong QT interval mellitus, hyperprolactinemia, decreased based on individual patient?s nausea, vomiting, nasopharyngitis, cardiovascular or cerebrovascular disease tolerability and/or efficacy). These bradycardia, bundle branch block, or conditions predisposing to monthly maintenace dose can be postural orthostatic tachycardia hypotension. Monitor complete blood administered in either the deltoid or syndrome, tachycardia, blood cholesterol count regularly. History of seizures & gluteal muscle increased, blood glucose increased, cardiac arrhythmias, risk for aspiration convulsion, dizziness postural, drooling, pneumonia. Conditions that contribute dysarthria, dyskinesia, dystonia, to core body temperature elevation or hypertonia, lethargy, neuroleptic dehydration. Parkinson's disease, malignant syndrome, oromandibular dementia with Lewy bodies. Pregnancy. dystonia, parkinsonism, psychomotor Elderly. Adolescents & children. May hyperactivity, syncope, oculogyric crisis, impair ability to drive or operate eye rolling, vision blurred, amenorrhea, machinery erectile dysfunction, galactorrhea, gynecomastia, menstruation irregular, sexual dysfunction Paliperidone 9 mg Extended A* Second or third line treatment of ADULT 6 mg once daily in the morning, Headache, tachycardia, akathisia, sinus Lactation, hypersensitivity to Centrally acting drugs, alcohol, Neuroleptic malignant syndrome, tardive Released Tablet schizophrenia adjusted if necessary; usual range 3 -12 tachycardia, extrapyramidal disorder, Paliperidone, Risperidone or to any levodopa, dopamine agonists, dyskinesia (discontinue use), diabetes mg daily. Renal impairment (creatinine somnolence, dizziness, sedation, tremor, product component itraconazole mellitus, cerebrovascular disease or clearance between 10-50 mL/min) 3 mg hypertonia, dystonia, orthostatic conditions predisposing to hypotension, once daily. Avoid if creatinine clearance hypotension & dry mouth. Menstrual seizure, Parkinson's disease, conditions less than 10mL/min disturbances, erectile dysfunction, that contribute to core body galactorrhoea and gynaecomastia temperature elevation or dehydration, pregnancy, adolescent and children. May impair ability to drive or operate machinery

Pantoprazole 40 mg Tablet A/KK i) Helicobacter pylori eradication ii) Peptic i) 40 mg twice daily in combination with Gastrointestinal disturbances (nausea Pregnancy, lactation, moderate to severe May affect absorption of drugs Not for mild GI complaint eg nervous ulcer disease iii) Erosive and non-erosive any of the 2 antibiotics (Clarithromycin and vomitting, diarrhoea, constipation, hepatic or renal impairment. Patients which are pH-dependent eg dyspepsia; renal impairment & elderly reflux oesophagitis (GERD and NERD) iv) 500 mg twice daily, Amoxicillin 1 g twice upper abdominal pain, flatulence) skin with known hypersensitivity to any ketoconazole. Reduced (granules). Exclude gastric & oesophageal Zollinger-Ellison Syndrome v) Prevention daily or Metronidazole 400 mg twice rash, pruritus, dizziness, oedema, fever, component of the formulation. bioavailability of atazanavir. malignancy. Reduced absorption of vit of NSAID induced gastropathy daily) for 1-2 weeks ii) 40 mg daily for 2 - depression, vision disturbances, Hypersensitivity. Combination therapy Coumarin anticoagulants eg B12. Hepatic impairment. Pregnancy & 4 weeks iii) 20 - 40 mg daily on morning headache, liver enzyme changes, raised for eradication of H pylori in patients w/ phenprocoumon or warfarin lactation. Childn <12 yr. for 4 weeks iv) Initially 80 mg daily, dose triglycerides moderate to severe hepatic or renal (monitor prothrombin time/INR) can be titrated up or down as needed. v) impairment 20 mg daily. CHILD not recommended

Paracetamol 500 mg Tablet C+ Mild to moderate pain and pyrexia ADULT: 500 - 1000 mg every 4 - 6 hours, Allergic reactions, skin rash Nephropathy Anticoagulants, alcohol, liver Renal and hepatic failure. Avoid chronic maximum of 4 g daily enzyme inducers, aspirin, use chloramphenicol and phenobarbitone

Pentoxifylline 400 mg Tablet A/KK Peripheral vascular disease 400 mg 2 - 3 times daily Gastrointestinal effects, hypersensitivity Cerebral haemorrhage, extensive retinal Increased risk of bleeding with Hypotension, coronary artery disease, reactions, dizziness, agitation, sleep haemorrhage, acute myocardial ketorolac, possibly increased risk of renal impairment, severe hepatic disturbances, headache infarction, pregnancy and lactation bleeding with other NSAIDs impairment

Perindopril 4 mg and Indapamide A/KK Essential hypertension, for patients One tablet daily, preferably taken in the Headache, asthenia, dizziness, sleep Hypersensitivity to other ACE inhibitors Lithium, insulin, sulfonylureas, Renal insufficiency especially when 1.25 mg Tablet whose blood pressure is insufficiently morning and before a meal. disturbances, cramps, hypotension, rash, or sulphonamides. Bilateral renal artery baclofen, NSAIDs, high dose associated with systemic autoimmune controlled by perindopril alone. gastrointestinal disturbances, slight stenosis or single functioning kidney, salicylates, tricyclic collagen vascular diseases. Concomitant reversible increase in urea and plasma severe renal failure (creatinine clearance antidepressants, neuroleptics, treatment with immunosuppressant or creatinine, hypokalaemia, hyponatraemia less than 30 mL/min), dialysis patients, corticosteroids, tetracosactide, treatment causing leucopoenia. Marked with hypovolaemia, raised uric acid and hepatic encephalopathy, severe hepatic potassium-sparing diuretics, sodium and water depletion, blood glucose levels impairment, hyperkalaemia or potassium salts, potassium- hypotension, chronic heart failure, hypokalaemia, untreated lowering drugs, anaesthesia, cirrhosis with oedema and ascites, decompensated cardiac insufficiency. allopurinol, immunosuppressant, ischemic heart disease, cerebral Previous history of angioneurotic cardiac glycosides, procainamide circulatory insufficiency, severe cardiac oedema linked to treatment with ACE and other drugs which cause insufficiency (grade IV) or IDDM patients. inhibitor, hereditary or idiopathic torsades de pointes, Monitor serum potassium regularly. angioneurotic oedema. Pregnancy and antihypertensive drugs, metformin, Surgery, elderly, hyperaldosteronism, lactation calcium salts, ciclosporin, iodinated malnourishment, acute porphyria contrast media Perindopril 4 mg Tablet B i) Hypertension ii) Congestive heart i) 4 mg as single dose, may be increased Gastrointestinal disorders, dizziness, Angioedema induced by other Potassium supplements or Arterial hypotension, renal failure, water failure iii) Stable coronary artery disease to a single 8 mg dose. ELDERLY: Start headaches, mood and or sleep disorders, angiotensin converting enzyme (ACE) potassium-sparing diuretics may and sodium depletion, renovascular treatment with 2 mg dose. In renal asthenia, taste disorder, cramps, inhibitors. Hypersensitivity to this or any induce hyperkalaemia especially in hypertension, surgery or anaesthesia, insufficiency, dose should be adapted localized skin rashes, dry cough, other angiotensin converting enzyme renal failure. Neuroleptics or elderly. Haemodialysis, avoid according to creatinine clearance ii) angioneurotic oedema inhibitor. Pregnancy (second and third imipramine-like antidepressants combination with highly permeable Single starting oral dose of 2 mg should trimesters particularly), lactation. increase risk of postural membranes (polyacrylonitrile). Measure be increased to a single 4 mg once BP hypotension. Serum lithium plasma creatinine at baseline and during acceptability has been demonstrated iii) concentrations may rise during the month following institution of 4 mg once daily for 2 weeks, may be lithium therapy treatment. May precipitate excessive increased to 8 mg once daily. ELDERLY: 2 hypotension in severe chronic heart mg once daily for 1 week, then 4 mg once failure with or without associated renal daily for the following week, may be insufficiency. Patients with ischaemic increased up to 8 mg once daily heart disease or cerebrovascular disease in whom excessive fall in blood pressure may result in myocardial infarction or cerebrovascular accident, hepatic impairment

Perindopril 8 mg Tablet B i) Hypertension ii) Congestive heart i) 4 mg as single dose, may be increased Gastrointestinal disorders, dizziness, Angioedema induced by other Potassium supplements or Arterial hypotension, renal failure, water failure iii) Stable coronary artery disease to a single 8 mg dose. ELDERLY: Start headaches, mood and or sleep disorders, angiotensin converting enzyme (ACE) potassium-sparing diuretics may and sodium depletion, renovascular treatment with 2 mg dose. In renal asthenia, taste disorder, cramps, inhibitors. Hypersensitivity to this or any induce hyperkalaemia especially in hypertension, surgery or anaesthesia, insufficiency, dose should be adapted localized skin rashes, dry cough, other angiotensin converting enzyme renal failure. Neuroleptics or elderly. Haemodialysis, avoid according to creatinine clearance ii) angioneurotic oedema inhibitor. Pregnancy (second and third imipramine-like antidepressants combination with highly permeable Single starting oral dose of 2 mg should trimesters particularly), lactation increase risk of postural membranes (polyacrylonitrile). Measure be increased to a single 4 mg once BP hypotension. Serum lithium plasma creatinine at baseline and during acceptability has been demonstrated iii) concentrations may rise during the month following institution of 4 mg once daily for 2 weeks, may be lithium therapy treatment. May precipitate excessive increased to 8 mg once daily. ELDERLY: 2 hypotension in severe chronic heart mg once daily for 1 week, then 4 mg once failure with or without associated renal daily for the following week, may be insufficiency. Patients with ischaemic increased up to 8 mg once daily heart disease or cerebrovascular disease in whom excessive fall in blood pressure may result in myocardial infarction or cerebrovascular accident, hepatic impairment

Phenobarbitone 30 mg Tablet B Epilepsy ADULT: 60 - 180 mg daily on. CHILD: Up Hypersensitivity, rash, hypotension, Hypersensitivity to phenobarbital Alcohol, antibacterial, warfarin, Depression, renal impairment, to 8 mg/kg daily drowsiness, ataxia, respiratory products, porphyria antidepressants, other pulmonary insufficiency, elderly, avoid depression, dyskinesias antiepileptics, antipsychotics, abrupt discontinuation, pregnancy, antiviral, cyclosporin breast feeding, porphyria, hyperactivity in children

Phenoxymethyl Penicillin 125 mg C i) Treatment or prophylaxis of infections i) ADULT: 500 - 750 mg 6 hourly.CHILD; Skin rashes, anaphylaxis, urticaria, fever, Hypersensitivity to penicillin Antirheumatics& antipyretics Use cautiously in patients with penicillin Tablet caused by susceptible organisms ii) up to 1 year: 62.5 mg, 1 - 5 years: 125 joint pain. Haemolytic anaemia, blood inhibit excretion. Neomycin may or cephalosporin. Hypersensitivity Prophylactic, rheumatic fever mg, 6 - 12 years: 250 mg 6 hourly ii) disorders, gastrointestinal distress& cause malabsorption reactions or asthma. Haematological& ADULT: 125 - 250 mg twice daily. CHILD: superinfection renal function test required on long-term 25 - 50 mg/kg in divided doses every 6 - 8 treatment. Not for trivial infection. Renal hours. Maximum: 3 g/day or hepatic impairment Phenytoin Sodium 100 mg Capsule B Epilepsy ADULT and CHILD more than 6 years: 300- Nystagmus, ataxia, lethargy, blood Hypersensitivity to phenytoin or Various drugs may increase Avoid abrupt withdrawal, liver 400 mg/day in 3 - 4 divided doses before dyscrasias, cardiovascular toxicity, hydantoin products, sinus bradycardia, phenytoin serum levels either by insufficiency, porphyria, discontinue if meals. Maximum: 600 mg/day. CHILD: nausea, vomiting, headache, tremor, SA block, second and third degree AV decreasing its rate of metabolism skin rash occurs, diabetes, elderly, Initially 5 mg/kg/day in 2 - 3 divided insomnia, gingival hypertrophy, acne, block and Adams-Stokes syndrome by the hepatic CYP450 2C9 and pregnancy, breast feeding. Severe doses. Maintenance: 4 - 8 mg/kg/day. lupus erythematosus, Stevens-Johnson (intravenous phenytoin only) 2C19 enzymatic system myocardial insufficiency. Potential for an Maximum: 300 mg/day syndrome, leukopenia, megaloblastic (eg.disulfiram, omeprazole, increase in risk of suicidal thoughts or anaemia, hirsutism, hepatitis. Slurred ticlopidine), by competing for the behaviours. speech, decreased coordination, mental protein binding sites (eg. confusion, constipation, toxic hepatitis, salicylates, sulfisoxazole, liver damage, hematopoietic tolbutamine), or by a combination complications, dermatological of both processes (eg. manifestations, agranulocytosis, bullous phenylbutazone, valproate dermatosis, granulocytopenic disorder, sodium). Some drugs may decrease liver damage, nephrotoxicity, phenytoin serum levels (eg. pancytopenia, purpuric rash, scaling ciprofloxacin, theophylline, eczema, thrombocytopenia, toxic sucralfate). epidermal necrolysis

Piracetam 1.2 g Tablet A* Mild cognitive impairment, post Initially 7.2 g daily in 2 - 3 divided doses, Nervousness, agitation, irritability, Previous hypersensitivity to piracetam. Warfarin: an increased risk of Renal insufficiency (possible need for concussional head syndrome, head injury increased according to response by 4.8 g anxiety and sleep disturbances, fatigue Huntington's chorea bleeding dose adjustments), elderly patients with disorder, chronic vertigo and myoclonus daily every 3 - 4 days to maximum of 20 g or drowsiness, gastrointestinal multiple diseases daily. CHILD under 16 years not disturbances recommended

Pizotifen 0.5 mg Tablet B Prophylactic treatment of vascular Starting with 0.5mg daily, the dosage Sedation, dizziness, dry mouth and Hypersensitivity to the drug. Children Central effects of sedatives, Narrow-angle glaucoma, obesity, urinary headache should be progressively increased. The constipation. Increased appetite, less than 2 years. Postural giddiness hypnotics, antihistamines, including retention. May affect ability to drive and average maintenance dosage is 1.5mg sedation, nausea, fatigue. Rarely, certain common cold preparations operate machinery. Pregnancy, breast daily in divided doses or as a single dose hypersensitivity reactions, face oedema, and alcohol may be enhanced. feeding. Dosage reduction may be at night. Max dose: 4.5 mg/day and 3 rash, central nervous system stimulation, Antagonised hypotensive effect of necessary in renal impairment, prostatic mg/dose. Child: >2 yr: Up to 1.5 mg daily hallucinations, seizures, depression, adrenergic neuron blockers. May hyperplasia, pyloroduodenal obstruction, in divided doses. Max dose: 1 mg/dose. drowsiness, headache, palpitation, mask warning signs of damage epilepsy, hepatic impairment, elderly, arrhythmias, gastrointestinal caused by ototoxic drugs eg. young children. Pregnancy, lactation disturbance, palpitations, blood aminoglycosides disorders, convulsions, sweating, myalgia, paraesthesias, extrapyramidal effects, sleep disturbances, confusion, tinnitus, tremor, hypotension, hair loss

Potassium Chloride 600 mg SR Tablet B For the treatment and specific ADULT: 2 - 3 tablets daily. Severe Nausea, vomiting, gastrointestinal Acute dehydration, heat cramps, Potassium sparing diuretics, salt Severe renal impairment, cardiac disease, prevention of hypokalaemia deficiency: 9 - 12 tablets daily or ulceration, ECG changes hyperkalaemia, renal failure and in substitutes, ACE inhibitors, hyperkalaemia. Initial potassium according to the needs of the patient conditions in which potassium retention angiotensin-II receptor antagonists, replacement therapy, should not involve is present or where additives of methenamine, ciclosporin, glucose infusions, because glucose may potassium and chloride could be clinically tacrolimus cause a further decrease in the plasma detrimental potassium concentration Pramipexole Dihydrochloride 0.125 A* Treatment for signs and symptoms of Dose escalation: 0.125 mg 3 times daily Nausea, constipation, somnolence, Hypersensitivity to pramipexole or to any Cimetidine, amantadine, Renal impairment, severe cardiovascular mg Tablet advanced idiopathic Parkinson's disease. on week 1 then 0.25 mg 3 times daily hallucination, confusion, dizziness, of the excipients antipsychotics (typical), central disease. Avoid abrupt withdrawal. It may be used as monotherapy or in week 2 then 0.5 mg 3 times daily on dyskinesia, amnesia, asthenia, dream nervous system depressants. Avoid Pregnancy and lactation. May impair combination with levodopa week 3. Increase by 0.75 mg at weekly disorder, extrapyramidal movements, alcohol ability to drive or operate machinery intervals if needed up to maximum of 4.5 insomnia, orthostatic hypotension mg/day. Patient on levodopa: Reduce dose. Renal impairment: In patient with creatinine clearance < 20ml/min, the daily dose of pramipexole should be started at 0.125 mg daily instead of 0.25mg and the maximum dose should not > 1.5 mg daily

Pramipexole Dihydrochloride A Treatment for signs and symptoms of Dose escalation: 0.375 mg/day on week Common - Cardiovascular: orthostatic Hypersensitivity to pramipexole or any Cimetidine, amantadine, Renal impairment, severe CV disease. Extended Release 0.375mg Tablet advanced idiopathic Parkinson's disease. 1, 0.75 mg/day on week 2, 1.5 mg/day on hypotension Gastrointestinal: other component of Sifrol ER. antipsychotics (typical), central Behavioural changes may occur It may be used as monotherapy or in week 3. Increase by 0.75 mg at weekly constipation, nausea Neurologic: nervous system depressants. Avoid (reflecting symptoms of impulse control combination with levodopa intervals if needed up to a max of 4.5 amnesia, asthenia, confusion, dizziness, alcohol disorders & compulsive behaviours eg mg/day. Patient on l-dopa: reduce dose. dream disorder, dyskinesia, binge eating, compulsive shopping, Renal Impairment: CrCl 30-50 mL/min extrapyramidal movements, headache, hypersexuality & pathological gambling). Initially 0.375 mg every other day. May insomnia, somnolence Psychiatric: Dose reduction/taper discontinuation be increased by 0.375 mg at weekly hallucinations Serious - Cardiovascular: should be considered. Pathologic intervals to max 2.25 mg/day heart failure Dermatologic: malignant changes. Avoid abrupt withdrawal. melanoma Neurologic: sleep attack Pregnancy & lactation. May affect ability to drive or operate machinery

Pravastatin Sodium 20 mg Tablet A/KK Hypercholesterolaemia and coronary 10 - 20 mg once daily. Maximum: 40 mg Rash, myalgia, headache, non-cardiac Hypersensitivity to pravastatin, liver Increased risk of myopathy and/or Heavy alcohol use, history of liver heart disease intolerant or not daily. In patients concomitantly taking chest pain, nausea, vomiting, diarrhoea, disease, pregnancy or lactation rhabdomyolysis with concomitant disease. Discontinue therapy if serum responsive to other forms of therapy. In cyclosporine, with or without other fatigue. Cognitive impairment (e.g. use of Cholestyramine, transaminase levels rise to 3 times upper health clinics, Pravastatin is restricted to immunosuppressive drugs: Initial dose is memory loss, forgetfulness, amnesia, cyclosporine, Lipid Metabolism limit of normal and are persistent. May HIV patients on HAART. 10mg/day and titration to higher doses memory impairment, confusion). Regulators such as Gemfibrozil, cause myopathy and renal failure due to should be performed with caution. Increase in HbA1c and fasting blood fenofibrate, other fibrates and rhabdomyolysis. Concomitant Maximum dose 20mg/day. glucose. niacin (nicotinic acid), administration of fibrates, nicotinic acid, Clarithromycin, Erythromycin, immunosuppressives including colchicines and systemic fusidic cyclosporin, macrolide antibiotics acid. (erythromycin, clarithromycin), itraconazole and ketoconazole, may increase the risk of myopathy. Cases of myopathy, including rhabdomyolysis, have been reported with pravastatin co- administered with colchicines.

Prazosin HCl 1 mg Tablet B Hypertension Initially 0.5 mg 2 - 3 times daily, the initial Dizziness, orthostatic hypotension, Hypersensitivity to prazosin products or Additive hypotensive effect with Dizziness, lightheadedness, orthostatic dose on retiring to bed at night; oedema, palpitations, urinary other quinazolines diuretics or other antihypertensives hypotension, syncope, fainting and increased to 1 mg 2 - 3 times daily after 3 incontinence, dyspnoea, priapism, sudden loss of consciousness due to first- - 7 days: further increased if necessary to headache, lack of energy, nausea dose effect maximum 20 mg daily Prazosin HCl 2 mg Tablet B Hypertension Initially 0.5 mg 2 - 3 times daily, the initial Dizziness, orthostatic hypotension, Hypersensitivity to prazosin products or Additive hypotensive effect with Dizziness, lightheadedness, orthostatic dose on retiring to bed at night; oedema, palpitations, urinary other quinazolines diuretics or other antihypertensives hypotension, syncope, fainting and increased to 1 mg 2 - 3 times daily after 3 incontinence, dyspnoea, priapism, sudden loss of consciousness due to first- - 7 days: further increased if necessary to headache, lack of energy, nausea dose effect maximum 20 mg daily

Prazosin HCl 5 mg Tablet B Hypertension Initially 0.5 mg 2 - 3 times daily, the initial Dizziness, orthostatic hypotension, Hypersensitivity to prazosin products or Additive hypotensive effect with Dizziness, lightheadedness, orthostatic dose on retiring to bed at night; oedema, palpitations, urinary other quinazolines diuretics or other antihypertensives hypotension, syncope, fainting and increased to 1 mg 2 - 3 times daily after 3 incontinence, dyspnoea, priapism, sudden loss of consciousness due to first- - 7 days: further increased if necessary to headache, lack of energy, nausea dose effect maximum 20 mg daily

Prednisolone 5 mg Tablet B i) Replacement therapy for primary and i) 5 - 25 mg daily in divided doses ii) 10 - Cushing's syndrome and growth Live vaccines; herpes simplex keratitis, Phenytoin, phenobarbital, rifampin Hypothyroidism, cirrhosis, ulcerative secondary adrenocortical insufficiency ii) 20 mg/m2 body surface daily in divided retardation in children; osteoporosis, systemic infections increase clearance of colitis, CHF, convulsive disorders, Adrenogenital syndrome iii) Other doses iii) ADULT: 5 - 60 mg daily. CHILD: fractures. Peptic ulceration; glaucoma, methylprednisolone. Potassium thrombophlebitis, peptic ulcer, elderly. therapy 0.5 - 2 mg/kg/day in divided doses every cataracts; hyperglycaemia, pancreatitis; depleting diuretics enhance DM, hypertension, psychological 6 - 8 hours or as a single daily increased appetite, obesity. potassium depletion. Skin test disturbances, osteoporosis; pregnancy, antigens and immunizations lactation. Adrenal suppression and decrease response. Increase infection. circulating glucose level and may need adjustment of insulin or oral hypoglycaemics

Pregabalin 75 mg Capsule A* i) Second line treatment of neuropathic i) Initially, 75 mg twice daily. May be Somnolence, euphoric mood, confusion, Hypersensitivity to pregabalin or any CNS depressants (eg, alcohol, Hereditary problems of galactose pain in patients who do not response to increased to 150 mg twice daily after 3-7 decreased libido, irritability, ataxia, other component of the product, breast- lorazepam, oxycodone) intolerance, Lapp lactase deficiency or first line drugs ii) Fibromyalgia days. Max: 600 mg/day after an abnormal coordination, tremor, feeding glucose-galactose malabsorption, avoid additional 7-day interval ii) Initially, 75 dysarthria, paraesthesia, blurred vision, abrupt withdrawal, renal impairment, mg twice daily. May be increased to 150 diplopia, vertigo, vomiting, erectile diabetes, chronic heart failure, pregnancy mg twice daily within 1 week or 225 mg dysfunction, peripheral oedema, & lactation, children less than 17 years, twice daily. Max: 450 mg/day angioedema, abnormal gait, increased elderly patients. Potential for an increase weight in risk of suicidal thoughts or behaviours Prednisolone acetate 1% ophthalmic A For steroid responsive inflammation of 1 to 2 drops to be instilled into the Increased intraocular pressure, with optic Acute untreated purulent ocular No data available. Posterior sub capsular cataract formation suspension the palpebral and bulbar conjunctiva, conjunctival sac 2 to 4 times daily. During nerve damage, defects in the visual infections, acute superficial herpes has been reported after heavy or cornea and anterior segment of the the initial 24 to 48 hours the dosage may fields. Also posterior subcapsular simplex (dendritic keratitis), vaccinia, protracted use of topical ophthalmic globe. be safely increased to 2 drops every cataract formation, secondary ocular varicella and most other viral diseases of corticosteroids. Acute anterior uveitis hour. Care should be taken not to infections from fungi or viruses liberated the cornea and conjunctiva, ocular may occur in susceptible individuals. The discontinue therapy prematurely. from ocular tissues, perforation of the tuberculosis, and fungal diseases of the use of steroids after cataract surgery globe when used in conditions where eye, and sensitivity to any components of may delay healing and increase the there is thinning of the cornea or sclera, the formulation. incidence of filtering blebs. If signs of and delayed wound healing. hypersensitivity or other serious Corticosteroid-containing preparations reactions occur, discontinue use of this can also cause acute anterior uveitis or preparation. Use in Pregnancy - Safety of perforation of the globe. Mydriasis, loss intensive or protracted use of topical of accommodation and ptosis has steroids during pregnancy has not been occasionally been reported following substantiated. Nursing Mothers - It is not local use of corticosteroids. Systemic side known whether topical administration effects may occur with extensive use of could result in sufficient systemic steroids. There have been rare absorption to produce detectable occurrences of systemic quantities in breast milk. Caution should hypercorticoidism after use of topical be exercised when prednisolone is steroids. administered to a nursing woman taking into consideration the importance of the drug to the mother. Use in Children - Safety and effectiveness of corticosteroids in children below the age of two years has not been established.

Primaquine 7.5 mg base Tablet B i) Treatment of malaria ii) Prophylaxis i) 15 mg daily for 14 days, increased to Nausea, vomiting, epigastric distress, Hypersensitivity. Childn <1 yr. Acute flare- Primaquine may inhibit metabolism G6PD deficiency; pregnancy; NADH together with a schizonticide such as higher doses or longer course if abdominal cramps, leukopaenia, ups of systemic diseases (RA, SLE) having of chloroquine. Avoid ethanol. methaemoglobin reductase deficient chloroquine resistance in P.vivax occurs. ii) ADULT: 30 leucocytosis, agranulocytosis, tendency for agranulocytopaenia, Potentially Fatal: Mepacrine may patients. Monitor Hb levels and blood mg once weekly. CHILD: 0.5 mg once methaemoglobinemia in NADH Pregnancy and lactation. potentiate toxicity of primaquine. counts routinely. Patients with systemic weekly Child: 250 mcg/kg daily for 14 methaemoglobin reductase-deficient Potentially haemolytic drugs eg, diseases that have an increased risk of days. Should be taken with food. Take individuals. Potentially Fatal: Haemolytic sulphonamides, nitrofurans and granulocytopenia. Withdraw treatment if with meals to avoid GI discomfort. anaemia (G6PD deficient), bone marrow suppressants eg, signs of haemolysis or thrombocytopaenia, leucopaenia, AV methotrexate, phenylbutazone, methaemogloinaemia occur. block. chloramphenicol should not be co- admin with primaquine.

Prochlorperazine Maleate 5mg B i) Severe nausea and vomiting ii) Nausea and vomiting Adult: As maleate Cholestatic jaundice, cardiac CNS depression, comatose patients. Additive anticholinergic effects with Extrapyramidal syndrome, hypotension, Tablet Vertigo/labyrinthine disorders or mesilate: 20 mg, further doses are arrhythmias, orthostatic hypotension, Bone marrow depression, antihistamines, tricyclic epilepsy, impaired hepatic, renal, CV, given if needed. Recommended buccal leucopaenia, thrombocytopaenia, dry phaechromocytoma, prolactin- antidepressants and drugs used in cerebrovascular or respiratory function, dose: As maleate: 3-6 mg bid. Vertigo mouth, blurring of vision, glaucoma, dependent tumours, hypersensitivity. parkinsonism. May reduce the glaucoma. May impair ability to drive or Adult: As maleate or mesilate: 15-30 mg urinary retention, constipation, Childn <2 yr. Pregnancy and lactation. antihypertensive effect of perform tasks requiring mental alertness daily, given in divided doses. May reduce galactorrhoea, gynaecomastia, guanethidine and other adrenergic or physical coordination. Parenteral use gradually to 5-10 mg daily. amenorrhoea and impotence. Buccal: neurone blockers. May also in children is not recommended. History Recommended buccal dose: 3-6 mg bid. Transient numbness of gum and tongue. increase risk of arrhythmias when of jaundice, parkinsonism, diabetes May be taken with or without food. Potentially Fatal: Bone-marrow used with drugs that prolong QT mellitus, hypothyroidism, myasthenia suppression. Cardiac arrhythmias or interval. Potentially Fatal: gravis, paralytic ileus, prostatic aspiration. Potentiation of other CNS hyperplasia or urinary retention. Regular depressants including alcohol, eye examinations are recommended in sedatives, hypnotics, barbiturates, patients on long-term treatment. opioids, antihistamines and general anaesthetics.

Prolase Tablet B Oedema and inflammation in conjunction 2 tablet 4 times daily Skin rash, vertigo and gastrointesinal Blood clotting disease No known Renal or hepatic dysfunction and with other physical or chemotherapeutic upsets pregnancy measures Progesterone 100 mg capsule A* Supplementation of the luteal phase. Oral route: On average for progesterone Oral: somnolence, dizziness. Local Oral: severe hepatic dysfunction Vaginal: Unknown. Delay evacuation of dead egg or insufficiency, the daily dose of discomfort (erythema/burning or unknown. interruption of non progressive progesterone is 200-300mg per day; one itching), bloating, vaginal discharge, pregnancy. May impair ability to drive or capsule after breakfast and one to two spotting, metrorrhagia, breast fullness operate machinery. capsules at bedtime. Vaginal route: 4 to 6 capsules (in 2 to 3 divided doses) per day starting from the day of the HCG injection until the 12th week of pregnancy.

Proparacaine HCI 0.5% Ophthalmic B Topical anaesthesia in ophthalmic Deep anaesthesia:1 or 2 drops in the Transient stinging and burning, Hypersensitivity Hyaluronidase, St John's wort, Use cautiously in patients with cardiac Drops procedures (eyes) every 5 to 10 minutes for 3 to 5 conjunctival redness, keratitis, systemic increase effects of disease and hyperthyroidism, prolonged doses. For minor surgical procedures: toxicity. Long term use may result in phenylephedrine, tropicamide use not recommended. Protect the eye instill 1 to 2 drops every 5 to 10 minutes corneal damage, loss of vision and retard from irritants, rubbing and foreign bodies for 1 to 3 doses. Tonometry and/or healing during period of anaesthesia tonography procedure: 1 to 2 drops in each eye before procedure.

Propranolol HCl 40 mg Tablet B i) Hypertension ii) Angina iii) Myocardial i) Initially 80 mg twice daily increased as Bronchospasm, bradycardia, depression, Hypersensitivity to propranolol, asthma, Alpha-1 adrenergic blockers, Avoid abrupt withdrawal, bronchospastic infarct iv) Cardiac arrhythmia v) Portal required to a usual range of 160 - 320 mg nausea, vomiting, dizziness, central bradycardia, 2nd and 3rd degree AV amiodarone, chlorpromazine, disease, congestive heart failure, hypertension vi) Migraine vii) daily. CHILD: Initial doses of 1 mg/kg in nervous system effects, muscle cramps, block, cardiogenic shock, overt cardiac cimetidine, clonidine, cocaine, diabetes, hepatic disease, peripheral Thyrotoxicosis divided doses, can be increased to 2 - 4 fluid retention, skin rashes, dry mouth failure, obstructive airway disease digoxin, dihydroergotamine, vascular disease, renal disease, mg/kg/day in divided doses ii) Initial dose dihydropyridine, calcium channel myasthenia gravis, pregnancy, breast of 40 mg 2 - 3 times daily. Maintenance blocker, disopyramide, epinephrine, feeding 120 - 240 mg daily iii) 40mg 4 times daily ergotamine, flecainide, flunarizine, for 2 - 3 days then 80 mg twice daily, fluvoxamine, furosemide, risk of beginning 5 - 21 days after infarction iv) lignocaine toxicity increased 10 - 40 mg 3 - 4 times daily v) Initially 40 mg twice daily. The dose may be increased as required up to 160 mg twice daily vi) Initial prophylaxis dose: 40 mg 2 - 3 times daily. The dose may be increased at weekly intervals up to 160 mg daily vii) Adjunct: 10 - 40 mg 3 - 4 times daily. CHILD: Arrythmias, thyrotoxicosis: 0.25 - 0.5 mg/kg 3 - 4 times daily as required

Propylthiouracil 50 mg Tablet B Hyperthyroidism ADULT Initially 300-450mg in 8 hourly GI disturbances, headache, arthralgia, Hypersensitivity Anticoagulants, beta blockers, Reserve use for patients who are unable intervals (can be given up to 600- myalgia, oedema, alopecia, pruritus and digitalis glycosides, theophylline to tolerate carbimazole, radioactive 900mg/daily) until symptoms are rashes. Potentially fatal: agranulocytosis, iodine therapy and surgery. Severe liver controlled in 1-2 months. Maintenance aplastic anaemia, liver injury and liver injury and acute liver failure, hepatic or 50-150mg daily for at least 12-18 failure renal impairment. Monitor for liver injury months. CHILDREN 6-10 years: 50- and agranulocytosis especially in the first 150mg. CHILDREN > 10 years: 150-300mg 6 months of therapy. Pregnancy and daily. All doses are to be given in 3 lactation. divided doses daily. Taken with food. Pyrazinamide 500 mg Tablet B Tuberculosis Adult: 20-40mg/kg daily (max 1500mg) or Liver toxicity depending on treatment Porphyria, severe liver damage, acute Concurrent use of pyrazinamide Slightly impaired liver function, 50mg/kg biweekly (max 2000mg). duration & concomitant therapy. liver disease, pregnancy, lactation and zidovudine may result in hyperuricaemia, arthralgia, renal Children: 20-30mg/kg daily or 30- Transient increase in serum transminase decreased efficacy of pyrazinamide. insufficiency, diabetes mellitus 40mg/kg thrice weekly. levels, acute atrophy of the liver. Nausea, Cyclosporin, ethionamide vomiting, anorexia, diarrhoea, abdominal pain. Hyperuricaemia may occur with dosages more than 2 g/day

Pyridostigmine Bromide 60 mg B Myasthenia gravis ADULT: 30 - 120 mg at suitable intervals Abdominal cramps, excessive sweating, Intestinal or urinary obstruction Potentiates actions of morphine Bronchial asthma (extreme caution) or Tablet throughout the day, total daily dose 0.3 - bronchoconstriction, lacrimation, derivatives and barbiturates, bronchitis, renal disease, cardiac 1.2 g. CHILD up to 6 years initially 30 mg, bradycardia, asystole, diaphoresis, succinylcholine dysrhythmias, cholinergic crisis 6 - 12 years initially 60 mg, usual total diarrhoea, nausea, vomiting, cramp, daily dose 30 - 360 mg muscle fasciculation, asthenia, miosis

Pyridoxine HCl 10 mg Tablet C+ i)Pyridoxine-dependent convulsions in i) INFANT 4 mg/kg daily for short periods Peripheral sensory neuropathy, Hypersensitivity to pyridoxine or any Levodopa, penicillamine, selegiline, Pregnancy, lactation, neonatal seizures, infant ii)Sideroblastic anaemia iii)B6- ii) 100 - 400 mg daily in divided doses iii) hypotonia, respiratory difficulties, nausea component of preparation phenytoin concurrent treatment with levodopa. deficient anaemia in adult iv) Prophylaxis ADULT 20 - 50 mg up to 3 times daily iv) and other gastrointestinal complaints, Long term use in a dose of 200 mg or to peripheral neuritis in isoniazid therapy Prophylaxis 10 mg daily, therapeutic 50 photosensitivity, vesicular lesions and more daily has been associated with v) Nausea and vomiting of pregnancy and mg 3 times daily v) 20 - 100 mg daily bullous lesions neuropathy irradiation sickness

Quetiapine Fumarate 100 mg A* i) Schizophrenia ii) Short term treatment i) Initial titration schedule over 4 days: 25 Headache, somnolence, weight gain, Hypersensitivity, severe CNS depression, Antihypertensives, cimetidine, CNS Pregnancy, hepatic impairment, renal Immediate Release Tablet of acute manic episodes associated with mg twice daily on Day 1, increase in steps postural hypotension, tachycardia, bone marrow suppression, blood depressants, alcohol, impairment, cerebrovascular disease, bipolar I disorder, either monotherapy or of 25 - 50 mg 2 to 3 times daily on Days 2 palpitations, dizziness, rash, abdominal dyscrasias, severe hepatic disease, coma carbamazepine, barbiturates, hyperglycaemia and diabetes mellitus. adjunct to lithium or divalproex iii) and 3 to reach target dose of 300 - 400 pain, constipation, dyspepsia, anorexia, valproate, phenytoin, rifampicin, Cardiovascular disease, use with drugs Treatment of depressive episodes mg daily by Day 4, given in 2 - 3 divided dry mouth, constipation, leucopenia, thioridazine, ketoconazole, known to prolong QTc interval. Renal & associated with bipolar disorder doses. Institute further dose dyspepsia, elevated serum erythromycin. Other centrally- hepatic impairment. History of seizures & adjustments, if indicated, at intervals of 2 transaminases (ALT, AST), mild asthenia, acting drugs, alcohol, macrolide diabetes mellitus. Pregnancy & lactation. days or more, in steps of 25 - 50 mg twice peripheral oedema, weight gain, antibiotics Elderly. May affect ability to drive or daily ii) 100 mg (Day 1), 200 mg (Day 2), syncope, rhinitis operate machinery 300 mg (Day 3) & 400 mg (Day 4). Further dosage adjustments up to 800 mg/day by Day 6 should be in increments of not more than 200 mg/day. Adjust dose within the range of 200 - 800 mg/day depending on clinical response and tolerability of the patient. Usual effective dose range: 400 - 800 mg/day iii) 50 mg ORALLY once a day on Day 1, then 100 mg once daily on Day 2, then 200 mg once daily on Day 3, then 300 mg once daily on Day 4 (all doses given at bedtime); patients requiring higher doses should receive 400 mg on Day 5, increased to 600 mg on Day 8 (week 1) Quetiapine Fumarate 200 mg A* i) Schizophrenia ii) Short term treatment i) Initial titration schedule over 4 days: 25 Headache, somnolence, weight gain, Hypersensitivity, severe CNS depression, Antihypertensives, cimetidine, CNS Pregnancy, hepatic impairment, renal Immediate Release Tablet of acute manic episodes associated with mg twice daily on Day 1, increase in steps postural hypotension, tachycardia, bone marrow suppression, blood depressants, alcohol, impairment, cerebrovascular disease, bipolar I disorder, either monotherapy or of 25 - 50 mg 2 to 3 times daily on Days 2 palpitations, dizziness, rash, abdominal dyscrasias, severe hepatic disease, coma carbamazepine, barbiturates, hyperglycaemia and diabetes mellitus. adjunct to lithium or divalproex iii) and 3 to reach target dose of 300 - 400 pain, constipation, dyspepsia, anorexia, valproate, phenytoin, rifampicin, Cardiovascular disease, use with drugs Treatment of depressive episodes mg daily by Day 4, given in 2 - 3 divided dry mouth, constipation, leucopenia, thioridazine, ketoconazole, known to prolong QTc interval. Renal & associated with bipolar disorder doses. Institute further dose dyspepsia, elevated serum erythromycin. Other centrally- hepatic impairment. History of seizures & adjustments, if indicated, at intervals of 2 transaminases (ALT, AST), mild asthenia, acting drugs, alcohol, macrolide diabetes mellitus. Pregnancy & lactation. days or more, in steps of 25 - 50 mg twice peripheral oedema, weight gain, antibiotics Elderly. May affect ability to drive or daily ii) 100 mg (Day 1), 200 mg (Day 2), syncope, rhinitis operate machinery 300 mg (Day 3) & 400 mg (Day 4). Further dosage adjustments up to 800 mg/day by Day 6 should be in increments of not more than 200 mg/day. Adjust dose within the range of 200 - 800 mg/day depending on clinical response and tolerability of the patient. Usual effective dose range: 400 - 800 mg/day iii) 50 mg ORALLY once a day on Day 1, then 100 mg once daily on Day 2, then 200 mg once daily on Day 3, then 300 mg once daily on Day 4 (all doses given at bedtime); patients requiring higher doses should receive 400 mg on Day 5, increased to 600 mg on Day 8 (week 1)

Quetiapine Fumarate 200 mg A* i)Schizophrenia ii) Moderate to severe i) & ii) 300 mg once daily on Day 1 then Headache, somnolence, weight gain, Hypersensitivity, severe CNS depression, Antihypertensives, cimetidine, CNS Pregnancy, hepatic impairment, renal Extended Release Tablet manic episodes in bipolar disorder iii) 600 mg on Day 2. Maintenance dose: 400 postural hypotension, tachycardia, bone marrow suppression, blood depressants, alcohol, impairment, cerebrovascular disease, Major depressive episodes in bipolar to 800 mg once daily. Maximum dose: palpitations, dizziness, rash, abdominal dyscrasias, severe hepatic disease, coma carbamazepine, barbiturates, hyperglycaemia and diabetes mellitus. disorder 800 mg daily iii) 50 mg on Day 1, 100 mg pain, constipation, dyspepsia, anorexia, valproate, phenytoin, rifampicin, Cardiovascular disease, use with drugs on Day 2, 200 mg on Day 3 and 300 mg dry mouth, constipation, leucopenia, thioridazine, ketoconazole, known to prolong QTc interval. Renal & on Day 4. Recommended daily dose is dyspepsia, elevated serum erythromycin. Other centrally- hepatic impairment. History of seizures & 300 mg. May be titrated up to 600 mg transaminases (ALT, AST), mild asthenia, acting drugs, alcohol, macrolide diabetes mellitus. Pregnancy & lactation. daily. In elderly or hepatic peripheral oedema, weight gain, antibiotics Elderly. May affect ability to drive or impairment:Start with 50mg/ day, may syncope, rhinitis operate machinery be increased in increments of 50mg /day to an effective dose.

Quetiapine Fumarate 300 mg A* i) Schizophrenia ii) Moderate to severe i) & ii) 300 mg once daily on Day 1 and Headache, somnolence, weight gain, Hypersensitivity, severe CNS depression, Antihypertensives, cimetidine, CNS Pregnancy, hepatic impairment, renal Extended Release Tablet manic episodes in bipolar disorder iii) 600 mg on Day 2. Maintenance dose: 400 postural hypotension, tachycardia, bone marrow suppression, blood depressants, alcohol, impairment, cerebrovascular disease, Major depressive episodes in bipolar ? 800 mg once daily. Maximum dose: 800 palpitations, dizziness, rash, abdominal dyscrasias, severe hepatic disease, coma carbamazepine, barbiturates, hyperglycaemia and diabetes mellitus. disorder mg daily iii) 50 mg on Day 1, 100 mg on pain, constipation, dyspepsia, anorexia, valproate, phenytoin, rifampicin, Cardiovascular disease, use with drugs Day 2, 200 mg on Day 3 and 300 mg on dry mouth, constipation, leucopenia, thioridazine, ketoconazole, known to prolong QTc interval. Renal & Day 4. Recommended daily dose is 300 dyspepsia, elevated serum erythromycin. Other centrally- hepatic impairment. History of seizures & mg. May be titrated up to 600 mg daily transaminases (ALT, AST), mild asthenia, acting drugs, alcohol, macrolide diabetes mellitus. Pregnancy & lactation. peripheral oedema, weight gain, antibiotics Elderly. May affect ability to drive or syncope, rhinitis operate machinery

Quetiapine Fumarate 400 mg A* i) Schizophrenia ii) Moderate to severe i) & ii) 300 mg once daily on Day 1 and Headache, somnolence, weight gain, Hypersensitivity, severe CNS depression, Antihypertensives, cimetidine, CNS Pregnancy, hepatic impairment, renal Extended Release Tablet manic episodes in bipolar disorder iii) 600 mg on Day 2. Maintenance dose: 400 postural hypotension, tachycardia, bone marrow suppression, blood depressants, alcohol, impairment, cerebrovascular disease, Major depressive episodes in bipolar ? 800 mg once daily. Maximum dose: 800 palpitations, dizziness, rash, abdominal dyscrasias, severe hepatic disease, coma carbamazepine, barbiturates, hyperglycaemia and diabetes mellitus. disorder mg daily iii) 50 mg on Day 1, 100 mg on pain, constipation, dyspepsia, anorexia, valproate, phenytoin, rifampicin, Cardiovascular disease, use with drugs Day 2, 200 mg on Day 3 and 300 mg on dry mouth, constipation, leucopenia, thioridazine, ketoconazole, known to prolong QTc interval. Renal & Day 4. Recommended daily dose is 300 dyspepsia, elevated serum erythromycin. Other centrally- hepatic impairment. History of seizures & mg. May be titrated up to 600 mg daily transaminases (ALT, AST), mild asthenia, acting drugs, alcohol, macrolide diabetes mellitus. Pregnancy & lactation. peripheral oedema, weight gain, antibiotics Elderly. May affect ability to drive or syncope, rhinitis operate machinery Quetiapine Fumarate 50 mg A* i)Schizophrenia ii)Moderate to severe i) & ii) 300 mg once daily on Day 1 then Headache, somnolence, weight gain, Hypersensitivity, severe CNS depression, Antihypertensives, cimetidine, CNS Pregnancy, hepatic impairment, renal Extended Release Tablet manic episodes in bipolar disorder 600 mg on Day 2. Maintenance dose: 400 postural hypotension, tachycardia, bone marrow suppression, blood depressants, alcohol, impairment, cerebrovascular disease, iii)Major depressive episodes in bipolar to 800 mg once daily. Maximum dose: palpitations, dizziness, rash, abdominal dyscrasias, severe hepatic disease, coma carbamazepine, barbiturates, hyperglycaemia and diabetes mellitus. disorder 800 mg daily. iii)50 mg on Day 1, 100 mg pain, constipation, dyspepsia, anorexia, valproate, phenytoin, rifampicin, Cardiovascular disease, use with drugs on Day 2, 200 mg on Day 3 and 300 mg dry mouth, constipation, leucopenia, thioridazine, ketoconazole, known to prolong QTc interval. Renal & on Day 4. Recommended daily dose is dyspepsia, elevated serum erythromycin. Other centrally- hepatic impairment. History of seizures & 300 mg. May be titrated up to 600 mg transaminases (ALT, AST), mild asthenia, acting drugs, alcohol, macrolide diabetes mellitus. Pregnancy & lactation. daily. In elderly or hepatic impairment: peripheral oedema, weight gain, antibiotics Elderly. May affect ability to drive or Start with 50mg/ day, may be increased syncope, rhinitis operate machinery in increments of 50mg /day to an effective dose.

Raltegravir 400 mg tablet A* Raltgeravir combination with other 400mg administered orally, twice daily Nausea,Asthenia,Dizziness,Headache,Ins Specific contraindications have not been Raltegravir when taken with certain Hypersensitivity reactions have been antiretroviral agents is indicated for the with or without food, to be given omniaFatigue, serious adverse effect: determined other medications, such as reported, including cases of organ treatment of HIV-1 infection in patients combination with other antiretroviral Stevens-Johnson syndrome, Toxic atazanavir, phenobarbital, and dysfunction and hepatic failure; who are contraindicated to boosted agent. epidermal necrolysis, Hypersensitivity phenytoin where the interactions discontinue if signs and symptoms Protease Inhibitor or who are intolerant reaction, Rhabdomyolysis, Suicidal, Renal with these drugs can alter the level appear; monitoring and medical to boosted Protease Inhibitor. failure of raltegravir in blood, possibly management required. Myopathy or making it less effective. rhabdomyolysis, predisposition (eg, concomitant use of drugs known to cause these conditions); grade 2 to 4 creatine kinase laboratory abnormalities have been reported. Opportunistic infections, indolent or residual; inflammatory response (immune reconstitution syndrome) may occur during initial phase of treatment. Phenylketonurics, skin reactions, severe and sometimes fatal (eg, Stevens- Johnson syndrome, toxic epidermal necrolysis), have been reported; discontinue if signs and symptoms occur

Ramipril 2.5 mg Tablet A i) Hypertension and congestive heart i) Hypertension: Initially 2.5 mg once Nausea, dizziness & headache, dry cough, Hypersensitivity, history of angioedema Enhanced hypotensive effects by Renal or hepatic impairment, failure ii) Post-myocardial infarction iii) daily, increased at intervals of 1 - 2 weeks hypotension, hypokalemia, fatigue, with ACE inhibitors, bilateral renal artery alcohol, alprostadil and hyperstimulated renin-angiotensin Reducing risk of myocardial infarction, to maximum 10 mg once daily; pruritus, rash & fever ,pancreatitis, stenosis or a single kidney with unilateral anaesthetics system stroke or cardiovascular death in Congestive heart failure:Initially 1.25 mg angioedema renal artery stenosis. Pregnancy and diabetics or patients with increased once daily. Max: 10 mg/day ii) Initially 2.5 lactation cardiovascular risks mg twice daily for 2 days then increased to maximum 5 mg twice daily iii) Initially 1.25 - 2.5 mg once daily, increased to 5 mg once daily after 1 week, maximum dose: 10 mg once daily after 3 weeks

Ramipril 5 mg Tablet A i) Hypertension and congestive heart i) Hypertension: Initially 2.5 mg once Nausea, dizziness & headache, dry cough, Hypersensitivity, history of angioedema Enhanced hypotensive effects by Renal or hepatic impairment, failure ii) Post-myocardial infarction iii) daily, increased at intervals of 1 - 2 weeks hypotension, hypokalemia, fatigue, with ACE inhibitors, bilateral renal artery alcohol, alprostadil and hyperstimulated renin-angiotensin Reducing risk of myocardial infarction, to maximum 10 mg once daily; pruritus, rash & fever ,pancreatitis, stenosis or a single kidney with unilateral anaesthetics system stroke or cardiovascular death in Congestive heart failure:Initially 1.25 mg angioedema renal artery stenosis. Pregnancy and diabetics or patients with increased once daily. Max: 10 mg/day ii) Initially 2.5 lactation cardiovascular risks mg twice daily for 2 days then increased to maximum 5 mg twice daily iii) Initially 1.25 - 2.5 mg once daily, increased to 5 mg once daily after 1 week, maximum dose: 10 mg once daily after 3 weeks Ranitidine 150 mg Tablet B i) Benign gastric and duodenal ulcer ii) i) 150 mg twice daily (at morning and Gastrointestinal disturbances, diarrhoea, Hypersensitivity to ranitidine Absorption may be reduced by H2-receptor antagonists should be used Reflux oesophagitis iii) Non-ulcer night) or 300 mg on night for 4-8 weeks. altered liver function tests (rarely liver concomitant administration with with caution in hepatic impairment, in dyspepsia iv) Zollinger-Ellison Syndrome Maintenance: 150-300 mg on night ii) damage), headache, dizziness, rash and high doses (2 g) of sucralfate renal impairment, pregnancy and in 150 mg twice daily or 300 mg on night for tiredness. Rare side-effects include acute breast-feeding. H2-receptor antagonists 8-12 weeks iii) 150 mg daily or twice daily pancreatitis, bradycardia, AV block, might mask symptoms of gastric cancer. iv) 150 mg and may be increased as confusion, depression and hallucinations Avoid in porphyrias. Ranitidine and necessary to 6 g/day particularly in the elderly or the very ill, phenytoin is not recommended. If no hypersensitivity reactions (including alternatives exist, clinical monitoring of fever, arthralgia, myalgia, anaphylaxis), patient response, tolerance and serum blood disorders (including phenytoin concentrations is agranulocytosis, leucopenia, recommended, especially during the first pancytopenia, thrombocytopenia) and month of therapy skin reactions (including erythema multiforme and toxic epidermal necrolysis). There have been occasional reports of gynaecomastia and impotence

Rifampicin 150 mg Capsule B i) Tuberculosis ii) Leprosy iii) Prophylaxis i) ADULT: 450 - 600 mg as a single Flushing, itching, gastrointestinal Hypersensitivity and jaundice patient May reduce the activity of Alcoholism, patients with impaired liver for meningococcal meningitis morning dose. CHILD: 10 - 20 mg/kg body reactions, pseudomembranous colitis, anticoagulant, corticosteroids, function, pregnancy, lactation weight daily in 1 - 2 doses. Directly hepatitis, thrombocytopenia, muscle cyclosporin, digitalis, oral observed therapy (DOT): 10 mg/kg twice weakness. Flu syndrome may occur with contraceptives, oral weekly or 3 times/week. Maximum: 600 intermittent dosage regimens. May hypoglycaemics mg ii) 600 mg/day iii) 600 mg twice daily produce a reddish brown discoloration of for 2 days body fluids

Rifampicin 150 mg, Isoniazid 75 mg, B Treatment of both pulmonary and ADULT: 30 - 37 kg: 2 tablets daily, 38 - 54 Reddish discoloration of body fluids, Combined preparation not suitable for Oral contraceptives, hormone Impaired renal or liver function, diabetes Pyrazinamide 400 mg & Ethambutol extrapulmonary tuberculosis, in the kg: 3 tablets daily, 55 - 70 kg: 4 tablets increased hepatic enzyme levels, use in children. History of drug-induced replacement therapy, mellitus, chronic alcoholism, HCl 275 mg Tablet intensive treatment phase daily, more than 70 kg: 5 tablets daily gastrointestinal disturbances, tiredness, hepatitis, acute liver diseases regardless anticoagulants, antidiabetics, undernourished patients and history of drowsiness, headache, dizziness, ataxia, of their origin, peripheral neuritis antihypertensives, cardiac drugs, gout, convulsive disorders, and acute leucopenia, eosinophilia, flushing, itching, antiepileptics, antacids, cimetidine, porphyria. Avoid tyramine and histamine- rash, disturbances in the menstrual cycle, opioid analgesics, disulfiram, containing food. May impair ability to induction of crisis in Addison patients, 'flu- anxiolytics, sedatives, drive or operate machinery like' symptoms, disturbances of liver sulfinpyrazone, allopurinol, function, hepatitis, peripheral colchicine, probenecid, neuropathy, agranulocytosis, corticosteroids, chloramphenicol, eosinophilia, thrombocytopenia, allergic ketoconazole, dapsone, reactions, lupus erythematosus-like methadone, theophylline, syndrome, pellagra, gynaecomastia, cyclosporin A, azathioprine, alcohol hyperuricaemia, interstitial nephritis, dysuria, photosensitivity, porphyria, reversible retrobulbar neuritis with a reduction of visual acuity, central scotoma and green-red color blindness, jaundice, peripheral neuritis, confusion, hallucinations, joint pain, fever, malaise, anorexia and abdominal pain

Rifampicin 150mg + Isoniazid 75mg B For pulmonary tuberculosis in which 30-37kg: 2 tablets once daily, 38-54kg: 3 Rifampicin: Headache, muscular Patients with previous hypersensitivity Rifampicin: May reduce the activity Risk of liver dysfunction. Liver function tablet organisms are susceptible in continuation tablets once daily, 55-70kg: 4 tablets weakness, gastrointestinal disturbances, reaction to any of the rifamycins or to of anticoagulant, methadone, test should be performed prior to phase treatment for 4 months once daily, Above 70kg: 5 tabs once daily hepatitis, thrombocytopenia, transient isoniazid including drug-induced corticosteroids, digitoxin, oral therapy and periodically during leukopenia, elevations in serum BUN and hepatitis. Patients with previous isoniazid- contraceptives, oral treatment. Hypersensitivity reaction; Not uric acid, allergic reactions. Isoniazid: associated hepatic injury; severe adverse hypoglycaemics, quinidine, for intermittent therapy; staining of Peripheral neuropathy, convulsion, optic reactions to isoniazid, such as fever, chills disopyramide, dapsone. Isoniazid: contact lenses; red-orange coloured neuritis, elevated serum transaminases, and arthritis; acute liver disease of any Decreases excretion of phenytoin urine, feces, sputum, saliva and sweat jaundice, hepatitis, agranulocytosis, etiology and increases its effect. occurs; reliability of oral contracpetives aplastic anemia, thrombocytopenia, affected; pregnancy, lactation; severe hypersensitivity reactions. renal dysfunction Rifampicin 300 mg Capsule B i) Tuberculosis ii) Leprosy iii) Prophylaxis i) Tuberculosis ADULT: Daily doses: Flushing, itching, gastrointestinal Hypersensitivity and jaundice patient May reduce the activity of Alcoholism, patients with impaired liver for meningococcal meningitis 10mg/kg/day Body weight doses: 10- reactions, pseudomembranous colitis, anticoagulant, corticosteroids, function, pregnancy, lactation 15/kg/day CHILD: 10 - 20 mg/kg body hepatitis, thrombocytopenia, muscle cyclosporin, digitalis, oral weight daily in 1 - 2 doses. Maximum weakness. Flu syndrome may occur with contraceptives, oral daily dose : 600mg Directly observed intermittent dosage regimens. May hypoglycaemics therapy (DOT): 10 mg/kg twice weekly or produce a reddish brown discoloration of 3 times/week. Maximum: 600 mg ii) body fluids Leprosy: ADULT: 600 mg/day CHILDREN: 10mg/kg iii) Prophylaxis for meningococcal meningitis: ADULT: 600 mg twice daily for 2 days CHILDREN: 10mg/kg twice daily for 2 days INFANT: 5mg/kg twice daily for 2 days"

Risperidone 1 mg Tablet B Psychoses and schizophrenia ADULT : 2 mg in 1 - 2 divided doses on Somnolence, dizziness, hyperkinesia, Hyperprolactinaemia, hypersensitivity to Tramadol, increased risk of Neuroleptic malignant syndrome, tardive first day then 4 mg in 1 - 2 divided doses nausea, extrapyramidal effects, risperidone products, prolonged QT seizures. Carbamazepine, increased dyskinesia, QT prolongation, on 2nd day then 6 mg in 1 - 2 divided constipation, anxiety, headache, rhinitis, interval risperidone clearance. Levodopa, cardiovascular or cerebrovascular disease doses on 3rd day (slower titration rash, dyspepsia, tachycardia, dry mouth, loss of levodopa efficacy. Clozapine, or conditions that predispose patients to appropriate in some patients); usual weight gain, sexual dysfunction, decreased risperidone clearance. orthostatic hypotension, hypothermia or range 4 - 8 mg daily; dose above 10 mg hyperprolactinaemia, menstrual Amphotericin, Class Ia and III hyperthermia, previous diagnosis of daily only if benefit outweigh risk irregularities, severe hypotension, antiarrhythmics, acetalozamide, breast cancer or prolactin-dependent (maximum 16 mg daily). Elderly (or in tardive dyskinesia, neuroleptic malignant central alpha2 agonists, systemic tumours, renal insufficiency, hepatic hepatic or renal impairment): initially 0.5 syndrome and hyperglycaemia corticosteroids, diuretics, tricyclic insufficiency, Lewy body dementia or mg twice daily increased in steps of 0.5 antidepressants Parkinson's disease, seizure history, mg twice daily to 1 - 2 mg twice daily. pathologic changes in blood count, Not recommended in children under 15 dysphagia, elderly patients, hypotension, years hypovolaemia, dehydration, agents prolonging QT, risk of aspiration pneumonia. Known cardiovascular disease, dosage should be gradually titrated as recommended, a dose reduction should be considered when hypotension occurs. Epilepsy, pregnancy ad lactation. May affect ability to drive or operate machinery Risperidone 2 mg Tablet B Psychoses and schizophrenia ADULT : 2 mg in 1 - 2 divided doses on Somnolence, dizziness, hyperkinesia, Hyperprolactinaemia, hypersensitivity to Tramadol, increased risk of Neuroleptic malignant syndrome, tardive first day then 4 mg in 1 - 2 divided doses nausea, extrapyramidal effects, risperidone products, prolonged QT seizures. Carbamazepine, increased dyskinesia, QT prolongation, on 2nd day then 6 mg in 1 - 2 divided constipation, anxiety, headache, rhinitis, interva. It is also contraindicated in coma risperidone clearance. Levodopa, cardiovascular or cerebrovascular disease doses on 3rd day (slower titration rash, dyspepsia, tachycardia, dry mouth, caused by CNS depressants, bone loss of levodopa efficacy. Clozapine, or conditions that predispose patients to appropriate in some patients); usual weight gain, sexual dysfunction, marrow depression and avoided in decreased risperidone clearance. orthostatic hypotension, hypothermia or range 4 - 8 mg daily; dose above 10 mg hyperprolactinaemia, menstrual phaeochromocytoma Amphotericin, class Ia and III hyperthermia, previous diagnosis of daily only if benefit outweigh risk irregularities, severe hypotension, antiarrhythmics, acetalozamide, breast cancer or prolactin-dependent (maximum 16 mg daily). Elderly (or in tardive dyskinesia, neuroleptic malignant central alpha2 agonists, systemic tumours, renal insufficiency, hepatic hepatic or renal impairment): initially 0.5 syndrome and hyperglycaemia corticosteroids, diuretics, tricyclic insufficiency, Lewy body dementia or mg twice daily increased in steps of 0.5 antidepressants Parkinson's disease, seizure history, mg twice daily to 1 - 2 mg twice daily. pathologic changes in blood count, Not recommended in children under 15 dysphagia, elderly patients, hypotension, years hypovolaemia, dehydration, agents prolonging QT, risk of aspiration pneumonia. Known cardiovascular disease, dosage should be gradually titrated as recommended, a dose reduction should be considered when hypotension occurs. Epilepsy, pregnancy ad lactation. May affect ability to drive or operate machinery

Rivaroxaban 10 mg Tablet A* Prevention of venous thromboembolism 10 mg once daily. Initial dose should be Hypotension, constipation, diarrhoea, Active bleeding, hepatic disease CYP3A4 inhibitors (eg azole Hemorrhagic risks, uncontrolled severe in patients undergoing elective hip or taken 6 to 10 hour post-surgery provided fever, oedema, unspecified pain, wound associated with coagulopathy, severe antifungals, macrolides, HIV arterial hypertension, active ulcerative knee replacement surgery that haemostasis has been established. healing complications, increased renal impairment, galactose intolerance, protease inhibitors, nefazodone, gastrointestinal disease, vascular Duration of treatment: Major hip surgery transaminases, sleep disorders, dizziness, Lapp lactase deficiency or glucose- diltiazem & verapamil) & inducers retinopathy, recent intracranial or 5 weeks. Major knee surgery 2 weeks pruritus, post-procedural haemorrhage galactose malabsorption, children and (eg rifampicin, barbiturates, intracerebral hemorrhage, recent brain, adolescent less than 18 year, pregnancy phenytoin, St. John's wort) intraspinal or intracerebral vascular & lactation abnormalities, spinal or ophthalmological surgery, hip fracture surgery, renal and hepatic impairment

Rivaroxaban 15 mg Tablet A* i)Prevention of stroke and systemic i)20mg once daily or 15mg once daily (for Hypotension, constipation, diarrhoea, Active bleeding, hepatic disease CYP3A4 inhibitors (eg azole Hemorrhagic risks, uncontrolled severe embolism in adult patients with non- patients with moderate renal impairment fever, oedema, unspecified pain, wound associated with coagulopathy, severe antifungals, macrolides, HIV arterial hypertension, active ulcerative valvular atrial fibrillation with one or (creatinine clearance 30-49 ml/min) healing complications, increased renal impairment, galactose intolerance, protease inhibitors, nefazodone, gastrointestinal disease, vascular more risk factors, such as Congestive Dosage: ii) & (iii) 15mg BD for 21 days, transaminases, sleep disorders, dizziness, Lapp lactase deficiency or glucose- diltiazem & verapamil) & inducers retinopathy, recent intracranial or heart failure (CHF), hypertension, age ≥ followed by 20mg OD. pruritus, post-procedural haemorrhage galactose malabsorption, children and (eg rifampicin, barbiturates, intracerebral hemorrhage, recent brain, 75 yrs, diabetes mellitus, prior stroke or adolescent less than 18 year, pregnancy phenytoin, St. John's wort) intraspinal or intracerebral vascular transient ischaemic attack. ii)Treatment & lactation abnormalities, spinal or ophthalmological of deep vein thrombosis (DVT), and surgery, hip fracture surgery, renal and prevention of recurrent DVT and hepatic impairment pulmonary embolism (PE) following an acute DVT in adults. iii) Treatment of Pulmonary Embolism (PE), and prevention of recurrent DVT and pulmonary embolism (PE) following an acute PE in adults. Rivaroxaban 20 mg Tablet A* i)Prevention of stroke and systemic i)20mg once daily or 15mg once daily (for Hypotension, constipation, diarrhoea, Active bleeding, hepatic disease CYP3A4 inhibitors (eg azole Hemorrhagic risks, uncontrolled severe embolism in adult patients with non- patients with moderate renal impairment fever, oedema, unspecified pain, wound associated with coagulopathy, severe antifungals, macrolides, HIV arterial hypertension, active ulcerative valvular atrial fibrillation with one or (creatinine clearance 30-49 ml/min) healing complications, increased renal impairment, galactose intolerance, protease inhibitors, nefazodone, gastrointestinal disease, vascular more risk factors, such as Congestive Dosage (ii) & (iii)15mg BD for 21 days, transaminases, sleep disorders, dizziness, Lapp lactase deficiency or glucose- diltiazem & verapamil) & inducers retinopathy, recent intracranial or heart failure (CHF), hypertension, age ≥ followed by 20mg OD. pruritus, post-procedural haemorrhage galactose malabsorption, children and (eg rifampicin, barbiturates, intracerebral hemorrhage, recent brain, 75 yrs, diabetes mellitus, prior stroke or adolescent less than 18 year, pregnancy phenytoin, St. John's wort) intraspinal or intracerebral vascular transient ischaemic attack. ii)Treatment & lactation abnormalities, spinal or ophthalmological of deep vein thrombosis (DVT), and surgery, hip fracture surgery, renal and prevention of recurrent DVT and hepatic impairment pulmonary embolism (PE) following an acute DVT in adults. iii) Treatment of Pulmonary Embolism (PE), and prevention of recurrent DVT and pulmonary embolism (PE) following an acute PE in adults.

Rivastigmine 1.5 mg Capsule A* For psychiatrists and neurologists only. Initial dose 1.5 mg 2 times daily, may Nausea, vomiting, anorexia, dizziness, Known hypersensitivity to the drug, Cholinomimetic drugs, History of toxicity (especially excessive Mild to moderately severe dementia increase by 1.5 mg 2 times daily every 2 diarrhoea, abdominal pain, loss of other carbamate derivatives, severe liver anticholinergic medications, cholinergic responses) related to other associated with Alzheimer's or weeks to maximum of 6 mg 2 times daily. appetite, dyspepsia and headache. impairment succinylcholine-type muscle cholinesterase inhibitors (e.g: tacrine), Parkinson's disease If treatment is interrupted for several Potentially Fatal: Serious GI reactions relaxants during anaesthesia. diabetes, cardiovascular/pulmonary days, should be reinitiated at the lowest such as anorexia, vomiting and weight disease, gastrointestinal disorders, daily dose loss concurrent use of agents with anticholinergic activity, urogenital tract obstruction, parkinsonism, pregnancy, renal or hepatic insufficiency, high incidence of nausea and vomiting, concurrent NSAIDs, asthma or obstructive pulmonary disease, anorexia, weight loss, neurological conditions resulting in seizures, extrapyramidal symptoms, tremor, Lactation

Ropinirole HCl 0.25 mg Tablet A* Parkinson disease in younger patients 0.25 mg 3 times daily gradually Dizziness, headache, somnolence, Hypersensitivity to ropinirole, pregnancy Neuroleptics and other centrally Several renal or hepatic failure, and patients with dyskinesias, especially increasing till adequate response nausea, vomiting, dyskinesia, and lactation, hepatic or severe renal active dopamine antagonist, other concomitant use of alcohol, others peak dose dyskinesias obtained up to a maximum of 24 mg/day. hallucinations (dose related), sleep impairment dopamine agonists, ciprofloxacin, central nervous system depressants and Most patients need 3-9 mg/day attacks, postural hypotension, syncope, high dose oestrogen, hormone neuroleptics. Pregnancy. May impair abdominal pain replacement therapy, ability to drive or operate machinery. antiarrhythmias, inhibitors of Withdrawal should be gradual CYP1A2 eg, cimetidine, erythromycin, fluvoxamine, isoniazid, ritonavir and zileuton may increase serum concentrations of ropinirole. Ethanol, kava kava, gotu kola, valerian and St John's wort may increase central nervous system depression

Ropinirole HCl 1 mg Tablet A* Parkinson disease in younger patients 0.25 mg 3 times daily gradually Dizziness, headache, somnolence, Hypersensitivity to ropinirole, pregnancy Neuroleptics and other centrally Several renal or hepatic failure, and patients with dyskinesias, especially increasing till adequate response nausea, vomiting, dyskinesia, and lactation, hepatic or severe renal active dopamine antagonist, other concomitant use of alcohol, others peak dose dyskinesias obtained up to a maximum of 24 mg/day. hallucinations (dose related), sleep impairment dopamine agonists, ciprofloxacin, central nervous system depressants and Most patients need 3-9 mg/day attacks, postural hypotension, syncope, high dose oestrogen, hormone neuroleptics. Pregnancy. May impair abdominal pain replacement therapy, ability to drive or operate machinery. antiarrhythmias, inhibitors of Withdrawal should be gradual CYP1A2 eg, cimetidine, erythromycin, fluvoxamine, isoniazid, ritonavir and zileuton may increase serum concentrations of ropinirole. Ethanol, kava kava, gotu kola, valerian and St John's wort may increase central nervous system depression Rosuvastatin 10 mg Tablet A* Dyslipidaemia not responsive to Initially 5-10 mg once daily (5mg in Pharyngitis, headache, diarrhoea, Active liver disease including elevated Warfarin, vitamin K antagonists, Monitor renal and liver function. atorvastatin 40 mg or equivalent doses of patients with pre-disposing factors to dyspepsia, nausea, myalgia, asthenia, serum transaminases more than 3 times ciclosporin, gemfibrozil, Predisposing factors for myopathy such other statins myopathy), increased if necessary at back pain, flu syndrome, urinary tract upper limit of normal. Severe renal lopinavir/ritonavir, antacids as renal impairment, advanced age, intervals of at least 4 weeks to 20 mg infection, rhinitis, sinusitis, altered liver impairment (creatinine clearance less (aluminium and magnesium hypothyroidism. Acute serious conditions once daily, increased after further 4 function tests, paraesthesia, abdominal than 30 mL/min). Patients with hydroxide), erythromycin, suggestive of myopathy or predisposing weeks to 40 mg daily ONLY in severe pain, flatulence, constipation and myopathy. Patients receiving ketoconazole, spirinolactone, to the development of renal failure hypercholesterolemia with high vomiting. Cognitive impairment (e.g. concomitant ciclosporin. Pregnancy and cimetidine, oral contraceptives, secondary to rhabdomyolysis. cardiovascular risk. Patient of Asian memory loss, forgetfulness, amnesia, lactation digoxin, fenofibrate Concurrent use of fibrates may cause origin, patients on concomitant memory impairment, confusion). severe myositis and myoglobinuria, ciclosporin/fibrate and patients with risk Increase in HbA1c and fasting blood concurrent use of other lipid-lowering factors for myopathy/rhabdomyolysis glucose. therapies including gemfibrozil may (including personal/family history of increase the risk of myopathy muscular disorders/toxicity), the maximum dose should be 20 mg daily

Rosuvastatin 20 mg Tablet A* Dyslipidaemia not responsive to Initially 5-10 mg once daily (5mg in Pharyngitis, headache, diarrhoea, Active liver disease including elevated Warfarin, vitamin K antagonists, Monitor renal and liver function. atorvastatin 40 mg or equivalent doses of patients with pre-disposing factors to dyspepsia, nausea, myalgia, asthenia, serum transaminases more than 3 times ciclosporin, gemfibrozil, Predisposing factors for myopathy such other statins myopathy), increased if necessary at back pain, flu syndrome, urinary tract upper limit of normal. Severe renal lopinavir/ritonavir, antacids as renal impairment, advanced age, intervals of at least 4 weeks to 20 mg infection, rhinitis, sinusitis, altered liver impairment (creatinine clearance less (aluminium and magnesium hypothyroidism. Acute serious conditions once daily, increased after further 4 function tests, paraesthesia, abdominal than 30 mL/min). Patients with hydroxide), erythromycin, suggestive of myopathy or predisposing weeks to 40 mg daily ONLY in severe pain, flatulence, constipation and myopathy. Patients receiving ketoconazole, spirinolactone, to the development of renal failure hypercholesterolemia with high vomiting. Cognitive impairment (e.g. concomitant ciclosporin. Pregnancy and cimetidine, oral contraceptives, secondary to rhabdomyolysis. cardiovascular risk. Patient of Asian memory loss, forgetfulness, amnesia, lactation digoxin, fenofibrate Concurrent use of fibrates may cause origin, patients on concomitant memory impairment, confusion). severe myositis and myoglobinuria, ciclosporin/fibrate and patients with risk Increase in HbA1c and fasting blood concurrent use of other lipid-lowering factors for myopathy/rhabdomyolysis glucose. therapies including gemfibrozil may (including personal/family history of increase the risk of myopathy muscular disorders/toxicity), the maximum dose should be 20 mg daily

Salicylazosulphapyridine A/KK i) Treatment of inflammatory bowel i) ADULT, acute attack 1-2 g 4 times daily Nausea, anorexia, fever, blood disorders Hypersensitivity to sulfonamides and Reduced absorption of folate, Hepatic or renal impairment, G6PD (Sulfasalazine) 500 mg Tablet disease of ulcerative colitis and Crohn's until remission occurs (if necessary (megaloblastic anaemia), hypersensitivity salicylates, acute intermittent porphyria digoxin, antibacterial deficiency, risk of haematological and disease ii) Rheumatoid arthritis corticosteroids may also be given), reactions (including exfoliative and children less than 2 years hepatic toxicity (differential white cell, reducing to a maintenance dose of 500 dermatitis, epidermal necrolysis, red cell and platelet counts initially and mg 4 times daily, CHILD over 2 years, pruritus, photosensitisation, anaphylaxis, at monthly intervals for first 3 months, acute attack 40-60 mg/kg daily, serum sickness, ocular complications liver function tests at monthly intervals maintenance dose 20-30 mg/kg daily ii) (including periorbital oedema), for first 3 months), kidney function tests ADULT, initially; 0.5-1 g/day, increase stomatitis, parotitis, ataxia, aseptic at regular intervals, upper gastro- weekly to maintenance dose of 2 g/day meningitis, vertigo, tinnitus, insomnia, intestinal side-effects common over 4 g in 2 divided doses, maximun 3 g/day. depression, hallucinations, kidney daily, porphyria CHILD over 6 years, juvenile rheumatoid reactions (including proteinuria, arthritis: 30-50 mg/kg/day in 2 divided crystalluria, haematuria), oligospermia, doses up to a maximum of 2 g/day urine may be coloured orange, bone marrow depression, peripheral neuropathy Saxagliptin 2.5 mg Tablet A/KK FUKKM restriction: As add-on therapy for Recommended starting dose and Upper respiratory tract infection, urinary Serious hypersensitivity reactions eg Strong inhibitors of CYP3A4/5 eg Insulin secretagogues, such as patient who failed therapy and/or maintenance dose in patients with tract infection, headache, anaphylaxis, angioedema to any DPP4 ketoconazole, atazanavir, sulfonylureas, cause hypoglycemia. contraindicated/unable to tolerate normal renal function and mild renal nasopharyngitis, peripheral oedema, inhibitor. clarithromycin, indinavir, Therefore, a lower dose of the insulin metformin and/or sulphonylurea. i) As insufficiency (CrCl more than 50 ml/min) hypoglycemia, urticarial, facial edema itraconazole, nefazodone, secretagogue may be required to reduce add on therapy in type 2 diabetes is 5 mg once daily. For patients with and sinusitis. nelfinavir, ritonavir, saquinavir & the risk of hypoglycemia when used in patients inadequately controlled on moderate to severe renal insufficiency telithromycin. combination with saxagliptin. metformin monotherapy and high risk of (CrCl less than or equal to 50 ml/min) Monitoring: HbA1c 3 to 6 monthly. hypoglycaemia, especially elderly dose is 2.5 mg once daily Severe and disabling arthralgia. patients with co-morbidities. ii) As add on Pancreatitis therapy in type 2 diabetes patients inadequately controlled with a sulphonylure and intolerant/contraindicated for metformin therapy iii) As add on therapy in type 2 diabetes patients inadequately controlled on metformin and sulphonylurea combination therapy iv) In patients with renal failure where metformin contraindicated Not to be used in patients with HbA1c > 8% on single/combination OAD, as insulin initiation is preferred.

