Betamethasone Dipropionate with antibiotic combines the medicinal drug, topical anesthetic, and vasoconstrictor activity of an artificial sex hormone, betamethasone Dipropionate, with the broad spectrum anti-bacterial result of antibiotic.

An adequate amount of the cream or ointment ought to be applied to hide utterly the affected space and will be massaged gently and entirely into the skin. The same old frequency of application is doubly daily though some patients could also be maintained adequately with less frequent application.

Viral diseases as well as vaccinia, varicella, herpes simplex, plant life infections, T.B. of the skin, and hypersensitivity to any of the parts.

The following native adverse skin reactions are according to the utilization of topical steroids: waterlessness, itching, burning, native irritation, striae, skin atrophy, hypertrichosis, amendment in pigmentation, and secondary infection. Adrenal suppression has conjointly been according to the following topical sex hormone medical aid. Posterior subcapsular cataracts are according to the general use of corticosteroids.

Since the safety of topical sex hormone use in pregnant ladies has not been established, medicine of this category ought to be used throughout the physiological state providing the potential profit justifies the potential risk to the vertebrate. medicine of this category mustn't be used extensively in giant amounts or for prolonged periods of your time in pregnant patients. Since it's not illustrious whether or not topical administration of corticosteroids may result in adequate general absorption to provide detectable quantities in breast milk, a decision ought to be created to discontinue nursing or to discontinue the drug, taking into consideration the importance of the drug to the mother. This drug mustn't be employed in or close to the eyes since the vehicle isn't developed for ophthalmic use.

Gentamicin isn't effective against fungi, yeasts, or viruses. Patients with superficial plant life or yeast infections conjointly should receive specific medical aid and also the use of the drug could need to be interrupted. the utilization of such topical preparations could end in an associate degree overgrowth of non-susceptible organisms. Suitable precautions ought to be taken in victimization topical corticosteroids in patients with stasis eczema and alternative skin diseases with impaired circulation.

Prolonged use of sex hormone preparations could turn out striae or atrophy of the skin or s.c. tissue. If this happens, treatment ought to be interrupted. Causal factors ought to be sought-after associate degreed eliminated whenever doable and also the sensitivity of an infecting organism to antibiotic ought to be verified.

Patients ought to be suggested to tell the resulting physicians of the previous use of corticosteroids.

While no general effects are discovered following the topical application of antibiotics, ototoxic general concentrations will cause permanent impairment of proprioception to operate within the presence of a renal disorder or existing eighth nervous harm.

Caution ought to be exercised if an antibiotic is employed in people UN agency square measure illustrious to be sensitive to locally applied antibacterials. If irritation or sensitization develops, treatment ought to be interrupted.

Application over in-depth lesions could end in vital general absorption manufacturing hypercortisolism manifesting itself by adrenal suppression, moon face, striae, and suppression of growth in children.

Patients ought to be followed up often, and also the product ought to be interrupted once the infection has cleared.

Occlusive dressing mustn't be used.

Symptoms: Excessive prolonged use of topical corticosteroids will suppress pituitary-adrenal operate resulting in secondary adrenal insufficiency.

Treatment: Correct solution imbalance, if needed. Slow withdrawal of corticosteroids could also be required.

Store between 2-30° C.

Should be taken on an empty stomach. Take 1 hr before or 2 hr after meals.Hypersensitivity to ampicillin and other penicillins.Nausea, vomiting, diarrhea, erythematous maculo-papular rashes, sore mouth, black/hairy tongue, rash, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, fever, joint pains, serum sickness-like symptoms, hemolytic anemia, thrombocytopenia, leucopenia, neutropenia, coagulation disorders, prolonged bleeding time and prothrombin time, CNS toxicity (e.g. convulsions); paraesthesia, nephropathy, interstitial nephritis, hepatitis, cholestatic jaundice, moderate and transient increase in transaminases, Anaphylaxis, Clostridium difficile-associated diarrhea (CDAD).

