General practice aid.






















































































































































































































































































































































































































CORTICOSTEROIDS Beclometasone Dipropionate, Budesonide, Fluticasone Propionate, Dexamethasone, Budesonide, Hydrocortisone, Prednisolone, Clobetasol, Isoflupredone.
PSYCOTROPIC SUBSTANCE Chloropromazine Hcl
TOXOIDS AND ANTITOXINS Tetanus toxoid, Tetanus antitoxin
VACCINES Rabies vaccine, Felocell, Rabies vaccine, DHPP, DHPPL, Varicella Virus vaccine.
ANTIBIOTIC CLASSES Penicillins, Tetracyclines, Cephalosporins, Quinolones, Lincomycins, Macrolides, Sulfonamides, Glycopeptides, Aminoglycosides, Carbapenems.
Biliary-tract infection. Ciprofloxacin, Gentamicin
MOUTH WASH Chlorhexidine Gluconate, Hexetidine, Oxidising Agents, Povidone-Iodine, Sodium Chloride, Thymol.
ORAL ULCERATION Benzydamine Hcl, Carbenoxolone Sodium, Corticosteroids, Carmellose Sodium, Flurbiprofen, Salicylates.
BRONCHODILATORS Salbutamol, Tarbutaline Sulphate, Bambuterol Hcl, Fentoterol Hydrobrpmide, Formoterol Fumarate, Eformoterol Fumarate, Salmeterol, Tulobuterol Hcl, Adrenalin(Epinephrine), Ephedrine Hcl, Orciprenaline Sulphate, Ipratropium Bromide, Oxitropium Bromide, Theophylline, Aminophylline, Theophylline, Etophylline, Terbutaline, Salbutamol, Albuterol, Fluticasone.
Antithyriod drugs. Methimazole, Carbimazole, Propylthiouacil.
Central Nervous System Stimulants, CNS stimulants(aaa)Dexamfetamine Sulphate, Modafinil, Methylphenidate Hcl, Cocaine.
ANTIDIARRHOEALLoperamide, Metronidazole.
AMOEBICIDESDiloxanide Furoate, Metronidazole, Tinidazole.
PARENTERAL ANTICOAGULANTS Heparin, Certoparin, Dalteparin Sodium, Enoxaparin, Reviparin Sodium, Tinzaparin Sodium, Danaparoid Sodium, Lepirudin, Epoprostenol.
Gastro-intestinal system infections. Campylobacter enteritis(Clarithromyci, Azithroycin, Erythromycin)Salmonellosis(Ciprofloxacin, Cefotaxime)Shigellosis(Ciprofloxacin, Azithromycin)Typhoid(Cefotaxime-Azithromycin)Clostridium difficile(Metronidazole, Vancomycin, Fidaxomicin)
Nose infection. First line(Phenxymethylpenicillin, Doxycycline, Clarithromycin.Erythromycin i pregnancy.Second line(Co-amoxiclav. Consult microbiologist.
SEDATIVE Ketamine, Triflupromazine, Xylazine.
Animal and Human bites. Co-amoxiclav, Doxicycline+Metronidazole Antitetanus toxin, HIV and Hepatitis B, C vaccine.
UTERINE TONICS Ergometrine, Valethamate.
Skin infection. Small areas(Topical fusidic acid, Topical mupirocin.Widespread area(Oral flucloxacillin, Phenoxymethylpenicillin, Clarithromycin, Azithromycin, Erythromycin)
Chronic obstructive pulmonary disease(COPD)Oral(First line-Amoxicillin, Clarithromycin, Doxycycline, Second line-Co-amoxiclav, Levofloxacin, Co-trimoxazole.Intravenous(First line-Amoxicillin, Co-amoxiclav, Clarithromycin, Co-trimoxazole, or Piparacillin+tazobactam, Second line-consult microbiologist. Send sputum sample for culture.
FAECAL SOFTENERS(aaa) Arachis Oil, Liquid Parafin.
LAXATIVESMethylcellulose, Sterculia, Bisacodyle, Dantron, Docusate Sodium, Glycerol, Senna, Sodium Picosulfate, Lactitol, Lactulose, Macrogols, MagnesiumSales, Phosphate(Rectal), Sodium Citrate(Rectal).
ANTICOUGHGuaifenesin, Choripheniramine meliate, Morphine, Cetrizine, Codeine, Pholcodine, Methadone.
VASODILATER ANTIHYPERTENSIVE DRUGSDiazoxide, Hydralazine Hcl, Minoxidil, Sodium Nitroprusside.