Saxagliptin 5 mg Tablet A/KK FUKKM restriction: As add-on therapy for 2.5-5mg once daily. Patients with CrCl < Acute pancreatitis, hypersensitivity Serious hypersensitivity reactions eg Strong inhibitors of CYP3A4/5 eg Insulin secretagogues, such as patient who failed therapy and/or 50ml/min, and when coadministered reactions (including anaphylaxis and anaphylaxis, angioedema to any DPP4 ketoconazole, atazanavir, sulfonylureas, cause hypoglycemia. contraindicated/unable to tolerate with strong CYP450 3A4/5 inhibitors: angioedema), upper respiratory tract inhibitor. clarithromycin, indinavir, Therefore, a lower dose of the insulin metformin and/or sulphonylurea. i) As 2.5mg OD infection, urinary tract infection, itraconazole, nefazodone, secretagogue may be required to reduce add on therapy in type 2 diabetes headache, nasopharyngitis, lymphopenia, nelfinavir, ritonavir, saquinavir & the risk of hypoglycemia when used in patients inadequately controlled on rash, peripheral oedema, facial oedema, telithromycin. combination with saxagliptin. Pregnancy, metformin monotherapy and high risk of sinutis. lactation. Severe and disabling arthralgia. hypoglycaemia, especially elderly Pancreatitis. patients with co-morbidities. ii) As add on therapy in type 2 diabetes patients inadequately controlled with a sulphonylure and intolerant/contraindicated for metformin therapy iii) As add on therapy in type 2 diabetes patients inadequately controlled on metformin and sulphonylurea combination therapy iv) In patients with renal failure where metformin contraindicated Not to be used in patients with HbA1c > 8% on single/combination OAD, as insulin initiation is preferred.

Selegiline HCl 5 mg Tablet A* Only for treatment of late stage 5 mg twice daily at breakfast and lunch. Hypotension, nausea, confusion, Extrapyramidal symptoms not related to Hyperpyrexia and central nervous History of peptic ulcer, pregnancy and Parkinsonism with on and off Maximum 10 mg/day agitation, hallucination, dyskinesia, sleep dopamine deficiency, thyrotoxicosis, system toxicity with pethidine. lactation, elderly, concurrent use of phenomenon disturbances, psychosis, constipation, dry narrow angle glaucoma agitated Hypertension and central nervous tricyclic antidepressants, uncontrolled mouth, headache, tremor, dizziness psychosis, hypersensitivity to selegiline system excitation with fluoxetine hypertension. Suicidal ideation and products. Pregnancy and sertraline. Hypotension with behavior or worsening depression, MAOIs. Carbamazepine, increased risk during the first few months amitriptyline, amphetamine of therapy or following changes in dosage (particularly in children, adolescents and young adults with major depressive disorder) Sertraline HCI 50 mg Tablet B Major depression, obsessive-compulsive Depression, obsessive-compulsive Male sexual dysfunction, gastrointestinal Concurrent use or recent use of MAOIs, MAO inhibitors, serotonergic drugs, Concomitant use with tryptophan and disorder (OCD), panic disorder disorder: 50 mg/day, may increase in complain, tremor, dizziness, insomnia, hypersensitivity to sertraline products caffeine/ergotamine, cimetidine, fenfluramine, impaired hepatic function, steps of 50mg at weekly interval, headache, dry mouth, somnolence, lithium, metoprolol, phenytoin, electroconvulsive therapy, abnormal max:200mg/day. Panic disorder: Initially ejaculatory dysfunction, dyspepsia, propranolol, warfarin, digoxin, bleeding, avoid abrupt discontinuation, 25 mg/day. After 1 week, increase dose decreased libido, sweating, anorexia, alcohol, central nervous system hyponatraemia, history of seizures, MAO to 50 mg/day. All dose changes should be agitation, visual disturbances, serotonin depressants, carbamezepine, inhibitors, uricosuric effect. Concomitant made at intervals of more than 1 week, syndrome, withdrawal syndrome, rash, clozapine, cyclosporine, NSAIDs, use of alcohol should be avoided. max: 200 mg/day pharyngitis, purpura, agranulocytosis, aspirin, erythromycin, elevated liver enzyme, antidepressants metoclopramide, tramadol, St. increase the risk of suicidal John's wort, tolbutamide, tricyclic antidepressants, zolpidem, diazepam

Sevelamer 800mg Tablet A* Control of hyperphosphatemia in adult Starting dose is one or two 800mg Most frequently occurring adverse Patients with hypophosphatemia or i) Sevelamer hydrochloride which i) Renal patients with dysphagia, patients receiving haemodialysis and tablets three times per day with meals. reaction in short term, 8 weeks, cross bowel obstruction. contains the same active moiety as swallowing disorders, severe GI motility peritoneal dialysis. Restriction: Adjust by one tablet per meal in two over study were nausea and vomiting. In sevelamer carbonate, decrease disorders including severe constipation Sevelamer carbonate 800mg tablet weeks interval as needed to obtain long term studies with sevelamer bioavailability of ciprofloxacin by or major GI tract surgery have not been should be used in context of multiple serum phosphorus target (1.13 to hydrochloride, which contains the same approximately 50%. ii) During post established. ii) Caution should be therapeutic approach which include 1.78mmol/L). active moiety as sevelamer carbonate, marketing experience, very rare exercised when sevelamer is used in calcium supplement, 1, 25-hydroxy the most common adverse events cases of increased TSH levels have patients with these GI disorders. Vitamin D3 or one of its analogues to included vomiting, nausea, diarrhea, been reported in patients co- control the development of renal bone dyspepsia, abdominal pain, flatulence administered sevelamer disease. and constipation. hydrochloride and levothyroxine. Closer monitoring of TSH levels is therefore recommended in patients receiving both medications. iii) When administering an oral medication where a reduction in the bioavailability of that medication would have a clinically significant effect on its safety or efficacy, the drug should be administered at least one hour before or three hours after sevelamer, or physician should consider monitoring blood levels of the drug. Sildenafil Citrate 20 mg Film-coated A* Treatment of adult patients with ADULTS ≥ 18 years: The recommended Erythema, flushing, indigestion, Concurrent regular or intermittent use of Nitrates, Ritonavir and other Potent Anatomical deformation of the penis Tablet pulmonary arterial hypertension dose is 20mg three times a day. Tablets headache, insomnia, visual disturbance, organic nitrates in any form; hypotensive CYP3A Inhibitors: concomitant use ,concurrent use with other classified as WHO functional class II and should be taken approximately 6 to 8 epistaxis, nasal congestion, rhinitis, effects may be potentiated, concomitant of sildenafil with ritonavir and other phosphodiesterase 5 inhibitors is not III, to improve exercise capacity. Efficacy hours apart with or without food. cardiovascular morbidity, myocardial use of HIV protease inhibitors, potent CYP3A inhibitors is not recommended, concomitant use with has been shown in primary pulmonary ELDERLY (≥65 years): Dosage infarction (rare ), sickle cell anemia with hypersensitivity to sildenafil or any of its recommended, other drugs that strong CYP3A inhibitors is not hypertension and pulmonary adjustments are not required in elderly vasoocclusive crisis, non-arteritic components reduce blood pressure: alpha recommended, conditions adversely hypertension associated with connective patients. Clinical efficacy as measured by ischemic optic neuropathy, retinal blockers, amlodipine. Monitor affected by vasodilatory effects (eg, tissue disease. 6-minute walk distance could be less in haemorrhage, decreased hearing, blood pressure when co- resting hypotension, fluid depletion, elderly patients. IMPAIRED RENAL sudden onset sudden hearing loss, administering blood pressure severe left ventricular outflow FUNCTION: Initial dose adjustments are priapism (infrequent), prolonged erection lowering drugs with sildenafil obstruction, or autonomic dysfunction); not required in patients with renal of penis (infrequent). may be potentiated, coronary artery impairment, including severe renal disease causing unstable angina, hearing impairment (creatinine clearance impairment; hypertension (blood <30ml/min). A downward dose pressure greater than 170/110), adjustment to 20 mg twice daily should myocardial infarction, stroke, or life- be considered after a careful benefit-risk threatening arrhythmia within the last 6 assessment only if therapy is not well- months, non-arteritic anterior ischemic tolerated. IMPAIRED HEPATIC optic neuropathy has been reported, FUNCTION: Initial dose adjustments are priapism has been reported, pulmonary not required in patients with hepatic hypertension secondary to sickle cell impairment (Child-Pugh class A and B). A anemia; increased risk of veno-occlusive downward dose adjustment to 20mg crisis requiring hospitalization, twice daily should be considered after a pulmonary veno-occlusive disease; careful benefit-risk assessment only if pulmonary vasodilators may significantly therapy is not well-tolerated. worsen cardiovascular status, retinitis pigmentosa; genetic disorders of retinal phosphodiesterases may be present

Simvastatin 10 mg Tablet B Hypercholesterolaemia and coronary 10 - 20 mg once daily. Maximum: 80 mg Abdominal pain, flatulence, constipation, Hypersensitivity to simvastatin products, May cause slight elevation of Heavy alcohol use, history of liver heart disease intolerant or not daily asthenia and headache, rarely hepatitis, active liver disease, pregnancy and serum digoxin. Cholestyramine and disease. Discontinue therapy if serum responsive to other forms of therapy hypersensitivity syndrome, upper lactation colestipol increase bioavailability of transaminase levels rise to 3 times upper respiratory infection. Cognitive simvastatin. Increased limit of normal and are persistent. May impairment (e.g. memory loss, concentrations with mibefradil cause myopathy and renal failure due to forgetfulness, amnesia, memory rhabdomyolysis. Concomitant impairment, confusion), increase in administration of fibrates, nicotinic acid, HbA1c and fasting blood glucose. immunosuppressives including ciclosporin, macrolide antibiotics (erythromycin, clarithromycin), itraconazole and ketoconazole or nefazodone may increase the risk of myopathy

Simvastatin 40 mg Tablet B Hypercholesterolaemia and coronary 10 - 20 mg once daily. Maximum: 80 mg Abdominal pain, flatulence, constipation, Hypersensitivity to simvastatin products, May cause slight elevation of Heavy alcohol use, history of liver heart disease intolerant or not daily asthenia and headache, rarely hepatitis, active liver disease, pregnancy and serum digoxin. Cholestyramine and disease. Discontinue therapy if serum responsive to other forms of therapy hypersensitivity syndrome, upper lactation colestipol increase bioavailability of transaminase levels rise to 3 times upper respiratory infection. Cognitive simvastatin. Increased limit of normal and are persistent. May impairment (e.g. memory loss, concentrations with mibefradil cause myopathy and renal failure due to forgetfulness, amnesia, memory rhabdomyolysis. Concomitant impairment, confusion), increase in administration of fibrates, nicotinic acid, HbA1c and fasting blood glucose. immunosuppressives including ciclosporin, macrolide antibiotics (erythromycin, clarithromycin), itraconazole and ketoconazole or nefazodone may increase the risk of myopathy Sodium Valproate 200 mg Tablet B i. Epilepsy ii. Treatment and prevention i. Epilepsy: ADULT: Initially 600 mg/day in Nausea, vomiting, headache, dizziness, Increases phenobarbital, primidone and Increases phenobarbital, primidone Avoid sudden withdrawal, certain of mania associated with bipolar 2 - 3 divided doses, dose may be ataxia, tremor, weight gain, transient hair phenytoin free form plasma and phenytoin plasma metabolic disorders, fatigue, loss of disorders increased by 200 mg at 3-day intervals to loss, oedema, thrombocytopenia, concentrations. Potentiates toxic effect concentrations. Potentiates toxic appetite, vomiting. Pregnancy and max 2.5 g/day. Usual maintenance dose: leukopenia. Liver dysfunction, of carbamazepine. Risk of rash may be effect of carbamazepine. Risk of lactation. Avoid concomitant use of 1-2 g/day (20-30 mg/kg/day). CHILD: gastrointestinal disorders increased by coadministration with rash may be increased by salicylates in children less than 3 years More than 20 kg. Initially 400 mg/day lamotrigine. May potentiate the effect of coadministration with lamotrigine. due to risk of liver toxicity, use of with spaced increases until control is antipsychotics, MAOIs, antidepressants May potentiate the effect of salicylates in children less than 16 years achieved (usually 20-30 mg/kg/day), and benzodiazepines. Monitor neuroleptics, MAOIs, is also not recommended. Monitor liver dose may be increased to 35 mg/kg/day. prothrombin time when used with antidepressants and function before therapy and during first 6 Less than 20 kg 20 mg/kg/day, in severe anticoagulants. Caution when used with benzodiazepines. Potentiate effects months. Potential for an increase in risk cases the dose may be increased newer anti-epileptics whose of MAOIs. Monitor prothrombin of suicidal thoughts or behaviours. provided plasma concentration can be pharmacodynamics are not well- time when used with Pancreatitis, renal insufficiency, SLE, monitored. ii. Treatment and prevention established. Zidovudine, mefloquine, anticoagulants. Caution when used hyperammonaemia, diabetic patients, of mania associated with bipolar chloroquine, imipenam, meropenam with newer anti-epileptics whose weight gain Female children, female disorders: Adults: The recommended pharmacodynamics are not well- adolescents, women of childbearing initial dose is 1000mg/day. The dose established potential, pregnancy (due to high should be increased as rapidly as possible teratogenic potential and risk of to achieve the lowest therapeutic dose, developmental disorders in infants which produces the desired clinical exposed in utero to valproate) effects. The recommended maintenance dosage for the treatment of bipolar disorder is between 1000mg and 2000mg daily. In exceptional cases, the dose may be increased to not more than 3000mg daily.

Solifenacin Succinate 5 mg Tablet A* Symptomatic treatment of urge 5mg od. Dose can be increased to 10mg Dry mouth, constipation, headache, and Solifenacin is contraindicated in patients Atazanavir, clarithromycin, Angioedema of the face, lips, tongue, and incontinence and/or increased urinary if necessary. blurred vision with urinary retention, patients with indinavir, itraconazole, larynx, potentially life-threatening, has frequency and urgency as may occur in uncontrolled narrow-angle glaucoma, ketoconazole, nefazodone, been reported. Bladder outflow patients with overactive bladder patients who have demonstrated nelfinavir, potassium chloride, obstruction, clinically significant; risk of syndrome. hypersensitivity to the drug substance or ritonavir, saquinavir, telithromycin. urinary retention. Gastrointestinal other components of the product, severe Max dose is 5mg/day when given motility, decreased. Hepatic impairment, gastro-intestinal condition (including with ketoconazole or other potent (Child-Pugh score 7-9); dosage not to toxic megacolon and gastric retention), CYP3A4 inhibitor. exceed 5mg/day. Hepatic impairment. myasthenia gravis, patients undergoing Narrow-angle glaucoma. QT interval haemodialysis, patients with severe prolongation has been reported. Renal hepatic impairment, patients with severe impairment, severe (CrCl less than 30 renal impairment or moderate hepatic mL/min); dosage adjustment impairment and who are on treatment recommended. with a potent CYP3A4 inhibitor, e.g. ketoconazole

Spironolactone 25 mg Tablet B Oedema and ascites in cirrhosis of the ADULT: 100 - 200 mg daily in divided Headache, drowsiness, gastrointestinal Hypersensitivity, hyperkalaemia, renal Angiotensin converting enzyme Hyperkalaemia or progressive renal liver, congestive heart failure doses. Increase to 400 mg if required. disturbances including cramp and failure, anuria, patients receiving other inhibitors, ciclosporin: failure, impaired hepatic or renal CHILD: initially 3 mg/kg daily in divided diarrhoea, ataxia, mental confusion, potassium-sparing diuretics or potassium hyperkalaemia. Aspirin: decreased function, diabetes mellitus, patients likely doses hirsutism, deepening of the voice, supplements spironolactone effectiveness. to develop acidosis. Pregnancy and menstrual irregularities, impotence, skin Digoxin: digoxin toxicity (nausea, lactation rashes, hyponatraemia, hyperkalaemia vomiting, cardiac arrhythmias). NSAIDs: reduced diuretic effectiveness, hyperkalaemia Strontium Ranelate 2 g Granules- A* Treatment of postmenopausal 2 g sachet once daily Headache, disturbances in Hypersensitivity to strontium ranelate or Food, milk and derivative products, Not recommended for patient with CrCl osteoporosis to reduce risk of vertebral consciousness, memory loss, venous to any of the excipients. Current or medicinal products containing <30ml/min, use with caution in patients and hip fractures when biphosphonates thromboembolism (VTE), nausea, previous venous thromboembolic events calcium, may reduce the at increased risk of venous are contraindicated or not tolerated diarrhea, loose stools, dermatitis, (VTE), including deep vein thrombosis bioavailability of strontium ranelate thromboembolism (VTE), including past eczema, blood creatine phosphokinase and pulmonary embolism. Temporary or by approximately 60-70%. Therefor history of VTE, patient should be (CPK) increased. Severe skin side effects : permanent immobilisation due to e.g. administration of strontium and informed to stop strontium immediately DRESS, SJS and TEN Interaction : Food, post-surgical recovery or prolonged bed such product should be seperated and permanently when a rash occurs and milk and derivative products, medicinal rest. Established, current or past history by at least 2 hours. Strontium seek medical advice. Strontium contains products containing calcium, may reduce of iscchaemic heart disease, peripheral ranelate treatment should be a source of phenylalanine, which may be the bioavailability of strontium ranelate arterial disease and/or cerebrovascular suspended during treatment with harmful for people with phenylketonuria by approximately 60-70%. Therefor disease. Uncontrolled hypertension. oral tetracycline and quinolone administration of strontium and such antibiotics. product should be seperated by at least 2 hours. Strontium ranelate treatment should be suspended during treatment with oral tetracycline and quinolone antibiotics.

Sulfadoxine 500 mg and B Treatment of Plasmodium falciparum Chloroquine resistant falciparum malaria Rash, pruritus, contact dermatitis, Severe renal or hepatic impairment, Increased halofantrine and Discontinue if skin reactions occur. Avoid Pyrimethamine 25 mg Tablet malaria in patients in whom chloroquine acute attack Adult: Per tab contains urticaria, nausea and feeling of fullness, blood dyscrasias, hypersensitivity to chlorpromazine levels. Increased excessive exposure to sunlight. Analysis resistance is suspected and malaria pyrimethamine 25 mg and sulfadoxine headache. Rarely, Steven-Johnson and components, megaloblastic anaemia due effects of warfarin.Increased risk of for crystalluria during prolonged prophylaxis for travellers to areas where 500 mg: 2-3 tabs as a single dose. Do not Lyell's syndromes, blood dyscrasias, liver to folate deficiency, pregnancy at term myelosupression with zidovudine, prophylaxis therapy is recommended, chloroquine-resistant malaria is endemic repeat for at least 7 days. Child: cell damage, agranulocytosis, aplastic and during lactation, infants ≤ 2 mth old. clozapine. Lorazepam. impaired renal or hepatic function, Pyrimethamine 25mg + Sulfadoxine anaemia, thrombocytopenia, hepatitis, sulfamethoxsazole, trimethoprim. periodic blood counts are recommended, 500mg (Tablet): <2 yr (5-10 kg): 1/2 (half) nephrotoxicity possible folate deficiency, severe allergic tab as a single dose; 2-5 yr (>10-20 kg): 1 or bronchial asthma tab as a single dose; 5-10 yr (< 20-30 kg): 1 1/2 (one and half) tab as a single dose; 10-14 yr (> 30-45 kg): 2 tab as a single dose. Do not repeat for at least 7 days. Renal impairment: Dose reduction may be needed. Severe: contra-indicated. Hepatic impairment: Dose reduction may be needed. Severe: contra-indicated.

Sulphamethoxazole 400 mg & B i) Severe or complicated infections due to i) ADULT: 1 - 3 tablets twice daily ii) Gastrointestinal upsets, stomatitis, Marked liver parenchymal damage, Increased risk of thrombocytopenia Haematological disorders, elderly, Trimethoprim 80 mg Tablet susceptible infection ii) Treatment and Treatment: ADULT & CHILD over 4 glossitis and skin rashes, tinnitus, blood dyscrasias, severe renal with thiazide diuretics in elderly. pregnancy, lactation, G6PD deficiency, prophylaxis of pneumocystis carinii weeks: 120 mg/kg/day in 2 - 4 divided erythema multiforme, Stevens-Johnson impairment, pregnancy, hypersensitivity. May require dosage reduction of folate deficiency, impaired renal function pneumonia (PCP) in doses for 14 days. Prophylaxis: ADULT: syndrome, Lyell's syndrome, leucopenia, Use with caution in premature babies or warfarin and phenytoin. May immunocompromised patients 960 mg once daily or 960 mg on alternate neutropenia, thrombocytopenia, full-term infants in the neonatal period displace methotrexate from plasma days (3 times a week) or 960 mg twice agranulocytosis, megaloblastic anaemia, protein binding sites. Increased risk daily on alternate days (3 times a week). pancytopenia or purpura, hyperkalaemia of venticular arrhythmias with CHILD; 6 weeks - 5 months: 120 mg twice amiodarone daily on 3 consecutive days or 7 days per week; 6 months - 5 years: 240 mg; 6 - 12 years: 480 mg Sulpiride 200 mg Tablet B Acute and chronic schizophrenia, chronic 200-400 mg twice daily; 800 mg daily in Extrapyramidal syndrome, drowsiness, Hypersensitivity to sulpiride, Tramadol, increased risk of Cardiovascular disease, manic or delusional psychoses predominantly negative symptoms and dry mouth, urinary retention, phaeochromocytoma, prolactin seizures. Other central nervous hypomanic patients, renal insufficiency, 2.4 g daily in mainly positive symptoms. tachycardia, postural hypotension, dependent tumour, in combination with system depressants, alcohol, neuroleptic malignant syndrome, Elderly, lower initial dose; increased dizziness, galactorrhoea, gynaecomastia, sultopride and dopamine agonists apart levodopa. Dopamine agonists, hyperthyroidism, pulmonary disease, gradually according to response. Child amenorrhoea, sedation, somnolence. from in patients with Parkinson's disease, sultopride, halofantrine, urinary retention, previous under 14 years not recommended Early dyskinesia, tardive dyskinesia, lactation, levodopa, class Ia and III pentamidine, sparfloxacin, hypersensitivity to other benzamide sedation or drowsiness, transient antiarrhythmics, certain neuroleptics moxifloxacin, bradycardiac agents, derivatives eg. metoclopramide, elderly hyperprolactinemia, weight gain, QT (thioridazine, chlorpromazine, hypokalaemic agents, patients. Pregnancy, lactation, interval prolongation, orthostatic levomepromazine, trifluoperazine, antihypertensives, if treatment Parkinson's disease. May be exacerbated hypotension, neuroleptic malignant cyamemazine, amisulpride, tiapride, with neuroleptics is necessary in by the presence of bradycardia, syndrome pimozide, haloperidol, droperidol), patients with Parkinson's disease hypokalaemia, a long QT which is either bepridil, cisapride, diphemanil, receiving treatment with dopamine congential or acquired (due to erythromycin, mizolastine, vincamine, agonists, the latter must be combination with a medicinal product halofantrine, pentamidine, sparfloxacin, gradually reduced and then increasing the QT interval). Do not use in moxifloxacin discontinued the event of congential galactosaemia, glucose/galactose malabsorption syndrome or lactase deficiency and children less than 6 year. Parkinson's disease, renal impairment, epileptic patients. Avoid alcohol

Tamoxifen Citrate 20 mg Tablet A Breast cancer 20 mg in 1-2 divided doses. Max: 40 Menopausal symptoms, fluid retention, Hypersensitivity to Tamoxifen. Pregnancy Warfarin, allopurinol, ciclosporin, Caution in patients with leukopenia, mg/day peripheral oedema, nausea, vomiting, and lactation, pulmonary embolus bromocriptine, rifampicin, thrombocytopenia, retinopathy or with myelosuppression, tumour flare, history, history of deep vein thrombosis clopidogrel, cyclophosphamide, family/past history of hypercoagulable endometrial hyperplasia, polyps and fluorouracil, methotrexate, states or thromboembolic disease. Pelvic small risk of endometrial cancer, visual mitomycin, concurrent use with examination should be carried out for disturbance including corneal changes, letrozole may result in reduced patients on long term use of tamoxifen cataracts and retinopathy letrozole serum concentrations, aminoglutethimide may decrease tamoxifen plasma concentrations

Tamsulosin HCl 400 mcg Extended A* Second line treatment of functional 400 mcg once daily Abnormal ejaculation, reduced libido, History of orthostatic hypotension, Drugs which may reduce blood Patients receiving antihypertensive Release Tablet symptoms of benign prostatic priapism, intra-operative floppy iris severe hepatic insufficiency, pressure, cimetidine, fluoxetine, treatment, elderly patients, hepatic and hyperplasia (BPH) in patients who do not syndrome (IFIS), dizziness, syncope, hypersensitivity to Tamsulosin HCl or any ketoconazole, sildenafil renal impairment, during cataract tolerate first line drugs or when first line palpitations, postural hypotension, other component of the product surgery (risk of intra-operative floppy iris drugs are inappropriate or rhinitis, vomiting, constipation, syndrome) contraindicated diarrhoea, rash, angioedema, asthenia, drowsiness, blurred vision

Telmisartan 80 mg Tablet A/KK i)Hypertension in patients who cannot i) 40mg - 80mg once daily ii) 80mg once Headache, dizziness, upper respiratory Hypersensitivity to telmisartan products, Potassium-sparing diuretics, Angioedema (associated with aspirin and tolerate ACE inhibitors because of cough daily infection and cough pregnancy and renal artery stenosis, potassium supplements, salt or penicillin allergy), discontinue with ii)Reduction of the risk of myocardial lactation, biliary obstructive disorders, substitutes containing potassium or laryngeal stridor or angioedema of the infarction, stroke, or death from severe hepatic impairment other medicinal products that may face, tongue or glottis. Aortic or mitral cardiovascular causes in patients 55 cause hyperkalaemia (esp digoxin, valve stenosis, biliary cirrhosis or biliary years or older at high risk of developing lithium) May increase hypotensive obstruction, coronary artery disease and major cardiovascular events who are effect of other antihypertensive elderly, biliary obstructive disorders or unable to take ACE inhibitors hepatic insufficiency, Patient with diabetes mellitus & coronary artery disease (CAD). Tenofovir Disoproxil Fumarate 300 A/KK Treatment of HIV-1 infection in adults in 1 tablet once daily. Nausea, vomiting, diarrhoea, abdominal Hypersensitivity to tenofovir or Increased plasma level of tenofovir Liver impairment; caution in Hepatitis B mg & Emtricitabine 200 mg Tablet combination with other antiretroviral pain, dyspepsia, flatulence, pain, emricitabine. and reduced plasma levels of other virus (HBV) coinfection, may result in agents (such as non-nucleoside reverse hypersensitivity, increased pigmentation, agent: atazanavir, lopinavir (both severe and acute exacerbation or flare up transcriptase inhibitors or protease asthenia, osteonecrosis, osteomalacia, have to be co-administered with of hepatitis on discontinuation of inhibitors). metabolic abnormalities (e.g. ritonavir). Increased adverse events treatment. Renal impairment; dosing hyperglycaemia, insulin resistance, of other agent: didanosine. adjustment required in CrCl < 50ml/min, hypercholesterolaemia, Increased risk of nephrotoxicity not recommended if CrCl < 30ml/min. hypertriglyceridaemia, when used with other nephrotoxic Avoid co-administration of nephrotoxic hyperlactataemia), lipodystrophy, agents (e.g. aminoglycosides, agents. Lactation, avoid breast feeding. elevated lipase, amylase, creatine kinase vancomycin, etc). Increased plasma Avoid co-administration of lamivudine. or transaminases levels, level when used with other agents hyperbilirubinaemia, insomnia, abnormal excreted renally by active tubular dreams, neutropenia, anaemia, immune secretion (e.g. probenecid). reactivation syndrome, renal impairment, acute renal failure, fanconi syndrome.

Tenofovir Disoproxil Fumarate 300 A* i)Treatment of HIV-1 infected adults in 300mg once daily. Renal Dose Diarrhoea, nausea, vomiting, abdominal Lactation. Do not co-administer with Decreased atazanavir Renal impairment. Hepatomegaly or at mg Tablet combination with other antiretroviral Adjustment: 300mg every 48hours (30- pain, flatulence, dyspepsia, anorexia, skin fixed dose combinations containing concentration with tenofovir unless risk for liver disease. Elderly and agents. ii)Use as first line monotherapy 49ml/min); 300mg every 72hours (10- rash, peripheral neuropathy, headache, tenofovir. also co-administered with ritonavir. pregnancy. Discontinue therapy if there for chronic hepatitis B or as a rescue 29ml/min); 300mg every 7 days after dizziness, insomnia, depression, Increased serum concentration of is a rapid rise in aminotransferase therapy for patients with drug resistance dialysis (Hemodialysis) dyspnoea, asthenia, sweating, myalgia, tenofovir or co-administered drug if concentrations, progressive hepatitis B virus (according to resistant myopathy, body fat redistribution, taken with drugs that are hepatomegaly or steatosis, metabolic or profile or treatment guidelines). osteomalacia. Hypophosphataemia, eliminated by active tubular lactic acidosis of unknown cause. raised amylase and liver enzymes, secretion.Potentially Fatal: Monitor creatinine clearance and serum hepatitis, hypertriglyceridaemia, Increased risk of renal impairment phosphorus routinely in patients at risk hyperglycaemia, neutropenia, nephritis, with recent or concurrent use of of renal impairment. Bone monitoring for nephrogenic diabetes insipidus, renal nephrotoxic agents (e.g. patients with history of pathologic bone impairment, proximal tubulopathy, aminoglycosides, amphotericin B, fracture or at risk of osteopenia. Test for Fanconi syndrome, immune foscarnet, ganciclovir, pentamidine, presence of chronic hepatitis b virus reconstitution syndrome. Potentially vancomycin, cidofovir or interleukin- (HBV) before initiating therapy. If Fatal: Lactic acidosis with severe 2); monitor renal function wkly if tenofovir is discontinued in patients co- hepatomegaly with steatosis; severe unavoidable. Increased didanosine infected with HIV and HBV, monitor acute exacerbations of hepatitis B. Acute levels and thereby increasing risk of hepatic function for several month for renal failure. pancreatitis and peripheral exacerbation of hepatitis. Monitor child neuropathy, with a high treatment exposed in utero to combination drug for failure rate with concurrent use; possible mitochondrial dysfunction. avoid concurrent use. Terazosin HCl 1 mg Tablet A/KK Only for treatment of Benign Prostatic Initially 1 mg at night, increased in a Tachycardia, dizziness, syncope, Hypersensitivity to terazosin products or In patients currently on beta Carcinoma of the prostate and benign Hyperplasia. Not to be used for stepwise fashion to 2 mg, 5 mg or 10 mg headache and asthenia, nasal congestion, other quinazolines blockers, the first dose response prostatic hyperplasia may cause the treatment of hypertension once daily drowsiness, nausea, peripheral edema, (marked initial drop in blood same symptoms. Prostate cancer should postural hypotension. pressure, particularly on standing) be ruled out prior to treatment. to an alpha-1 adrenergic blocking Dizziness, lightheadedness, orthostatic drug may be exaggerated. hypotension, syncope (first-dose effect). Concomitant therapy with Patients advised to avoid driving or doing ibuprofen and antihypertensive hazardous tasks for the first 12 hours agents has been reported to result after the initial dose or when dose is in increases in blood pressure and increased. interference with blood pressure control

Terazosin HCl 2 mg Tablet A/KK i) Treatment of Benign Prostatic i)Initially 1 mg at night, increased in a Tachycardia, dizziness, syncope, Hypersensitivity to terazosin products or In patients currently on beta Carcinoma of the prostate and benign Hyperplasia. ii)Hypertension stepwise fashion to 2 mg, 5 mg or 10 mg headache and asthenia, nasal congestion, other quinazolines blockers, the first dose response prostatic hyperplasia may cause the once daily. ii)Initial: 1mg once daily at drowsiness, nausea, peripheral edema, (marked initial drop in blood same symptoms. Prostate cancer should bedtime, Maintenance: 1-5mg once postural hypotension. pressure, particularly on standing) be ruled out prior to treatment. (morning or evening) or twice daily. Max: to an alpha-1 adrenergic blocking Dizziness, lightheadedness, orthostatic 20-40mg/day drug may be exaggerated. hypotension, syncope (first-dose effect). Concomitant therapy with Patients advised to avoid driving or doing ibuprofen and antihypertensive hazardous tasks for the first 12 hours agents has been reported to result after the initial dose or when dose is in increases in blood pressure and increased. interference with blood pressure control

Testosterone 250 mg/ml Injection A* Only for treatment of male infertility, By IM only. Hypogonadism 250 mg every High doses : oedema, reversible Androgen-dependent carcinoma of the Phenobarbital, concurrent Regular examinations of the prostate in protein deficiency during convalescence 2-3 weeks. To maintain an adequate interruption or reductions in prostate and mammary gland in males, administration with coumarin man. Therapy must be discontinued if after surgery and wasting disorder. In androgenic effect 250 mg every 3-6 spermatogenesis in the testicles and a hypercalcaemia accompanying malignant derivatives may result in bleeding women with mammry carcinoma women, supplementary therapy of weeks. Potency disorders 250 mg every 4 corresponding reduction in testicle size. tumours, patient who have previously develop hypercalcaemia under the progressive mammary carcinoma weeks. Male climateric disorders: 250 mg Gynecomastia. Women : signs of experienced hypersensitivity reaction to hormonal treatment. every 3-4 weeks. Repeated 6-8 weeks masculinisation (virilisation) eg. Acne, the product courses at 2-3 months interval male-pattern hair growth (hirsutism), loss of hair (alopecia) and voice changes.

Theophylline 250 mg Long Acting B Reversible airways obstruction and acute ADULT: 250 mg 2 times daily. CHILD Gastric irritation,nausea, vomiting, Hypersensitivity to theophylline Azole antifungals,macrolides, Patients with reduced thyroid function, Tablet severe asthma under 12 years : Up to 10 mg/kg body anorexia, epigastric pain,reactivation of quinolones, oral contraceptives, congestive heart failure, acute weight 2 times daily peptic ulcer, gasro esophageal reflux, disulfiram, interfereon alpha and pulmonary oedema,chronic obstructive haematemesis, tachycardia, palpiation, verapamil, cimetidine, high dose pulmonary disease, severe hypoxia, headache, CNS stimulation, reflex allopurinol pneumonia, acute febrile episodes, viral hyperexcitability, insomnia and tremor. infection, impaired liver function: Other possible reactions include reduced theophylline clearance. Patients diarrhea, extrasystoles, flushing, with cardiac arrythmias, coronary artery hypotension, tachypnoea, potentiation of disease, unstable angina, diuresis, albuminuria, haematuria, rash, cardiomyopathy and severe hyperglycemia, hypokalaemia, alopecia, hypertension.Patients with peptic ulcer inappropriate ADH secretion(high dose), disease or gastro esophageal reflux. more serious signs of high serum Concomitant medication use which levels(usually above 30 microgram/mL) results in reduced theophylline such as cardiac arrythmias and clearance. convulsions, may appear without prior warning

Thiamine Mononitrate 10 mg Tablet C For the prevention or treatment of i) Mild to chronic deficiency: 10-25 mg Contact dermatitis, chronic pigmented Hypersensitivity to thiamine or any Alkaline solutions, bicarbonates, Not known Vitamin B1 deficiency syndromes daily ii) Severe deficiency: 200- 300 mg purpura, skin rash, itching component carbonates, citrates, erythromycin including beri-beri and peripheral neuritis daily lactobionate, iron salts, associated with pellagra methohexital, neutral solutions, alkaline barbiturate solutions (eg phenobarbital, thiopental) Tibolone 2.5 mg Tablet A* Treatment of complaints resulting from 2.5mg daily Endometrial hyperplasia and endometrial Hypersensitivity to tibolone, breast Enhances the effect of Women with hormone dependent the natural or surgical menopause & in carcinoma (rare), change in body weight, cancer (known or suspected), oestrogen- anticoagulants such as warfarin tumours, cardiovascular or cases at high risk for breast carcinomas vaginal bleeding, gastrointestinal upsets, dependent neoplasms, cerebrovascular since Tibolone can increase blood cerebrovascular disorders including where general hormone replacement changes in liver parameters, increased disease, history of stroke, arterial fibrinolytic activity.Concurrent thrombophlebitis, thromboembolic therapy is contraindicated facial hair growth, pretibial oedema and disease, thromboembolic disorders, administration of tibolone and processes or a history of these arthralgia or myalgia. history of cholestatic jaundice, hepatic tacrolimus may lead to increased conditions, undiagnosed vaginal bleeding tumours (benign or malignant), abnormal tacrolimus toxicity and severe liver disorders. Liver disease. vaginal bleeding Patients with hypercholesterolaemia and impaired glucose tolerance. Stop tibolone 4 weeks before elective surgery when prolonged immobilisation after surgery is likely

Ticagrelor 90 mg Tablet A* a)Patient who failed clopidogrel Initially, 180mg as single dose followed Dyspnoea, epistaxis; GI haemorrhage; SC Active pathological bleeding,history of CYP3A4 inhibitors; CYP3A4 inducers Patients at risk of bleeding eg recent readmitted to hospital with recurrent by 90mg bd with maintenance dose of or dermal bleeding, bruising; procedural intracranial haemorrhage, moderate to (rifampicin, carbamazepine, trauma, recent surgery, coagulation atherothrombotic event while patients ASA 75-150 mg daily. site haemorrhage. severe hepatic impairment, co- dexamethasone, phenytoin, disorders, active or recent GI bleeding; are on clopidogrel. b) ACS patients with:i) administration with strong CYP3A4 phenobarb); simvastatin; cisapride concomitant administration of NSAIDs, STEMI - going for invasive (PCI), ii) inhibitors (eg ketoconazole, or ergot alkaloids, digoxin, oral anticoagulants &/or fibrinolytics; NSTEMI/UA - intermediate to high risk clarithromycin, nefazodone, ritonavir, cyclosporin; β-blockers, Ca-channel surgery. Patients at risk for bradycardic (based on TIMI score). iii) Other atazanavir) blockers. events. Asthma/COPD. History of complicated ACS cases treated either hyperuricaemia or gouty arthritis. medically or invasively via PCI or CABG Pregnancy & lactation. (risk of Stent thrombosis, 3VD etc.)

Ticlopidine HCl 250 mg Tablet A/KK i) Prevention of thrombotic stroke for 250 mg twice daily taken with food Minor gastrointestinal disorders. Rarely Hypersensitivity to ticlopidine or its Any drugs likely to produce Predisposition to bleeding, including patients who are sensitive /intolerant to cutaneous allergic manifestations, components, patients with active coagulation gastric or duodenal ulcers. Underlying Acetysalicylic Acid ii) Maintenance of thrombocytopenia, cholestatic icterus bleeding disorders. Neutropenia or haematologic disorders. Concomitant coronary bypass surgery or angioplasty and or rise in transaminases. thrombocytopenia, severe liver oral anticoagulant therapy or iii) Maintenance of patency of access in Neutropenia and thrombocytopenia impairment nonsteroidal antiinflammatory agents patients on chronic haemodialysis (monitor full blood count weekly initially) (including aspirin). Liver disease, patients undergoing lumbar puncture or surgical procedure. Ticlopidine should be discontinued if the absolute neutrophil count falls below 1200/mm3 or if the platelet count falls below 80,000/mm3. If possible, ticlopidine should be discontinued 10 to 14 days prior to surgery

Tolterodine Tartrate ER 4 mg Capsule A* Treatment of overactive bladder with 4 mg once daily. May decrease to 2 mg Mild to moderate antimuscarinic effects, Urinary retention, uncontrolled narrow Erythromycin, clarithromycin, Significant bladder outlet obstruction, symptoms of urinary, frequency or urge once daily depending on response and dryness of mouth, dyspepsia, reduced angle glaucoma, toxic megacolon, metoclopramide, cisapride gastrointestinal obstruction disorders, incontinence tolerability lacrimation myasthenia gravis. Pregnancy and renal disease, hepatic disease, autonomic lactation neuropathy, hiatus hernia, concomitant treatment with CYP3A4 inhibitors

Topiramate 25 mg Tablet A* Add-on therapy for intractable partial ADULT: Initially 25-50mg nightly for 1 Cognitive dysfunction, sedation, Hypersensitivity to topiramate CNS depressants, oral Avoid abrupt withdrawal, hepatic or epilepsy week. Subsequently at wkly or bi-wkly diarrhoea, weight loss, dizziness, contraceptives, lithium, renal impairment, behavioral disorders or intervals, increase dose by 25-50 to abdominal pain, nausea, anorexia, propranolol, diltiazem. Plasma cognitive deficit, paraesthesia, 100mg/day in 2 divided doses. CHILD confusion, impaired speech, ataxia, concentration decreased by predisposition to or history of aged 2 and above: Approx 5-9 mg/kg/day drowsiness, fatigue, asthenia, visual phenytoin and carbamazepine. nephrolithiasis, pregnancy, lactation. in 2 divided doses. Titrate at 25mg (or disturbances, nystagmus, taste disorder, Ensure adequate hydration. May impair less, based on a range of 1-3mg/kg/day) leucopenia, renal calculi, somnolence and ability to drive or operate machinery. nightly for the 1st week. Subsequently at paraesthesia Potential for an increase in risk of suicidal 1 or 2 wkly intervals, with increments of thoughts or behaviours. Acute myopia 1-3 mg/kg/day in 2 divided dose. and secondary angle closure glaucoma. Topiramate 50 mg Tablet A* Add-on therapy for intractable partial ADULT: Initially 25-50mg nightly for 1 Cognitive dysfunction, sedation, Hypersensitivity to topiramate CNS depressants, oral Avoid abrupt withdrawal, hepatic or epilepsy week. Subsequently at wkly or bi-wkly diarrhoea, weight loss, dizziness, contraceptives, lithium, renal impairment, behavioral disorders or intervals, increase dose by 25-50 to abdominal pain, nausea, anorexia, propranolol, diltiazem. Plasma cognitive deficit, paraesthesia, 100mg/day in 2 divided doses. CHILD confusion, impaired speech, ataxia, concentration decreased by predisposition to or history of aged 2 and above: Approx 5-9 mg/kg/day drowsiness, fatigue, asthenia, visual phenytoin and carbamazepine. nephrolithiasis, pregnancy, lactation. in 2 divided doses. Titrate at 25mg (or disturbances, nystagmus, taste disorder, Ensure adequate hydration. May impair less, based on a range of 1-3mg/kg/day) leucopenia, renal calculi, somnolence and ability to drive or operate machinery. nightly for the 1st week. Subsequently at paraesthesia Potential for an increase in risk of suicidal 1 or 2 wkly intervals, with increments of thoughts or behaviours. Acute myopia 1-3 mg/kg/day in 2 divided dose. and secondary angle closure glaucoma.

Tramadol HCl 50 mg Capsule A/KK Moderate to severe acute or chronic pain ADULT: 50mg initially, can take another Sweating, dizziness, vomiting, dry mouth, Narcotic withdrawal treatment, Amitryptiline, chlorpromazine, Reduced level of consciousness, (eg. Post-operative pain, chronic cancer 50mg after 30 - 60 min if pain not gastrointestinal disturbances, cerebral hypersensitivity, acute alcoholism. Acute clozapine, dothiepin, fluoxetine, respiratory disorders, increased pain and analgesia/pain relief for patients relieved. Max 400 mg daily. CHILD: convulsions especially on co-medication intoxication with alcohol, analgesics, fluvoxamine, haloperidol, intracranial pressure, pregnancy, with impaired renal function) 1mg/kg/dose repeated every 6 hours with neuroleptics, physical dependence. sedatives or psychotropic drugs. MAOI risperidone, sertraline, sulpiride, lactation, history of epilepsy. Opiate (Max: 2mg/kg/dose and 100mg/dose) Rarely, palpitations, tachycardia, therapy (within the 14 days of last thioridazine, trifluoperazine: dependence, hypersensitivity to faintness, circulatory collapse, discontinuation) increased risk of seizures. morphine-like analgesics, children less headaches, constipation, skin reactions. Moclobemide, selegiline: nausea, than 1 year. Myxedema, hypothyroidism Very rarely, muscular weakness, altered vomiting, cardiovascular collapse, or hypoadrenalism. Hepatic or renal appetite, micturition disturbances respiratory depression, seizures. function disorders. May impair ability to Carbamazepine: decreased drive or machinery operation (alcohol). tramadol efficacy. Digoxin: increased risk of digoxin toxicity (nausea, vomiting, cardiac arrhythmias). Increased incidence of seizures when used with tricyclic antidepressants eg cyclobenzaprine, MAOI, SSRIs, neuroleptic agents and other drugs that lower the seizure threshold

Tranexamic Acid 250 mg Capsule B Haemorrhage associated with excessive ADULT: 1-1.5 g (15-25 mg/kg) 2-4 times Nausea, vomiting, diarrhoea, Severe renal impairment, Anti-inhibitor coagulant complex, Cardiovascular disease, cerebrovascular fibrinolysis daily. CHILD: 25 mg/kg/day 2-3 times hypotension, thrombosis, disturbances in thromboembolic disease, intravascular oral contraceptive, oestrogen, disease, concomitant antifibrinolytic daily. Menorrhagia (initiated when colour vision clotting process, disturbance of colour tretinoin therapy. Concomitant therapy with menstruation has started), 1 g 3 times vision and subarachnoid haemorrhage oestrogens or thrombolytics. Renal daily for up to 4 days; maximum 4 g daily impairment and transurethral prostatectomy (potential for intravesicular clotting) Trifluoperazine HCI 5 mg Tablet B Psychotic disorder ADULT: Initially 5 mg twice daily, increase Seizures, extrapyramidal effects, blood Coma, bone marrow depression, Tramadol, increased risk of Tardive dyskinesias may develop, by 5 mg after 1 week, then at 3-day dyscrasias, agranulocytosis, neuroleptic hypersensitivity to trifluoperazine seizures. Lithium, weakness, concomitant lithium therapy intervals. Maximum 40 mg/day. CHILD malignant syndrome, dry mouth, products and other phenothiazines, pre- dyskinesias, increased (encephalopathic syndrome), may up to 12 years: Initially up to 5 mg daily in constipation, orthostatic hypotension, existing liver damage, central nervous extrapyramidal symptoms, increase anginal pain, neuroleptic divided doses adjusted to response, age blurred vision, tardive dyskinesia, urinary system depression encephalopathy and brain damage. malignant syndrome, glaucoma or and body weight retention, photosensitivity, rash, nausea, Procyclidine, decreased retinopathy. If affected by drowsiness do tachycardia, dizziness, fatigue, headache, phenothiazine serum not drive or operate machinery. weight gain, jaundice, dystonic reaction concentrations and effectiveness, cardiovascular or respiratory disease, in children, sensitivity reactions eg enhanced anticholinergic effects phaeochromocytoma, parkinsonism, agranulocytosis, leucopenia, leucocytosis (ileus, hyperpyrexia, sedation, dry epilepsy, renal or hepatic impairment, and haemolytic anaemia mouth). Phenytoin, increased or pregnancy and lactation decresed phenytoin levels and possibly reduced phenothiazine levels. Ethanol, increased central nervous system depression and an increased risk of extrapyramidal reactions. Amphotericins, class Ia and III antiarrhythmics, beta2 agonists, acetazolamide, central alpha2 agonists, systemic corticosteroids, diuretics, MAOIs, tricyclic antidepressants

Trimetazidine 20 mg Tablet B Prophylactic treatment of episodes of 20 mg 3 times daily Gastrointestinal disorders such as nausea Concomitant administration with MAOIs Not known Pregnancy especially first trimester, angina pectoris and vomiting unstable angina, hypertension, renal or hepatic insufficiency

Triprolidine HCl 2.5 mg and B Decongestion of the upper respiratory ADULT 2.5 mg every 4 - 6 hours; Drowsiness, sleep disturbances, skin Angle-closure glaucoma, hypersensitivity Antihypertensives, tricyclic Diabetes, hypertension, heart disease, Pseudoephedrine HCl 60 mg Tablet tract in common cold, hay fever, allergic maximum dose 10 mg/day. CHILD (syrup) rashes, dryness of nose, mouth and to triprolidine products, Children less antidepressants, decongestants, hyperthyroidism, elevated intraocular and vasomotor rhinitis and aerotitis 6 - 12 years : 1.25 mg every 4 - 6 hours; throat, hypotension or hypertension, than 2 years of age. appetite suppresants, pressure, prostatic enlargement, asthma, maximum dose 5 mg/day 4 - 6 years : tachycardia, anorexia, nausea, vomiting, amphetamine-like psychostimulant, chronic obstructive pulmonary disease, 0.938 mg every 4 - 6 hours; maximum constipation, diarrhoea, abdominal pain, other sympatomimetics prostatic hypertrophy, pyloric dose 3.744 mg/day 2 - 4 years : 0.625 mg wheezing, tightness of chest, impotence, obstruction, stenosing peptic ulcer. May every 4 - 6 hours; maximum dose 2.5 blurred vision, urinary retention impair ability to drive or operate mg/day machinery. To be used with caution and doctor's advice in children 2 to 6 years of age.

Ursodeoxycholic Acid 250 mg A Cholestatic liver diseases (eg. primary 10-15 mg/kg daily in 2 to 4 divided doses Nausea, vomiting, diarrhoea, gallstone Radio-opaque stones, pregnancy, non- Absorption decreased by Hepatic enzymes (alanine and aspartate Capsule biliary cirrhosis, primary cholangitis etc) usually for 3 months to 2 years. If there is calcification, pruritus, pulpy stools functioning gall bladder, chronic liver cholestyramine, colestipol or transaminase) should be monitored upon no decrease in stone size after 18 disease, peptic ulceration, inflammatory aluminium hydroxide containing the initiation of therapy and thereafter as months, further treatment seems not to diseases and other conditions of the antacids. Should not be used with indicated by the particular clinical be useful small intestine, colon and liver which drugs such as oestrogenic circumstances interfere with enterohepatic circulation hormones that increase bile of bile salts cholesterol Valproic Acid and Sodium Valproate B i) In the treatment of generalized or i) Adults: Dosage should start at 500mg Nausea, vomiting, headache, dizziness, Hepatic disease or significant hepatic Increases phenobarbital, primidone Haematological, Renal insufficiency, (ER) 500mg Tablet partial epilepsy, particularly with the daily increasing by 200mg at three-day ataxia, tremor, weight gain, transient hair dysfunction, hypersensitivity to valproate and phenytoin plasma Systemic lupus erythematosus, following patterns of seizures:absence, intervals until control is achieved. This is loss, oedema, thrombocytopenia, sodium, valproic acid or divalproex concentrations. Potentiates toxic Hyperammonaemia: very commonly myoclonic, tonic-clonic, atonic-mixed as generally within the dosage range leukopenia. Liver dysfunction, sodium, porphyria effect of carbamazepine. Risk of causes weight gain, which may be well as, for partial epilepsy:simple or 1000mg to 2000mg per day. Children: gastrointestinal disorders rash may be increased by marked and progressive. Patients should complex seizures, secondary generalized >20KG: 500mg/day (irrespective of coadministration with lamotrigine. be warned of the risk of weight gain at seizures, specific syndrome (West, weight) with spaced increases until May potentiate the effect of the initiation of therapy and appropriate Lennox-Gastatut). ii) Treatment and control is achieved. ii) Initial dose of antipsychotics, MAOIs, strategies should be adopted to minimize prevention of mania associated with 1000mg/day, to be increase rapidly as antidepressants and it . Female children, female adolescents, bipolar disorders. possible to achieve lowest therapeutic benzodiazepines. Monitor women of childbearing potential, dose, which produce desired clinical prothrombin time when used with pregnancy (due to high teratogenic effects. Recommend initial dose is anticoagulants. Caution when used potential and risk of developmental 1000mg & 2000mg daily. Max dose with newer anti-epileptics whose disorders in infants exposed in utero to 3000mg daily. pharmacodynamics are not well- valproate) established, zidovudine, mefloquine, chloroquine, imipenam, meropenem.

Varenicline Tartrate 0.5 mg and 1 mg A/KK Smoking cessation treatment 0.5 mg once daily for Day 1-3, then 0.5 Constipation, flatulence, nausea, Hypersensitivity to varenicline or any Cimetidine, insulin, theophylline, Serious neuropsychiatric symptoms, Tablet mg twice daily for Day 4-7, then 1 mg vomiting, dream disorder, headache, other product component transdermal nicotine severe renal impairment, smoking twice daily; duration of treatment is 12 insomnia, psychiatric disorders cessation may alter the pharmacokinetics weeks (depression), suicidal thoughts or pharmacodynamics of some drugs including theophylline, warfarin and insulin, intolerable nausea; dose reduction should be considered

Varenicline Tartrate 1 mg Tablet A/KK Smoking cessation treatment 0.5 mg once daily for Day 1-3, then 0.5 Constipation, flatulence, nausea, Hypersensitivity to varenicline or any Cimetidine, insulin, theophylline, Serious neuropsychiatric symptoms, mg twice daily for Day 4-7, then 1 mg vomiting, dream disorder, headache, other product component transdermal nicotine severe renal impairment, smoking twice daily; duration of treatment is 12 insomnia, psychiatric disorders cessation may alter the pharmacokinetics weeks (depression), suicidal thoughts or pharmacodynamics of some drugs including theophylline, warfarin and insulin, intolerable nausea; dose reduction should be considered

Venlafaxine HCl 150 mg Extended A* i) Depression ii) Generalized anxiety i), ii) & iii) ADULT: 75 mg once daily. May Abnormal ejaculation, anorgasmia, Recent or concomitant use of MAOIs, risk Clozapine, dexfenfluramine, History of MI or unstable heart disease. Release Capsule disorder iii) Social anxiety disorder (social increase dose by 75 mg/day every 4 days impotence, anorexia, constipation, of potentially life-threatening serotonin droperidol, fenfluramine, Routine BP monitoring is advisable. phobia) iv) Panic disorder to a maximum dose of 225 mg/day, weight loss, diarrhoea, dyspepsia, syndrome hypersensitivity to venlafaxine haloperidol, linezolid, lithium, Preexisting HTN. History of convulsions, (severe depression: max: 375mg/day) iv) anxiety, dizziness, insomnia, hydrochloride or any other component of metoclopramide, moclobemide, bipolar disorder, aggression. Patients 37.5 mg/day for the first 4-7 days after nervousness, somnolence, tremor, the product NSAIDs, procarbazine, selegiline, predisposed to bleeding. Monitor serum which the dose should be increased to 75 asthenia, abnormal bleeding, activation thioridazine, tramadol, cholesterol during long-term treatment. mg once daily. CHILD and ADOLESCENT of mania, suicide ideation, hepatitis, trifluoperazine, amoxicillin, aspirin, Elderly patients taking diuretics, vol under 18 years not recommended. hypertension, hyponatraemia, seizures, celecoxib ,diclofenac, etoricoxib, depletion or dehydration. May impair sweating symptom, nausea, dream ginkgo, NSAIDs, jujube ,ketoprofen, ability to drive or operate machinery. disorder, headache, blurred vision ketorolac, mefenamic acid, Avoid abrupt w/drawal. Childn <18 yr. meloxicam, mirtazapine, Pregnancy & lactation. Renal or hepatic phenylbutazone, procarbazine, impairment. sulindac, zolpidem Venlafaxine HCl 75 mg Extended A* i) Depression ii) Generalized anxiety i), ii) & iii) ADULT: 75 mg once daily. May Abnormal ejaculation, anorgasmia, Recent or concomitant use of MAOIs, risk Clozapine, dexfenfluramine, History of MI or unstable heart disease. Release Capsule disorder iii) Social anxiety disorder (social increase dose by 75 mg/day every 4 days impotence, anorexia, constipation, of potentially life-threatening serotonin droperidol, fenfluramine, Routine BP monitoring is advisable. phobia) iv) Panic disorder to a maximum dose of 225 mg/day, weight loss, diarrhoea, dyspepsia, syndrome hypersensitivity to venlafaxine haloperidol, linezolid, lithium, Preexisting HTN. History of convulsions, (severe depression: max: 375mg/day) iv) anxiety, dizziness, insomnia, hydrochloride or any other component of metoclopramide, moclobemide, bipolar disorder, aggression. Patients 37.5 mg/day for the first 4-7 days after nervousness, somnolence, tremor, the product NSAIDs, procarbazine, selegiline, predisposed to bleeding. Monitor serum which the dose should be increased to 75 asthenia, abnormal bleeding, activation thioridazine, tramadol, cholesterol during long-term treatment. mg once daily. CHILD and ADOLESCENT of mania, suicide ideation, hepatitis, trifluoperazine, amoxicillin, aspirin, Elderly patients taking diuretics, vol under 18 years not recommended hypertension, hyponatraemia, seizures, celecoxib ,diclofenac, etoricoxib, depletion or dehydration. May impair sweating symptom, nausea, dream ginkgo, NSAIDs, jujube ,ketoprofen, ability to drive or operate machinery. disorder, headache, blurred vision ketorolac, mefenamic acid, Avoid abrupt w/drawal. Childn <18 yr. meloxicam, mirtazapine, Pregnancy & lactation. Renal or hepatic phenylbutazone, procarbazine, impairment. sulindac, zolpidem

Verapamil HCl 40 mg Tablet B i) Supraventricular tachyarrhythmias ADULT: 40 - 80 mg 3-4 times daily. In oral Constipation, dizziness, nausea or Cardiovascular shock, complicated acute Increased risk of myocardial First degree AV block, bradycardia, (SVT) prophylaxis ii) angina long term therapy, max: 480 mg daily vertigo, headache, hypotension, ankle myocardial shock, severe conduction depression with beta-blockers or hypotension. May impair ability to drive oedema, flushing, fatigue, nervousness, disorders (2nd and 3rd degree AV block, inhalation anaesthetic. May or operate machinery. Pregnancy, paraesthesia, bradycardiac arrhythmias, SA block), sick sinus syndrome, heart increase plasma digoxin lactation. Severe hepatic impairment. dyspnoea, raised prolactin levels, single failure, atrial fibrillation/flutter and concentration and plasma Slows down markedly the elimination of cases of galactorrhoea, myalgia, simultaneous preexcitation syndrome, cyclosporin concentration alcohol and prolongs the duration of arthralgia, allergic skin reactions, myasthenia gravis, pregnancy, not alcohol purpura, photosensitisation dermatitis, recommended in lactation. gynaecomastia, reversible increase in transaminases and or alkaline phosphatase, gingival hyperplasia, tachycardia, palpitations, impotence, tinnitus, tremor, heart failure Vildagliptin 50 mg Tablet A/KK FUKKM restriction: As add-on therapy for ADULT over 18 years: 50mg bd when Tremor, dizziness, headache, nausea, Hypersensitivity to vildagliptin or to any Low potential for interactions with Vildagliptin is not a substitute for insulin patient who failed therapy and/or combine with metformin, 50 mg od when asthenia, hypoglycaemia, weight of the excipients. co-administered medicinal in insulin-requiring patients. Vildagliptin contraindicated/unable to tolerate combine with sulphonylurea increase, oedema peripheral, products. Since vildagliptin is not a should not be used in patients with type metformin and/or sulphonylurea. i) As hyperhidrosis, decreased blood glucose, cytochrome P (CYP) 450 enzyme 1 diabetes or for the treatment of second line therapy in type 2 diabetes headache, chills, gastro-oesophageal substrate and dose not inhibit or diabetic ketoacidosis. Renal Impairment. patients inadequately controlled on reflux disease. induced CYP 450 enzymes, it is not Hepatic impairment. Liver enzyme maximal tolerated dose of metformin likely to interact with active monitoring. Cardiac failure. Skin monotherapy and high risk of substances that are substrate, disorders. Pancreatitis. Hypoglycaemia. hypoglycaemia. ii) As second line therapy inhibitors or inducers of these Patients receiving vildagliptin in in type 2 diabetes patients inadequately enzymes. Hypoglycaemic effect of combination with a sulphonylurea may controlled on maximal tolerated dose of vildagliptin may be reduced by be at risk of hypoglycaemia. Pregnancy, sulphonylurea and certain active substances including lactation. intolerant/contraindicated for metformin thiazides, corticosteroids, thyroid therapy. iii) As third line therapy in type 2 products, sympathomimetics. diabetes patients inadequately controlled with dual OAD combination therapy with sulphonylurea and metformin iv) As a monotherapy in type 2 diabetes mellitus patients inadequately controlled by diet and exercise alone and for whom metformin is inappropriate due to contraindications or intolerance. v) An adjunct to diet and exercise to improve glycaemic control in patients with type 2 diabetes mellitus: As a dual therapy in combination with insulin in patients with insufficient glycaemic control. Insulin dose and regimen should be optimized before addition of vildagliptin.

Vitamin B Complex Tablet C+ Prophylaxis and treatment of vitamin B 1-2 tablets daily Skin rashes or itching in allergic persons. Sensitivity to thiamine and Alcohol may inhibit absorption of Not for treatment of pernicious anaemia deficiency Nicotanamide in large doses may cause nicotinamide.Nicotanamide in large these vitamins or other megaloblastic anaemias where liver disease and active peptic ulcer. doses may cause liver disease and active vitamin B12 is deficient peptic ulcer. Thiamine: Weniche's encephalopathy. Vitamin B1, B6, B12 Tablet B For deficiency or raised requirement of 1 - 3 tablets 3 times daily swallowed Hypersensitivity reactions to vitamin B1 Hypersensitivity to any of the active The effect of Levodopa may be Regular monitoring is recommended for Vitamin B1, B6, B12 unchewed. ingredients or excipients reduced when vitamin B6 is long-term treatment. Neurobion film- administered concomitantly. coated tablets contain lactose and Pyridoxine-Antagonists eg, sucrose; therefore, its use is not Isoniazid, Cycloserine, recommended in patients with Penicillamine, Hydralazine: The intolerance to some sugars. Pregnancy efficacy of vitamin B6 (pyridoxine) and lactation (high doses of vitamin B6 may be decreased. Loop Diuretics ie, >600 mg daily, may inhibit the eg, Furosemide: In long-term use, production of breast milk) the blood level of thiamine may be reduced.

Vortioxetine 10mg Tablet A* Treatment of major depressive episodes 10mg once daily in adults less than 65 Nausea, decreased appetite, abnormal Hypersensitivity to the active substance Vortioxetine is extensively Suicide/suicidal thoughts or clinical in adults. years of age. Depending on the individual dreams, dizziness, diarrhoea, or to any of the excipients. Concomitant metabolized in the liver, primarily worsening, seizures, serotonin syndrome patient response, the dose may be constipation, vomiting, generalized use with non-selective monoamine through oxidation catalysed by or neuroleptic malignant syndrome, increased to a maximum of 20mg pruritus. oxidase inhibitors (MAOIs) or selective CYP2D6 and to a minor extend mania/hypomania, haemorrhage, vortioxetine once daily or decreased to a MAO-A inhibitors. CYP3A4/5 and CYP2C9, and hyponatraemia, renal Impairment, minimum of 5mg vortioxetine once daily. subsequent glucuronic acid hepatic impairment, elderly & paediatric After the depressive symptoms resolve, conjugation. No inhibitory or populations, pregnancy & lactation. treatment for at least 6 months is inducing effect of vortioxetine was recommended for consolidation of the observed in the drug-drug anti-depressive response. interaction studies for the CYP isozymes CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 or CYP3A4/5. Vortioxetine is a poor P-gp substrate and Warfarin Sodium 1 mg Tablet B Treatment and prophylaxis of Initially 10 mg daily for 2 days. Haemorrhage, alopecia, fever, Haemorrhagic tendencies, pregnancy, Activity potentiated by cimetidine, Severe to moderate hepatic or renal thromboembolic disorders Maintenance dose, 3-9 mg daily gastrointestinal disorders, blood dyscrasias, hypersensitivity to clofibrate, co-trimoxazole, insufficiency, concomitant use of according to the INR (taken at the same hypersensitivity reactions, `purple toes'. warfarin products erythromycin, quinidine, antiplatelet drugs or drugs with time each day) Occasionally skin necrosis (obese elderly phenylbutazone, sulfonamides, ulcerogenic activity. Surgery and dental patients), jaundice, hepatic dysfunction, amiodarone, rifampicin, extraction, congestive heart failure. nausea, vomiting, pancreatitis carbamazepine, phenytoin, azole Concurrent use with thrombolytic drugs, antifungals, metronidazole. Drugs known or suspected protein C deficiency. which may increase risk of bleeding Moderate to severe hypertension, severe including aspirin, NSAIDs, diabetes, severe allergic or anaphylactic dipyridamole, clopidrogel, disorders. Patients with hyperthyroidism ticlopidine or hypothyroidism may have a substantially altered response to warfarin. Avoid concurrent use with herbal medicines and limit Vitamin K rich vegetables

Warfarin Sodium 2 mg Tablet B Treatment and prophylaxis of Initially 10 mg daily for 2 days. Haemorrhage, alopecia, fever, Haemorrhagic tendencies, pregnancy, Activity potentiated by cimetidine, Severe to moderate hepatic or renal thromboembolic disorders Maintenance dose, 3-9 mg daily gastrointestinal disorders, blood dyscrasias, hypersensitivity to clofibrate, co-trimoxazole, insufficiency, concomitant use of according to the INR (taken at the same hypersensitivity reactions, `purple toes'. warfarin products erythromycin, quinidine, antiplatelet drugs or drugs with time each day) Occasionally skin necrosis (obese elderly phenylbutazone, sulfonamides, ulcerogenic activity. Surgery and dental patients), jaundice, hepatic dysfunction, amiodarone, rifampicin, extraction, congestive heart failure. nausea, vomiting, pancreatitis carbamazepine, phenytoin, azole Concurrent use with thrombolytic drugs, antifungals, metronidazole. Drugs known or suspected protein C deficiency. which may increase risk of bleeding Moderate to severe hypertension, severe including aspirin, NSAIDs, diabetes, severe allergic or anaphylactic dipyridamole, clopidrogel, disorders. Patients with hyperthyroidism ticlopidine or hypothyroidism may have a substantially altered response to warfarin. Avoid concurrent use with herbal medicines and limit Vitamin K rich vegetables Warfarin Sodium 5 mg Tablet B Treatment and prophylaxis of Initially 10 mg daily for 2 days. Haemorrhage, alopecia, fever, Haemorrhagic tendencies, pregnancy, Activity potentiated by cimetidine, Severe to moderate hepatic or renal thromboembolic disorders Maintenance dose, 3-10 mg daily gastrointestinal disorders, blood dyscrasias, hypersensitivity to clofibrate, co-trimoxazole, insufficiency, concomitant use of according to the INR (taken at the same hypersensitivity reactions, `purple toes'. warfarin products erythromycin, quinidine, antiplatelet drugs or drugs with time each day) Occasionally skin necrosis (obese elderly phenylbutazone, sulfonamides, ulcerogenic activity. Surgery and dental patients), jaundice, hepatic dysfunction, amiodarone, rifampicin, extraction, congestive heart failure. nausea, vomiting, pancreatitis carbamazepine, phenytoin, azole Concurrent use with thrombolytic drugs, antifungals, metronidazole. Drugs known or suspected protein C deficiency. which may increase risk of bleeding Moderate-severe hypertension, severe including aspirin, NSAIDs, diabetes, severe allergic or anaphylactic dipyridamole, clopidrogel, disorders. Patients with hyperthyroidism ticlopidine or hypothyroidism may have a substantially altered response to warfarin. Avoid concurrent use with herbal medicines and limit Vitamin K rich vegetables

Zidovudine 100 mg Capsule A/KK i) Management of patients with i) HIV infection Adult: 600 mg daily in Anaemia, neutropenia, leucopenia, Abnormally low neutrophil cell count Increased haematological toxicity Monitor carefully haematological asymptomatic and symptomatic (early or divided doses, in combination with other nausea, headache, rash, abdominal pain, (less than 0.75 x 109/L) or abnormally with IV pentamidine, lamivudine, parameters. If anaemia or advanced) HIV infections with CD4 cell antiretroviral agents. Child: 6 wk - 12 yr: fever, myalgia, paraesthesia, vomiting, low Hb levels (less than 7.5 g/dL). dapsone, vancomycin flucytosine, myelosuppression occurs dose counts less than 500 cu. mm ii) Neonatal 160 mg/m2 every 8 hr. Max: 200 mg insomnia and anorexia, asthenia, Hypersensitivity to zidovudine. New born amphotericin, ganciclovir, adjustments are suggested. Patients with prophylaxis every 8 hr. May be used in combination malaise, somnolence, diarrhoea, infants with hyperbilirubinaemia rifampicin, interferon alfa, pre-existing bone marrow compromise. with other anti-retrovirals. Renal and dizziness, sweating, dyspnoea, dyspepsia, requiring treatment other than cyclophosphamide and other with Pregnancy and lactation. Renal and Hepatic impairment: Dose reduction may flatulence, bad taste, chest pain, loss of phototherapy, or increased transaminase bone marrow suppressive or hepatic impairment. be needed. ii) Prophylaxis of HIV mental acuity, anxiety, urinary frequency, levels of over five times than the upper cytotoxic agents. Increased risk of infection in neonates Child: Neonates: 2 depression, generalised pain, chills, limit of normal. zidovudine toxicity with mg/kg every 6 hr for 1st 6 wk of life, cough, urticaria, pruritus and flu-like atovaquone, chloramphenicol, starting within 12 hr after birth. Renal syndrome fluconazole, valproate. Decreased and hepatic impairment: Dose absorption with clarithromycin. adjustment may be needed. Increased zidovudine concentration and increased potential for hypersensitivity reactions with probenecid. Increased incidences of headache with benzodiazepines Avoid stavudine (due to inhibition of activation of stavudine), didanosine, ribavirin (antagonize effect of zidovudine) with zidovudine.