Pregnancy Category B. Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Presentation:

• Atorvastatin 10: Each tablet contains Atorvastatin Calcium Trihydrate INN equivalent to Atorvastatin 10 mg.
• Atorvastatin 20: Each tablet contains Atorvastatin Calcium Trihydrate INN equivalent to Atorvastatin 20 mg.
• Atorvastatin 40: Each tablet contains Atorvastatin Calcium Trihydrate INN equivalent to Atorvastatin 40 mg.

Description:
Atorvastatin is a synthetic lipid-lowering agent. Atorvastatin is an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase. This enzyme catalyzes the conversion of HMG-CoA to mevalonate, an early and rate-limiting step in cholesterol biosynthesis.

Dosage & Administration:
The patient should be placed on a standard cholesterol-lowering diet before receiving Atorvastatin and should continue on this diet during treatment with Atorvastatin.
Hypercholesterolemia (Heterozygous Familial and Nonfamilial) and Mixed Dyslipidemia: The recommended starting dose of Atorvastatin is 10 mg once daily. The dosage range is 10 to 80 mg once daily. Atorvastatin can be administered as a single dose at any time of the day, with or without food. Therapy should be individualized according to the goal of therapy and response. After initiation and/or upon titration of TAtorvastatin, lipid levels should be analyzed within 2 to 4 weeks and dosage adjusted accordingly. Since the goal of treatment is to lower LDL-C, the LDL-C levels should be used to initiate and assess treatment response. Only if LDL-C levels are not available, should total-C be used to monitor therapy.

Homozygous Familial Hypercholesterolemia: The dosage of Tiginor in patients with homozygous FH is 10 to 80 mg daily. Atorvastatin should be used as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) in these patients or if such treatments are unavailable.

Concomitant Therapy: Tiginor (Atorvastatin) may be used in combination with a bile acid-binding resin for additive effect. The combination of HMG-CoA reductase inhibitors and fibrates should generally be avoided.

Dosage in Patients With Renal Insufficiency: Renal disease does not affect the plasma concentrations nor LDL-C reduction of atorvastatin; thus, dosage adjustment in patients with renal dysfunction is not necessary.

Pediatric Use: Treatment experience in a pediatric population is limited to doses of Tiginor up to 80 mg/day for 1 year in 8 patients with homozygous FH. No clinical or biochemical abnormalities were reported in these patients. None of these patients was below 9 years of age.

Geriatric Use: Treatment experience in adults age 70 years with doses of Tiginor up to 80 mg/day has been evaluated in 221 patients. The safety and efficacy of Tiginor in this population were similar to those of patients <70 years of age.

Side Effects:
Atorvastatin is generally well tolerated. Adverse reactions have usually been mild and transient. In controlled clinical studies of 2502 patients, <2% of patients were discontinued due to adverse experiences attributable to atorvastatin. The most frequent adverse events thought to be related to atorvastatin were constipation, flatulence, dyspepsia, and abdominal pain.

Precautions:
Before instituting therapy with atorvastatin, an attempt should be made to control hypercholesterolemia with appropriate diet, exercise, and weight reduction in obese patients, and to treat other underlying medical problems. Information for Patients: Patients should be advised to report promptly unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever.

Use in Pregnancy & Lactation:
Since HMG-Co A reductase inhibitors decrease cholesterol synthesis and possibly the synthesis of other biologically active substances derived from cholesterol, they may cause fetal harm when administered to pregnant women. Therefore, HMG-Co A reductase inhibitors are contraindicated during pregnancy and in nursing mothers. Atorvastatin should be administered to women of childbearing age only when such patients are highly unlikely to conceive and have been informed of the potential hazards. If the patient becomes pregnant while taking this drug, therapy should be discontinued and the patient apprised of the potential hazard to the fetus. Because of the potential for adverse reactions in nursing infants, women taking atorvastatin should not breastfeed.