NAUSEA AND VERTIGO DRUGS Cinnarizine, Cyclizine, Meclozine Hcl, Promethazine Hcl, Metoclopramide, Granisetron, Ondansetron, Tropisetron, Betahistine, Chlorpromazine Hcl, Perphennazine, Prochlorperazine, Trifluoperazine, Domperidone, Nabilone, Hyoscine Hydrobromide
ANTIPLATELET DRUGS Abciximab, Aspirin, Clopidogrel, Dipyridamole, Eptifibatide, Ticlopidine Hcl, Tirofiban.
ANTIMOTILITY DRUGS Codine Phosphate, Co-Phenotrope, Lopramide Hcl, Morphine.
PCSK9 inhibitors(cholesterol-lowering drugs) Evolocumab(Repatha) , Alirocumab (Praluent), Inclisiran(Leqvio) .
PROTON PUMP INHIBITORSThey inhibit the action of proton pumps in the stomach lining. These pumps are responsible for releasing acid into the stomach, which is essential for the digestion of food. By blocking these pumps, PPIs reduce the production of stomach acid, thereby decreasing acidity levels in the stomach and providing relief from conditions such as acid reflux, gastroesophageal reflux disease (GERD) and peptic ulcers. Proton pump inhibitors (PPIs) Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole, Rabiprazole.
NEBULIZER DRUGSAlbuterol Sulfate, Ipratropium bromide, Fluticasone, Beclomethasone, Salmeterol.
ANTIMUSCARINICS(aaa) Pirenzipine.
ULCER HEALING DRUGS Cimetidine, Famotidine, Nizatidine, Ranitidine, Pirenzipine, Misoprostol, Carbenoxolone Sodium, Ranitidine Bismuth Citrate, Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole, Rabiprazole
ANALGESICS Ibuprofen, Ketoprofen, Chlorzoxazone, Diclofenac sodium, Aceclofenac, Alfentanil, Meloxicam, Paracetamol, Phenylbutazone, Aspirin, Paracetamol, Nefopam Hcl, Morphine, Buprenorphine, Codeine Phosphate, Dextromoramide, Dextropropoxyphene Hcl, Diamorphine Hcl, Dihydrocodeine Tertrate, Dipipanone Hcl, Fentanyl, Hydromorphone Hcl, Meptazinol, Methadone Hcl, Nalbuphine Hcl, Oxycodone Hcl, Papaveretum, Pentazocine, Pethidine Hcl, Phennazocine Hydrpbromide, Tramadol Hcl, Almotriptan, Naratriptan, Rizatriptan, Sumatriptan, Zolmitriptan, Ergotamine Tertrate, Isometheptene mucate, Pizotifen, Clonidine Hcl, Methysergide.
ANTIFUNGAL DRUGSClotrimazole, Miconazole, Griseofulvin, Terbinafine, Ketoconazole, Itraconazole, Amphotericin B.
ANTISPASMODICS Atropine Sulphate, Drofenine Hcl, Propyphenazone, Dicycloverine Hcl, Dicyclomine Hcl, Hyoscine Butylbromide, Propantheline Bromide, Alverine Citrate, Mebeverine Hcl, Peppermint Oil.
INFUSION FLUIDS Sterofundin ISO Solution for Infusion, Calcium, Dextrose saline, Normal saline, Ringers Lactate, Sodium bicarbonate.
EYE INFECTIONS Bacterial Eye Infections Gentmicin, Tobramycin., Cefuroxime, Azithromycin, Ciprofloxacin, Levofloxacin, Moxifloxacin, Ofloxacin, Chloramphenicol, Fusidic acid. Protozoal Eye infection Propamidine isetionate. Viral Eye infection Aciclovir, Ganciclovir.
Dry eye conditions(aaa) Acetylcysteine, Carbomers-polycrylic acid, Carmellose sodium, Hydroxyethylcellulose, Hypromellose, Hypromellose with dextran70, Liquid paraffin with white soft paraffin and wool alcohols, Polyvinyl alcohol, Sodium chloride, Sodium hyaluronate, Sodium hyaluronate and trehalose, Soybean oil.
ANTHELMINTICS Alben, Oxyclo, Levamisole, Tricla, Fenben, Pipera, Niclosamide, Praziquantel, Tetrami, Ivermectin, Pyrantel pamoate
HYPNOTICS Nitrazepan, Flunitrazepan, Flurazepam, Loprazolam, Lormetazepam, Temazepam, Zaleplon, Zolpidem, Zopiclone, Chloral Hydrate, Triclofos Sodium, Clomethiazole, Promethazine Hcl.
ANTIOBESITY DRUGSOrlistat, Sibutramine Hcl.
ANTICONVULSIVES Carbamazepine 200mg, Sodium Valproate 200mg, Diazepam, Lorazepam, Levetracetam 250mg, Phenobarbitone sodium.
NEBULISATION DRUGSSalbutamol, Ipratropium bromide, Budesonide, Levosalbutamol, Formoterol, Tobramycin, Dornase alfa, Hypertonic saline solution, Epinephrine, Amikacin.
ANXIOLYTICS Benzidiazepines, Diazepam, Alprazolam, Bromazepam, Chlordiazepoxide, Chlorzepate Dipotassium, Lorazepam, Oxazepam Buspirone Hcl, Meprobamate.
ANTIEMETICSMetoclopramide, Ondansetron, Maropitant, Promethazine.