Zidovudine 300 mg & Lamivudine A/KK HIV infection in combination with at least ADULT and CHILD over 12 years: 1 tablet Nausea, vomiting, diarrhoea, abdominal Abnormally low neutrophil cell count Trimethoprim, phenytoin, Advanced cirrhotic liver disease due to 150 mg Tablet one other antiretroviral drug twice daily pain, cough; headache, fatigue, insomnia, (less than 0.75 x 109/L) or abnormally paracetamol, aspirin, codeine, chronic hepatitis B infection. Severe malaise, fever, rash, alopecia, muscle low Hb levels (less than 7.5 g/dL). morphine, indomethacin, hepatic or renal impairment. Monitor disorders, peripheral neuropathy, Hypersensitivity to zidovudine. New born ketoprofen, naproxen, oxazepam, haematological parameters. Pregnancy pancreatitis, neutropenia, anaemia, infants with hyperbilirubinaemia lorazepam, cimetidine, clofibrate, and lactation. thrombocytopenia and red-cell aplasia, requiring treatment other than dapsone and isoprinosine, lactic acidosis, raised liver enzymes and phototherapy, or increased transaminase potentially nephrotoxic or serum amylase, somnolence, dizziness, levels of over five times than the upper myelosuppressive drugs, ribavirin sweating, dyspnoea, dyspepsia, limit of normal. flatulence, bad taste, chest pain, loss of mental acuity, anxiety, urinary frequency, depression, generalised pain, chills, urticaria, pruritus and flu-like syndrome.

zinc oxide, benzyl benzoate and C For relief of pruritus, burning and Insert 1 suppository night and morning Local irritation Hypersensitivity to any component of Not known Not for prolonged use. Use in children is balsam peru suppository soreness in patients with haemorrhoids after bowel movements; do not use for preparation not recommended and perianal conditions longer than 7 days OR please refer to the product insert. Zolpidem Tartrate 10 mg Tablet A For treatment of insomnia 10-mg tablet daily. Stilnox should always Nausea, dizziness, dependence, vertigo, Obstructive sleep apnoea, acute Alcohol, analgesics, Depression, drug or alcohol abuse, be taken just before going to bed. In headache, drowsiness, myalgias, pulmonary insufficiency, respiratory antidepressants, anticoagulants, hepatic impairment, avoid prolonged use elderly patients or patients with hepatic dyspepsia, dry mouth, lethargy, flu-like depression, myasthenia gravis, severe sedating antihistamines, in elderly, lactation, renal impairment, insufficiency: Dosage should be halved ie, symptoms, depression, constipation, hepatic impairment, psychotic illness, antipsychotics, benzodiazepines, abrupt discontinuation, central nervous 5 mg. Dosage must never exceed 10 ataxia, hallucinations pregnancy, breastfeeding, central alpha 2 agonists, ethanol, system effects, drowsiness, hallucination mg/day. hypersensitivity opiate agonists/antagonists, itraconazole, sertraline, rifampicin, ritonavir, venlafaxine

Zuclopenthixol 20 mg/ml Drops A* Only for psychoses with insight or Acute Schizophrenia and Other Acute Extrapyramidal syndrome, drowsines, Severe central nervous system Alcohol, barbiturates and central Previous hypersensitivity to other compliance Psychoses; Severe Acute States of anticholinergic effect, tachycardia, depression, coma, blood dyscrasias, nervous system depressant, neuroleptic agents, particularly Agitation; Mania: Oral treatment: Usually postural hypotension, dizziness, tardive phaeocromocytoma. Previous tricyclic antidepressant, thioxanthenes, fluphenazine, and 10-50 mg/day. In moderate to severe dyskinesia, urinary retention, disturbed hypersensitivity to zuclopenthixol or metoclopramide - increased effect perphenazine. Hepatic or renal disease or cases initially 20 mg/day increased, if accommodation, tachycardia clopenthixol. Comatose states, acute cardiovascular disease, pregnancy, necessary, by 10-20 mg/day every 2-3 alcohol, barbiturate and opiate breastfeeding, epileptic or parkinsonian days to ≥75 mg daily. intoxication. Pregnancy patients or organic brain syndrome. Patients on long-term therapy should be monitored carefully. May affect ability to drive or operate machinery

Acetazolamide 500 mg Injection B Reduction of intra-ocular pressure in Adult : 250-1000mg per 24hours, usually Nausea, vomiting, diarrhoea, taste Hypokalaemia, hyponatraemia, Aspirin, cyclosporin, digitalis, Not generally recommended for open-angle glaucoma, secondary in divided doses for amounts over 250mg disturbances, loss of appetite, hyperchloraemic acidosis, severe hepatic digoxin, lithium, phenytoin, prolonged use but if given monitor blood glaucoma and peri-operatively in angle- daily paraesthesia, flushing, headache, impairment, renal impairment, quinidine, topiramate count and plasma electrolyte closure glaucoma dizziness, fatigue, irritability, depression, sulphonamide hypersensitivity, Addison's concentration, pulmonary obstruction thirst, polyuria, reduced libido, metabolic disease, chronic non-congestive angle- (risk of acidosis), elderly, pregnancy and acidosis and electrolyte disturbances on closure glucoma lactation, Stevens-Johnson syndrome, long-term therapy toxic epidermal necrosis, high-dose aspirin, high dose may decrease diuresis and may increase drowsiness, pulmonary obstruction or emphysema, diabetes

Acetylcysteine 200 mg/ml Injection A* Antidote for paracetamol poisoning Diluted with dextrose 5% and infused IV. Anaphylactic reactions, urticaria, Hypersensitivity to acetylcysteine Carbamazepine : increased risk of Asthma, history of bronchospasm and Initial, 150 mg/kg IV in 200 ml over 60 angioedema, bronchospasm, nausea, products, children under 2 years of age subtherapeutic carbamazepine risk of anaphylactoid reactions and minutes, then 50 mg/kg IV in 500 ml over vomiting, tachycardia, dizziness, fever levels. Nitroglycerin : enhanced history of peptic ulceration 4 hours, followed by 100 mg/kg IV in hypotension and nitroglycerin- 1000 ml over 16 hours. Total dose: induced headache. Penicillin G, 300mg/kg in 20 hour tetracycline : loss of antibiotic efficacy

Acriflavine 0.1% Lotion C+ Infected skin, lesions, cuts, abrasions, Apply undiluted three times daily to the Hypersensitivity to acriflavine compound Hypersensitivity to acriflavine compound. Not known Prolonged application, may stain skin, wounds and burns. affected part . hair & fabric. Acyclovir 250 mg Injection A* Treatment and prophylaxis of herpes ADULT: 5 mg/kg by IV infusion 8 hourly Skin rashes; GI effects, neurological Patients known to be hypersensitivity to Increased mean half-life & plasma In patients receiving Zovirax IV at higher simplex in immunocompromised, severe for 5 days, doubled to 10mg/kg every 8 reactions (IV infusion) acyclovir concentration with probenecid doses, specific care regarding renal initial genital herpes and Varicella -Zoster hourly in varicella-zoster in the function should be taken, particularly immunocompromised and in simplex when patients are dehydrated or have encephalitis (usually given for at least 10 any renal impairment days in encephalitis; possibly for 14 - 21 days). NEONATE & INFANT up to 3 months with disseminated herpes simplex: 20mg/kg every 8 hourly for 14 days (21 days in CNS involvement), varicella- zoster 10-20mg/kg every 8 hourly usually for 7 days. CHILD, 3 months - 12 years: Herpes simplex or Varicella Zoster: 250 mg/m2 8 hourly for 5 days, doubled to 500 mg/m2 8 hourly for varicella-zoster in the immunocompromised and in simplex encephalitis (usually given for 10 days in encephalitis)

Acyclovir 3% Eye Ointment A* Only for the treatment of herpes simplex Apply 1 cm 5 times daily. Continue for at Local irritation and inflammation Hypersensitivity to acyclovir Not known Not known keratitis least 3 days after healing reported , vision abnormalities Acyclovir 5% Cream A* Herpes simplex infections of the skin, Apply every 4 hours for 5 - 10 days Transient burning or stinging or Hypersensitivity to acyclovir or Not known Application to mucous membranes, including initial and recurrent labial and erythema, mild drying or flaking of the valacyclovir pregnancy, lactation. Should not be used genital herpes simplex infections skin in the eyes

Adenosine 3 mg/ml Injection B Rapid conversion of paroxysmal ADULT: Initially: 3 mg given as a rapid IV Facial flush, dyspnoea, a feeling of Bradycardia, bronchoconstrictive or Actions may be potentiated by Avoid concomitant use of dipyridamole supraventricular tachycardia to sinus bolus (over 2 seconds). Second dose: If thorasic constriction, nausea, bronchospastic lung disease (eg. dipyridamole and carbamazepine. and methylxanthines (eg: caffeine, rhythm the first dose does not result in lightheadedness, feeling of discomfort, asthma). Hypersensitivity to adenosine, Theophylline & caffeine inhibit its theophylline). Cardiac arrest, heart block, elimination of the supraventricular sweating, palpitations, hyperventilation, second-degree or third-degree AV block action heart transplant patients, hypertension, tachycardia with in 1 or 2 minutes, 6 mg head pressure, apprehension, blurred (unless pacemaker fitted), sinus node hypotension, myocardial infarction. should be given also as a rapid IV bolus. vision, burning sensation, bradycardia, disease (eg. sick sinus syndrome) Proarrhythmic events; new rhythms, Third dose: If the second dose does not chest pains, headache, dizziness, particularly at time of conversion and result in elimination of the heaviness in arms, arm, back and neck unstable angina supraventicular tachycardia with in 1-2 pains; metallic taste minutes, 12 mg should be given also as a rapid IV bolus

Adrenaline Acid (Epinephrine) B Cardiopulmonary resuscitation 1 mg by intravenous injection repeated Hypertension, arrhythmias, nausea, Cardiac dilatation, coronary insufficiency. Beta-blocking,alpha-adrenergic Elderly patients, patients with; CV Tartrate 1 mg/ml Injection every 3-5 minutes according to response vomiting, headache, shortness of breath, Within 2 weeks of MAOI use.Organic blockers disease, pulmonary oedema, sneezing brain damage, narrow-angle glaucoma. agents,antihistamines,tricyclic hypertension, hyperthyroidism, diabetes, Shock. Concurrent use with local antidepressants carvedilol, psychoneurotic illness, asthma, anesthetics for injection of certain areas chlorpromazine, halothane, prefibrillatory rhythm, or anesthetic (eg; fingers, toes, ears); increased risk of moclobemide, rocuronium, cardiac acidents. Bronchial vasoconstriction and sloughing of tissue. selegiline, timolol,methyldopa, asthma/emphysema,cerebrovascular oncurrent use with cyclopropane or diuretics, oxytoxic drugs hemorrhage, pregnancy, lactation, halogenated hydrocarbon anaesthetics; children may produce fatal ventricular arrhythmias. Labor; may delay the second stage

Albendazole 200 mg/5 ml Suspension C+ i) Single or mixed infestations of i)Child 12-24months: 200mg as a single Gastrointestinal discomfort, dizziness, Patients with hypersensitivity to Concurrent use with Discontinue therapy if liver function test intestinal parasites ii) Strongyloides dose ii) Adult & Child above 2 years: headache, erythema multiforme, Stevens- albendazole or to the benzimidazole drug dexamethasone may result in an elevations are significant, retinal lesions, infection 400mg as a single dose for 3 consecutive Johnson syndrome, agranulocytosis, class. Pregnancy (avoid pregnancy for at increased risk of albendazole cerebral hypertensive episodes, days; Child 12 - 24months: 200mg as a aplastic anemia, leukopenia, least one month following therapy) adverse effects pregnancy, hepatic disease, retinal single dose for 3 consecutive days pancytopenia, thrombocytopenia, lesions hepatotoxicity Alcohol 70% Solution C+ Use as antiseptic and disinfectant Apply to the skin undiluted or when Mental impairment, gastrointestinal Not known Chlorpropamide, metronidazole, Pregnancy, nursing mothers, elderly needed disturbances, severe effects include cefoperazone, respiratory depression, coma and death cefoperazone/sulbactam and cefotaxime

Alfacalcidol 2 mcg/ml Drops A* i) Renal osteodystrophy in patients on NEONATES : 0.1 mcg/kg/day Hypercalcaemia-stop immediately until Hypercalcaemia, metastatic calcification, Thiazide diuretics, calcium, Take care to ensure correct dose to haemodialysis ii) Hypoparathyroidism serum calcium levels return to normal (in hyperphosphataemia (except when phosphates, carbamazepine, infants, monitor plasma calcium and and pseudohypoparathyroidism iii) about one week) and then resumed at occurring with hypoparathyroidism), phenobarbitone, phenytoin, creatinine during dosage titration Adjunct to the management of tertiary half the previous dose. Anorexia, nausea, hypermagnesaemia, vitamin D primidone, rifampicin, isoniazid, hyperparathyroidism iv) Rickets and vomiting, diarrhoea, lassitude, polyuria, overdose,known hypersensitivity to corticosteroid. osteomalacia v) Osteoporosis sweating, headache, thirst, vertigo, alfacalcidol, vitamin D or any of its pruritus, rash, urticaria,hypercalciuria analogues and derivatives. and ectopic calcification. In case of renal impairment, hyperphosphataemia. In hypercalcaemic dialysis patients, possibility of calcium influx from the dialysate should be considered

Alkaline Nasal Douche B To remove nasal plug To be diluted with an equal volume of Excessive use can be toxic due to its Not known Not known Epistaxis, not to be used in cranial warm water before use absorption surgery or trans nasal neuro surgical procedure

Alprostadil 500 mcg/ml Injection A* For treatment of congenital heart 0.05 - 0.1 mcg/kg/min by continuous IV Bradycardia, fever, hypotension, Neonates with respiratory distress Heparin Concurrent anticoagulants, neonates diseases which are ductus arteriosus infusion, then decreased to lowest tachycardia, neonatal apnoea, seizures syndrome with bleeding tendencies, spinal cord dependent effective dose injury

Alteplase 50mg Injection A* Thrombolytic treatment of acute 0.9 mg/kg (maximum of 90 mg) infused The most common and serious side In the indication acute ischaemic stroke Alteplase breaks down clots and Bleeding disorders, high blood pressure, ischaemic stroke. over 60 minutes with 10% of the total effect with alteplase is bleeding. Minor the following contraindications apply in thereby interferes with the body's recent injury or surgery, liver disease, dose administered as an initial bleeding is more common, but significant addition: Symptoms of ischaemic attack ability to stop bleeding. Therefore, endocarditis, any allergies. Use extra intravenous bolus. Treatment must be bleeding such as into the brain or fatal began more than 4.5 hours prior to drugs which also interfere with the caution to avoid injury and trauma while started as early as possible within 4.5 bleeding also occurs. Nausea, vomiting, infusion start or when time of symptom body's ability to form blood clots using this medication due to the Amikacin 250mg/ml Injection A Infections due to susceptible organisms ADULT: (IM or IV): 15 mg/kg/day 8 - 12 Ototoxicity, nephrotoxicity, Pregnancy, perforated ear drum, Potentiation of toxicity in Renal impairment; vertigo, tinnitus. hourly for 7 - 10 days. Maximum: 1.5 neuromuscular blockade. Tinnitus, myasthenia gravis, hypersensitivity. combination with loop diuretics, Discontinue if signs of ototoxicity, g/day. CHILD: 15 mg/kg/day 8 - 12 vertigo; ataxia and overt deafness. cephalothin, vancomycin, neurotoxicity or hypersensitivity occurs; hourly. Maximum: 1.5 g/day. Neonates: cyclosporin. Prolongs action of lactation. Safety has not been Initial loading dose of 10 mg/kg followed neuromuscular blockers. Increased established for treatment period >14 by 7.5 mg/kg/day 12 hourly. Maximum risk of respiratory depression with days. Monitor renal function before and 15mg/kg/day either halothane, methoxyflurane during treatment. & neuromuscular blockers

Amino Acids Injection A Source of amino acids in patients needing Dose to be individualised. ADULT usually Gastrointestinal upset, flushing, Patients with inborn errors of amino acid Not known Liver disease, renal impairment IV nutrition 500-2000 ml by IV. ADULT usual sweating, thrombophlebitis metabolism, irreversible liver damage, requirement for amino acid: 1-2 g/kg/day severe uraemia without dialysis Aminophylline 25 mg/ml Injection B Reversible airways obstruction, acute Adult: Loading dose: 5 mg/kg (ideal body Tachycardia, palpitations, nausea and Hypersensitivity to theophylline or Azole antifungals, ciprofloxacin, Should not be administered concurrently severe brochospasm weight) or 250-500 mg (25 mg/ml) by other gastrointestinal disturbances, derivatives, hypersensitivity to clarithromycin, erythromycin : with ephedrine or with other xanthine slow inj or infusion over 20-30 min. headache, CNS stimulation, insomnia, ethylenediamine increased risk of theophylline medications. Use with caution Maintenance infusion dose: 0.5 arrythmias, also allergy to toxicity. Caffeine : increased paediatrics, elderly patients, smokers mg/kg/hr. Max rate: 25 mg/min. Child: ethylenediamine which can cause caffeine level. Halothane : ,patients undergoing influenza Loading dose: same as adult dose. urticaria, erythema, and exfoliative increased risk of arrthmia immunisation, patient with reduced Maintenance dose: 6 mth-9 yr: 1 dermatitis hepatic clearance.Patients with mg/kg/hr and 10-16 yr: 0.8 mg/kg/hr. ischaemic heart disease, hypertension,hyperthyroidism, epilepsy, history of peptic ulcer disease, glaucoma, diabetis mellitus, severe hypoxemia, angina pectoris, acute mycardial injury or pre-existing arrythmias.

Amiodarone 150 mg/3ml Injection A* Arrhythmias when other drugs are Initial infusion of 5mg/kg via large venous Reversible corneal microdeposits; Cardiogenic shock, hypersensitivity to Antiarrhythmics, beta-blockers, Acute myocardial infarction, sino-atrio, contraindicated or ineffective access over 20-120 minutes with ECG colored halos. Hyper or hypothyroidism. amiodarone, second or third degree AV stimulating laxatives, diuretics block AV or other severe conduction monitoring; subsequent infusion given if Rarely; photosensitization and block (if no pacemaker is present). inducing hypokalaemia, systemic disorder ( unless the patient has a necessary according to response up to a pigmentation. Reversible diffuse Severe sinus bradycardia and severe corticosteroids, tetracosactide, pacemaker),severe hypotension,severe maximum of 1.2 g in 24 hours interstitial pneumopathy or peripheral sinus-node dysfunction amphotericin B, digitalis, respiratory failure, bradycardia, neuropathy anticoagulants, phenytoin, general cardiomegaly,corneal microdeposits anaesthetic, ciclosporin (impaired vision)

Amoxicillin & Clavulanate 228 mg/5 A/KK Infections caused by susceptible Mild to Moderate infection: Diarrhoea, pseudomembraneous colitis, Hypersensitivity to penicillins, possible Aminoglycosides, anticoagulants, Caution use in patient with hepatic ml Syrup organisms 25mg/kg/day (based on Amoxicillin dose) indigestion, GI upsets, increased liver cross sensitivity with other β-lactams. probenecid, allopurinol, oral dysfunction, Cholestatic Jaundice has in 2 divided dose. Severe infection: enzyme History of penicillin-associated contraceptive been reported. Possibility of crystalluria, 45mg/kg/day (based on Amoxicillin dose) cholestatic jaundice or hepatic adequate fluid intake and urinary output in 2 divided dose dysfunction should be maintained. Dose adjustment needed for renal impairment patient.

Amoxicillin 1 g & Clavulanate 200 mg A Infections caused by susceptible CHILD less than 3 months: 30mg/kg 12 Diarrhoea, pseudomembraneous colitis, Hypersensitivity to penicillins, possible Aminoglycosides, anti-coagulants, Pregnancy, breast-feeding, renal or liver Injection organisms. Respiratory tract, skin, soft hourly. 3 months - 12 years: 30mg/kg 6 - GI upsets, increased liver enzyme, cross sensitivity with other ‚-lactams. oral contraceptives, methotrexate failure, pseudomembranous colitis tissue, GUT infection, septicaemia, 8 hourly. ADULT: 1.2 g by IV or urticaria and erythematous multiforme, History of penicillin-associated peritonitis, post-operative infection & intermittent infusion 6 - 8 hourly Steven-Johnson syndrome, toxic cholestatic jaundice or hepatic osteomyelitis epidermal necrolysis, exfoliative dysfunction dermatitis, transient leucopenia, thrombocytopenia, haemolytic anaemia

Amoxicillin Trihydrate 125 mg/5 ml B Infections caused by susceptible strains CHILD less than 10 years: 125 - 250 mg 8 Diarrhoea, indigestion, urticarial or Hypersensitivity to penicillins Aminoglycosides, oral Hypersensitivity to cephalosporins, renal Syrup of gram positive and gram negative hourly. CHILD less than 20 kg: 20 - 40 erythematous rash, hepatitis, cholestatic contraceptives or hepatic impairment, superinfection organisms mg/kg/day in 3 - 4 divided doses jaundice

Amphotericin B 50 mg Injection A Systemic fungal infections ADULT: 0.25 mg/kg/day by IV infusion, Fever, headache, anorexia, weight loss, Hypersensitivity Corticosteroids, nephrotoxic Avoid rapid infusion, renal impairment. gradually increase if tolerated to 1 GI disturbances, malaise, epigastric pain, antibiotics and antineoplastics Hepatic & renal function tests, blood mg/kg/day. Maximum in severe cases: dyspepsia, generalized pain, anaemia, count & plasma electrolyte monitoring 1.5 mg/kg daily or on alternate days. For abnormal renal function. Rarely are required. Pregnancy, lactation neonates, lower doses are recommended cardiovascular toxicity, haematologic reactions, neurologic reactions, liver failure Ampicillin Sodium 1g & Sulbactam A Treatment of susceptible bacterial ADULT: 1.5 - 12 g/day in divided doses 6 - Blood and Lymphatic System (e.g History of allergic reaction to any Alloprinol, Aminoglycosides, Overgrowth of non-susceptible organism. Sodium 500mg Injection infections 8 hourly. Maximum: 4 g Sulbactam. anaemia, hemolytic anaemic, penicillins Bacteriostatic drugs Check periodically for organ system CHILD: 150-300 mg/kg/day 6 - 8 hourly. thrombocytopenia etc) Gastrointestinal (Cloramphenicol, erythromycin, dysfunction during prolong therapy Prophylaxis of surgical infections: 1.5 - 3 (e.g nausea, vomitting, diarrhoe etc) sulphonamides and tetracyclines), g at induction of anaesthesia. May be Hepatobiliary Disorders (e.g Mthotrexate, Probenecid repeated 6 - 8 hourly. NEONATES: First bilirubinemia, jaundice etc) Immune week of life, 75mg/kg/day in divided System (e.g anaphylactic reaction) doses every 12 hour Nervous System (e.g Rare reports of convulsion) Renal and Urinary System (e.g Rare reports of interstitial nephritis) Skin and Subcutaneous Tissue (e.g rash, itching reaction etc) Hepatic (e.g Transient elevation of ALT, AST)

Ampicillin Sodium 500 mg Injection B Treatment of susceptible bacterial 250 - 500 mg IM/IV every 4 - 6 hours. GI disturbances, skin rashes, pruritis, Hypersensitivity to penicillins Excretion impaired by probenecid. Hypersensitivity to cephalosporins. infections (non beta-lactamase- Maximum: 400 mg/kg/day. Meningitis: 2 urticartia, fever, anaphylaxis, blood Increased risk of skin rashes with Chronic treatment requires assessment producing organisms); meningitis g 6 hourly. CHILD: 150 mg/kg/daily IV in disorders, superinfection allopurinol. May decrease of renal, hepatic& haematopoietic divided doses. Usual children dose less effectiveness of oral contraceptives functions. Renal impairment, lymphatic than 10 years, half adult dose and atenolol leukaemia

Anti RhD Immunoglobulin Injection B Prevention of Rh(D) sensitisation to i) Antenatal prophylaxis: According to Pain at injection site. Slight temperature Rh(D)-positive mother Live virus vaccines Never administer to infant. IgA Rh(D)-negative woman: general recommendations, currently elevation deficiency. Hypersensitivity to thiomersal i) Pregnancy/delivery of Rh(D)-positive administered doses range from 50 – 330 or human Ig infant micrograms or 250 - 1650 IU. For specific ii) Abortion/threatened abortion, ectopic details, please refer to product's package pregnancy or hydatidiform mole insert. iii) Transplacental haemorrhage resulting ii) Postnatal prophylaxis: According to from antepartum haemorrhage, general recommendations, currently amniocentesis, chorionic biopsy or administered doses range from 100 – 300 obstetric manipulative procedures e.g. micrograms or 500 – 1500 IU. For specific external version or abdominal trauma details, please refer to product's package insert.

Antivenene Cobra Injection B Treatment of patients who exhibit Initial dose of 100ml of reconstituted Transient tenderness at injection site, Hypersensitivity to any component of the Not known Respiratory support maybe essential. manifestations of systemic envenoming antivenene given by slow intravenous cutaneous reaction and alterations in formulation, unless the benefits Sensitivity testing should be performed following a bite by Cobra (Naja kaouthia). infusion (2ml/min). Subsequent dose can temperature, nausea, vomiting, outweigh the risks and appropriate before the administration be given every 12 hours according to the cardiovascular and reactions management for anaphylaxis is available clinical symptoms. As product may differ (tachycardia, bradycardia, hypotension), from batches and manufacturer, it is allergic reactions, shock. strongly recommended to refer to the product insert on dosing recommendation.

Antivenene Pit Viper Injection B Treatment of patients who exhibit Initial dose of 30ml of reconstituted Transient tenderness at injection site, Hypersensitivity to any component of the Not known Sensitivity testing should be performed manifestations of systemic envenoming antivenene given by slow intravenous cutaneous reaction and alterations in formulation, unless the benefits before the administration following a bite by Malayan Pit Viper infusion (2ml/min). Subsequent dose can temperature, nausea, vomiting, outweigh the risks and appropriate (Calloselasma rhodostoma). be given every 6 hours according to the flatulence, cardiovascular and pulmonary management for anaphylaxis is available clinical symptoms. As product may differ reactions (tachycardia, bradycardia, from batches and manufacturer, it is hypotension, angioedema, strongly recommended to refer to the bronchospams), allergic reactions, product insert on dosing anaphylaxis, periorbital edema. recommendation. Antivenene Serum (Sea snake) 1000 B Treatment of patients who exhibit 1000 units by IV infusion over 1/2 to 1 Allergic reactions including anaphylactic Hypersensitivity to any component of the Not known Sensitivity testing should be performed units Injection manifestations of systemic envenoming hour. In severe cases 3000 -10000 units shock and delayed serum sickness, formulation, unless the benefits before the administration following a bite by sea snake. may be required headache, urticaria, rash, pyrexia, chills, outweigh the risks and appropriate abdominal pain, nausea, vomiting, management for anaphylaxis is available diarrhea, myalgia, local injection site reactions, chest pain.

Aqueous Cream C+ Dry skin As a soap or apply to the skin as an Not known Not known Not known It should not be used before emollient cream phototherapy or in phototesting procedures

Artemether 20mg + Lumefantrine B Acute uncomplicated falciparum malaria ADULT and CHILD over 12 years weighing Abdominal pain, anorexia, diarrhea, Hypersensitivity to lumefantrine or Droperidol, amiloride, amitriptyline, Electrolyte disturbances, hepatic 120mg Tablet over 35 kg : 4 tablets as a single dose at vomiting, nausea, palpitation, cough, halofantrine, or artemether or other azithromycin, chlorpromazine, impairment, renal impairment, the time of initial diagnosis, again 4 headache, dizziness, sleep disturbances, artemisinin compounds, history of ciprofloxacin, clomipramine, concomitant administration of drugs that tablets after 8 hours and then 4 tablets asthenia, arthralgia, myalgia, cough, arrhythmias, bradycardia, and congestive erythromycin, fluconazole, prolong QT interval, first trimester of twice daily (morning and evening) on fatigue, pruritus, rash heart failure accompanied by reduced frusemide, hydrochlorothiazide, pregnancy each of the following two days (total left ventricular ejection fraction, mefloquine, nalidixic acid, course comprises 24 tablets). INFANT congenital QT interval prolongation. Not ofloxacin, procainamide, and CHILD weighing 5 kg to less than 35 recommended in the first trimester of pyrimethamine, quinidine, quinine, kg : A 6 dose regimen with 1 to 3 tablets pregnancy or in children below 5 kg, spironolactone, sulfadoxine and per dose, depending on bodyweight lactation, family history of sudden death pyrimethamine

Artesunate 60 mg Injection B Treatment of severe malaria caused by 2.4mg of artesunate/kg body weight, by Transient and reversible Artesunate is contraindicated in patients Artesunate is rapidly and Hepatic or renal insufficiency. Pregnancy Plasmodium falciparum in adults and intravenous (IV) or intramuscular (IM) reticulocytopaenia, drug fever, rash, with hypersensitivity to artesunate or extensively converted to and lactation. children injection, at 0, 12 and 24 hours, then bradycardia, transient 1st-degree heart other artemisinins. dihydroartemisinin (DHA), the once daily until oral treatment can be block and reversible elevation of serum active metabolite, primarily by substituted. For adults and children with transaminases. plasma and erythrocyte esterases. severe malaria or who are unable to DHA elimination is also rapid (half- tolerate oral medicines, artesunate 2.4 life approximately 45 min) and the mg/kg body weight IV or IM given on potential for drug-drug interactions admission (time = 0), then at 12 hrs and appears limited. 24 hrs, then once a day for 5-7 days is the recommended treatment.

Artificial tears/eye lubricant B Symptomatic relief of severe dry eye Instill 1-2 drops in affected eye(s) as Burning, stinging, allergic reactions, red Hypersensitivity to hypromellose or Unknown Avoid contamination of the applicator tip ophthalmic gel conditions and as lens lubricant during needed. Refer to product information eyes, blurred vision, raised intraocular carbomer through contact, self-prescribed use as ophthalmic diagnostic procedures leaflet. pressure, sticking of eyelids (discharge). an ocular lubricant should not exceed 3 days ,treat emergent elevations of intraocular pressure. Studies in children have not been performed

Artificial tears/eye lubricant B Tear deficiency, ophthalmic lubricant; for 1 - 2 drops several times a day. Refer to Increases in intraocular pressure, blurred Hypersensitivity to hydroxypropyl Not known Self-prescribed use as an ocular lubricant ophthalmic solution relief of dry eyes and eye irritation product information leaflet. vision methylcellulose should not exceed 3 days, avoid contamination of the applicator tip through contact, remove viscoelastic solutions form the anterior chamber at the end of the surgical procedure, treat emergent elevations of intraocular pressure Atracurium Besylate 10 mg /ml in 2.5 A* Muscle relaxant in general anaesthesia, Adult & childn >2 mth 0.3-0.6 mg/kg IV. Cutaneous reactions; bradycardia, Known allergic hypersensitivity to Mixed block with suxamethonium Neonates, severe CVS disorders, renal or ml Injection Endotracheal intubation, Aid controlled Endotracheal intubation dose: 0.5-0.6 transient hypotension in patients with Atracurium besylate. which is difficult to reverse with hepatic dysfunction, myasthenia gravis ventilation. mg/kg. Supplementary dose: 0.1-0.2 CVS disorders; dyspnoea, bronchospasm; anticholinergic drugs. Ketamine and other neuromuscular disorders, mg/kg as required. Continuous infusion rash and urticaria. may potentiate the effects of severe electrolyte imbalances, rates of 0.3-0.6 mg/kg/hr to maintain atracurium. Concurrent use with respiratory insufficiency or pulmonary neuromuscular block during long surgical tamoxifen or danazol may prolong disease, asthma;,burns, cardiopulmonary procedure. effects of atracurium. bypass, smoking, pregnancy and Neuromuscular blockade lactation. Atracurium should be used potentiated by parenteral during pregnancy only if the potential Magnesium salts, anaesthetics, benefit to the mother outweighs any aminoglycosides and polypeptide potential risk to the foetus. Dosage for antibiotics, botulinum A toxin. obese patients should be based on ideal Malignant hyperthermia with body-weight to prevent overdosing. halogenated anaesthetics and succinylcholine. MAOIs.

Atropine Sulphate 1% Eye Drops B Determination of refraction, strabismus, PREOPERATIVE MYDRIASIS : one drop of Systemic toxicity esp in children, on Glaucoma, chronic respiratory disease, Additive anticholinergic effects with Reflux oesophagitis, elderly, infants and iritis and iridocyclitis, after extra or a 1% solution supplemented with one prolonged use may lead to irritation, sick sinus syndrome, thyrotoxicosis, quinidine, antidepressants and children. Pregnancy. intracapsular extraction of lens drop of 2.5 or 10% phenylephrine prior to hyperaemia, oedema and conjunctivitis. cardiac failure, pyloric stenosis, prostatic some antihistamines. surgery. ANTERIOR UVEITIS or Increased intraocular pressure. hypertrophy. POSTOPERATIVE MYDRIASIS : one drop of a 1% or 2% solution up to 3 times a day Atropine Sulphate 1mg/ml Injection B i) Reduce vagal inhibition,salivary and i) Adult: 300-600 mcg IM/SC 30-60 Dry mouth, dysphagia, constipation, Glaucoma, chronic respiratory disease, Additive anticholinergic effects with Reflux oesophagitis, elderly, infants and bronchiol secretion in anaesthesia ii) minutes before anaesthesia. flushing and dryness of skin, tachycardia, sick sinus syndrome, thyrotoxicosis, quinidine, antidepressants and children. Pregnancy. Reversal of excessive bradycardia iii) Alternatively, 300-600 mcg IV palpitations, arrhythmias, mydriasis, cardiac failure, pyloric stenosis, prostatic some antihistamines. Reversal of effect of competitive muscle immediately before induction of photophobia, cycloplegia, raised hypertrophy. relaxants iv) Overdosage with other anaesthesia. Child: >20 kg: 300-600 mcg; intraocular pressure. Toxic doses cause compounds having muscarinic action v) 12-16 kg: 300 mcg; 7-9 kg: 200 mcg; >3 tachycardia, hyperpyrexia, restlessness, Organophosphate poisoning kg: 100 mcg. Doses to be given via IM/SC confusion, excitement, hallucinations, admin 30-60 minutes before delirium and may progress to circulatory anaesthesia.ii) Adult: 500 mcg every 3-5 failure and resp depression. Potentially minutes. Total: 3 mg. Max Dosage: 0.04 Fatal: Atrial arrhythmias, AV dissociation, mg/kg body weight.iii) Adult 0.6-1.2 mg multiple ventricular ectopi. before or with anticholinesterase iv) Adult: 0.6-1 mg IV/IM/SC, repeated every 2 hr. v) Adult: 2 mg IV/IM, every 10-30 minutes until muscarinic effects disappear or atropine toxicity appears. In severe cases, dose can be given as often as every 5 minutes. In moderate to severe poisoning, a state of atropinisation is maintained for at least 2 days and continued for as long as symptoms are present. Child: 20 mcg/kg given every 5-10 minutes.

Azithromycin 200 mg/5 ml Granules A* Treatment of complicated respiratory CHILD 36 - 45 kg: 400 mg, 26 - 35 kg: Nausea, abdominal discomfort, vomiting, Known hypersensitivity to azithromycin Antacids. Ergot derivatives. Moderate or severe renal impairment; tract infections not responding to 300mg, 15 - 25 kg 200 mg, less than 15 flatulence, diarrhoea & loose stools. or any of the macrolides Monitor patients on concurrent severe liver impairment; pregnancy & standard macrolides kg: 10 mg/kg. To be taken daily for 3 days Hearing impairment, interstitial nephritis, warfarin, digoxin or cyclosporin. lactation or to be taken as a single dose on day 1, acute renal failure, abnormal liver Increase levels of tacrolimus, then half the daily dose on days 2 - 5 function, dizziness/vertigo, convulsions, phenytoin, bromocriptine, headache, somnolence. Cardiac disopyramide disorders: palpitations, arrhythmia, supraventricular tachycardia, QT prolongation, torsades de pointes. Skin and subcutaneous tissue disorders: allergic reactions, erythema multiforme, Steven-Johnson Syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS). Azithromycin 500 mg Injection A* Only for treatment of severe atypical 500 mg IV as a single daily dose for a Nausea, abdominal discomfort, vomiting, Known hypersensitivity to azithromycin Antacids, ergot derivatives. Moderate to severe renal impairment, pneumonia minimum of two days followed by 500 flatulence, diarrhoea& loose stools. or any of the macrolides Monitor patients on concurrent severe liver impairment; patients at mg oral dose as a single daily dose to Hearing impairment, interstitial nephritis, warfarin, digoxin or ciclosporin. increased risk for prolonged cardiac complete a 7 - 10 days course acute renal failure, abnormal liver Increase levels of tacrolimus, repolarization; pregnancy & lactation. function, dizziness& vertigo, convulsions, phenytoin, bromocriptine, Avoid co-administration w/ ergot headache, somnolence. Cardiac disopyramide derivatives. disorders: palpitations, arrhythmia, supraventricular tachycardia, QT prolongation, torsades de pointes. Skin and subcutaneous tissue disorders: allergic reactions, erythema multiforme, Steven-Johnson Syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS).

Balanced Salt Solution A For irrigation during ocular surgery Irrigate as directed Ocular irritation Hypersensitivity to any of the Not known For local use only. The use of additives components of product with this solution may cause corneal decompensation

BCG Vaccine Freeze-Dried Injection C+ For the prevention of tuberculosis 0.1 ml by intradermal injection. INFANT Superficial, self healing ulceration, Congenital or acquired cell-mediated Not known Children born to HIV positive mothers, under 12 months: 0.05 ml injection site reaction, lymphadenopathy immune deficiencies (including HIV), pregnancy patients with systemic corticosteroid/ immunosuppressive treatment, malignant condition, pyrexia, generalised infected dermatoses, organ abnormalities, pregnancy.

Beclomethasone dipropionate A/KK Regular treatment of asthma where use Based on treatment approach. i) Pharyngitis, headache, dysphonia. Known hypersensitivity to Reduced effect w/ β-blockers. Cardiac arrhythmias especially 3rd 100mcg and formoterol fumarate of a combination product (inhaled Maintenance therapy (taken as regular Paradoxical bronchospasm; tremor, beclomethasone dipropionate, Additive effect w/ theophylline or degree AV block & tachyarrhythmias; dihydrate 6mcg pressurized corticosteroid and long-acting beta2 maintenance treatment with a separate palpitations, cough, muscle spasms, formoterol fumarate dehydrate and/or other β-adrenergic drugs. idiopathic subvalvular aortic stenosis, inhalation solution agonist) is appropriate in: i) Patients not as needed rapid-acting bronchodilator): prolongation of QTc interval; oral any of the excipients Quinidine, disopyramide, hypertrophic obstructive adequately controlled with inhaled Dose recommendations for adults 18 candidiasis, throat irritation. procainamide, phenothiazines, cardiomyopathy, severe heart disease corticosteroids and "as needed" inhaled years and above: One or two inhalations antihistamines, MAOIs, tricyclic particularly acute MI, ischaemic heart short-acting beta2 agonist, or ii) Patients twice daily. The maximum daily dose is 4 antidepressants, L-dopa, L- disease, CHF, occlusive heart diseases already adequately controlled on both inhalations. ii) Maintenance and reliever thyroxine, oxytocin, furazolidone, particularly arteriosclerosis, arterial HTN inhaled corticosteroids and long-acting therapy (taken as regular maintenance procarbazine, alcohol. Halogenated & aneurysm. Patients known or beta2-agonists. treatment and as needed in response to hydrocarbons, xanthine derivatives, suspected congenital or drug-induced asthma symptoms): Dose steroids or diuretics, digitalis prolongation of QTc interval. recommendations for adults 18 years glycosides. Disulfiram or Thyrotoxicosis, DM, and above: The recommended metronidazole. phaeochromocytoma & untreated maintenance dose is 1 inhalation twice hypokalaemia; active or quiescent daily (one inhalation in the morning and pulmonary TB, fungal & viral infections in one inhalation in the evening). Patients the airways. Monitor serum K levels in should take 1 additional inhalation as severe & unstable asthma. Monitor needed in response to symptoms. If blood glucose levels regularly. Avoid symptoms persist after a few minutes, an abrupt discontinuation of treatment. Not additional inhalation should be taken. for use in acute asthma. Prolonged & The maximum daily dose is 8 inhalations. high-dose treatment. Pregnancy & lactation. Children & adolescent <18 yr.

Beclomethasone Dipropionate 200 A/KK Prophylaxis of asthma especially if not ADULT : 1 - 2 puff twice daily. May Candidiasis of the mouth and throat, Hypersensitivity to beclomethasone Not known Pulmonary tuberculosis, pregnancy. mcg/dose Inhaler fully controlled by bronchodilators increase to 2 puff 2 - 4 times daily CHILD : hoarseness or throat irritation, headache, dipropionate, acute asthma Adrenal insufficiency (when replacing 1 puff twice daily. May increase to 1 puff secondary hypocortisolism, osteoporosis, exacerbations, status asthmaticus. systemic corticosteroid therapy), 2 - 4 times daily cataract, glaucoma, paradoxical Special care is necessary in patients with exposure to viral infection (chickenpox, bronchospasm (discontinue active or quiescent pulmonary measles), ocular herpes simplex, immediately). Patients are advised to tuberculosis tuberculosis (active or quiescent), gargle after using the medication untreated fungal, bacterial, or systemic viral infections Benzalkonium 0.01% - 0.02% Cream B Prevention and treatment of nappy rash Wash and dry baby's bottom. Apply by Dermatitis Hypersensitivity to benzalkonium Not known Avoid contact with the eyes, mouth and spreading the cream evenly paying products nose particular attention to the fold of the skin, after every nappy change

Benzathine Penicillin 2.4 MIU (1.8 g) B i) Treatment of mild to moderately i) ADULT: 1.2 mega units IM ii) For Allergic reactions, glossitis, stomatitis, Hypersensitivity to penicillins& Bacteriostatic antibiotics, anti- Diabetes. Not for SC, IV or intralumbarly Injection severe infections due to Penicillin G- syphillis: 2.4 mega units weekly for 1 - 3 haemolytic anaemia, leucopenia, cephalosporins. Severe pneumonia, inflammatory, antirheumatics, or into body cavities. Impaired renal sensitive organisms ii) Treatment of weeks thrombocytopenia, agranulocytosis, empyema, sepsis, pericarditis, antipyretics, probenecids, oral function, infants, elderly, hypersensitivity syphillis neuropathy, nephropathy, Jarisch- meningitis, peritonitis or arthritis contraceptives to cephalosporins. Very high doses in Herxheimer reactions secondary to requiring high dose of penicillin levels, poor renal function (risk of neurotoxicity) bacteriolysis. CNS toxicity including bronchial asthma or heart failure. Avoid contact, skin convulsions; diarrhoea; antibiotic- sensitization may occur. Monitor serum associated colitis. Potentially Fatal: potassium concentration, renal and Anaphylaxis. haematological status.

Benzydamine HCl 0.15% Solution B For relief of painful condition of the oral Used as a 30 seconds gargle or rinse, Oral numbness, dryness or thirst, Known hypersensitivity to the drug or to Not known Hepatic or renal impairment, pregnancy, cavity undiluted. ADULT 15 ml. CHILD less 12 tingling, warm feeling in mouth, altered any of the components of the vehicle children less than 6 years, in bacterial years 5-15 ml. Uninterrupted treatment sense of taste infection, appropriate antibacterial should not be more than 7 days therapy should be used in addition to product

Benzydamine Hydrochloride 3.0 A* Temporary relief of painful conditions of ADULTS and CHILDREN OVER 12 YEARS: 2- Oral numbness, occasional burning or Patients with known hypersensitivity to There are no known drug If a sore throat is either caused or mg/ml throat spray the mouth and throat including tonsillitis, 4 sprays (1-2mg) directly onto the stinging sensation, dryness or thirst, benzydamine or to the other interactions with Difflam Anti- complicated by a bacterial infection, sore throat, radiation mucositis, sore/inflamed area and swallow gently. tingling, warm feeling in mouth and components listed. inflammatory Throat Spray/Difflam appropriate antibacterial therapy should aphthous ulcers, pharyngitis, swelling, Repeat every 1 1/2 to 3 hours as altered sense of taste, nausea, vomiting, Forte Anti-inflammatory Throat be considered in addition to the use of redness, inflammatory conditions, post- necessary. CHILDREN 6-12 YEARS: 2 retching, GI disorders, dizziness, Spray. Difflam Forte Anti-Inflammatory Throat orosurgical and periodontal procedures. sprays (1mg) directly onto sore/ inflamed headache and drowsiness, Spray. (For pediatric and otorhinolaringology area and swallow gently. Repeat every hypersensitivity rare but maybe use. Restrict to patients who are not able 11/2 to 3 hours as necessary. CHILDREN associated with pruritis, rash, urticarial, to gargle) UNDER 6 YEARS: Not recommended. photodermattis and ocassionally Uninterrupted treatment should not laryngospasm or bronchospasm. exceed seven days, unless under medical supervision

Benzyl Benzoate 12.5 % Emulsion C Scabies - for child 2-12 years old After bath, apply over the whole body, May be irritant to the skin of some Hypersensitivity to benzyl benzoate Not known Contact with mucous membranes, head, (Child) neck down and leave on for 24 hours patients, burning sensation especially on face, broken or inflammed skin, avoid then wash off. Reapply for another 24 genitalia and excoriations occasionally contact with eyes. Not recommended hours, the first repeat application should rashes, stinging and contact dermatitis, during lactation. be within 5 days of the initial application, local irritation, particularly in children, a third application may be required in splash contact with benzyl benzoate may some cases produce irritation to the eyes and mucous membranes

Benzyl Benzoate 25 % Emulsion C+ Scabies for adult and children more than After bath, apply over the whole body, May be irritant to the skin of some Hypersensitivity to benzyl benzoate Not known Contact with mucous membranes, head, (Adult) 12 years old. neck down and leave on for 24 hours patients, burning sensation especially on face, broken or inflammed skin, avoid then wash off. Reapply for another 24 genitalia and excoriations occasionally contact with eyes. Not recommended for hours, the first repeat application should rashes, stinging and contact dermatitis, children, lactation (withhold during be within 5 days of the initial application, local irritation, particularly in children, treatment) a third application may be required in splash contact with benzyl benzoate may some cases. produce irritation to the eyes and mucous membranes Benzylpenicillin 1 mega unit (600 mg) B i) Infections caused by susceptible i) Adult: 600mg - 3600mg (1 - 6 mega Hypersensitivity reactions, GI History of anaphylaxis, accelerated (e.g. Bacteriostatic antibiotics, anti- Very high doses in poor renal function Injection organisms ii) Infective endocarditis units) daily, divided into 4 to 6 doses. disturbances, eosinophilia, haemolytic hives) or serum sickness reaction to inflammatory, antirheumatics, (risk of neurotoxicity) or heart failure. Higher doses (24 mega units) in divided anaemia, leucopenia, agranulocytosis. previous penicillin administration antipyretics, probenecids, oral Avoid contact, skin sensitization may doses may be given in serious infections Convulsions in the presence of severely contraceptives occur. Monitor serum potassium such as meningitis. Child 1 month to 12 reduced renal function, epilepsy, concentration, renal and haematological years old: 100mg/kg/day in 4 divided meningitis or cerebral oedema or during status. doses, not exceeding 4g/day; Infants 1 -4 cardiopulmonary bypass procedure. High weeks: 75mg/kg/day in 3 divided doses; dose may result in hypernatremia and Newborn Infants: 50mg/kg/day in 2 hypokalemia divided doses ii)7.2 to 12g (12 - 20 mega units) maybe given daily in divided doses

Benzylpenicillin 5 mega units (3 g) B i) Infections caused by susceptible i) ADULT: 600 - 1200 mg IM 4 times daily, Hypersensitivity reactions, GI History of anaphylaxis, accelerated (e.g. Bacteriostatic antibiotics, anti- Very high doses in poor renal function Injection organisms ii) Infective endocarditis increased if necessary in more serious disturbances, eosinophilia, haemolytic hives) or serum sickness reaction to inflammatory, antirheumatics, (risk of neurotoxicity) or heart failure. infections. CHILD: 50 - 100 mg/kg body anaemia, leucopenia, agranulocytosis. previous penicillin administration antipyretics, probenecids, oral Avoid contact, skin sensitization may weight daily IV in 2 - 4 divided doses ii) Convulsions in the presence of severely contraceptives occur. Monitor serum potassium ADULT: 7.2 g daily by slow IV infusion in 6 reduced renal function, epilepsy, concentration, renal and hematological divided doses meningitis or cerebral oedema or during status. cardiopulmonary bypass procedure

Beractant Intratracheal Suspension A* Treatment of newborn baby with birth 100 mg/kg (4 ml/kg) body weight Transient bradycardia, hypoxia, Not known Not known Continuous monitoring with arterial or (200 mg phospholipids in 8 ml vial) weight of 700 g or greater undergoing intratracheally up to 4 doses in 1st 48 hr. endotracheal tube reflux transcutaneous measurement of mechanical ventilation for respiratory Doses should not be given more systemic oxygen and carbon dioxide. distress syndrome, whose heart rate and frequently than 6 hrly. To be Infants <600 g birthwt. For intratracheal arterial oxygenation are continuously administered as soon as possible. use only monitored

Betamethasone 17-Valerate 0.01- B Eczemas, prurigo nodularis, limited Apply sparingly to affected area 2 - 3 Local skin atrophy, striae, systemic Viral diseases, bacteria and fungal Not known Extensive or prolonged use, pregnancy, 0.05% Cream psoriasis in appropriate in sites times daily then reduced to once daily hypercorticism, folliculitis, hypertrichosis, infection, acne, rosacea and perioral infant and children less than 4 years. when improvement occurs acneiform eruptions, hypopigmentation dermatitis. Hypersensitivity to Avoid contact with eyes and allergic contact dermatitis betamethasone products

Betamethasone 17-Valerate 0.1% A Eczemas, prurigo nodularis, psoriasis Apply sparingly to affected area 2 - 3 Local skin atrophy, striae, systemic Viral diseases, bacteria and fungal Not known Extensive or prolonged use, pregnancy, Cream (excluding widespread plaque psoriasis) times daily then reduced to once daily hypercorticism, folliculitis, hypertrichosis, infection, acne, rosacea and perioral infant and children less than 4 year. when improvement occurs acneiform eruptions, hypopigmentation dermatitis. Hypersensitivity to Avoid contact with eyes. Use in patients and allergic contact dermatitis betamethasone products 12 years of age younger

Betamethasone Disodium Phosphate B Allergic dermatosis in the ear Apply 2 - 3 drops 3 - 4 times daily, reduce Rise in intraocular pressure, epistaxis, Viral, fungal infection, tuberculous, As general with other Prolonged use in infants, may impair and Neomycin Sulphate 0.5% Ear frequency when relief obtained ulceration of throat purulent eye infection, glaucoma, otitis corticosteroids ability to drive and operate machinery, Drops media, history of perforation of the ear pregnancy, withdraw if there is spread of drum, allergy to neomycin or to any infection component of the preparation

Bisacodyl 10 mg Suppository C i) Constipation ii) Bowel preparation for i) ADULT and CHILD over 10 years: 10 mg, Rarely,electrolyte and fluid imblances, Ileus, intestinal obstruction, acute Milk, antacids, warfarin Prolonged use, abdominal pain, radiological procedures and surgery CHILD less than 10 years 5 mg insert abdominal discomfort, diarrhoea, rectal abdominal conditions, rectal bleeding, inflammatory bowel disease, sudden, rectally ii) ADULT 10-20 mg, CHILD over 4 burning, vomiting appendicitis persistent change in bowel habits and years 5 mg the following morning before ulcerated haemorrhoids of rectal fissures procedures insert rectally

Bisacodyl 5 mg Suppository C i) Constipation i) ADULT and CHILD over 10 years: 10 mg, Rarely,electrolyte and fluid imblances, Ileus, intestinal obstruction, acute Milk, antacids, warfarin Prolonged use, abdominal pain, ii) Bowel preparation for radiological CHILD less than 10 years 5 mg insert abdominal discomfort, diarrhoea, rectal abdominal conditions, rectal bleeding, inflammatory bowel disease, sudden, procedures and surgery rectally burning, vomiting appendicitis persistent change in bowel habits and ii) ADULT 10-20 mg, CHILD over 4 years 5 ulcerated haemorrhoids of rectal fissures mg the following morning before procedures insert rectally Brimonidine Tartrate 0.15% A* Lowering of intraocular pressure in 1 drop in the affected eye(s) 3 times daily Oral dryness, ocular hyperemia, burning Hypersensitivity to brimonidine, Alcohol, sedative, barbiturates, Severe cardiovascular disease, liver Ophthalmic patients with open-angle glaucoma or and stinging, headache, blurring, foreign concomitant MAOI therapy opiates, anaesthesia, tricyclic impairment, renal impairment, ocular hypertension body sensation, fatigue, drowsiness, antidepressant, beta blocker, depression, Raynauld's phenomenon, conjunctival follicles, ocular pruritus. antihypertensive orthostatic hypotension, thromboangiitis Allergic conjunctivitis, hypertension obliterans, pregnancy, lactation

Brinzolamide 1% and Brimonidine A* Decrease of elevated intraocular 1 drop in the affected eye(s) 2 times Ocular hyperaemia, ocular allergic type • Hypersensitivity to the active It is contraindicated in patients The medicinal product should not be tartrate 0.2% ophthalmic suspension pressure (IOP) in adult patients with daily. reactions (eye allergy, keratitis, eye pain, substance(s) or to any of the excipients receiving monoamine oxidase injected. Patients should be instructed open-angle glaucoma or ocular ocular discomfort, blurred vision, or to sulphonamides. • Patients receiving inhibitors and patients on anti not to swallow the eye drops. Precaution hypertension for whom monotherapy abnormal vision, ocular hyperaemia, monoamine oxidase (MAO) inhibitor depressants which affect on ocular effects, systemic effects, provides insufficient IOP reduction. conjunctival blanching), dysgeusia (bitter therapy. • Patients on antidepressants, noradrenagic transmission. Caution cardiac disorders, acid/base or unusual taste in the mouth following which affect noradrenergic transmission is advised in patients taking disturbances, hepatic impairment, instillation) and dry mouth. The safety (e.g. tricyclic antidepressants and medicinal products which can affect mental alertness, the use of profile was similar to that of the mianserin). • Patients with severe renal the metabolism and uptake of benzalkonium chloride and use in individual components of brinzolamide impairment. • Patients with circulating amines (e.g. paediatric population. 10 mg/mL and brimonidine 2 mg/mL. hyperchloraemic acidosis. • Neonates chlorpromazine, methylphenidate, and infants under the age of 2 years. reserpine, serotonin- norepinephrine reuptake inhibitors), antihypertensives, cardiac glycosides, systemic medicinal products which may interact with α-adrenergic agonists or interfere with their activity i.e. agonists or antagonists of the adrenergic receptor (e.g. isoprenaline, prazosin), CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, clotrimazole, ritonavir and troleandomycin) and oral carbonic anhydrase inhibitors concomitantly.

Bromhexine HCl 4 mg/2 ml Injection A Secretolytic therapy in acute and chronic 4 to 8 mg SC, IM or IV 2 - 3 times daily Occasionally gastrointestinal effects like Hypersensitivity to bromhexine May lead to higher antibiotic 1)Gastrointestinal ulceration 2) bronchopulmonary diseases associated (maximum 24mg/ day). Elderly: Max nausea, diarrhoea, indigestions, concentration in lung tissue. Oral pregnancy 3) lactation 4)Contains sodium with abnormal mucous secretion and initial dose: 3 mg daily. abdominal fullness. In rare cases skin anticoagulants metabisulphite that may cause impaired mucous transport rashes headache, vertigo, dizziness, anaphylactic symptoms or less severe sweating, skin rash, transient rise in asthmatic episode in susceptible people. serum transaminase and perspiration Patients treated with bromhexine will have been reported. have increase in flow of secretions/mucus

Bromhexine HCl 4 mg/5 ml Elixir B Secretolytic therapy in acute and chronic 1) Adults :10 ml three times a day.Can Uncommon: nausea, vomitting, Pain in Hypersensitivity to bromhexine May lead to higher antibiotic Gastrointestinal ulceration, pregnancy, bronchopulmonary diseases associated increase up to 15 ml four times a day. the upper part of your abdomen, concentration in lung tissue. Oral lactation. When taking bromhexine, with abnormal mucous secretion and 2)Children 5 to 12 years : 5 ml four times Diarrhoea. anticoagulants mucus will increase in air passages. This impaired mucous transport a day 3)Children 2 to 5 years: 5 ml two Rare : Allergic reactions, skin rash. is common as it is due to the way the times a day drug works. Stop taking the drugs if serious allergic reactions eg; swelling of face or throat, wheezing or sudden difficulties in breathing and skin lesions such as severe blistering or peeling of your skin, mouth, eyes and genitals occured. Budesonide 160 mcg and Formoterol A/KK i)Regular treatment of asthma where use Asthma Maintenance therapy Adult ≥18 Palpitations, candida infections in the Hypersensitivity to budesonide, Itraconazole, ritonavir, CYP3A4 Taper dose when discontinuing 4.5 mcg Inhalation (Turbuhaler) of a combination (inhaled corticosteroid yr 160 mcg to 320 mcg bd. Some patients oropharynx, headache, tremor, mild formoterol or lactose (which contains inhibitors. β-blockers (including eye treatment. Seek medical advice if and long-acting beta2-agonist) is may require up to a max of 640 mcg bd. irritation in the throat, coughing and small amounts of milk protein). drops), potent CYP3A4 inhibitors. treatment is ineffective or exceeds appropriate:- - Patients not adequately Adolescent 12-17 yr 160 mcg to 320 mcg hoarseness, tachycardia, nausea, muscle Quinidine, disopyramide, highest recommended dose. controlled with inhaled corticosteroids bd. Childn 6-11 yr 160 mcg bd, <6 yr Not cramps, dizziness, agitation, restlessness, procainamide, phenothiazines, Maintenance dose should be taken even and ?as needed? inhaled short-acting recommended. Maintenance & relief nervousness, sleep disturbances, bruises antihistamines (terfenadine), when asymptomatic. Prophylactic use eg beta2-agonists. or - Patients already Adult ≥18 yr 320 mcg/day either as 160 MAOIs (furazolidone & before exercise, has not been studied. adequately controlled on both inhaled mcg bd or 320 mcg either morning or procarbazine) & tricyclic Therapy should not be initiated during an corticosteroids and long- acting beta2- evening. For some patients a antidepressants, anesthetic, exacerbation. Should be discontinued agonists. ii) Symptomatic treatment of maintenance dose of 320 mcg bd may be digitalis. upon paradoxical bronchospasm, with an patients with severe COPD (FEV1 <50% appropriate. Patients should take 160 immediate increase in wheezing after predicted normal) and a history of mcg additional inhalation as needed in dosing. Potential systemic effects in repeated exacerbations, who have response to symptoms. If symptoms patients on high doses for prolonged significant symptoms despite regular persist after a few minutes, an additional periods eg adrenal suppression, reduced therapy with long-acting bronchodilators. inhalation should be taken. Not more bone mineral density, glaucoma, than 960 mcg should be taken on any cataract. Thyrotoxicosis, single occasion. A total daily dose of phaeochromocytoma, diabetes mellitus, more than 1280 mcg is not normally untreated hypokalaemia, hypertrophic needed, however a total daily dose of up obstructive cardiomyopathy, idiopathic to 1920 mcg could be used for a limited subvalvular aortic stenosis, severe period. Patients using more than 1280 hypertension, aneurysm, severe mcg daily should seek medical advice, cardiovascular disorders. Unstable & should be reassessed & their acute asthma. Monitor K levels. maintenance therapy reconsidered. Pregnancy, lactation. Monitor growth in Childn & adolescent <18 yr Not children & adolescents especially with recommended. COPD Adult ≥18 yr 320 long-term therapy. Formoterol may mcg bd. induce prolongation of the QTc-interval. Fungal or viral infections in the airways.

Budesonide 200 mcg/dose Inhalation B Maintenance treatment of asthma as ADULT : 200 - 1600 mcg daily in 2 - 4 Mild irritation of the throat, coughing, Hypersensitivity to budesonide. Oral or parenteral corticosteroids - Acute exacerbations, accompanied by prophylactic therapy especially if not fully divided doses. Maintenance with twice and generally reversible hoarseness of Moderate to severe bronchiectasis effects enhanced by the increased mucous viscosity and mucous controlled by bronchodilators daily dosing. CHILD more than 7 years the voice. Bad taste, dryness of the concomitant use. Amiodarone - plugging. Caution in viral infections such 200 - 800 mcg, 2 - 7 years 200 - 400 mcg. throat. Candidiasis of the mouth and increased risk of developing as varicella, in untreated fungal and To be taken orally in 2 - 4 divided doses throat, paradoxical bronchoconstriction, Cushing's syndrome. Ketoconazole, bacterial infections of the respiratory headache, nausea, tiredness, thirst, erytromycin, ritonavir - increased system. Pregnancy and lactation diarrhoea, skin reaction budesonide plasma concentrations

Budesonide 500 mcg/2 ml Nebuliser B Maintenance treatment of asthma as ADULT : Initially 1 - 2 mg twice daily. Mild irritation of the throat, coughing, Hypersensitivity to budesonide. Oral or parenteral corticosteroids - Acute exacerbations, accompanied by Solution prophylactic therapy especially if not fully CHILD 3 months - 12 years of age : 500 and generally reversible hoarseness of Moderate to severe bronchiectasis effects enhanced by the increased mucous viscosity and mucous controlled by bronchodilators mcg - 1 mg. Maintenance dose : half of the voice. Bad taste, dryness of the concomitant use. Amiodarone - plugging. Caution in viral infections such the above doses throat. Candidiasis of the mouth and increased risk of developing as varicella, in untreated fungal and throat, paradoxical bronchoconstriction, Cushing's syndrome. Ketoconazole, bacterial infections of the respiratory headache, nausea, tiredness, thirst, erytromycin, ritonavir - increased system. Pregnancy and lactation diarrhoea, skin reaction budesonide plasma concentrations

Budesonide 64mcg Nasal Spray A/KK Seasonal allergic, perennial rhinitis and ADULT and CHILD 6 years and older. Nasal irritation, nose bleeding, dryness of Severe nasal infection, recurrent nasal Erythromycin, clarithromycin, Severe fungal and viral nasal infections, nasal polyposis Rhinitis : 2 spray into each nostril once throat, epistaxis, pharyngitis, cough, bleeding, hypersensitivity to budesonide lansoprazole, amoxicillin, chronic use, liver cirrhosis, reduce liver daily in the morning or 1 spray into each nasal irritation, bronchospasm, cataract, products, status asthmaticus or other fluvoxamine, itraconazole, function, pulmonary tuberculosis, nostril twice daily. Nasal polyps : 2 spray cushing's syndrome, glaucoma, acute episodes of asthma ketoconazole, protease inhibitors, glaucoma, adrenal suppression twice daily secondary hypocortisolism voriconazole, cimetidine Bupivacaine 0.5 % Heavy Injection A Used for spinal anaesthesia ADULT: 2 - 4 ml. Not to exceed 2 mg/kg Confusion, nervousness, dizziness, Hypovolaemia, complete heart block, Hyaluronidase, propofol, Neurological disorder, severe in a single dose tinnitus, respiratory depression and intravenous regional anaesthesia (Bier's rapacuronium, verapamil, bradycardia, cardiac conduction convulsion, hypotension and bradycardia, block). Acute active disease of the CNS antiarrhythmias. abnormalities, hypoxaemia, acidosis, hypersensitivity eg meningitis, tumours, poliomyelitis & hyperkalaemia, predisposition to cranial haemorrhage, active TB or malignant hypothermia, pregnancy. metastatic lesions in the vertebral Resuscitative equipment & drugs should column. Septicaemia. Pernicious anaemia be immediately available. Hypovolaemia with subacute combined degeneration of due to haemorrhage or dehydration, the spinal cord. Pyrogenic infection of the aortocaval occlusion, coronary or skin at or adjacent to the site of cerebrovascular disease. Chronic puncture. Cardiogenic or hypovolaemic neurological disorders. May impair ability shock. Coagulation disorders or ongoing to drive or operate machinery anticoagulant treatment

Bupivacaine 0.5 % Injection B For peripheral sympathetic nerve and Regional nerve block or epidural block: Confusion, nervousness, dizziness, Hypovolaemia, complete heart block, Hyaluronidase, propofol, Neurological disorder, severe epidural (excluding caudal) anaesthesia 15 - 30 ml. Nerve block of finger or toe: 2 - tinnitus, respiratory depression and intravenous regional anaesthesia (Bier's rapacuronium, verapamil, bradycardia, cardiac conduction and obstetrics anaesthesia 6 ml. Maximum: 2 mg/kg body weight in convulsion, hypotension and bradycardia, block). Acute active disease of the CNS antiarrhythmias abnormalities, hypoxaemia, acidosis, any 4 hours period, equivalent to 25 - 30 hypersensitivity, arrhythmias and cardiac eg meningitis, tumours, poliomyelitis & hyperkalaemia, predisposition to ml in adults of average weight arrest; methemoglobinaemia; seizures, cranial haemorrhage, active TB or malignant hypothermia, pregnancy restlessness. Prolonged block metastatic lesions in the vertebral column. Septicaemia. Pernicious anaemia with subacute combined degeneration of the spinal cord. Pyrogenic infection of the skin at or adjacent to the site of puncture. Cardiogenic or hypovolaemic shock. Coagulation disorders or ongoing anticoagulant treatment Bupivacaine 0.5 % with Adrenaline B Regional nerve block or epidural block. 10 - 40 ml (0.25 %) or maximum : 2 Light headedness, nervousness, Allergy or hypersensitivity to amide type May potentiate the cardiac effects Preexisting neurological or 1:200,000 Injection mg/kg body weight in any 4 hours period, apprehension, euphoria, confusion, local anesth. Epidural or spinal anesth in of antiarrhythmics (eg mexiletine & neuromuscular disease eg myasthenia equivalent to 25 - 30 ml of 0.5% solution drowsiness, tinnitus, blurred vision, patients with uncorrected hypotension. lignocaine). CNS acting drugs: gravis; CNS or spinal cord disease eg diplopia, nausea, vomiting, sensations of Infection and/or septicaemia. Obstetric tricyclic antidepressants or MAOIs, meningitis, spinal fluid block, cranial or heat, cold or numbness, urinary paracervical block, IV regional anesth phenothiazines & butyrophenones. spinal haemorrhage, tumours, retention, paraesthesia circumoral, (Bier's block). Thyrotoxicosis; regions Oxytocic drugs of the ergot type. poliomyelitis, syphilis, TB or metastatic hyperacusis, twitching, tremors, with compromised blood supply, Adrenergic neuron blocking agents lesions of the spinal cord, severe hepatic convulsions, unconsciousness, resp extremities. severe hemorrhage, severe eg guanethidine, debrisoquine, disease, severe renal dysfunction, depression &/or arrest, agitation, hypotension or shock and arrhythmias, bethanidine. β-blocker eg hyperthyroidism, epilepsy, severe numbness of the tongue, difficulty in such as complete heart block, which propranolol. Inhalation anesth eg bradycardia, severe cardiac conduction swallowing & slurred speech. CV: severely restrict cardiac output (spinal chloroform, halothane, abnormalities, severe shock or digitalis bradycardia, hypotension: anesthesia) cyclopropane, trichloroethylene or intoxication, Stokes-Adams or Wolff- Haemodynamic: maternal hypotension. other halogenated cmpds. Cardiac Parkinson-White syndrome, hypoxaemia, Neurologic: spinal block of varying glycosides, quinidine, acidosis, hyperkalaemia, predisposition magnitude (including total spinal block), hypoglycaemics to malignant hypothermia, fetal hypotension secondary to spinal motor, bradycardia/tachycardia frequently sensory &/or autonomic (sphincter follows paracervical block with some control) deficit of some lower spinal amide type local anesth & may be segment w/ slow recovery (several mth) associated with fetal acidosis & hypoxia. or incomplete recovery in rare instances Added risk in prematurity, toxaemia of when caudal or lumbar epidural block has pregnancy & fetal distress. Monitor fetal been attempted. Backache & headache. heart rate. Pregnancy. Allergic type Neuropathy, peripheral nerve injury & reactions including anaphylactic type arachnoiditis. Inadvertent subarachnoid symptoms & life-threatening or less inj may lead to CNS depression, resp severe asthmatic episodes in certain arrest & CV collapse. Allergic: cutaneous susceptible people. Extreme caution in lesions, urticaria, oedema or patients with severe or untreated anaphylactoid reactions hypertension, poorly controlled thyrotoxicosis, ischaemic heart disease, heart block, cerebrovascular insufficiency, advanced diabetes & any other pathological condition that might be aggravated by effects of adrenaline. Adrenaline may induce anginal pain in patients suffering from ischaemic heart disease. Ventricular fibrillation, prefibrillatory rhythm, tachycardia, myocardial infarction, phenothiazine- induced circulatory collapse & prostatic hypertrophy

Calamine Cream C+ Soothes and relieves nappy rashes, Apply to the affected area as required, 1- Rash or irritation Not known Not known Avoid contact with eyes and other prickly heat, minor skin irritations, insect 3 times daily mucous membranes. Not to be used on bites and sunburn, Pruritic skin open wounds or burns. conditions. Calamine Lotion C+ Soothes and relieves nappy rashes, Apply to the skin as required and allow to Rash or irritation Not known. Not known Avoid contact with eyes and other prickly heat, minor skin irritations, insect dry, 1-3 times daily mucous membranes. Not to be used on bites and sunburn, Pruritic skin open wounds or burns. conditions. Calcitriol 1 mcg/ml Injection A* Management of hypocalcaemia and/or Initially dose, depending on severity, 1 Hypercalcaemia, nausea, vomiting, Hypercalcaemia, metastatic calcification, Cytochrome P450 effect. Monitor serum calcium, phosphorus, secondary hyperparathyroidism in mcg (0.02 mg/kg) to 2 mcg 3 times polydipsia, polyuria, weakness, vitamin D toxicity and hypersensitivity to Cholestyramine, thiazides diuretics, magnesium and alkaline phosphatase, patients undergoing chronic renal dialysis weekly, approximately every other day headache, somnolence, dry mouth, calcitriol products corticosteroids, magnesium- urinary calcium and phosphorus. Patients constipation, muscle pain, bone pain, containing antacids, digitalis on digitalis. Pregnancy and lactation.Take metallic taste care to ensure correct dose to infants, monitor plasma calcium and creatinine during dosage titration Calcium Gluconate 10% Injection B i)Acute hypocalcaemia ii)Hypocalcaemic i) 1-2 g (2.25-4.5 mmol). CHILD 50 mg/kg GI irritation; soft-tissue calcification, skin Hypercalcaemia, hypercalciuria Increased inotropic and toxic Impaired renal function; cardiac disease; tetany iii)Cardiac resuscitation ii) ADULT 1g (2.2 mmol) by slow IV sloughing or necrosis after IM/SC inj. (hyperparathyroidism,Vitamin D effects when used with cardiac hypercalcaemia-associated diseases, e.g. injection followed by continuous infusion Hypercalcaemia characterised by overdosage, decalcifying tumours such as glycosides. Complex formation with sarcoidosis; other malignancies. of 4 g (8.8 mmol) daily anorexia, nausea, vomiting, constipation, plasmocytoma, bone metastases); severe tetracyclines.High vitamin D intake Pregnancy. iii) IV or intracardiac injection, 10 ml abdominal pain, muscle weakness, renal failure; patients treated with should be avoided unless specially mental disturbances, polydipsia, polyuria, digitalis; not advisable to administer inidcated. May reduce the nephrocalcinosis, renal calculi; chalky calcium gluconate to galactosaemic response of verapamil and possibly taste, hot flushes and peripheral patients. other calcium channel blockers. vasodilation. Potentially Fatal: Cardiac arrhythmias and coma.

Calcium Polystyrene Sulphonate A Hyperkalemia resulting from acute or 15 - 30g daily in 2-3 divided doses. Each Bronchopneumonia associated with Should be avoided in patients with Digitalis preparation, antacid and Patients should be monitored for Powder 5G/SACHET chronic renal failure dose should be suspended in 30 - 50ml of inhalation of calcium polystyrene conditions such as hyperparathyroidism, laxatives containing aluminium, electrolytes disturbances, especially water and administered orally sulphonate. Anorexia, nausea, vomiting, multiple myeloma, sarcoidosis, or magnesium or calcium, dried hypokalaemia and hypercalcaemia. May constipation, diarrhea, colon perforation, metastatic carcinoma who may present aluminium hydroxide gel, cause perforation in intestine, necrosis in hypopotassaemia, calcium overloading with renal failure together with magnesium hydroxide, precipitate mucous membrane of intestine, large and hypercalcaemia hypercalcaemia calcium carbonate. Calcium ions are intestine ulcer, colon necrosis released from the resin in the gastrointestinal tract and this may reduce the absorption of tetracycline given by mouth

Carbachol 0.01% Intraocular Solution A For intraocular use for miosis during Instill no more than 0.5 ml gently into the Ocular: burning, itching, smarting, Contraindicated in conditions where Not known Retinal disease; conjunctival or corneal surgery anterior chamber blurred vision, conjunctival vascular pupillary constriction is undesirable such damage. Intraocular pressure and visual congestion, myopia, lens changes with as acute iritis, anterior uveitis and some fields should be monitored in those with chronic use, vitreous haemorrhage, and forms of secondary glaucoma. Acute simple chronic glaucoma and those pupillary block Systemic: Ciliary spasm inflammatory disease of the anterior receiving long-term treatment with a leads to headache and browache which segment miotic. Caution in cardiac disease, may be more severe in the initial 2 - 4 hypertension, asthma, peptic ulceration, weeks of treatment. Flushing, sweating, urinary-tract obstruction and parkinson's epigastric distress, abdominal cramps, disease tightness in urinary bladder

Carbamazepine 100 mg/5 ml (2% A Epilepsy ADULT: Initially, 100-200 mg once or Rash, Stevens-Johnson Syndrome, Hypersensitivity to carbamazepine Plasma level is increased by Breast feeding, pregnancy, liver or kidney w/v) Syrup twice daily gradually increased by nausea, drowsiness, dizziness, ataxia, products or tricyclic compounds, bone erythromycin, diltiazem, isoniazid, dysfunction, increased intraocular increments of 100-200 mg every 2 week. blood dyscrasias, confusion, agitation, marrow suppression, porphyria. verapamil, fluoxetine, cimetidine pressure, history of cardiac damage, Maintenance: 0.8-1.2 g daily in divided visual disturbance, constipation or Concomitant MAOIs. and decreased by other elderly patients, glaucoma, may doses. CHILD: 10-15 years: 0.6-1 g daily; 5-diarrhoea, anorexia, leukopenia, blood antiepileptics and theophylline. exacerbate certain types of idiopathic 10 years: 400-600 mg daily; 1-5 years: disorders, Syndrome of inappropriate May reduce alcohol tolerance and epilepsy. Avoid abrupt discontinuation. 200-400 mg daily; less than or equal to 1 ADH (SIADH), cardiac conduction antagonise the effects of non- Neonatal withdrawal syndrome. year: 100-200 mg daily. Alternatively, 10- abnormalities, gynaecomastia. Allergic depolarising muscle relaxants. Potential for an increase in risk of suicidal 20 mg/kg body weight daily in divided skin reactions, vomiting, accommodation Cytochrome P450 3A4 inducers or thoughts or behaviours doses. Max: Adult: 1.6 g daily disorders, diplopia, raised liver enzymes, inhibitors, oral contraceptive thrombocytopenia and hyponatraemia, exfoliative dermatitis.

Carboprost Tromethamine 250 mcg A* Postpartum haemorrhage refractory to Initially 250 mcg deep IM inj. The dose Nausea, vomiting and diarrhoea, Hypersensitivity to prostagladin, acute Not known History of asthma, hypo- or Injection oxytocin may be repeated at intervals of 15-90 paraesthesia, fever or chills, dystonia, pelvic inflammatory disease, cardiac, hypertension, CV, renal or hepatic min if necessary. Max total dose: 2 mg. breast tenderness, hyperthermia and renal, pulmonary or hepatic disease disease, anemia, jaundice, diabetes, flushing, bronchospasm, cardiovascular epilepsy. Patients w/ compromised collapse (scarred) uteri, transient pyrexia, chorioamnionitis. Cefazolin Sodium 1 g Injection A Infection caused by cefazolin-sensitive ADULT: Uncomplicated infections: 500 - Drug induced fever, reddening of skin Hypersensitivity to cephalosporins Warfarin, probenecid Adjusted dosage in patients with severe microorganism, infection of the 1000 mg 2 - 3 times daily. Moderately with heat sensation, angioneurotic renal impairment. Caution use in patients respiratory tract, urogenital tract, skin severe and severe infections: 500 - 1000 edema, itch, Steven Johnson Syndrome, with a history of pencillin allergy. and soft tissue, bile duct, bones and joint, mg 3 - 4 times daily. Severe life- urticaria, eosinophilia, allergic nephritis, Prolonged use may result in fungal or endocarditis, systemic septic infection, threatening infections: 1 - 1.5 g 4 times GI disturbances, anaphylactic reactions. bacterial superinfection, including peri-operative/ surgical prophylaxis daily. Rarely, dose up to 12 g daily. Pseudomembranous enterocolitis, C.difficile-associated diarrhea and CHILDREN >1 month: 25-50mg/kg/day in leukopenia, thrombocytopenia, pseudomembranous colitis. May be 3-4 divided dose neutropenia and associated with increased INR. History of hepatotoxicity,encephalopathy, seizure Seizure disorder with presence of renal disorder may increase risk of seizure.