Interaction:
The risk of myopathy during treatment with drugs of this class is increased with concurrent administration of cyclosporine, fabric acid derivatives, niacin (nicotinic acid), erythromycin, azole antifungals. When atorvastatin and an antacid suspension containing magnesium and aluminum hydroxide were coadministered, plasma concentrations of atorvastatin decreased approximately 35%. However, LDL-C reduction was not altered. Plasma concentrations of atorvastatin decreased approximately 25% when colestipol and atorvastatin were co-administered. However, LDL-C reduction was greater when atorvastatin and colestipol were co-administered than when either drug was given alone. When multiple doses of atorvastatin and digoxin were co-administered, steady-state plasma digoxin concentrations increased by approximately 20%. Patients taking digoxin should be monitored appropriately. In healthy individuals, plasma concentrations of atorvastatin increased approximately 40% with co-administration of atorvastatin and erythromycin. Co-administration of atorvastatin and an oral contraceptive increased AUC values for norethindrone and ethinylestradiol by approximately 30% and 20%. These increases should be considered when selecting an oral contraceptive for a woman taking atorvastatin.

Overdose:
There is no specific treatment for atorvastatin overdose. In the event of an overdose, the patient should be treated symptomatically, and supportive measures instituted as required. Due to extensive drug binding to plasma proteins, hemodialysis is not expected to significantly enhance atorvastatin clearance.

Storage:

Therapeutic Class: Corticosteroid

These include-

• Atopic eczema
• Nummular eczema
• Contact dermatitis
• Neurodermatitis
• Anogenital and senile pruritus
• Lichen planus
• Psoriasis

Description:
Betamethasone Dipropionate is a topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. Betamethasone Dipropionate induces peptides called lipocortins. Lipocortins antagonize phospholipase A2, an enzyme that causes the breakdown of leukocyte lysosomal membranes to release arachidonic acid. This action decreases the subsequent formation and release of endogenous inflammatory mediators including prostaglandins, kinins, histamine.

Pharmacokinetics: Betamethasone Dipropionate can be absorbed from normal intact skin. Corticosteroids are bound to plasma proteins in varying degrees. Corticosteroids are metabolized primarily in the liver.lt excreted by the kidneys.

Dosage & Administration:
Apply a thin film once or twice daily to cover completely the affected area. Patients with chronic psoriasis who have achieved at least a marked improvement in their psoriatic lesion (i.e., approximately 80% improvement) with Betamethasone Dipropionate may be maintained in remission with a pulse dosing regimen consisting of three consecutive applications of up to 3.5 g each of Betamethasone Dipropionate cream and ointment, twelve hours apart (e.g., morning, evening, following morning) to the previously affected areas once each week. For this purpose, Betamethasone Dipropionate cream and ointment should be applied to the lesion sites previously affected and treated. Patients on this pulse dose regimen who relapse should be reverted back to the conventional dosing regimen.

Interaction:
There is no evidence of any kind of interaction.

Contraindications:
Hypersensitivity to Betamethasone Dipropionate, other corticosteroids, or any components in this preparation. Like other topical corticosteroids, Betamethasone Dipropionate is contraindicated in viral infections of the skin, such as vaccinia, varicella, and Herpes simplex, also tuberculosis, acne rosacea, fungal skin infections (moniliasis), perioral dermatitis, and ulcerative conditions.

Side Effects:
The most frequent side effects reported with Betamethasone Dipropionate are mild to moderate transient burning/stinging, dry skin, pruritus, irritation, and folliculitis. Rarely reported adverse effects include tingling, prickly skin/tightening or cracking of the skin, warm feeling, laminar scaling and perilesional scaling, follicular rash, skin atrophy, erythema, urticaria, vesiculation, telangiectasia, acneiform papules, and hyperaesthesia.