Calcium channel blockers.Calcium channel blockers block calcium entering the muscle cells of the heart and blood vessels. By blocking calcium channels, it causes relaxation of the blood vessel walls, leading to vasodilation and decrease blood pressure. In heart, Calcium channel blockers reduce the force and rate of the heart's contractions, which can help lower blood pressure and relieve symptoms of certain heart conditions like angina or arrhythmias. These medications are used to treat conditions such as hypertension, Angina and certain heart rhythm disorders. Common calcium channel blockers. Amlodipine : Nifedipine : Felodipine : Diltiazem : Verapamil : Nicardipine : Isradipine : Lercanidipine : Nimodipine : Bepridil
Beta-blockers Beta-blockers, Also known as beta-adrenergic blocking agents, work by blocking the effects of stress hormones like adrenaline (epinephrine) on the body's beta receptors. By doing so, they reduce the heart rate, Decrease the force of contraction of the heart muscle and lower blood pressure. This can help in treating conditions such as hypertension, Angina and certain arrhythmias. Common Beta-blockers Propranolol: Metoprolol: Atenolol: Carvedilol: Bisoprolol: Nebivolol:
β-lactamase inhibitors.They are often combined with certain antibiotics, such as amoxicillin, to enhance their effectiveness by preventing bacterial enzymes (β-lactamases) from degrading the antibiotic. This combination is commonly used in the treatment of bacterial infections to overcome bacterial resistance. β-lactamase inhibitors. Clavulanic acid: Sulbactam: Tazobactam: Avibactam: Vaborbactam:
ANTIPSYCHOTIC DRUGS are medications primarily used to manage symptoms of psychosis. These symptoms can include delusions, hallucinations, Disorganized thinking and agitation. Antipsychotics are commonly prescribed to treat conditions such as schizophrenia, Bipolar disorder and severe depression with psychotic features. They work by modulating the activity of neurotransmitters, particularly dopamine, in the brain to help alleviate symptoms and improve overall functioning. First-generation antipsychotics drugs. Chlorpromazine: Haloperidol: Fluphenazine: Perphenazine: Trifluoperazine: Thioridazine Second-generation antipsychotics drugs. Aripiprazole: Risperidone: Olanzapine: Quetiapine: Ziprasidone: Paliperidone: Lurasidone: Asenapine: Brexpiprazole: Cariprazine:
EMETICSApomorphine Hcl, Hydrogenperoxide.
MUCOLYTICS Carbocisteine, Mecysteine Hcl, Dornase Alfa.
COUGH SUPPRESSANTS Codine Phosphate, Pholcodine, Methadone, Hcl, Morphine Hcl
ANTIPROTOZOALS Buparva, Diminazene, Quinapyramine, Diaveridine, Sulphachlorpyrazine.
Muscle Relaxants Baclofen, Benzodiazepines, Carisoprodol, Chlorzoxazone, Cyclobenzaprine, Dantrolene (Dantrium), Metaxalone, Methocarbamol, Orphenadrine, Tizanidine.
Glaucoma drugs Pilocarpine Hcl, Acetazolamide, Prostaglandin, Brinzolamide, Optacarpine, Apraclonidine, Naproxen, Betaxolol, Brinzolamide.
QUINOLONE ANTIBIOTICSIndications - Acute prostatis. Ciprofloxacin, Cinoxacin, Delafloxacin, Gatifloxacin, Gemifloxacin, Levofloxacin, Moxifloxacin, Norfloxacin, Ofloxacin, Sparfloxacin, Lomefloxacin, Trovafloxacin, Nalidixic acid Acute prostatis can be treat Quinolone+Trimethoprim
ANTIARRHYTHMIC DRUGS Adenosine, Amiodarone Hcl, Disopyramide, Flecainide Acetate, Procainnamide Hcl, Quinidine.
OSMOTIC DIURETICS Mannitol
POTASSIUM SPARING DIURETICS Amiloride Hcl, Thiamterene, Spironolactone.
LOOP DIURETICS Furosemide, Frusemide, Bumetanide, Torasemide.
THIAZIDE DIURETICS Bendroflumethiazide, Bendrofluazide, Chlortalidone, Cyclopenthiazide, Hydrochlorothiazide(DURUTON), Indapamide, Metolazone, Polythiazide, Xipamide.
Aminoglycoside antibioticsAminoglycoside antibiotics work by inhibiting bacterial protein synthesis. They bind to the bacterial ribosome, specifically the 30S subunit, Causing misreading of mRNA and ultimately leading to the production of faulty proteins. This disrupts bacterial growth and leads to cell death. Aminoglycoside antibiotics Streptomycin: gentamicin: Amikacin: Kanamycin: Neomycin:
Tetracycline antibioticsTetracycline antibiotics work by inhibiting bacterial protein synthesis, But they do so by binding to the bacterial ribosome's 30S subunit and preventing the attachment of aminoacyl-tRNA molecules to the mRNA-ribosome complex. This blocks the elongation of the peptide chain during protein synthesis, ultimately inhibiting bacterial growth and reproduction. Tetracycline antibiotics Doxycycline: Minocycline: Demeclocycline: Oxytetracycline: Chlortetracycline: Glycylcyclines (Tigecycline): Eravacycline: Sarecycline: Omadacycline:
CARDIAC GLYCOSIDESDigoxin . Digitoxin.
BILE ACID SEQUESTRANTS ColestyraminClarithromycine.
DRUGS ACTING ON THE GALL BLADDER Ursodeoxycholic Acid.
Antineoplastic drugs(Proteasome inhibitors) Carfilzomib, Ixazomib.
Antineoplastic drugs(Protein knase inhibitors) Abemaciclib, Afatyinib, Everolimus, Idelalisib, Trametinib, Temsirolimus.
