Indications:
Osimertinib is indicated for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M mutation-positive non-small cell lung cancer (NSCLC), as detected by an FDA-approved test, whose disease has progressed on or after EGFR tyrosine kinase inhibitor (TKI) therapy.

Presentation:
Osimertinib 80: Each tablet contains Osimertinib Mesylate INN equivalent to Osimertinib 80 mg.

Therapeutic Class: Anti-Viral {Respiratory viral infections (Influenza)}

Use in Special Populations:
Geriatric Use: Dosage adjustment is not needed in patients over the age of 65.
Hepatic Impairment: A total daily dose of 8mg should not be exceeded (patients with severe hepatic impairment).
Renal Impairment: No dosage adjustment is recommended.

Storage:
Store at temperature not exceeding 30ºC in a dry place. Protect from light and moisture.

Olopatadine Ophthalmic Solution 7 mg
Therapeutic Class: Anti Allergic

Indications:
This drug is indicated for the treatment of the sign and symptoms of allergic conjunctivitis (itchy, watery, red, irritated eyes).

Presentation:
Olopatadine Max Sterile Eye Drops: Each ml eye drop contains Olopatadine
Hydrochloride USP is equivalent to Olopatadine 7 mg.

Description:
Olopatadine is an inhibitor of the release of histamine from the mast cell and a relatively selective histamine H 1 -antagonist that inhibits histamine-induced inflammatory effects on human conjunctival epithelial cells.

Dosage & Administration:
Adults and children (age 2 years and above)
One drop in the conjunctival sac of the affected eye(s) once daily.

Side Effects:
Following adverse effects can be seen in some patients:
Headache, asthenia, blurred vision, burning or stinging, cold syndrome, dry
eye, foreign body sensation, hyperaemia, hypersensitivity, keratitis, lid edema,
nausea, pharyngitis, pruritus, rhinitis, sinusitis.

Precautions:
To prevent contaminating the dropper tip and solution, care should be taken not
to touch the eyelids or surrounding areas with the dropper tip of the bottle.
Patients should be advised not to wear a contact lens if their eye is red.

Use in Pregnancy & Lactation:
Pregnancy: Pregnancy category C. For this drug, no clinical data on exposed
pregnancies are available.
Lactation: It is not known if this medicine passes into breast milk, therefore it is
not recommended for use during breastfeeding.

Interaction:
Interactions with other medications have not been investigated in vivo.

Overdose:
No information is available.

Storage:
Keep out of the reach of children. Store in a cool, dry place, away from heat and direct light.
Do not use more than 4 weeks after opening

Indications:
This drug is indicated for the treatment of the sign and symptoms of allergic conjunctivitis (itchy, watery, red, irritated eyes).

Presentation:
Olopatadine DS Eye Drops: Each ml eye drop contains Olopatadine Hydrochloride USP equivalent to Olopatadine 2 mg.

Description:
Olopatadine is an inhibitor of the release of histamine from the mast cell and a relatively selective histamine H1 -antagonist that inhibits histamine-induced inflammatory effects on human conjunctival epithelial cells.

Dosage & Administration:
Adults and children (above 2 years of age)
One drop in the conjunctival sac of the affected eye(s) once daily.

Side Effects:
Following adverse effects can be seen in some patients:
Headache, asthenia, blurred vision, burning or stinging, cold syndrome, dry eye, foreign body sensation, hyperemia, hypersensitivity, keratitis, lid edema, nausea, pharyngitis, pruritus, rhinitis, sinusitis.

Precautions:
To prevent contaminating the dropper tip and solution, care should be taken not to touch the eyelids or surrounding areas with the dropper tip of the bottle. Patients should be advised not to wear a contact lens if their eye is red.

Use in Pregnancy & Lactation:
Pregnancy: Pregnancy category C. For this drug, no clinical data on exposed pregnancies are available.
Lactation: It is not known if this medicine passes into breast milk, therefore it is not recommended for use during breastfeeding.

Interaction:
Interactions with other medications have not been investigated in vivo.

Overdose:
No information is available.

Storage:
Keep out of the reach of children. Store in a cool, dry place, away from heat and direct light. Do not use it more than 4 weeks after opening.

Indications:
Olopatadine is indicated for the treatment of ocular itching associated with allergic conjunctivitis.