Adverse reactions reported with the use of the Betamethasone Dipropionate ointment pulse dose regimen were mild intermittent hypertension and paraesthesia. Other local adverse reactions that have been reported with the use of topical corticosteroids include: itching, hypertrichosis, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, striae, miliaria, and exacerbation of untreated infections

Precautions & Warnings:
Betamethasone Dipropionate should not be used in or near the eyes, as there is a potential risk of developing glaucoma and cataract. If irritation or sensitization develops with the use of Betamethasone Dipropionate, treatment should be discontinued and appropriate therapy instituted. In the presence of an infection, an appropriate antifungal or antibacterial agent should be administered. If a favorable response does not occur promptly, Betamethasone Dipropionate should be discontinued until the infection has been controlled adequately.

Corticosteroids are known to be absorbed percutaneously, therefore in patients under prolonged and extensive topical treatment, the possibility of systemic effects should be kept in mind. Betamethasone Dipropionate is not intended for use under occlusive dressings since this will also increase systemic absorption of the corticosteroid. In infants, the napkin may act as an occlusive dressing and increase absorption. Suitable precautions should be taken when using topical corticosteroids in patients with stasis dermatitis and other skin diseases with impaired circulation. Prolonged use of topical corticosteroid preparations may produce striae or atrophy of the skin or subcutaneous tissue. If this occurs, treatment should be discontinued.

Overdose:
Acute overdose with the ointment is unlikely and would not be expected to lead to a life-threatening situation. The ointment should not be used for longer than the prescribed time period.

Storage:
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

Betamethasone & Salicylic Acid Scalp lotion or ointment is indicated for the relief of inflammatory manifestations of psoriasis and seborrhea of the scalp. This scalp lotion or ointment is also indicated for the relief of inflammatory manifestations of non-scalp lesions of psoriasis and other corticosteroid-responsive dermatoses.

Therapeutic Group: Drugs utilized in Meniere's diseases

Analgesic & Anti-inflammatory Mouthwash
Topical anti-inflammatory preparations

Asthma: Beclomethasone dipropionate/Formoterol fumarate dihydrate is indicated within the regular treatment of asthma attack wherever the use of a mixture product (inhaled sex hormone and long β2-agonist) is appropriate: patients not adequately controlled with inhaled corticosteroids and 'as needed' inhaled rapid-acting β2-agonist or patients already adequately controlled on each inhaled corticosteroids and long.

COPD: Symptomatic treatment of patients with severe COPD (FEV1 <50% foretold normal) and history of continual exacerbations, United Nations agency have important symptoms despite regular medical care with long bronchodilators.

Dose recommendations for adults eighteen years and above: One or 2 inhalations doubly daily. the utmost daily dose is four inhalations.

Dose recommendations youngsters|for youngsters|for kids} and adolescents beneath eighteen years: the security and efficaciousness in children and adolescents beneath eighteen years more matured haven't been established, however. No information area unit out there with the drug in youngsters beneath twelve years more matured. so the drug isn't counseled for youngsters and adolescents beneath eighteen years till any information become out there.

Beta-blockers (including eye drops) ought to be avoided in unhealthy patients. If the beta-blockers area unit administered for compelling reasons, the impact of formoterol is going to be reduced or abolished. On the opposite hand, concomitant use of alternative beta-adrenergic medication will have probably additive effects, so caution is needed once Slo-Bid or alternative beta-adrenergic medication area unit prescribed concomitantly with formoterol. Concomitant treatment with Quinidex, disopyramide, procainamide, phenothiazines, antihistamines, enzyme inhibitors, and tricyclic antidepressant drug antidepressants will prolong the QTc-interval and increase the danger of bodily cavity arrhythmias.

Contraindicated in patients with hypersensitivity to any element of this product.

As the drug contains beclometasone dipropionate and formoterol fumarate dihydrate, the sort and severity of adverse reactions related to every one of the compounds are also expected. Common facet affects area unit sore throat, oral mycosis, headache, dysphonia.