Antineoplastic drugs(Tyrosine kinase inhibitors) Alectinib, Axitinib, Binimetinib, Bosutinib, Brigatinib, Imatinib, Lapatinib, Nilotinib, Nintedanib, Osimertinib, Ceritinib, Crizotinib, Dasatinib, Erlotinib, Gefitinib, Ibrutinib, Ruxolitinib, Pazopanib, Sunitinib, Tivozanib, Vandetanib, Lenvatinib, Midostaurin
Antineoplastic drugs(Several protein kinase inhibitors) Cabozantinib, Regorafenib.
Antineoplastic drugs(Mitogen-activated kinase inhibitors) Cobimetinib, Encorafenib.
Antineoplastic drugs(BRAF kinase inhibitors)Dabrafenib, Vemurafenib
Antineoplastic drugs(Cyclin-dependent kinase inhibitors) Palbociclib, Ribociclib.
Antineoplastic drugs(PARP inhibitors) Olaparib, Rucaparib.
Antineoplastic drugs(Selective inhibitors of B-cell lymphoma) Venetoclax
Antineoplastic drugs(Hedgehog pathway inhibitors) Vismodegib.
Antineoplastic drugs(Vascular endothelial growth factor inhibitors) Aflibercept.
Other Antineoplastic drugs Ponatinib, Niraparib.
ANTINEOPLASTIC DRUGS(Cancer) Vincristine Sulphate, Methotrexate, Lithium Antimony Thiomalate, Carboplatin.
Allergic conjunctivitis Antazoline with xylometazoline, Azelastine Hcl, Epinastine Hcl, Ketotifen, Olopatadine, Lodoxamide, Nedocromil sodium, Sodium cromoglicate)
Penicillin (antibiotics) Penicillin work by inhibiting the formation of bacterial cell walls. They target enzymes called transpeptidases, which are involved in cross-linking the peptidoglycan strands in the bacterial cell wall. By inhibiting these enzymes, penicillin disrupts the synthesis of the bacterial cell wall, leading to weakened cell walls and ultimately cell lysis, which causes the bacteria to die. Penicillin antibiotics Penicillin G: Penicillin V: Amoxicillin: Ampicillin: Oxacillin: Cloxacillin: Dicloxacillin: Flucloxacillin: Ticarcillin: Piperacillin: Carbenicillin: Mezlocillin:
VENTRICULAR ARRHYTHMIAS DRUGS Bretylium Tosilate, Lidocaine Hcl, Lignocaine Hcl, Mexiletine Hcl, Propranolol Hcl(CARDENOL tab), Acebutolol, Atenolol Betaxolol Hcl, Bisoprolol Fumarate, Carvedilol, Celiprolol Hcl, Esmolol Hcl, Labitalol Hcl Metoprolol Tertrate Nadolol, Oxprenolol Hcl, Pindolol, Sotalol Hcl, Timolol Maleate.
Sympathomimetic drugs, Adrenergic agonists. Sympathomimetic refers to drugs or substances that mimic (imitate the effects of the sympathetic nervous system. This system is responsible for the body's "fight or flight" response, including increased heart rate, Dilated pupils and heightened alertness. Sympathomimetic drugs work by mimicking the actions of the sympathetic nervous system, specifically by stimulating adrenergic receptors. This leads to effects such as increased heart rate, elevated blood pressure, Dilation of air passages and increased alertness. Sympathomimetic drugs. Albuterol, Pseudoephedrine, Epinephrine (Adrenaline), Norepinephrine (Noradrenaline), Dopamine, Phenylephrine, Ephedrine, Isoproterenol, Terbutaline, Dobutamine.
Parasympathomimetic drugs, Cholinergic agonists drugs. Parasympathomimetic refers to substances or drugs that mimic (imitate) the effects of the parasympathetic nervous system. This system is responsible for rest and digest functions in the body, such as slowing heart rate, increasing gastrointestinal activity and promoting relaxation. By stimulate parasympathetic nervous system's cholinergic receptors leads to various effects, including increased gastrointestinal motility, Decreased heart rate, Constriction of the pupils and increased glandular secretions. Parasympathomimetic drugs. Acetylcholine: Bethanechol: Pilocarpine: Carbachol: Methacholine: Donepezil: Rivastigmine: Physostigmine:
ANTIHISTAMINES Acrivastine, Cinnarizine, Cyclizine, Cetrizine Hcl, Desloratadine, Fexofenadine Hcl, Loratadine, Mizolastine, Terfenadine, Alimemazine Tertrate(Trimeprazine), Azatadine maleate, Brompheniramine meleate, Chlorphenamine maleate(Chlorpheniramine maleate), Clemastine, Cyproheptadine Hcl, Diphenhydramine Hcl, Diphenylpyraline Hcl, Doxylamine, Hydroxyzine Hcl, Promethazine Hcl, Triprolidine Hcl.