Cefepime 1 g Injection A* Febrile neutropenia, septicaemia, lower ADULT: 1 - 2 g twice daily for most GI disturbances (diarrhoea, nausea, Hypersensitivity to cephalosporins, Typhoid vaccine Hypensensitivity, pseudomembranous respiratory tract infection, urinary tract infections. For severe infections including vomiting), history of colitis, penicillins or other beta-lactam colitis& superinfection may occur. infection, skin and skin structure febrile neutropenia: 2 g 3 times daily. hypersensitivity, respiratory and CNS antibiotics Discontinue therapy if allergic reaction infections, gynaecologic and intra- CHILD:2 mth - 16 yr: ≤40 kg: 50 mg/kg disorders including headache, vaginitis occurs. Pregnancy, lactation abdominal infections every 8-12 hr for 7-10 days

Cefoperazone Sodium 1 g Injection A Infections due to gram-negative bacteria ADULT: 1 - 2 g twice daily IM or IV. By IV, Hypersensitivity reactions eg. rash, Hypersensitvity to cephalosporins Heparin, typhoid vaccine, warfarin Penicillin-sensitive patients, severe biliary adult dose may be doubled. Maximum: urticaria, fever, neutropenia (reversible), obstruction, severe hepatic disease or 16 g daily in divided doses. CHILD & hypothrombinaemia, GI effects & local coexisting renal dysfunction INFANT: 50 - 200 mg/kg/day in 2 - 4 reactions, vitamin K deficiency divided doses. NEONATE less than 8 days: 50 - 200 mg/kg/day 12 hourly

Cefoperazone Sodium 500 mg & A i) Treatment of infections due to multi- ADULT: 1 - 2 g twice daily. In severe or Diarrhoea, nausea, vomiting, Known allergy to penicillins, sulbactam or Heparin, typhoid vaccine, warfarin Hepatic dysfunction & concomitant renal Sulbactam Sodium 500 mg Injection drug resistance pathogens producing B- refractory infections the daily dosage of maculopapular rash, urticaria; cephalosporins impairment, ingestion of alcoholic lactamase ii) Treatment of infections sulbactam/cefoperazone may be eosinophilia; drug fever beverages; overgrowth of nonsusceptible caused by Acinetobacter species increased up to 8g (4g cefopreazone organisms activity) CHILD: 40 - 80 mg/kg/day in 2 to 4 equally divided doses; in serious or refractory infections, may increase to 160mg/kg/d in 2 - 4 equally divided doses.

Cefotaxime 1 g Injection A Infections due to gram-negative bacteria ADULT: 1 g 12 hourly (up to 12 g/day in Rash, pruritus, diarrhoea, nausea, Hypersensitivity to cephalosporins Aminoglycosides, probenecid, Hypersensitivity to penicillins, history of severe cases). CHILD: 50 - 180 mg/kg/day vomiting, colitis, thrombocytopenia, typhoid vaccine gastrointestinal disease especially colitis, in 4 - 6 divided doses eosinophilia, leucopenia, hypersensitivity pregnancy & lactation reactions, GI effects, anaphylactic shock(rare)

Cefotaxime 500 mg Injection A Infections due to gram-negative bacteria ADULT: 1 g 12 hourly (up to 12 g/day in Rash, pruritus, diarrhoea, nausea, Hypersensitivity to cephalosporins Aminoglycosides, probenecid, Hypersensitivity to penicillins, history of severe cases). CHILD: 50 - 180 mg/kg/day vomiting, colitis, thrombocytopenia, typhoid vaccine gastrointestinal disease especially colitis, in 4 - 6 divided doses eosinophilia, leucopenia, hypersensitivity pregnancy & lactation reactions, GI effects, anaphylactic shock(rare)

Ceftazidime 1 g Injection A Severe gram negative bacterial infections ADULT: 1 g 8 hourly or 2 g 12 hourly. In GI upsets, CNS effects, phlebitis or Hypersensitivity to cephalosporins Aminoglycosides, probenecid, Hypersensitivity to penicillins, renal severe infections: 2 g 8 hourly. CHILD: 25 - thrombophlebitis at the IV injection site, chloramphenicol, live typhoid impairment 150 mg/kg/day in 2 - 3 divided doses pain and/or inflammation after IM vaccine injection, very rarely hypersensitivity reactions. Transient haematologicals changes

Ceftazidime 2 g Injection A Severe gram negative bacterial infections ADULT: 1 g 8 hourly or 2 g 12 hourly. In GI upsets, CNS effects, phlebitis or Hypersensitivity to cephalosporins Aminoglycosides, probenecid, Hypersensitivity to penicillins, renal severe infections: 2 g 8 hourly. CHILD: 25 - thrombophlebitis at the IV injection site, chloramphenicol, live typhoid impairment 150 mg/kg/day in 2 - 3 divided doses pain and/or inflammation after IM vaccine injection, very rarely hypersensitivity reactions. Transient haematologicals changes Ceftriaxone 1g Injection A Infections caused by susceptible ADULT: 1 - 2 g once daily. Severe GI upsets, haematological changes, skin Hypersensitivity to cephalosporins. Ciclosporin, typhoid vaccine Previous hypersensitivity to penicillins, organisms infection: 4 g daily at 12 hour intervals. reactions, coagulation disorders, Neonates aged less than or 28 days if anaphylactic shock, severe renal & INFANT & CHILD, 3 weeks - 12 years: 20 - phlebitis, agranulocytosis, renal they require treatment with calcium- hepatic failure, pregnancy. Ceftriaxone 80 mg/kg body weight daily. CHILD with precipitations containing intravenous solutions, and calcium -containing solutions may be body weight 50 kg or more: adult dose. including calcium-containing infusions administered sequentially to one another NEONATE up to 2 weeks: 20 - 50 mg/kg such as parenteral nutrition, because of if the infusion lines are thoroughly body weight daily, not to exceed 50 the risk of precipitation of ceftriaxone- flushed between infusions with mg/kg calcium compatible fluid. Diluents containing calcium (Ringer's / Hartmann's solution) are not to be used to reconstitute ceftriaxone vials or to further dilute a reconstituted vial for IV administration because a precipitate can form. Ceftriaxone must not be administered simultaneously with calcium- containing intravenous solutions, including continous calcium -containing infusions such as parenteral nutrition via a Y-site, because precipitation of ceftriaxone- calcium can occur

Cefuroxime Axetil 125 mg/5 ml A Infections caused by susceptible 30 mg/kg/day in 2 divided doses, up to GI disturbances occasionally Hypersensitivity to cephalosporins Drugs which reduce gastric acidity, Anaphylactic reaction to penicillins, Suspension organisms 500 mg daily. pseudomembraneous colitis, such as proton pump inhibitors and Severe renal impairment; pregnancy, hypersensitivity reactions, eosinophilia, H2 antagonists lactation headache, superinfection

Cefuroxime Sodium 1.5 g Injection A Infections caused by susceptible ADULT: 750 mg every 6 - 8 hours as IM or Hypersensitivity, GI disturbances Hypersensitivity to cephalosporins Probenecid, aminoglycosides, live Anaphylactic reaction to penicillins, organisms, surgical prophylaxis IV. Severe infections: 1.5 g every 6 - 8 including pseudomembraneous colitis, typhoid vaccine concurrent treatment with potent hours as IV. CHILD: 30 - 100 mg/kg/day in haematological changes, superinfection, diuretics. Renal impairment 3 - 4 divided doses or 2-3 divided doses in transient pain at IM injection site, neonates. Surgical prophylaxis: 1.5 g IV thrombophlebitis (IV injection)

Cephalexin Monohydrate 125 mg/5 B Respiratory tract infections, ear, nose CHILD: 25 - 100 mg/kg/day every 6 GI disturbances, overgrowth of non- Hypersensitivity to cephalosporins Concurrent treatment with high Hypersensitivity to penicillins, renal ml Syrup and throat infections, urinary tract hourly. Maximum: 4 g daily susceptible organisms, hypersensitivity doses of cephalosporins& impairment, superinfection. Pregnancy infections, obstetric and gynaecologic reactions, reversible neutropenia aminoglycosides or potent diuretics and lactation infections may adversely affect renal function. Probenecid may increase or prolong plasma level & toxicity of cephalosporins

Cetrimide 2% Lotion. C+ As shampoo and cleansing agent Apply to affected area Cutaneous irritation and local effects Hypersensitivity to cetrimide Not known Contact with the eyes, brain, meninges, and middle ear should be avoided. Cetrimide should not be used in body cavities or as an enema Charcoal, Activated 50 g Granules A Emergency treatment of acute oral ADULT:Acute poisoning: 50 - 100g in Black feces, diarrhea, vomiting, Poisoning which caused by irritating Leflunomide (moderate, probable). It should be administered immediately poisoning and drug overdose suspension. Severe poisoning: 50 - 100g pulmonary aspiration, hypotension, substances (such as strong acids or Mycophenolate Mofetil (major, and a doctor should be sent for as an initial dose followed by 20g every 4 - electrolyte imbalance, gastrointestinal bases). Oesophagoscopy. Gastroscopy. theoretical). Mycophenolic Acid immediately. The use of activated 6 hours. CHILDREN: 1g/kg/dose obstruction. Non-intact and non-protected airway. (major, theoretical) charcoal will cause the feces to be black. Not recommended for treatment of It will not adsorb well organic and diarrhea on children under 6 years of age inorganic salts and solvents, e.g. salts of without medical supervision. iron, lithium, thallium, cyanide, menthanol, ethanol, ethylene glycol, and petroleum containing solvents. With these substances, other methods of poison elimination (e.g. gastric lavage) should be used.

Chloral Hydrate 200 mg/5 ml Mixture B Preoperative sedation ADULT : 0.5 - 1 g (max 2 g) with plenty of Arrhythmias, hallucination, Hypersensitivity to chloral hydrate Warfarin, increased risk of History of gastritis or duodenal ulcers, water at bedtime. CHILD : Neonate: 30- disorientation, nausea, vomiting, products, cardiac disease, hepatic or bleeding. Frusemide, cardiovascular mentally depressed patients, severe 50 mg/kg; up to 100 mg/kg may be used diarrhoea, gastric irritation, vertigo, renal impairment, pregnancy, breast toxicity (diaphoresis, hypertension, cardiac disease, respiratory disease, with respiratory monitoring. 1 mth-12 yr: nightmares, delirium, flatulence, feeding, porphyria, gastritis tachycardia). Alcohol, increased lactation, acute intermitent porphyria, 30-50 mg/kg (max: 1 g); up to 100 mg/kg abdominal distention, leucopenia, sedation. May reduce effect of skin/mucous membrane irritation, avoid (max: 2 g) may be used; 12-18 yr: 1-2 g. eosinophilia, ketonuria, respiratory phenytoin prolonged use and abrupt withdrawal Doses to be taken 45-60 minutes before depression, rashes procedure. May be given rectally if oral route is not available.

Chloramphenicol 0.5% Eye Drops C Broad spectrum antibiotic in superficial Instill 1 drop of a 0.5% solution every 2 Allergic reactions, superinfection, bone Hypersensitivity to chloramphenicol Not known Overgrowth of non-susceptible eye infections hr. Increase dosage interval upon marrow hypoplasia including aplastic products organisms in prolonged use improvement. To continue treatment for anaemia at least 48 hr after complete healing

Chloramphenicol 1% Eye Ointment C Treatment of ocular infections involving ADULT and CHILD : Apply to the Allergic reactions, superinfection, bone Hypersensitivity to chloramphenicol Not known Overgrowth of non-susceptible the conjunctiva and/or cornea caused by conjunctiva, a thin strip (approximately 1 marrow hypoplasia including aplastic products organisms in prolonged use chloramphenicol susceptible organisms cm) of ointment every 3 hours or more anaemia frequently

Chloramphenicol 5% w/v Ear Drops C Acute otitis media, otitis externa with Apply 2 - 3 drops into the ear 2 - 3 times Sensitivity to the vehicle propylene Hypersensitivity to chloramphenicol With other antibacterials, Use with caution in the presence of perforation daily. Not to be used for long term glycol, local irritation with symptoms of products, perforated tympanic antiepileptics, anticoagulants, perforated tymphanic membrane. burning, itching, urticaria, transient membrane, chronic otitis media with cyclosporin Overgrowth of non-susceptible infection stinging perforation over prolonged use

Chlorhexidine 1:200 in Alcohol with C+ To be used undiluted for hand and skin Pre-op surgical hand disinfection: Spread Occasionally irritative skin reactions, rare Hypersensitivity to chlorhexidine Incompatible with soaps and other Avoid contact with eyes, brain meninges, Emollient (Hand Disinfectant). disinfections 5ml throughly over both hands and generalised allergic reactions, dizziness, gluconate or any component of the anionic agents. Hypochlorite body cavities, middle ear. Not for forearms, rubbing vigorously. When dry confusion, headache or stupor formulation bleaches may cause brown stains injection. Avoid prolonged skin contact. apply a further 5ml and repeat to develop in fabrics which have Allow to dry before proceeding procedure. Antiseptic hand disinfection previously been in contact with on the ward: Spread 3ml throughly over chlorhexidine solutions the hands and wrist rubbing vigorously until dry. Disinfection of patient's skin: Prior to surgery, apply to a sterile swab and rub thoroughly over the operation site for a minimum of 2 mins

Chlorhexidine Gluconate 0.2 % C As a gargle Rinse mouth with 10 ml for about 1 Occasionally, irritative skin reactions, Patients who have previously shown a Not known Avoid prolonged skin contact with Mouthwash minute twice daily extremely rare, generalised allergic hypersensitivity reaction to alcoholic solution. Avoid contact with reactions chlorhexidine. However, such reaction eyes, brain, meninges, middle ear and are extremely rare body cavities. For external use only Chlorhexidine gluconate 1% cream C+ As a disinfectant cream. It can be used Clean the affected skin area and apply Rarely irritancy, rashes and skin Hypersensitivity to any of the ingredients Chlorhexidine is incompatible with Not to be used on the brain, meninges or for disinfection or lubricating during cream as required. sensitivity. especially in those with a history of anionic agents. perforated ear drum. Keep disinfectant gynaecological and obstetric procedures possible chlorhexidine-related allergic cream out of the eyes, ears and mouth. or childbirth. reactions. Pregnancy and lactation. The product is not contraindicated during pregnancy and lactation. However, as with all medicines during pregnancy, caution should be exercised.

Chlorhexidine Gluconate 2% in C Use as disinfectant in central venous Skin Preparation:Use Chlorhexidine Defatting of the skin resulting in dryness, Avoid contact with eyes. Not known Avoid contact with eyes. Alcohol 70% Solution catheter care bundle Gluconate 2% in Isopropyl Alcohol 70% cracking and dermatitis (with repeated or and allow to dry. Catheter acces:Apply to prolonged contact), ingestion may cause catheter ports or hubs prior to accessing gastrointestinal disturbances. Inhalation the line for administering fluids or of high concentration may cause injections breathing difficulties, headaches, dizziness or unconsciousness.

Chlorhexidine Gluconate 4% Scrub C+ Surgical hand scrub/disinfection, pre-op Surgical hand disinfection: Apply 5ml to Occasionally irritative skin reactions, Hypersensitivity to chlorhexidine Not known For external use only. Avoid contact with skin preparation clean hands and forearms for 1 min. generalised allergic reactions, may cause gluconate or any component of the eyes and middle ear Rinse and repeat with another 5ml for a gastrointestinal disturbances. Inhalation formulation further 2 mins and then rinse and dry. of solvent vapours may give rise to General skin disinfection: Apply nausea, headaches and dizziness appropriate quantity to wet area and scrub for 1 min. Rinse thoroughly & dry

Chlorhexidine Gluconate 5% Solution C+ i) Preoperative skin disinfection ii) i) & iii) 1 : 10 in 70 % Alcohol ii) 1 : 100 Mucosal irritation (discontinue if Hypersensitivity to any of its components Avoid cemented glass components Avoid contact with meninges, application Wounds or burns iii) Emergency desquamation), parotid gland swelling, into hairy areas and not use as a disinfection of instruments irritation and gastrointestinal preoperative skin preparation for the disturbances. Inhalation of solvent face or head. Keep disinfectant solution vapours may give rise to nausea, out of the eyes, ears and mouth headaches and dizziness

Chlorinated Lime Solution & Buffered C Wound or ulcer Apply to affected areas undiluted as a Skin irritation Patients who have previously shown a Not known Topically applied hypochlorites may Acetate Solution cleansing agent hypersensitivity reaction dissolve blood clots and cause bleeding

Chlorpheniramine Maleate 10 mg/ml B Allergic conditions 10 - 20 mg IM or SC, repeated if required. Drowsiness, dizziness, stinging or burning Hypersensitivity to chlorpheniramine, not Alcohol pontentiate CNS Porphyria, pregnancy, asthma, glaucoma, Injection Not to exceed 40 mg in 24 hours. 10 - 20 sensation at injection site, hypotension, to be used in children less than 2 years of depressants, actions prolonged by avoid operating vehicles or machinery. mg over 1 minute by slow IV CNS stimulation, tinnitus, blurred vision, age. MOAIs, anticholigernic drugs Parenteral injection have to be protected irritability, lassitude from light to prevent discolouration. To be used with caution and doctor's advice in children 2 to 6 years of age.

Chlorpheniramine Maleate 2 mg/5 C Symptomatic treatment of allergic CHILD 2 - 5 years : 1 mg every 4 - 6 hours Drowiness, dizziness, hypotension, CNS Hypersensitivity to chlorpheniramine, Alcohol pontentiate CNS Porphyria, pregnancy, asthma, glaucoma, ml Syrup conditions responsive to antihistamine (maximum 6 mg daily) 6 - 12 years : 2 mg stimulation, tinnitus, blurred vision, not to be used in children less than 2 depressants, actions prolonged by avoid operating vehicles or machinery, to every 4 - 6 hours (maximum 12 mg daily) irritability, lassitude years of age. MAOIs, anticholinergic drugs be used with caution and doctor's advice in children 2 to 6 years of age.

Choline Salicylate 8.7%, Cetylkonium B For relief of the pain and discomfort in Apply to area 4 times daily Not known Infants less than 4 months or in patients Not known Excessive use can lead to salicylate Chloride 0.01% Dental Gel mouth ulcers and sores, infant teething with a history of salicylate sensitivity. poisoning. During therapy, do not give and denture irritation Preparations containing aspirin should aspirin to children 16 year. Co- not be given to young children during administration with drugs for blood clots treatment to avoid any risk of excessive and gout. Stomach ulcer. Pregnancy salicylate levels Chorionic Gonadotrophin Human A* i)Treatment of infertile women to induce i) & ii)Induction of ovulation: 5000 - Thromboembolism, oedema, headache, Hypersensivity to human gonadotrophins When used with gonadotrophins Use of human gonadotrophin either to (HCG) 5000 IU Injection ovulation ii) As a luteal support in 10,000 units one day following last dose irritability, restlessness, depression and , known or suspected sex hormone - (Follicle Stimulating Hormone), induce ovulation or as a luteal support, controlled ovarian hyperstimulation of menotropin. Up to 3 repeat injections tiredness, salt and fluid retention, pain at dependent tumours, malformations of ovarian hyperstimulation may increase the risk of ovarian cycles of 5000 units each may be given within injection site, skin rashes the sexual organs;Pregnancy & lactation. syndrome, enlargement of ovarian hyperstimulation syndrome (OHSS) the following 9 days to prevent cysts or rupture of ovarian cysts insufficiency corpus luteum and multiple births may occur

Ciprofloxacin 200 mg/100 ml A Treatment of infections due to Suggest to rephrase ADULT: the dosage Nausea, diarrhoea, vomiting, dyspepsia, Hypersensitivity to ciprofloxacin or other Suggest: Drugs metabolised by Epilepsy, CNS disorder, liver damage, Injection susceptible bacterial strains range is 100-400mg twice daily abdominal pain, flatulence, anorexia, quinolones. Children, adolescents, CYP1A2 (e.g Theophylline, renal impairment. Avoid prolonged Gonorrhoea: 100mg single dose Upper dizziness, headache, tiredness, agitation, pregnancy and lactation Clozapine, Tizanidine) Oral Anti- exposure to sunlight and Lower Urinary Tract Infection: 100mg trembling, insomnia, peripheral coagulants NSAIDs Phenytoin, bd Upper and Lower Respiratory Tract paralgesia, sweating, unsteady gait, Cyclosporin, Glibenclamide, Infection: 200mg bd-400mg twice daily convulsions, increase in intracranial Methotrexate, Probenecid and Cystic Fibrosis with psuedomonal Lower pressure, anxiety states, nightmares, other prokinetic drugs RTI: 400mg bd Others: 200-400mg bd confusion, depression, hallucinations, inhalation Anthrax: 400mg bd impaired taste and smell, visual disturbances, tinnitus, transitory impairment of hearing, especially at high frequencies, skin reactions

Clindamycin Phosphate 150 mg/ml A* i) Skin and soft tissue infections, bone & i) ADULT: 0.6 - 2.7 g daily (in 2 - 4 divided Diarrhoea, occasionally associated with Hypersensitivity to clindamycin or Neuromuscular blockers, History of GI disease, especially Injection joint infections ii) Cerebral toxoplasmosis doses); up to 4.8 g daily; CHILD over 1 severe colitis, skin reactions, jaundice, lincomycin. Patients with diarrhoea erythromycin colitis.Discontinue immediately if month, 20 - 40 mg/kg/day or 350 haematopoietic changes. Local irritation, diarrhoea or colitis develops. Renal or mg/m2/day in 3 - 4 divided doses ii) 1200 pain at IM injection site. hepatic impairment. Perform periodic mg every 6 hours for 3 weeks followed Thrombophlebitis may occur with IV liver and kidney function tests with by 300 mg orally every 6 hours for injection. Rarely, cardiopulmonary arrest prolonged therapy and in neonates and another 3 weeks & hypotension following too rapid IV infants. Pregnancy and lactation. administration Superinfection.

Clobetasol Propionate 0.05% Cream A Short term treatment only of more Apply sparingly once or twice daily, Local atrophic skin changes, Rosacea, acne vulgaris, skin lesions Not known INFANTS and CHILD: prolonged and resistant dermatoses eg. psoriasis, changing to lower potency therapy as hypercorticism, burning, stinging, caused by viral, fungal and bacterial continuous use, pregnancy, avoid contact recalcitrant eczemas, lichen planus, soon as condition is controlled. For mild irritation and adrenal suppression infections. Hypersensitivity to clobetasol with eyes. Do not use for greater than 2 discoid lupus erythematosus and other to moderate use maximum for 2 weeks. or other corticosteroid consecutive weeks or with occlusive conditions which do not respond For moderate to severe maximum dressing satisfactorily to less potent steroids duration 4 consecutive weeks. Max: 50 g/week

Clotrimazole 1% Cream B Cutaneous candidiasis, Tinea corporis, Rub in gently onto affected and Skin reactions, contact dermatitis, Hypersensitivity to clotrimazole Not known Contact with eyes and mucous Tinea cruris, Tinea pedis and Tinea surrounding skin 2 or 3 times daily pruritis menbranes should be avoided versicolor continuing for about 2 weeks beyond the dissapearance of all symptoms

Clotrimazole 1% Ear Drop B Otomycosis; concomitant therapy with 4 to 5 drops 3 to 4 times daily local irritation Hypersensitive to clotrimazole Not known Perforated eardrums, otitis media, antibiotics and corticosteroid ear drops pegnancy and lactation

Clotrimazole 500 mg Vaginal Tablet B Vaginal candidiasis 500 mg as a single one-time dose Local irritation or skin reaction and mild Hypersensitivity to clotrimazole Concurrent use with Monitor hepatic function in patients with burning, nausea, vomiting, troches, betamethasone may result in pre-existing hepatic impairment, not for increased liver enzymes increased susceptibility to skin ophthalmic use and vaginal use in infection or enhanced organism pregnant patients should be supervised growth. Concurrent use with by a physician tacrolimus may increase plasma concentration of tacrolimus and cause toxicity (nephrotoxicity, hyperglycaemia, hyperkalaemia), fentanyl Cloxacillin Sodium 125 mg/5 ml B Treatment of susceptible bacterial Child: 50-100 mg/kg in divided doses Neutropenia, agranulocytosis; GI upsets; Hypersensitivity to cloxacillin Probenecid impairs renal excretion. Renal impairment. Neonates born to Suspension infections, notably penicillinase- every 6 hr rash. Sore mouth or tongue. Black hairy products/penicillins, cephalosporins Decreases anticoagulant effect mothers hypersensitive to penicillin. producing staphylococci tongue.Neuromuscular hypersensitivity; Hypersensitivity to cephalosporins. pseudomembranous colitis; anaphylaxis. History of ulcerative colitis. Supra- infection with prolonged used.

Cloxacillin Sodium 250 mg Injection B Treatment of susceptible bacterial ADULT: 250 to 500 mg every 6 hours Fever, rash, nausea, vomiting, diarrhoea, Hypersensitivity to cloxacillin or Allopurinol, chloramphenicol. History of asthma or allergic-type infections, notably penicillinase- depending on type and severity of hepatotoxicity, anaphylaxis penicillins Probenecid impairs renal excretion. reactions to other medications, producing staphylococci infections infection. CHILD less than 20 kg: 25 to 50 Anticoagulant effect is decreased. overgrowth of nonsusceptible organisms. mg/kg/day in equally divided doses every Tetracycline, oestrogen-containing Pregnancy and lactation.Renal 6 hours oral contraceptives. Antiperistalstic impairment. antidiarrhea(opiates, diphenoxylate, atropine)

Cloxacillin Sodium 500 mg Injection B Treatment of susceptible bacterial ADULT: 250 to 500 mg every 6 hours Fever, rash, nausea, vomiting, diarrhoea, Hypersensitivity to cloxacillin or Allopurinol, chloramphenicol. History of asthma or allergic-type infections, notably penicillinase- depending on type and severity of hepatotoxicity, anaphylaxis penicillins Probenecid impairs renal excretion. reactions to other medications, producing staphylococci infections infection. CHILD less than 20 kg: 25 to 50 Anticoagulant effect is decreased. overgrowth of nonsusceptible organisms mg/kg/day in equally divided doses every Tetracycline, oestrogen-containing 6 hours oral contraceptives

Coal Tar with Salicylic Acid (various B Dandruff, seborrhoeic dermatitis, atopic Apply to the affected areas or as in See product leaflet Avoid contact with eyes, mucous concentrations) Solution dermatitis, eczema and psoriasis product leaflet membranes or broken skin. Avoid exposure to sun or strong artificial light. Should not be used for acute or pustular psoriasis or on inflammed skin. It stains skin, hair, some fabrics, plastics, and enamel

Cocaine 10% Solution B To produce local anaesthesia or Maximum total dose recommended for Can cause addiction, arrythmia, Never given by injection due to its Interacts with some drugs and can Avoid in porphyria and direct sunlight vasoconstriction during endoscopic nasal application to the nasal mucosa in palpitation, central nervous system marked sympathomimetic effcts cause arrhythmia. surgery, turbinectomy septoplasty, healthy adult is 1.5 to 2 mg/kg of a 10% stimulation, syncope, seizure, coronary polypectomy etc cocaine solution arteriosclerosis Colistimethate Sodium 1 million IU A* Intravenous administration for the A minimum of 5 days treatment is Apnoea, transient sensory disturbances Hypersensitivity to colistimethate or Aminoglycoside such as gentamicin, Patients with porphyria, renal per vial (Polymyxin E) treatment of serious infections caused by generally recommended. For the (such as facial paraesthesia and vertigo) polymyxin B. Myasthenia gravis. amikacin, netilmicin, tobramycin impairment. Nephrotoxicity, Gram negative bacteria, when more treatment of respiratory exacerbations in and rarely, vasomotor instability, slurred and neuromuscular blocking drugs. neurotoxicity and bronchospam may commonly used systemic antibacterial cystic fibrosis patients, treatment should speech, visual disturbances, confusion or occur. Monitor serum colistimethate agents may be contraindicated or may be be continued up to 12 days. Children and psychosis. Nephrotoxicity reported sodium concentration. May affect ability ineffective because of bacterial adults (including elderly): Up to 60kg: following the use of higher than to drive or operate machinery as resistance. 50,000 units/kg/day to a maximum of recommended doses or failure to reduce neurotoxicity may occur with the 75,000 units/kg/day. The total daily dose the dosage in patients with renal possibility of dizziness, confusion or should be divided into three doses given impairment or during concomitant use of visual disturbances. Pregnancy & at approximately 8-hour intervals. Over other nephrotoxic drugs. Hypersensitivity lactation. 60kg: 1-2 million units three times a day. reactions such as rash, drug fever. Local The maximum dose is 6 million units in irritation at injection site. 24 hours. Renal impairment: In moderate to severe renal impairment, excretion of colistimethate sodium is delayed. Therefore, the dose and dose interval should be adjusted in order to prevent accumulation. Suggested Dosage Adjustment in Renal Impairment (for over 60 kg body weight): - Mild (CrCl 20- 50 ml/min): 1-2 million units every 8 hr. - Moderate (CrCl 10-20 ml/min): 1 million units every 12-18 hr. - Severe (CrCl <10 ml/min): 1 million units every 18-24 hr.

Compound Sodium Lactate C Replacement of extracellular losses of 100-1000 ml by IV or according to the Anxiety, panic attacks, apprehension or Lactic acidosis, severe acidosis, Not known Metabolic or respiratory alkalosis, (Hartmanns Solution) fluid and electrolytes, as an alkaliniser needs of the patient fear, paraesthesias, tremors, dizziness, hypernatraemia and conditions where congestive heart failure, other sodium- agent metabolic alkalosis, hypokalaemia sodium administration would be retaining conditions, concurrent detrimental corticosteroids, conditions impairing lactate utilisation (severe hepatic insufficiency, shock, beriberi, hypoxia) and during prolonged therapy

Conjugated Oestrogens 0.625 mg/g A Atrophic vaginitis and post menopausal Intravaginally or topically 0.5-2g daily Nausea, vomiting, endometrial Oestrogen dependent neoplasia, known Latex condom, phenorbarbital, Fluid retention, hypertriglyceridemia, Cream atrophic urethritis depending on severity of condition. hyperplasia, venous thrombosis, or suspected pregnancy, undiagnosed phenytoin, carbamazepine, history of cholestatic jaundice, asthma, Administration should be cyclic, with 3 neoplasm benign and malignant, oedema abnormal vaginal bleeding, rifampicin, dexamethasone, epilepsy, migraine, hypocalcemia, weeks on conjugated estrogens and one thromboembolic disorders, neuro- erythromycin, clarythromycin, hypothyroidism. week off. Estrogens should be used for ophthalmologic vascular disease, breast ketoconazole, itraconazole. the shortest duration possible when cancer (except metastatic disease treating atrophic vaginitis. Every 3 to 6 therapy) months attempts should be made to taper or discontinue therapy and conjugated estrogens should be titrated to give the lowest possible dosage to control symptoms Continuous Ambulatory Peritoneal B For chronic renal diseases requiring Dose depending on clinical cases Peritonitis, hernias, hyperglycaemia, Not known Drug with low molecular weight, Abdominal sepsis, previous abdominal Dialysis Solution containing 1.5% dialysis and acute therapy-resistance protein malnutrition and catheter high water solubility, low volume of surgery or severe inflammatory bowel Dextrose renal failure eg. prior to transfer to a complications. Long-term peritoneal distribution, low protein binding disease. Dialysis solutions should be dialysis centre dialysis results in progressive structural and high renal clearance are most warmed to body temperature with dry changes to the peritoneal membrane extensively removed by dialysis e.g. heat because wet heat carries a risk of ultimately resulting in dialysis failure aminoglycosides. Dialysis-induced microbial contamination changes in fluids and electrolytes

Continuous Ambulatory Peritoneal B For chronic renal diseases requiring Dose depending on clinical cases Peritonitis, hernias, hyperglycaemia, Not known Drug with low molecular weight, Abdominal sepsis, previous abdominal Dialysis Solution containing 4.25% dialysis and acute therapy-resistance protein malnutrition and catheter high water solubility, low volume of surgery or severe inflammatory bowel Dextrose renal failure eg. prior to transfer to a complications. Long-term peritoneal distribution, low protein binding disease. Dialysis solutions should be dialysis centre dialysis results in progressive structural and high renal clearance are most warmed to body temperature with dry changes to the peritoneal membrane extensively removed by dialysis e.g. heat because wet heat carries a risk of ultimately resulting in dialysis failure aminoglycosides. Dialysis-induced microbial contamination changes in fluids and electrolytes

Copper Sulphate Crystal C Wounds The tip of the crystal should be Severe irritant contact dermatitis and Dermal hypersensitivity reactions Not known Skin exposure may result in severe moistened by dipping in water and may produce systemic toxicity, especially irritation applied carefully to the lesion if applied to injured skin as occurred when copper sulfate was previously used in burn treatment

Crotamiton 10 % Cream B i) Pruritus ii) Scabies iii) Insect bite i) and iii) Massage into affected area until Nausea, vomiting and abdominal pain. Hypersensitivity; acute exudative Not known For external use only. Pregnancy. reactions the medication is completely absorbed. Topical: Pruritus, contact dermatitis, dermatitis. Application to the eye, Repeat as needed. Apply 2 or 3 times rash, irritation, warm sensation. mouth, other mucous membranes or on daily ii) Apply to the whole body from excoriated skin. Do not apply on nipples below the chin. 2nd application is applied when breastfeeding. 24 hr later. May need to use once daily for up to 5 days.

Cyanocobalamin 1 mg/ml Injection B i) Prophylaxis of anaemia associated with i) Prophylaxis of anaemia: 250-1000 mcg Diarrhoea, urticaria, pruritus, skin rash, Hypersensitivity to any component of Neomycin, aminosalicylic acid, Hereditary optic atrophy, vitamin B12 Vitamin B12 deficiency ii) Uncomplicated IM every month ii) Uncomplicated hypokalaemia, polycythemia vera, cyanocobalamin or hydroxycobalamin histamine H2 receptor antagonists, therapy can mask folic acid deficiency, pernicious anaemia or Vitamin B12 pernicious anaemia or Vitamin B12 volume overload formulations, Leber's disease. colchicine, oral contraceptives, hypokalaemia and risk of gastric cancer is malabsorption malabsorption: Initial 100 mcg daily for 5- chloramphenicol higher in patients with pernicious 10 days followed by 100-200 mcg anaemia monthly until complete remission is achieved. Maintenance: up to 1000 mcg monthly. CHILD 30-50 mcg daily for 2 or more weeks (to a total dose of 1-5mg). OR AS PRESCRIBED. Cyclopentolate 0.2% with A Dilating agent for premature babies 1 drop every 5 - 10 minutes; not Increased intraocular pressure, psychotic Untreated narrow-angle glaucoma, Cyclopentolate may interfere with The lacrimal sac should be compressed Phenylephrine 1% Eye Drops exceeding three times to produce rapid reactions and behavioural disturbances untreated anatomically narrow angles, the ocular anti-hypertensive action by digital pressure for two to three mydriasis. Observe infants closely for at in children, burning/irritation upon hypersensitivity to any component of this of carbachol, pilocarpine, or minutes after instillation to reduce least 30 minutes instillation, photophobia, blurred vision preparation ophthalmic cholinesterase excessive systemic absorption. Down's and superficial punctate keratitis, ataxia, inhibitors syndrome, angle-closure glaucoma, long- incoherent speech, restlessness, term use. Patient may experience hallucinations, hyperactivity, seizures, sensitivity to light and should protect disorientation as to time and place, and eyes in bright illumination during dilation. failure to recognize people Feeding intolerance may follow ophthalmic use of this product in infants. Patients with cardiovascular disease, hypertension, hyperthyroidism

Cyclopentolate 1% Eye Drops A Mydriasis and cycloplegia ADULT : 1 drop of solution in eye(s); may Mild tachycardia, secretion decrease and Should not used in children under 6 years Cyclopentolate may interfere with May impair ability to drive or operate repeat after 5-10 minutes if needed. action on the CNS, blurred vision, old unless directed by physician antiglaucoma action of carbachol or machinery CHILD : 1 drop of solution in eye(s); may increased intraocular pressure, allergic pilocarpine repeat after 5-10 minutes if needed. Pre- reactions. Psychotic reactions and treatment on the day prior to behavioural disturbances (usually in examination is usually not necessary. If children) eg; ataxia, incoherant speech, desirable, 1 or 2 drops may be instilled restlessness, hallucinations, the evening prior to examination. hyperactivity, seizures, disorientation as to time and place.

Desferrioxamine B A i) Acute iron poisoning in children ii) i) 2 g by IM immediately and 5 g by Thrombocytopenia, hypotension, Anuria or severe renal disease Ascorbic acid, phenothiazines Safety and effectiveness have not been Methanesulphonate 0.5 g Injection Investigation and treatment of mouth after gastric lavage ii) 0.5 - 1.5 g tachycardia, flushing, rash, anaphylactic established in children under the age of 3 haemochromatosis iii) Diagnosis and by IM injection daily iii) Diagnosis: 5 mg reaction, disturbance of vision and years, vision or auditory problem. treatment of aluminium toxicity in per kg by slow intravenous infusion hearing, vomiting, diarrhoea, shock, Concomitant vitamin C with patients with renal failure and dialysis iv) during the last hour of haemodialysis. tachyarrhythmia, ototoxicity (frequent), desferrioxamine in patients with severe Chronic iron toxicity or overload Treatment: 5 mg per kg once a week by mycosis (rare) chronic iron overload or cardiac failure, slow intravenous infusion during the last high doses and concomitant low ferritin hour of dialysis iv) 30 - 50 mg/kg levels have been associated with growth retardation, increased susceptibility to Yersinia enterocolitica, Yersinia pseudotuberculosis, mucormycosis, patients with aluminum overload or aluminum-related encephalopathy

Desflurane Liquid A i) Induction and maintenance of ADULT: Induction , initially 3% in oxygen Dose-dependent hypotension and Known sensitivity to halogenated agents Enhanced effects of neuromuscular Patients with, or at risk of, raised anaesthesia in adult ii) Maintenance of or nitrous oxide/oxygen and increased by respiratory depression. Cough, breath and in patients with known or genetic blockers; CNS depressants. Lower intracranial pressure. Cardiac, anaesthesia in infants & children 0.5%-1% every 2-3 breaths or as holding, salivation, apnoea and susceptibility to malignant hyperthermia dose is required when used with respiratory, renal or hepatic impairment. tolerated (up to 11%), until loss of laryngospasm. Post-operation nausea & ;History of liver dysfunction, jaundice or opioids, benzodiazepines and other Elderly or obese patients. May impair consciousness. Maintenance: 2.5%-8.5% vomiting. Transient increase of white unexplained fever, leucocytosis,or sedatives. Enhanced hypotensive ability to drive or operate machinery. with or without concomitant nitrous blood cells count, malignant eosinophilia after a previous halogenated effects of ACE inhibitors, tricyclic Avoid alcohol. Concomitant use with oxide CHILD: maintenance, inhaled in hyperthermia. anesthetic administration. Not to be antidepressants (TCAs), MAOIs, adrenaline or other sympathomimetics. concentrations of 5.2%-10% with or used as the sole agent for anesthetic antihypertensives, antipsychotics, Pregnancy and lactation without concomitant nitrous oxide induction in patients at risk of coronary beta-blockers. artery disease or in patients where increases in heart rate or blood pressure are undesirable. Not to be used as an induction for pediatric patients. Desmopressin Acetate 4 mcg/ml A Diabetes insipidus ADULT : 1 - 4 mcg IV daily. CHILD :0.4 Nausea, hypertension, hypotension, Hypersensitivity to desmopressin , Chlorpropamide, fludrocortisone, Avoid fluid overload in the very young Injection mcg daily palpitation, anaphylaxis, transient hyponatremia or a history of lithium, carbamazepine, and the elderly, conditions characterized headache, stomach pain, epistaxis and hyponatremia , moderate-to-severe renal chloropromazine, indomethacin by fluid and or electrolyte imbalance and fatigue, transient fall in blood pressure impairment , unstable angina pectoris , those at risk for increased intracranial with reflex tachycardia and facial flushing decompensated cardiac insufficiency and pressure. Caution in renal concentration von Willebrand's disease type IIB capacity testing for infant less than 1 year. In hemostatic use, avoid fluid overload in patient taking diuretics

Dexamethasone and Neomycin A Treatment of ocular inflammation when 1 - 2 drops hourly for severe cases and 4 - Burning and stinging or local irritation Hypersensitivity to its component, viral, Not known Glaucoma, corneal or scleral thinning, Sulphate and Polymyxin B Sulphate concurrent use of an antimicrobial is 6 hourly for mild infection may occur. Hypersensitivity (due to fungal, tuberculosis and other infections history of HSV infection Ophthalmic Suspension judged necessary neomycin content). Ocular itching, of the eye. The use is contraindicated reddening, conjunctival oedema, rash or after uncomplicated removal of a corneal persistent irritation, periorbital oedema. foreign body Elevation of intraocular pressure with possible development of glaucoma, and infrequent optic nerve damage, posterior subcapsular cataract formation and delayed wound healing

Dexamethasone Sodium Phosphate A Acute steroid responsive inflammatory 1 - 2 drops 4 - 6 times a day Red eye, steroid glaucoma, steroid Viral, fungal, tuberculosis and other Not known Prolonged use may lead to posterior 0.1% Eye Drops and allergic conditions cataract, thinning of the cornea and infections of the eye. Hypersensitivity to subcapsular cataract formation and sclera. Burning, dry eyes, photophobia, dexamethasone glaucoma with raised optic-ocular glaucoma, elevated intraocular pressure, pressure. Pregnancy. Extensive use may optic nerve damage, cataract lead to systemic effects

Dexamethasone Sodium Phosphate 4 B i) Prophylaxis and management of Initially 0.5 - 9 mg IM, IV or infusion daily, Fluid and electrolyte disturbances, Hypersensitivity, administration of live Barbiturates, phenytoin, rifampin During periods of stress. Mask the signs mg/ml Injection nausea and vomiting in cancer depending upon the disease being muscle weakness, peptic ulcer vaccines and systemic fungal infection. may decreases dexamethasone of infection and decrease resistance to chemotherapy, post-operation and treated effects; dexamethasone decreases infection. Discontinue treatment by palliative care, ii) Treatment of effect of salicylates, vaccines, reducing the dosage gradually. Patients adrenocortical function abnormalities, iii) toxoids. Increased effect: with ocular herpes simplex, psychic Any other treatment requiring Salmeterol: The addition of derangements, gastric duodenal ulcer, corticosteroid therapy. salmeterol has been demonstrated congestive heart failure, hypertension, to improve response. Diuretics, diabetes mellitus, chronic renal failure, antidiabetics, cardiac glycosides, uremia and elderly. Unless considered oestrogens, somatropin, life saving, the use of systemic mifepristone, NSAIDs. administration of corticosteroids is contraindicated in patients with osteoporosis, psychoses or severe psychoneurosis.

Dexmedetomidine HCl 100 mcg/ml A* i) Sedation of intubated and mechanically i) Not to be infused for more than 24 Hypotension (more frequent), Hypersensitivity to dexmedetomidine Enhances effects of anaesthesia, Significant cardiovascular dysfunction, Injection ventilated ICU patients. For use only by hours, 1 mcg/kg over 10 minutes as hypertension, cardiovascular disease, sedative, hypnotics and other CNS advanced heart block, renal and hepatic specialist anaesthetist ii) For sedation of loading dose. Maintenance dose: 0.2 - nausea, dry mouth, hypoxia, somnolence depressants, opiods impairment, elderly more than 65 years, non-intubated patients prior to and/or 0.7 mcg/kg/hr ii) Not to be infused for pregnancy, lactation, diabetes mellitus, during surgical and other procedures more than 24 hours, 1 mcg/kg over 10 chronic hypertension minutes as loading dose. Maintenance dose: 0.2 - 0.7 mcg/kg/hr Dextrose 10% Injection B For parenteral replenishment of fluid and According to the needs of the patient Thrombophlebitis, rebound Do not use concentrated solutions of Not known Diabetes mellitus or carbohydrate minimal carbohydrate calories as hypoglycaemia, hypokalaemia, dextrose in patients with anuria, diabetic intolerance and hyperglycaemia may required by the clinical condition of the pulmonary embolism, right atrial coma, hyperglycaemia, intracranial or accentuate neurologic damage for an patient thrombosis, extravasation intraspinal haemorrhage, delirium ischaemic insult. Patients at risk for tremens in dehydrated patients and cerebral ischaemia, acute stroke, glucose-galactose malabsorption impending cardiac arrest or severe syndrome. Do not administered hypotension unless hypoglycaemia is simultaneously with blood through the suggested or until glucose is determined same infusion set because of the possibility that pseudoagglutination of red cells may occur

Dextrose 5% Injection B For parenteral replenishment of fluid and According to the needs of the patient Thrombophlebitis, rebound Do not use concentrated solutions of Not known Diabetes mellitus or carbohydrate minimal carbohydrate calories as hypoglycaemia, hypokalaemia, dextrose in patients with anuria, diabetic intolerance and hyperglycaemia may required by the clinical condition of the pulmonary embolism, right atrial coma, hyperglycaemia, intracranial or accentuate neurologic damage for an patient thrombosis, extravasation intraspinal haemorrhage, delirium ischaemic insult. Patients at risk for tremens in dehydrated patients and cerebral ischaemia, acute stroke, glucose-galactose malabsorption impending cardiac arrest or severe syndrome. Do not administered hypotension unless hypoglycaemia is simultaneously with blood through the suggested or until glucose is determined same infusion set because of the possibility that pseudoagglutination of red cells may occur

Dextrose 50% Injection B For parenteral replenishment of fluid and According to the needs of the patient Thrombophlebitis, rebound Do not use concentrated solutions of Not known Diabetes mellitus or carbohydrate minimal carbohydrate calories as hypoglycaemia, hypokalaemia, dextrose in patients with anuria, diabetic intolerance and hyperglycaemia may required by the clinical condition of the pulmonary embolism, right atrial coma, hyperglycaemia, intracranial or accentuate neurologic damage for an patient thrombosis, extravasation intraspinal haemorrhage, delirium ischaemic insult. Patients at risk for tremens in dehydrated patients and cerebral ischaemia, acute stroke, glucose-galactose malabsorption impending cardiac arrest or severe syndrome. Do not administered hypotension unless hypoglycaemia is simultaneously with blood through the suggested or until glucose is determined same infusion set because of the possibility that pseudoagglutination of red cells may occur

Dextrose Powder B Use as a diagnostic agent for diabetes 75 g stat Thrombophlebitis, rebound Do not use concentrated solutions of Not known Diabetes mellitus or carbohydrate hypoglycaemia, hypokalaemia dextrose in patients with anuria, diabetic intolerance and hyperglycaemia may coma and hyperglycaemia, intracranial or accentuate neurologic damage for an intraspinal haemorrhage, delirium ischemic insult, patients at risk for tremens in dehydrated patients and cerebral ischemia, acute stroke, glucose-galactose malabsorption impending cardiac arrest, or severe syndrome hypotension unless hypoglycaemia is suggested or until glucose is determined

Diazepam 5 mg Rectal Solution B Status epilepticus, skeletal muscle spasm Status epilepticus - ADULT: 0.5 mg/kg Drowsiness, dizziness, vertigo, Respiratory depression, acute pulmonary Central nervosu system Respiratory disease, history of drug or repeated after 12 hours if necessary. hallucinations, blurred vision, confusion, insufficiency, severe hepatic impairment, depressants, alcohol, barbiturates, alcohol abuse, drug dependence, CHILD (febrile convulsions, prolonged or muscle weakness, fatigue, incontinence acute narrow angle glaucoma, antibacterials, antivirals, pregnancy, breast feeding, renal and recurrent): 0.5 mg/kg (maximum 10 mg), or urinary retention, constipation, rashes, myasthenia gravis omeprazole hepatic impairment and avoid operating repeated if necessary. Not recommended changes in libido, leukopenia and vehicles or machinery for children below 2 years gastrointestinal disturbances. Paradoxical reactions in children and elderly Diazepam 5 mg/ml Injection B i) Status epilepticus ii) Skeletal muscle i) Status epilepticus, by slow IV: 5-10 Drowsiness, dizziness, vertigo, Respiratory depression, acute pulmonary Central nervous system Respiratory disease, history of drug or spasm iii) Anxiety disorders every 10-15 minute (rate not more than hallucinations, blurred vision, confusion, insufficiency, severe hepatic impairment, depressants, barbiturates, alcohol, alcohol abuse, drug dependence, 5 mg/min), to a total dose of 30 mg, may muscle weakness, fatigue, incontinence acute narrow angle glaucoma, isoniazid, rifampicin, phenytoin, pregnancy, breast feeding, renal and repeat in 2 hour if needed. Infants 30 or urinary retention, constipation, rashes, myasthenia gravis, hypersensitivity to ritonavir, omeprazole, cimetidine, hepatic impairment and avoid operating days to 5 years, 0.05-0.3 mg/kg/dose changes in libido, leukopenia and diazepam products, patients less than 6 theophylline, digoxin, vehicles or machinery given over 2-3 minutes, every 15-30 gastrointestinal, hypotension, ataxia, months old, alcohol intoxication, central erythromycin, itraconazole minutes to a total dose of 5 mg, repeat in respiratory depression, sedation, nervous system depression 2-4 hours if necessary. CHILD more than depression, headache, nausea, tremor, 5 years, 1 mg by slow IV, every 2-5 withdrawal syndrome, neutropenia, minutes, maximum 10 mg, repeat in 2-4 hepatotoxicity, pancytopenia, hours if necessary ii) Skeletal muscle thrombocytopenia, blood dyscrasias, spasm, by slow IV or IM, 5-10 mg bradycardia, dependence/abuse. repeated if necessary in 3-4 hours. CHILD Paradoxical reactions in children and (tetanus): 30 days - 5 years, 1-2 mg IM or elderly IV slowly every 3-4 hours as needed. 5 years and above, 5-10 mg IM or IV slowly every 3-4 hours if needed iii) Anxiety disorders, 2-10 mg by slow IV (not more than 5 mg/min). Repeat if necessary every 3-4 hours

Diclofenac 1% Gel A Post-traumatic inflammation of the Apply 3 - 4 times daily and gently rubbed Allergic or non allergic contact Hypersensitivity to diclofenac or other Increase plasma concentration of Do not apply to diseased skin or open tendons,ligaments & joints. Localised in dermatitis. Generalized skin rash, NSAIDs; history of asthma induced by lithium, methotrexate & warfarin. wounds or injuries. Avoid contact with forms of soft tissue rheumatism and hypersensitivity and photosensitivity aspirin or other NSAIDs. Reduces effects of diuretics & beta eyes or mucous membranes. Systemic degenerative rheumatism reactions blockers side effects when applied to large areas of skin & over a prolonged period of time. Late pregnancy and lactation.

Diclofenac 12.5 mg Suppository A Pain and inflammation in rheumatic ADULT: 75 - 150 mg daily in divided Occasionally gastrointestinal disorders, Patients with history of hypersensitivity Increases plasma concentration of Patients w/ known CV disease or risk disease and juvenile arthritis doses. CHILD 1-12 years, 12.5- 25 mg headache, dizziness, vertigo, rash, to diclofenac or aspirin/other NSAIDs. warfarin, lithium, & methotrexate. factors for CV disease, fluid retention or daily proctitis Peptic or intestinal ulcer. History of May reduce effects of diuretics & heart failure, SLE, HTN, history of GI asthma, urticaria or acute rhinitis beta blockers. May alter plasma disease. Patients who may be adversely precipitated by aspirin or other NSAIDs. concentration of sulfonylureas. affected by prolongation of bleeding Lactation. Use of suppository is Caution with concomitant use of time. Hepatic and renal impairment. contraindicated in patients with recent diuretics and antihypertensives (eg Elderly. Lactation. rectal bleeding. beta-blockers, ACEI ), methotrexate, other NSAIDs and corticosteroids, SSRIs. Monitoring recommended for patients receiving anticoagulants, antiplatelets agents as well as blood glucose level if used concomitantly with antidiabetics. Digoxin, ciclosporin, quinolones Diclofenac 25 mg Suppository A Pain and inflammation in rheumatic ADULT: 75 - 150 mg daily in divided Occasionally gastrointestinal disorders, Patients with history of hypersensitivity Increases plasma concentration of Patients w/ known CV disease or risk disease and juvenile arthritis doses. CHILD 1-12 years, 12.5- 25 mg headache, dizziness, vertigo, rash, to diclofenac or aspirin/other NSAIDs. warfarin, lithium, & methotrexate. factors for CV disease, fluid retention or daily proctitis Peptic or intestinal ulcer. History of May reduce effects of diuretics & heart failure, SLE, HTN, history of GI asthma, urticaria or acute rhinitis beta blockers. May alter plasma disease. Patients who may be adversely precipitated by aspirin or other NSAIDs. concentration of sulfonylureas. affected by prolongation of bleeding Lactation. Use of suppository is Caution with concomitant use of time. Hepatic and renal impairment. contraindicated in patients with recent diuretics and antihypertensives (eg Elderly. Lactation. rectal bleeding. beta-blockers, ACEI ), methotrexate, other NSAIDs and corticosteroids, SSRIs. Monitoring recommended for patients receiving anticoagulants, antiplatelets agents as well as blood glucose level if used concomitantly with antidiabetics. Digoxin, ciclosporin, quinolones

Diclofenac Sodium 50 mg A Pain and inflammation in rheumatic ADULTS: 75 - 150 mg daily in divided Occasionally gastrointestinal disorders, Patients with history of hypersensitivity Increases plasma concentration of Previous history of gastrointestinal Suppository disease and juvenile arthritis doses. Maximum 150mg/day. PAEDS headache, dizziness, vertigo, rash, to diclofenac or aspirin/other NSAIDs. warfarin, lithium, & methotrexate. ulceration, bleeding, or perforation. more than 6 months : 1 - 3 mg/kg body proctitis Peptic or intestinal ulcer. History of May reduce effects of diuretics & Renal dysfunction. Hypertension or weight daily in divided doses. Maximum asthma, urticaria or acute rhinitis beta blockers. May alter plasma cardiac conditions aggravated by fluid 3mg/kg/day (Max 150mg/day). precipitated by aspirin or other NSAIDs. concentration of sulfonylureas. retention and oedema. History of liver Last trimester of pregnancy. Lactation. Caution with concomitant use of dysfunction, coagulation defects. Severe Use of suppository is contraindicated in diuretics and antihypertensives (eg skin reactions (SJS, TEN). patients with recent rectal bleeding. beta-blockers, ACEI ), methotrexate, other NSAIDs and corticosteroids, SSRIs. Monitoring recommended for patients receiving anticoagulants, antiplatelets agents as well as blood glucose level if used concomitantly with antidiabetics. Digoxin, ciclosporin, quinolones

Diclofenac Sodium 75 mg/3 ml A/KK Pain and inflammation in rheumatic IM 75 mg once daily (2 times daily in Pruritus, rash, contact dermatitis, pain, History of or active of GI ulcer or ACEI, angiotensin II antagonists, Patient with CHF, dehydration, Injection disease severe cases) for not more than 2 days. dry skin, exfoliation, paraesthesia, bleeding. Hypersensitivity to diclofenac anticoagulants, cholestyramine and hypertension, decreased renal or hepatic Max 150mg/day. Not suitable for constipation, diarrhoea, headache, or any component of the formulation. colestipol, ticlopidine, aspirin. function, active GIT ulceration or children. dizziness, vertigo, nausea, vomiting, History of asthma, urticaria or acute Monitoring recommended for bleeding, pre-existing asthma, severe gastrointestinal disorders, anorexia, rhinitis to diclofenac, aspirin or other patients receiving anticoagulants, skin reactions (SJS, TEN). increase transaminases NSAIDs. Pregnancy (third trimester). antiplatelets agents as well as blood glucose level if used concomitantly with antidiabetics. Lithium, digoxin, ciclosporin, quinolones Digoxin 250 mcg/ml Injection A Heart failure with atrial fibrillation, Rapid digitilisation: ADULT & CHILD over Nausea, vomiting, anorexia, diarrhoea, Digoxin is contraindicated in intermittent Plasma concentration increased by Acute myocardial infarction, acute supraventricular arrhythmias (particularly 10 years, initially 0.75 - 1.5 mg, followed abdominal pains, salivation, sweating; complete heart block or second degree quinidine, verapamil, nifedipine, myocarditis, amyloid cardiomyopathy, AV atrial fibrillation) by 250 mcg 6 hourly until digitilisation is headache, facial pain, malaise, fatigue, atrioventcular block,especially if there is amiodarone. Hypokalaemia may be block. Chronic constrictive pericarditis, complete drowsiness, depression, disorientation, a history of Stokes-Adams attacks. associated with diuretics, lithium, electrolyte imbalance (eg. hypokalaemia, mental confusion, delirium, hallucination, Contraindicated in arrhythmias caused by carbenoxolone, corticosteroids. hypocalcaemia or hypercalcaemia, visual cardiac glycoside Antacids, neomycin may reduce hypomagnesaemia), hypothyroidism, disturbance.Hypokalaemia.Ventricular intoxication,supraventricular arrhythmias serum level of digoxin hypoxia, idiopathic hypertrophic premature contractions, atrial or as in the Wolff-Parkinson-White subaortic stenosis. Renal disease, severe ventricular arrhythmias and conduction syndrome,ventriculartachycardia,hypertr bradycardia, severe heart failure and defects ophic cardiomyopathy, and pulmonary disease, ventricular hypersensitivity to digoxin. tachycardia and Wolff-Parkinson-White syndrome

Dinoprostone (Prostagladin E2) 3 mg A Induction of labour 3 mg vaginal tablet to be inserted high Gastrointestinal upsets, uterine Hypersensitivity to dinosprostone, pelvic Oxytocin: an increased risk of Glaucoma elevated intraocular pressure, Vaginal Tablet into the posterior formix. A second 3 mg hypercontractility with or without fetal inflammatory disease, extrauterine oxytocic toxicity (uterine asthma or history of asthma. tablet may be inserted after 6-8 hours if bradycardia, rapid cervical dilatation with pregnancy, cephalopelvic disproportion, hyperstimulation). The sequential Cephalopelvic relationships carefully labour is not established. Max 6 mg low Apgar score, headache fetal distress, placenta previa, hypertonic use of oxytoxin following evaluated prior to use. During use, or hyperactive uterine patterns, administration of vaginal tablet is uterine activity, fetal status and unexplained vaginal bleeding during recommended,with a dosing progression of cervical dilatation current pregnancy interval of at least 6 hours. evaluated at frequent intervals. In patients with history of hypertonic uterine Diphenhydramine Hydrochloride 14 C Cough ADULT : 5 - 10 ml 2 - 3 times daily. CHILD Cardiovascular: hypotension, headache, Hypersensitivity to diphenhydramine or Reduces the absorption of the May cause drowsiness, may impair ability mg/5 ml Expectorant : 2.5 - 5 ml 2 - 3 times daily (not to be palpitations, tachycardia, extrasystoles. other antihistamines of similar chemical antituberculous agent para- to drive and operate machine or any used in children less than 2 years of age) Hematological : hemolytic anemia, structure, lactation, newborns or infants. aminosalicylic acid (PAS) from the activities requiring mental alertness. thrombocytopenia, agranulocytosis. CNS Not to be used in children less than 2 gastrointestinal tract. Additive Elderly patients since sedation and : sedation, sleepiness, dizziness, years of age. effects if use with hypnotics, hypotension occur frequently in patients disturbed coordination, fatigue, sedatives, tranquilizers and alcohol. over 60 years old. Special risk patients : confusion, restlessness, excitation, MAO inhibitors prolong and glaucoma, pyloroduodenal obstruction, nervousness, tremor, irritability, intensify the anticholinergic symptomatic prostatic hypertrophy, insomnia, euphoria, praesthesia, vertigo, (drying) bladder neck obstruction, patients with tinnitus, neuritis, convulsions. increased intraocular pressure, Ophthalmic: blurred vision, diplopia v) GI hyperthyroidism, cardiovascular disease, : epigastric distress, anorexia, nausea, hypertension, history of asthma or lower vomitting, diarrhoea, constipation. respiratory tract disease iv) children : Genitourinary: urinary frequency, difficult may prodeuce excitation in young urination, urinary retention, early children. To be used with caution and menses. Respiratory : thickening of doctor's advice for children 2 to 6 years bronchial secretions, tightness in chest of age. and wheezing, nasal stuffiness. Dermatological : urticaria, rash, photosensitivity ix) others : dry mouth, nose an throats, chills, excessive perspiration Diphenhydramine Hydrochloride 7 C Cough ADULT : 5 - 10 ml 2 - 3 times daily. CHILD Cardiovascular: hypotension, headache, Hypersensitivity to diphenhydramine or Reduces the absorption of the May cause drowsiness, may impair ability mg/5 ml Expectorant : 2.5 - 5 ml 2 - 3 times daily (not to be palpitations, tachycardia, extrasystoles. other antihistamines of similar chemical antituberculous agent para- to drive and operate machine or any used in children less than 2 years of age) Hematological : hemolytic anemia, structure, lactation, newborns or infants. aminosalicylic acid (PAS) from the activities requiring mental alertness. thrombocytopenia, agranulocytosis. CNS Not to be used in children less than 2 gastrointestinal tract. Additive Elderly patients since sedation and : sedation, sleepiness, dizziness, years of age. effects if use with hypnotics, hypotension occur frequently in patients disturbed coordination, fatigue, sedatives, tranquilizers and alcohol. over 60 years old. Special risk patients : confusion, restlessness, excitation, MAO inhibitors prolong and glaucoma, pyloroduodenal obstruction, nervousness, tremor, irritability, intensify the anticholinergic symptomatic prostatic hypertrophy, insomnia, euphoria, praesthesia, vertigo, (drying) bladder neck obstruction, patients with tinnitus, neuritis, convulsions. increased intraocular pressure, Ophthalmic: blurred vision, diplopia v) GI hyperthyroidism, cardiovascular disease, : epigastric distress, anorexia, nausea, hypertension, history of asthma or lower vomitting, diarrhoea, constipation. respiratory tract disease iv) children : Genitourinary: urinary frequency, difficult may prodeuce excitation in young urination, urinary retention, early children. To be used with caution and menses. Respiratory : thickening of doctor's advice for children 2 to 6 years bronchial secretions, tightness in chest of age. and wheezing, nasal stuffiness. Dermatological : urticaria, rash, photosensitivity ix) others : dry mouth, nose an throats, chills, excessive perspiration

Dobutamine 12.5mg/ml (20ml) A Hypotension and heart failure Initial 0.5-1 mcg/kg/min by IV, Increased heart rate, blood pressure and Hypersensitivity to dobutamine, Beta-blockers, nitroprusside Arrhythmias, hypovolaemia . May be Injection maintenance 2.5-10mcg/kg/min. ventricular ectopic activity, , anginal pain, idiopathic hypertrophic subaortic ineffective in patients who have recently Frequently,doses up to 20mcg/kg/min nonspecific chest pain, palpitations stenosis received a beta-blocker, in such cases are required for adequate hemodynamic shortness of breath, nausea, headache peripheral vascular resistance may improvement. On rare occasions,infusion increase. Monitor EKG and blood rates up to 40mcg/kg/min pressure constantly, serum potassium, pulmonary wedge pressure and cardiac output. Myocardial infarction and severe coronary artery disease.

Dopamine HCl 200 mg/5ml Injection B Non-hypovolemic hypotension Initial dose 2-5 mcg/kg/min with Increased heart rate, blood pressure and Pheochromocytoma, tachyarrhythmias Beta-blockers, methyldopa, Angina pectoris, conditions such as incremental changes of 5-10 mcg/kg/min ventricular ectopic activity, anginal pain, or ventricular fibrillation phenytoin, tricyclic antidepressants hypovolaemia, hypoxia, hypercapnia, and at 10-15 minutes intervals until adequate nonspecific chest pain, palpitations and acidosis should be corrected prior to response is noted. Most patients are shortness of breath, nausea, headache administration of dopamine. Patients maintained at less than 20 mcg/kg/min. allergic to sulfite. Patients receiving If dosage exceeds 50 mcg/kg/min, assess MAOIs will exhibit enhanced dopamine renal function frequently effects. Patients with pre-existing vascular damage secondary to atherosclerosis, diabetes, Raynaud's disease or frostbite since dopamine can produce peripheral necrosis or gangrene

Ear Wax Softener B Occlusion or partial occlusion of the Instill 5 drops into the ears. Refer product Not known Otitis externa, seborrhoeic dermatitis, Not known Not known external auditory meatus by soft wax or information leaflet eczema affecting the external ear, wax plug perforated eardrums Enoxaparin Sodium 40 mg Injection A* i) Prevention of Deep Vein i) Prophylaxis for DVT especially in Haemorrhagic symptoms, Active major bleeding, hypersensitivity to Increased risk of haemorrhage Carefully monitor patients for possible Thrombosis(DVT) especially in surgical patients: moderate risk, 20 mg thrombocytopenia (rare), haematomas & enoxaparin, heparin, thrombocytopenia when used with NSAIDs, spinal or epidural bleeding and if perioperative and high risk surgical cases SC approximately 2 hours before surgery skin necrosis at injection site; skin due to enoxaparin, acute GI ulcer ticlopidine, corticosteroids, dextran neurological impairment is detected, ii) Treatment of DVT then 20 mg every 24 hours for minimum allergies or systemic allergic reactions 40. May potentiate effects of oral treat immediately. Active or history of iii) Unstable angina and non Q wave 7 - 10 days, high risk (eg orthopaedic anticoagulants. Vit K antagonists, recent gastrointestinal ulceration and Myocardial Infarction surgery, medical patients, 40mg every 24 anti-platelet drugs haemorrhage, bacterial endocarditis, hours for at least 6 days until patient bleeding diathesis. Concomitant therapy ambulant, max 14 days. with agents that inhibit platelets. ii) Treatment of DVT or pulmonary Congenital or acquired bleeding embolism, 1.5 mg/kg every 24 hours, disorders. Do not give via intramuscular usually for 5 days and until adequate oral injection. Elderly patients and patients anticoagulation established. with renal insufficiency may experience iii) Unstable angina and non-ST-segment- delayed elimination of enoxaparin. elevation myocardial infarction 1 mg/kg Haemorrhagic stroke, post-op period every 12 hours, usually for 2 - 8 days following brain & spinal cord or ophthalmological surgery. Uncontrolled arterial hypertension. Use with extreme caution in patients with history of heparin-induced thrombocytopenia. Diabetic retinopathy, low molecular weight heparins or unfractionated heparin cannot be used interchangeably, unit for unit

Enoxaparin Sodium 60 mg Injection A* i) Prevention of Deep Vein i) Prophylaxis for DVT especially in Haemorrhagic symptoms, Active major bleeding, hypersensitivity to Increased risk of haemorrhage Carefully monitor patients for possible Thrombosis(DVT) especially in surgical patients: moderate risk, 20 mg thrombocytopenia (rare), haematomas & enoxaparin, heparin, thrombocytopenia when used with NSAIDs, spinal or epidural bleeding and if perioperative and high risk surgical cases SC approximately 2 hours before surgery skin necrosis at injection site; skin due to enoxaparin, acute GI ulcer ticlopidine, corticosteroids, dextran neurological impairment is detected, ii) Treatment of DVT then 20 mg every 24 hours for minimum allergies or systemic allergic reactions 40. May potentiate effects of oral treat immediately. Active or history of iii) Unstable angina and non Q wave 7 - 10 days, high risk (eg orthopaedic anticoagulants. Vit K antagonists, recent gastrointestinal ulceration and Myocardial Infarction surgery, medical patients, 40mg every 24 anti-platelet drugs haemorrhage, bacterial endocarditis, hours for at least 6 days until patient bleeding diathesis. Concomitant therapy ambulant, max 14 days. with agents that inhibit platelets. ii) Treatment of DVT or pulmonary Congenital or acquired bleeding embolism, 1.5 mg/kg every 24 hours, disorders. Do not give via intramuscular usually for 5 days and until adequate oral injection. Elderly patients and patients anticoagulation established. with renal insufficiency may experience iii) Unstable angina and non-ST-segment- delayed elimination of enoxaparin. elevation myocardial infarction 1 mg/kg Haemorrhagic stroke, post-op period every 12 hours, usually for 2 - 8 days following brain & spinal cord or ophthalmological surgery. Uncontrolled arterial hypertension. Use with extreme caution in patients with history of heparin-induced thrombocytopenia. Diabetic retinopathy, low molecular weight heparins or unfractionated heparin cannot be used interchangeably, unit for unit Ephedrine HCl 30 mg/ml Injection B Treatment of bronchial spasm in asthma, By IM, SC or IV. Severe, acute Nervousness, anxiety, apprehension, Anaesthesia with cyclopropane or Should not be administered Angina pectoris, chronic heart disease. adjunct to correct haemodynamic bronchospasm : 12.5-25 mg. Further fear, tension, agitation, excitation, halothane, diabetes (for ephedrine concomitantly with other Chronic use may cause an anxiety state. imbalances and treat hypotension in dosage should be determine by patient restlessness, weakness, irritability, injection). Hypersensitivity to ephedrine sympathomimetic agents. Alpha Prostatic hypertrophy, pregnancy epidural and spinal anaesthesia response. When used as a pressor agent : insomnia, dizziness, lightheadness, or other sympathomimetic amines. and beta-adrenergic blocking ADULT 25 - 50 mg SC/IM. If necessary, a vertigo, confusion, delirium, Hypertension or other cardiovascular agents. Cyclopropane or second IM dose of 50 mg or an IV dose of hallucinations or euphoria. Throbbing disorders, obstetrical procedures with halogenated hydrocarbons general 25 mg may be given. Direct IV injection, headache, respiratory difficulty, fever or maternal blood pressure, lactation anaesthetics. MAOIs 10 - 25 mg may be given slowly. a feeling of warmth, pallor, dryness of Maximum parenteral ADULT dose : 150 the nose and throat, precordial pain, mg in 24 hours. CHILD : 3 mg/kg or 100 sweating, mild epigastric distress, mg/m2 SC or IV daily, in 4 - 6 divided anorexia, nausea or vomiting. Acute doses urinary retention or difficulty in urination. May initially decrease urine formation. Palpitation and tachycardia. Extrasystoles and potentially fatal arrhythmias including ventricular fibrillation especially in patients with organic heart disease

Erythromycin Ethylsuccinate 200 B Treatment of susceptible bacterial Child: 30-50 mg/kg daily, increased to Rash, urticaria; nausea, vomiting, GI Hypersensitivity; porphyria; hepatic May antagonise therapeutic effects Hepatic& renal impairment, myasthenia mg/5 ml Suspension infections twice the usual dose in severe cases. 2-8 discomfort; ototoxicity; central impairment; pregnancy. lincomycin and clindamycin. gravis yr: 1 g daily in divided doses; <2 yr: 500 neurotoxicity; agranulocytosis; Concurrent usage may lead to mg daily in divided doses. arrhythmias; pancreatitis. Potentially increased absorption of alcohol. Fatal: Hepatotoxicity, cholestatic Potentially Fatal: May potentiate jaundice; raised serum transaminases; actions of neuromuscular blockers, eosinophilia. oral anticoagulants, ciclosporin, theophylline. Terfenadine, astemizole, cisapride toxicity increased.