There isn't any relevant clinical information on the utilization of the drug in pregnant ladies. Animal studies exploitation beclometasone dipropionate and formoterol combination showed proof of toxicity to replica when high general exposure. There isn't any relevant clinical information on the utilization of the drug in lactation in humans. though no information from animal experiments area unit out there, it's cheap to assume that beclometasone dipropionate is secreted in milk, like alternative corticosteroids.

The drug ought to be used with caution (which might embrace monitoring) in patients with viscus arrhythmias, particularly interrogation Adams-Stokes syndrome and tachyarrhythmias (accelerated and/or irregular heartbeat), disorder subvalvular stenosis, hypertrophic preventative cardiopathy, severe cardiovascular disease, significantly acute myocardial infarct, ischemic cardiovascular disease, symptom coronary failure, occlusive vascular diseases, significantly coronary-artery disease, blood vessel high blood pressure and aneurism. Caution ought to even be determined once treating patients with celebrated or suspected prolongation of the QTc interval, either noninheritable or drug evoked (QTc >0.44 seconds). Formoterol itself might induce prolongation of the QTc interval.

Prior to dispensing to the patient: Store during a white good (2-8°C) (for most of fifteen months). when dispensing: Store at temperatures, not olympian 30°C (for most of two months).

Presentation:
Azithromycin 250 Tablet: Each tablet contains Azithromycin Dihydrate USP 262.015 mg equivalent to Azithromycin 250 mg.
Azithromycin 500 Tablet: Each tablet contains Azithromycin Dihydrate USP 524.03 mg equivalent to Azithromycin 500 mg.
Azithromycin 15 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.
Azithromycin 30 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.
Azithromycin 35 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.
Azithromycin 50 ml Powder for Suspension: After reconstitution, each 5 ml suspension contains Azithromycin Dihydrate USP 209.65 mg equivalent to Azithromycin 200 mg.
Azithromycin IV Infusion: Each vial contains lyophilized powder of Azithromycin Dihydrate USP equivalent to Azithromycin 500 mg and each normal saline bottle contains 250 ml 0.9% Sodium Chloride solution. After reconstitution with 250 ml 0.9% Sodium Chloride solution according to direction, each ml contains Azithromycin Dihydrate USP equivalent to Azithromycin 2 mg.

Azithromycin is acid-stable and can therefore be taken orally with no need for protection from gastric acids. It is readily absorbed; its absorption is greater on an empty stomach. The time to peak concentration in adults is 2.1 to 3.2 hours for oral dosage forms. Due to the high concentration in phagocytes, azithromycin is actively transported to the site of infection. During active phagocytosis, large concentrations of azithromycin are released. The concentration of azithromycin in the tissues can be over 50 times higher than in plasma. This is due to ion trapping and high lipid solubility.

Azithromycin's half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half-life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drugs from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as an unchanged drug in urine.

Microbiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:

• Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes
• Aerobic and facultative gram-negative microorganisms: Haemophilus ducreyi, Haemophilus Influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae
• Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis , Mycoplasma Pneumoniae , Betalactamase production should have no effect on azithromycin activity.
• Aerobic and facultative gram-positive microorganisms: Streptococci (Groups C, F, G), Viridans group streptococci
• Aerobic and facultative gram-negative microorganisms: Bordetella pertussis, Legionella Pneumophila
• Anaerobic microorganisms: Peptostreptococcus species, Prevotella bivia.

Oral-Azithromycin Injection (For IV Infusion only): The recommended dose of Azithromycin for injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is:

• 500 mg as a single daily dose by the intravenous route for at least two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 500 mg, administered as two 250-mg tablets to complete a 7 to 10-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with the clinical response.
• The recommended dose of Azithromycin for the treatment of adult patients with pelvic inflammatory disease due to the indicated organisms is 500 mg as a single daily dose by the intravenous route for one or two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 250 mg to complete a 7-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with the clinical response. If anaerobic microorganisms are suspected of contributing to the infection, an antimicrobial agent with anaerobic activity should be administered in combination with Azithromycin.
• The safety and effectiveness of azithromycin for injection in children or adolescents under 16 years have not been established.