Acetylcholinesterase inhibitors Acetylcholinesterase (AChE) is an enzyme found in the nervous system, particularly at neuromuscular junctions and cholinergic synapses. Its primary role is to rapidly hydrolyze the neurotransmitter acetylcholine (ACh) into choline and acetate. This breakdown process terminates the action of acetylcholine, Allowing for precise control of neural signaling. Dysfunction of acetylcholinesterase can lead to various neurological and neuromuscular disorders. Indications - Alzheimer’s disease, such as memory loss, Confusion and problems with thinking and reasoning. Acetylcholinesterase inhibitors. Pyridostigmine (Mestinon), Neostigmine (Prostigmin), Edrophonium (Tensilon), Donepezil: Rivastigmine: Galantamine:
Muscarinic agonists, Cholinergic agonists. The drugs mimic the action of acetylcholine at muscarinic receptors found in various tissues, including smooth muscles, Cardiac muscles and glands. By activating muscarinic receptors, these drugs can produce effects such as increased glandular secretions, smooth muscle contractions and changes in heart rate. Indications - Glaucoma and in the management of urinary retention, Certain gastrointestinal disorders. Muscarinic agonists drugs. Bethanechol: Pilocarpine: Carbachol: Methacholine: Oxotremorine: Cevimeline: McN-A-343: Muscarine:
Antimuscarinic or Anticholinergic drugs.The drugs block the action of acetylcholine by inhibiting to bind receptors. They decreased smooth muscle contraction, reduced glandular secretions and increased heart rate. Indications - Overactive bladder, irritable bowel syndrome, motion sickness, Parkinson's disease and some types of poisoning. They are also commonly used in anesthesia to prevent unwanted muscarinic effects during surgery, such as excessive salivation or bradycardia. Side effects - Dry mouth, Constipation, Blurred vision and urinary retention, particularly at higher doses or for extended periods. Anticholinergics drugs, Muscarinic Antagonists drugs. Atropine: Scopolamine: Tiotropium: Oxybutynin: Tolterodine: Glycopyrrolate: Ipratropium: Benztropine: Solifenacin:Trihexyphenidyl: Darifenacin: Fesoterodine: Hyoscyamine: Dicyclomine:
Drugs for inflammatory eye conditionsNepafenac, Betamethasone, Dexamethasone, Fluorometholone, Prednisolone, Betamethasone with neomycin, Dexamethasone with framycetin sulfate and gramicidin, Dexamethasone with hypromelloe, neoycin and polymycinB sulfate, Dexamethasone with tobramycin, Cicloporin, Cenegermin.
Synthetic Synthetic prostaglandin, Prostacyclin analog.They reduce Pulmonary arterial hypertension (PAH) thereby reduce the workload of the heart and improved exercise capacity and symptoms associated with PAH. Synthetic Synthetic prostaglandin, Prostacyclin analog. Epoprostenol: Treprostinil: Iloprost: Beraprost: Latanoprost: Dinoprostone:
Alpha-1 blockers, Alpha-1 adrenergic antagonists. These drugs block the action of a neurotransmitter called norepinephrine at alpha-1 adrenergic receptors(Found in various tissues, including blood vessels and the prostate gland.) and they cause relaxation of smooth muscle of blood vessel walls, leading to vasodilation. Alpha-1 blockers or alpha-1 adrenergic antagonists. Doxazosin: Prazosin: Terazosin: Alfuzosin: Tamsulosin: Silodosin:
Phosphodiesterase type 5 (PDE5) inhibitors.They increase levels of cGMP in the smooth muscle cells of the penis, leading to relaxation and dilation of blood vessels. So increase blood flow to the penis to maintain erection during sexual stimulation. They also inhibit PDE5 and increase levels of cGMP in the smooth muscle cells of the pulmonary arteries, leading to vasodilation and decreased pulmonary vascular resistance. So they improve exercise capacity and reduce symptoms associated with PAH. PDE5 inhibitors have potential therapeutic effects on Raynaud’s phenomenon and certain cardiovascular conditions. Phosphodiesterase type 5 (PDE5) inhibitors. Sildenafil: Tadalafil: Vardenafil: Avanafil:
Dopamine agonists.Dopamine agonists work by mimicking the effects of dopamine, A neurotransmitter in the brain that plays a key role in regulating movement, emotions. By activating dopamine receptors, these medications help to compensate for the loss of dopamine-producing cells in conditions like Parkinson's disease, where dopamine levels are reduced. This activation of dopamine receptors helps to improve motor function and alleviate symptoms. Dopamine agonists. Ropinirole: Pramipexole: Apomorphine: Bromocriptine: Rotigotine:
Digoxin (Cardiac stimulant)Indications - Cardiac glycoside used in left ventricular failure, Congestive heart failure, Ischaemic heart disease, Supraventricular arrhythmias, Atrial fibrillation. Contraindications - Ventricular fibrillation, Hypertrophic obstructive cardiomyopathy, Supraventricular arrhythmias associated with accessory conduction pathways (e.g. Wolff-Parkinson-White syndrome). Cautions - Electrolyte imbalance (especially hypokalemia), Renal impairment, Hypothyroidism, Elderly, Acute myocardial infarction, Recent cardioversion. Trade Names - Digitoxin tab:®, Lanoxin tab:® Adult: Initial oral dose: 0.75–1.5 mg in divided doses over 24 hours (digitalizing dose), then maintenance 0.125–0.25 mg once daily. Child: Oral: 0.01–0.015 mg/kg/day in divided doses (based on age and renal function).
Digoxin specific antibody (Antidote)Indications - Digoxin poisoning. Trade Names - Inj: Digibind®, DigiFab® Adult: Dose depends on amount ingested or serum digoxin level; typically 38 mg vial neutralizes ~0.5 mg of digoxin. Child: Same as adult, dose adjusted by weight and serum level.
Calcitriol (Synthetic vitamin D) Indications - Renal osteodystrophy, hypocalcemia, secondary hyperparathyroidism, osteoporosis (including postmenopausal osteoporosis), mild to moderate plaque psoriasis. Contraindications - Hypercalcemia, hypervitaminosis D, hypersensitivity to calcitriol or vitamin D analogs. Cautions - Renal impairment, history of kidney stones, cardiac arrhythmias, dehydration. Avoid - Renal impairment, breastfeeding. Trade names - Liquical® Cap Drug interactions - Thiazide diuretics (may increase risk of hypercalcemia), digoxin, magnesium-containing antacids. Adult: Typically 0.25 to 0.5 mcg daily; dose adjusted based on serum calcium and clinical response. Child: Usually 0.25 to 0.5 mcg daily; dose individualized.