Erythromycin Lactobionate 500 mg A* Only for treatment of i) certain forms of Adult & Child: 25 - 50mg/kg /day infusion Rash, urticaria; nausea, vomiting, GI Hypersensitivity; porphyria; hepatic May antagonise therapeutic effects Hepatic& renal impairment, myasthenia Injection meningitis ii) septicaemia not responding every 6 hours. Maximum: 4 g/day. discomfort; ototoxicity; central impairment; pregnancy lincomycin and clindamycin. gravis to usual antibiotics iii) mycoplasma neurotoxicity; agranulocytosis; Concurrent usage may lead to pneumonia iv) infection with gram- arrhythmias; pancreatitis. Potentially increased absorption of alcohol. positive organisms (e.g. tetanus, Fatal: Hepatotoxicity, cholestatic Potentially Fatal: May potentiate streptococcal infection) associated with jaundice; raised serum transaminases; actions of neuromuscular blockers, Penicillin allergy, only when oral eosinophilia. oral anticoagulants, ciclosporin, erythromycin cannot be given theophylline. Terfenadine, astemizole, cisapride toxicity increased. Erythropoietin Human Recombinant A i) Treatment of anaemia associated with i) ADULT by IV injection over 1-5 minutes, Dizziness, drowsiness, headache, Uncontrolled hypertension. In elective Potentiated by hematinic agents. To minimize the risk of hypertension, the 2000 IU/0.5ml Injection chronic renal failure. Dialysis patients initially 50 units/kg 3 times weekly arthralgia, myalgia, increased blood surgery patients not participating in an Dose adjustment required if given rate of increase in haemoglobin should who are haemoglobin less than 8 g or adjusted according to response in step of pressure, hypertensive crisis, autologous blood pre-donation together with ciclosporin not exceed 2 g/dL/month. Measure exhibiting symptoms of anaemia 25 units/kg 3 times weekly at interval of thrombocytosis, skin reactions at programme who have severe coronary, haemoglobin levels once weekly until although haemoglobin more than 8 g and at least 4 weeks. CHILD initially as for injection site (SC). Hyperkalaemia, peripheral, arterial, carotid or levels stabilise and periodically pre-transplant cases ii) Anaemia in adult. Maintenance, bodyweight under hyperphosphataemia, increased BUN and cerebrovascular diseases including thereafter, more frequent monitoring cancer (non-myeloid malignancies) with 10 kg usually 75-150 units/kg 3 times uric acid, increased creatinine (especially patients with recent myocardial should be done in patients with a concomitant chemotherapy weekly, bodyweight 10-30 kg usually 60- in chronic renal failure patients) infarction or cerebrovascular accident baseline haemoglobin of more than 14 150 units/kg 3 times weekly, bodyweight g/dL. History of seizures, gout, porphyria. over 30 kg usually 30-100 units/kg 3 Conditions associated with thrombotic or times weekly ii) ADULT by SC injection vascular events, hepatic dysfunction. (max. 1 ml per injection site), initially 150 Monitor platelet count during first 8 units/kg 3 times weekly, increased if week of therapy. Evaluate ferrous stores appropriate rise in haemoglobin not during therapy. Ferrous substitution is achieved after 4 weeks to 300 units/kg 3 recommended for patients whose serum times weekly. Discontinue if inadequate ferritin levels are 15 g/dL. Ischaemic response after 4 weeks at higher dose heart disease, chronic heart failure. Pregnancy and lactation

Erythropoietin Human Recombinant A i) Treatment of anaemia associated with i) ADULT by IV injection over 1-5 minutes, Dizziness, drowsiness, headache, Uncontrolled hypertension. In elective Potentiated by hematinic agents. To minimize the risk of hypertension, the 4000 IU Injection chronic renal failure. Dialysis patients initially 50 units/kg 3 times weekly arthralgia, myalgia, increased blood surgery patients not participating in an Dose adjustment required if given rate of increase in haemoglobin should who are haemoglobin less than 8 g or adjusted according to response in step of pressure, hypertensive crisis, autologous blood pre-donation together with ciclosporin not exceed 2 g/dL/month. Measure exhibiting symptoms of anaemia 25 units/kg 3 times weekly at interval of thrombocytosis, skin reactions at programme who have severe coronary, haemoglobin levels once weekly until although haemoglobin more than 8 g and at least 4 weeks. CHILD initially as for injection site (SC). Hyperkalaemia, peripheral, arterial, carotid or levels stabilise and periodically pre-transplant cases ii) Anaemia in adult. Maintenance, bodyweight under hyperphosphataemia, increased BUN and cerebrovascular diseases including thereafter, more frequent monitoring cancer (non-myeloid malignancies) with 10 kg usually 75-150 units/kg 3 times uric acid, increased creatinine (especially patients with recent myocardial should be done in patients with a concomitant chemotherapy weekly, bodyweight 10-30 kg usually 60- in chronic renal failure patients) infarction or cerebrovascular accident baseline haemoglobin of more than 14 150 units/kg 3 times weekly, bodyweight g/dL. History of seizures, gout, porphyria. over 30 kg usually 30-100 units/kg 3 Conditions associated with thrombotic or times weekly ii) ADULT by SC injection vascular events, hepatic dysfunction. (max. 1 ml per injection site), initially 150 Monitor platelet count during first 8 units/kg 3 times weekly, increased if week of therapy. Evaluate ferrous stores appropriate rise in haemoglobin not during therapy. Ferrous substitution is achieved after 4 weeks to 300 units/kg 3 recommended for patients whose serum times weekly. Discontinue if inadequate ferritin levels are 15 g/dL. Ischaemic response after 4 weeks at higher dose heart disease, chronic heart failure. Pregnancy and lactation Esmolol HCl 10 mg/ml Injection A* Tachycardia and hypertension in By IV infusion usually within range of 50 - Hypotension, dizziness, somnolence, Hypersensitivity to esmolol products, Catecholamine-depleting drugs. Anaesthesia/surgery (myocardial perioperative period 200 mcg/kg/min confusions, headache, agitation, fatigue, bradycardia, heart block, overt cardiac Concomitant use with verapamil depression), atrial fibrillation nausea and vomiting failure, cardiogenic shock (caution in patients with depressed (hypotension occurs more frequently in myocardial function) these patients), avoid abrupt withdrawal, gradual withdrawal over a period of 1 to 2 weeks is recommended. Bronchospastic disease, cerebrovascular insufficiency, congestive heart failure, diabetes mellitus. Due to the potency and rapid onset of clinical effects, small initial doses are recommended, the infusion rate should be controlled carefully, preferably with a volumetric infusion pump. Elderly patients (hypotension occurs more frequently in these patients), hyperthyroidism/thyrotoxicosis, myasthenic conditions, peripheral vascular disease, postoperative patients (hypotension occurs more frequently in these patients) and renal disease

Esomeprazole 40 mg Injection A* i) Acute erosive/ ulcerative oesophagitis i) 20- 40 mg once daily for 2-5 days ii) 80 Abdominal pain , constipation , diarrhoea Hypersensitivity to esomeprazole in Citalopram, imipramine, Exclude gastric malignancy prior to ii) Non -variceal upper gastrointestinal mg by IV bolus followed by 8mg/hour , dyspepsia , flatulence , nausea , patients with known hypersensitivity to clomipramine, phenytoin, treatment. Severe renal or hepatic bleed infusion for 72 hours dizziness, headache erythema any component of the formulation diazepam, ketoconazole , insufficiency. Pregnancy; lactation multiforme , Stevens-Johnson syndrome, itraconazole, warfarin,effects on (discontinue). Long-term treatment toxic epidermal necrolysis, dermatitis absorption, effects on hepatic should be kept under regular metabolism/cytochrome P-450 surveillance. Fructose intolerance, pathways,clarithromycin and glucose-galactose malabsorption or amoxicillin (increase esomeprazole sucrase-isomaltase insufficiency. and 14-hydroxyclarithromy) Monitoring when initiating and ending concomitant treatment with warfarin. Severe liver impairment

Ether Solvent C To remove adhesive plaster from the skin Dose depending on the route and Not known Hypersensitivity to iohexol/iopromide Not known Not known procedure products, intrathecal corticosteroids, immediate repeat myelography, local or systemic infection

Ethyl Chloride 100ml Spray C For minor surgical procedures including Spray to affected area at a distance of Transient hypertension, narcosis, Hypersensitivity to ethyl chloride Cisatracurium, St John's Wort Ethyl chloride is highly flammable and lancing boils, incision and drainage of about 30cm until a fine white film is vomiting and coma. Thawing of frozen products and vascular impairment of the mixtures of the gas with 5% to 15% of air small abscesses, pain due to athletic produced tissue after surgery may be painful. extremities. Porphyria. Application on are explosive; never use it in the injuries and pain due to injection Chemical frostbite may occur following broken skin or mucous membranes presence of an open flame or near administration prolonged spraying onto the skin. electric cautery equipment. Caution Nephrotoxicity or hepatotoxicity (long- should be taken to avoid frostbite; when term exposure) used for cryotherapy, protect adjacent skin with petrolatum. Inhalation of ETHYL CHLORIDE can produce narcosis or even fatal coma with respiratory or cardiac arrest. Cover eyes, nose and mouth if spraying near the face.To protect against tissue sloughing, cover the skin adjacent to the area being treated with petrolatum. Avoid spilling the liqd on the skin. Freezing may also distort the histological structure of biopsy specimens. Highly flammable. Avoid inhalation when used as local anaesthesia Etomidate 20 mg/10 ml Injection A* Induction of general anaesthesia for Adult: 300 mcg/kg given slowly over 30- Hypotension, adrenal suppression, Hypersensitivity. Reduced or at risk of Antipsychotics, sedatives or Not for administration by prolonged haemodynamically unstable patients 60 seconds into a large vein in the arm. myoclonus, transient skeletal reduced adrenocortical function. opioids; calcium-channel blockers. infusion due to hazarads of prolonged Child: Up to 30% more than the standard movements, uncontrolled eye Porphyria. suppression of endogenous cortisol and adult dose. Elderly: 150-200 mcg/kg, movements, hiccups. Excitatory aldosterone production, severe asthma, subsequently adjusted according to phenomena eg, involuntary myoclonic severe cardiovascular disease. Not to use effects. muscle movements, convulsions; for maintenance of anaesthesia. Opioid hypersensitivity reactions, pain on analgesics or benzodiazepines may be injection; postoperative nausea and given as premedications to reduce risk of vomiting convulsions. Pre-existing epilepsy. Elderly and child less than 10 years. Pregnancy and lactation.

Etonogestrel 68 mg Implant A/KK Contraception A single implant inserted subdermally Undesirable effects with a frequency Pregnancy, venous thromboembolic Drug interactions, which result in Pre-existing or risk of breast cancer. and can be left in place for three years. >5%: Acne, headache, increase in body disorder, severe hepatic disease, an increased clearance of sex Prolonged immobilisation. Diabetes. The implant can be removed at any time weight, breast tenderness and pain; progestogen-dependent tumours, hormones, can lead to Women predisposed to chloasma should but not later than three years after the >2.5%-≤5%: Alopecia, depressive moods, undiagnosed vaginal bleeding, and breakthrough bleeding and avoid sun & UV exposure. Lactation. date of insertion. emotional lability, changes in libido, hypersensitivity to the active substance contraceptive failure. The Concomitant treatment with hepatic abdominal pain, dysmenorrhoea. A rise in or to any of the excipients of mechanism of this interaction enzyme inducers may necessitate the blood pressure has occasionally been etonogestrel implant. appears to be based on the hepatic use of additional barrier contraception. seen. enzyme-inducing properties of these drugs. Interactions may be expected during concomitant use of hydantoins, barbiturates, primidone, carbamazepine or rifampicin; interactions with oxcarbazepine, rifabutin, troglitazone, felbamate and griseofulvin are also suspected. Maximal enzyme induction is generally not seen before 2-3 weeks but may then be sustained for at least 4 weeks after cessation of drug therapy.

Factor VIIa (Recombinant) eptacog A* Treatment of bleeding episodes and Initially 4.5 KIU (90 mcg)/kg body weight Rash, itching, nausea, fever, headache, Hypersensitivity to Factor VII or any Simultaneous use of prothrombin Advanced atherosclerotic disease: alfa (activated) 50 KIU (1 mg) prevention of excessive bleeding in IV bolus over 2-5 minutes, followed by 3- malaise, diaphoresis, changes in blood component of the formulation complex concentrates, activated or increased risk of thrombotic events. Injection connection with surgery in patients with 6 KIU (60-120 mcg)/kg body weight pressure,renal failure, cerebrovascular not should be avoided Concomitant use of activated or inherited or acquired haemophilia with depending on type & severity of disorder, angina pectoris, atrial nonactivated prothrombin complex inhibitors to coagulation factors VIII or IX haemorrhage or surgery performed. arrhythmia, circulatory shock, concentrates: increased risk of Dosing interval: initially 2-3 hour to hemorrhage, hemarthrosis thrombotic events .Crush injury; obtain haemostasis and until clinically disseminated intravascular coagulation improved. If continued therapy is (DIC),Septicemia: increased risk of needed, dose interval can be increased thrombotic events .Elderly, non- successively to every 4, 6, 8 or 12 hours hemophilia, intracerebral hemorrhage patients: increased risk of arterial thromboembolic adverse events, including myocardial ischemia, myocardial infarction, cerebral ischemia and or infarction. Factor VIII (Human blood coagulation A* i)The treatment and prophylaxis of i. Von Willebrand Disease: Spontaneous Allergic, anaphylactic reactions or fever Not known Has not been established in Patients with a known allergy to factor factor) & Von Willebrand factor haemorrhage or surgical bleeding in Von Bleeding Episodes: Initially, factor VIII are rarely observed in patients receiving appropriate studies. VII concentrates, or human albumin. Injection Willebrand Disease (VWD) when 1- 12.5-25 IU/kg and ristocetin cofactor 25- factor VIII preparations. Headache, back Allergic, anaphylactic reactions or fever deamino-8-D-arginine vasopressin 50 IU/kg followed by factor VIII 12.5 pain, anxiety, chest pain, arthralgia, are rarely observed in patients receiving (desmopressin, DDAVP) treatment alone IU/kg and ristocetin cofactor 25 IU/kg skeletal pain, dizziness, flushing, fever, factor VIII preparations. If any adverse is ineffective or contraindicated. ii)The subsequently every 12-24 hrs. Minor influenza-like symptoms, pharyngitis event occurs while this product being treatment and prophylaxis of bleeding Surgery: Factor VIII 30 IU/kg and administered, the rate of injection should associated with factor VIII deficiency due ristocetin cofactor 60 IU/kg daily. Major be slowed or stopped to alleviate to haemophilia A. Surgery: Initially, factor VIII 30-40 IU/kg symptoms. The product contains blood and ristocetin cofactor 60-80 IU/kg group antibodies. If very high doses are followed by factor VIII 15-30 IU/kg and used in patients with blood group A, B or ristocetin cofactor 30-60 IU/kg AB, the patient should be monitored for subsequently every 12-24 hrs. signs of intravascular haemolysis. Prophylaxis: Factor VIII 12.5-20 IU/kg and ristocetin cofactor 25-40 IU/kg 3 times weekly. ii. Hemophilia A therapy: Minor haemorrage: 10-15 IU/kg every 12-24 hours. Moderate to severe haemorrhage: 15-40 IU/kg every 8 to 24 hours. Minor surgery: Loading dose 20-30 IU/kg, maintenance dose 15-30 IU/kg. Major surgery: Loading dose 40-50 IU/kg, maintenance dose 10-40 IU/kg. Prophylaxis: 25-40 IU/kg three times weekly As product may differ from one to another, it is strongly advised to refer to the manufacturer (product insert) in regards to dosing calculation.

Fentanyl Citrate 50 mcg/ml Injection A Short duration analgesia during pre- Dose should be individualized according Respiratory depression, apnoea, muscle Children more than 2 years, asthma, Amiodarone : cardiac toxicity (low Pulmonary function impairment, (100mcg/2ml) medication induction and maintenance to age, body weight, physical status, rigidity, bradycardia, cardiac respiratory depression, head injury, cardiac output). Azole antifungals, liver/kidney dysfunction, cardiac of anaesthesia, and in the immediate underlying pathological conditions and dysrhythmia, tachyarrhythmia, chest patients receiving MAOIs within previous macrolide antibiotics : increased or bradyarrhythmias, use of narcotic post-operative period. type of surgery and anaesthesia. ADULT: pain, hypertension, hypotension, 14 days, hypersensitivity, myasthenia prolonged opioid effects (CNS antagonists for respiratory depression, Premedication: IM 50 - 100 mcg, 30 - 60 hypoventilation, neutropenia gravis, increased intracranial pressure, depression, respiratory adjunct to conduction anaesthesia, mins prior to surgery. Adjunct to general pregnancy and lactation. depression). Beta-adrenergic elderly, debilitated patients, concomitant anaesthesia: Induction IV 50 - 100mcg, blockers, calcium channel blockers : meuroleptics, muscle rigidity, drug repeat 2 - 3 mins intervals until desired severe hypotension. dependence, respiratory depression, effect is achieved. IV/IM 25 - 50mcg in Carbamazepine : decreased plasma pregnancy, during labour. elderly and poor risk patients. concentrations of fentanyl. Maintenance: IV/IM 25 - 50mcg. Adjunct Diazepam : significant decreases of to regional anaesthesia: IM/slow IV 50 - mean arterial pressure and 100mcg when additional analgesia is systemic vascular resistance. required. Post-operatively (recovery Naltrexone : precipitation of opioid room): IM 50 - 100mcg for pain control, withdrawal symptoms. Phenytoin : tachypnoea and emergency delirium. decreased plasma concentrations May be repeated in 1- 2 hours as needed. of fentanyl. Protease inhibitors : CHILD (2 - 12 years): Induction & increased risk of fentanyl toxicity maintenance: 2 - 3 mcg/kg. (CNS depression, respiratory depression). Ferric Ammonium Citrate 800 mg/10 C Prevention and treatment of iron- CHILD up to 1 year 5 ml, 1 - 5 years 10 ml, Abdominal cramps, nausea, vomiting, Not to be given in patient receiving Concurrent administration with Haemochromatosis, ml Paediatric Mixture deficiency anaemias taken well diluted with water diarrhoea or constipation, dark stools, repeated blood transfusion. Vitamin C increases absorption of haemoglobinopthies, existing heartburn, temporary teeth staining and Haemochromatosis, haemolytic anaemia, oral iron. Given with tetracycline, gastrointestinal diseases. Should be well discolouration of urine known hypersensitivity to iron salts decreased tetracycline and iron diluted with water and drink through a effectiveness. Fluoroquinolones, straw to prevent teeth discoloration levodopa, methyldopa, penicillamine, antacids, H2 blockers, proton pump inhibitors, chloramphenicol. Dairy foods, decreased iron bioavailability. Aluminium, calcium or magnesium containing products, decreased iron effectiveness

Filgrastim (G-CSF) 30 MU/ml A* i) Reduction in the duration of i) Adult: SC or IV 5 mcg/kg/day. Initiation: Chest pain, fever, hypersensitivity Hypersensitivity to filgrastim, severe Vincristine, topotecan, lithium Secondary acute myeloid leukemia. Injection neutropenia and incidence of febrile 24 - 72 hours after chemotherapy. reaction, alopecia. Bone pain, flu-like congenital neutropenia (Kostmann's Perform regular white blood cell, platelet neutropenia in cytotoxic chemotherapy Duration: Until a clinically adequate symptoms, nausea and vomiting, adult syndrome) with abnormal cytogenetics and hematocrit count throughout for malignancy except chronic myeloid neutrophil recovery is achieved (absolute respiratory distress syndrome, sickle cell therapy. Monitor ANC and spleen size. leukemia and myelodysplastic syndrome neutrophil count of at least 1 x 109/L on crisis, hepatomegaly, splenic Bone marrow infiltrating infections or ii) Haemopoeitic stem cell 2 consecutive days) ii) Refer to protocol enlargement, transient hypotension, malignancy. Sickle cell disease. transplantation (HSCT)/stem cell epistaxis urinary abnormalities (dysuria, Pregnancy and lactation harvesting proteinuria, hematuria), exacerbation of rheumatoid arthritis, thrombocytopenia, anemia raised uric acid

Fluconazole 2 mg/ml Injection A i) Oropharyngeal candidiasis, atrophic i) 50 - 100 mg daily for 7 - 14 days Hepatotoxicity; nausea, abdominal pain, Known hypersensitivity to fluconazole or Warfarin, oral sulfonylureas, Pregnancy, lactation, renal impairment, oral candidiasis associated with dentures, (Maximum 14 days) except in severely vomiting, diarrhoea, flatulence; elevated to related azole compounds, co- phenytoin, rifampicin, cyclosporin, liver impairment. May prolong QT other candidal infections of mucosa ii) immunocompromised patients, liver function values; headache; rash, administration with terfenadine in theophylline, cisapride, interval. Tinea pedis, corporis, cruris, versicolor treatment can be continued for longer exfoliative dermatitis. Rerely: patient receiving high dose of carbamazepine, calcium channel and dermal candidiasis iii) Invasive periods. Atrophic oral candidiasis angioedema, anaphylactic reactions and fluconazole, co-administration of other blocker, celecoxib, fentanyl, HMG- candidal& cryptococcal infections associated with dentures: 50 mg daily for thrombocytopenia. drugs known to prolong the QT interval CoA reductace inhibitors, losartan, (including meningitis) iv) Prevention of 14 days. Other candidal infections of and which are metabolised via the methadone, oral contraceptives, relapse of cryptococcal meningitis in mucosa: 50 - 100 mg daily for 14 - 30 enzyme CYP3A4 such as cisapride, prednisone, rifabutin, saquinavir, AIDS patients after completion of days. CHILD: 3 - 6 mg/kg on first day then astemizole, erythromycin, pimozidine sirolimus, zidovudine. primary therapy v) Prevention of fungal 3 mg/kg daily (every 72 hours in and quinidine. infections in immunocompromised NEONATE up to 2 weeks old, every 48 patients considered at risk as a hours in NEONATE 2 - 4 weeks old) ii) 50 consequence of HIV infections or mg daily for 2 - 4 weeks, maximum 6 neutropenia following cytotoxic weeks iii) 400 mg initially then 200 - 400 chemotherapy, radiotherapy or bone mg daily for 6 - 8 weeks. CHILD: 6-12 marrow transplant mg/kg daily (every 72 hours in NEONATE up to 2 weeks old, every 48 hours in NEONATE 2 - 4 weeks old) iv) 100 - 200 mg daily v) 50 - 400 mg daily. CHILD: 3 - 12 mg/kg daily (every 72 hours in NEONATE up to 2 weeks old, every 48 hours in NEONATE 2 - 4 weeks old) Flumazenil 0.1 mg/ml Injection B i) Diagnosis and/or management of i) Initial, 0.2 mg IV over 30 seconds; if Cardiac arrhythmias, bradycardia, Hypersensitivity to Competitively blocks all drugs Patients with a history of long-term (0.5mg/5ml) benzodiazepine overdose due to self- desired level of consciousness not dizziness, nausea, vomiting, seizure, flumazenil/benzodiazepines, cyclic which act at the benzodiazepine benzodiazepine abuse, head injuries, poisoning or accidental overdose ii) obtained after an additional 30 seconds, injection site pain, headache, abnormal antidepressant overdose, patients who receptor, such as Triazolopyridine, history of panic disorder, liver disease, Reversal of sedation following give dose of 0.3 mg IV over 30 seconds; vision, blurred vision, agitation have been given a benzodiazepine for zolpidem. drug and alcohol dependent patients, anaesthesia with benzodiazepine further doses of 0.5 mg IV over 30 control of a potentially life-threatening neuromuscular blocking agents. Monitor seconds may be given at 1-minutes condition (eg, control of intracranial patient for an appropriate period for intervals if needed to maximum total pressure or status epilepticus) possibility of resedation, respiratory dose of 3 mg; patients with only partial depression or other residual response to 3 mg may require additional benzodiazepine effects following the use slow titration to a total dose of 5 mg; if of flumazenil. Epileptic patients receiving no response 5 minutes after receiving benzodiazepine treatment for a total dose of 5 mg, overdose is unlikely to prolonged period. be benzodiazepine and further treatment with flumazenil will not help ii) 0.2 mg IV over 15 seconds; if desired level of consciousness is not obtained after waiting 45 seconds, a second dose of 0.2 mg IV may be given and repeated at 60- seconds intervals as needed (up to a maximum of 4 additional times) to a maximum total dose of 1 mg; most patients respond to doses of 0.6 to 1 mg; in the event of resedation, repeated doses may be given at 20-minutes intervals if needed; for repeat treatment, no more than 1 mg (given as 0.5 mg/minute) should be given at any one time and no more than 3 mg should be given in any one hour

Fluorescein 1 mg Ophthalmic Strip B Diagnostic fluorescein angiography or Moisten tip with tear fluid from lower Nausea and headache, other symptoms Hypersensitivity to any of the Not known History of allergy or bronchial asthma. angioscopy of the fundus and of the iris fornix, sterile water or ophthalmic and signs of hypersensitivity, allergic components of product. Not to be used Pregnancy especially in the first vasculature solution and gently stroke across the conjunctivitis, peri-orbital oedema, with soft contact lenses trimester, lactation conjunctiva anaphylactic reaction, urticaria, rash

Fluorometholone 0.1% Ophthalmic A* Treatment of steroid responsive ocular 1-2 drops qds. During the initial 24-48 hr, Burning or stinging, ocular irritation, Hypersensitivity to its component, ocular Not known Glaucoma. Pregnancy & lactation. Suspension inflammation dose may be increased to 2 drops 2 hrly. unpleasant taste, blurred vision, viral or fungal or tuberculosis infection, increased intra-ocular pressure, contact lense use glaucoma, cataract, corneal thinning

Flupenthixol Decanoate 20mg/ml B Chronic psychoses By deep IM, initial test dose of 5-20 mg, Sedation, restlesness, extrapyramidal Hypersensitivity to flupenthixol. Barbiturates, guanethidine or Patients known to have a predisposition lnjection then after at least 7 days. 20 - 40 mg symptoms, anticholinergic effects, Extremely excitable or overactive similar compounds, to movement disorders (may cause repeated at intervals of 2 - 4 weeks. weight gain. Insomnia, drowsiness. patients. Acute alcohol, barbiturate or metoclopramide and piperazine, extrapyramidal symptoms). Hepatic or Maximum 400 mg weekly. Usual Rarely extrapyramidal symptoms, if opiate poisoning. Bone marrow tramadol. May enhance the renal impairment. CV or respiratory maintenance dose 50 mg every 4 weeks recommended dose is exceeded. depression, coma response to alcohol, and other CNS disease, phaeochromocytoma. to 300 mg every 2 weeks. ELDERLY, Occasionally tardive dyskinesia in long- depressants Convulsive disorders. Withdraw gradually initially quarter to half adult dose. CHILD term therapy if patient was previously treated with not recommended. Deep IM neuroleptics with sedative effect. recommended. Not for IV use Patients on high doses and long-term therapy should be monitored carefully. Should not be given during pregnancy and lactation Fluphenazine Decanoate 25 mg/ml B Long term management of psychotic By deep IM : Test dose 12.5 mg (6.25 mg Weight gain, agranulocytosis, akathisia, Comatose or severely depressed Tramadol, increased risk of Patients exposed to extreme heat or Injection disorders in ELDERLY), then after 4-7 days 12.5 mg- extrapyramidal effects, hepatotoxicity, patients, blood dyscrasias, liver damage, seizures. Cisapride, levofloxacin, phosphorous insecticides, history of 100 mg repeated at intervals of 14-35 neuroleptic malignant syndrome, hypersensitivity to fluphenazine increased risk of cardiotoxicity (QT convulsive disorder, mitral insufficiency days, adjusted according to response. hyperprolactinaemia, sedation, products, subcortical brain damage, prolongation, torsades de pointes, or other cardiovascular diseases and CHILD not recommended orthostatic hypotension, anticholinergic phaeochromocytoma, severe cardiac arrest). Pethidine, increase phaeochromocytoma; history of effects, seizures, aplastic anaemia, hypotension, bone marrow depression in central nervous system and neuroleptic malignant syndrome, history cholestatic jaundice, drowsiness, respiratory depression. Levodopa, of cholestatic jaundice, hypersensitivity dependence, antimuscarinic effects, loss of levodopa efficacy. reaction to other phenothiazines, insomnia, depression, convulsions, Procyclidine, decreased patients undergoing surgery may require agitation, tachycardia, postural phenothiazine serum lower doses of anaesthetics or hypotension, allergic reactions, concentrations, decreased depressants, history of dermatoses, agranulocytosis, tardive dyskinesia, phenothiazines effectiveness, myasthenia gravis, Parkinson's disease, depressive reactions enhance anticholinergic effects seizure disorder, elderly, debilitated, liver (ileus, hyperpyrexia, sedation, dry or kidney impairment, CV or respiratory mouth). Sertraline, fluoxetine; disorders, diabetes, pheochromocytoma, increased risk of developing acute epilepsy, glaucoma. May impair parkinsonism. Class Ia and III temperature regulatory mechanism antiarrhytmics, beta2 agonists, carbamazepine, central alpha2 agonists, systemic corticosteroids, diuretics, lithium tricyclic antidepressants, alcohol, CNS depressants, clonidine

Fluticasone Furoate 27.5 mcg/dose A* Treatment of nasal symptoms Adults/Adolescents (≥12 years) : 1-2 Headache and epitaxis. Immune Hypersensitivity to fluticasone furoate Bupropion, Clarithromycin, Concomitant use with ritonavir (not Nasal Spray (rhinorrhea, nasal congestion, nasal sprays (27.5 mcg/spray) in each nostril hypersensitivity reaction and glaucoma and other component of product Darunavir, Indinavir, Itraconazole, recommended) and other potent CYP3A4 itching and sneezing) and ocular once daily. Children (2-11 years) : 1-2 Ketoconazole, Nefazodone, inhibitors such as ketoconazole. Fungal symptoms (itching/burning, sprays (27.5 mcg/spray) in each nostril Nelfinavir, Ritonavir, Saquinavir, or bacterial infection, untreated local or tearing/watering, and redness of the once daily Telithromycin, Tipranavir systemic. Glaucoma, cataracts or eye) of seasonal and perennial allergic increased intraocular pressure, history of rhinitis. ;, vision changes. Hepatic impairment. Hypersensitivity reactions (anaphylaxis, urticaria, angioedema, rash) may occur. Immunosuppression may occur. Localized infections of the nose due to Candida albicans, nasal ulcers, nasal surgery or nasal trauma. Ocular herpes simplex . Paediatric patients ; may reduce growth velocity. Systemic corticosteroid effects (hypercorticism, adrenal suppression). Tuberculosis, viral and parasitic infection

Fluticasone Propionate 125 B Prophylactic treatment for asthma ADULT and CHILD more than 16 years i) Mouth and throat candidiasis, Hypersensitivity to any of the Caution when co-administered with Not for acute attacks but for routine long- mcg/dose Inhaler Mild asthma : 100 mcg - 250 mcg twice hoarseness (patients are advised to components potent CYP3A4 inhibitors e.g. term management. Caution when daily ii) Moderate asthma : 250 - 500 mcg gargle after using the medication), ketoconazole, ritonavir transfering patients from systemic twice daily iii) Severe asthma : 500 mcg - paradoxical bronchospasm, cutaneous steroid treatment, pregnancy, rarely, 1000 mcg twice daily. Alternatively, the hypersensitivity reactions. Headache, inhaled therapy may mask underlying starting dose of fluticasone dipropionate giddiness, dizziness,sleep disorders, eosinophilic conditions e.g. Churg Strauss may be gauged at half the total daily migraines, paralysis of cranial nerves, Syndrome, active or quiescent dose of beclomethasone dipropionate or mood disorders pulmonary tuberculosis. Safety and equivalent administered by inhalation. efficacy not established for children CHILD 4 - 11 years, 50 mcg twice daily younger than 12 years (maximum 100 mcg twice daily), CHILD 1- 4 years, 50-100mcg microgram twice daily Follitropin Alpha (Recombinant A* i) Infertility treatment in anovulatory i) 75 - 150 IU daily, should commence Fever, arthralgia, pain in lower abdominal Pregnancy, lactation, ovarian hCG and Clomiphene Citrate may Evaluate patient for hypothyroidism, Human FSH) 300 IU/0.5 ml Injection women who have been unresponsive to within the first 7 days of the menstrual region, nausea, vomiting and weight enlargement or cyst not due to polycystic potentiate the follicular response. adrenocortical deficiency, treatment with clomiphene citrate ii) cycle and increased by 37.5 IU or 75 IU at gain, ovarian hyperstimulation syndrome ovarian disease, gynaecological Concurrent use of GnRH agonist or hyperprolactinaemia and pituitary or Stimulation of follicular development for 7 or 14 days interval. Max daily dose 225 (OHSS), multiple pregnancy haemorrhages of unknown aetiology, antagonist may increase the dose hypothalamic tumours before starting intra-uterine cycles iii) Stimulation of IU ii) 150 - 225 IU daily commencing on ovarian, uterine or mammary carcinoma of Gonal F needed to elicit an therapy follicular development in assisted days 2 or 3 of the cycle. Max daily dose tumours of the hypothalamus and adequate ovarian response. reproductive technology in the 450 IU pituitary gland management of infertility

Follitropin Beta (Recombinant A* Infertility treatment in anovulatory To be individualized. Give in multiples of Ovarian hyperstimulation, bruising, pain, Pregnancy, lactation, ovarian Concomitant use with clomiphene Exclude presence of uncontrolled non- Human FSH) 300 IU Injection women who have been unresponsive to 50 IU. Starting dose can be 50 IU - 200 IU redness, swelling and itching, ectopic enlargement or cyst not due to polycystic citrate may enhance the follicular gonadal endocrinopathies (eg thyroid, treatment with clomiphene citrate. daily. It can be a step-up regime or a step- pregnancy, multiple gestations, ovarian disease, gynaecological response. A higher dose may be adrenal or pituitary disorders). Stimulation of follicular development for down, depending on the protocol and the arteriothromboembolism haemorrhages of unknown aetiology, needed after pituitary Predisposition to thrombosis. Conversion intra-uterine insemination cycles and ovarian response ovarian, uterine or mammary carcinoma, desensitization induced by a GnRH from conventional syringe to pen assisted reproductive technology in the tumours of the hypothalamus and agonist injector. Women: Perform baseline & management of infertility. pituitary gland periodic ultrasonographic assessment of follicular development & determination of oestradiol levels. Men: Consider combination treatment w/ hCG only after monotherapy w/ hCG for min 16 wk has failed; conduct semen analysis 4-6 mth after start of therapy. Fondaparinux Sodium 2.5 mg/0.5 ml A* i) Prevention of venous thromboembolic i) 2.5 mg once daily given by SC, Pruritus, rash, injection site hemorrhage, Active major bleeding; increased risk for Agents that increase the risk of Increased haemorrhagic risk eg Injection events (VTE) in orthopedic surgery (e.g. administered 6 hr following surgical fever, anemia, bleeding, major bleeding episodes;risk of hemorrhage (eg, other congenital or acquired coagulopathy, hip fracture, major knee or hip closure provided homeostasis has been thrombocytopenia, fever, nausea, uncontrollable hemorrhage, acute anticoagulants, NSAIDs, platelet active ulcerative GI disease, recent replacement surgery), abdominal surgery established. Usual duration of therapy is vomiting, constipation bacterial endocarditis, body weight less inhibitors). Discontinue prior to intracranial haemorrhage or shortly after in patients at risk of thromboembolic 5 to 9 days; for hip fracture patients, an than 50 kg for prophylactic therapy of hip administration of fondaparinux brain, spinal or ophth surgery, diabetic complication. ii) Treatment of unstable extended course of up to 24 days is fracture, hip replacement or knee retinopathy, uncontrolled arterial angina or non-ST segment elevation recommended. ii) ADULT more than 18 replacement surgery, or abdominal hypertension, moderate renal myocardial infarction [UA/NSTEMI] in years: 2.5 mg once daily given by SC, surgery; increased risk for major bleeding impairment (CrCl < 30-50 mL/min), patients for whom urgent invasive initiated as soon as possible after episode. Fondaparinux-related severe hepatic impairment. Measure management (PCI) is not indicated. iii) diagnosis and continued for up to 8 days thrombocytoenia. Hypersensitivity to platelet counts at baseline & end of Treatment of ST segment elevation or until hospital discharge. If patient fondaparinux or any of its recepients. treatment. Elderly. Pregnancy & myocardial infarction (STEMI) in patients needs to undergo PCI, unfractionated Severe renal impairment (CrCl less than lactation. Avoid concurrent managed with thrombolytics or are not heparin to be admin as per local practice 30 ml/min for venous thromboembolic administration with drugs that may receiving other forms of reperfusion protocol, taking into account the events and 20 ml/min for acute coronary increase haemorrhagic risk therapy patient's bleeding risk and time of last events) dose of fondaparinux. Fondaparinux may be restarted no earlier than 2 hr after sheath removal. iii) ADULT more than 18 years: 2.5 mg once daily; first dose to be given IV (directly through an existing IV line or as infusion in 25 or 50 ml of 0.9% saline over 1-2 min), subsequent doses to be given SC. Treatment to be initiated as soon as diagnosis is made and continued up to a max of 8 days or until hospital discharge, whichever comes earlier. If patient needs to undergo non-primary PCI, unfractionated heparin to be admin as per local practice protocol, taking into account the patient's bleeding risk and time of last dose of fondaparinux. Fondaparinux may be restarted no earlier than 3 hr after sheath removal

Frusemide 10 mg/ml Injection B Pulmonary oedema Initially 20 -40 mg IM or slow IV (rate not Hypokalaemia, hyperuricaemia, Anuria, hypersensitivity to furosemide, Activated charcoal, amikacin, Alterations in blood glucose and glucose exceeding 4 mg/min). CHILD: 0.5 - 1.5 hypotension, hyperglycaemia, hepatic coma and pre-coma. Severe gentamicin, kanamycin, angiotensin tolerance tests. Diabetes mellitus, mg/kg. Max: 20 mg daily hyponatremia hypokalaemia, severe hyponatraemia, converting enzyme inhibitors, electrolyte imbalance (eg: hypokalaemia, hypovolaemia with or without aspirin, chloral hydrate, digoxin hyponatraemia), fluid imbalance, concomitant hypotension steroids, NSAIDs dehydration, blood volume reduction with circulatory collapse and possible vascular thrombosis and emboli may occur with excessive diuresis, especially in elderly patients. Gout or hyperuricaemia. Hepatic disease (cirrhosis and ascites). Hypersensitivity to sulfonamides. Ototoxicity (hearing loss, tinnitus), avoid rapid injection, high doses or concurrent administration of other ototoxic agents. If high-dose therapy is used, controlled intravenous infusion is recommended at a rate not to exceed 4 mg/min. Severe progressive renal disease (azotemia, oliguria). Systemic lupus erythematosus Fuller's Earth Powder C Adsorbent in pesticide poisoning Adult: 100-150g every 2-4 hours. Child: 1- Irritation of the skin, inflammation, Not known Not known Not known 2g/kg. (100g of Fuller's Earth is mixed blistering, cracking, shedding of the nails, with 200ml water. Repeat until Fuller's delayed healing of cuts and wounds Earth is seen in stool (normally between 4-6 hours)

Fusidic Acid 1% Eye Drops A For staphylococcal infections 1 drop in conjunctival sac 12 hourly. To Transient stinging Hypersensitivity to any components of Not relevant Do not apply to eyes with contact lenses be continued for 2 days after the eye the product appears normal. On the first day of treatment, may be applied more frequently : 1 drop 4 hourly. Surgical prophylaxis : 1 drop every 12 hours, 24 - 48 hours before operation

Fusidic Acid 2% Cream A Skin infections caused by staphylococci, Apply to affected area 2 - 3 times daily Rashes, irritation, pruritus and contact Infections caused by non-susceptible Not known Avoid contact with eyes and other streptococci, corynebacterium dermatitis organisms in particular Pseudomonas mucous membranes minutissumun and other sodium fusidate- aeruginosa sensitive organisms

Fusidic Acid 2% in Betamethasone A/KK Inflammatory dermatosis where bacterial Uncovered lesion- Apply 2 to 3 times Mild stinging, irritation, rash Viral disease of skin, perioral dermatitis, Not known Avoid prolong use on flexures and Valerate 0.1% Cream infection is likely to occur eg atopic daily. Covered lesions- Less frequent acne rosacea and ulcerative condition intertriginous areas should be avoided eczema, discoid eczema, stasis eczema, applications may be adequate seborrhoic dermatitis, contact dermatitis, lichen simplex chronicus, psoriasis, discoid lupus erythematosus

Gamma Benzene Hexachloride 0.1 % B For treatment of head lice Leave lotion on hair for exactly 4 Seizures, dermatitis, dizziness, eczema, Pregnancy and premature babies, Not known Not for oral ingestion and avoid eye Lotion minutes. Then wash off of the hair and papular lesions, itching, Henoch- lactation. Avoid in patients with a history contact. Dermatological disorders, skin with warm water. Schonlein purpura, percutaneous of epilepsy (e.g. HIV, history of head excoriated skin, elderly. Simultaneous absorption, atypical leukaemia, aplastic trauma or prior seizure, CNS tumor, use of lindane lotion and other creams, anemia and abnormal vision on the use excessive alcohol consumption) or who ointments or oils. CNS toxicity may be of lindane cream have a low body-weight, hypersensitivity greater in the young; use with extreme to lindane products, Norwegian (crusted) caution in infants, children, and pregnant scabies ,other skin conditions (e.g. atopic and nursing mothers, conditions which dermatitis, psoriasis) that may increase may increase the risk of seizure systemic absorption

Gamma Benzene Hexachloride 1% A/KK Only for scabies in adult weighing more Only for single application. Adult: Apply a Seizures, dermatitis, dizziness, eczema, Adults weighing less than 50kg. Not known Not for oral ingestion and avoid eye Lotion than 50kg. Use should be restricted to thin layer of 1% topical preparation onto papular lesions, itching, Henoch- Pregnancy and premature babies, contact. Dermatological disorders, patients who have failed treatment with all skin areas from the neck to toes. Schonlein purpura, percutaneous lactation. Avoid in patients with a history excoriated skin, elderly. Simultaneous or cannot tolerate other medications Completely wash off from the body with absorption, atypical leukaemia, aplastic of epilepsy (e.g. HIV, history of head use of lindane lotion and other creams, that pose less risk warm water after 8-12 hr. anemia and abnormal vision on the use trauma or prior seizure, CNS tumor, ointments or oils. CNS toxicity may be of the cream. excessive alcohol consumption) or who greater in the young; use with extreme have a low body-weight, hypersensitivity caution in infants, children, and pregnant to lindane products, Norwegian (crusted) and nursing mothers, conditions which scabies, other skin conditions (e.g. atopic may increase the risk of seizure. dermatitis, psoriasis) that may increase systemic absorption.

Gemeprost (Prostagladin E1 A Inducing abortion in the first trimester Cervical dilatation: 1 pessary 3 hourly Vaginal bleeding, mild uterine pain, Known hypersensitivity to prostagladins, Oxytocin and other labour inducers Obstructive airway disease, elevated Synthetic Analogue) 1 mg Pessary before surgery to a max of 5 pessaries gastrointestinal disturbances, headache, renal function disturbances, uterine or accelerator can potentiate the intraocular pressure, cervicitis or over 24 hours muscle weakness, dizziness, flushing, fragility related to uterine scarring and action of Gemeprost vaginitis, ulcerative colitis, cardiovascular chills, backache, dyspnoea, chest pain, placenta previa. disease, renal or hepatic disease. palpitations and mild pyrexia. Anapylactic Patients with hypertension or reactions (rare) hypotension

Gentamicin 0.1% Cream A* For localised infections Apply 2 - 3 times daily Avoid prolonged use Hypersensitivity to gentamicin or other Not known Discontinue if irritation or sensitization aminoglycosides occurs Gentamicin 0.3% Eye Drops A/KK Broad spectrum antibiotic in superficial 1 - 2 drops every 4 hours, in severe Non-specific conjunctivitis, conjunctival Hypersensitivity to aminoglycosides or Not known Hypersensitivity reactions. Do not wear eye infections and also for Pseudomonas infection dosage may be increased up to epithelial defect and hyperemia, any component of the product contact lenses during and for a period aeruginosa 2 drops every hour temporary burning sensation (rare), following application of medicine. Cross irritation, stinging, itching and allergenicity among aminoglycosides may dermatitis,hypokalemia, occur. Discontinue if no improvement hypomagnesemia, hypocalcemia seen after 5 days or if irritation or hypersensitivity develops. Overgrowth of non-susceptible organisms. No relevant information available for use in children, pregnancy and lactation

Gentamicin Sulphate 40 mg/ml B Infections due to susceptible organisms ADULT: 3 - 5 mg/kg/day 8 hourly IM or Vestibular& auditory toxicity, renal Known hypersensitivity. Patients with Increased risk of severe respiratory Concurrent use of neuromuscular Injection (80mg/2ml) IV. CHILD up to 2 weeks: 3mg/kg every toxicity, neuromuscular blockade, pre-existent vestibular& or cochlear depression when used concurrently blocking agents; myasthenia gravis, 12 hours; 2 weeks - 12 years: 2 mg/kg 8 superinfection, nausea, vomitting, rash, disease. Administration of other ototoxic with anaesthetics or parkinsonism; conditions predisposing to hourly blood disorders and/or nephrotoxic antibiotics. opioids.†Potentially Fatal: ototoxicity and nephrotoxicity; lactation. Pregnancy and lactation Increased incidence of ototoxicity Monitor plasma concentrations of when combined with ethacrynic gentamicin in patients receiving high acid and furosemide. doses or prolonged courses, in infants, Cephalosporins, ciclosporin, elderly, patients with renal impairment, cisplatin, vancomycin, cystic fibrosis or significant obesity. hydrocortisone and indometacin Monitor auditory and renal functions. potentiate nephrotoxicity. Potentiates neuromuscular blocking agents.

Glucagon (Lyophilised) 1 mg/ml B Management of hypoglycaemia Adult, children > 20kg: 1mg by SC, IM or Nausea, vomiting, hypoglycaemia, Hypersensitivity to glucagon or lactose. Insulin, indomethacin, warfarin Ineffective in chronic hypoglycaemia, Injection IV. Children < 20kg : 0.5mg. If patient abdominal pain, hypersensitivity Phaeocromocytoma alcohol-induced hypoglycaemia, does not respond within 10 minutes, reactions starvation and adrenal insufficiency; administer IV glucose. Repeat in 20 Pregnancy. minutes if necessary. Glycerin C+ As a lubricant and osmotic dehydrating Apply to area when required Mainly due to dehydration action, Not known Not known Cause irritation when given locally, local agent irritation anesthetic may be used before application

Glycerin 25% and Sodium Chloride C+ Constipation 1 enema as required Rectal discomfort, burning sensation Hypersensitivity to any component in the Not known Frequent or prolonged use of laxatives 15% Enema preparation may result in dependence

Glyceryl Trinitrate 5 mg/ml Injection A Prophylaxis and treatment of angina, left Initial 5 mcg/min delivered via infusion Flushing, dizziness, tachycardia and For IV :Constrictive pericarditis, Hypotensive effect enhanced by Severe renal or hepatic impairment. (50mg/10ml) ventricular failure. Not for direct IV pump. Subsequent titration must be throbbing headache. Large doses cause pericardial tamponade, restrictive alcohol, beta blockers, Need to be diluted for infusion via injection. adjusted to clinical situation with dose vomiting, restlessness, blurred vision, cardiomyopathy, symptomatic antihypertensives, tricyclic approved administration sets only. increment becoming more cautious as hypotension (which can be severe), hypotension, hypersensitivity to organic antidepressants, narcotics, Absorption by plastics & filters. Nitrate- partial response is seen. syncope and rarely cyanosis and nitrates sildenafil. May potentiate effects of free interval is recommended in patients methaemoglobinaemia, impairment of antihistamines, anticholinergics. on continuous treatment with nitrates to respiration and bradycardia Antagonises pressor action of reduce the risk of tolerance sympathomimetics Glycopyrrolate 200 mcg/ml Injection A* i) To reduce secretions (respiratory tract) i) Pre-op: 4 mcg/kg via IM administration Dry mouth, blurred vision, tachycardia, Glaucoma, obstructive uropathy, GI Cisapride, with other Autonomic neuropathy, children and for certain types of surgery ii) Reversal of 30-60 mins before procedure. urinary retention, constipation, severe obstruction, myasthenia gravis, anticholinergics or medications elderly patients, congestive heart failure, neuromuscular block in patients where Intraoperative: 0.1 mg via IV allergic reactions including hypersensitivity to glycopyrrolates with anticholinergic activity, such coronary heart disease, hypertension, atropine is contraindicated administration, repeat at 2-3 min anaphylactic/anaphylactoid reactions; newborns less than 1 month of age as phenothiazines, antiparkinson hyperthyroidism, ileostomy or intervals when needed. Max: 400 hypersensitivity; urticaria, pruritus, dry drugs, or tricyclic antidepressants, colostomy, mild hepatic or renal disease, mcg/dose. ii) 0.2 mg by IV for each 1 mg skin, and other dermal manifestations; may intensify the antimuscarinic prostatic hypertrophy, tachyarrythmia, of neostigmine or 5 mg pyridostigmine some degree of mental confusion and/or effects and may result in an tachycardia. May cause heat prostration, excitement, especially in elderly increase in anticholinergic side neuromuscular blockade effects.Post-marketing reports have included cases of heart block and QTc interval prolongation associated with the combined use of glycopyrrolate and an anticholinesterase

Glycopyrronium 50mcg, Inhalation A/KK For maintenance bronchodilator One capsule daily. The recommended Common: Nasopharyngitis, insomnia, Hypersensitivity to the active substance Co-inhalation with other inhaled Not indicated for the initial treatment of Powder Hard Capsules treatment to relieve symptoms in adult dose is the inhalation of the content of headache, dry mouth, gastroenteritis, or to any of the excipients. anticholinergic-containing drugs. acute episodes of bronchospasm, patients with chronic obstructive one capsule once daily using inhaler. It is urinary tract infection. Uncommon: paradoxical bronchospasm, and use with pulmonary disease (COPD). COPD recommended to be administered, at the rhinitis, cystitis, hyperglycaemia, caution in patients with narrow angle diagnosis is confirmed by spirometry. same time of the day each day. No hypoaesthesis, atrial fibrillation, glaucoma and urinary retention, severe relevant use of glycopyrronium in palpitations, sinus, congestions, renal impairment and end stage renal pediatric population (<18 years) for productive cough, throat disease, patient with history of COPD. irritation,epistaxis, dyspepsia, dental cardiovascular disease, rare hereditary caries, rash, pain in extremity, problems of galactose intolerance, the musculoskeletal chest pain, dysuria, Lapp lactase deficiency or glucose - urinary retention, fatigue, asthenia galactose malabsorption.

Goserelin 3.6 mg Depot Injection A Prostate 3.6 mg depot injection every 28 days Bone pain, hot flashes, gynecomastia, Pregnancy, lactation, hypersensitivity to Not Known Initially may increase bone pain, increase cancer,endometriosis,leiomyoma uteri impotence, breakthrough bleeding, deep goserelin products, leutenizing hormone- serum testosterone levels, and worsen and assissted reproduction,breast cancer venous thrombosis, depression, releasing hormon (LHRH) or LHRH symptoms of prostatic cancer.Isolated in premenopausal and perimenopausal imsomnia analogues. Depot injection of 10.8 mg is cases of spinal cord compression and women suitable for hormonal contraindicated in women renal impairment from ureteral manipulation obstruction have occurred.History of prior treatment that may have resulted in bone mineral density loss or patients with increased risk factors for decreased bone mineral density

Granisetron HCl 1 mg/ml Injection A i) Prevention and treatment of nausea i) ADULT 1-3 mg as an IV bolus not not Headache, asthenia, fever, pain, Hypersensitivity to granisetron and other Cytochrome P450 effect (minor). Subacute intestinal obstruction, and vomiting associated with less than 30 seconds; maximum 9 bradycardia, constipation, nausea, 5-HT3 receptor antagonists. Injection Apomorphine combination can pregnancy and lactation, liver disease. chemotherapy and radiotherapy ii) Post- mg/day. CHILD over 2 years; single dose leukopenia, thrombocytopenia, contains benzyl alcohol and should not cause profound hypotension and May mask paralytic ileus/gastric operative nausea and vomiting of 10-40 mcg/kg as an IV infusion; hypersensitivity reaction, transiet be used in neonates loss of consciousness. distension. Cardiac co-morbidities, on maximum 3 mg/day ii) ADULT 1 mg by increases in liver enzymes, rash Coadministration with drugs that cardio-toxic chemotherapy and/or slow IV injection over 30 seconds prior to can prolong QT interval may result concommitant electrolyte abnormalities induction of anaesthesia in serious arrythmias Haemato Polyvalent Snake B Passive immunisation against poisonous For initial does, at least 20mL of Occasionally, transient tenderness at the None, unless the patient is known to be - Since the antivenin is prepared from Antivenom Injection of a range of haematotoxic snakebites or reconstituted serum should be given by injection site, cutaneous reaction and hypersensitive to any of the constitution horse serum, sensitisation to neurotoxic snakebites, based on the type slow intravenous infusion (not more than alterations in temperature may occur. In of the product, appropriate precautions heterologous protein may occur in some of snake identified. 1mL/minute). If symptoms still persist, some cases, nausea, vomiting, and also must be taken. individuals. To avoid serious allergic the second dose should be repeated 2 circulatory reactions (e.g. tachycardia, reactions, skin test should be performed hours or even earlier after the initial bradycardia, hypotension, sweating, prior to the administration by injection dose. The further dose should be vertigo) and allergic reactions (e.g. with 0.02 mL of 1:100 antivenin dilutions repeated every 6 hours according to the flush, urticaria, dyspnea) have been intradermally. It should be noted that the clinical symptoms. Administration: Draw observed, extending in isolated cases as skin test may not predict the anaphylaxis 10mL of the sterile water for injection to far as shock. The patient should be nor delay serum sickness reactions. the freeze-dried antivenin, shake well to monitored for an extended period of dissolve the contents until the serum time. Therapeutic measures depend on became clear colourless or pale yellow the nature and severity of side effects. liquid, ready for administration. Antihistamines and if necessary adrenaline, high doses of corticosteroids, volume replacement, oxygen should be available when needed.

Haemodialysis Concentrate with A For acute renal failure, chronic renal Dose depending on clinical cases Nausea, vomiting, hypotension, muscle Not known Generally, drugs of low molecular Unstable cardiovascular disease or active Acetate failure, overhydration, intoxication, cramps and air embolus. Effects related weight, high water solubility, low bleeding. During haemodialysis and adjustment of acid-base and electrolyte to vascular access include infection, volume of distribution, low protein haemofiltration, heparin are required to balance thrombosis and haemorrhage. Long-term binding and high renal clearance prevent clotting of the blood in the complications in dialysed patients, some are most extensively removed by extracorporeal circuit. Dialysis solutions of which may relate to renal failure itself, dialysis e.g. aminoglycosides. should be warmed to body temperature include haemodialysis-related Dialysis-induced changes in fluids with dry heat because wet heat carries a amyloidosis, acquired cystic kidney and electrolytes risk of microbial contamination disease and accelerated atherosclerosis. Dialysis dementia is a special hazard of aluminium overload

Haemodialysis Concentrate with A For acute renal failure, chronic renal Dose depending on clinical cases Nausea, vomiting, hypotension, muscle Not known Generally, drugs of low molecular Unstable cardiovascular disease or active Bicarbonate failure, overhydration, intoxication, cramps and air embolus. Effects related weight, high water solubility, low bleeding. During haemodialysis and adjustment of acid-base and electrolyte to vascular access include infection, volume of distribution, low protein haemofiltration, heparin are required to balance thrombosis and haemorrhage. Long-term binding and high renal clearance prevent clotting of the blood in the complications in dialysed patients, some are most extensively removed by extracorporeal circuit. Dialysis solutions of which may relate to renal failure itself, dialysis e.g. aminoglycosides. should be warmed to body temperature include haemodialysis-related Dialysis-induced changes in fluids with dry heat because wet heat carries a amyloidosis, acquired cystic kidney and electrolytes risk of microbial contamination disease and accelerated atherosclerosis. Dialysis dementia is a special hazard of aluminium overload Haloperidol 5 mg/ml Injection B Acute psychoses and mania ADULT: IM or IV , 2 mg - 10 mg then Extrapyramidal symptoms (EPS), tardive Parkinson's disease, severe CNS Tramadol, fluoxetine, fluvoxamine, Concomitant anticoagulant use, every 4 - 8 hours according to response dyskinesia, sedation, hypotension, depression, bone marrow suppression, carbamazepine, concomitant CNS depressant use to total maximum 18 mg daily. Use in tachycardia, insomnia, anxiety, weight severe cardiac or hepatic disease, cisapride,dicoumarol, procyclidine, (anaesthetics, opiates, and alcohol), child is not recommended changes, anticholinergic effects, comatose states, hypersensitivity to methyldopa, olanzapine, rifampicin, history of convulsive disorders, known gynaecomastia, galactorrhoea, menstrual haloperidol. Lactation lithium, tricyclic antidepressants. allergies or allergic reactions to drugs, irregularities, neuroleptic malignant May increase the plasma levels of manic patients, neuroleptic malignant syndrome, arrhythmias, seizure, haloperidol when used with syndrome, elderly patients, impaired jaundice, hyperpyrexia. Anxiety, clozapine or chlorpromazine liver function, CV disease, thyrotoxicosis. depression, anorexia, leukopaenia Parkinsonism, angle-closure glaucoma, benign prostatic hyperplasia; severe cardiac or hepatic disease, presence of acute infections or leucopaenia; hyperthyroidism; pregnancy, elderly, children. Patients receiving anticoagulants. Discontinue treatment upon signs of neurological toxicity in patients taking lithium. Temperature regulation: Impaired core body temperature regulation may occur

Heparin 1000 units/ml Injection B i) Prophylaxis and treatment of venous i) By IV injection, loading dose of 5000 Haemorrhage, cutaneous necrosis, Hypersensitivity, in patients who are Alprostadil, alteplase, aspirin, Heparin should be used cautiously in thrombosis and pulmonary embolism. ii) units (10,000 units in severe pulmonary thrombocytopenia, anaphylaxis, actively bleeding, or have blood cefoperazone, clopidogrel, dextran, patients with allergies since it is of animal Treatment of myocardial infarction and embolism) followed by continuous hyperkalaemia dyscrasias, in patients with haemophilia moxalactam, reteplase, urokinase, origin, renal and hepatic disease. arterial embolism. iii) Prevention of infusion of 15-25 units/kg/hr. By SC or other blood disorders, and in cases warfarin, digitalis, tetracyclines, Hypertension during menstruation. clotting in arterial and heart surgery and injection (for DVT) of 15,000 units every where sufficient blood coagulation tests nicotine, antihistamines, ACE Patients with indwelling catheters. for prevention of cerebral thrombosis 12 hours (laboratory monitoring on daily are not available inhibitors, analgesics, Precaution must be taken if using long- basis essential to adjust dose). Small dipyridamole,drotrecogin Alfa, term subcutaneous heparin in pregnant adult or child, lower loading dose then, iloprost, nitrates, sibutramine women and bacterial endocarditis 15-25 units/kg/hr by IV infusion, or 250 units/kg every 12 hours by SC injection. ii) As i), for unstable angina and acute peripheral arterial occlusion. iii) Prophylaxis in general surgery, by SC injection, 5000 units 2 hour before surgery, then every 8-12 hours for 7 days or until patient is ambulant, during pregnancy (with monitoring), 5000-10000 units every 12 hours. An adjusted dose regimen may be used for major orthopaedic surgery or low molecular weight heparin may be selected

Heparin Sodium 50 units in Sodium B To maintain patency of peripheral venous Flush with 5 ml (50 units) every 4 hours Haemorrhage, cutaneous necrosis, Hypersensitivity in patients who are Alprostadil, alteplase, aspirin, Thrombocytopenia, Heparin- induced Chloride Injection catheters or as required thrombocytopenia, anaphylaxis, actively bleeding or have blood cefoperazone, clopidogrel, dextran, thrombocytopenia, Heparin resistant, hyperkalaemia dyscrasias, in patients with haemophilia moxalactam, reteplase, urokinase, Increased risk of bleeding to older or other blood disorders and in cases warfarin, digitalis, tetracyclines, patients,especially women. where sufficient blood coagulation tests nicotine, antihistamines, ACE are not available inhibitors, analgesics, dipyridamole,drotrecogin Alfa, iloprost, nitrates, sibutramine Hepatitis B Immunoglobulin (Human) A i) For post-exposure prophylaxis of i) Adults: Recommended Dose: 1000- Fatigue, malaise, nausea, diarrhoea, Selective IgA deficiencies Live vaccines "Pregnancy, immunodeficiency and or 100iu Injection hepatitis B 2000 IU IM and if necessary, the dose reactions at injection site, minor fever, receiving immunosuppresant therapy, ii) Prophylaxis against recurrence of should be increased or repeated. dizziness, myalgia, arthritis. severely compromised cardiopulmonary hepatitis B infection in chronic hepatitis B Children: Inject 32-48 IU/kg of body status, multiple sclerosis. Should not be post liver transplantation weight, should be administered within 7 administered intravenously or in the days after exposure to HBsAg (preferably gluteal region." within 48 hrs). Neonates: Recommended Initial Dose: 100-200 IU. The 1st dose should be administered within 5 days after birth (preferably within 48 hrs) and booster dose should be 32-48 IU/kg body weight. The booster dose should be administered between 2 and 3 months after the 1st administration. ii) Different regimens depending on hepatitis B virus (HBV) DNA positivity

Hepatitis B Vaccine Injection C+ Immunisation against infections caused Dose depends on the products used. Fatigue, malaise, nausea, diarrhoea, Hypersensitivity to any of the Not known Pregnancy, immunodeficiency and or by Hepatitis B virus Please refer to package insert. Example: reactions at injection site components receiving immunosuppresant therapy, 1. Euvax-B Adult (from 16 years old) - severely compromised cardiopulmonary 20mcg/dose Neonates, infants & children status up to and including 15 years - 10mcg/dose 2. Engerix-B Adult (from 20 years old) - 20mcg/dose Neonates, infants & children up to and including 19 years - 10mcg/dose Second dose to be given after 1 month and booster dose after 6 months

Human Albumin Injection (20% & B i) Acute hypovolemic shock ii) i) ADULT 25 g. CHILD 0.6 g/kg body CHF precipitation, oedema, Hypersensitivity to albumin; patients at ACE inhibitors: May have increased Hepatic or renal failure due to protein 5%) Hypoproteinaemia iii) Neonatal weight ii) Maximum daily dose is 2g iii) 1 hypertension, hypervolemia, risk for acute circulatory overload risk of atypical reactions; withhold load; rapid infusion of albumin solutions hyperbilirubinaemia g/kg before exchange transfusion. Dose hypotension, tachycardia,chills, fever, (cardiac failure, pulmonary edema, ACEIs for at least 24 hours prior to may cause vascular overload. Patients is given at rate of 1 ml of 25% solution headache, pruritus, rash, urticaria, severe anemia) plasma exchanges using large requiring sodium restriction (Sodium per minute nausea, vomiting, bronchospasm, volumes of albumin levels in this product are 48-100mmol/L). pulmonary oedema, anaphylaxis Human Normal Globulin Injection A i) Hypogammaglobulinaemia and other i) 50 mg/kg body weight daily for 5 days, Local reaction at injection site, allergic Anaphylactic or severe systemic Live virus vaccines Increased risk of acute renal failure in (3gm in 50ml) deficiency states ii) Severe refractory then 25 - 50 mg/kg weekly for reaction, headache, malaise, fever, chest response to human Ig. Selective IgA patients with renal impairment, DM, idiopathic thrombocytopenia purpura maintenance according to the severity of tightness, back pain deficiencies who have known antibody hypovolaemia, overweight, concomitant (platelet less than 20,000) with internal the condition ii) 400 mg/kg daily for 5 against IgA nephrotoxic medicinal products or >65 bleeding, particularly central nervous days with a further dose of 400 mg/kg as yr. High infusion rate may increased risk system iii) Septicaemia in required iii) Septicaemia in of adverse reactions. Ensure adequate immunocompromised patients or immunocompromised patients or hydration prior to IV infusion of patients not responding to antibiotics iv) patients not responding to antibiotics iv) immunoglobulin. Monitor urine output Chronic lymphocytic leukaemia not 250 mg/kg per month Dose varies and serum creatinine levels during responding to conventional therapy depending on brand used treatment. Avoid concurrent use of loop diuretics during IV infusion of immunoglobulin. Live vaccines should generally be given 3 wk before or 3 mth after admin of normal immunoglobulin. Different formulations and brands of human normal immunoglobulins may not be equivalent, thus individual literature should be consulted. Pregnancy and lactation.

Hydralazine HCl 20 mg Injection B Hypertensive crisis in pregnancy i) Slow IV injection, ADULT: 5-10 mg Tachycardia, palpitation, hypotension, Idiopathic systemic lupus erythematous, Concomitant treatment with other Hepatic impairment, renal impairment, diluted with 10ml sodium chloride 0.9%. fluid retention, gastrointestinal severe tachycardia, high output heart vasodilators, calcium antagonists, coronary artery disease, cerebrovascular May be repeated after 20-30 minutes if disturbances, headache, dizziness, failure, myocardial insufficiency due to ACE inhibitors, diuretics, disease necessary. ii) IV infusion 200-300 systemic lupus erythematosus-like mechanical obstruction, dissecting aortic antihypertensives, tricyclic mcg/minutes. Maintenance dose 50-150 syndrome, abnormal liver function, aneurysm, cor pulmonale, porphyria antidepressants and major mcg/minutes jaundice, blood disorders including tranquillisers, as well as the haemolytic anaemia, leukopenia, consumption of alcohol, may thrombocytopenia potentiate the blood pressure- lowering effect

Hydrocortisone 1% Cream B Inflammatory and pruritic manifestations Apply sparingly to affected area 2 - 3 Local atrophic skin changes, impaired Fungal and bacterial infections, Not known Prolonged use in infants and children, of corticosteroid responsive dermatoses times daily until condition improve, then skin healing tuberculosis of the skin, viral disease of ulceration at infection site, diabetes reduce frequency the skin, acne vulgaris, rosacea, perioral mellitus. Should not be used on pregnant dermatitis. Hypersensitivity to patients in large amounts or for hydrocortisone prolonged period of time. Lactation.

Hydrocortisone Sodium Succinate C Conditions responsive to systemic or Initially 100 - 500 mg IV over 30 seconds Fluid and electrolyte disturbances, Hypersensitivity, systemic fungal Concurrent use of barbiturates, Discontinue treatment by reducing the 100 mg Injection local glucocorticoid injection therapy to more than 10 minutes. Dose may be muscle weakness, peptic ulcer infection carbamazepine, phenytoin, dosage gradually especially in emergencies repeated at intervals of 2, 4 or 6 hours primidone or rifampicin may enhance the metabolism and reduce the effects of systemic corticosteroids. Oral contraceptives or ritonavir may increase plasma concentrations of corticosteroids

Hydrogen Peroxide 20 volume C Skin disinfection, particularly cleansing Hydrogen Peroxide 6% (=approx. 20 vol) Bleaching effect on hair, irritating burn Should not be used in abscesses Incompatible with reducing agents, Large or deep wound, avoid normal skin, Solution and deodorising wounds and ulcers shall be dispensed. For cleansing on the skin, mucous membrane and eye. including organic matter and bleaches fabric. Strong solution which wounds: 1.5% to 6% solution apply 2-3 Continued use as a mouthwash may oxidisable substances, some contain 27% and 30% (100 vol) are only times daily or when nescessary. As a cause reversible hypertrophy of the metals, metallic salts, iodides and for the preparation of weaker solution mouthwash: rinse the mouth for 2-3 papillae of the tongue permanganates and should not be applied to tissue minutes with 15ml of hydrogen peroxide undiluted 6% diluted in half a tumblerful of warm water 2-3 times daily. Disinfecting cleaned equipment: immersion for 30 minutes in 6% solution. As ear drop for removal of wax: hydrogen peroxide 6% diluted with 3 parts of water preferably just before use Hyoscine N-Butylbromide 1 mg/ml B Gastrointestinal tract and genito-urinary ADULT 10-20mg, 3-4 times a day. CHILD 6-Xerostomia, dyshidrosis, tachycardia, Obstructive disease of the Intensifies anticholinergic effects of Geriatric and pediatric patients, Liquid tract spasm, dyskinesia of the biliary 12 years old: 10mg 3 times a day. urinary hesistancy and retention, allergic gastrointestinal or urinary tract, narrow- tricyclic antidepressants, pregnancy, breastfeeding, intestinal system reactions, skin reactions, confusions, angle glaucoma, cardiac antihistamines, quinidine, atony, paralytic ileus and ulcerative excitement, constipation, paralytic ileus tachyarrhythmias, myasthenia gravis, amantadine and disopyramide. colitis, coronary artery diseases, prostatic hypertrophy with urinary Enhances tachycardic effects of arrhythmias , heart failure, hypertension, retention beta-adrenergic agents. Dopamine xerostomia, hiatal hernia with reflux antagonist eg metoclopramide esophagitis, prostatic hypertrophy reduces effects of both drugs on gastrointestinal tract

Hyoscine N-Butylbromide 20 mg/ml B Gastrointestinal tract and genito-urinary 20 mg IM/IV repeated after 30 min if Xerostomia, dyshidrosis, tachycardia, Obstructive disease of the Intensifies anticholinergic effects of Geriatric and pediatric patients, Injection tract spasm, dyskinesia of the biliary needed. Max: 100 mg daily. urinary hesistancy and retention, allergic gastrointestinal or urinary tract, narrow- tricyclic antidepressants, pregnancy, breastfeeding, intestinal system reactions, skin reactions, confusions, angle glaucoma, cardiac antihistamines, quinidine, atony, paralytic ileus and ulcerative excitement, constipation, paralytic ileus, tachyarrhythmias, myasthenia gravis, amantadine and disopyramide. colitis, cardiac disease, coronary artery rarely anaphylactoid reactions & prostatic hypertrophy with urinary Enhances tachycardic effects of diseases, arrhythmias , heart failure, anaphylactic shock retention, paraben allergy (multi-dose beta-adrenergic agents. Dopamine hypertension, xerostomia, hiatal hernia vial for injection contains parabens) antagonist eg metoclopramide with reflux esophagitis, prostatic reduces effects of both drugs on hypertrophy gastrointestinal tract

Ichthammol Glycerin 10% Ear Drops C Ear wick for otitis externa with oedema 2 - 3 drops 3 - 4 times daily and in ear Slightly irritant to skin, if excessive can Allergy and hypersensitivity to any of its Not known Not known wick for otitis externa impair hearing ability component

Imipenem 500 mg and Cilastatin 500 A* Severe infections caused by susceptible Based on type or severity of infection, Thrombophlebitis, pain, erythema & Hypersensitivity to local anaesthetics of Ganciclovir Hypersensitivity to penicillins, mg Injection pathogens especially useful in infections susceptibility of pathogen(s) and patient tenderness following injection. Rash, the amide-type and in patients with cephalosporins and other beta lactams. involving ESBL organisms. Not to be used condition including body weight and urticaria, pruritus, GI disturbances, severe shock or heart block History of GI disease. Caution in patients for prophylaxis renal function. ADULT: 1 - 2 g/day in 3 - 4 pseudomembranous colitis, with CNS disorders and or compromised divided doses. Maximum: 4 g/day or 50 haematological disturbances, increase in renal function in whom accumulation of mg/kg/day. Infusion rate: less than 500 liver enzymes, taste perversion. drug could occur. If CNS symptoms occur, mg dose: over 20 - 30 minutes, more Myoclonic activity, seizures, psychic dosage should be decreased or than 500 mg: dose over 40 - 60 minutes. disturbances, confusional states discontinued. Usage during pregnancy, CHILDREN: ≥ 40kg body weight should lactation and children less than 3 months receive adult doses. CHILDREN AND or paediatrics patients with impaired INFANTS: <40kg body weight should renal function (serum creatinine receive 15mg/kg at six hour intervals. >2mg/dL). The total daily dose should not exceed 2g.

Immunoglobulin Tetanus Human 250 B Passive immunization against tetanus Prophylaxis of tetanus: IM 250 units. Pain, tenderness, erythema at injection HIV patients Never administer tetanus toxoid Known intolerence to blood or blood Units/Vial Injection Treatment of tetanus: IM 30 - 300 site, fever (mild), urticaria, angioedema, and tetanus immunoglobulin (TIG) derivatives units/kg muscle stiffness, anaphylaxis reaction, in same syringe (toxoid will be sensitization to repeated injections neutralized), toxoid may be given at a separate site, concomitant administration with T-dependant antigen (Td) may decrease its immune response, especially in individuals with low prevaccination antibody titers Indacaterol maleate and A* As a once-daily maintenance One capsule inhalation daily. - Very common (≥1/10): Upper Hypersensitivity to the active substances, Concomitant use not - Not indicated for the initial treatment of glycopyrronium bromide (fixed dose bronchodilator treatment to relieve respiratory tract infection - Common (≥ to lactose or to any of the other recommended: Beta-adrenergic acute episodes of bronchospasm, combination) 110/50mcg, inhalation symptoms in adult patients with chronic 1/100 to < 1/10): Nasopharyngitis, excipients. blockers, anticholinergics, asthma, paradoxical bronchospasm. - powder hard capsules obstructive pulmonary disease (COPD). urinary tract infection, sinusitis, rhinitis, sympathomimetic agents. Caution Use with caution in patients with narrow dizziness, headache, cough, required with concomitant use: angle glaucoma and urinary retention, oropharyngeal pain, dyspepsia, dental Hypokalaemic treatment. To be severe renal impairment and end stage caries, gastroenteritis, musculoskeletal taken into account with renal disease, patient with history of pain, pyrexia, chest pain - Uncommon (≥ concomitant use: Drugs that inhibit cardiovascular disease, hypokalaemia, 1/1000 to < 1/100): Hypersensitivity, CYP3A4 and P-glycoprotein will hyperglycaemia, convulsive disorders, angioedema, diabetes, insomnia, increase serum Indacaterol; organic thyrotoxicosis, unsually responsive to paraesthesia, glaucoma, cardiac cation transport such as cimetidine beta2-adrenergic agonists, rare disorders, paradoxical bronchospasm, will increase serum hereditary problems of galactose epistaxis, dry mouth, pruritus, myalgia, Glycopyrronium. intolerance, the Lapp lactase deficiency pain in extremity, muscle spasm, bladder or glucose - galactose malabsorption obstruction and urinary retention, peripheral oedema, fatigue

Insulin Aspart 100 IU/ml Injection A* Diabetic Type 1 and 2 in patients that still Dose to be individualised. The average Transient oedema, local reactions and fat Hypersensitivity to insulin aspart and its Oral hypoglycaemic agents, Decreased insulin requirements due to experienced hypoglycaemia with use of daily insulin requirement is between 0.5 hypertrophy at injection site, components, hypoglycaemia octreotide, MAOIs, alcohol, lithium, hepatic or renal impairment, human insulin to 1.0 units/kg body weight hypoglycaemia, hypokalaemia, non selective beta blocker, ACE malabsorption, diarrhoea, generalized hypersensitivity inhibitor, salicylates, anabolic nausea/vomiting, hypothyroidism steroids, glucocorticoids, oral hypokalaemia, stress due to fever, contraceptives, sulphonamides, infection, surgery, trauma, systemic disopyramides, diuretics fibrates, allergic reactions fluoxetine, propoxyphene, thyroid hormone, symphatomimetics, danazol, niacin, isonazide, guanethidine, reserpine, clonidine, phenothiazine

Insulin Aspart 30% and Protaminated A/KK Diabetic type 1 and 2 in patients that still Dose to be individualised. The average Hypoglycaemia, lipodystrophy, Hypersensitivity to insulin aspart and its Oral hypoglycaemic agents, Decreased insulin requirements due to Insulin Aspart 70% 100 U/ml experienced hypoglycaemia with use of daily insulin requirement is between 0.5 cutaneous hypersensitivity, injection site components, hypoglycaemia octreotide, MAOIs, alcohol, lithium, hepatic or renal impairment, Injection human insulin to 1.0 units/kg body weight reaction , diabetic ketoacidosis, non selective beta blocker, ACE malabsorption, diarrhoea, hypoglycaemia inhibitor, salicylates, anabolic nausea/vomiting, hypothyroidism, steroids, glucocorticoids, oral hypokalaemia, stress due to fever, contraceptives, sulphonamides, infection, surgery, trauma, systemic disopyramides, diuretics fibrates, allergic reactions fluoxetine, propoxyphene, thyroid hormone, symphatomimetics, danazol, niacin, isonazide, guanethidine, reserpine, clonidine, phenothiazine

Insulin Detemir 100 IU/ml Injection A/KK i)Type 1 Diabetes patients on basal bolus Individualized dose given via SC once or Hypoglycaemia, allergic reactions, Hypersensitivity to insulin detemir or any Oral antidiabetics, MAOIs, Monitor glucose levels in elderly and in Prefilled syringe/cartridge regimen, whom experience twice daily. Initiate at a dose of 10IU or lipodystrophy, pruritus, rash, mild of its excipients, hypoglycemia nonselective β-blockers, ACE patients with renal or hepatic hypoglycemia with conventional insulin, 0.1-0.2IU/kg. For twice daily dosing, the injection site reactions, oedema, weight inhibitors, salicylates, alcohol, impairment. Transferring from other to be used in combination with rapid or evening dose can be administered either gain. thiazides, glucocorticoids, β- insulin types should be done under strict short-acting insulin. ii)Type 2 Diabetes with the evening meal, at bedtime, or 12 sympathomimetics, thyroid & medical supervision. Concomitant illness patients on oral anti-diabetics and basal hours after the morning dose. growth hormones, danazol, especially infection usually increase insulin regimen or basal bolus insulin octreotide/lanreotide. insulin requirement. Do not administer regimen whom experience hypoglycemia intravenously. Risk of with conventional basal insulin. hyper/hypoglycemia during therapy. Pregnancy and lactation, children. Insulin Glargine 300IU/3ml Prefilled A/KK i) Diabetes mellitus type I in adults and ADULT and CHILD over 6 years: Severe hypoglycemic episodes, Hypersensitivity, intravenous ACE inhibitors, aspirin, beta- Insulin dose adjustment may be needed Pen for Injection child over 6 years ii) Diabetes mellitus individualised dose given by SC, once lipodystrophy, rash, diabetic administration blockers, fibrates, fluoxetine, with renal or hepatic impairment, illness, type II in adult daily at the same time every day. Adult ketoacidosis, allergic skin reactions fenfluramine, fluoroquinolones, stress, emotional disturbances or in patients who are insulin naÔve may be ginseng, MAOIs, oestrogen and elderly patients, may impair ability to initiated with 10IU daily. progestogens, somatropin, lithium, drive and operate machinery clonidine, sulphonamide antibiotic, pentoxifylline

Insulin Glulisine 100u/ml solution for A* Treatment of adults, adolescents and Glulisine should be given shortly (0-15 Hypoglycaemia, Injection site reactions, Hypersensitivity to the active substance Substances that may enhance the Conditions which may make the early injection in pre-filled pen 3ml children 6 years or older with diabetes min) before or soon after meals. Apidra local hypersensitivity reactions, systemic or to any of the excipients. blood-glucose-lowering activity and warning symptoms of hypoglycaemia mellitus, where treatment with insulin is should be used in regimens that include hypersensitivity reactions, Hypoglycaemia. increase susceptibility to different or less pronounced include long required. an intermediate or long acting insulin or Lipodystrophy. hypoglycaemia include oral duration of diabetes, intensified insulin basal insulin analogue and can be used antidiabetic agents, angiotensin therapy, diabetic nerve disease, and with oral hypoglycaemic agents. The converting enzyme (ACE) inhibitors, medicinal products such as beta blockers dosage of Apidra should be individually disopyramide, fibrates, fluoxetine, or after transfer from animal-source adjusted. monoamide oxidase inhibitors insulin to human insulin. (MAOIs), pentoxifylline, propoxyphene, salicylates and sulfonamide antibiotics. Substances that may reduce the blood-glucose- lowering activity include corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents (e.g. epinephrine Insulin Recombinant Neutral Human B Diabetes mellitus Dose to be individualised. The average Hypoglycemia, peripheral neuropathy Hypersensitivity, hypoglycaemia, MAOIs,[adrenaline], alcohol, salbutamol, corticosteroid, oral Psychic stress, infection, pregnancy Short Acting 100 IU/ml Injection in daily insulin requirement is between 0.3- (due to fast improvement in blood insulinoma, usage in insulin pump contraceptives, beta-blocker, 10ml vial 1.0 units/kg body weight/day. Daily glucose control), transient refraction thyroid hormone, diuretic insulin requirement may be higher in disorders, lipodystrophy, injection site patients with insulin resistance, and reactions, urticaria, rash, oedema. lower in patients with residual, endogenous insulin production.