Presentation:
Olopatadine Sterile Eye Drops: Each ml contains 1.11 mg Olopatadine Hydrochloride USP equivalent to Olopatadine 1 mg.
Olopatadine DS Sterile Eye Drops: Each ml contains 2.22 mg of Olopatadine Hydrochloride USP equivalent to Olopatadine 2mg.

Description:
Olopatadine is an inhibitor of the release of histamine from the mast cell and a relatively selective histamine H1 -antagonist that inhibits histamine-induced inflammatory effects on human conjunctival epithelial cells.

Dosage & Administration:
Olopatadine: Adults and children (above 3 years of age). One drop of Lopadine in the conjunctival sac of the affected eye(s) twice daily.
Olopatadine DS: Adults and children (above 2 years of age). One drop in each affected eye once a day.

Side Effects:
Ocular: blurred vision, burning or stinging, conjunctivitis, dry eye, foreign body sensation, hyperemia, hypersensitivity, keratitis, lid edema, pain, and ocular pruritus.
Non-ocular: asthenia, back pain, flu syndrome, headache, increased cough, infection, nausea, rhinitis, sinusitis, and taste perversion.

Precautions:
To prevent contaminating the dropper tip and solution, care should be taken not to touch the eyelids or surrounding areas with the dropper tip of the bottle. Patients should be advised not to wear a contact lens if their eye is red. Olopatadine should not be used to treat contact lens-related irritation.

Use in Pregnancy & Lactation:
Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Therefore, this drug should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the embryo or fetus.
It is not known if this medicine passes into breast milk, therefore it is not recommended for use during breastfeeding.

Overdose:
No information is available.

Storage:
Store in a safe place. Keep out of the reach of children. Do not use it more than 4 weeks after opening.

Indications:
Olopatadine Nasal Spray is an H1 receptor antagonist indicated for the relief of the symptoms of seasonal allergic rhinitis in adults and children 6 years of age and older.

Presentation:
Each bottle contains 120 metered doses of Olopatadine Hydrochloride INN. Each actuation delivers Olopatadine Hydrochloride INN 665 mcg. (Equivalent to 600 mcg of Olopatadine).

Description:
Olopatadine, an antihistamine, works by blocking the action of histamine in the body, which reduces allergy symptoms. Olopatadine Hydrochloride treats sneezing, itching, runny nose, and other nasal symptoms of allergies. Olopatadine Nasal Spray contains 0.6% w/v Olopatadine (base) in a nonsterile aqueous solution with a pH of approximately 3.7. After initial priming (5 sprays), each metered spray from the nasal applicator delivers 100 microliters of the aqueous solution containing 665 mcg of olopatadine Hydrochloride, which is equivalent to 600 mcg of Olopatadine (base). Olopatadine Nasal Spray also contains benzalkonium chloride (0.01%), dibasic sodium phosphate, edetate disodium, sodium chloride, hydrochloric acid, and/or sodium hydroxide (to adjust pH), and purified water.

Dosage & Administration:
Administer Olopatadine Nasal Spray by the intranasal route only.
Adults and Adolescents 12 years of age and older: Two sprays per nostril twice daily.
Children 6 to 11 years of age: One spray per nostril twice daily.

Side Effects:
A bitter taste in the mouth, nosebleeds, or irritation/soreness in the nose may occur. Drowsiness may rarely occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Precautions:
Priming: Before initial use, prime Olopatadine Nasal Spray by releasing 5 sprays or until a fine mist appears. When Olopatadine Nasal Spray has not been used for more than 7 days, re-prime by releasing 2 sprays. Avoid spraying Olopatadine Nasal Spray into the eyes.
Patients should be informed to avoid spraying Olopatadine Nasal Spray in their eyes.

Use in Pregnancy & Lactation:
Pregnancy:
Pregnancy Category C; No adequate and well-controlled studies in pregnant women have been conducted. Olopatadine Nasal Spray should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the embryo or fetus.
Lactation:
It is not known whether topical nasal administration could result in sufficient systemic absorption to produce detectable quantities in human breast milk. Olopatadine Nasal Spray should be used by nursing mothers only if the potential benefit to the patient outweighs the potential risks to the infant.

Interaction:
Interaction with other medications has not been investigated.