Ibandronic acid (Bisphosphonate) Indications - Reduction of bone damage in bone metastases from breast cancer, hypercalcaemia of malignancy, treatment and prevention of postmenopausal osteoporosis, prevention of skeletal fractures. Contraindications - Hypocalcaemia, esophageal abnormalities delaying esophageal emptying, inability to remain upright for at least 30 minutes after oral dose, hypersensitivity to ibandronic acid. Cautions - Cardiac disease, atypical femoral fractures, renal impairment, gastrointestinal disorders (esophagitis, gastritis), dental procedures (risk of osteonecrosis of the jaw). Avoid - Hypocalcaemia. Trade names - Bondronat tab:®, Bonviva tab:®, Bondronat inj:® Drug interactions - Calcium supplements, antacids, and other oral medications containing divalent cations (may reduce absorption if taken simultaneously). Adult: Oral 150 mg once monthly or 3 mg intravenous infusion every 3 months. Child: Not established; use in children not recommended.
Teriparatide (Calcium regulating drug) Indications - Treatment of osteoporosis in postmenopausal women and in men at increased risk of fractures, treatment of corticosteroid-induced osteoporosis. Contraindications - Paget’s disease of bone, unexplained elevations of alkaline phosphatase, prior radiation therapy involving the skeleton, hypercalcemia, hypersensitivity to teriparatide. Cautions - Hypercalcemia, history of bone malignancy or skeletal metastases, renal impairment. Avoid - Pregnancy, breastfeeding. Trade names - Forteo® (injection) Drug interactions - Calcium supplements and vitamin D (may increase serum calcium), digoxin (monitor for digitalis toxicity due to hypercalcemia). Adult: 20 mcg subcutaneously once daily. Child: Not established; use in children not recommended.
Alendronate, Alendronic acid (Bisphosphonate)Indications - Postmenopausal osteoporosis (brittle bones), osteoporosis in men, prevention and treatment of corticosteroid-induced osteoporosis in postmenopausal women. Contraindications - Hypocalcaemia, abnormalities of oesophagus (e.g. stricture or achalasia), inability to stand or sit upright for at least 30 minutes, hypersensitivity to alendronate. Cautions - Renal impairment, active upper gastrointestinal disorders (e.g. dysphagia, duodenitis, gastritis, ulcers), poor dental hygiene or dental procedures (risk of osteonecrosis of jaw). Avoid - Hypocalcaemia, pregnancy, breast feeding. Side Effects - Abdominal pain, dyspepsia, oesophagitis, musculoskeletal pain, osteonecrosis of jaw (rare), atypical femoral fractures. Trade Names - Ostim tab®, Maxmarvil®, Incepta®, Osto 70 mg Film Coated tab® Drug Interactions - Calcium supplements, antacids, iron, magnesium (reduce absorption); NSAIDs (increase GI irritation). Adult: 70 mg orally once weekly or 10 mg daily, taken with plain water at least 30 minutes before first food or drink. Child: Not recommended in children due to lack of safety and efficacy data.
Denosumab (Drug affecting bone structure) Indications - Treatment of osteoporosis in postmenopausal women and in men at increased risk of fractures, treatment of corticosteroid-induced osteoporosis, giant cell tumour of bone. Contraindications - Hypocalcemia, hypersensitivity to denosumab or any component of the formulation. Cautions - Hypocalcemia (correct before treatment), renal impairment, infections, dental problems (risk of osteonecrosis of the jaw). Avoid - Pregnancy, breastfeeding. Trade names - Prolia®, Xgeva® Drug interactions - May interact with calcium and vitamin D supplements; ensure adequate calcium and vitamin D intake. Adult: 60 mg subcutaneously every 6 months (osteoporosis), 120 mg subcutaneously every 4 weeks (giant cell tumour). Child: Not established; use in children is generally not recommended.
Risedronate sodium (Bisphosphonate) Indications - Paget's disease, postmenopausal osteoporosis, prevention of osteoporosis, treatment of osteoporosis in men at high risk of fractures. Contraindications - Hypocalcemia, esophageal abnormalities that delay esophageal emptying, inability to sit or stand upright for at least 30 minutes, hypersensitivity to risedronate or bisphosphonates. Cautions - Renal impairment, upper gastrointestinal disorders (e.g., GERD, gastritis), dental problems (risk of osteonecrosis of the jaw). Avoid - Pregnancy, breastfeeding. Trade names - Actonel®, Atelvia® Drug interactions - Calcium, antacids, and oral supplements containing magnesium or aluminum may reduce absorption; separate administration times. Adult: 5 mg once daily or 35 mg once weekly orally for osteoporosis; doses may vary for Paget's disease. Child: Not established; use in children is generally not recommended.
Dexamethasone (Corticosteroid) Indications - Local treatment of inflammation (short-term), macular oedema following branch or central retinal vein occlusion (specialist use only), visual impairment due to diabetic macular oedema in adults who are pseudophakic or insufficiently responsive or unsuitable for non-corticosteroid therapy (specialist use only), treatment of inflammation of the posterior segment of the eye presenting as non-infectious uveitis (specialist use only). Avoid - Bacterial meningitis, avoid abrupt cessation; taper gradually over 5–7 days. Cautions - Use with caution in systemic infections, diabetes mellitus, glaucoma, hypertension, and patients with peptic ulcer history. Drug Interactions - Enzyme inducers (e.g., rifampicin, phenytoin), NSAIDs, anticoagulants, antidiabetics, live vaccines. Trade Names - Dexamethasone tab: Decadron®, Dexpoten® syrup, Maxidex® eye drops (Specialist use only) Adult: Dose and route vary by indication; oral dose typically 0.5–10 mg daily in divided doses. Child: Individualized based on condition and weight; specialist supervision advised.