Insulin Recombinant Neutral Human B Diabetes mellitus Dose to be individualised. The average Hypoglycemia, peripheral neuropathy Hypoglyacemia, insulinoma MAOIs, alcohol, corticosteroid, oral Psychic stress, infection, pregnancy Short-acting 100IU/ml Penfill and daily insulin requirement is between 0.3- (due to fast improvement in blood contraceptives, beta-blocker, Refill 1.0 units/kg body weight/day. Daily glucose control), transient refraction thyroid hormone, diuretic insulin requirement may be higher in disorders, lipodystrophy, injection site patients with insulin resistance, and reactions, urticaria, rash, oedema lower in patients with residual, endogenous insulin production.

Insulin Recombinant Synthetic B Diabetes mellitus Dose to be individualised. The daily Hypoglycemia; edema, refraction Hypoglyacemia, insulinoma MAOIs, alcohol, corticosteroid, oral Psychic stress, infection, pregnancy Human Intermediate-Acting insulin requirement is usually between anomalies, local hypersensitivity contraceptives, beta-blocker, 100IU/ml in Vial for Injection 0.3 and 1.0IU/kg /day reactions, lipodystrophy at inj site. thyroid hormone, diuretic

Insulin Recombinant Synthetic B Diabetes mellitus Dose to be individualised. The average Hypoglycemia, peripheral neuropathy Hypersensitivity, hypoglycaemia, MAOIs, alcohol, corticosteroid, oral Psychic stress, infection, pregnancy Human Premixed 100IU/ml in Vial daily insulin requirement is between 0.3- (due to fast improvement in blood insulinoma contraceptives, beta- blocker, for Injection 1.0 units/kg body weight/day. Daily glucose control), transient refraction thyroid hormone, diuretic insulin requirement may be higher in disorders, lipodystrophy, injection site patients with insulin resistance, and reactions, urticaria, rash, oedema. lower in patients with residual, endogenous insulin production. Insulin Recombinant Synthetic B Insulin dependent diabetes mellitus, non Dose to be individualised. The daily Rare incidence of allergy and lipoatrophy Hypoglyacemia, insulinoma MAOIs, alcohol, corticosteroid, oral Psychic stress, infection, pregnancy Human, Intermediate-Acting 100 insulin dependent diabetes unresponsive insulin requirement is usually between contraceptives, beta-blocker, IU/ml Penfill and Refill to treatment to diet or oral 0.3 and 1.0IU/kg /day thyroid hormone, diuretic hypoglycaemics, hyperkalaemia to assure proper utilisation of glucose and reduce glucosuria in non diabetic patients receiving parenteral nutrition

Insulin Recombinant Synthetic B Insulin dependent diabetes mellitus, non Dose to be individualised. The average Rare incidence of allergy and lipoatrophy Hypoglyacemia, insulinoma MAOIs, alcohol, corticosteroid, oral Psychic stress, infection, pregnancy Human, Premixed 100 IU/ml Penfill insulin dependent diabetes unresponsive daily insulin requirement is between 0.5- contraceptives, beta- blocker, and Refill to treatment to diet or oral 1.0 units/kg body weight thyroid hormone, diuretic hypoglycaemics, hyperkalaemia to assure proper utilisation of glucose and reduce glucosuria in non diabetic patients receiving parenteral nutrition

Iodine and Potassium Iodide Solution B i) Pre-operative treatment of i) 1 ml daily in divided doses ii) 2 - 3 ml Hypersensitivity reactions, headache, Breast feeding Concomitant use with lithium may Should not be used for long term thyrotoxicosis ii) Thyrotoxicosis crisis daily lacrimation result in hypothyroidism and treatment. Pregnancy, lactation, children decrease the effects of oral anticoagulants

Iopamidol Injection A i) Neuroradiology : myeloradiculography, For angiography and cardiac cases- dose Pulmonary hypertension, cerebral There are no definite or absolute Metformin Asthma, history of allergy, severe hepatic cisternography and ventriculography ii) depending on the route and procedure. venous thrombosis, coagulation contraindications, with the possible and renal impairment, dehydrated Angiograph : cerebral arteriography, For selected vascular examination - abnormalities, hypotension, nausea, exception of Waldenstrom's patient, severe hypertension, advanced thoracic aortography, abdominal bottles of 30 ml and 100 ml; dose vomiting, neurological sequelae to macroglobulinaemia, multiple myeloma cardiac disease, phaeochromocytoma, aortography, angiocardiography, depending on the route and procedure lumbar myelography, myocardial and severe liver and kidney diseases sickle-cell disease, hyperthyroidism, very selective visceral arteriography, infarction, stroke, ventricular old and very young patient, multiple peripheral arteriography, venography, arrhythmias, bradycardia and transient myeloma or other paraproteinemia, digital subtraction angiography (DSA), ischemic attacks, hives, skin rash, homozygous sickle cell disease, known DSA of cerebral arteries, DSA of urticaria, pruritus, severe sensitivity to iodine peripheral arteries, DSA of abdominal thrombocytopenia, deep venous arteries iii) Urography : intravenous thrombosis, dizziness, neurobahavioral urography iv) Contrast enhancement in reactions, headache CT Scanning, arthrography, fistulography

Ipratropium Bromide 0.025% B Only for treatment of : i) Patients with ADULT : 500 mcg up to 4 times daily. Headache, nausea, dry mouth, rare and Hypersensitivity to ipratropium products, Bronchodilatory effect intensified Narrow-angle glaucoma, prostatic Inhalation Solution (250 mcg/ml) ischaemic heart disease who may CHILD 5 - 12 years : 125 - 250 mcg up to 4 reversible anticholinergic side effects, atropine, soya lecithin or related food by beta-adrenergic and xanthine hypertrophy, cystic fibrosis, bladder-neck develop extrasystole with salbutamol or times daily, 12 years : 250 - 500 mcg up ocular side effects if substances enters products preparation. Anticholinergic effects obstruction terbutaline ii) Patients with chronic to 4 times daily eyes, cough of other drugs may be enhanced. bronchitis who have airway obstruction Cisapride - loss of cisapride efficacy and who do not respond to salbutamol or terbutaline. Reversible airways obstruction, particularly in chronic obstructive pulmonary disease

Ipratropium Bromide 0.5 mg and B Management of reversible Acute attacks : 1 unit dose vial. In severe Headache, dizziness, nervousness, Hypersensitivity to atropine or its Xanthine derivatives, other Patients predisposed to glaucoma, Salbutamol 2.5 mg per UDV bronchospasm associated with cases not relieved by 1 unit dose vial, 2 tachycardia, fine tremor, palpitations. derivatives or to any other component. anticholinergics, beta2-agonists, insufficiently controlled diabetes obstructive airway diseases unit dose vials may require, patient Potentially serious hypokalaemia may Hypertrophic obstructive beta-blockers, tricyclic anti mellitus, recent myocardial infarction, should consult a doctor immediately. result from beta2-agonist therapy, cardiomyopathy or tachyarrythmia depressants, MAOIs, severe organic heart or vascular Maintenance : 1 unit dose vial 3 - 4 times dryness of mouth, dysphonia, ocular glucocorticoids - increased risk of disorders, hyperthyroidism, daily complications, allergic type reactions tachycardia, agitation, hypomania, phaechromocytoma, risk of narrow-angle hypokalaemia glaucoma, prostatic hypertrophy or bladder-neck obstruction, hypoxia, cystic fibrosis, pregnancy and lactation, uriticaria, angioedema, rash, broncospasm, oropharyngeal oedema Ipratropium Bromide 20 mcg and B Management of symptoms in chronic ADULT & CHILD more than 6 years; Acute Fine tremor of skeletal muscles, Hypertrophic obstructive Other beta-adrenergics and Insufficiently controlled Diabetes Fenoterol 50 mcg/dose Inhaler obstructive airway disorders with asthma 2 puffs. Severe cases: if breathing nervousness, dry mouth, headache, cardiomyopathy, tachyarrhythmias. anticholinergics, xanthine Mellitus, recent Myocardial Infarction, reversible bronchospasm such as has not noticeably improved after 5 mins, dizziness, tachycardia and palpitations, Hypersensitivity to atropine-like derivatives, steroids, diuretics, severe organic heart or vascular bronchial asthma and chronic bronchitis 2 further puffs may be taken. hypokalaemia, cough, nausea, vomiting, substances & sympathomimetic amines digoxin, MAOI, tricyclic disorders or patients with undelying with or without emphysema Intermittent and long-term treatment 1- sweating, weakness, myalgia/muscle antidepressants, halogenated severe heart disease hyperthyroidism, 2 puffs for each administration, up to cramps hydrocarbon anaesthesia phaeochromocytoma, prostatic max 8 puffs/day (average: 1-2 puffs three hypertrophy, bladder-neck obstruction, times daily) cystic fibrosis, predisposition to narrow- angle glaucoma. Pregnancy, lactation

Ipratropium Bromide 20 mcg and B Management of reversible ADULT and ELDERLY : 2 inhalations 4 Headache, dizziness, nervousness, Hypersensitivity to atropine or its Xanthine derivatives, other Patients predisposed to glaucoma, Salbutamol base 100 mcg/dose bronchospasm associated with times daily. Maximum : 12 inhalations tachycardia, fine tremor, palpitations. derivatives or to any other component. anticholinergics, beta2-agonists, insufficiently controlled diabetes Inhalation obstructive airway diseases daily. CHILD under 12 years not Potentially serious hypokalaemia may Hypertrophic obstructive beta-blockers, tricyclic anti mellitus, recent myocardial infarction, recommended result from beta2-agonist therapy, cardiomyopathy or tachyarrythmia depressants, MAOIs, severe organic heart or vascular dryness of mouth, dysphonia, ocular glucocorticoids : increased risk of disorders, hyperthyroidism, complications, allergic type reactions tachycardia, agitation, hypomania, phaechromocytoma, risk of narrow-angle hypokalaemia glaucoma, prostatic hypertrophy or bladder-neck obstruction, hypoxia, cystic fibrosis, pregnancy and lactation, urticaria, angioedema, rash, broncospasm, oropharyngeal oedema

Iron (III) hydroxide sucrose complex B Treatment of iron deficiency anaemia: a) Individualised dosage. ADULT and Anaphylactoid reactions, metallic taste, Anaemia not due to iron deficiency, iron Doxycycline, levodopa, Avoid fast infusion as can cause 20mg/ml solution for injection where there is a clinical need for rapid ELDERLY: Cumulative dose is to be headache, nausea, vomiting, overload or disturbances in utilisation of methyldopa, mycophenolate hypotension, cardiovascular collapse. Do iron supply b) in patients who cannot administered in single doses of 100 - 200 hypotension, diarrhoea, leg cramp, loss iron, history of asthma, eczema or atopy, mofetil, ofloxacin, omeprazole, not administer concomitant with oral tolerate oral iron therapy or who are non- mg of iron 2 - 3 times weekly depending of consciousness, seizure, dyspnoea history of cirrhosis or hepatitis, serum penicillamine, tetracycline, zinc iron preparations compliant c) in active inflammatory on Hb level. By IV drip infusion, slow IV transaminases 3 times the upper limit, bowel disease where oral iron injection or directly into the venous limb acute or chronic infection, chronic preparations are ineffective of the dialyser. Total cumulative dose: alcoholism 1000 mg

Iron Dextran 50 mg Fe/ml Injection B Severe iron deficiency anaemia An initial test dose of 0.5 ml should be Adverse effects may be delayed 24-48 hr Anaemia that are not due to iron ACE inhibitors may increase History of allergies or asthma. Pre- given over the desired route. For severe after IV admin or 3-4 days after IM deficiency; haemochromatosis; potential anaphylatic reactions. existing CV disease, hepatic impairment. iron deficiency anaemia, 1-2 ml daily admin. Flushing, dizziness, fever, chills, haemolytic anemia. Severe liver damage Parenteral chromphenicol may May worsen rheumatoid arthritis. Not given by deep IM. Dosage is nausea, headache, diaphoresis. Chest or acute kidney infection. Lactation. delay response of anaemia to iron recommended in children <4 mth. Admin individualized according to total iron pain or tightness, shock, MI, therapy. Bone scans performed of oral iron salts should be ceased before deficit hypertension, tachycardia, bradycardia with pertechnetate-labelled giving parenteral iron. Rapid IV admin and arrhythmias. Local reactions, pain disphosphonates have shown may cause vascular flushing and and staining may occur at the site of inj dense areas of increased activity hypotension. Pregnancy. after IM inj. after intramuscular injection

Ketamine 10 mg/ml Injection B Sole anaesthetic for short procedures or IV Initially, 1-4.5 mg/kg IV, a dose of 2 Cardiovascular stimulation, increased i)In those whom a significant elevation of i)concurrent use with barbiturate i)Should be used by or under the induction of anaesthesia in certain types mg/kg produces anesth for 5-10 mins. IM arterial pressure, tachycardia, emergence blood pressure would consititute a and/or narcotics may cause direction of experienced phisicians with of patients (e.g in shock states) Initially, 6.5-13 mg/kg IM, a dose of 10 phenomena (hallucination and other serious hazard and in those who have prolonged recovery time; maintenance of airway and in control of mg/kg produces anesth for 12-25 mins. transient psychotic squelae, vivid shown hypersensitivity to drug. ii)Concurrent use with halogen respiration ii) Should not be used alone in dreams), muscle hyperactivity. Irrational ii)increase intraocular or CSF pressure hydrocarbon inhalation anesthetics surgery or diagnostic procedure of behaviour. Increased muscle tone iii)eclampsia or pre-eclampsia iv)prone to may prolonged recovery time from pharynx, larynx, or bronchial tree due to sometimes resembling seizures. hallucinations v) History of cardiovacular anethesia; iii) concurrent use of anti-the reflexes of are active. if used alone, Temporary hypertension, hypotension, accident,severe angina, myocardial hypertensives or CNS depression- muscle relaxant, with proper attention to bradycardia, arrhythmias. respiratory infarction producing medication with high respiration, may be required. iii)IV dose depression, apnoea, laryngospasm, dose or rapidly administered should be administered over 60 sec as diplopia, nystagmus; nausea, vomiting, Ketamine increased risk of more rapid administration may result in lachrymation; hypersalivation; raised hypotension and/or respiratory respiratory depression or apnea iv) use intraocular and cerebrospinal fluid depression iv)administer with with caution in chronic alcoholic and pressure; skin irritation and pain at caution in patient receiving thyrioid acutely-alcohol-intoxicated person as injection site hormones due to risk of increased in cerebrospinal fluid has been hypertension and tachycardia reported. Ketamine 50 mg/ml Injection B Sole anaesthetic for short procedures or IV Initially, 1-4.5 mg/kg IV, a dose of 2 Cardiovascular stimulation, increased i)In those whom a significant elevation of i) Concurrent use with barbiturate i) Should be used by or under the induction of anaesthesia in certain types mg/kg produces anesthesia for 5-10 arterial pressure, tachycardia, emergence blood pressure would constitute a and/or narcotics may cause direction of experienced physicians with of patients (e.g in shock states) mins. IM Initially, 6.5-13 mg/kg IM, a phenomena (hallucination and other serious hazard and in those who have prolonged recovery time; ii) maintenance of airway and in control of dose of 10 mg/kg produces anesthesia transient psychotic squelae, vivid shown hypersensitivity to the drug. ii) Concurrent use with halogen respiration ii) Should not be used alone in for 12-25 mins. dreams), muscle hyperactivity. Irrational Increase intraocular or CSF pressure iii) hydrocarbon inhalation anesthetics surgery or diagnostic procedure of behaviour. Increased muscle tone eclampsia or pre-eclampsia iv) prone to may prolonged recovery time from pharynx, larynx, or bronchial tree due to sometimes resembling seizures. hallucinations v) History of cardiovascular anesthesia; iii) concurrent use of the reflexes of being active. If used alone, Temporary hypertension, hypotension, accident,severe angina, myocardial anti-hypertensives or CNS muscle relaxant, with proper attention to bradycardia, arrhythmias. respiratory infarction depression-producing medication respiration, may be required. iii) IV dose depression, apnoea, laryngospasm, with high dose or rapidly should be administered over 60 seconds diplopia, nystagmus; nausea, vomiting, administered Ketamine increased as more rapid administration may result lachrymation; hypersalivation; raised risk of hypotension and/or in respiratory depression or apnea iv) use intraocular and cerebrospinal fluid respiratory depression iv) with caution in chronic alcoholic and pressure; skin irritation and pain at administer with caution in patient acutely-alcohol-intoxicated person as injection site receiving thyroid hormones due to increased in cerebro-spinal fluid has been risk of hypertension and reported. tachycardia

Ketoprofen 30 mg Transdermal A Treatment of signs & symptoms of Apply 1 plaster to the affected area twice Pruritus and localised erythema. Hypersensitivity. Avoid in patients whom Not known Bronchial asthma. Avoid in children less Plaster arthritis deformans, periarthritis humero- daily aspirin or other NSAIDs-induced asthma than 5 years. If skin rash occurs after scapularis, tendinitis, peritendinitis, sore or other allergic-type reactions. Avoid in application, treatment should be muscle, swelling, pain resulting from patient with exudative dermatoses, stopped. Pregnancy trauma (eg. contusion, distorsion, eczema sores & infected skin or broken sprain). skin. Do not apply to the mucous membranes or eyes.

Labetalol HCl 5 mg/ml Injection B Hypertension crisis ADULT: 20mg injected slowly for at least Hypotension, bradycardia, nausea, Hypersensitivity to labetalol products, Alpha-1 adrenergic blockers, Anaesthesia/surgery, including when 2 min, followed by 40-80mg dose every vomiting bradycardia, asthma/obstructive airway amiodarone, bepridil, cimetidine, used in cases to control bleeding 10 min, if necessary upto 300 mg. Patient disease, cardiogenic shock, heart block clonidine, digoxin, dihydropyridine, (myocardial depression). Avoid abrupt should remain supine during and 3 hr overt cardiac failure calcium channel blockers, diltiazem, withdrawal; gradual withdrawal over a after the procedure. enflurane, epinephrine, flunarizine, period of 1 to 2 weeks is recommended. halothane, hypoglycemic agents, Bronchospastic disease, congestive heart imipramine, isoflurane, lidoflazine, failure, diabetes mellitus methyldopa, verapamil

Lactulose 3.35 g/5 ml Liquid C+ i) Constipation ii) Hepatic i) ADULT 15 ml twice daily adjusted to Flatulence, cramps and abdominal Galactosaemia, intestinal obstruction Response may be altered by anti- Diabetics, patients with lactose encephalopathy patient's need. CHILD 0.5 ml/kg/dose discomfort infective agents intolerance, pregnancy, lactation once or twice daily ii) 30-50 ml 3-4 times daily, dose adjusted to produce 2-3 soft stools daily. CHILD 1 ml/kg/dose 3-4 times daily Lamotrigine 50 mg Tablet A i) Adjunctive or monotherapy for partial i) Up to 200 mg daily in single or divided Dizziness, fatigue, headache, Hypersensitivity to lamotrigine products Metabolism is increased by Concomitant use of other antiepileptics, seizures and generalised tonic-clonic dosage ii) 25- 200 mg daily hypersensitivity reactions, rashes, carbamazepine, phenobarbital, discontinue therapy at the first sign of seizures not satisfactorily controlled with malaise, leukopenia, thrombocytopenia, phenytoin and primidone, rash, renal, hepatic or cardiac other antiepileptic drugs ii) Prevention of photosensitivity, blurred vision, decreased by valproate. Central impairment, pregnancy, lactation. Closely mood episodes in adult 18 years and conjunctivitis, drowsiness, insomnia, nervous system events occur with monitor and consider withdrawal if above with bipolar disorder, ataxia, nausea. Irritability, drowsiness, carbamazepine. Rifampicin, hypersensitivity syndrome develops. predominately by preventing depressive insomnia, tremor, nystagmus, ataxia, ethinyloestradiol/levonorgestrel Avoid abrupt withdrawal (reduce dosage episodes diplopia, blurred vision, gastrointestinal combination enhances the stepwise over a period of 2 week) unless disturbances, arthralgia, pain including metabolism of lamotrigine. Sodium serious skin reaction occurs. Significant back pain. Rarely, severe skin reactions valproate reduces the metabolism hepatic or renal impairment. Monitor including Stevens-Johnson syndrome and of lamotrigine. Possible and adjust dose if necessary in women toxic epidermal necrolysis interference with folate who are starting or stopping hormonal metabolism during long-term contraceptives during Lamictal therapy. therapy Close supervision of patients at high risk of suicide in bipolar disorder. Potential for an increase in risk of suicidal thoughts or behaviours

Leucovorin Calcium (Calcium A i) Biochemical modulator for 5- i) 200mg/m2 by slow IV injection over a Anaphylatoid reactions, urticaria, nausea, Hypersensitivity to leucovorin, pernicious May diminish the effect of anti- Undiagnosed megaloblastic anaemia, Folinate) 50 mg Injection Fluorouracil in the treatment of minimum 3 minutes, followed by 5- vomiting, diarrhoea, stomatitis, fatigue anaemia or megaloblastic anaemia epileptic substances such as folate dependent tumors; pregnancy. colorectal cancer ii) As rescue for high Fluorouracil or 20mg/m2 IV followed by 5- where vitamin B12 is deficient phenobarbitone, phenytoin. When Monitor calcium levels in patients dose methotrexate iii) Gestational Fluorouracil. In both cases, treatment is calcium folinate is given in receiving combined 5-Fluorouracil/Folinic trophoblastic disease repeated daily for 5 days; may repeat at conjunction with a folic acid acid treatment. To be given parenterally 4-week intervals for 2 courses then 4- to antagonist (e.g. cotrimoxazole, in the presence of GI toxicity, nausea or 5-week intervals ii) 15 mg (approximately pyrimethamine) the efficacy of the vomiting. 10mg/m2) every 6 hours for 10 doses, folic acid antagonist may either be starting 24 hours after the beginning of reduced or completely neutralised. the methotrexate infusion iii) 6 - 12 mg Concomitant administration with 5- exactly 30 hours after each dose of Fluorouracil may enhance the methotrexate. In EMA-CO regime for efficacy and toxicity of 5- high risk gestational trophoblastic Fluorouracil disease, use 30 mg IM

Leuprolide Acetate 11.25 mg A* i) Endometriosis ii) Hormonal therapy in 11.25 mg every 3 months Hot flashes, vaginal haemorrhage, bone Pregnancy, hypersensitivity to leuprolide Not known Undiagnosed abnormal vaginal bleeding, Injection advanced prostate cancer pain, nausea, vomiting, peripheral products/GnRH agonists congestive heart failure or other oedema, gastrointestinal disturbances, conditions requiring sodium restriction, dizziness, headache, paraesthesia, history of thromboembolism or congestive heart failure, oedema, cardiovascular disease, metastatic thrombophlebitis, breast tenderness, vertebral lesions, urinary tract impotence, increases/decreases in obstruction history of osteoporosis, certain hormone levels lactation, occurrence of memory disorders Leuprolide Acetate 3.75 mg Injection A* i) Endometriosis ii) Hormonal therapy in i) 3.75 mg monthly for 3 - 6 months ii) Men : prostate tumor flare, aggravation Women who are, or may become Not known Undiagnosed abnormal vaginal bleeding, advanced prostate cancer 3.75 mg IM or SC injection monthly of prostate cancer, weight gain, weight pregnant while receiving the drug, congestive heart failure or other loss, loss orr decreased libido, headache, hypersensitivity to leuprolide conditions requiring sodium restriction, muscular weakness, vasodilation, hot products/GnRH agonist, women with history of thromboembolism or flushes, hypotension, orthostatic undiagnosed vaginal bleeding. cardiovascular disease, metastatic hypotension, dry skin, hyperhydrosis, vertebral lesions, urinary tract rash, urticaria, abornormal hair growth, obstruction history of osteoporosis, hair disorder, night sweats, lactation, occurrence of memory hypotrichosis, pigmentation disorder, disorders cold seat, hirsutism, gynaecomastia, breast tenderness, erectile dysfunction, testicular pain, breast enlargement, breast pain, prostate pain, penile swelling, penis diorder, testis atrophy, mucosal dryness, bone density decreased. Women : weight gain, weight loss, loss or decreased libido, affects lability, headache, hot flushes, vasodilatation, hypotension, acne, seborrhea, dry skin, urticaria, skin odour abnormal, hyperhydrosis, hair growth abnormal, hirsutism, hair disorder, eczema, nail disorder, night sweats, gynecomastia, vaginal haemorrhage, dysmenorrhea, menstrual disorder, breast enlargement, breast engorgement, breast atrophy, genital discharge, vaginal discharge, galactorrhea, breast pain, metrorrhagia, menopausal symptoms, dyspareunia, uterine disorder, vaginitis, menorrhagia, feeling hote, irritability, bone density decreased

Levetiracetam 100 mg/ml Injection A* i) Monotherapy therapy in the treatment i) ADULTS and ADOLESCENT (from 16 Asthenia, somnolence/fatigue, Hypersensitivity to levetiracetam or Antidepressants: anticonvulsant Keppra is excreted in human breast milk. of partial onset seizures with or without years): Starting dose: 250 mg twice daily, thrombocytopenia, abdominal pain, other pyrrolidone derivatives or any of effect of antiepileptics possibly Breastfeeding is not recommended. secondary generalization in patients from Increase dose to 500 mg twice daily after diarrhoea, dyspepsia, nausea, vomiting, the excipients antagonised by MAOIs and tricyclic- age 16 years of age with newly 2 week. Dose can be further increased by amnesia, ataxia, convulsion, dizziness, related antidepressants (convulsive diagnosed epilepsy ii) Adjunctive 250 mg twice daily every 2 weeks headache, hyperkinesia, tremor, balance threshold lowered). Anticonvulsant treatment in partial onset seizures with depending upon the clinical response. disorder, disturbance in attention, effect of antiepileptics antagonised or without secondary generalization in Max: 1500 mg twice daily. ii) ADULT memory impairment, aggression, by SSRIs and tricyclics (convulsive adults and children from 4 years of age more than 18 years and ADOLESCENT (12 agitation, depression, emotional threshold lowered). Avoid with epilepsy; juvenile myoclonic to 17 years) more than or equal to 50 kg: lability/mood swings, hostility, insomnia, concomitant use of antiepileptics epilepsy and idiopathic generalized tonic Initially 500 mg twice daily may be irritability, nervousness, personality with St John?s wort . Antimalarials: clonic epilepsy from 12 years of age. To increased up to 1500 mg twice daily. disorders, thinking abnormal, anorexia, possible increased risk of be initiated when conventional IV Dose changes can be made in 500 mg weight increase. The risk of anorexia is convulsions when antiepileptics antiepileptic drugs failed to achieve twice daily increments or decrements 2 higher when topiramate is co given with chloroquine and control, or oral form is temporarily not to 4 weekly. CHILD (4 to 11 years) and administered with levetiracetam, vertigo, hydroxychloroquine. feasible in seizure emergencies ADOLESCENT (12 to 17 years) less than diplopia, vision blurred, myalgia, Anticonvulsant effect of 50 kg : Initially 10 mg/kg twice daily, may accidental injury, infection, antiepileptics antagonised by be increased up to 30 mg/kg twice daily. nasopharyngitis, cough increased, mefloquine Dose changes should not exceed eczema, pruritus, rash. increments or decrements of 10 mg/kg twice daily every 2 weeks. CHILD more than or equal to 50 kg: Adult dose Levetiracetam 100 mg/ml Oral A* As adjunctive therapy in the treatment of CHILD: 4-11 years and adolescent (12-17 Asthenia, somnolence/fatigue, Hypersensitivity to levetiracetam Evening primrose, ginkgo Avoid abrupt discontinuation, renal Solution partial onset seizures with or without years) less than 50 kg: Initially 10 mg/kg thrombocytopenia, abdominal pain, products impairment, severe hepatic impairment, secondary generalization in adults and twice daily, may be increased up to 30 diarrhoea, dyspepsia, nausea, vomiting, pregnancy, lactation, elderly. May affect children from 4 years of age with mg/kg twice daily. Dose changes should amnesia, ataxia, convulsion, dizziness, ability to drive or operate machinery. epilepsy not exceed increments or decrements of headache, hyperkinesia, tremor, balance Potential for an increase in risk of suicidal 10 mg/kg two times daily twice weekly disorder, disturbance in attention, thoughts or behaviours memory impairment, aggression, agitation, depression, emotional lability/mood swings, hostility, insomnia, irritability, nervousness, personality disorders, thinking abnormal, anorexia, weight increase.

Levobupivacaine 5mg/ml Injection A Production of local or regional anesthesia Surgical anesthesia : Lumber epidural : 10 Hypotension, anemia, nausea, vomiting, Intravenous regional anaesthesia (Bier's St John's Wort Use with caution in patients with for surgery and obstetrics, and for - 20 ml (50 - 150 mg) , caesarean section : fever, pruritus, cardiac arrest, cardiac block), paracervical block in obstetrics hypotension, hypovolemia, heart block, postoperative pain management 15 - 30 ml (75 - 150 mg), intrathecal: 3 ml dysrhythmia, apnea hepatic or cardiac impairment (15 mg), peripheral nerve block : 1 - 40 ml, ilioinguinal/iliohypogastric block. CHILD : 0.25 - 0.5 ml/kg (1.25-2.5 mg/kg)

Levonorgestrel 52 mg Intrauterine A* i) Contraception (Initial release rate of 20 i) & ii):One unit intrauterine device to be Menstrual changes, lower abdominal Active hepatic disease, active Not known Discontinue treatment if crescendo System mcg/24 hours). ii) Idiopathic menorrhagia inserted into the uterine cavity within 7 pain, acne or other skin problems, thrombophlebitis or thromboembolic migraine or other symptoms indicating days of the onset of menstruation or backpain, mastalgia, headache, vaginal disorders, haemorrhagic diathesis, transient cerebral ischaemia, immediately after first trimester discharge, mood changes, nausea, carcinoma of the breast, pregnancy, exceptionally severe headache, jaundice, abortion. Postpartum insertion should be oedema, weight gain, decreased libido, undiagnosed abnormal uterine bleeding, marked increase of blood pressure, postponed until 6 weeks after sweating, hair loss, greasy hair, ectopic undiagnosed abnormal genital bleeding, unexplained loss of vision or other delivery.Can be inserted at any time of pregnancy, pelvic inflammatory disease history of idiopathic intracranial symptoms of retinal thrombosis occurs. amenorrheic woman. One unit IUD is (PID), perforation of uterine wall, hypertension, hypersensitivity Hormone dependent neoplasia including effective for 5 years enlarged follicles may develop breast cancer, malignancies affecting the blood or leukaemias, severe arterial disease eg stroke or myocardia infarction. Diabetics. In recurrent endometriosis, pelvic infections or if an acute infection does not respond to treatment within a few days, perforation, accidental pregnancy. Not a contraceptive of choice during lactation

Lignocaine 10 % w/w Spray B For surface anaesthesia in dental Spray to affected part Circumoral paraesthesia, numbness of Hypersensitivity to lidocaine or amide Potentiation of cardiac effects Cardiovascular disease, wounds or practice, in otorhinolaryngology and the tongue, light headedness, tinnitus, type of local anaesthetics antiarrhythmias. Lidocaine should traumatised mucosa in the application paracentesis severe hypotension, bradycardia, be used with caution with dental region. Partial or complete heart block, arrhythmia, cardiovascular collapse. Sore injection anaesthesia, other local elderly and patients in poor general throat, hoarseness, loss of voice, allergic anaesthetics or class intrabursal health. Advanced liver disease or severe reactions (rare) (IB) antiarrhythmic drugs, as the renal dysfunction. Avoid contact with toxic effects are additive. Tocainide eyes, wound or traumatised mucosa and drugs that reduce the clearance of lidocaine (eg, cimetidine or β-blockers) may cause potentially toxic plasma concentrations when lidocaine is given in repeated high doses over a long time period Lignocaine 2% Jelly B Use for endotracheal tubes and Apply to affected area 10 mins before Allergic reactions. Intoxication, Hypersensitivity to lidocaine or amide Potentiation of cardiac effects Traumatised mucosa and sepsis in the instruments, painful procedures in the catheterization, etc cutaneous and hypersensitivity type of local anaesthetics. Hypovolaemia, antiarrhythmias. Drugs structurally region of application, chronic heart ear, nose and throat, burns, wounds, symptoms. Sore throat. Central nervous heart block or other conduction related to local anaesthesia failure, bradycardia or respiratory abrasions, lacerations; catheterisation of system excitation followed by depression disturbances depression, hepatic insufficiency. Should the male and female urethra and for with drowsiness, respiratory failure and not be used as ophthalmic drug. symptomatic treatment of cystitis and coma, numbness of tongue and perioral Presence of sepsis or severely urethritis region, myocardial depression, peripheral traumatized mucosa in area of vasodilation, hypotension, bradycardia, application. When used for endotracheal arrhythmia, cardiac arrest. Prolonged use tube lubrication, avoid introducing into in the eye may lead to severe contact the lumen of the tube. Closely supervise keratitis and corneal damage patients being treated with class III antiarrhythmic drugs eg amiodarone and monitor ECG due to the additive effects

Lignocaine 2% with Chlorhexidine B To provide local anaesthesia and Adult Male†Instil 20 mL slowly into the Nervousness, dizziness, sedation, blurred Hypersensitivity to lidocaine or amide Potentiation of cardiac effects, Severe hypertension, severe cardiac 0.05% Gel lubrication during catheterization, urethra until it reaches external vision, tinnitus, gastrointestinal effects. type of local anaesthetics. Severe antiarrhythmic drugs, β-receptor- insufficiency, arteriosclerotic heart exploration by sound and other sphincter, proximal to the prostrate. Rarely: allergic reactions bradycardia blocking agents, calcium channel disease, cerebrovascular insufficiency, endourethral operations and Subsequently, apply compression at the antagonists heart block, seriously impaired hepatic examinations, cytoscopy and corona for several mins. Fill the length of and renal function, traumatized mucosa symptomatic treatment of painful cystitis the urethra w/ the remaining and or inflammation/sepsis in the region and urethritis gel.†Sounding procedure or of the proposed application and in cytoscopy†Instill 40 mL (in 3-4 portions) patients with tendency to convulsions into the insertion area then allow 5-10 mins for anaesth to take effect.†Adult Female†Prior to urological procedure, instill 5-10 mL in small portions to fill the whole urethra & allow anaesth to take effect in 3-5 mins.Childn <12 yr†Up to 6 mg/kg.

Lignocaine HCl (Lidocaine) 2% B For local or regional anaesthesia and Local anesthesia: Nervousness, dizziness, sedation, blurred Local inflammation and/or sepsis, Potentiation of cardiac effects Neurological disorder, severe Injection nerve block. Not for IV use. ADULT Maximum: 100 mg; vision, tinnitus, gastrointestinal effects, septicaemia. Hypovolaemia, heart block antiarrhythmias, phenytoin, beta- bradycardia, cardiac conduction CHILD Maximum: 3 mg/kg dose-related methaemoglobinaemia and and other conduction disturbances, blockers, cimetidine abnormalities, pregnancy, congestive cyanosis. Restlessness, excitement, bradycardia, cardiac decompensation or heart failure, respiratory depression, nervousness, paraesthesia, vomiting, hypotension hepatic or renal insufficiency, epilepsy, muscle twitching and tremors, shock, myasthenia gravis. Elderly. convulsions. Numbness of tongue and Pregnancy and lactation perioral region, light headedness, sedation, CNS depression, respiratory failure and coma. Arrhythmias, bradycardia, cardiac arrest, anaphylaxis. Lassitude, amnesia, foetal intoxication Lignocaine HCl (Lidocaine) 20 mg/ml B Ventricular tachycardia and ventricular 50-100 mg IV as a bolus, repeated after 5 Nervousness, dizziness, paraesthesia, Hypersensitivity to amide local Beta-adrenergic blockers; increased Adams-Stokes syndrome, advanced heart Injection fibrillation. For IV use. To be diluted minutes if necessary. Maintenance : 1-4 drowsiness, tinnitus, disorientation, anesthetics, Stokes-Adams syndrome, lidocaine failure. EKG monitoring for intravenous before use mg/min by IV infusion under ECG blurred vision, tremor, convulsions, Wolff-Parkinson-White syndrome,severe levels.Cimetidine;decreased administration. Epidural anaesthesia; a monitoring respiratory depression, hypotension, degrees of sinoatrial, AV or lidocaine level. Class I test dose is recommended, heart block, bradycardia intraventricular block in absence of antiarrhythmic agents (eg, hepatic disease, hypovolaemia, renal pacemaker, ophthalmic use tocainide, mexiletine);toxic effects disease, severe degrees of sinoatrial, are additive and potentially atrioventricular or intraventricular block. synergistic. Procainamide; additive Shock, sinus bradycardia, spinal neurological and cardiac effects. anaesthesia, severe haemorrhage, shock, Succinylcholine;prolongation of heart block, local infection at injection neuromuscular blockade. site, septicaemia. Wolff-Parkinson-White Incompatibility with; amphotericin syndrome B, parenteral cephalosporins, doxycycline, epinephrine, isoprenaline, methohexital, nitroprusside, norepinephrine, phenytoin, sodium bicarbonate, sulfadiazine

Lignocaine HCl 5% and A* Preparation of nasal mucosa for surgery Adults and children over 12 years : 5 Phenylepherine may rarely cause tremor Known hypersensitivity to either of the Propranolol or cimetidine may Elderly and debilitated: should reduce Phenylephrine HCl 0.5% Nasal Spray (eg. Cautery to Little's area), aid the squirts per nostril. Children: 8 to 12 years or palpitations. Rarely nervousness, active ingredients or any of the non reduce the clearance of lignocaine. dose. Eating and drinking: Food /drink treatment of acute nose bleeds and 3 squirts per nostril, 4 to 8 years 2 squirts nausea, vomiting, tinnitus, dizziness, active ingredients, hypersensitivity to Antiarrhythmic drugs:lignocaine should not be ingested within 2 hours of removal of foreign bodies from the nose, per nostril, 2 to 4 years 1 squirt per numbness or disorientation may occur other local anaesthetics of the amide can have additive effects or local anaesthetic use. Patients with topical anaesthesia of the pharynx prior nostril. Doses are to be administered following rapid absorption of lignocaine. type and to other sympathomimetic antagonistic effects. cardiovascular disease, hypertension, to direct or indirect laryngoscopy, topical once only. The most commonly noted side effect is agents, pregnancy, children less than 2 Suxamethonium: lignocaine severe bradycardia, conduction anaesthesia and local vasoconstriction a transient bitter taste in the mouth years old prolongs the action of disturbances or severe digitalis prior to endoscopy of the upper airways lasting 1-2 minutes. suxamethonium. Phenytoin: intoxication. Patients with impaired lignocaine and phenytoin have kidney or liver function. Asthmatic additive cardiac depressant effects. patients: contains sodium metabisulfite. Antidepressants: may interact with Genetic predisposition to malignant phenylephrine hyperthermia and pre-existing abnormal neurological conditions. Should not be used in pregnancy. May be used as directed in breastfeeding mothers.

Liquid Paraffin C Constipation ADULT 10-30 ml daily at night but should Anal seepage of paraffin and consequent Nausea, vomiting, undiagnosed May impair the absorption of fat Avoid prolong use, patients with with not be taken immediately before going anal irritation after prolonged use, abdominal pain, pregnancy, difficulty soluble vitamin recent change of bowel habits or to bed. CHILD not recommended granulomatous reactions caused by swallowing, bedridden patients, children suspected bowel malignancy and rectal absorption of small quantities of liquid less than 3 years bleeding paraffin, lipoid pneumonia and interference with the absorption of fat soluble vitamins

Loratadine 1 mg/ml Syrup A Allergic rhinitis, chronic urticaria and ADULT and CHILD over 6 years : 10 mg Headache, nervousness, sedation Hypersensitivity to loratadine, not to be Cimetidine, erythromycin, Impaired liver and renal function (use other allergic dermatological disorders once daily. CHILD 2 - 6 years: 5 mg once used in children less than 2 years of age. ketoconazole and other hepatic lower dose). Should not take with alcohol daily enzyme inhibitors and avoid operating vehicle and machinery, to be used with caution and doctor's advice in children 2 to 6 years of age.

Magnesium Sulphate 45% Paste C Inflammatory skin conditions such as Apply under dressing Prolonged or repeated use may damage Hypersensitivity to magnesium sulfate Not known Avoid contact with eyes and other boils and carbuncles the surrounding skin mucous membranes Magnesium Sulphate 50% Injection C i)Treatment and prophylaxis of acute i)Mild hypomagnesemia (ADULT): 1gm Hypermagnesaemia characterised by Heart block, severe renal impairment Additive central depressant effects Renal impairment, myasthaenia gravis, hypomagnesaemia ii) Prevention and magnesium sulphate (8mEq) IM every 6 nausea, vomiting, flushing, thirst, (<20ml/min), myocardial damage. Should with central nervous system digitalised patients; pregnancy. Monitor treatment of life-threatening seizures in hours for 4 doses. Severe hypotension, drowsiness, confusion, not be administered to pregnant women depressants. Neuromuscular serum-magnesium concentrations. An the treatment of toxemias of pregnancy hypomagnesemia (ADULT): 0.25 g/kg IM slurred speech, double vision, 2 hours prior delivery, unless it is the only blocking agents, cardiac glycosides, intravenous preparation of calcium salt (pre-eclampsia and eclampsia) over 4 hours. Alternative dose of 5g may bradycardia, muscle weakness. therapy available to prevent eclamptic nifedipine (calcium gluconate) should be readily be given by slow intravenous infusion Hypocalcaemia; paralytic ileus. IM: seizures. There is a risk the neonate will available for use when magnesium over 3 hours ii) Toxemia of pregnancy: An Irritation and pain at site of injection be born with hypermagnesemia and sulphate is given intravenously. initial intravenous dose of 4gm of depressed breathing magnesium sulphate is recommended. Followed by an intramuscular dose of 4- 5gm into each buttock. This may be followed by a dose of 4-5gm into alternate buttocks every 4 hours as needed. Alternatively, the initial dose IV dose may be followed by an infusion of 1- 2gm/hr

Magnesium Trisilicate Mixture C Heartburn, dyspepsia 10-20 ml 3-4 times daily before meals Diarrhoea, systemic alkalosis has been Acute surgical abdomen, hypersensitivity Major: sodium polystyrene Renal impairment-nonabsorbable reported when administered orally with to antacids, hypophosphataemia sulfonate (advoid). Moderate: calcium, magnesium or aluminum cation-exchange resins tetracyclines, ketoconazole, preparations such as antacids or laxatives itraconazole, dipyridamole, should not be used in patients receiving quinolones, captopril, iron and oral cation-exchange resins. aspirin (adjust frequency interval) Alternatively, the interaction may be avoided by administering the resin as an enema

Mannitol 20% Injection (20 g/100 ml) A Cerebral oedema 0.25- 2 g/kg IV of a 15% to 25% solution Hyperkalaemia, diarrhoea, renal failure, Anuria, pulmonary oedema/congestion, Lithium toxicity (with diuretic Cardiopulmonary dysfunction, renal over 30-60 minutes. Safety and efficacy acidosis, pulmonary oedema, seizure, severe chronic heart failure, intracranial induce hyponatraemia). Increased dysfunction. An in-line filter should be not established in children under 12 thrombophlebitis, urinary retention bleeding, renal damage/dysfunction nephrotoxicity with ciclosporin. used during intravenous administration. years of age (after initiation of mannitol) Maintain proper fluid and electrolyte balance. Monitor urinary output. Renal dysfunction and solutions should be examined for crystals before use. Solutions of 15% and 20% should always be filtered

Medroxyprogesterone Acetate 50 B Prevention of pregnancy and to provide 150mg to be administered once every 3 Gastrointestinal distress, oedema, Thromboembolic disorders, liver disease, Concurrent use with Depression, epilepsy, migraine, asthma, mg/ml Injection long term contraception month menstrual disorders, dermatologic breast or genital cancer, undiagnosed aminoglutethimide may result in diabetes, cardiac or renal dysfunction, effects abnormal vaginal bleeding, known or decreased medroxyprogesterone fluid retention, thromboembolic suspected pregnancy, hypersensitivity to efficacy. Concurrent use with disorders, cerebral apoplexy, history of medroxyprogesterone products, missed nevirapine may result in loss of convulsions, liver disease, known or abortion contraceptive efficacy. Concurrent suspected breast cancer, undiagnosed use with succinylcholine may result vaginal bleeding or miscarriage. in prolongation of neuromuscular blockade

Menthol 1.6% in Industrial C Decongestion of the upper respiratory As directed for local use Hypersentivity reactions including Not known Not known Not known Methylated Spirit Inhalation tract contact dermatitis Meropenem 1 g Injection A* i. Emperical treatment for presume ADULT: 0.5g - 1g 8 hourly CHILD: (aged 3 Local injection site reactions, rash, Hypersensitivity to meronem, Probenecid, valproic acid, typhoid History of hypersensitivity to infections in patients (adult and children) months and over): 10-40mg/kg 8 hourly, pruritus, urticaria, abdominal pain, carbapenems, penicillins or other beta- vaccine carbapenems or other beta-lactam with febrile neutropenia, used as if body weight over 50kg, adult dosage nausea, vomiting, diarrhoea, headache, lactam antibiotics antibiotics, penicillins and monotherapy or in combination with anti- should be used paraesthesia, oral and vaginal cephalosporins. Monitor transaminase virals or antifungal agent ii. Septicaemia candidiasis, reversible and bilirubin levels when used in hepatic iii. Serious infections in renal impaired thrombocytopenia, leucopenia, disease. Not recommended for MRSA patients eosinophilia, thrombocytopenia, infections. Consider diagnosis of neutropenia pseudomembranous colitis in patients who develop diarrhoea. Critically ill patients with Pseudomonas aeruginosa infection. Pregnancy and lactation

Meropenem 500 mg Injection A* i. Emperical treatment for presume ADULT: 0.5g - 1g 8 hourly CHILD: (aged 3 Local injection site reactions, rash, Hypersensitivity to meronem, Probenecid, valproic acid, typhoid History of hypersensitivity to infections in patients (adult and children) months and over): 10-40mg/kg 8 hourly, pruritus, urticaria, abdominal pain, carbapenems, penicillins or other beta- vaccine carbapenems or other beta-lactam with febrile neutropenia, used as if body weight over 50kg, adult dosage nausea, vomiting, diarrhoea, headache, lactam antibiotics antibiotics, penicillins and monotherapy or in combination with anti- should be used paraesthesia, oral and vaginal cephalosporins. Monitor transaminase virals or antifungal agent ii. Septicaemia candidiasis, reversible and bilirubin levels when used in hepatic iii. Serious infections in renal impaired thrombocytopenia, leucopenia, disease. Not recommended for MRSA patients eosinophilia, thrombocytopenia, infections. Consider diagnosis of neutropenia pseudomembranous colitis in patients who develop diarrhoea. Critically ill patients with Pseudomonas Aeruginosa infection. Pregnancy and lactation

Methoxy Polyethylene Glycol- A* Treatment of anaemia associated with Non Erythropoiesis Stimulating Agent Hypertension, vascular access Uncontrolled hypertension, known No interaction studies have been Uncontrolled hypertension. Evaluate iron epoetin Beta 150 mcg/0.3 ml chronic renal failure. Prescribing (ESA)-treated patients : 0.6 mcg/kg, once thrombosis, headache, hypersensitivity, hypersensitivity to the active substance performed status prior to and during treatment to Injection in Prefilled Syringe restriction: Patients who require higher every two weeks (IV or SC). When the Hb hypertensive encephalopathy and rash or any of the excipients determine whether supplementary iron doses of erythropoietin if it is more cost is >11g/dl, administration can be reduced (rare). Increased risk of mortality and/or is necessary. Discontinue if Pure Red Cell saving to use a long-acting agent instead to once monthly using the dose equal to tumour progression and Pure Red Cell Aplasia (PRCA) is diagnosed. May of short-acting agents. twice the previous two weekly dose. ESA- Aplasia. stimulate growth of any type of treated patients : 120-360 mcg once malignancy. Pregnancy and lactation. Not monthly or 60-180 mcg every two weeks recommended for patients < 18 years.

Methoxy Polyethylene Glycol- A* Treatment of anaemia associated with Non Erythropoiesis Stimulating Agent Hypertension, vascular access Uncontrolled hypertension, known No interaction studies have been Uncontrolled hypertension. Evaluate iron epoetin Beta 200 mcg/0.3 ml chronic renal failure. Prescribing (ESA)-treated patients : 0.6 mcg/kg, once thrombosis, headache, hypersensitivity, hypersensitivity to the active substance performed status prior to and during treatment to Injection in Prefilled Syringe restriction: Patients who require higher every two weeks (IV or SC). When the Hb hypertensive encephalopathy and rash or any of the excipients determine whether supplementary iron doses of erythropoietin if it is more cost is >11g/dl, administration can be reduced (rare). Increased risk of mortality and/or is necessary. Discontinue if Pure Red Cell saving to use a long-acting agent instead to once monthly using the dose equal to tumour progression and Pure Red Cell Aplasia (PRCA) is diagnosed. May of short-acting agents. twice the previous two weekly dose. ESA- Aplasia. stimulate growth of any type of treated patients : 120-360 mcg once malignancy. Pregnancy and lactation. Not monthly or 60-180 mcg every two weeks. recommended for patients < 18 years.

Methyl Salicylate 25% Ointment C+ Relief of minor aches and pains of To be massage well to the affected area, Extreme overdosage results in excessive Neonates and patients with aspirin or Not known Avoid contact with broken or inflammed muscles and joints associated with 3 - 4 times daily. irritation, tinnitus, nausea, vomiting. salicylate idiosyncrasy (urticaria and skin, near to the eyes or mucous simple backache, arthritis and rheumatic Epidermal necrolysis in very prolonged angioneurotic oedema as allergic membrane. Reports of apnoea and conditions. application. responses). instant collapse in infants following the application to their nostrils. May increase chances of bleeding with excessive application for those taking warfarin. Methylene Blue 1% Injection B For treatment of idiopathic and drug- Adult and children: 1 to 2 mg/kg (0.1 to Hypertension, hypotension, sweating Hypersensitivity to methylene blue, Not known Haemolytic anaemia (Heinz-body induced methaemoglobinemia 0.2 mL/kg of a 1% solution) IV very slowly symptom, abdominal pain, diarrhea, severe renal impairment, anaemia) and hyperbilirubinaemia in over 5 minutes. This dosage can be nausea, vomiting ,dizziness, headache, methaemoglobinemia in cyanide neonates who had been exposed to repeated if necessary after one hour. confusion, cardiac dysrhythmia, poisoning, intraspinal injection, G6PD methylene blue in the amniotic cavity. malignant hyperthermia, hemolytic deficiency. Do NOT administer by subcutaneous or anemia, methemoglobinemia intrathecal injection, renal impairment.

Methylprednisolone Sodium A Suppression of inflammatory and allergic 15 - 30 mg/kg daily. Large doses may be GI upsets, aseptic necrosis of femoral & Systemic fungal infection. Decreased effect: Phenytoin, Ocular herpes simplex; psychic Succinate 0.5 g Injection disorders, cerebral oedema, repeated 4 - 6 hourly for up to 48 hours humeral heads; peptic ulceration with phenobarbital, rifampicin increases derangements; non-specific ulcerative immunosuppression treatment of possible perforation & hemorrhage; clearance of methylprednisolone. colitis; active or latent peptic ulcer, renal haematological and oncological manifestations of latent diabetes Potassium depleting diuretics insufficiency, hypertension, osteoporosis, disorders, treatment of shock states and mellitus; anaphylactic reactions with or enhance potassium depletion. myasthenia gravis; immunisation (defer); endocrine disorders without circulatory collapse, cardiac Increased toxicity: Skin test active or latent TB; unusual stress; arrest or arrhythmias, bronchospasm. antigens, immunizations decrease pregnancy, lactation. May mask signs of Fluid & electrolyte disturbances. response of methylprednisolone infection & new infection may appear. Posterior subcapsular cataracts & glaucoma w/ possible damage to optic nerves may occur. Reduce dose gradually.

Methylprednisolone Sodium A Suppression of inflammatory and allergic 15 - 30 mg/kg daily. Large doses may be Fluid and electrolyte disturbances, Hypersensitivity, systemic fungal Decreased effect: Phenytoin, Discontinue treatment by reducing the Succinate 1 g Injection disorders, cerebral oedema, repeated 4 - 6 hourly for up to 48 hours muscle weakness, peptic ulcer, infection phenobarbital, rifampicin increases dosage gradually immunosuppression treatment of osteoporosis, abdominal distention, clearance of methylprednisolone. haematological and oncological nausea and vomiting Potassium depleting diuretics disorders, treatment of shock states and enhance potassium depletion. endocrine disorders Increased toxicity: Skin test antigens, immunizations decrease response of methylprednisolone

Metoclopramide HCl 1 mg/ml Syrup B i) Dyspepsia, flatulence, hiatus hernia, i) CHILD over 5 years: 2.5 - 5 ml 3 times Extrapyramidal effects (especially in Concomitant therapy with drugs which Increased absorption of aspirin, Hepatic and renal impairment, elderly, peptic ulceration, reflux oesophagitis, daily. 3 - 5 years 2 ml 2 - 3 times daily. 1 - children and young adults), are likely to cause extrapyramidal paracetamol, tetracycline, young adults and children; may mask gastritis, duodenitis, cholelithiasis, 3 years: 1 ml 2 - 3 times daily. Under 1 hyperprolactinaemia, tardive dyskinesia, reactions, epileptics, gastrointestinal levodopa, ethanol, cyclosporine, underlying disorders such as cerebral nausea, vomiting ii) Promote bowel year: 1 ml 2 times daily ii) Single dose drowsiness, restlessness, anxiety, haemorrhage, obstruction (mechanical), opioid analgesics and irritation; avoid for 3 - 4 days following transit during diagnostic procedures given 10 minutes before examination. drowsiness, fatigue, akathisia, insomnia, or perforation, hypersensitivity to antimuscarinics antagonise effect gastrointestinal surgery, may cause acute CHILD over 5 years: 2.5 - 5 ml. Between 3 depression, neuroleptic malignant metoclopramide, pheochromocytoma. on gastro-intestinal activity, hypertensive response in - 5 years: 2 ml. Under 1 year: 1 ml syndrome, diarrhoea, bronchospasm and Immediately after GI surgery where antipsychotics (increased risk of phaeochromocytoma, pregnancy and cardiac conduction abnormalities, stimulation of GI tract motility might be extrapyramidal effects). Decrease breast feeding, porphyria. Use cautiously galactorrhea, gynaecomastia. dangerous. absorption of digoxin, antagonized in patients with depression, Parkinson's by anticholinergic drugs and disease or hypertension, insulin dosage narcotic analgesics. Additive or timing of dosage may require sedative effects with alcohol, adjustment sedatives, hypnotics, narcotics or tranquilizers

Metoclopramide HCl 5 mg/ml B i) Dyspepsia, flatulence, hiatus hernia, i) ADULT over 20 years: 10 mg 3 times Extrapyramidal effects (especially in Concomitant therapy with drugs which Increased absorption of aspirin and Hepatic and renal impairment, elderly, Injection peptic ulceration, reflux oesophagitis, daily. ADULT between 12 - 20 years: 5 mg children and young adults), are likely to cause extrapyramidal paracetamol; opioid analgesics and young adults and children; may mask gastritis, duodenitis, cholelithiasis, 3 times daily. CHILD under 12 years: 0.12 hyperprolactinaemia, tardive dyskinesia, reactions, epileptics, gastrointestinal antimuscarinics antagonise effect underlying disorders such as cerebral nausea, vomiting ii) Promote bowel mg/kg/dose 6 - 12 hourly ii) Single dose 5 drowsiness, restlessness, anxiety, haemorrhage, obstruction (mechanical), on gastro-intestinal activity, irritation; avoid for 3 - 4 days following transit during diagnostic procedures - 10 minutes before examination; ADULT drowsiness, fatigue, akathisia, insomnia, or perforation, hypersensitivity to antipsychotics (increased risk of gastro-intestinal surgery, may cause and CHILD over 15 years: 10 - 20 mg; depression, neuroleptic malignant metoclopramide, pheochromocytoma. extrapyramidal effects). Decrease acute hypertensive response in CHILD less than 15 years: 0.12 syndrome, diarrhoea, bronchospasm and Immediately after GI surgery where absorption of digoxin phaeochromocytoma; pregnancy and mg/kg/dose 6 - 12 hourly cardiac conduction abnormalities, stimulation of GI tract motility might be breast feeding; porphyria. Use cautiously galactorrhea, gynaecomastia. dangerous. in patients with depression, Parkinson's disease or hypertension Metronidazole 200 mg/5 ml B Anaerobic infection CHILD: 7.5 mg/kg 3 times daily for 7 days Unpleasant taste in mouth, furry tongue, Hypersensitivity to metronidazole. Alcohol, warfarin, phenobarbitone, Caution in patient with active disease of Suspension gastrointestinal disturbances, urticaria, Chronic alcohol dependence lithium, phenytoin,c imetidine, CNS except for brain abscess of hepatic angioedema, drowsiness, dizziness, amiodarone, busulfan, encephalopathy headache, ataxia, skin rashes, pruritus, carbamazepine, cholestyramine, darkening of urine, peripheral cyclosporine, dihydroergotamine, neuropathy or transient epileptiform disulfiram, ergotamine, fluorouracil, seizures ,leucopenia, nausea, vomiting, tacrolimus erythema multiforme, angioedema, hepatitis, jaundice, thrombocytopenia, aplastic anaemia, myalgia, arthralgia

Metronidazole 500 mg/100 ml A Anaerobic infections ADULT: 500 mg IV infusion 8 hourly. GI disturbances, urticaria, angioedema, Hypersensitivity to metronidazole Alcohol, warfarin, phenobarbitone, If administered for more than 10 days, Injection CHILD: 7.5 mg/kg body weight every 8 drowsiness, dizziness, headache, ataxia, lithium, phenytoin, cimetidine, haematological tests are recommended. hours. Neonates: 15mg/kg LD, followed skin rashes, pruritus, darkening of urine, amiodarone, busulfan, Re-administer immediately after by 7.5mg/kg every 12 hourly. 1 month to peripheral neuropathy or transient carbamazepine, cholestyramine, haemodialysis. Caution in patient with 18 years: 7.5mg/kg (maximum 500mg) epileptiform seizures, leucopenia, cyclosporine, dihydroergotamine, active disease of CNS except for brain every 8 hours. anaphylaxis disulfiram, ergotamine, fluorouracil, abscess or hepatic encephalopathy. tacrolimus. will inactivate oral Pregnancy & lactation typhoid vaccine

Micafungin Sodium 50mg Injection A* i) Treatment of invasive candidiasis, i) Dosage for adults, adolescents ≥ 16 Diarrhoea, nausea, vomiting, Micafungin is contraindicated in patients Micafungin has a low potential for Hypersensitivity: Anaphylactic / including candidemia in adults when years of age and the elderly for the constipation, abdominal pain, dyspepsia, with hypersensitivity to any component interactions with medicines anaphylactoid reactions including shock intolerance or resistance to Amphotericin treatment of invasive candidiasis: - Body pyrexia, mucosal inflammation, rigors, of this medication or to other metabolised via CYP3A mediated may occur. Skin and subcutaneous tissue B or Fluconazole. ii) Treatment of weight > 40kg: 100mg/day* - Body peripheral oedema, fatigue, echinocandins. pathway. However, patients disorder: Exfoliative cutaneous reactions, invasive candidiasis in children. weight ≤ 40kg: 2mg/kg/day* *If patient's hypokalaemia, hypomagnesaemia, receiving sirolimus, nifedipine or such as Steven-Johnson syndrome and response is inadequate, e.g. persistence hypocalcaemia, anorexia, itraconazole in combination with toxic epidermal necrosis have been of cultures or if clinical condition does hyperglycaemia, fluid overload, micafungin should be monitored for reported. Haemolysis: Isolated cases of not improve, the dose may be increased bacteraemia, sepsis, cough, dyspnea, toxicity and the dosage of haemolysis including acute intravascular to 200 mg/day in patients weighing > epitaxis, thrombocytopenia, neutropenia, sirolimus, nifedipine or itraconazole haemolysis or haemolytic anaemia have 40kg or 4mg/kg/day in patients weighing anaemia, febrile neutropenia, rash, should be reduced if necessary. been reported. Hepatic effects: Early ≤ 40kg. Treatment duration for invasive pruritus, headache, insomnia, anxiety, discontinuation in the presence of candidiasis: should be a minimum of 14 hypotension, hypertension, phlebitis, significant and persistent elevation of days. The antifungal treatment should back pain, tachycardia. ALT / AST is recommended. Micafungin continue for at least one week after two treatment should be conducted on a sequential negative blood cultures have careful risk/benefit basis, particularly in been obtained and after resolution of patients having severe liver function clinical signs and symptoms of infection. impairment or chronic liver diseases. Use ii) Dosage for children: Body weight ≤ in pregnancy: There are no adequate or 40kg: 2mg/kg/day; Body weight > 40kg: well-controlled studies of micafungin in 100mg/day pregnant women. Use in lactation: Micafungin and its metabolites were excreted in the milk of lactating rats. However, it is not known whether micafungin is excreted in human breast milk. Therefore, caution should be exercised when micafungin is administered during breastfeeding. Use in the elderly: No dose adjustment is necessary for the elderly. Miconazole 2% Cream C i) Fungal infections: Tinea pedis, Tinea Apply sparingly and rub gently onto Ocassional skin irritation or sensitivity, Children less than 2 year. Not known First trimester of pregnancy, lactation. corporis, Tinea capitis and other affected area 1-2 times daily continuing contact dermatitis, vaginal burning due Hypersensitivity to manizole products Local sensitization or irritation, to dermatophyte infections caused by for 14 days after lesions have healed to cream base discontinue use Trichophyton and Epidermophyton species; ii) Antifungal agent that has been in various candida infections including vaginal candidiasis. Prescribing Restriction(s): To be used as 2nd line treatment at health facilities without medical officer.

Midazolam 5 mg/ml Injection A Pre-operative sedation, induction of Usual sedative range 2.5 - 7.5 mg (about Muscle stiffness, induration of veins, Acute narrow angle glaucoma, Neuroleptics, tranquilizer, Elderly, COPD, congestive heart failure, general anaesthesia, premedication and 70 mcg/kg by IV injection over 30 pain, redness, headache, apnoea, hypersensitivity to midazolam products, antidepressant, hypnotics, respiratory failure, severe electrolyte and sedation in ICU and sedation for minor seconds). Premedication by IM injection nausea, coughing, vomitting, drowsiness, acute alcohol intoxication, shock, analgesics, anaesthetics, fluid disturbances, pregnancy and procedures 70 - 100 mcg/kg 30 -60 minutes before respiratory depression, phlebitis, lactation antipsychotics, anxiolytics, lactation, hepatic and renal impairment, surgery; ELDERLY: 1 - 1.5 mg/kg. gastrointestinal disturbances, increased antiepiletics, antihistamines, labor and delivery, prolonged use and Induction: Induction by slow IV infusion appetite, jaundice, hypotension, erythromycin, clarithromycin, abrupt withdrawal, moderate lowering of 200 - 300 mcg/kg (ELDERLY 100 - 200 bronchospasm, pain at the site of cimetidine, omeprazole, diltiazem, intraocular pressure in ophthalmic. mcg/kg. CHILD over 7 years 150 - 200 injection efavirenz, indinavir, nelfinavir, Children under 15 kg not to exceed 1 mcg/kg); Maximum: 0.35mg/kg. Sedation ritonavir, saquinavir, fluvoxamine, mg/ml in ICU 0.03 - 0.2 mg/kg/hour halothane, sevoflurane, thiopental, itraconazole, theophylline, atorvastatin

Modified Fluid Gelatin 4% Injection B For primary volume replacement in ADULT 500 - 1500 ml given as IV infusion Hypersensitivity reactions, severe Not known Not known Patients with cardiac disease hypovolaemia, peri-operative anaphylactoid stabilization of the circulation, haemodilution, extracorporeal circulation (haemodialysis and heart-lung machine)

Mometasone Furoate 50 mcg A* Allergic rhinitis ADULT and CHILD, 12 years and above: Headache, pharyngitis, cough epistaxis, Severe nasal infections especially CYP3A4, amphotericin, antidiabetic Presence of untreated localized infection Aqueous Nasal Spray 100 mcg/day (2 sprays) to each nostril viral infection, chest pain, candidiasis, patients with haemorrhagic agents, antifungal agents involving the nasal mucosa, recent nasal once daily. Maximum 200 mcg (4 sprays) dysmenorrhoea, vomiting, nausea, diathesis or a history of recurrent nasal (imidazole), diuretics, potassium- surgery or trauma, pregnancy, infection once daily. Reduce to 50 mcg (1 spray) diarrhoea, dyspepsia bleeding, fungal, viral or tubercular skin wasting (loop or thiazide), e.g. tuberculosis, infection of the once daily when control achieved. CHILD lesions, herpes simplex or zoster, fluoroquinolones respiratory tract, untreated systemic 3 - 11 years old: 50 mcg (1 spray) to each hypersensitivity to mometasone or other fungal, bacterial, viral or parasitic nostril once daily corticosteroids, status asthmaticus or infections or ocular herpes simplex, other acute episodes of asthma (oral systemic effects e.g. hypercorticism, inhalation) reduced bone mineral density and adrenal suppression, untreated systemic infections Monobasic Sodium Phosphate 48%, A Bowel cleansing prior to colonoscopy, 45 ml diluted with half a glass (120 ml) of Nausea and bloating, abdominal cramps, Gastrointestinal obstruction, gastric Salts of magnesium, aluminium and Pregnancy, severe renal impairment, Dibasic Sodium Phosphate 18% radiological examination or bowel water, followed by one full glass (240 ml) vomiting retention, gastro-intestinal ulceration, calcium will bind phosphate and heart disease (congestive cardiac failure, surgery of water to be taken depending on the perforated bowel, congestive cardiac reduce absorption. Vitamin D will hypertension and oedema), ulcerative time of the procedure. For morning failure, toxic colitis, toxic megacolon or increase absorption of phosphate colitis (Irritable Bowel Syndrome) reflux procedure, 45 ml dilute with half glass of ileus with diuretics and drugs affect oesophagitis, preexisting electrolyte water should be taken at 7 am and the serum electroytes may induce disturbances (low serum calcium second 45 ml at 7 pm on the day before hyperphosphataemia, concentration, hyperkalaemia) the procedure. For afternoon procedure, hypocalaemia and hypernatraemia the first dose should be taken at 7 pm on the day before and the second dose at 7 am on the day of the procedure. Solid food must not be taken during the preparation period; clear fluids or water can be taken liberally. Not recommended for use in children

Morphine Sulphate 10 mg/ml B For moderate to severe pain especially ADULT: 5-20mg SC or IM every 4 hours in Constipation, nausea, vomiting, Acute bronchial asthma, respiratory MAOIs: hypotension and Children less then 1 year, neonates, Injection that associated with neoplastic disease terminal pain CHILD: Up to 1 month: 0.15 drowsiness, dry mouth, psychomimetic insufficiency, severe CNS depression, GI exaggeration of CNS and premature infants, elderly, chronic mg/kg body weight; 1 - 12 months: 0.2 effect (dysphoria, hallucination, obstruction, biliary colic (these conditions respiratory depressant effects. obstructive airway disease, pregnancy, mg/kg body weight; 1 - 5 years: 2.5 - 5 nightmare), urinary retention, respiratory are not contra-indications in patients Naltrexone: precipitation of opioid lactation, renal and hepatic impairment, mg ; 6 - 12 years: 5 - 10 mg depression (rare). Convulsions; dry who are terminally ill), hypersensitivity to withdrawal symptoms. Cimetidine : hypothyroidism mouth, headache, vertigo; palpitations; morphine, MAOIs morphine toxicity (CNS depression, hypothermia; pruritus, urticaria; respiratory depression) tachycardia, bradycardia; blurred vision; miosis; dependency

Moxifloxacin 0.5% Ophthalmic A* Treatment of conjunctivitis caused by CHILD more than 1 year and ADULT: 1 Conjunctivitis, decreased visual acuity, Hypersensitivity to moxifloxacin and Unlike some other Not to be injected subconjuctivally or Solution susceptible organism drop to affected eye(s) 3 times daily for 7 dry eye, keratitis, ocular discomfort, quinolone fluoroquinolones, no clinical introduced directly to the anterior days hyperemia, pain and pruritus, significant drug-drug interactions chamber of the eye, prolong use, subconjunctival hemorrhage, tearing between moxifloxacin and pregnancy and lactation. itraconazole, theophylline, warfarin, digoxin, oral contraceptives, probenicid, ranitidine or glyburide.

Multivitamin Injection B For prevention and treatment of vitamin Initially 2 - 4 pairs IV 4 - 8 hourly, Hypervitaminosis, high doses may induce Hypersensitivity to product components Pyridoxine will antagonise the Severe renal or liver failure deficiencies reducing to 1 pair IV daily. For less paraesthesia and hypotension therapeutic effect of levodopa serious cases, 1 pair IV 1 - 2 times daily or (should not be administered based on individual requirements concurrently), vitamin B6 reduces the plasma levels of phenobarbitone and phenytoin, ascorbic acid increases plasma level of ethinyloestradiol

Multivitamin Syrup C+ For prevention and treatment of vitamin CHILD 5 ml daily or based on Hypervitaminosis Hypersensitivity to product components Pyridoxine will antagonise the Severe renal or liver failure deficiencies manufacturer therapeutic effect of levodopa (should not be administered concurrently), vitamin B6 reduces the plasma levels of phenobarbitone and phenytoin, ascorbic acid increases plasma level of ethinyloestradiol

Mupirocin 2% Ointment A For MRSA infections only ADULT and CHILD: Apply up to three Stinging or burning, pruritus Hypersensitivity to mupirocin products Avoid products with polyethylene Not for ophthalmic or intranasal use. Use times daily for up to 10 days glycol with caution if there is evidence of moderate or severe renal impairment Nalbuphine HCl 10 mg/ml Injection B Perioperative analgesia, for relief of 10 - 20 mg SC, IM or IV every 3 - 6 hours Sedation, sweating, GI upsets, vertigo, Hypersensitivity to nalbuphine Phenothiazines, alcohol, CNS Impaired renal/hepatic function, MI, moderate to severe pain dry mouth, allergic reactions depressants impaired respiration, biliary tract surgery

Naloxone HCl 0.4 mg/ml Injection B For the complete/partial reversal of Initially 0.4 - 2 mg IV repeated at Opiate withdrawal symptoms, nausea, Hypersensitivity to naloxone Clonidine: hypertension Dependence may precipitate withdrawal narcotic depression including respiratory intervals of 2 - 3 minutes according to vomiting, tachycardia, tremor, sweating, symptoms, concurrent cardiotoxic drugs, depression induced by opioids such as patient's needs pulmonary oedema, hyperventilation, pre-existing cardiac disease, narcotic natural and synthetic narcotics. Diagnosis cardiac dysrhythmia, biliary colic, dependency, pregnancy, lactation, of suspected acute opioids overdosage dysphagia, memory impairment, seizure, neonates agitation, dyspnea, laryngeal spasm, pulmonary edema, tachyarrhythmia

Neomycin 0.5% Cream B Infections of the skin due to susceptible Apply sparingly to affected area up to 3 Skin sensitization or contact dermatitis. Hypersensitivity to neomycin or other Not known Superinfection may occur on prolonged organisms times daily (For short term use, 1 - 2 The sensitivity disappears when aminoglycosides use. Renal impairment weeks) treatment is discontinued

Neostigmine Methylsulphate 2.5 B i) Myasthenia gravis ii) Reversal of non- i) ADULT: 1 - 2.5 mg at suitable intervals Allergic reactions, salivation, Mechanical intestinal or urinary Antagonism effect by lithium, Bronchial asthma (extreme caution), mg/ml Injection depolarising neuromuscular blockade by SC, IM or IV. Usual total daily dose 5 - gastrointestinal upsets, diaphoresis, obstruction, peritonitis antimuscarinics, aminoglycoside, bronchitis, bradycardia, peptic ulcer, 20 mg. CHILD: 200 - 500 mcg at suitable diarrhea, flatulence, increased peristalsis, clindamycin, procainamide, epilepsy, parkinsonism, pregnancy and intervals throughout the day. NEONATE: nausea and vomiting, cardiac quinidine, propranolol. Enhanced lactation 50 - 250 mcg every 4 hours ii) By IV dysrhythmia, anaphylaxis, seizure, effect of suxamethonium. injection over 1 minute, 50 - 70 mcg/kg bronchospasm, respiratory arrest, Chloroquine have potential to (maximum 5 mg) after or with atropine respiratory depression increase symptoms of myasthenia sulphate 0.6 - 1.2 mg gravis. Cyclopropane or halothane

Nepafenac 0.1% ophthalmic solution A* Reduction in the risk of postoperative One drop 3 times/day beginning 1 day Head ache, keratitis, punctate keratitis, Patient with previously demonstrated Nepafenac at concentrations up to Use of topical NSAID may result in macular oedema associated with prior to cataract surgery, continued on eye discharge, conjunctivitis allergic, hypersensitivity to any of the ingredients 300ng/mL did not inhibit the in keratitis. In some susceptible patients, cataract surgery in diabetic patients. the day of surgery and up to 60 days of vision blurred, dry eye, eye pain, eye in the formulation or to other NSAIDs. vitro metabolism of 6 specific continued use of topical NSAIDs may the postoperative period as directed by pruritus, lacrimation increased, eyelid marker substrates of cytochrome result in epithelial breakdown, corneal the clinician. An additional drop should margin crusting, foreign body sensation P450 (CYP) isozymes (CYP1A2, thinning, corneal erosion, corneal be administered 30 to 120 minutes prior in eye, nausea, dry mouth, allergic CYP2C9, CYP2C19, CYP2D6, CYP2E1 ulceration or corneal perforation. These to surgery. dermatitis. and CYP3A4). Therefore, drug-drug events might be sight threatening. interactions involving CYP- Concomitant use of topical NSAIDs and mediated metabolism of topical steroids may increase the concomitantly administered drugs potential for healing problem. Nepafenac are unlikely. Drug-drug interactions may increase bleeding of ocular tissues mediated by protein binding are (including hyphaemas) in conjunction also unlikely. with ocular surgery. Patients should be advised not to wear contact lenses during treatment with nepafenac ophthalmic suspension. An acute ocular infection may be masked by the topical use of anti-inflammatory medicines. There is a potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other non-steroidal anti- inflammatory agents. The safety and effectiveness of nepafenac ophthalmic suspension in paediatric patients below the age of 10 years have not been established. Netilmicin Sulphate 150 mg/2 ml A Systemic infections ADULT: 4 - 6.5 mg/kg/day IM or IV in 2 - 3 Nephrotoxicity, neurotoxicity (auditory & Known allergy to netilmicin Lysine, tacrolimus, neuromuscular Renal impairment; neuromuscular Injection equally divided doses for 7 - 14 days. vestibular toxicity); local reactions; GI products/aminoglycosides blockers such as alcuronium, disorder eg myasthenia gravis or Maximum: 7.5 mg/kg/day. CHILD: 5 - 7.5 effects, fever; blood coagulation pancuronium, rocuronium, Parkinson, hypocalcaemia. Pregnancy & mg/kg/day 8 - 12 hourly depending on abnormalities vecuronium lactation. Good hydration during gestation and age. Maximum: 7.5 treatment required mg/kg/day

Neuro Polyvalent Snake Antivenom B Passive immunisation against poisonous For initial dose, at least 20mL of Occasionally, transient tenderness at the None, unless the patient is known to be Unknown Since the antivenin is prepared from Injection of a range of haematotoxic snakebites reconstituted serum should be given by injection site, cutaneous reaction and hypersensitive to any of the constitution horse serum, sensitisation to neurotoxic snakebites, based on the type slow intravenous infusion (not more than alterations in temperature may occur. In of the product, appropriate precautions heterologous protein may occur in some of snake identified. 1mL/minute). If symptoms still persist, some cases, nausea, vomiting and also must be tkaken. individuals. To avoid serious allergic the second dose should be repeated 2 circulatory reactors (e.g. tachycardia, reactions, skin test should be performed hours or even earlier after the initial bradycardia, hypotension, sweating, prior to the administration by injection dose. The further dose should be vertigo) and allergic reactions (e.g. with 0.02mL of 1:100 antivenin dilutions repeated every 6 hours according to the flush, urticaria,dyspnea) have been intradermally. It should be noted that the clinical symptoms. Administration: Draw observed, extending in isolated cases as skin test may not predict the anaphylaxis 10mL of the sterile water for injection to far as shock. The patient should be nor delay serum sickness reactions. the freeze-dried antivenin, shake well to monitored for an extended period of dissolve the contents until the serum time. Therapeutic measures depend on became clear colourless or pale yellow the nature and severity of side effects. liquid, ready for administration. Antihistaminse and if necessary adrenaline, high doses of corticosteroids, volume replacement, oxygen should be available when needed.