Indications:
Olmesartan Medoxomil & Hydrochlorothiazide 20 Plus is indicated for the treatment of hypertension.

Presentation:
Each tablet contains Olmesartan Medoxomil INN 20 mg and Hydrochlorothiazide BP 12.5 mg.

Description:
Angiotensin II formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE), is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. It also stimulates aldosterone secretion by the adrenal cortex. Olmesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland). In-vitro-binding studies indicate that Olmesartan is a reversible & competitive inhibitor of the AT1 receptor. Olmesartan does not inhibit ACE (kinase II, the enzyme that converts angiotensin I to angiotensin II and degrades bradykinin).

Hydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing the excretion of Sodium and Chloride in approximately equivalent amounts. Indirectly, the diuretic action of Hydrochlorothiazide reduces plasma volume with consequent increases in plasma renin activity, increases aldosterone secretion & urinary Potassium loss, and decreases serum Potassium. The renin-aldosterone link is mediated by angiotensin II. So, co-administration of an angiotensin II receptor antagonist tends to reverse the potassium loss associated with these diuretics.

Dosage & Administration:
Hypertension
The usual starting dose of Olmesartan Medoxomil & Hydrochlorothiazide 20 Plus is one tablet once daily. Dosing should be individualized. Depending on the blood pressure response, the dose may be titrated at intervals of 2-4 weeks.

Patients with Renal Impairment:
The usual regimens of therapy with Olmesartan Medoxomil & Hydrochlorothiazide 20 Plus may be followed provided the patient's creatinine clearance is >30 mL/min. In patients with more severe renal impairment, loop diuretics are preferred to thiazides. So, Xyotil 20 Plus is not recommended.

Patients with Hepatic Impairment:
No dosage adjustment is necessary with hepatic impairment.

Side Effects:
The common side-effects are nausea, headache, dizziness, hyperuricemia, upper respiratory tract infection, and urinary tract infection. Other adverse effects are chest pain, back pain, peripheral edema, abdominal pain, dyspepsia, gastroenteritis, diarrhea.

Precautions:

• Periodic determination of serum electrolytes should be performed at appropriate intervals to detect possible electrolyte imbalance like Hypokalemia, hyponatremia, and hypochloremic alkalosis.
• Hyperuricemia may occur in certain patients receiving thiazide therapy.
• Impaired renal function.

Use in Pregnancy & Lactation:
Safety and effectiveness in nursing mother & pregnancy have not been established. The drug should be discontinued during these conditions.

Interaction:
Olmesartan:
No significant drug interactions were reported in studies in which Olmesartan Medoxomil was co-administered with hydrochlorothiazide, digoxin, or warfarin in healthy volunteers. Olmesartan Medoxomil is not metabolized by the cytochrome P450 system and has no effects on P450 enzymes; thus, interactions with drugs that inhibit, induce, or are metabolized by those enzymes are not expected.

Hydrochlorothiazide:
When administered concurrently, the following drugs may interact with thiazide diuretics:

• Alcohol, Barbiturates, or Narcotics - Potentiation of orthostatic hypotension may occur.
• Antidiabetic drugs (oral agents and Insulin) - Dosage adjustment of the antidiabetic drug may be required.
• Other antihypertensive drugs - Additive effect or potentiation.
• Corticosteroids, ACTH.
• Lithium.

Overdose:
Olmesartan: 

Limited data are available in regard to overdosage in humans. The most likely manifestation of overdosage would be hypotension and tachycardia. Supportive treatment should be instituted.

Hydrochlorothiazide:
The most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, and dehydration) resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias.

Hepatic Impairment Patients: No dosage adjustment is necessary with hepatic impairment.

Pediatric use: Safety and effectiveness in pediatric patients have not been established.

Geriatric use: Clinical studies of Olmesartan and Hydrochlorothiazide combination did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious.Storage:
Store in a cool and dry place, protect from light and moisture. Keep out of the reach of children.

Indications:
Olmesartan is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents.
Storage:
Store in a cool & dry place below 30ºC, protect from light & moisture. Keep out of the reach of children.

(Schizophrenia, Prevention of Bipolar Disorder, Mania)
Presentation:
Olanzapine 5: Each tablet contains Olanzapine INN 5 mg.
Olanzapine 10: Each tablet contains Olanzapine INN 10 mg.