Iloprost (Synthetic prostaglandin, Prostacyclin analog) Indications - Idiopathic pulmonary arterial hypertension, pulmonary hypertension associated with connective tissue disease (specialist use). Avoid - Unstable angina, severe arrhythmia, active bleeding, breastfeeding. Cautions - Hypotension, hepatic impairment, history of syncope, chronic obstructive pulmonary disease. Drug Interactions - Antihypertensives (additive hypotensive effect), anticoagulants (increased bleeding risk), vasodilators. Trade Names - Ventavis® inhalation solution, Ilomedin® injection, Iloprost® tablets Adult: Inhalation: 2.5–5 micrograms per dose, 6–9 times daily depending on tolerance and need. Child: Not recommended (use only under strict specialist supervision).
Sodium Nitroprusside (Vasodilator) Indications - Hypertensive emergencies, acute heart failure, controlled hypotension during anaesthesia. Avoid - Compensatory hypertension, severe vitamin B12 deficiency, known hypersensitivity. Cautions - Hyponatraemia, hypothermia, hypothyroidism, hepatic impairment, renal impairment, pregnancy. Drug Interactions - Other antihypertensives, vasodilators, medications affecting cyanide metabolism (e.g., hydroxocobalamin). Trade Names - Nitropress® inj Adult: IV infusion starting at 0.3 mcg/kg/min; titrate up to a maximum of 10 mcg/kg/min based on BP response. Child: Use with extreme caution; initiate at 0.3–0.5 mcg/kg/min under specialist supervision.
Obeticholic Acid (Farnesoid X receptor agonist) Indications - Primary biliary cholangitis (PBC), in combination with ursodeoxycholic acid when response is inadequate or as monotherapy if UDCA is not tolerated. Avoid - Complete biliary obstruction, pregnancy, breastfeeding, decompensated cirrhosis. Cautions - Hepatic impairment, pruritus, gallstone history. Drug Interactions - Bile acid sequestrants (reduce absorption), warfarin, CYP1A2 substrates. Trade Names - Ocaliva® tab Adult: 5 mg once daily; may increase to 10 mg once daily after 6 months if tolerated. Child: Not recommended due to limited data.
Flecainide Acetate (Antiarrhythmic) Indications - Treatment of paroxysmal supraventricular tachycardia (including AV nodal reentrant and AV reentrant tachycardia), paroxysmal atrial fibrillation or flutter, and life-threatening ventricular arrhythmias. Contraindications - Second- or third-degree AV block, right bundle branch block with left hemiblock, cardiogenic shock, recent myocardial infarction. Cautions - Structural heart disease, renal or hepatic impairment, elderly, electrolyte imbalance. Avoid - Avoid use in chronic atrial fibrillation, pregnancy, and breastfeeding unless absolutely necessary. Trade Names - Tambocor® tab Drug Interactions - Increased risk of arrhythmia with other antiarrhythmics, beta-blockers, or calcium channel blockers. Inhibited by amiodarone and cimetidine. Adult: Oral: 50–150 mg twice daily; dose individualized based on response and ECG monitoring. Child: Oral: Initial 1–3 mg/kg/day in divided doses; max 6 mg/kg/day under specialist supervision.
Edrophonium (Short-acting acetylcholinesterase inhibitor)Indications - Used in the diagnosis of myasthenia gravis via the edrophonium (Tensilon) test; temporarily improves muscle strength in suspected cases. Contraindications - Known hypersensitivity to edrophonium or other anticholinesterases. Cautions - Bradycardia, cardiac conduction disorders, hypotension, peptic ulcer disease, seizure disorders. Avoid - Use with caution or avoid in patients with asthma, urinary or gastrointestinal obstruction, severe hepatic or renal impairment, pregnancy, or breastfeeding. Side Effects - Bradycardia, hypotension, excessive salivation, nausea, vomiting, abdominal cramps, muscle weakness, blurred vision, respiratory distress. Trade Names - inj: Tensilon® Drug Interactions - May enhance effects of other cholinergic drugs; antagonized by anticholinergics (e.g., atropine).Adult: IV: 2 mg as test dose followed by additional 8 mg if no adverse reaction; observe for immediate response (onset: 30–60 seconds; duration: 5–10 minutes). Child: IV: 0.1 mg/kg slowly under close monitoring; maximum single dose 5 mg.
Dronedarone (Antiarrhythmic)Indications - Maintenance of sinus rhythm in patients with paroxysmal or persistent atrial fibrillation who are in sinus rhythm or will be cardioverted. Contraindications - Severe hepatic impairment, NYHA class III/IV heart failure, permanent atrial fibrillation, second or third-degree AV block. Cautions - Electrolyte imbalance, QT prolongation, moderate hepatic or renal impairment. Avoid - Pregnancy, breastfeeding, bradycardia, concurrent use with strong CYP3A inhibitors or QT-prolonging agents. Trade Names - tab: Multaq® Drug Interactions - Avoid with potent CYP3A4 inhibitors (e.g., ketoconazole), digoxin, and warfarin (requires monitoring). Adult: Oral: 400 mg twice daily with meals. Child: Not recommended for use in children.