Noradrenaline Acid Tartrate A Septic shock and shock where peripheral Infuse and titrate to desired pressure Gangrene, cyanosis peripheral. Blood volume deficit MAOIs, tricyclic antidepressants Peripheral vascular thrombosis, (Norepinephrine Bitartrate) 1 mg/ml vascular resistance is low response. Range: 0.05 - 0.5 Occasionally, bradycardia, anxiety, concomitant cyclopropane and halothane Injection mcg/kg/minute transient headache, plasma volume anaesthesia, profound hypoxia. depletion (prolonged administration), Coadministration with MOAIs or tricyclic respiratory difficulty, ischaemic injury antidepressants. Sulfite allergy (seen more frequently in asthmatic than nonasthmatic patients)

Nystatin 100,000 units/g Cream C Prevention and treatment of cutaneous Apply liberally to affected area twice Skin irritation Hypersensitivity to nystatin Not known Pregnancy infections caused by Candida albicans daily or as required. After lesion has disappeared continue treatment for 10 days to prevent relapses. Nail infection: Cut nails as short as possible. Apply cream once daily until growth of new nail has set in

Nystatin 100,000 units/ml B Prevention and treatment of candidiasis NEWBORN: 50,000-100,000 units daily. GI disturbances, rash, urticaria , Steven Hypersensitivity to nystatin Not known Not intended to treat systemic mycoses. Suspension of the skin and mucous membranes, CHILD up to 5 years: 100,000 -500,000 Johnson Syndrome, oral irritation If hypersensitivity develops, discontinue protection against candidas overgrowth units 6 hourly. CHILD up to 6-12 years use during antimicrobial /corticosteroid and ADULT: 500,000-1,000,000 units 3 to therapy and as selective 4 times daily decontamination regimens Octreotide 0.1 mg/ml Injection A i) Acromegaly ii) Treatment of patients i, ii and iii) Initially 0.005 - 0.1 mg SC 1 - 2 Local reaction and discomfort at injection Hypersensitivity to octreotide Reduces absorption of cyclosporin, Growth hormone secreting pituitary with symptoms associated with gastro- times daily, increase gradually up to 0.1 - site. Anorexia, nausea, vomiting, crampy cimetidine. Increases bioavailability tumours (can expand and cause space entero-pancreatic endocrine tumours iii) 0.2 mg 3 times daily iv) 0.1 mg 3 times abdominal pain, abdominal bloating, of bromocriptine occupying effects), insulinomas Carcinoid tumours with features of the daily for 7 consecutive days, starting on flatulence, loose stools, diarrhoea, (exaggerate hypoglycaemia), diabetes, carcinoid syndrome, VIPomas, the day of operation, at least 1 hour steatorrhea, rarely progressive pregnancy and lactation glucagonomas, gastrinomas/Zollinger- before laparotomy v) 25 mcg/hour for 5 abdominal distension, severe epigastric Ellison syndrome, GRFomas, insulinomas days by continous IV infusion pain, abdominal tenderness, guarding, iv) Prevention of complications following acute pancreatitis. Impairment of post- pancreatic surgery v) Emergency prandial glucose tolerance, management of bleeding gastro- hyperglycaemia, hypoglycemia, isolated eosophageal varices in patients with case of hepatic dysfunction, bradycardia, cirrhosis anaphylactic reactions. Long-term treatment: gallstones

Ofloxacin 0.3% Otic Solution A/KK i. Acute otitis media with tympanostomy CHILD: 1 - 12 years: 5 drops twice daily Ear ache, secondary fungal infection, Hypersensitiviti to ofloxacin, pregnancy, Antacids, sucralfate, oral If otic therapy does not resolve otorrhea tubes ii. Chronic suppurative otitis media for 10 days. ADULT and CHILD over 12 otalgia, hearing reduction lactation antidiabetics, warfarin, after a full course of therapy, further with perforated tympanic membranes years: 6 - 10 drops twice daily and remain theophylline, probenecid, evaluation is suggested for other and iii. Otitis externa in the ear about 10 minutes aminoglycosides, beta-lactam underlying causes. Prolonged use may antibiotics result in overgrowth of fungal

Olive Oil Ear Drops C Impacted wax softener 3 - 4 drops 3 - 4 or as directed Not known Not known Not known Perforated ear drum

Olodaterol HCL 2.5mcg/puff, solution A* Indicated as a maintenance 5 mcg (2 puffs) once daily. Common: Nasopharyngitis, dizziness, Hypersensitivity to olodaterol or to any Adrenergic agents, xanthine - Should not be used in asthma or acute for inhalation bronchodilator treatment in patients hypertension, rash and arthralgia. Other: of the excipients. derivatives, steroids, or non- bronchospasm. - Immediate with chronic obstructive pulmonary Tachycardia, arrhythmia, palpitations, potassium sparing diuretics, beta- hypersensitivity reactions. - Caution in disease (COPD). myocardial ischaemia, angina pectoris, adrenergic blockers (including eye patients with cardiovascular disorders, hypertension or hypotension, tremor, drops), MAO inhibitors and tricyclic convulsive disorders or thyrotoxicosis, headache, nervousness, insomnia, antidepressants, QTc prolonging prolongation of the QT interval and in dizziness, dry mouth, nausea, muscle drugs, co-administration of patients who are unusually responsive to spasms, fatigue, malaise, hypokalaemia, ketoconazole increased systemic sympathomimetic amines. - Halogenated hyperglycaemia, and metabolic acidosis. exposure to olodaterol by hydrocarbon anaesthetics. - Should not approximately 70%. be used in conjunction with other long- acting beta2-adrenergic agonists. - Patients who have been taking inhaled, short-acting beta2-adrenergic agonists on a regular basis should be instructed to use them only for symptomatic relief of acute respiratory symptoms. - Hypokalemia. - Hyperglycemia. - Paradoxical bronchospasm.

Olopatadine hydrochloride A* Temporary prevention of ocular itching One drop in each affected eye once a day Headache, asthenia, burning or stinging, Hypersensitivity to Olopatadine HCl or Not known Pregnancy, lactation ophthalmic solution 0.2% due to allergic conjunctivitis cold syndrome, dry eye, foreign body any other ingredient of the products sensation, hyperemia, keratitis, lid edema, pharyngitis, pruritis, rhinitis, sinusitis, taste perversion Oral Rehydration Salt C Replacement of fluid and electrolytes ADULT: 200 - 400 ml ( 1 - 2 sachets ) for Hypernatremia, nausea and vomiting Patients with renal failure or Potassium sparing diuretics Cardiac failure, hypertension, impaired loss in diarrhoea every loose motion. CHILD: 200 ml (1 hyperkalaemia renal function, peripheral and pulmonary sachet) for every loose motion. In severe oedema, toxaemia in pregnancy dehydration 100 ml/kg for 3 - 4 hours. INFANT: 1 - 1.5 times their usual feed volume (50 ml per stool for small infant)

Oseltamivir 75mg capsule A/KK i) For treatment of patients with Recommended dose in adults and Nausea, vomiting, headache, abdominal Hypersensitivity to oseltamivir No clinically significant interactions Elevated liver enzymes have been suspected or confirmed influenza and adolescents ≥ 13 years of age and body pain, bronchitis, insomnia and vertigo. phosphate or to any components of the known. reported in patients with influenza-like severe disease (requiring hospitalization weight >40kg is 75mg twice daily for 5 Rare cases of anaphylaxis and serious product. illness receiving oseltamivir. Self-injury or evidence of lower respiratory tract days. No dose adjustment is necessary skin reactions including toxic epidermal and delirium have reported in patients infection). ii) For treatment of patients for patients with creatinine clearance necrolysis, Steven-Johnson syndrome receiving oseltamivir hence patients with suspected or confirmed influenza above 60 ml/min. Dose and erythema multiforme have been must be monitored for abnormal and with co-morbidity and associated recommendations for renal impairment reported. behaviour. with increased risk of influenza patients as follows: a) Creatinine complications. Not to be used as clearance of >30-60 mL/min: 30 mg twice prophylaxis. daily for 5 days b) Creatinine clearance of 10-30 ml/min: 30 mg of once daily for 5 days c) In patients undergoing routine hemodialysis an initial dose of 30 mg can be administered prior to the start of dialysis if influenza symptoms develop during the 48 hours between dialysis sessions. To maintain plasma concentrations at a therapeutic level, a dose of 30 mg should be administered after every hemodialysis session. d) For peritoneal dialysis a dose of 30 mg administered prior to the start of dialysis followed by further 30 mg doses administered every 5 days is recommended for treatment. Dosing recommendation cannot be provided for patients with end-stage renal disease (creatinine clearance of <10 ml/min) not undergoing dialysis. No dose adjustment needed in patients with hepatic impairment and the elderly.

Oxymetazoline HCl 0.025% A/KK Acute colds, paranasal sinusitis and otitis 1 - 2 drops twice daily in each nostril for After local use of oxymetazoline Skin and mucosal inflammation of the Anticholinergic, beta blockers, Cardiovascular disease, diabetes mellitus, (Paediatric) Nasal Drops media child more than 1 year transient irritation may occur. Rebound nasal vestibules with incrustation, linezolid, methylphenidate, tricyclic hypertension, prostatic enlargement, congestion may occur after frequent or narrow angle glaucoma, hypersensitivity antidepressants, hypertensive crisis prolonged use over 3 to 5 days, thyroid prolonged nasal use. Systemic effects to oxymetazoline or other adrenergic if used during treatment with MAOI disease have occurred after local administration, agents burning, sneezing, nasal dryness, hypertension

Oxymetazoline HCl 0.025% A Acute colds, paranasal sinusitis and otitis 2 - 3 sprays into each nostril twice daily After local use of oxymetazoline Skin and mucosal inflammation of the Anticholinergic, beta blockers, Cardiovascular disease, diabetes mellitus, (Paediatric) Nasal Spray media for child more than 1 year transient irritation may occur. Rebound nasal vestibules with incrustation, linezolid, methylphenidate, tricyclic hypertension, prostatic enlargement, congestion may occur after frequent or narrow angle glaucoma, hypersensitivity antidepressants, hypertensive crisis prolonged use over 3 to 5 days, thyroid prolonged nasal use. Systemic effects to oxymetazoline or other adrenergic if used during treatment with MAOI disease have occurred after local administration, agents burning, sneezing, nasal dryness, hypertension Oxymetazoline HCl 0.05% (Adult) A/KK Acute colds, paranasal sinusitis and otitis 1 - 2 drops twice daily in each nostril After local use of oxymetazoline Skin and mucosal inflammation of the Anticholinergic, beta blockers, Cardiovascular disease, diabetes mellitus, Nasal Drops media transient irritation may occur. Rebound nasal vestibules with incrustation, linezolid, methylphenidate, tricyclic hypertension, prostatic enlargement, congestion may occur after frequent or narrow angle glaucoma, hypersensitivity antidepressants, hypertensive crisis prolonged use over 3 to 5 days, thyroid prolonged nasal use. Systemic effects to oxymetazoline or other adrenergic if used during treatment with MAOI disease have occurred after local administration, agents burning, sneezing, nasal dryness, hypertension

Oxymetazoline HCl 0.05% (Adult) A Acute colds, paranasal sinusitis and otitis 2 - 3 sprays into each nostril twice daily, After local use of oxymetazoline Skin and mucosal inflammation of the Anticholinergic, beta blockers, Cardiovascular disease, diabetes mellitus, Nasal Spray media maximum 6 sprays per nostril/day transient irritation may occur. Rebound nasal vestibules with incrustation, linezolid, methylphenidate, tricyclic hypertension, prostatic enlargement, congestion may occur after frequent or narrow angle glaucoma, hypersensitivity antidepressants, hypertensive crisis prolonged use over 3 to 5 days, thyroid prolonged nasal use. Systemic effects to oxymetazoline or other adrenergic if used during treatment with MAOI disease have occurred after local administration, agents burning, sneezing, nasal dryness, hypertension

Oxytocin 10 units/ml Injection B Induction of labour IV: 0.5 - 1 milliunits/minute; gradually Gastrointestinal upsets, water Hypersensitivity to oxytocin, significant Prostaglandins, inhalation For induction or enhancement only as IV increase dose in increments of 1 - 2 intoxication resulting from large amounts cephalopelvic disproportion, unfavorable anaesthetics, vasoconstrictor infusion, careful monitoring of fetal heart milliunits/minute until desired of solution or too rapid infusion, cardiac fetal positions, fetal distress, hypertonic agents rate and uterine contractions are contraction pattern is established; dose arrhythmias or hyperactive uterus, contraindicated required may be decreased after desired vaginal delivery frequency of contractions is reached and labor has progressed to 5 - 6 cm dilation

Oxytocin 5 units & Ergometrine C+ i) Prevention and treatment of post i) 1 ml IM, may be repeated after 2 Gastrointestinal upsets, abdominal pain, Pregnancy, labour (except second stage Vasoconstrictors, prostaglandins, Hypertension, cardiac, hepatic or renal Maleate 0.5 mg/ml Injection partum haemorrhage ii) Management of hours. Should not exceed 3 ml within 24 headache, dizziness, skin rashes. Rarely following delivery of the anterior halothane anaesthesia disease. Should not be given until after third stage of labour hours ii) For routine management of third hypertension, bradycardia, cardiac shoulder), severe hypertension, pre- delivery of child & in multiple births not stage of labour, 1 ml IM following arrthymias, chest pain, anaphylactoid eclampsia, eclampsia, severe disorders of until the last child has been delivered delivery of the anterior shoulder or reactions cardiac, hepatic or renal function, immediately after delivery of the child occlusive vascular disease, sepsis and in patients with a history of hypersensitivity Pamidronate Disodium 30 mg A* Hypercalcaemia of malignancy (tumour - Dose depends on the initial serum Myelosuppression, hypertension, Hypersensitivity to biphosphonates Caution when coadministration Risk of hypocalcaemia especially in Injection induced hypercalcaemia) calcium levels. Doses range from a single hypotension, thrombophlebitis, malaise, with potentially nephrotoxic drugs. patients with Paget's disease, monitor if infusion of 30 - 90 mg nausea, vomiting, fever, anorexia, Combination with thalidomide may pre-existing anaemia, leucopenia, or hypomagnesaemia, hypokalaemia, increase risk of renal dysfunction thrombocytopenia are present, follow hyperkalaemia, hypernatraemia, complete blood count during the first 2 hypocalcaemia, hypophosphataemia, weeks of treatment, history of anaemia, thrombocytopenia, hypoparathyroidism. Do not administer lymphocytopenia, headache, insomnia, as a bolus injection or with other somnolence, conjunctivitis, hypertension, bisphosphonates or calcium-containing gastrointestinal disturbances, rash, IV infusions. Monitor serum electrolytes, transient musculoskeletal pain, reactions Calcium, phosphates, renal function (at at infusion site, deterioration of the start of treatment and prior to each preexisting renal disease, acute renal further dose). Renal impairment, cardiac failure, increased serum creatinine disease. Caution in road/machinery increased serum urea. Uncommon: users. Pregnancy, lactation. Children. allergic reactions, seizures, agitation, Severe hepatic impairment. Patients dizziness, lethargy, uveitis, dyspepsia, should be advised to inform their dentist pruritus, muscle cramps, abnormal liver while under treatment or if dental function tests. Rare: focal segmental surgery is planned glomerulosclerosis, nephrotic syndrome, anaphylactic shock, reactivation of herpes simplex and zoster, leukopenia, confusion, visual hallucinations, scleritis, episcleritis, xanthopsia, left ventricular failure, chronic heart failure, haematuria

Pantoprazole 40 mg Injection A* Bleeding peptic ulcer and acute stress 40 mg twice daily until oral Gastrointestinal disturbances (nausea Pregnancy, lactation, moderate to severe May affect absorption of drugs Proton pump inhibitors reduce gastric ulceration administration can be resumed. CHILD and vomitting, diarrhoea, constipation, hepatic or renal impairment. Patients which are pH-dependant in patients acidity and increase the risk of not recommended upper abdominal pain, flatulence) skin with known hypersensitivity to any with known hypersensitivity to any gastrointestinal infections. It may mask rash, pruritus, dizziness, oedema, fever, component of the formulation component of the formulation symptoms of gastric cancer (exclude depression, vision disturbances, malignancy in suspected gastric ulcers) headache, liver enzyme changes, raised triglycerides

Paracetamol 10mg/ml in 100ml A Mild to moderate pain and pyrexia Body Weight (BW) ≤ 10kg: 7.5mg/kg, Allergic reactions, skin rash Nephropathy Anticoagulants, alcohol, liver Renal and hepatic failure. Avoid chronic Solution for IV Infusion max: 30mg/kg BW >10kg to ≤ 33kg: enzyme inducers, aspirin, use 15mg/kg, max 60mg/kg not exceeding 2g chloramphenicol and BW >33kg to ≤ 50kg: 15mg/kg, max phenobarbitone 60mg/kg not exceeding 3g BW >50kg (with risk of hepatotoxicity): 1g, max 3g BW >50kg (without risk of hepatotoxicity): 1g, max 4g OR as in the product leaflet

Paracetamol 120 mg/5 ml Syrup C+ Mild to moderate pain and pyrexia CHILD: up to 1 year: 60 - 120 mg. 1 - 5 Allergic reactions, skin rash Nephropathy Anticoagulants, alcohol, liver Renal and hepatic failure. Avoid chronic years: 120 - 240 mg. 6 - 12 years: 240 - enzyme inducers, aspirin, use 480 mg per dose. Repeat every 4 - 6 chloramphenicol and hours when necessary. Maximum of 4 phenobarbitone doses in 24 hours Paracetamol 125 mg Suppository C+ Symptomatic relief of fever and post ADULT & CHILDREN more than 12 years Allergic reactions, skin rash Nephropathy Anticoagulants, alcohol, liver Renal and hepatic failure. Avoid chronic operative pain whom cannot tolerate old: 500mg - 1g every 4-6 hours CHILD 6 - enzyme inducers, aspirin, use oral preparations. 12 years : 250 - 500 mg; 1 - 5 years : 125 - chloramphenicol and 250 mg; 3 - 11 months : 80 mg inserted phenobarbitone every 4 - 6 hours if necessary, maximum 4 doses in 24 hours. INFANTS under 3 months should not be given Paracetamol unless advised by doctor; a dose of 10 mg/kg (5 mg/kg if jaundiced) is suitable.

Paracetamol 250 mg Suppository B Symptomatic relief of fever and post ADULT & CHILDREN more than 12 years Allergic reactions, skin rash Nephropathy Anticoagulants, alcohol, liver Renal and hepatic failure. Avoid chronic operative pain whom cannot tolerate old: 500mg - 1g every 4-6 hours CHILD 6 - enzyme inducers, aspirin, use oral preparations. 12 years : 250 - 500 mg; 1 - 5 years : 125 - chloramphenicol and 250 mg; 3 - 11 months : 80 mg inserted phenobarbitone every 4 - 6 hours if necessary, maximum 4 doses in 24 hours. INFANTS under 3 months should not be given Paracetamol unless advised by doctor; a dose of 10 mg/kg (5 mg/kg if jaundiced) is suitable.

Paraffin Mole Alba (White Soft C Xerosis and ichthyosis Apply to the affected area Hypersensitivity to any component Hypersensitivity to any component Not known Avoid exposure to fire Paraffin)

Parecoxib Sodium 40mg Injection A* Management of post operative pain in 40 mg followed by 20 or 40 mg every 6 to Hypotension, back pain, dizziness, Patients undergoing Coronary Bypass Warfarin, diuretics, Moderate hepatic impairment, severe the immediate post operative setting 12 hours, as required. Use limited to two alveolar osteitis, ecchymosis, peripheral Grafting (CABG) procedures and patients antihypertensives, ACEI, renal impairment, pre-disposition to fluid only days only with a maximum dose of 80 oedema, bradycardia , increased with elevated cardiovascular risk such as ciclosporin, tacrolimus, fluconazole, retention, coronary artery bypass graft mg/day. Reduce the initial dose by 50% creatinine, hypokalaemia, agitation, those with congestive heart failure ketoconazole, propafenone, surgery, dehydration, history of G1 in elderly less than 50 kg insomnia, cerebrovascular disorders, (NYHA II-IV), established ischaemic heart metoprolol, phenytoin, diazepam, perforations, ulcers or bleeds. Patients Stevens-Johnson Syndrome, pharyngitis disease and or cerebrovascular disease, lithium, CYP2C19 substances with hypertension or with bleeding oliguria erythema multiforme, acute patients who have experienced asthma, disorders renal failure urticaria, or allergic-type reactions after taking acetylsalicylic acid, NSAIDs, COX-2 specific inhibitors, hypersensitivity to sulphonamides Pentamidine Isethionate 300 mg A* Only for the treatment of pneumonia due 4 mg/kg once daily by slow IV infusion for Hypotension, hypoglycaemia, Pregnancy, lactation, hypersensitivity to Nephrotoxic effects of pentamidine Malnutrition, hyperglycaemia or Injection to Pneumocytosis carinii at least 14 days pancreatitis, cardiac arrhythmias, pentamidine or diamidine compounds, when given concomittantly with hypoglycaemia, hepatic dysfunction, leucopenia, thrombocytopenia, acute severe renal impairment other nephrotoxic drugs or renal dysfunction, hypertension or renal failure, hypocalcaemia, Stevens- sequentially, may be additive. hypotension, anaemia, leucopenia or Johnson syndrome, abnormal liver Amiodarone, amitriptyline, thrombocytopenia, renal impairment, function tests, albuminuria, astemizole, chloral hydrate, pregnancy nephrotoxicity, acute hypotension, chloroquine, chlorpromazine, pancreatitis, gastrointestinal clarithromycin, droperidol, disturbances, confusion, hallucinations, enflurane, erythromycin, arrhythmias, anaemia, hyperkalaemia, fluconazole, fluoxetine, rash, pain, local induration, sterile fluphenazine, haloperidol, abscess and muscle necrosis at injection halothane, imipramine, isoflurane, site mefloquine, octreotide, perphenazine, procainamide, prochlorperazine, promethazine, propafenone, quetiapine, quinidine, risperidone, sotalol, sulfamethoxazole, trimethoprim, vasopressin

Peritoneal Dialysis Solution (1.5% B For chronic renal disease requiring Dose depending on clinical cases Peritonitis, hernias, hyperglycaemia, Not known Generally, drugs of low molecular Abdominal sepsis, previous abdominal Dextrose) dialysis and for acute renal failure protein malnutrition and catheter weight, high water solubility, low surgery or severe inflammatory bowel complications. Long-term peritoneal volume of distribution, low protein disease. Dialysis solutions should be dialysis results in progressive structural binding and high renal clearance warmed to body temperature with dry changes to the peritoneal membrane are most extensively removed by heat because wet heat carries a risk of ultimately resulting in dialysis failure dialysis eg aminoglycosides. Dialysis-microbial contamination induced changes in fluids and electrolytes

Peritoneal Dialysis Solution (4.25% B For chronic renal disease requiring Dose depending on clinical cases Peritonitis, hernias, hyperglycaemia, Not known Generally, drugs of low molecular Abdominal sepsis, previous abdominal Dextrose) dialysis and for acute renal failure protein malnutrition and catheter weight, high water solubility, low surgery or severe inflammatory bowel complications. Long-term peritoneal volume of distribution, low protein disease. Dialysis solutions should be dialysis results in progressive structural binding and high renal clearance warmed to body temperature with dry changes to the peritoneal membrane are most extensively removed by heat because wet heat carries a risk of ultimately resulting in dialysis failure dialysis eg aminoglycosides. Dialysis-microbial contamination induced changes in fluids and electrolytes Pethidine HCl 100 mg/2 ml Injection B For relief of moderate to severe pain ADULT: 0.5 - 2 mg/kg SC or IM every 3 - 4 Respiratory depression, dizziness, Hypersensitivity, concurrent use of Cimetidine: pethidine toxicity Cirrhosis, elderly, neonates, children, (medical and surgical), pre-anaesthetic hours if necessary. CHILD: by IM 0.5 - 2 sweating, disorientation, MAOIs, intracranial lesions causing (respiratory depression, central liver/renal dysfunction, convulsive medication and obstetrical analgesia mg/kg. Up to 1 year : 1- 2 mg/kg weight hallucination,agitation, tremor, increased pressure, atrioventricular nervous system depression, disorders, reduced cardiac output, IM, 1 - 5 years : 12.5 - 25 mg IM, 6 - 12 multifocal myoclonus, convulsion, flutter, respiratory depression, renal hypotension). Isoniazid: cardiac infarction, cardiac disease, years: 25 - 50 mg IM Gastrointestinal disturbances, failure and a predisposition to hypotension and central nervous supraventricular tachycardia, pregnancy, hypotension, hypertension, bradycardia, convulsions or seizures. Head injury, system depression. Moclobemide: lactation.May impair ability to drive or urine retention, Lightheadedness, brain tumour. Cardiac arrhythmias. cardiovascular instability, operate machinery. Elderly. Reduced dizziness, sedation, sweating, bizzare Concurrent use of MAOIs. Pre-eclampsia, hyperpyrexia, coma or possible plasma protein binding. feeling, disorientation, hallucinations, eclampsia. Convulsive states. Diabetic serotonin syndrome (hypertension, Phaeochromocytoma. Hypothyroidism, psychosis. Dry mouth, nausea, vomiting, acidosis. Acute alcoholism or delerium hyperthermia, myoclonus, mental Addison's disease. Prostatic hypertrophy, constipation. Hypotension, vasodilation, tremens. Severe liver disease, incipient status changes). Naltrexone: urethral stricture. Diabetes. Glaucoma tachycardia, bradycardia, gangrene. encephalopathy, low platelet count, precipitation of opioid withdrawal Rash, pruritus, urticaria, erythema, coagulation disorders or receiving symptoms. Phenothiazines: injection site complications, anuria. anticoagulant treatment. Continuous IV increase in central nervous system Increased biliary tract pressure, infusion in renal impairment. Patient- and respiratory depression. choledochoduodenal sphincter spasm. controlled analgesia in young children & Phenytoin: decreased pethidine Neurotoxicity, neuropsychiatric toxicity. adult wiith poor cognitive function effectiveness. Procarbazine, Hyperactivity or agitation, depression, selegiline: cardiac instability, mental clouding, dysphoria hyperpyrexia, coma. Ritonavir: increased risk of central nervous system stimulation and excitation. Barbiturates, chloral hydrate, benzodiazepines. Butyrophenones, CNS depressants: pethidine enhances the CNS depressant effects of these drugs. MAOIs, amphetamine reactions. Anticoagulants. Reduces paracetamol absorption Pethidine HCl 50 mg/ml Injection B For relief of moderate to severe pain ADULT: 0.5 - 2 mg/kg SC or IM every 3 - 4 Respiratory depression, dizziness, Hypersensitivity, concurrent use of Cimetidine: pethidine toxicity Cirrhosis, elderly, neonates, children, (medical and surgical), pre-anaesthetic hours if necessary. CHILD: by IM 0.5 - 2 sweating, disorientation, MAOIs, intracranial lesions causing (respiratory depression, central liver/renal dysfunction, convulsive medication and obstetrical analgesia mg/kg. Up to 1 year : 1- 2 mg/kg weight hallucination,agitation, tremor, increased pressure, atrioventricular nervous system depression, disorders, reduced cardiac output, IM, 1 - 5 years : 12.5 - 25 mg IM, 6 - 12 multifocal myoclonus, convulsion, flutter, respiratory depression, renal hypotension). Isoniazid: cardiac infarction, cardiac disease, years: 25 - 50 mg IM Gastrointestinal disturbances, failure and a predisposition to hypotension and central nervous supraventricular tachycardia, pregnancy, hypotension, hypertension, bradycardia, convulsions or seizures. Head injury, system depression. Moclobemide: lactation.May impair ability to drive or urine retention, Lightheadedness, brain tumour. Cardiac arrhythmias. cardiovascular instability, operate machinery. Elderly. Reduced dizziness, sedation, sweating, bizzare Concurrent use of MAOIs. Pre-eclampsia, hyperpyrexia, coma or possible plasma protein binding. feeling, disorientation, hallucinations, eclampsia. Convulsive states. Diabetic serotonin syndrome (hypertension, Phaeochromocytoma. Hypothyroidism, psychosis. Dry mouth, nausea, vomiting, acidosis. Acute alcoholism or delerium hyperthermia, myoclonus, mental Addison's disease. Prostatic hypertrophy, constipation. Hypotension, vasodilation, tremens. Severe liver disease, incipient status changes). Naltrexone: urethral stricture. Diabetes. Glaucoma tachycardia, bradycardia, gangrene. encephalopathy, low platelet count, precipitation of opioid withdrawal Rash, pruritus, urticaria, erythema, coagulation disorders or receiving symptoms. Phenothiazines: injection site complications, anuria. anticoagulant treatment. Continuous IV increase in central nervous system Increased biliary tract pressure, infusion in renal impairment. Patient- and respiratory depression. choledochoduodenal sphincter spasm. controlled analgesia in young children & Phenytoin: decreased pethidine Neurotoxicity, neuropsychiatric toxicity. adult wiith poor cognitive function effectiveness. Procarbazine, Hyperactivity or agitation, depression, selegiline: cardiac instability, mental clouding, dysphoria hyperpyrexia, coma. Ritonavir: increased risk of central nervous system stimulation and excitation. Barbiturates, chloral hydrate, benzodiazepines. Butyrophenones, CNS depressants: pethidine enhances the CNS depressant effects of these drugs. MAOIs, amphetamine reactions. Anticoagulants. Reduces paracetamol absorption

Phenobarbitone Sodium 200 mg/ml B Status Epilepticus ADULT: 10 mg/kg IV at a rate of not Hypersensitivity, rash, hypotension, Hypersensitivity to phenobarbital Alcohol, antibacterial, warfarin, Depression, renal impairment, Injection faster than 100 mg/minute. Initial drowsiness, ataxia, respiratory products, porphyria antidepressants, other pulmonary insufficiency, elderly, avoid maximum dose does not exceeding 1 gm. depression, dyskinesias antiepileptics, antipsychotics, abrupt discontinuation, pregnancy, Daily maintenance of 1 - 4 mg/kg/day. antiviral, cyclosporin breast feeding, porphyria, hyperactivity CHILD: 10 - 20 mg/kg/dose loading dose, in children followed by repeated doses at 10 mg/kg/dose (strictly in ICU setting). Maintenance 5 - 8 mg/kg/day

Phenoxymethyl Penicillin 125 mg/5 C Treatment or prophylaxis of infections CHILD: Up to 1 year: 62.5 mg 6 hourly; 1 - Skin rashes, anaphylaxis, urticaria, fever, Hypersensitivity to penicillin Antirheumatics& antipyretics Use cautiously in patients with penicillin ml Syrup caused by susceptible organisms 5 years: 125 mg 6 hourly; 6 - 12 years: joint pain. Haemolytic anaemia, blood inhibit excretion. Neomycin may or cephalosporin. Hypersensitivity 250 mg 6 hourly disorders, gastrointestinal distress& cause malabsorption reactions or asthma. Haematological & superinfection renal function test required on long-term treatment. Not for trivial infection. Renal or hepatic impairment Phenylephrine HCI 2.5% Eye Drops B For pupillary dilation in uveitis, for Mydriasis and vasoconstriction: 1 drop of Marked increase in blood pressure in low- Narrow-angle glaucoma, infant, elderly Tricyclic antidepressants, Caution if administered with or up to 3 refraction without cyclopegic. For 2.5% or 10% solution, repeated in one weight neonates, infant and adult with with severe arteriosclerotic, propranolol weeks after MAOI therapy. Infant with fundoscopy and other diagnostic hour if necessary. Chronic mydriasis: 1 idiopathic hypotension. Cardiovascular cardiovascular or cerebrovascular cardiac anomalies. To prevent pain and procedures drop of a 2.5% or 10% solution 2 - 3 times reactions in the elderly disease. During intraocular operative subsequent lacrimation on a day. Uveitis with posterior synechiae procedures when corneal epithelial administration, a suitable topical (treatment) or synechiae, posterior barrier is disturbed. Not recommended anesthetic may be applied a few minutes (prophylaxis): 1 drop of a 2.5% or 10% for use in low birth weight infants before use of phenylephrine solution. solution, repeated in one hour if Repeated use of phenylephrine, necessary, not to exceed three times a especially in older patients, may result in day. Treatment may be continued the rebound miosis and a reduced mydriatic following day, if necessary effect. Medication may cause increased sensitivity of eyes to light

Phenytoin Sodium 50mg/ml lnjection B Status epilepticus i) Status epilepticus: ADULT 10 - 15 Nystagmus, ataxia, lethargy, blood Hypersensitivity to phenytoin or Various drugs may increase Avoid abrupt withdrawal, liver mg/kg by slow IV. Maximum 50 dyscrasias, cardiovascular toxicity, hydantoin products, sinus bradycardia, phenytoin serum levels either by insufficiency, porphyria, discontinue if mg/minute. Maintenance: 100 mg nausea, vomiting, headache, tremor, SA block, second and third degree AV decreasing its rate of metabolism skin rash occurs, diabetes, elderly, orally/IV every 6 - 8 hours. CHILD 15 - 20 insomnia, gingival hypertrophy, acne, block and Adams-Stokes syndrome by the hepatic CYP450 2C9 and pregnancy, breast feeding. Severe mg/kg by slow IV. Maximum: 1 - 3 lupus erythematosus, Stevens-Johnson (intravenous phenytoin only) 2C19 enzymatic system myocardial insufficiency. Potential for an mg/kg/minute ii) Neurosurgery 100 - 200 syndrome, leukopenia, megaloblastic (eg.disulfiram, omeprazole, increase in risk of suicidal thoughts or mg IM approximately at 4 hourly interval anaemia, hirsutism, hepatitis. Slurred ticlopidine), by competing for the behaviours. speech, decreased coordination, mental protein binding sites (eg. confusion, constipation, toxic hepatitis, salicylates, sulfisoxazole, liver damage, hematopoietic tolbutamine), or by a combination complications, dermatological of both processes (eg. manifestations, agranulocytosis, bullous phenylbutazone, valproate dermatosis, granulocytopenic disorder, sodium). Some drugs may decrease liver damage, nephrotoxicity, phenytoin serum levels (eg. pancytopenia, purpuric rash, scaling ciprofloxacin, theophylline, eczema, thrombocytopenia, toxic sucralfate). epidermal necrolysis

Pilocarpine 2% Eye Drops B Miotics in chronic open-angle glaucoma 1 drop 1 - 4 times a day Ciliary spasm leads to headache and Contraindicated in conditions where Not known Retinal disease; conjunctival or corneal browache which may be more severe in pupillary constriction is undesirable such damage. Intraocular pressure and visual the initial 2 - 4 weeks of treatment. as acute iritis, anterior uveitis and some fields should be monitored in those with Ocular side effects include burning, forms of secondary glaucoma. Acute simple chronic glaucoma and those itching, smarting, blurred vision, inflammatory disease of the anterior receiving long-term treatment with a conjunctival vascular congestion, myopia, segment miotic. Caution in cardiac disease, lens changes with chronic use, vitreous hypertension, asthma, peptic ulceration, haemorrhage and pupillary block urinary-tract obstruction and parkinson's disease

Piperacillin 4 g & Tazobactam 500 mg A* Febrile neutropenia, lower respiratory Adult and children more than 12 years: Diarrhea, nausea, vomiting, rash, Hypersensitivity to penicillins, Probenecid, aminoglycosides Bleeding manifestations, neuromuscular Injection tract infection and severe sepsis 4.5g 6 hourly, for neutropenia adult and pruritus, allergic reactions. cephalosporins or beta-lactamase (physical incompatibility - cannot excitability in renal impairment, children more than 50kg: 4.5g 6 hourly. inhibitors be given concurrently), heparin, increased risk of fever and rash in cystic Children less than 50kg: 90mg/kg 6 vecuronium, methotrexate. fibrosis, patients requiring sodium hourly restriction. Not to use in children who do not have neutropenia Pneumococcal polysaccharide A* Active immunization for the prevention ADULT: to be administered as a single • Gastrointestinal disorders: Very Hypersensitivity to the active substances, Children and adolescents 6-17 PCV 13 must not be administered conjugate vaccine (adsorbed) 13- of pneumococcal disease caused by dose to adults 18 years and older common: Decreased appetite; Common: to any of the excipients. The years of age and adults 18-49 years intravascularly. Appropriate medical valent injection Streptococcus pneumoniae serotypes including those previously vaccinated Vomiting; diarrhea • Skin and administration of PCV 13 should be of age: No data are currently treatment and supervision should always 1,3,4,5,6A, 6B, 7F, 9V, 14, 18C, 19A, 19F with a pneumococcal polysaccharide subcutaneous tissue disorders:Common: postponed in subjects suffering from available regarding concomitant be readily available in case of a rare and 23F in these population with vaccine. The need for re-vaccination with Rash • General disorders and acute, severe febrile illness. However, use with other vaccines. Adults anaphylactic event following the associated risk in Invasive Pneumococcal a subsequent dose of PCV13 has not administration site conditions: Very the presence of a minor infection, such aged 50 years and older: PCV 13 administration of the vaccine. This Disease (IPD): a) Infants/children from 2 been established. INFANT: Infants aged 2- common: Pyrexia; irritability; any as a cold, should not result in the deferral may be administered vaccine should not be given as an months of age and adult with one of the 6 months: i) Three-dose primary series: vaccination-site erythema, of vaccination. concomitantly with the seasonal intramuscular injection to individuals following conditions: i. Functional or The recommended immunisation series induration/swelling or pain/tenderness; trivalent inactivated influenza with thrombocytopenia or any anatomical asplenia; ii. Cochlear implant; consists of four doses, each of 0.5 mL. somnolence; poor quality sleep. • vaccine (TIV). Concomitant use with coagulation disorder that would iii. Congenital immune-deficiency; iv. The primary infant series consists of Vaccination-site erythema or other vaccines has not been contraindicate intramuscular injection, Haematopoietic and solid organ three doses, with the first dose usually induration/swelling (after the booster investigated. Different injectable but may be given subcutaneously if the transplant. b) High risk infants/children given at 2 months of age and with an dose and in older children [age 2 to 5 vaccines should always be given at potential benefit clearly outweighs the (from 2 months old) with one of the interval of at least 1 month between years]): Common: Pyrexia > 39°C; different injection sites. risk. PCV 13 will only protect against following conditions: i. doses. The first dose may be given as Vaccination-site movement impairment Concomitant administration of PCV Streptococcus pneumoniae serotypes Immunosuppression (including early as six weeks of age. The fourth (due to pain); vaccination-site erythema 13 and 23-valent polysaccharide included in the vaccine, and will not asymptomatic HIV) ii. Nephrotic (booster) dose is recommended between or induration/swelling (after infant vaccine has not been studied. protect against other microorganisms syndrome iii. Chronic lung or heart 12-15 months of age, or ii) Two-dose series). • Blood and lymphatic system that cause invasive disease, pneumonia, disease (Adapted from Paediatric primary series: A series consisting of disorders: Lymphadenopathy (localised or otitis media. As with any vaccine, PCV Protocols for Malaysia Hospital, 3rd three doses, each of 0.5 mL may be to the region of the vaccination site). • 13 may not protect all individuals Edition). c) Adults aged 60 years and considered. The first dose may be given Immune system disorders: receiving the vaccine from pneumococcal above with one of the following from the age of 2 months, with a second Anaphylactic/anaphylactoid reaction disease. Individuals with impaired conditions: i) Chronic lung diseases, dose 2 months later. The third (booster) including shock; angioedema. • Skin and immune responsiveness. Safety and including chronic obstructive pulmonary dose is recommended between 11-15 subcutaneous tissue disorders: Erythema immunogenicity data are available for a disease (COPD), emphysema & asthma months of age. Preterm infants (<37 multiforme. • General disorders and limited number of individuals with sickle (requiring frequent hospital visit & use of weeks gestation): The recommended administration site conditions: cell disease, HIV infection, or with a multiple medications); ii) Chronic liver immunisation series consists of four Vaccination-site urticaria; vaccination- haematopoietic stem cell transplant. disease including cirrhosis, biliary atresia, doses, each of 0.5 mL. The primary infant site dermatitis; vaccination-site pruritus; Safety and immunogenicity data for PCV chronic hepatitis; iii) Chronic cardiac series consists of three doses, with the flushing. • Additional information in 13 are not available for individuals in disease, including congestive heart first dose given at 2 months of age and special populations: Apnoea in very other specific immuno-compromised failure, congenital heart disease, and with an interval of at least 1 month premature infants (≤28 weeks of groups (e.g., malignancy or nephrotic cardiomyopathies. between doses. The first dose may be gestation). Children and adolescents syndrome) and vaccination should be given as early as six weeks of age. The aged 6 to 17 years of age • Nervous considered on an individual basis. fourth (booster) dose is recommended system disorders: Common: Headaches • between 11 and 15 months of age. Gastrointestinal disorders: Very Unvaccinated infants and children ≥ 7 common: Decreased appetite; Common: months of age Infants aged 7-11 months: Vomiting; diarrhoea. • Skin and Two doses, each of 0.5 ml, with an subcutaneous tissue disorders: Common: interval of at least 1 month between Rash; urticaria or urticaria-like rash. • doses. A third dose is recommended in General disorders and administration site the second year of life. CHILDREN: conditions: Very common: Irritability; any Children aged 12-23 months: Two doses, vaccination-site erythema; each of 0.5 ml, with an interval of at least induration/swelling or pain/tenderness; 2 months between doses. Children and somnolence; poor quality sleep; adolescents aged 2 years to 17 years: vaccination-site tenderness (including One single dose of 0.5 ml. Young Children impaired movement); Common: Pyrexia. (12-59 months) completely immunized Adults ≥18 years and the elderly • with PCV (7 valent): One dose of 0.5 mL Metabolism and nutrition disorders: Very of Pneumococcal polysaccharide common: Decreased appetite. • Nervous Pneumococcal Vaccine (Polyvalent) A Prevention of pneumococcal infections in Primary injection: 1 single injection (0.5 Injection site reaction, fever, haemolytic Hypersensitivity to pneumococcal Not known Previously had major allergic reaction high risk subjects from the age of 2 years ml) only. Booster: Must not be given anaemia, thrombocytopenia, vaccine components after vaccination, receiving including patient with a history of within 5 years except in very high risk anaphylactic reaction, swollen gland, immunosuppresant therapy, pregnancy. splenectomy or scheduled splenectomy patient who received the vaccine while headache, myalgia, tiredness. under immunosuppressive treatment

Podophyllum 10 - 20% Paint B External anogenital warts Apply 2 - 3 drops carefully to lesion after Inflammation of the surrounding skin Pregnancy, use on bleeding warts, moles, Not known Sensitive parts of the body. Caustic to protecting surrounding area with may occur, in which case treatment birthmarks and concomitant steroid healthy skin. Keep away from eyes vaseline. Wash off after 6 hours or if feel should be suspended therapy burning sensation and repeat 2 - 3 times weekly or once weekly Polyethylene Glycol /Macrogol 4000 A Bowel cleansing prior to colonoscopy, 1 sachet dissolved in 1 L of water. 2-3 L of Nausea, vomiting, sensation of fullness Dehydration, severe heart failure, colonic Oral medication should not be Elderly Powder radiological examination or colonic oral solution are required. When morning disease causing fragility of the mucosa administered within 1 hour of start surgery. Suitable for patients with heart surgery is planned, the oral solution is (active carcinoma), actual or suspected of therapy failure or renal failure given in the late afternoon the day prior. ileus or intestinal occlusion, gastric If surgery is scheduled in afternoon, the retention, bowel perforation, severe oral solution should be given on the colitis, children under 15 years same day for ingestion to be completed three hours before surgery

Polymyxin B Sulphate 10,000 U, B Treatment of bacterial infection and 3 drops 3 - 4 times daily. External Local sensitivity reactions, ototoxicity Hypersensitivity to any of its Antibacterials eg amphotericin, Avoid prolong use, perforated eardrum, Neomycin Sulphate 5 mg and inflammation of the external auditory auditory meatus and canal to be components, viral ear infection anticoagulants, antifungals, hypersensitivity to sulfites Hydrocortisone 10 mg Ear Drops meatus thoroughly cleansed and dried before antivirals each application but soap should not be used as the antibiotics may be inactivated by it

Potassium Chloride 1 g/10 ml B For the correction of severe By slow IV infusion depending on the Nausea, vomiting, gastrointestinal Acute dehydration, heat cramps, Potassium sparing diuretics, salt Dilute before use, not for IV bolus. Injection hypokalaemia and when sufficient deficit or the daily maintenance ulceration, electrocardiogram changes hyperkalaemia, renal failure and in substitutes, ACE inhibitors, Severe renal impairment, cardiac disease, potassium cannot be taken by mouth requirements. 1 g diluted in 500 ml conditions in which potassium retention angiotensin-II receptor antagonists, hyperkalaemia. Initial potassium normal saline or glucose and given slowly is present or where additives of methenamine, ciclosporin, replacement therapy, should not involve over 2 - 3 hours potassium and chloride could be clinically tacrolimus glucose infusions, because glucose may detrimental cause a further decrease in the plasma potassium concentration.

Potassium Chloride 1 g/10 ml C Potassium depletion 1 g once or twice daily until serum Nausea, vomiting, gastrointestinal Acute dehydration, heat cramps, Potassium sparing diuretics, salt Severe renal impairment, cardiac disease, Mixture potassium is restored ulceration, ECG changes hyperkalaemia, renal failure and in substitutes, ACE inhibitors, hyperkalaemia. Initial potassium conditions in which potassium retention angiotensin-II receptor antagonists, replacement therapy, should not involve is present or where additives of methenamine, ciclosporin, glucose infusions, because glucose may potassium and chloride could be clinically tacrolimus cause a further decrease in the plasma detrimental potassium concentration

Potassium Citrate 3 g/10 ml and C For systemic or urine alkalinization ADULT: 15-30 ml well diluted with water. Hyperkalaemia, metabolic alkalosis, Severe renal impairment with oliguria, Concurrent administration of Congestive heart failure, hypertension, Citric Acid Mixture CHILD up to 1 year: 2.5 ml 3 times daily; 1 nausea, vomiting, diarrhoea, mild azotemia or anuria, Addison's disease, potassium citrate with potassium- pulmonary or peripheral oedema, - 5 years: 5 ml 3 times daily; 6 - 12 years: diuresis adynamic episodica hereditaria, acute containing medications, toxaemia of pregnancy, monitor serum 10 ml 3 times daily. To be taken well dehydration, heat cramps, severe angiotensin-converting enzyme electrolytes especially bicarbonate in diluted with water, after meals and at myocardial damage, potassium citrate in inhibitors or cardiac glycosides, patients with renal disease, decreased bedtime. patients with hyperkalemia, sodium concurrent administration with urinary output, especially in the presence citrate for patients on sodium restriction aluminum-based gels of hypocalcaemia

Potassium Dihydrogen Phosphate A For treatment of hypophosphataemia Up to 10mmol phosphate administered Diarrhoea, nausea, stomach pain, Renal insufficiency, renal failure, Aluminium and magnesium- Renal insufficiency, cardiac disease, Injection over 12 hours flatulence, vomiting, bradycardia, hyperphosphataemia, hypocalcaemia, containing antacids, sucralfate, metabolic alkalosis hyperkalaemia, weakness, dyspnoea hyperkalaemia, hypernatraemia, potassium-sparing diuretics, salt Addison's disease substitutes, ACE inhibitors, digitalis

Potassium Permanganate 1:10,000 C+ Cleansing and deodorising suppurative As soaks or wet dressing 1 - 3 times daily Irritant to tissues and stain skin brown Hypersensitivity to any component Not known Avoid contact with eyes and other Solution eczematous reactions and wounds or as required mucous membranes

Povidone Iodine 10% (equivalent to B Skin operation prior to surgery, in To be applied undiluted in pre-operative Rash, pruritus, local oedema Hypersensitivity to iodine or any Not known Highly toxic if ingested, sodium 1% iodine) Solution cleansing open wounds, as an antiseptic skin disinfection and general antisepsis. component of the formulation thiosulfate is the most effective chemical for operative wounds infections antidote, avoid contact with eyes, use with caution in infants and nursing women Pralidoxime 25 mg/ml Injection B Antidote in the treatment of Adult: Used in combination with Nausea, vomiting, dizziness, headache, Hypersensitivity to pralidoxime, Not known Myasthenia gravis, renal dysfunction, organophosphorus insecticide poisoning atropine. Admin atropine via IM/IV inj blurred vision, bitter after taste, phosphorus/inorganic phosphate slow IV infusion may prevent and in the control of overdosage by and repeat as needed until patient shows hyperventilation, laryngeal spasm poisoning, organophosphates without tachycardia, laryngospasm and muscle anticholinergic drugs used in the signs of atropine toxicity. Maintain anticholinesterase activity rigidity. Not effective in poisonings due treatment of myasthenia gravis atropinisation for at least 48 hr. As soon to organophosphates without as the effects of atropine are observed, 1- anticholinesterase activity, not effective 2 g of pralidoxime (chloride, iodide or in poisonings due to mesilate) may be given via IM/IV inj. phosphorus/inorganic phosphates, renal Repeat dose after 1 hr, then every 8-12 impairment hr, if necessary. In severe poisoning, continuous infusion of 200-500 mg/hr may be given, titrated according to response. Alternatively, pralidoxime chloride may be given at an initial dose of 30 mg/kg via IV infusion over 20 minutes or IV inj over 5 minutes, followed by IV infusion at 8 mg/kg/hr. Max: 12 g/24 hr. Child: As mesilate: 20-60 mg/kg. Renal impairment: Dose adjustment may be required.

Prochlorperazine Mesylate 12.5 B i) Severe nausea and vomiting ii) Deep IM injection, 12.5 mg repeated if Extrapyramidal symptoms, drowsiness, CNS depression or coma, bone marrow Tramadol, increased risk of Hypotension, pregnancy and lactation, mg/ml Injection Vertigo/labyrinthine disorders necessary after 6 hours and then postural hypotension, coma, neuroleptic depression, phaeochromocytoma, seizures. Procyclidine, decreased glaucoma, prostatic hypertrophy, followed by an oral dose. Not malignant syndrome, cholestatic hypersensitivity to phenothiazines, phenothiazine serum stenosing peptic ulcer, children with recommended in children jaundice, leucopenia and agranulocytosis, comatose states, cardiovascular collapse concentrations, decreased acute illnesses, dehydration or constipation, dry mouth, urinary phenothiazine effectiveness, electrolyte imbalance, signs and retention, liver damage and insomnia enhanced anticholinergic effects symptoms suggestive of Reye's (ileus, hyperpyrexia, sedation, dry syndrome in children and adolescents, mouth). Levodopa, loss of levodopa patients with tardive dyskinesia or a efficacy. Ethanol, increased central history of neuroleptic malignant nervous system depression and an syndrome, epilepsy, acute narrow angle increased risk of extrapyramidal glaucoma, liver damage, insomnia, renal reactions dysfunction, parkinson's disease, myasthenia gravis. May lower convulsive threshold thus dosage adjustments of anticonvulsants may be neccessary.

Procyclidine HCl 5 mg/ ml Injection B i) All forms of Parkinson's disease i) Initial dose 2.5mg TDS, increasing by Excitability, dizziness, hallucinations Closed-angle glaucoma, narrow-angle Anticholinergic-like drugs, Hypotension, severe psychoses, prostatic (idiopathic paralysis agitants), post- 2.5-5mg/day at intervals of 2 or 3 days (seen on abuse), dry mouth, glaucoma, hypersensitivity to chlorpromazine, haloperidol, hypertrophy, tachycardia, urinary encephalitis and arteriosclerosis ii) To until the optimum clinical response is constipation, urinary retention, agitation, procyclidine products, gastrointestinal promethazine, thioridazine, retention, hepatic or renal impairment, control troublesome extrapyramidal achieved. Usual maintenance dose: 15- restlessness, convulsions tract or urinary outflow obstruction, trifluoperazine and lactation, pregnancy, children, elderly. symptoms induced by neuroleptic drugs 30mg/day. Max: 60mg/day ii) Initial dose prostatic hypertrophy, tardive dyskinesia prochlorperazine. Reduced including pseudo-parkinsonism, acute 2.5mg TDS, increasing by 2.5mg daily in patients on neuroleptic drugs peristaltic movement affects dystonic reactions and akathisia until symptoms are relieved. Usual absorption of erythromycin, maintenance dose: 10-30mg/day. IV penicillin Emergency: 5-10 mg. IM Emergency: 5- 10 mg as a single dose, may repeat after 20 mins if needed. Max: 20 mg/day. Promethazine HCl 25 mg/ml Injection B Allergic conditions By deep IM: ADULT: 25 - 50 mg, Sedation, gastrointestinal disturbances, Hypersensitivity to promethazine. Antihypertensives, phenothiazines, Pregnancy, lactation, cardiovascular or maximum 100 mg. CHILD 5 - 10 years : antimuscarinic effects, muscular Comatose patients, acute attack of alcohol, anticholinergics, tricyclic hepatic diseases, narrow angle glaucoma, 6.25 - 12.5 mg. By slow IV: 25 - 50 mg in a weakness, tinnitus, allergic reactions, asthma, children under 2 years, SC and antidepressants, MAOIs, evening asthma, COPD, pediatric patient, peptic solution of 2.5 mg/ml in water for blood disorders, respiratory depression intra- or peri-arterial injection primrose oil ulcer, pyloduodenal obstruction, injection. Maximum 100 mg prostatic hypertrophy, to be used with caution and doctor's advice in children 2 to 6 years of age.

Promethazine HCl 5 mg/5 ml Syrup B Allergic conditions CHILD 2 - 5 years: 5 - 15 mg daily 5 - 10 Sedation, gastrointestinal disturbances, Hypersensitivity to promethazine. Antihypertensives, phenothiazines, Pregnancy, lactation, cardiovascular or years : 10 - 25 mg daily antimuscarinic effects, muscular Comatose patients, acute attack of alcohol, anticholinergics, tricyclic hepatic diseases, narrow angle glaucoma, weakness, tinnitus, allergic reactions, asthma, children under 2 years of age. antidepressants, MAOIs, evening asthma, COPD, paediatric patient, peptic blood disorders, respiratory depression primrose oil ulcer, pyloduodenal obstruction, prostatic hypertrophy, to be used with caution and doctor's advice in children 2 to 6 years of age.

Propofol 10mg/ml (1%) Injection A* Induction & maintenance of general Adult: Induction: 20- 40 mg by injection i)hypotension and transient apnea may i) Patient with known hypersensitivity to Reduce dose if given with nitrous Monitor blood lipid concentration in anaesthesia. Sedation of ventilated ICU or infusion every 10 sec. Usual dose: 1.5- occur during induction of anesthesia, propofol; ii) Children younger than 3 oxide or halogenated anaesthetics. patients at risk for fat overload, risk of patients 2.5 mg/kg. Maintenance: 4-12 mg/kg/hr depending of dose; ii) bradycardia; iii) years old for induction and maintenance Increased sedative, anaesthetic and convulsion in epileptic patients, monitor or intermittent bolus inj of 20-50 mg. spontaneous movement and myocloni; of anasthesia; iii) Children younger than cardiorespiratory effects when signs of hypotension, airway obstruction Child: >8 yr: Induction dose of 2.5 mg/kg. iv) coughing; v) during recovery period: 16 years old for sedation; iv) High dose used with other CNS and oxygen desaturation. Cardiac, Maintenance dose: 9-15 mg/kg/hr by IV nausea, vomiting, headache, shivering during pregnancy, and obstetric depressants.ncompatibilities: respiratory, renal or hepatic impairment; infusion or intermittent bolus inj. Elderly: and sensations of cold as well as anaesthesia with exception of Propofol should not be mixed prior hypovolaemic or debilitated patients; Including neurosurgical and debilitated euphoria and sexual disinhibition; vi) post- termination of pregnancy ; v) to administration with injections or disorders of fat metabolism or conditions patients: Infuse at a rate of 20 mg every operative fever and discolouration of Electroconvulsive therapy infusion fluids other than with 5% where lipid emulsions should be used 10 sec. Maintenance: 3-6 mg/kg/hr. urine following prolonged administration Dextrose in PVC bags or glass cautiously.Ability to drive or operate Usual dose needed: 1-1.5 mg/kg. of profofol vii) anapylaxis infusion bottles or lignocaine machinery may be affected. Bradycardia. Duration of use : Can be administered for injection or alfentanil injection in Contains EDTA which chelates metal ions, a maximum period of 7 days. Sedation: plastic syringes. The neuromuscular- including zinc. Hence, consider need for 0.3 - 4 mg/kg/hour up to 3 days blocking agents, atracurium and supplemental zinc during prolonged mivacurium should not be given the administration especially in patients same IV line as Propofol without predisposed to zinc deficiency eg. prior flushing patients with burns, diarrhoea, major sepsis. Contains no antimicrobial preservatives. When aspirated, must be drawn aseptically into sterile syringe or giving set immediately after opening ampoule or breaking vial seal. Administration must commence with or without delay. Asepsis must be maintained for Propofol & infusion instrument throughout infusion period. Any fluids added to Propofol line must be administered close to cannula site.Propofol must not be administered via microbiological filter. Single infusion must not exceed 12 hour. At the end of the procedure or at 12 hours, whichever is sooner, both reservoir & infusion line must be discarded & replaced as appropriate. Propranolol HCl 1 mg/ml Injection A Arrhythmias and thyrotoxicosis crisis Slow IV injection in a dose of 1 mg over 1 Bronchospasm, bradycardia, depression, Hypersensitivity to propranolol, asthma, Alpha-1 adrenergic blockers, Anaesthesia/surgery (myocardial minute, repeated if necessary every 2 nausea, vomiting, dizziness, central bradycardia, 2nd and 3rd degree AV amiodarone, chlorpromazine, depression). Avoid abrupt withdrawal, minutes until a maximum of 10 mg has nervous system effects, muscle cramps, block, cardiogenic shock overt cardiac cimetidine, clonidine, cocaine, gradual withdrawal over a period of 1 to been given in conscious patients and 5 fluid retention, skin rashes, dry mouth failure, obstructive airway disease digoxin, dihydroergotamine, 2 weeks is recommended. mg in patients under anaesthesia. CHILD: dihydropyridine, calcium channel Bronchospastic disease, cerebrovascular 25 - 50 mcg/kg slow IV with appropriate blockers, diltiazem, disopyramide, insufficiency, congestive heart failure, monitoring epinephrine, ergotamine, diabetes mellitus, hepatic disease flecainide, flunarizine, fluvoxamine, furosemide, risk of lignocaine toxicity increased

Protamine Sulphate 10 mg/ml B Heparin overdose and following cardiac 5 ml slow IV injected over 10 minutes. If Hypotension, bradycardia, Hypersensitivity to protamine products Not known The rapid administration of protamine is Injection or arterial surgery or dialysis procedures administered within 15 minutes of hypersensitivity reactions associated with a higher incidence of when required to neutralize the effects heparin dose, 1 mg will neutralise adverse haemodynamic effects and of heparin administered during approximately 100 units of heparin. If anaphylactoid-like reactions. A solution extracorporeal circulation longer time has elapsed, less protamine of 10 mg/mL should be injected slowly is required. Not more than 50 mg should over 2 to 3 minutes to prevent be injected at any one time. The dose is haemodynamic effects and anaphylactic- dependent on the amount and type of like reaction, patients with a history of heparin to be neutralised, its route of fish allergy may also develop sensitivity administration and the time elapsed reaction. since it was last given and blood coagulation studies.

Protein Free Haemodialysate 10% A Trophic lesions in patients with arterial Apply 3 - 5 times daily Allergic skin reactions Hypersensitivity to any component Not known Burning sensation after application Jelly occlusive disease and with chronic venous insufficiency, burn injuries, impaired wound healing, decubitus ulcers and skin ulcer caused by irradiation

Protein Free Haemodialysate 20% A Eyes disorders e.g. burns, scalds, ulcers, Instill 1 drop 3 - 4 times daily Burning sensation, allergic reactions may Hypersensitivity to any component Topical antiviral drug such as Burning sensation after application Eye Gel prevention and treatment of radiation occur after repeated application acyclovir dermatitis, traumatic and ischaemic wound

Rabies Human Diploid Cell Vaccine B Pre-exposure and post-exposure Prophylaxis: 3 dose (1 ml each) schedule Erythema of injection site, fever with Pregnancy, acute febrile illness Corticosteroids, Allergy to neomycin, driving and using (Lyophilised) Injection vaccination against rabies on D0, D7 and D28. Booster dose after mild asthenia, malaise, headache, immunosuppressives machine. every 2 - 3 years. Post exposure dizziness, myalgia, GI disturbance. prophylaxis: use after attack of a potential rabid animal: 1 dose on D0, D3, D7, D14 and D28. In previously vaccinated individuals 2 doses on D0 and D3 Ranitidine 25 mg/ml Injection B i) Benign gastric/ duodenal ulceration, i) ADULT: Slow IV injection of 50 mg Gastrointestinal disturbances, diarrhoea, Hypersensitivity to ranitidine Absorption may be reduced by H2-receptor antagonists should be used reflux oesophagitis, Zollinger Ellison diluted to 20 ml and given over at least 2 altered liver function tests (rarely liver concomitant administration with with caution in hepatic impairment, in Syndrome ii) Stress ulcer prophylaxis in minutes. May be repeated every 6-8 damage), headache, dizziness, rash and high doses (2 g) of sucralfate renal impairment, pregnancy and in post-operative and high risk patients hours or IV infusion at rate of 25 mg/hour tiredness. Rare side-effects include acute breast-feeding. H2-receptor antagonists for 2 hours, may be repeated at 6-8 pancreatitis, bradycardia, AV block, might mask symptoms of gastric cancer. hours intervals or IM. CHILD: 1 confusion, depression and hallucinations Avoid in porphyrias. Ranitidine and mg/kg/dose 6-8 hourly. ii) Initial slow IV particularly in the elderly or the very ill, phenytoin is not recommended. If no injection of 50 mg, then continuous hypersensitivity reactions (including alternatives exist, clinical monitoring of infusion of 125-250 mcg/kg/hour fever, arthralgia, myalgia, anaphylaxis), patient response, tolerance and serum blood disorders (including phenytoin concentrations is agranulocytosis, leucopenia, recommended, especially during the first pancytopenia, thrombocytopenia) and month of therapy skin reactions (including erythema multiforme and toxic epidermal necrolysis). There have been occasional reports of gynaecomastia and impotence

Risperidone 1 mg/ml Oral Solution A Psychoses and schizophrenia ADULT: 2 mg in 1 - 2 divided doses on 1st Somnolence, dizziness, hyperkinesia, Hyperprolactinaemia, hypersensitivity to Tramadol, increased risk of Neuroleptic malignant syndrome, tardive day then 4 mg in 1 - 2 divided doses on nausea, extrapyramidal effects, risperidone products, prolonged QT seizures. Carbamazepine, increased dyskinesia, QT prolongation, 2nd day then 6 mg in 1 - 2 divided doses constipation, anxiety, headache, rhinitis, interva. It is also contraindicated in coma risperidone clearance. Levodopa, cardiovascular or cerebrovascular disease on 3rd day (slower titration appropriate rash, dyspepsia, tachycardia, dry mouth, caused by CNS depressants, bone loss of levodopa efficacy. Clozapine, or conditions that predispose patients to in some patients); usual range 4 - 8 mg weight gain, sexual dysfunction, marrow depression and avoided in decreased risperidone clearance. orthostatic hypotension, hypothermia or daily; dose above 10 mg daily only if hyperprolactinaemia, menstrual phaeochromocytoma Amphotericin, Class Ia and III hyperthermia, previous diagnosis of benefit outweighs risk (maximum 16 mg irregularities, severe hypotension, antiarrhythmics, acetalozamide, breast cancer or prolactin-dependent daily). Elderly (or in hepatic or renal tardive dyskinesia, neuroleptic malignant central alpha2 agonists, systemic tumours, renal insufficiency, hepatic impairment): initially 0.5 mg twice daily syndrome and hyperglycaemia, insomnia, corticosteroids, diuretics, tricyclic insufficiency, Lewy body dementia or increased in steps of 0.5 mg twice daily agitation, depression, fatigue antidepressants, phenothiazines, Parkinson's disease, seizure history, to 1-2 mg twice daily. Not recommended some β-blockers, fluoxetine, use pathologic changes in blood count, in children under 15 years with other centrally acting drugs dysphagia, elderly patients, (caution) hypovolaemia, dehydration, agents prolonging QT, risk of aspiration pneumonia, hyperglycaemia and diabetes mellitus, epilepsy, pregnancy and lactation. May affect ability to drive or operate machinery Rocuronium Bromide 10 mg/ml A* As an adjunct to general anaesthesia to Adult: Initially, 600 mcg/kg by inj. Higher Injection site pain/reaction, changes in Hypersensitivity to rocuronium or to the Anaesthetics, other non- Ventilator support is mandatory. Injection facilitate endotracheal intubation, to doses of 1 mg/kg may be used for vital signs and prolonged neuromuscular bromide ion or to any of the excipients depolarising neuromuscular Precautions: Residual curarization after provide skeletal muscle relaxation during intubation during rapid sequence block. (May vary from skeletal muscle blocking agents, neostigmine, extubation,anaphylactic reactions, surgery and to facilitate mechanical induction of anaesthesia. Maintenance: weakness to profound skeletal muscle edrophonium, pyridostigmine, prolonged paralysis and/or skeletal ventilation in adults, children and infants 150 mcg/kg by inj (may reduce to 75-100 paralysis resulting in respiratory aminopyridine derivatives, muscle weakness, long term from 3 months of age mcg/kg if inhalational anaesthesia is insufficiency or apnea). Anaphylactic and phenytoin or carbamazepine, administration of other non-depolarizing used) or by infusion at a rate of 300-600 anaphylactoid reactions: Bronchospasm, noradrenaline, azathioprine, neuromuscular locking agents in mcg/kg/hr. Doses should be based on cardiovascular changes( e.g., theophylline and calcium chloride combination with corticosteroid therapy, lean body weight for obese patients hypotension, tachycardia, circulatory patients with clinically significant hepatic weighing >30% above the ideal body collapse-shock), cutaneous changes (e.g., and/or biliary diseases ad/or renal weight. Child: Infants and children >1 angioedema, urticaria) failure, patients with neuromuscular mth: Initially, 600 mcg/kg by inj. disease or after poliomyelitis, Maintenance: 150 mcg/kg by inj or by myasthenia gravis or with the myastenic infusion at a rate of 300-600 mcg/kg/hr, (Eaton-Lambert) syndrome, maintenance doses may be required hypothermia, obesity, burns, more frequently than in adult patients. hypokalaemia, hypermagnesemia, Elderly: Reduced maintenance doses: 75- hypocalcemia, hypoproteinemia, 100 mcg/kg. Renal impairment: Initially, dehydration, acidosis, hypercapnia, 600 mcg/kg by inj. Maintenance: 75-100 cachexia, severe elctrolyte disturbances, mcg/kg. Hepatic impairment: or biliary altered blod pH or dehydration, tract disease: Initially, 600 mcg/kg by inj. pregnancy. Rocuronium should only be Maintenance: 75-100 mcg/kg. given to lactating womn only when the attending physician decides that the benefits outweigh the risks.Not recommended to drive or operate machinery within 24 hour after full recovery

Ropivacaine HCl 2 mg/ml Injection A* i) Surgical anaesthaesia including Dose adjusted according to patient Confusion, respiratory depression and Hypovolaemia, hypersensitivity to Hyaluronidase, propofol, Patient w/ partial or complete heart obstetrics ii) Acute pain management physical status and nature of procedure. convulsion, hypersensitivity, tachycardia, ropivacaine/amide-type anaesthetics, rapacuronium, verapamil, block, acute porphyria. May cause i) Lumbar epidural: 15-25 ml of 7.5 mg/ml nausea, backache, Horner's syndrome. severe hypotension, complete heart antiarrhythmias, fluvoxamine, chondrolysis when given via intra- solution; Caesarean section, 15-20 ml of Bradycardia, vomiting, paraesthesia, block. General contraindications related imipramine, theophylline and articular infusion. Severe hepatic 7.5 mg/ml solution in incremental doses ( temperature elevation, headache, to epidural anaesthesia, regardless of the enoxacin. Concomitant use with impairment. Pregnancy and lactation. max . total dose 150 mg). ii) lumbar urinary retention, dizziness, local anaesthetic used, should be taken other related amide-type local Acidosis, chronic renal disease. epidural: 10-20 ml of 2mg/ml solution hypertension, hypotension, rigors, into account anaesthetic Resuscitative equipment and drugs for followed by 10-15 ml of 2 mg/ml solution tachycardia, anxiety, hypoesthesia. treating toxic reactions should be at interval at of least 30 minutes. Labour Potentially Fatal: Cardiac arrest. immediately available pain 6-10 ml/hour of 2mg/ml solution

Ropivacaine HCl 7.5 mg/ml Injection A* i) Surgical anaesthaesia including Dose adjusted according to patient Confusion, respiratory depression and Hypovolaemia, hypersensitivity to Hyaluronidase, propofol, Patient w/ partial or complete heart obstetrics ii) Acute pain management physical status and nature of procedure. convulsion, hypersensitivity, tachycardia, ropivacaine/amide-type anaesthetics, rapacuronium, verapamil, block, acute porphyria. May cause i) Lumbar epidural: 15-25 ml of 7.5 mg/ml nausea, backache, Horner's syndrome. severe hypotension, complete heart antiarrhythmias, fluvoxamine, chondrolysis when given via intra- solution; Caesarean section, 15-20 ml of Bradycardia, vomiting, paraesthesia, block. General contraindications related imipramine, theophylline and articular infusion. Severe hepatic 7.5 mg/ml solution in incremental doses ( temperature elevation, headache, to epidural anaesthesia, regardless of the enoxacin. Concomitant use with impairment. Pregnancy and lactation. max . total dose 150 mg). ii) lumbar urinary retention, dizziness, local anaesthetic used, should be taken other related amide-type local Acidosis, chronic renal disease. epidural: 10-20 ml of 2mg/ml solution hypertension, hypotension, rigors, into account anaesthetic Resuscitative equipment and drugs for followed by 10-15 ml of 2 mg/ml solution tachycardia, anxiety, hypoesthesia. treating toxic reactions should be at interval at of least 30 minutes. Labour Potentially Fatal: Cardiac arrest. immediately available pain 6-10 ml/hour of 2mg/ml solution Salbutamol 0.5 % Inhalation Solution B Asthma and other conditions associated 2 ml may be inhaled up to 4 times daily Slight tremor (particularly in the hands), Hypersensitivity to any of their Antagonism with beta-blockers. Thyrotoxicosis, hyperthyroidism, with reversible airways obstruction over a period of 3 minutes per inhalation nervous tension, headache, peripheral components Use with caution with additional cardiovascular disease, arrhythmias, (0.5 ml diluted in 2.5 ml of normal saline dilatation and palpitations, tachycardia, adrenergic drugs, MAOI inhibitors susceptiility to QT-interval prolongation, by inhalation over 5 to 15 minutes) arrhythmias, disturbances of sleep and or tricyclic antidepressants - hypokalaemia, diabetes mellitus, not behaviour in children, muscle cramps, increased risk of tachycardia, appropriate for managing premature hypersensitivity reactions including agitation or hypomania labour, pregnancy and lactation paradoxical bronchospasm, urticaria, angioedema, hypotension, pulmonary oedema, erythema multiforme

Salbutamol 0.5 mg/ml Injection A Asthma and other conditions associated 500 mcg by SC/IM injection 4 hourly or Haemorrhage, thrombocytopenia, Hypersensitivity, hyperthyroidism or Monoamine oxidase inhibitors - Thyrotoxicosis, pregnancy and lactation. with reversible airways obstruction 250 mcg by slow IV. If required, by IV tachycardia and palpitations, erythema, thyrotoxicosis, tachycardia or increased risk of tachycardia, Potential for paradoxical bronchospasm, infusion, initially 5 mcg/min adjusted ventricular ectopic beats, myocardial tachycardiac arrthymias, subvalvular agitation or hypomania patients with cardiovascular disorders, according to response and heart rate, ischaemia and infarction have been aortic stenosis hyperthyroidism, diabetes mellitus, usually in the range 3 - 20 mcg/min reported following IV administration. phaeochromocytoma, patients with Fine tremor (particularly in the hands), history of aneursym and patients who nervous tension, headache, peripheral are usually responsive to dilatation and palpitations, tachycardia, sympathomimetics amines. Labour and arrhythmias, disturbances of sleep and delivery may be complicated behaviour in children. Muscle cramps and hypersensitivity reactions including paradoxical bronchospasm, urticaria, and angioedema

Salbutamol 100 mcg/dose Inhalation B Asthma and other conditions associated ADULT : 100 - 200 mcg up to 3 - 4 times Slight tremor (particularly in the hands), Hypersensitivity to any of their Antagonism with beta-blockers. Thyrotoxicosis, pregnancy and lactation, with reversible airways obstruction daily. CHILD : 100 mcg increased to 200 nervous tension, headache, peripheral components Use with caution with additional hyperthyroidism, cardiovascular disease, mcg if necessary dilatation and palpitations, tachycardia, adrenergic drugs, MAOI inhibitors arrhythmias, susceptiility to QT-interval arrhythmias, disturbances of sleep and or tricyclic antidepressants - prolongation, hypokalaemia, diabetes behaviour in children, muscle cramps, increased risk of tachycardia, mellitus, not appropriate for managing hypersensitivity reactions including agitation or hypomania premature labour, pregnancy and paradoxical bronchospasm, urticaria, lactation angioedema, hypotension, pulmonary oedema, erythema multiforme

Salbutamol 2 mg/5 ml Syrup B Asthma and other conditions associated CHILD 2 - 6 years : 1 - 2 mg 3 - 4 times Fine tremor (particularly in the hands), Hypersensitivity to any of their Monoamine oxidase inhibitors - Thyrotoxicosis with reversible airways obstruction daily, 6 - 12 years : 2 mg 3 -4 times daily nervous tension, headache, peripheral components increased risk of tachycardia, dilatation and palpitations, tachycardia, agitation or hypomania arrhythmias, disturbances of sleep and behaviour in children

Salbutamol 200mcg/dose Inhaler B Asthma and other conditions associated CHILD : 100 - 200 mcg. Maintenance : Slight tremor (particularly in the hands), Hypersensitivity to any of their Antagonism with beta-blockers. Thyrotoxicosis, pregnancy and lactation, with reversible airways obstruction 100 - 200 mcg 2 - 4 times daily. ADULT : nervous tension, headache, peripheral components Use with caution with additional hyperthyroidism, cardiovascular disease, 100 - 400 mcg. Maitenance : 100 - 400 dilatation and palpitations, tachycardia, adrenergic drugs, MAOI inhibitors arrhythmias, susceptiility to QT-interval mcg 2 - 4 times daily arrhythmias, disturbances of sleep and or tricyclic antidepressants - prolongation, diabetes mellitus, not behaviour in children, muscle cramps, increased risk of tachycardia, appropriate for managing premature hypersensitivity reactions including agitation or hypomania labour, pregnancy and lactation. paradoxical bronchospasm, urticaria, Hypokalemia may be potentiated with angioedema, hypotension, pulmonary concomitant treatment with xanthine oedema, erythema multiforme. derivatives, steroids, diuretics and also Potentially Fatal: Potentially serious by hypoxia. hypokalaemia after large dose Salbutamol 5 mg/5 ml Injection A* Prevention of uncomplicated premature Infusions containing 5 mg in 500ml (10 Haemorrhage, thrombocytopenia, Hypersensitivity, hyperthyroidism or Hypertensive crisis and other Potential for paradoxical bronchospasm, labour only mcg/ml) at the rate of 10 - 45 mcg/min tachycardia and palpitations, erythema, thyrotoxicosis, tachycardia or tachycardic adverse effects occur frenquently patients with cardiovascular disorders, increased at intervals of 10 minutes until ventricular ectopic beats, myocardial arrthymias, subvalvular aortic stenosis with the concurrent use of indirect- hyperthyroidism, diabetes mellitus, evidence of patient response as shown ischaemia and infarction have been acting sympathomimetics. phaeochromocytoma, patients with by reduction of strength, frequency or reported following IV administration. Concomitant administration of history of aneurysm and patients who duration of contractions; maintain rate Fine tremors (particularly in the hands), salbutamol and other beta-2 are usually responsive to for 1 hour after contractions have nervous tension, headache, peripheral agonists with corticosteroids, sympathomimetic amines. Labour and stopped, then gradually reduce by 50% dilatation and palpitations, tachycardia, diuretics or xanthines increases the delivery may be complicated. every 6 hours arrhythmias. Muscle cramps and risk of toxicity Thyrotoxicosis, pregnancy and lactation hypersensitivity reactions including paradoxical bronchospasm, urticaria and angioedema

Salicylic Acid 20% Ointment C Plantar warts Apply daily and protect surrounding skin Local irritation Hypersensitivity to salicylic acid. Age less Not known Avoid contact with eyes and mucous (eg with soft paraffin or specially than 2 years, diabetes, impaired membranes designed plaster) ,may need to continue circulation up to 3 months

Salmeterol 25 mcg and Fluticasone A* Regular treatment of reversible ADULT and CHILD more than 12 years : 1 - Hoarseness and dystonia, throat Hypersensitivity to any of the ingredients Beta-blockers, strong CYP3A4 Not for relief of acute symptoms. Not be Propionate 125 mcg Inhalation obstructive airway diseases including 2 puff twice daily. CHILD over 4 years : 1 irritation, headache, oropharyngeal of salmeterol, fluticasone or any inhibitors e.g. ketoconazole, initiated in patients with unstable and asthma. puff twice daily candidiasis and palpitations, tremor, component of the product ritonavir acutely deteriorating asthma, which may cardiac arrhythmias (atrial fibrillation and be a life-threatening condition. Should supraventricular tachycardia) not be used to transfer patients from oral to inhaled steroids. Treatment should not be stopped abruptly in patients with asthma due to risk of exacerbation, therapy should be titrated-down under physician supervision. Caution in patients with active or quiescent pulmonary tuberculosis, thyrotoxicosis, pre-existing cardiovascular disease, patients predisposed to low levels of serum potassium. Height of children receiving prolonged treatment with inhaled corticosteroid is regular monitored. When transferring from systemic to inhaled steroid therapy, monitor adrenocortical function regularly and withdraw systemic corticosteroid therapy gradually. Pregnancy and lactation. Salmeterol 25mcg and Fluticasone A* Regular treatment of reversible CHILD more than 12 years : 2 puff twice Hoarseness and dystonia, throat Hypersensitivity to any of the ingredients Beta-blockers, strong CYP3A4 Not for relief of acute symptoms. Not be Propionate 50mcg Inhalation obstructive airway diseases including daily. CHILD over 4 years : 2 puff twice irritation, headache, oropharyngeal of salmeterol, fluticasone or any inhibitors e.g. ketoconazole, initiated in patients with unstable and asthma in children, where use of lower daily No data on use for children aged candidiasis and palpitations, tremor, component of the product. ritonavir acutely deteriorating asthma, which may dose of a combination (bronchodilator under 4 years. cardiac arrhythmias (atrial fibrillation and be a life-threatening condition. Should and inhaled corticosteroids) is supraventricular tachycardia) not be used to transfer patients from oral appropriate. Prescribing is limited to to inhaled steroids. Treatment should not pediatric population for the purpose of be stopped abruptly in patients with dose tapering. asthma due to risk of exacerbation, therapy should be titrated-down under physician supervision. Caution in patients with active or quiescent pulmonary tuberculosis, thyrotoxicosis, pre-existing cardiovascular disease, patients predisposed to low levels of serum potassium. Height of children receiving prolonged treatment with inhaled corticosteroid is regular monitored. When transferring from systemic to inhaled steroid therapy, monitor adrenocortical function regularly and withdraw systemic corticosteroid therapy gradually. Pregnancy and lactation.