Description:
Olanzapine is a selective monoaminergic antagonist with high-affinity binding to Serotonin 5-HT, Dopamine, muscarinic, H1, and alpha receptors. It has a weak binding affinity to GABA-A, benzodiazepine, and beta-adrenergic receptors.

Indications:
Pyridoxine Hydrochloride & Doxylamine Succinate tablet is indicated for the treatment of nausea and vomiting of pregnancy in women.

Presentation:
Pyridoxine Hydrochloride & Doxylamine Succinate tablet: Each enteric-coated tablet contains Pyridoxine Hydrochloride BP 20 mg & Doxylamine Succinate BP 20 mg.

Description:
Doxylamine is an antihistamine that blocks Histamine (H1) receptor. It affects the vestibular system and decreases the stimulation of the vomiting center. Its muscarinic receptor inhibition may also play a role in antihistamine antiemetic activity. Pyridoxine (Vitamin B6) is a vitamin used to prevent nausea and vomiting due to its antiemetic properties.

Dosage & Administration:
Initially, take one Pyridox tablet orally at bedtime (Day 1). If this does adequately controls symptoms the next day, continue taking one tablet daily at bedtime only. However, if symptoms persist on Day 2, increase the daily dose to one tablet in the morning and one tablet at bedtime. The maximum recommended dose is two tablets per day, one in the morning and one at bedtime. Take on an empty stomach with a glass of water. Swallow the tablets whole. Do not crush, chew, or split Pyridoxine Hydrochloride & Doxylamine Succinate tablets. Take daily and not on an as-needed basis.

Side Effects:
Somnolence and falls or other accidents resulting from the effect of the combined use of Pyridoxine Hydrochloride & Doxylamine Succinate with CNS depressants.

Precautions:
Somnolence: Pyridox may cause somnolence due to the anticholinergic properties of doxylamine succinate, an antihistamine. Women should avoid engaging in activities requiring complete mental alertness, such as driving or operating heavy machinery.
Pyridoxine Hydrochloride & Doxylamine Succinate use is not recommended if a woman is concurrently using central nervous system (CNS) depressants. The combination may result in severe drowsiness leading to falls or accidents. Pyridoxine Hydrochloride & Doxylamine Succinate has anticholinergic properties and therefore, should be used with caution in women with asthma, increased intraocular pressure, narrow-angle glaucoma, Stenosing peptic ulcer, Pyloroduodenal obstruction, or urinary bladder-neck obstruction.

Use in Pregnancy & Lactation:
Pyridoxine Hydrochloride & Doxylamine Succinate is intended for use in pregnant women.

Interaction:
The use of Pyridox is contraindicated in women who are taking monoamine oxidase inhibitors (MAOIs), which prolong and intensify the adverse central nervous system effects (the anticholinergic effects) of antihistamines. Concurrent use of alcohol and other CNS depressants (such as hypnotic sedatives and tranquilizers) with Pyridox is not recommended.

Overdose:
Doxylamine Succinate & Pyridoxine Hydrochloride is an extended-release or Delayed Release formulation; therefore, signs and symptoms of intoxication may not be apparent immediately. Signs and symptoms of overdose may include restlessness, dryness of mouth, dilated pupils, sleepiness, vertigo, mental confusion, and tachycardia. At toxic doses, Doxylamine Succinate exhibits anticholinergic effects, including seizures, rhabdomyolysis, acute renal failure, and death. If treatment is needed, it consists of gastric lavage or activated charcoal, whole bowel irrigation, and symptomatic treatment.

Storage:
Store in a cool and dry place away from light.

Indications:
Pseudoephedrine, Guaiphenasine & Triprolidine indicated for the symptomatic relief of upper respiratory tract disorders accompanied by a productive cough that benefits from the administration of a nasal decongestant, a histamine H1-receptor antagonist, and an expectorant combination.

Presentation:
Each 5 ml syrup contains Guaiphenesin BP 100 mg, Pseudoephedrine Hydrochloride BP 30 mg, and Triprolidine Hydrochloride BP 1.25 mg.

Indications:
Protamine crystallised Insulin Aspart is an insulin analog indicated to improve glycemic control in patients with diabetes mellitus.

Presentation:
Each ml solution contains 100 IU (equivalent to 3.50 mg) Insulin Aspart (rDNA).