Salmeterol 50 mcg and Fluticasone A/KK i) Regular treatment of reversible i) ADULT and CHILD more than 12 years : Hoarseness and dystonia, throat Hypersensitivity to any of the ingredients Beta-blockers, strong CYP3A4 Not for acute unstable or acutely Propionate 250 mcg Inhalation obstructive airways diseases including 1 puff twice daily. ii) For COPD: Dose is irritation, headache, oropharyngeal of salmeterol, fluticasone or any inhibitors e.g. ketoconazole, deteriorating asthma. Active or quiescent asthma ii) For the regular treatment of one inhalation 50/250mcg to 50/500mcg candidiasis and palpitations, tremor, component of the product ritonavir pulmonary tuberculosis, thyrotoxicosis. chronic obstructive pulmonary disease twice daily. cardiac arrhythmias (atrial fibrillation and When transferring from systemic to (COPD) including chronic bronchitis and supraventricular tachycardia) inhaled steroid therapy, monitor emphysema adrenocortical function regularly and withdraw systemic corticosteroid therapy gradually. Pregnancy and lactation

Salmeterol 50 mcg and Fluticasone A/KK Category of prescriber A/KK is only i) ADULT and CHILD more than 12 years : Hoarseness and dystonia, throat Hypersensitivity to any of the ingredients Beta-blockers, strong CYP3A4 Not for acute unstable or acutely Propionate 500 mcg Inhalation approved for indication (i): i) Regular 1 puff twice daily ii) ADULT 1 puff twice irritation, headache, oropharyngeal of salmeterol, fluticasone or any inhibitors e.g. ketoconazole, deteriorating asthma. Active or quiescent treatment of reversible obstructive daily candidiasis and palpitations, tremor, component of the product ritonavir pulmonary tuberculosis, thyrotoxicosis. airways diseases including asthma. The cardiac arrhythmias (atrial fibrillation and When transferring from systemic to following indication is still under category supraventricular tachycardia) inhaled steroid therapy, monitor of prescriber A*: ii) Chronic obstructive adrenocortical function regularly and pulmonary disease including chronic withdraw systemic corticosteroid bronchitis and emphysema therapy gradually. Pregnancy and lactation

Selenium Sulphide 2.5% Shampoo A/KK Dandruff, seborrheic dermatitis of scalp Dandruff: apply 5-10 mL topically twice Oiliness or dryness of hair and scalp, hair Acute inflammation or exudation, broken Not known Avoid contact with eyes, mucous weekly for 2 weeks, then 1-4 times per discoloration, cutaneous sensitization skin, hypersensitivity to drug membranes, inflamed or broken skin or month, as needed, leave on for 2-3 min, and alopecia to extensive areas of the skin then rinse thoroughly. Seborrheic dermatitis of scalp: apply 5-10 mL topically twice weekly for 2 weeks, then 1-4 times per month, as needed, leave on for 2-3 min, then rinse thoroughly

Sevoflurane Liquid A* To be used only for i) induction and ii) i) Adult: Given via a calibrated vaporiser: Cardiorespiratory depression, Hypersensitivity to Benzodiazepine and opioids, Sevoflurane exposure should not exceed maintenance of anaesthesia Up to 5% v/v with oxygen or a mixture of hypotension, malignant hyperthermia, sevoflurane/halogenated anaesthetics, nitrous oxide, neuromuscular 2MAC.hours at flow rates of 1-<2 L/min. oxygen and nitrous oxide. Child: Given agitation, laryngospasm, increased malignant hyperthermia blocking agents, adrenaline, Fresh gas flow rates <1 L/min are not via a calibrated vaporiser: Up to 7% v/v. cough, salivation, acute renal failure, noradrenaline, Rifampicin recommended. KOH containing CO2 ii) Adult: 0.5-3% v/v with or without shivering, nausea, vomiting, rarely absorbents are not recommended for nitrous oxide. Child: 0.5-3% v/v with or dystonic movements in children, use of sevoflurane sympathomimetics. without nitrous oxide. postoperative hepatitis and seizure-like Pregnancy and lactation activity Silver Sulfadiazine 1% Cream B Prevention and treatment of infections in Burns: Apply 3 mm thick layer twice daily Transient leucopenia has occurred with Hypersensitivity to silver or to silver Concomitant cimetidine therapy Those allergic to sulfonamides may show severe burns, leg ulcers where infections with sterile applicator. Leg ulcer: apply at topical silver, haemolytic anaemia, sulphadiazine. Pregnant women at or may increase the likelihood of cross-sensitivity to silver sulfadiazine. may prevent healing and for the least 3 times a week probable febrile reaction, irritation, near term (increased kernicterus). causing leucopenia in silver Haemolysis may occur with glucose-6- prophylaxis of infections in skin grafting itching and burning at the application Preterm infants or newborns during first sulfadiazine-treated burn patients phosphate deficiency. Accumulation may site, argyria, hyperpigmentation two months occur in renal or hepatic insufficiency

Sodium Bicarbonate 1 g/15 ml B i) Relief of discomfort in mild urinary i) 3 g in every 2 hours until urinary pH Gastrointestinal cramps, flatulence, Alkalosis, hypernatremia, hypocalcaemia, Major: sodium polystyrene Excessive bicarbonate may lead to Mixture tract ii) Alkalinisation of urine exceeds 7 ii) Maintenance of alkaline belching, alkalosis on prolong use hypochloraemia, severe pulmonary sulfonate (systemic alkalosis). hypovolaemia and metabolic alkalosis in urine 5-10 g daily oedema, unknown abdominal pain Minor: amphetamine, aspirin, impaired renal function. History of chlorpropamide, congestive heart failure, history of renal dextroamphetamine, ephedrine, impairment, cirrhosis, hypertension, flecainide, itraconazole, concurrent corticosteroids, maintain high ketoconazole, lithium, urine output, monitor acid-base balance pseudoephedrine and electrolytes

Sodium Bicarbonate 5% w/v Ear C To soften the impacted ear wax 2-3 drops 3-4 times daily Contact dermatitis to sodium Not known Not known Not known Drops bicarbonate

Sodium Bicarbonate 8.4% (1 B For acceleration of excretion in drug According to the needs of the patient. In Gastrointestinal cramps, flatulence, Alkalosis, hypernatraemia, Amphetamine, aspirin, Renal impairment, peptic ulcer, mmol/ml) Injection intoxication (where excretion of the drug severe shock due to cardiac arrest: 50 ml alkalosis hypocalcaemia, hypochloraemia, severe chlorpropamide, congestive heart failure, oedema, into the urine is accelerated by elevated by IV pulmonary oedema, unknown abdominal dextroamphetamine, ephedrine, cirrhosis urine pH) and for acidosis pain itraconazole, ketoconazole, lithium, pseudoephedrine, flecainide

Sodium Bicarbonate and Magnesium C Heartburn, for rapid relief of dyspepsia ADULT 10-20 ml 3 times daily Gastrointestinal cramps, flatulence, Hypersensitivity to antacids, Tetracyclines, ketoconazole, Renal impairment Carbonate Compound Mixture belching, alkalosis on prolong use hypophosphataemia itraconazole, dipyridamole, quinolones, captopril, lithium and aspirin

Sodium Bicarbonate, Citric Acid, B For relieving of discomfort in mild urinary 4 - 8 g (1- 2 sachets) dissolved in a glass Mild laxative effect (eg: stomach Renal failure and hypernatremia, i) Decrease therapeutic effect of Patients on sodium restricted diet eg: Sodium Citrate and Tartaric Acid - 4 g tract infection, symptomatic relief of of cold water 4 times daily as prescribed cramps,belching, flatulence and Lactation. Overt cardiac failure, severe lithium and acidic drugs eg. Cardiac Failure per sachet dysuria to enchance the action to certain vomitting). Hypernatremia and/or myocardial damage, respiratory alkalosis, Chlorpropamide, salicylates, antibiotics especially some systemic alkalosis in prolonged and hypocalcemia, hypochloremia, tetracyclines and barbiturates ii) sulphonamides. In gout as urinary excessive use. Spontaneous stomach hypochlohydria, Addison's Disease, acute Increase therapeutic effect or alkalinizers to prevent cystallisation of rupture. dehydration and hyperthermia. toxicity of basic drugs eg. urates Amphetamines iii) Antacids with citrates may result in systemic alkalosis, calcium stones iv) aluminium based antacids with citrate salts may possibly result in acute aluminium toxicity v) Concomitant use with fluoroquinolones may result in crystalluria and nephrotoxicity.

Sodium Biphosphate 16%, Sodium A Bowel cleansing before colonic surgery, ADULT 133 ml (1 bottle) administered Local irritation and tenesmus Gastrointestinal obstruction, gastric Diuretics and drugs affect serum Pregnancy, severe renal impairment, Phosphate 6% Rectal Solution (Fleet colonoscopy or radiological examination rectally. CHILD more than 2 years half the retention, gastro-intestinal ulceration, electroytes may induce heart disease (chronic cardiac failure, Enema) to ensure the bowel is free of solid adult dose (66.6ml) perforated bowel, congestive cardiac hyperphosphataemia, hypertension and oedema), ulcerative contents. It is not to be used for failure, toxic colitis, toxic megacolon or hypocalaemia and hypernatraemia colitis (IBS) reflux oesophagitis, treatment of constipation ileus preexisting electrolyte disturbances (low serum calcium concentration, hyperkalaemia) Sodium Biphosphate 16%, Sodium A Bowel cleansing before colonic surgery, 45 ml diluted with half a glass (120 mL) of Nausea, bloating, less frequently Gastrointestinal obstruction, gastric Salts of magnesium, aluminium and Pregnancy, severe renal impairment, Phosphate 6% Solution (Oral Fleet) colonoscopy or radiological examination water, followed by one full glass (240 mL) abdominal cramps and vomiting retention, gastrointestinal ulceration, calcium will bind with phosphate heart disease (chronic cardiac failure, to ensure the bowel is free of solid of water. Timing of doses is dependent perforated bowel, congestive cardiac and reduce the absorption. Vitamin hypertension and oedema), ulcerative contents. It is not to be used for on the time of the procedure. For failure, toxic colitis, toxic megacolon or D will increase absorption of colitis (IBS) reflux oesophagitis, treatment of constipation morning procedure, first dose should be ileus phosphate with diuretics and drugs preexisting electrolyte disturbances (low taken at 7 a.m. and second at 7 p.m. on affect serum electroytes may serum calcium concentration, day before the procedure. For afternoon induce hyperphosphataemia, hyperkalaemia) procedure, first dose should be taken at hypocalcaemia and hypernatraemia 7 p.m. on day before and second dose at 7 a.m. on day of the procedure. Solid food should not be taken during the bowel preparation period. However clear fluids or water can be taken liberally. CHILD under 12 years not recommended

Sodium Chloride 0.18% with B For replenishing fluid and energy and for According to the needs of the patient Thrombophlebitis, rebound Hypernatraemia or fluid retention, Not known Restrict intake in impaired renal function, Dextrose 10% Injection restoring or maintaining the hypoglycaemia, hypokalaemia, sodium hypersensitivity (ophthalmic products), cardiac failure, hypertension, peripheral concentration of sodium and chloride accumulation and oedema sodium chloride solutions with and pulmonary oedema, toxaemia of ions preservatives in newborns, for injection pregnancy. Diabetes mellitus or or flushing of intravenous lines or mixing carbohydrate intolerance and medications, hypertonic saline hyperglycaemia may accentuate abortifacient in pregnancies less than 15 neurologic damage for an ischaemic weeks insult. Patients at risk for cerebral ischaemia, acute stroke, impending cardiac arrest or severe hypotension unless hypoglycaemia is suggested or until glucose is determined

Sodium Chloride 0.18% with B For replenishing fluid and energy and for According to the needs of the patient Thrombophlebitis, rebound Hypernatraemia or fluid retention, Not known Restrict intake in impaired renal function, Dextrose 4.23% Injection restoring or maintaining the hypoglycaemia, hypokalaemia, sodium hypersensitivity (ophthalmic products), cardiac failure, hypertension, peripheral concentration of sodium and chloride accumulation and oedema sodium chloride solutions with and pulmonary oedema, toxaemia of ions preservatives in newborns, for injection pregnancy. Diabetes mellitus or or flushing of intravenous lines or mixing carbohydrate intolerance and medications, hypertonic saline hyperglycaemia may accentuate abortifacient in pregnancies less than 15 neurologic damage for an ischaemic weeks insult. Patients at risk for cerebral ischaemia, acute stroke, impending cardiac arrest or severe hypotension unless hypoglycaemia is suggested or until glucose is determined

Sodium Chloride 0.45% Injection B For replenishing fluid and for restoring / 100 - 1000 ml by IV or according to the Nausea, vomiting, diarrhoea, abdominal Hypernatraemia or fluid retention, Not known Restrict intake in impaired renal function, maintaining the concentration of sodium needs of the patient cramps, congestive heart failure, hypersensitivity (ophthalmic products), cardiac failure, hypertension, peripheral and chloride ions hypertension, tachycardia, fluid sodium chloride solutions with and pulmonary oedema, toxaemia of accumulation, irritability, restlessness, preservatives in newborns, for injection pregnancy weakness, headache, dizziness, or flushing of intravenous lines or mixing obtundation and convulsions medications, hypertonic saline abortifacient in pregnancies less than 15 weeks Sodium Chloride 0.45% with B For replenishing fluid and energy and for According to the needs of the patient Thrombophlebitis, rebound Hypernatraemia or fluid retention, Not known Restrict intake in impaired renal function, Dextrose 5% Injection restoring or maintaining the hypoglycaemia, hypokalaemia, sodium hypersensitivity (ophthalmic products), cardiac failure, hypertension, peripheral concentration of sodium and chloride accumulation and oedema sodium chloride solutions with and pulmonary oedema, toxaemia of ions preservatives in newborns, for injection pregnancy. Diabetes mellitus or or flushing of intravenous lines or mixing carbohydrate intolerance and medications, hypertonic saline hyperglycaemia may accentuate abortifacient in pregnancies less than 15 neurologic damage for an ischaemic weeks insult. Patients at risk for cerebral ischaemia, acute stroke, impending cardiac arrest or severe hypotension unless hypoglycaemia is suggested or until glucose is determined

Sodium Chloride 0.9% Injection C+ For replenishing fluid and for 100 - 1000 ml by IV or according to the Nausea, vomiting, diarrhoea, abdominal Hypernatraemia or fluid retention, Not known Restrict intake in impaired renal function, restoring/maintaining the concentration needs of the patient cramps, congestive heart failure, hypersensitivity (ophthalmic products), cardiac failure, hypertension, peripheral of sodium and chloride ions hypertension, tachycardia, fluid sodium chloride solutions with and pulmonary oedema, toxaemia of accumulation, irritability, restlessness, preservatives in newborns, for injection pregnancy weakness, headache, dizziness, or flushing of intravenous lines or mixing obtundation and convulsions medications, hypertonic saline abortifacient in pregnancies less than 15 weeks

Sodium Chloride 0.9% with Dextrose C+ For replenishing fluid and energy and for According to the needs of the patient Thrombophlebitis, rebound Hypernatraemia or fluid retention, Not known Restrict intake in impaired renal function, 5% Injection restoring or maintaining the hypoglycaemia, hypokalaemia, sodium hypersensitivity (ophthalmic products), cardiac failure, hypertension, peripheral concentration of sodium and chloride accumulation and oedema sodium chloride solutions with and pulmonary oedema, toxaemia of ions preservatives in newborns, for injection pregnancy. Diabetes mellitus or or flushing of intravenous lines or mixing carbohydrate intolerance and medications, hypertonic saline hyperglycaemia may accentuate abortifacient in pregnancies less than 15 neurologic damage for an ischaemic weeks insult. Patients at risk for cerebral ischaemia, acute stroke, impending cardiac arrest or severe hypotension unless hypoglycaemia is suggested or until glucose is determined

Sodium Chloride 3% Injection B Acute dilutional hyponatraemia According to the needs of the patient Nausea, vomiting, diarrhoea, abdominal Hypernatraemia or fluid retention, During therapy with corticosteroids Restrict intake in impaired renal function, cramps, congestive heart failure, hypersensitivity (ophthalmic products), or ACTH there may be an increased cardiac failure, hypertension, peripheral hypertension, tachycardia, fluid sodium chloride solutions with retention of sodium and chloride. and pulmonary oedema, toxaemia of accumulation, irritability, restlessness, preservatives in newborns, for injection Decreased levels of lithium pregnancy weakness, headache, dizziness, or flushing of intravenous lines or mixing obtundation, convulsion medications, hypertonic saline abortifacient in pregnancies less than 15 weeks

Sodium Citrate 0.3 M Solution B Prophylaxis for aspiration pneumonitis Dose depending on clinical cases. Metabolic alkalosis, hypernatraemia, Aluminium toxicity and heart failure Quinidine, antacids especially those Renal tubular acidosis, chronic diarrhoea (use as an oral solution) Usually, 30 ml given 10- 60 minutes diarrhoea containing aluminium or sodium syndromes, peripheral or pulmonary before anaesthesia prior to elective bicarbonate oedema, hypertension, toxaemia of cesarean surgery is an effective antacid pregnancy

Sodium Citrate, Citric Acid Mixture 3 B Citrates and citric acid solutions are used ADULT 10 - 20 ml. CHILD up to 1 year 2.5 Hyperkalaemia, metabolic alkalosis, Severe renal impairment with oliguria, Concurrent administration of Congestive heart failure, hypertension, g/10 ml (SHOHL'S Solution) to correct the acidosis of certain renal ml tds; 1-5 year 5 ml tds; 6-12 years 10 nausea, vomiting, diarrhoea azotemia or anuria, Addison's disease, potassium citrate with potassium- pulmonary or peripheral oedema, tubular disorders to treat metabolic ml tds. To be taken well diluted with acute dehydration, heat cramps, severe containing medications, toxaemia of pregnancy, monitor serum acidosis for long-term urine alkalinization water myocardial damage. Potassium citrate in angiotensin-converting enzyme electrolytes, especially bicarbonate in for prevention and treatment of uric acid patients with hyperkalaemia. Sodium inhibitors or cardiac glycosides, patients with renal disease, decreased and calcium kidney stones and as citrate for patients on sodium restriction concurrent administration with urinary output, especially in the presence nonparticulate neutralizing buffers aluminum-based gels, blood of hypocalcaemia products containing citrate Sodium Cromoglycate 2% Eye Drops A/KK Prevention and treatment of allergic 1 or 2 drops 4 times daily Transient stinging and burning may occur Patients with known hypersensitivity to Not known Pregnancy, lactation, children up to 4 conjunctivitis including seasonal and after instillation and other symptoms of sodium cromoglycate or any other years of age, elderly, soft contact lense perennial allergic conjunctivitis and local irritation, itching, redness and ingredient of the products users vernal keratoconjunctivitis severe swelling of the eyes

Sodium Dichloroisocyanurate 2.5 g C Low and medium level disinfectant 50 - 10,000 ppm av chlorine Irritation on eyes, dermatitis, lung Avoid contact between solid and acid, Acids, alkalis and reducing agents. Avoid contact with skin and eyes Tablet damage, skin burns, ulceration, itching ammonia, urea and reducing agents Solid reacts with nitrogen compounds including ammonia and urea. For solid avoid contact with combustible organic materials such as paper, wood and textiles Sodium Valproate 200 mg/5 ml B Epilepsy ADULT: Initially 600 mg/day; dose may Nausea, vomiting, headache, dizziness, Hepatic disease or significant hepatic Increases phenobarbital, primidone Avoid sudden withdrawal, certain Syrup be increased by 200 mg at 3-day intervals ataxia, tremor, weight gain, transient hair dysfunction, hypersensitivity to valproate and phenytoin plasma metabolic disorders, fatigue, loss of to max 2500 mg/day. Usual maintenance loss, oedema, thrombocytopenia (dose sodium, valproic acid or divalproex concentrations. Potentiates toxic appetite, vomiting. Pregnancy and dose: 1000-2000 mg/day (20-30 related), leukopenia. Gastrointestinal sodium, porphyria effect of carbamazepine. Risk of lactation. Avoid concomitant use of mg/kg/day). CHILD: More than 20 kg. disorders, liver failure, children under the rash may be increased by salicylates in children less than 3 years Initially 400 mg/day with spaced age of two years are at increased risk, coadministration with lamotrigine. due to risk of liver toxicity, use of increases until control is achieved pancreatitis May potentiate the effect of salicylates in children less than 16 years (usually 20-30 mg/kg/day), dose may be antipsychotics, MAOIs, is also not recommended. Monitor liver increased to 35 mg/kg/day. Less than 20 antidepressants and function before therapy and during first 6 kg, 20 mg/kg/day. Severe cases: 50 benzodiazepines. Monitor months. Potential for an increase in risk mg/kg daily prothrombin time when used with of suicidal thoughts or behaviours. anticoagulants. Caution when used Pancreatitis, renal insufficiency, SLE, with newer anti-epileptics whose hyperammonaemia, diabetic patients, pharmacodynamics are not well- weight gain. Female children, female established. Zidovudine, adolescents, women of childbearing mefloquine, chloroquine, potential, pregnancy (due to high imipenem, meropenem. teratogenic potential and risk of developmental disorders in infants exposed in utero to valproate)

Sodium Valproate 400 mg Injection B Status epilepticus ADULT and CHILD above 10 years: 10 to Nausea, vomiting, headache, dizziness, Hepatic disease or significant hepatic Increases phenobarbital, primidone Avoid sudden withdrawal, certain 15 mg/kg/day IV, may increase 5 to 10 ataxia, tremor, weight gain, transient hair dysfunction, hypersensitivity to valproate and phenytoin plasma metabolic disorders, fatigue, loss of mg/kg/week to achieve optimal clinical loss, oedema, thrombocytopenia, sodium, valproic acid or divalproex concentrations. Potentiates toxic appetite, vomiting. Pregnancy and response (Maximum 60 mg/kg/day or leukopenia. Liver dysfunction, sodium, porphyria effect of carbamazepine. Risk of lactation. Avoid concomitant use of less with a therapeutic range of 50 to 100 gastrointestinal disorders rash may be increased by salicylates in children less than 3 years mcg/mL) coadministration with lamotrigine. due to risk of liver toxicity, use of May potentiate the effect of salicylates in children less than 16 years antipsychotics, MAOIs, is also not recommended. Monitor liver antidepressants and function before therapy and during first 6 benzodiazepines. Monitor months. Potential for an increase in risk prothrombin time when used with of suicidal thoughts or behaviours. anticoagulants. Caution when used Pancreatitis, renal insufficiency, SLE, with newer anti-epileptics whose hyperammonaemia, diabetic patients, pharmacodynamics are not well- weight gain. Female children, female established. Zidovudine, adolescents, women of childbearing mefloquine, chloroquine, potential, pregnancy (due to high imipenam, meropenam. teratogenic potential and risk of developmental disorders in infants exposed in utero to valproate) Sodium glycerophosphate for A Indicated in adult patients and infants as Adults: The recommended dosage is No adverse effects related to State of dehydration ,hypernatraemia, No interactions with other drugs Sodium glycerophosphate should be addition into infusion solution, 20ml a supplement in intravenous nutrition to individual. The recommended daily glycerophosphate have been reported. hyperphosphataemia, severe renal have been observed, but a used with caution in patients with vial meet the requirement of phosphate. dosage of phosphate during intravenous insufficiency, shock. moderate fall in serum phosphate impaired renal function. The phosphate nutrition would normally be 10-20mmol. can be seen during carbohydrate status of all patients should be This can be met by using 10-20ml of infusions. monitored regularly. Sodium sodium glycerophosphate to the infusion glycerophosphate must not be given solution or to the admixture for which undiluted. compatibility has been proved. Infants: The recommended dosage is individual. The recommended dose for infants and neonates is 1.0-1.5 mmol/kg bodyweight/day.

Streptokinase 1,500,000 IU Injection A* Acute myocardial infarction, acute Myocardial infarction: 1,500,000 units Nausea, vomiting, bleeding, reperfusion Hypersensitivity to streptokinase Aspirin, dipyridamole, eptifibatide, Arterial invasive procedures should be pulmonary embolism over 30 - 60 minutes. Pulmonary arrhythmias, hypotension, bronchospasm products, streptococcal infections within warfarin avoided before and during treatment and embolism: 250,000 units by IV infusion 6 months haemorrhage, cardiovascular invasive venous procedures should be over 30 minutes, then 100,000 units arrest, surgery or trauma within 1 month, performed carefully. Spontaneous every hour for up to 12-72 hours with subacute bacterial endocarditis bleeding from internal sites may occur. monitoring of clotting factors Concurrent use of anticoagulants with streptokinase is not recommended. Concurrent use of heparin may be required during intracoronary administration of streptokinase. Precaution must be taken during concurrent use of drugs that may alter platelet function (dextran, aspirin, indomethacin, phenylbutazone) and anticoagulants

Sugammadex 100 mg/ml Injection A* Indicated for reversal of neuromuscular 2 mg/kg sugammadex is recommended, Dysgeusia, awareness, reoccurrence of Hypersensitivity to the active substance Toremifene, flucloxacillin, fusidic Monitor respiratory function during blockade induced by rocuronium and if spontaneous recovery has occurred up blockade, drug hypersensitivity reaction, or to any of the excipients acid, hormonal contraceptives. recovery, prolonged neuromuscular vecuronium in selective patient group: to at least the reappearance of second bronchospasm. blockade, renal impairment, hepatic obese, elderly, underlying cardiovascular twitch tension of the train-of-four (T2). 4 impairment, QT prolongation, use in ICU disease. For pediatric population, mg/kg sugammadex is recommended if setting sugammadex is recommended for recovery has reached at least 1- 2 post- routine reversal tetanic counts (PTC). For immediate reversal following administration of rocuronium a dose of 16 mg/kg sugammadex is recommended

Sulphamethoxazole 200 mg & B Infections caused by susceptible Mild to moderate infections: more than Gastrointestinal upsets, stomatitis, Marked liver parenchymal damage, Increased risk of thrombocytopenia Haematological disorders, elderly, Trimethoprim 40 mg/5ml Suspension pathogens 2months: 8 - 12mg Trimethoprim/kg/day glossitis and skin rashes, tinnitus, blood dyscrasias, severe renal with thiazide diuretics in elderly. pregnancy, lactation, G6PD deficiency, divided every 12hours. Serious erythema multiforme, Stevens-Johnson impairment, pregnancy, hypersensitivity. May require dosage reduction of folate deficiency, impaired renal function Infections: 15-20mg syndrome, Lyell's syndrome, leucopenia, Use with caution in premature babies or warfarin and phenytoin. May Trimethoprim/kg/day divided every neutropenia, thrombocytopenia, full-term infants in the neonatal period displace methotrexate from plasma 6hours. agranulocytosis, megaloblastic anaemia, protein binding sites. Increased risk pancytopenia or purpura, hyperkalaemia. of venticular arrhythmias with High dose might cause hyperkalemia & amiodarone hyponatremia. Sulphamethoxazole 400 mg & A i) Severe or complicated infections when i) ADULT: 960 mg twice daily increased to Gastrointestinal upsets, stomatitis, Marked liver parenchymal damage, Increased risk of thrombocytopenia Haematological disorders, elderly, Trimethoprim 80 mg Injection oral therapy is not feasible ii) Treatment 1.44 g twice daily in severe infections. glossitis and skin rashes, tinnitus, blood dyscrasias, severe renal with thiazide diuretics in elderly. pregnancy, lactation, G6PD deficiency, and prophylaxis of pneumocystis carinii CHILD: 36 mg/kg daily in 2 divided doses erythema multiforme, Stevens-Johnson impairment, pregnancy, hypersensitivity. May require dosage reduction of folate deficiency, impaired renal function pneumonia (PCP) in increased to 54 mg/kg/day in severe syndrome, Lyell's syndrome, leucopenia, Use with caution in premature babies or warfarin and phenytoin. May immunocompromised patients infections ii) Treatment: ADULT & CHILD neutropenia, thrombocytopenia, full-term infants in the neonatal period displace methotrexate from plasma over 4 weeks: 120 mg/kg/day PO/IV agranulocytosis, megaloblastic anaemia, protein binding sites. Increased risk infusion in 2 - 4 divided doses for 14 days. pancytopenia or purpura, hyperkalaemia of venticular arrhythmias with Prophylaxis: ADULT: 960 mg once daily or amiodarone 960 mg on alternate days (3 times a week) or 960 mg twice daily on alternate days (3 times a week). CHILD 6 weeks - 5 months: 120 mg twice daily on 3 consecutive days or 7 days per week; 6 months - 5 years: 240 mg; 6 - 12 years: 480 mg

Suxamethonium Chloride 50 mg/ml B Muscle relaxant as an adjunct to Intravenous: Muscle relaxant in general Transient muscle fasciculation before Patients who are burnt, severely Increased effect: ACE inhibitors and Cardiac disease, electrolyte imbalance, lnj anaesthesia anaesthesia Adult: As chloride: single relaxation, increased intraocular and hyperkalaemic with penetrating eye angiotensin-II antagonists, alcohol, bone fracture, raised intraocular dose of 0.3-1.1 mg/kg injected; intragastric pressure, post-operative wounds, malignant hyperpyrexia, anaesthetics, anti-arrhythmics pressure, neuromuscular disease, infants, supplementary doses of 50-100% of the pain, bradycardia, tachycardia, massively traumatised patients or those (procainamide and quinidine), children, adolescents,elderly. initial dose may be given at 5-10 min hypertension, hypotension, muscarinic with extensive muscle degeneration eg. antibacterials (eg. Aminoglycosides, intervals. Max dose (repeated IV effects recent paraplegia. Patients with clindamycin, colistin and injection or continuous infusion): 500 advanced myasthenia gravis, piperacillin), antihypertensives, mg/hr Child: As chloride: <1 yr: 2 mg/kg; neurological defects or anxiolytics and hypnotics, beta- 1-12 yr: 1 mg/kg. Intramuscular: Muscle phaeochromocytoma, pregnancy and blockers (eg. propranolol), relaxant in general anaesthesia Adult: As lactation. botulinum toxin, calcium-channel chloride: 3-4 mg/kg. Max total dose: 150 blockers (eg. nifedipine and mg Child: As chloride: <1 yr: Up to 4-5 verapamil), cytotoxics (eg. mg/kg; ≥1 yr: Up to 4 mg/kg. Max dose: cyclophosphamide and thiotepa), 150 mg. lithium, magnesium salts, parasympathomimetics (eg. ecothiopate eye-drops, edrophonium, galantamine, neostigmine, pyridostigmine, rivastigmine and possibly donepezil), sympathomimetics (eg. bambuterol) Decreased effect: Analgesics (eg. Ibuprofen and possibly other NSAIDs), Antiepileptics (eg. carbamazepine and phenytoin)

Tenecteplase 10,000 unit (50 mg) A* Acute myocardial reinfarction where Less than 60 kg: 30 mg, 60 - 69 kg: 35 mg, Nausea, vomiting, hemorrhage, bleeding, Active internal bleeding, hypersensitivity Drug that affected coagulation and SBP > 180 mmHg, cerebrovascular Injection streptokinase is contraindicated due to 70 - 79 kg: 40 mg; 80 -90 kg: 45 mg, 90 kg epistaxis, GI & GU bleeding, superficial to tenecteplase, history of alter platelet function disease, known/suspected stroke or TIA, previous streptokinase induced or above: 50 mg. Administer single IV bleeding, reperfusion arrhythmia, cerebrovascular accident, intracranial or recent GI or GUT bleeding, recent IM antibodies. [Indicated when antibodies bolus over 5-10 seconds hypotension, allergic reaction, fever intraspinal surgery or trauma within 2 injection, elderly > 75 years, low body was given more than 5 days and less than months, intracranial neoplasm, weight < 60 kg 12 months] arteriovenous malformation, or aneurysm, known bleeding diathesis, severe uncontrolled hypertension, intracranial aneurysm

Tetanus Toxoid Injection C+ Immunization against tetanus infection 2 doses of 0.5 mL IM at an interval of 4-8 Local reaction, fever, headache and Hypersensitivity to any component of the Chloramphenicol "Not recommended for children less than wk, followed by the 3rd dose 6-12 mth malaise, brachial (cervical) neuritis, vaccine, febrile illness or acute infection, 7 years, convulsion, febrile illness. later. Booster: 0.5 mL IM every 10 yr. Guillain-Barre syndrome, nausea, severe allergic reaction after previous Adrenaline injection must be readily arthralgia, anaphylaxis, Arthus type dose. available in case of anaphylactic reaction. urticaria Do not administer IV. " Thiopental Sodium 500 mg Injection B i) General anaesthesia, induction ii) i) ADULT : For induction 200 - 400 mg. For Cardio-respiratory depression, i) complete absence of suitable veins; ii) Probenecid, Diazoxide, Opioid i) constant attendance and adequate Anticonvulsant for cases resistant to repeat injection 3 - 5 mg/kg over 10 - 15 arrhythmias, coughing, laryngospasm, allergy or hypersensitivity to analgesic, aminiophylline, facilities for support of respiration and conventional anticonvulsants in the ICU seconds until desired depth of bronchoconstriction, haemolytic anaemia barbiturates; iii) status asthmaticus or Benzodiazepine, Ethanol and CNS- circulation should be available when it is anaesthesia is obtained. Not FDA with renal failure, vasodilation, when an adequate airway cannot be depressant medication, Diuretics, being used; ii) should be administer with approved for use in pediatric patients ii) intracranial pressure changes, maintained during operation; Ketamine, Dexmedetomidine, caution (dose reduction recommended) 75 - 125 mg IV single dose; for local- hepatotoxicity and erythema, delirium, iv)porphyria ; v)shock and fixed cardiac Phenothiazine, Sulfisoxazole to patient with pre-existing hypotension anaesthetic induced convulsion: 125 - headache, amnesia, seizures, rash, output states or in condition where the hypnotic effect 250 mg IV over 10 minutes abdominal pain, rectal bleeding, is prolonged or intensified such as thrombophlebitis, pain at injection site, presence of liver disease and renal salivation, shivering disease;iii) respiratory depression may result from either unusual responsiveness to thiopental or an overdosage. should not be administer without raeadily available of resuscitative equipment.

Timolol Maleate 0.5% Eye Drops A Elevated intraocular pressure, chronic 1 drop for once daily or 2 times daily Bradycardia, hypotension, confusion, Bronchial asthma or a history of Cathecolamine-depleting drugs. History of atopy or a history of severe open angle glaucoma depending on manufacturer's depression, dizziness, fatigue, abdominal bronchial asthma, severe COPD, sinus Concurrent administration of oral anaphylactic reaction to a variety of recommendation. pain, diarrhoea, nausea, vomiting, bradycardia, second or third degree or systemic beta-adrenergic allergens, pregnancy and lactation. May dyspepsia, dry eye, ocular burning, atrioventricular block, overt cardiac blockers. Concurrent use of beta- impair ability to drive or operate corneal anaesthesia failure and cardiogenic shock blockers and digitalis with diltiazem machinery or verapamil may have additive effects in prolonging atrioventricular conduction time. Quinidine

Tinzaparin sodium 10,000 anti-Factor A* i)Treatment of deep vein thrombosis i)Treatment of DVT and PE, in Skin necrosis, erythema, increased liver Hypersensitivity to sodium bisulfite, Salicylates, NSAIDs, vitamin K Renal or hepatic impairment, recent Xa IU/ml Injection in Prefilled (DVT) and pulmonary embolism (PE), not conjunction with warfarin: 175 anti- function test, local pain, major bleeding, treatment of DVT in patient 90 years old antagonists, dextran. cerebral haemorrhage, trauma, recent syringe/cartridge amounting to hemodynamic instability. Factor Xa IU/kg SC once daily for at least granulocytopenic disorder (rare), and older with renal insufficiency, surgery to the central nervous system, (3,500iu/0.35ml: 4,500iu/0.45ml) ii)Prevention of post-operative DVT in 6 days. ii)Thromboprophylaxis in patients hematoma, neurological injury with generalized or local haemorrhagic concurrent spinal or epidural patients undergoing general and with:Moderate risk of thrombosis concurrent use of spinal or epidural tendency, uncontrolled severe anaesthesia, bleeding disorders, severe orthopaedic surgery. (general surgery):3,500 anti-Factor Xa IU anaesthesia, pancytopenia, hypertension, acute cerebral insults, thrombocytopenia. Do not administer IM SC 2 hrs before surgery and thrombocytopenia anaphylaxis, priapism septic endocarditis. (risk of haematoma). postoperatively, 3,500 anti-Factor Xa IU and death. once daily for 7-10 days. High risk of thrombosis (eg. total hip replacement):4,500 anti-Factor Xa IU SC or 50 anti-Factor Xa IU/kg body weight SC 2 hrs before surgery and then once daily until the patients has been mobilized.

Tinzaparin sodium 20,000 anti-Factor A* i)Treatment of deep vein thrombosis i)Treatment of DVT and PE, in Skin necrosis, erythema, increased liver Hypersensitivity to sodium bisulfite, Salicylates, NSAIDs, vitamin K Renal or hepatic impairment, recent Xa IU/ml Injection in Prefilled (DVT) and pulmonary embolism (PE), not conjunction with warfarin: 175 anti- function test, local pain, major bleeding, treatment of DVT in patient 90 years old antagonists, dextran. cerebral haemorrhage, trauma, recent syringe/cartridge amounting to hemodynamic instability. Factor Xa IU/kg SC once daily for at least granulocytopenic disorder (rare), and older with renal insufficiency, surgery to the central nervous system, (10,000iu/0.5m)l ii)Prevention of post-operative DVT in 6 days. ii)Thromboprophylaxis in patients hematoma, neurological injury with generalized or local haemorrhagic concurrent spinal or epidural patients undergoing general and with:Moderate risk of thrombosis concurrent use of spinal or epidural tendency, uncontrolled severe anaesthesia, bleeding disorders, severe orthopaedic surgery. (general surgery):3,500 anti-Factor Xa IU anaesthesia, pancytopenia, hypertension, acute cerebral insults, thrombocytopenia. Do not administer IM SC 2 hrs before surgery and thrombocytopenia anaphylaxis, priapism septic endocarditis. (risk of haematoma). postoperatively, 3,500 anti-Factor Xa IU and death. once daily for 7-10 days. High risk of thrombosis (eg. total hip replacement):4,500 anti-Factor Xa IU SC or 50 anti-Factor Xa IU/kg body weight SC 2 hrs before surgery and then once daily until the patients has been mobilized. Tiotropium 2.5mcg/puff solution for A/KK i) Maintenance bronchodilator treatment 5 mcg (2 puff) once daily, at the same Dry mouth, constipation, cough and local Hypersensitivity to tiotropium bromide, Beta-agonists and other Should not be used for the initial inhalation (Respimat) to relieve symptoms of patients with time of the day irritation, tachycardia, urinary retention, atropines or its derivatives eg. anticholinergics treatment of acute episodes of chronic obstructive pulmonary disease UTI, upper respiratory tract infection, Ipratropium or oxitropium or to any of bronchospasm, i.e. rescue therapy; avoid (COPD) in which the diagnosis of COPD is hypersensitivity reactions, pupil dilation, the excipients Not for children and getting the spray into eyes; may result in confirmed by spirometry. ii) As add-on blurred vision, myalgia, dyspepsia, rash. adolescents below 18 years old. precipitation or worsening of narrow maintenance bronchodilator treatment Pharyngitis, sinusitis, rhinitis and angle glaucoma, eye pain or discomfort, in adult patients with asthma who are epistaxis reported with the use of temporary blurring of vision, visual halos currently treated with the maintenance inhalation powder. or coloured images in association with combination of inhaled corticosteroids red eyes from conjunctival congestion (≥800µg budesonide/day or equivalent) and corneal oedema; dry mouth; avoid and long-acting β2-agonist and who using more frequently than once daily; experienced one or more severe Use with caution in patient with prostatic exacerbations in the previous year. hyperplasia or bladder-neck obstruction ;concomitant use with other anti- cholinergic containing drugs; avoid use in cardiac rhythm disorders, cystic fibrosis, renal failure;moderate to severe (CrCl of 50 mL/min or less); monitoring recommended, pregnancy, lactating/breastfeeding pregnancy and lactation.

Tiotropium 2.5mcg and Olodaterol A* As a maintenance bronchodilator 2 puffs once daily, at the same time of Common (≥1/100 to <1/10): Dry mouth Hypersensitivity to tiotropium, Anticholinergic agents, adrenergic Asthma, acute use, paradoxical 2.5mcg per actuation, inhalation treatment to relieve symptoms in adult the day Uncommon (≥1/1,000 to <1/100): olodaterol, any excipients, atropine or its agents, xanthine derivaties, bronchospasm, narrow-angle glaucoma, patients with chronic obstructive Dizziness, insomnia, headache, atrial derivatives. steroids or diuretics, beta-blockers, prostatic hyperplasia, bladder-neck pulmonary disease (COPD) fibrillation, palpitations, tachycardia, MAO inhibitors, tricyclic obstruction, eye symptoms, dental hypertension, cough, constipation. antidepressants, QTc prolonging caries, patients with renal impairment, drugs, cardiovascular effects, hypokalemia, hyperglycemia, anaesthesia.

Trace Elements and Electrolytes A* Only to be used to cover daily loss of 10 ml added to 500-1000 ml solution, Not known Total biliary obstruction. Should not be Not known Impaired biliary or renal function, liver (Adult) Solution electrolyte and trace elements for given by IV infusion given undiluted dysfunction (especially cholestasis. patient on parenteral nutrition Manganese blood levels and liver (Addamel®) function should be monitored regularly (Addaven®) (monthly). Should be stopped if manganese levels rise into the potentially toxic range

Tramadol HCl 50 mg/ml Injection A Moderate to severe acute or chronic pain ADULT: IV/IM/SC 50 - 100mg. (IV inj over Sweating, dizziness, vomiting, dry mouth, Narcotic withdrawal treatment, Amitryptiline, chlorpromazine, Reduced level of consciousness, (eg. Post-operative pain, chronic cancer 2-3 min or IV infusion). Initially 100 mg gastrointestinal disturbances, cerebral hypersensitivity, acute alcoholism. Acute clozapine, dothiepin, fluoxetine, respiratory disorders, increased pain and analgesia/pain relief for patients then 50 - 100 mg every 4 - 6 hours. . Max: convulsions especially on co-medication intoxication with alcohol, analgesics, fluvoxamine, haloperidol, intracranial pressure, pregnancy, with impaired renal function) 400 mg daily. CHILD (1 year and above): 1 with neuroleptics, physical dependence. sedatives or psychotropic drugs. MAOI risperidone, sertraline, sulpiride, lactation, history of epilepsy. Opiate - 2mg/kg/dose Rarely, palpitations, tachycardia, therapy (within the 14 days of last thioridazine, trifluoperazine: dependence, hypersensitivity to faintness, circulatory collapse, discontinuation) increased risk of seizures. morphine-like analgesics, children less headaches, constipation, skin reactions. Moclobemide, selegiline: nausea, than 1 year. Myxedema, hypothyroidism Very rarely, muscular weakness, altered vomiting, cardiovascular collapse, or hypoadrenalism. Hepatic or renal appetite, micturition disturbances respiratory depression, seizures. function disorders. May impair ability to Carbamazepine: decreased drive or machinery operation (alcohol). tramadol efficacy. Digoxin: increased risk of digoxin toxicity (nausea, vomiting, cardiac arrhythmias). Increased incidence of seizures when used with tricyclic antidepressants eg cyclobenzaprine, MAOI, SSRIs, neuroleptic agents and other drugs that lower the seizure threshold Tranexamic Acid 100 mg/ml Injection B Haemorrhage associated with excessive ADULT: Slow IV 0.5-1 g (10 - 15 mg/kg) 3 Nausea, vomiting, diarrhoea, Severe renal impairment, Anti-inhibitor coagulant complex Cardiovascular disease, cerebrovascular fibrinolysis times daily. Continuous infusion at a rate hypotension, thrombosis, disturbances in thromboembolic disease, intravascular oral contraceptive, oestrogen, disease, concomitant antifibrinolytic of 25 - 50 mg/kg daily. CHILD: slow IV 10 colour vision clotting process, disturbance of colour tretinoin therapy. Concomitant therapy with mg/kg/day 2-3 times daily vision, subarachnoid haemorrhage oestrogens or thrombolytics. Renal impairment and transurethral prostatectomy (potential for intravesicular clotting)

Travoprost 0.004% & Timolol 0.5% A* To decrease intraocular pressure (IOP) in 1 drop in the affected eye(s) once daily Eye irritation, ocular hyperaemia. Bronchial asthma, a history of bronchial Oral Ca-channel blockers, History of severe cardiac disease, Eye Drops patients with open-angle glaucoma or Nervousness, dizziness, headache, asthma or severe COPD. Sinus guanethidine or β-blocking agents, respiratory & cardiac reactions, subject ocular hypertension who are punctate keratitis, anterior chamber bradycardia, 2nd or 3rd degree AV block, antiarrhythmics, digitalis glycosides to spontaneous hypoglycaemia, diabetes. insufficiently responsive to other topical cells, anterior chamber flare, eye pain, overt cardiac failure or cardiogenic shock. or parasympathomimetics. May mask the signs of hypoglycaemia & anti glaucomas photophobia, eye swelling, conjunctival Severe allergic rhinitis & bronchial Antidiabetic medicinal products. hyperthyroidism & cause worsening of haemorrhage, corneal staining, ocular hyperreactivity; corneal dystrophies; Prinzmetal's angina, severe peripheral & discomfort, abnormal sensation in the hypersensitivity to other β-blockers. central circulatory disorders & eye, reduced visual acuity, visual hypotension. History of atopy or a history disturbance, blurred vision, dry eye, eye of severe anaphylactic reaction to a pruritus, allergic conjunctivitis, increased variety of allergens. May gradually lacrimation, eyelid irritation, eyelid change eye colour & increase length, erythema, blepharitis, asthenopia, thickness, pigmentation &/or number of growth of eyelashes, irregular or lashes. Aphakic patients, pseudophakic decreased heart rate, increased or patients w/ a torn posterior lens capsule decreased BP, bronchospasm, urticaria, or anterior chamber lenses, or patients skin hyperpigmentation (periocular), pain w/ known risk factors for cystoid macular in extremity. oedema. Remove contact lenses prior to application; reinsert after 15 minutes. May impair ability to drive or operate machinery. Renal or hepatic impairment. Pregnancy & lactation. Safety and efficacy in children & adolescent below 18 years old has not been established.

Triamcinolone Acetonide 0.1% Oral B Oral and perioral lesions Apply a thin layer to affected area 2-4 Prolonged use may lead to possible Hypersensitivity to any of its Minor interaction with Tuberculosis, peptic ulcer, diabetes Paste times daily absorption components, fungal or bacterial hypoglycaemic agents mellitus, pregnancy infections of the mouth or throat, herpetic lesions of known viral origin or intraoral lesions Triamcinolone Acetonide 10 mg/ml A Inflammation of joints, bursae and Smaller joints: 2.5 - 5 mg and larger Local atrophy, post injection flare, Systemic fungal infection, unstable or Phenytoin, phenobarbitone, Intercurrent infection, hypothyroidism, Injection tendon sheaths joints: 5 - 15 mg. Treatment should be pigmentation changes, sodium and fluid infected joints, lactation rifampicin, carbamazepine, cirrhosis, active or latent tuberculosis, limited to 1 mg/injection site to prevent retention, peptic ulcer, impaired wound hypoglycaemics, diuretics, renal insufficiency, cardiac failure, cutaneous atrophy healing, purpura, striae, increased anticholinesterases, salicylates diabetes, glaucoma, myasthenia gravis, ocular/intracranial pressure with pregnancy cushingnoid state, growth retardation

Triamcinolone Acetonide 40 mg/ml A/KK Allergies, dermatoses, rheumatoid 40-80 mg deep into the gluteal muscle Local atrophy, post injection flare, Systemic fungal infection, unstable or Phenytoin, phenobarbitone, Intercurrent infection, hypothyroidism, Injection arthritis and inflammatory opthalmic pigmentation changes, sodium and fluid infected joints, lactation rifampicin, carbamazepine, cirrhosis, active or latent tuberculosis, diseases retention, peptic ulcer, impaired wound hypoglycemics, diuretics, renal insufficiency, cardiac failure, healing, purpura, striae, increased anticholinesterases, salicylates diabetes, glaucoma, myasthenia gravis, ocular/intracranial pressure with pregnancy cushingnoid state, growth retardation Triprolidine HCl 1.25 mg and B Decongestion of the upper respiratory ADULT and CHILD more than 12 year : 10 Drowsiness, sleep disturbances, skin Angle-closure glaucoma, hypersensitivity Antihypertensives, tricyclic Diabetes, hypertension, heart disease, Pseudoephedrine HCl 30 mg per 5 ml tract in common cold, hay fever, allergic ml. CHILD 6 - 12 years : 5 ml 2 - 5 years : rashes, dryness of nose, mouth and to triprolidine products. Children less antidepressants, decongestants, hyperthyroidism, elevated intraocular Syrup and vasomotor rhinitis and sinusitis. 2.5 ml throat, hypotension or hypertension, than 2 years of age. appetite suppressants, pressure, prostatic enlargement, asthma, Doses to be taken twice daily or three tachycardia, anorexia, nausea, vomiting, amphetamine-like psychostimulant, chronic obstructive pulmonary disease, times daily constipation, diarrhea, abdominal pain, other sympathomimetics. prostatic hypertrophy, pyloric wheezing, tightness of chest, impotence, obstruction, stenosing peptic ulcer and blurred vision, urinary retention. avoid operating vehicles and machinery. To be used with caution and doctor's advice in children 2 to 6 years of age.

Tropicamide 1% Eye Drops A/KK Topical use to produce cycloplegic 1 - 2 drops several times a day Increased intraocular pressure, dryness Primary glaucoma or a tendency toward Antimuscarinic effects potentiated Individuals susceptible to belladona refraction for diagnostic purposes of mouth, transient stinging, allergic glaucoma. Sensitivity to tropicamide by concomitant use of amantadine, alkaloids, inflammed eyes, pregnancy, reactions, tachycardia, headache, tricyclic antidepressants, children, elderly. Infants and children, parasympathetics stimulation, blurred phenothiazine and butyrophenones may cause central nervous system vision, photosensitivity and antihistamines disturbances

Tuberculine PPD Injection B For routine Mantoux (tuberculin 10 units is injected intradermally Pain and pruritus may occur at the Subcutaneous injection, hypersensitivity Corticosteroid, immunosuppressive Sensitivity to tuberculin may be sensitivity) test injection site, occasionally with to tuberculin purified protein derivative, therapy, live virus vaccines diminished in the following conditions: vesiculation, ulceration or necrosis in previous severe reaction (e.g. viral or severe bacterial infection highly sensitive persons. If given to Vesiculation, ulceration, necrosis) including HIV infection and severe patients with tuberculosis a severe tuberculosis, neoplastic disease reaction may occur. Granuloma has been particularly lymphoma, sarcoidosis, reported. Hypersensitivity reactions, corticosteroid or immunosuppressive including anaphylaxis, to tuberculins therapy, recent administration of live have been reported rarely virus vaccines, ultraviolet light treatment, chronic renal failure and malnutrition. Tuberculins may be adsorbed onto the surface of syringes and should therefore be administered immediately. Tuberculin skin tests should not generally be administered to known tuberculin reactors because of the risk of a severe reaction at the test site Umeclidinium 62.5 mcg and A* Indicated as a maintenance One inhalation daily Common: Urinary tract infection, Hypersensitivity to the active substances Beta2-adrenergic blockers, CYP3A4 Asthma: UMEC/VI should not be used in Vilanterol 25mcg inhalation (Ellipta) bronchodilator treatment to relieve sinusitis, nasopharyngitis, pharyngitis, or to any of the excipients such as inhibitors, CYP2D6 inhibitors, P-gp patients with asthma since it has not symptoms in adult patients with chronic upper respiratory tract infection, Lactose monohydrate and Magnesium inhibitors, muscarinic antagonists, been studied in this patient population. obstructive pulmonary disease (COPD). headache, cough, oropharyngeal pain, stearate. beta2-adrenergic agonist, Paradoxical bronchospasm: constipation, dry mouth Uncommon: hypokalaemia treatment. Administration of UMEC/VI may product Rash, tremor, dysgeusia, atrial fibrillation, paradoxical bronchospasm that may be supraventricular tachycardia, rhythm life-threatening. Treatment with idioventricular, tachycardia, UMEC/VI should be discontinued supraventricular extrasystoles, immediately if paradoxical palpitations Rare: Anaphylaxis, bronchospasm occurs and alternative angioedema, urticarial, vision blurred, therapy instituted if necessary. Not for glaucoma, intraocular pressure acute use: UMEC/VI is not indicated for increased, paradoxical bronchospasm, the treatment of acute episodes of dysphonia, urinary retention, dysuria. bronchospasm. Deterioration of disease: Increasing use of short-acting bronchodilators to relieve symptoms indicates deterioration of control. In the event of deterioration of COPD during treatment with UMEC/VI, a re-evaluation of the patient and of the COPD treatment regimen should be undertaken. Cardiovascular effects: Cardiovascular effects, such as cardiac arrhythmias e.g. atrial fibrillation and tachycardia, may be seen after the administration of muscarinic receptor antagonists and sympathomimetics, including UMEC/VI. Therefore, UMEC/VI should be used with caution in patients with severe cardiovascular disease. Antimuscarinic Activity: Consistent with its antimuscarinic activity, UMEC/VI should be used with caution in patients with urinary retention or with narrow- angle glaucoma. Hypokalaemia: Beta2- adrenergic agonists may produce significant hypokalaemia in some patients. The decrease in serum potassium is usually transient, not requiring supplementation. Hyperglycaemia: Beta2-adrenergic agonists may produce transient hyperglycaemia in some patients. Coexisting conditions: UMEC/VI should be used with caution in patients with convulsive disorders or thyrotoxicosis, and in patients who are unusually responsive to beta2-adrenergic agonist. Excipients: This medical product contains Vancomycin HCl 500 mg Injection A* Only for the treatment of MRSA and Slow IV infusion, ADULT: 500 mg over at Thrombophlebitis, febrile reactions with Known hypersensitivity to this antibiotic Increased risk of ototoxicity with Rapid infusion-related reactions. Hearing CAPD peritonitis least 60 minutes every 6 hours or 1 g rigor during administration, loop diuretics, aminoglycosides. loss, renal impairment, pregnancy and over at least 100 minutes every 12 hours. nephrotoxicity, ototoxicity, nausea and Increased risk of nephrotoxicity lactation NEONATE up to 1 week, 15 mg/kg vomitting with aminoglycosides and initially, then 10 mg/kg every 12 hours. cephalosporins INFANT 1 - 4 weeks, 15 mg/kg initially then 10 mg/kg every 8 hours. CHILD over 1 month, 10 mg/kg every 6 hours

Vasopressin 20 units/ml Injection A i) Pituitary diabetes insipidus ii) i) 5 - 20 units SC or IM every 4 hours ii) 20 Abdominal cramps, nausea, vomiting, Hypersensitivity to vasopressin, poor Carbamazepine, chlorpropamide, Heart failure, migraine, epilepsy, asthma Oesophageal variceal bleeding units in 100 - 200 ml 5% dextrose saline passage of gas, tremor, vertigo, distal limb perfusion, hyperbilirubinemia clofibrate, urea, fludrocortisone, or other conditions which might be over 15 minutes as infusion which may "pounding" in head, bronchial and acute cardiac or bowel ischemia tricyclic antidepressants, exacerbated by fluid retention, renal be repeated after at intervals of 1 - 2 constriction, sweating, urticaria, noradrenaline, lithium, heparin and impairment. Avoid fluid overload hours. Maximum: 4 doses cutaneous gangerene. alcohol Verapamil HCl 2.5 mg/ml Injection A/KK Supraventricular tachycardia Initially 5-10mg given by slow IV over at Constipation, dizziness, nausea or Marked bradycardia, sick-sinus Effects enhanced by beta-blockers, Cardiac failure, complicated acute (5mg/2ml) least 2 minutes. The dose can be vertigo, headache, hypotension, ankle syndrome. 2nd or 3rd degree AV block. antiarrhythmics or inhalation myocardial infarction, atrial fibrillation repeated 10mg 30 minutes after the first oedema, flushing, fatigue, nervousness, Chronic heart failure, cardiogenic shock, anaesthetic. May intensify effects with Wolff-Parkinson-White syndrome, dose if the initial response is not paraesthesia, bradycardiac arrhythmias, Pregnancy, sick sinus syndrome, heart of other antihypertensives. Lithium hepatic impairment adequate. dyspnoea, raised prolactin levels, single failure, atrial fibrillation/flutter and (attenuated by verapamil, cases of galactorrhoea, myalgia, simultaneous preexcitation syndrome, enhanced neurotoxicity). Increases arthralgia, allergic skin reactions, myasthenia gravis, lactation. plasma level of cyclosporin, purpura, photosensitisation dermatitis, theophylline, digoxin, gynaecomastia, reversible increase in carbamazepine transaminases and or alkaline phosphatase, gingival hyperplasia, tachycardia, palpitations, impotence, tinnitus, tremor, heart failure

Vitamin B Complex 10 ml Injection B Prophylaxis and treatment of vitamin B 1-2 ml daily by IM Risk of anaphylactic shock. Allergy to Allergy to cobalamins, megaloblastic Pyridoxine reduces the effect of Not for treatment of pernicious anaemia deficiency cobalamins, megaloblastic anaemia of anaemia of pregnancy levodopa or other megaloblastic anaemias where pregnancy vitamin B12 is deficient

Vitamin K1 1 mg/ml Injection C+ Vitamin K deficiency in neonates Prophylaxis of vitamin K deficiency Anaphylaxis, dyspnoea, cyanosis, pain, Hypersensitivity to Vitamin K, menadione Decreased effect of oral Increased risk of severe haemolytic bleeding in neonates Child: Neonate: 0.5- swelling, phloebitis at the Inj site, (K3) administration in glucose-6- anticoagulants.Requirement for anaemia in neonates after large doses; 1 mg, given as a single dose via IM inj. diaphoresis, dizziness, hypotension phosphate dehydrogenase deficiency Vitamin K may be increased in severe hepatic impairment; pregnancy. Alternatively, 2 mg may be given orally, (rare), allergic reactions after SC and IM patients receiving in patients with Premature neonates weighing <2.5 kg followed by a 2nd dose of 2 mg after 4-7 inj. broad spectrum antibiotics, days. Intravenous Vitamin K deficiency quinidine, quinine, high doses of bleeding in neonates Child: Infant: 1 mg salicylates or antibacterial by IV/IM/SC inj, further doses may be sulphonamides. given if necessary

Vitamin K1 10 mg/ml Injection B Haemorrhage associated with 0.5 - 20 mg by very slow IV at a rate not Anaphylaxis, dyspnoea, cyanosis, pain, Hypersensitivity to Vitamin K, menadione Decreased effect of oral IV or IM administration only when hypoprothrombinaemia caused by exceeding 1 mg per minute swelling, phloebitis at the Inj site, (K3) administration in glucose-6- anticoagulants.Requirement for necessary (risk of anaphylaxis). overdose of anticoagulants diaphoresis, dizziness, hypotension phosphate dehydrogenase deficiency Vitamin K may be increased in Hypersensitivity reactions possible even (rare), allergic reactions after SC and IM patients receiving in patients with at first administration. The anticoagulant inj. broad spectrum antibiotics, action of heparin not counteracted by quinidine, quinine, high doses of phytomenadione Vitamin K. Reduce dose salicylates or antibacterial in elderly, liver impairment sulphonamides.

Water for Injection C+ As a diluent and vehicle for the According to the needs of the patient Not known Not known Not known The stability of any medicament administration of medications prepared should be checked Zidovudine 1% Injection A To reduce the rate of maternal-foetal i) Prophylaxis of maternal-foetal HIV Anaemia, neutropenia, leucopenia, Abnormally low neutrophil cell count Increased haematological toxicity Monitor carefully haematological transmission of HIV in: i) HIV-positive transmission during labour and delivery nausea, headache, rash, abdominal pain, (less than 0.75 x 109/L) or abnormally with IV pentamidine, lamivudine, parameters. If anaemia or pregnant women over 14 weeks of Adult: Loading dose: 2 mg/kg, followed fever, myalgia, paraesthesia, vomiting, low Hb levels (less than 7.5 g/dL). dapsone, vancomycin flucytosine, myelosuppression occurs dose gestation ii) Their newborn infants by continuous infusion of 1 mg/kg/hr insomnia and anorexia. Asthenia, Hypersensitivity to zidovudine. New born amphotericin, ganciclovir, adjustments are suggested. Patients with until umbilical cord is clamped. If malaise, somnolence, diarrhoea, infants with hyperbilirubinaemia rifampicin, interferon alfa, pre-existing bone marrow compromise. caesarean section is planned, start the IV dizziness, sweating, dyspnoea, dyspepsia, requiring treatment other than cyclophosphamide and other with Pregnancy and lactation. Renal and infusion 4 hr before the operation. Renal flatulence, bad taste, chest pain, loss of phototherapy, or increased transaminase bone marrow suppressive or hepatic impairment. and Hepatic impairment: Dose reduction mental acuity, anxiety, urinary frequency, levels of over five times than the upper cytotoxic agents. Increased risk of may be needed. HIV infection (to be depression, generalised pain, chills, limit of normal. zidovudine toxicity with discuss: not in indication) Adult: 1-2 cough, urticaria, pruritus and flu-like atovaquone, chloramphenicol, mg/kg every 4 hr, given as 2-4 mg/ml syndrome fluconazole, valproate. Decreased infusion over 1 hr. Child: As continuous absorption with clarithromycin. infusion: 20 mg/m2/hr. Alternatively, as Increased zidovudine concentration intermittent infusion: 120 mg/m2 every 6 and increased potential for hr. Renal impairment: Haemodialysis or hypersensitivity reactions with peritoneal dialysis: 1 mg/kg every 6-8 hr. probenecid. Increased incidences of ii) Prophylaxis of HIV infection in headache with benzodiazepines neonates Child: Neonates: 1.5 mg/kg Avoid stavudine (due to inhibition every 6 hr. Start treatment within 12 hr of activation of stavudine), after birth and continue for 1st 6 wk of didanosine, ribavirin (antagonize life. Dose to be given via IV infusion over effect of zidovudine) with 30 minutes. Renal impairment: Dose zidovudine. adjustment may be needed.

Zidovudine 10 mg/ml Syrup A* i) Management of patients with i) HIV infection Adult: 600 mg daily in Anaemia, neutropenia, leucopenia, Abnormally low neutrophil cell count Increased haematological toxicity Monitor carefully haematological asymptomatic and symptomatic (early or divided doses, in combination with other nausea, headache, rash, abdominal pain, (less than 0.75 x 109/L) or abnormally with bone marrow suppressive or parameters. If anaemia or advanced) HIV infections with CD4 cell antiretroviral agents. Child: 6 wk - 12 yr: fever, myalgia, paraesthesia, vomiting, low Hb levels (less than 7.5 g/dL). cytotoxic agents. Increased risk of myelosuppression occurs dose counts less than 500 cu. mm. ii) Neonatal 160 mg/m2 every 8 hr. Max: 200 mg insomnia and anorexia. Asthenia, Hypersensitivity to zidovudine. New born zidovudine toxicity with adjustments are suggested. Patients with prophylaxis every 8 hr. May be used in combination malaise, somnolence, diarrhoea, infants with hyperbilirubinaemia atovaquone, chloramphenicol, pre-existing bone marrow compromise. with other anti-retrovirals. Renal and dizziness, sweating, dyspnoea, dyspepsia, requiring treatment other than fluconazole, valproate. Decreased Pregnancy and lactation. Renal and Hepatic impairment: Dose reduction may flatulence, bad taste, chest pain, loss of phototherapy, or increased transaminase absorption with clarithromycin. hepatic impairment. be needed. ii) Prophylaxis of HIV mental acuity, anxiety, urinary frequency, levels of over five times than the upper Increased zidovudine concentration infection in neonates Child: Neonates: 2 depression, generalised pain, chills, limit of normal. and increased potential for mg/kg every 6 hr for 1st 6 wk of life, cough, urticaria, pruritus and flu-like hypersensitivity reactions with starting within 12 hr after birth. Renal syndrome probenecid. Increased incidences of and hepatic impairment: Dose headache with benzodiazepines adjustment may be needed. Avoid stavudine (due to inhibition of activation of stavudine), didanosine, ribavirin (antagonize effect of zidovudine) with zidovudine.

Zinc Oxide Cream C+ Skin protective in various skin conditions Apply 3 times daily or as required Hypersensitivity to any component Weeping dermatoses Not known Hypersensitivity to any component. such as nappy rash, eczema and problem Avoid contact with eyes. Not to be skin applied over deep or puncture wounds, infections or lacerations

Zoledronic Acid 4 mg Injection A* i) Treatment of hypercalcaemia of 4 mg reconstituted and should be given Flu-like symptom (bone pain, fever, Hypersensitivity to zoledronic acid or Aminoglycosides, other potentially Assess hydration status prior to malignancy ii) Prevention of skeletal as a 15 minutes IV infusion every 3-4 fatigue and rigors), athralgia, myalgia, other bisphosphonates, pregnancy, nephrotoxic drugs, thalidomide administration. Monitor serum related events in patients with multiple weeks hypophosphatemia, hypocalcemia, lactation electrolytes and creatinine. Evaluate myeloma involving multiple bone lesions incrase in blood creatinine and blood serum creatinine prior to each urea, nausea, vomiting, anorexia, rash, administration. If renal deterioration priritis, redness, swelling or pain at during treatment, zoledronic acid shoud injection site, anorexia, anaemia, be resumed when creatinine level headache, conjunctivities, renal returns to within 10% of baseline value. impairment Not recomended in patients with bone metastases with severe renal impairment (creatinine clearance < 30mL/min). While on treatment, patients should avoid invasive dental procedure if possible Zuclopenthixol Decanoate 200 B Only for treatment of agitated and By deep IM injection test dose 100 mg Extrapyramidal syndrome, drowsines, Severe central nervous system Alcohol, barbiturates and central Previous hypersensitivity to other mg/ml Injection violent patients suffering from followed after 7 - 28 days by 100 - 200 anticholinergic effect, tachycardia, depression, blood dyscrasias, nervous system depressant, neuroleptic agents, particularly schizophrenia who are not responding to mg or more followed by 200 - 400 mg at postural hypotension, dizziness, tardive phaeocromocytoma. Previous tricyclic antidepressant, thioxanthenes, fluphenazine and the available standard drugs intervals of 2 - 4 weeks adjusted dyskinesia, urinary retention, disturbed hypersensitivity to zuclopenthixol or metoclopramide - increased effect perphenazine, Hepatic or renal disease or according to response. Maximum 600 mg accommodation clopenthixol. Comatose states, acute cardiovascular disease, pregnancy, weekly. Child not recommended alcohol, barbiturate and opiate breastfeeding, epileptic or parkinsonian intoxication. Pregnancy patients or organic brain syndrome. Patients on long-term therapy should be monitored carefully. May affect ability to drive or operate machinery

Kemaskini 10 Julai 2019