Description:
Insulin Aspart rDNA is a sterile, clear solution of Insulin Aspart human insulin analog for
subcutaneous injection/infusion or intravenous injection. Protamine crystallised Insulin Aspart is a blood glucose-lowering agent with an earlier onset of action. Protamine crystallised Insulin Aspart produces more rapid onset of action compared to soluble human insulin. Insulin Aspart is homologous with regular human insulin with the exception of a single substitution of the amino acid Proline by aspartic acid in position B28 and is produced by recombinant DNA technology.

Dosage :
Insulin Aspart has a faster onset and a shorter duration of action than soluble human insulin. Due to the faster onset of action, Insulin Aspart should generally be given immediately before a meal. When necessary Insulin Aspart may be given soon after a meal.

Dosage of Insulin Aspart is individual and determined on the basis of the physician's advice in accordance with the needs of the patient. It should normally be used in combination with long-acting insulin given at least once a day.

The individual insulin requirement is usually between 0.5 and 1.0 IU/kg/day in adults and children over 2 years of age. In a meal-related treatment 50-70% of this requirement may be provided by Insulin Aspart and the remainder by long-acting insulin. Adjustment of dosage may also be necessary if patients undertake increased physical activity or change their usual diet. Exercise taken immediately after a meal may increase the risk of hypoglycaemia.

Subcutaneous Injection: Insulin Aspart should be administered by subcutaneous injection in the abdominal region, buttocks, thigh, or upper arm. Because Insulin Aspart has a more rapid onset and a shorter duration of activity than human regular insulin, it should be injected immediately (within 5-10 minutes) before a meal Continuous Subcutaneous Insulin Infusion (CSII) by External Pump Insulin Aspart can also be infused subcutaneously by an external insulin pump. The initial programming of the external insulin infusion pump should be based on the total daily insulin dose of the previous regimen. Approximately 50% of the total dose is usually given as meal-related boluses of Insulin Aspart and the remainder is given as a basal infusion. When used with an infusion pump Insulin Aspart should not be mixed with any other insulin.

Intravenous Use: Insulin Aspart can be administered intravenously under medical supervision for glycemic control with close monitoring of blood glucose and potassium levels to avoid hypoglycemia and hypokalemia. For intravenous use, Insulin Aspart should be used at concentrations from 0.05 IU/mL to 1.0 IU/mL insulin aspart in infusion systems using polypropylene infusion bags. Insulin Aspart has been shown to be stable in infusion fluids such as 0.9% sodium chloride.

Indications:
Induction and maintenance of general anesthesia. Sedation during intensive care. Sedation for surgical and diagnostic procedures.

Presentation:
Propofol Injection: Each vial contains Propofol BP 200 mg.

Description:
Propofol is a highly lipid-soluble, short-acting intravenous general anesthetic. The onset of general anesthesia occurs in most patients within 30-60 seconds. Most patients return to consciousness rapidly and recover without confusion or nausea. They are usually completely orientated within only a few minutes from recovery and fit for discharge after only a few hours. Contrary to many other anesthetic agents, propofol is not clinically significantly accumulated during maintenance dosage. It is therefore most suitable for sedation during intensive care.

Its distribution can best be described by a three-compartment open model: rapid distribution from blood to tissues (half-life 2-3 minutes), rapid metabolic elimination from blood (half-life 30-60 minutes), and a slower final phase, during which propofol is eliminated from poorly perfused tissue. The rapid onset of action is based on the fact that propofol, as a lipid-soluble substance, easily passes the blood-brain barrier and is distributed to the central nervous system. The dosage, blood concentrations, and duration of anesthesia are directly interrelated on recommended dosages. Propofol is metabolized in the liver to inactive glucuronide and sulfate conjugates, which are excreted in the urine.

Dosage & Administration:
Adults
Induction of general anesthesia: The dosage of Propofol should be titrated individually against the response of the patient. The ordinary initial dosage in adults is 40 mg (4 ml) by slow intravenous bolus injection at intervals of 10 seconds until the clinical signs show the onset of anesthesia. The ordinary induction dose in a healthy patient below 55 years of age is 2.2-2.5 mg/kg. A dose of 1.0-1.5 mg/kg is often sufficient for the older patient. Lower doses, most often 20 mg (2 ml) at intervals of 10 seconds, are recommended for a patient of ASA grades 3 and 4.

Maintenance of general anesthesia: Anaesthesia can be maintained by administering Propofol either by continuous infusion or by repeat bolus injections to maintain sufficient anesthesia.

Continuous infusion: The required rate of infusion varies considerably between patients. At the onset of anesthesia (roughly the first 10-20 minutes), some patients may require a slightly higher infusion rate (8-10 mg/kg/h). However, sufficient anesthesia is normally achieved by infusing 4-6 (up to 12) mg/kg/h of Propofol. Repeat bolus injections: 25-50 mg (2.5-5.0 ml) bolus injections, depending on response.

Sedation during intensive care: A bolus injection of 1.0-2.0 mg/kg should be given first, followed by continuous infusion adjusted according to the required degree of sedation. An infusion rate of 0.3-4 mg/kg/h is usually sufficient.

Sedation for surgical and diagnostic procedures: Dosages shall be adjusted individually. Sufficient sedation for surgical and diagnostic procedures can usually be achieved by administering initially 0.5-1 mg/kg during 1-5 minutes and maintained by continuous at a rate of 1-4.5 mg/kg/h. A bolus dose of 10-20 mg can be given in addition, should deeper sedation be suddenly required. Lower doses of Propofol are often sufficient for the patient of ASA grades 3 and 4, and for the older patient.

Children
Propofol is not recommended for use in children less than 3 years of age as its safety has not been demonstrated.

Induction of general anesthesia: Dosage of Propofol in children shell be adjusted for weight and age. The mean induction dosage in children over 8 years is 2.5 mg/kg, given by slow intravenous injection until the clinical signs show the onset of anesthesia. Younger children may need slightly higher doses of propofol per kilogram of weight. Lower dosages are recommended for children of ASA grades 3 and 4.

Maintenance of general anesthesia: Anaesthesia can be maintained by administering Propofol either by continuous infusion or by repeat bolus injections. Dosage shall be adjusted individually, but an infusion rate of 9-15 mg/kg/h is usually sufficient to achieve satisfactory anesthesia.

Sedation during intensive care, surgical diagnostic procedures: Propofol is not recommended for sedation in children as its efficacy and safety have not been demonstrated. Although no causal relationship has been established, serious adverse events (including fatalities) have been reported in cases, where propofol has been used against recommendations. Adverse events have most commonly been seen in children with respiratory tract infections given doses in excess of those recommended for adults.

Method of administration
In order to reduce pain on injection, the induction dose of propofol may be mixed immediately before injection in the plastic syringe with lidocaine 10 mg/ml injection, in a ratio of 1 part of lidocaine injection for 20 parts of Propofol.

Propofol can be administered either undiluted or diluted for infusion. Before injection or dilution, each ampoule or vial shall be inspected for any irregularity. Should any changes be observed, the product shall not be used. Suitable equipment shall be used to ensure the correct rate of infusion. Volumetric infusion pumps and syringe pumps, for example, are suitable for this purpose. The ordinary infusion set used alone is not sufficient to prevent accidental overdosage reliably enough.

Compatibility: Propofol may be diluted only with 5% dextrose infusion. Dilution shall not exceed 1 in 5 (containing 2 mg/ml Propofol) and shall be prepared in a PVC infusion bag or glass infusion bottle. If a PVC infusion bag is used, the bag should be full and the dilution is prepared by withdrawing a volume of infusion fluid and replacing it with an equal volume of Propofol. Special attention shall be paid to preparing the dilution aseptically, immediately before administration. Any diluted solution shall be used within 6 hours of preparation. Any remaining solution shall be discarded.

Side Effects:
Local: Propofol is normally well tolerated. Its most common undesirable effect is pain at the site of injection that can be reduced by mixing the preparation with lidocaine or by injecting it into one of the larger veins of the forearm or the intercubital fossa. Thrombosis and phlebitis are rare. Reconstitution:
Propofol should not be mixed prior to intravenous injection with solutions or infusion fluids other than 5% dextrose or lidocaine 10 mg/ml injection.

Storage:
Propofol should be stored at a temperature not exceeding 25º C. It must not be frozen. Any unused solution shall be discarded.

Indications:
Propantheline Bromide is indicated in the treatment of-

• Adjunctive therapy in the treatment of peptic ulcer (gastric and duodenal)
• Relief of the symptoms of gastritis (stomach upset, gastrointestinal bleeding, blood in vomit, blood in stool, persistent pain)
• Symptomatic treatment of the diarrhea-related irritable bowel syndrome (irritable colon, spastic colon, acute enterocolitis, functional GI disorders, etc)
• Urinary incontinence
• Control of salivation and enuresis
• Improves lactose intolerance
• Prevents excessive sweating (Hyperhidrosis)

Presentation:
Each film-coated tablet contains Propantheline Bromide BP 15 mg

Description:
Propantheline Bromide acts by a dual mechanism of action.

• Specific anticholinergic effect (antimuscarinic) at the acetylcholine-receptor sites
• The direct effect upon smooth muscle (musculotropic). 

This medication is a muscarinic antagonist having antispasmodic properties. It reduces the effect of acetylcholine, a chemical released from nerves that stimulate muscles, by blocking the receptors for acetylcholine on smooth muscle. It also has a direct relaxing effect on smooth muscle. In addition, Propantheline inhibits gastrointestinal motility and decreases gastric acid secretion, and controls excessive pharyngeal, tracheal, and bronchial secretions. Other secretions like pancreatic juice, sweat, and saliva are also reduced.
Dosage & Administration:
The usual initial adult dose of Propantheline Bromide is 75 mg daily.
One tablet 30 min before each meal (15 mg three times daily)
Two tablets at bedtime
Dosage adjustment should be made according to the patient's individual response and tolerance. But the maximum daily dosage should not exceed 120 mg.

Pediatric use: Safety and effectiveness in pediatric patients have not been established.

Side Effects:
The adverse effects of Propantheline Bromide are usually dose-related and are usually reversible when the therapy is discontinued. Variable degrees of dry mouth, dry skin, mydriasis might be noted. Other reported adverse effects include urinary retention, nausea, vomiting, constipation, headache, nervousness, mental confusion, etc.

Precautions:
Propantheline Bromide should be used with caution in the elderly and in all patients with autonomic neuropathy, hepatic or renal disease, hyperthyroidism, coronary heart disease, congestive heart failure, cardiac tachyarrhythmias, hypertension, since anticholinergics may aggravate this condition.

Use in Pregnancy & Lactation:
Propantheline Bromide is in the Pregnancy Category C. Animal reproduction studies have not been conducted with propantheline bromide. Propantheline bromide should be given to a pregnant woman only if clearly needed. It is not known whether this drug is excreted in milk. Because many drugs are excreted in milk, caution should be exercised when propantheline bromide is administered to a nursing woman. Suppression of lactation may occur with anticholinergic drugs.
Pediatric use
Safety and effectiveness in pediatric patients have not been established

Interaction:
Antacids or Absorbent Antidiarrhoeals may reduce the absorption of propantheline bromide, therefore resulting in a reduction of its therapeutic effectiveness. Therefore, take two to three hours apart from doses of propantheline bromide. Anticholinergics may delay the absorption of other medication given concomitantly. Significant drug interaction also occurs with concomitant use of digoxin, haloperidol,
corticosteroids, ketoconazole, levodopa, opioid analgesics, phenothiazines, urinary alkalizer.

OverDose:
The symptoms of overdosage with Propantheline Bromide progress from an intensification of the usual side effects (from nausea and vomiting) to CNS disturbances (from restlessness and excitement to psychotic behavior), circulatory changes, (flushing, fall in blood pressure, circulatory failure), respiratory failure, paralysis.

Storage:
Do not store above 30°C. Keep away from light and out of the reach of children.

Indications:
All forms of Parkinson's disease -

• Idiopathic Parkinsonism
• Post-encephalitic Parkinsonism
• Arteriosclerotic Parkinsonism
• Extrapyramidal symptoms -
• Pseudo-parkinsonism
• Acute dystonic reactions
• Akathisia.

Presentation:
Procyclidine 5: Each tablet contains Procyclidine Hydrochloride BP 5 mg.
Procyclidine Injection: Each 2 ml ampoule contains Procyclidine Hydrochloride BP 10 mg.

Description:
Procyclidine is an antimuscarinic tertiary amine, which acts by blocking excess acetylcholine at cerebral synapses. It also exhibits a direct antispasmodic effect on smooth muscle.