Adenosine (Antiarrhythmic)Indications - Rapid conversion to sinus rhythm in paroxysmal supraventricular tachycardia (PSVT), including PSVT associated with accessory bypass tracts (Wolff-Parkinson-White syndrome). Contraindications - Second or third-degree AV block, sick sinus syndrome (unless patient has a functioning pacemaker). Cautions - History of seizures, conduction disturbances, recent heart transplant, concomitant use of digoxin or verapamil. Avoid - Asthma, severe hypotension, obstructive pulmonary disease, long QT syndrome. Trade Names - inj: Adenocor® Drug Interactions - Increased effect with dipyridamole; antagonized by methylxanthines (e.g., theophylline, caffeine). Adult: 6 mg IV rapid bolus over 1–2 seconds; if ineffective, may give 12 mg after 1–2 minutes; may repeat once more if needed. Child: 0.05–0.1 mg/kg IV bolus; increase by 0.05–0.1 mg/kg every 1–2 minutes until conversion or max 0.3 mg/kg or 12 mg total dose.
Emicizumab (Monoclonal antibody)Indications - Prophylaxis to prevent or reduce the frequency of bleeding episodes in patients with hemophilia A (congenital factor VIII deficiency) with or without factor VIII inhibitors. Contraindications - Known hypersensitivity to emicizumab or any excipients. Cautions - Use effective contraception during treatment and for 6 months after the last dose; monitor for thrombotic microangiopathy when used with activated prothrombin complex concentrate. Avoid - Breastfeeding; use caution in patients with history of thrombosis. Trade Names - inj: Hemlibra® (Initiate by a specialist) Drug Interactions - Avoid concurrent use with activated prothrombin complex concentrate due to risk of thrombotic events. Adult: Loading dose: 3 mg/kg SC weekly for 4 weeks; then maintenance 1.5 mg/kg weekly or 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks. Child: Same dosing as adults; based on body weight, under specialist supervision.
Nimodipine (Calcium channel blocker)Indications - Prevention and treatment of ischemic neurological deficits following aneurysmal subarachnoid hemorrhage. Contraindications - Hypersensitivity to nimodipine or other dihydropyridine calcium channel blockers. Cautions - Hypotension, raised intracranial pressure, hepatic impairment, elderly patients, pregnancy. Avoid - Unstable angina, breastfeeding, concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin). Trade Names - tab: Nimotop® Drug Interactions - Increased plasma levels with CYP3A4 inhibitors; reduced effect with CYP3A4 inducers (e.g., rifampin, carbamazepine). Adult: 60 mg orally every 4 hours for 21 days, starting within 96 hours of subarachnoid hemorrhage. Child: Not established; use only under specialist guidance if necessary.
Etofenamate (Antirheumatic)Indications - Topical treatment of pain and inflammation in musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, tendonitis, and sprains. Contraindications - Known hypersensitivity to etofenamate, other NSAIDs, or excipients; broken or infected skin. Cautions - Avoid contact with eyes and mucous membranes; use with caution in patients with history of asthma or allergic reactions to NSAIDs. Avoid - Open wounds, eczema, pregnancy (especially third trimester), breastfeeding. Trade Names - gel: Dolo-Denk® Drug Interactions - Minimal systemic absorption, but caution with systemic NSAIDs due to potential cumulative effects. Adult: Apply 3–5 cm of gel to the affected area 3–4 times daily and massage gently. Child: Not recommended for children under 14 years of age.
Disodium hydrogen citrate (Urinary alkaliniser)Indications - Relief of dysuria, urinary tract infections, urinary alkalinisation. Contraindications - Severe renal impairment, metabolic alkalosis, sodium-restricted diets. Cautions - Cardiac disease, hypertension, renal impairment; monitor serum electrolytes with prolonged use. Avoid - In patients with sodium overload or hyperkalaemia risk. Trade Names - oral soln: Alkacitron® Drug Interactions - May affect the excretion of weakly basic or acidic drugs by altering urinary pH. Adult: 5–10 mL diluted in water, 3 times daily after meals. Child: Not recommended unless prescribed by a specialist.
Epoprostenol (Prostacyclin analogue)Indications - Pulmonary arterial hypertension, prevention of platelet aggregation during haemodialysis (specialist use). Contraindications - Heart failure due to severe left ventricular dysfunction, active bleeding, hypersensitivity. Cautions - Hypotension, bleeding disorders, pulmonary oedema; monitor blood pressure and platelet count. Avoid - Abrupt discontinuation; avoid use in conditions with increased bleeding risk. Trade Names - Flolan inj:®, Veletri inj:® (Specialist use only) Drug Interactions - May enhance effects of antihypertensives, anticoagulants, and antiplatelets. Adult: Initially 2 ng/kg/min IV infusion, titrated to effect and tolerance. Child: Dose under specialist supervision only.
Phenindione (Oral anticoagulant)Indications - Prophylaxis and treatment of venous thrombosis and pulmonary embolism, prophylaxis of embolisation in rheumatic heart disease. Contraindications - Active bleeding, severe hepatic impairment, recent surgery, pregnancy. Cautions - Renal impairment, hepatic impairment, elderly; frequent INR monitoring required. Avoid - Breastfeeding, alcohol consumption, NSAIDs, or other agents affecting clotting. Trade Names - Dindevan tab:® Drug Interactions - Potentiated by antibiotics, NSAIDs, and other anticoagulants; antagonised by vitamin K. Adult: Initial: 200–300 mg daily for 2 days, then adjust based on INR (typical maintenance 25–100 mg/day). Child: Dose individualized based on INR, under specialist supervision only.
Nicardipine HCl (Calcium channel blocker, Dihydropyridine)Indications - Prophylaxis of angina, mild to moderate hypertension, life-threatening hypertension, post-operative hypertension. Contraindications - Acute porphyria, cardiogenic shock, significant aortic stenosis, unstable or acute angina. Cautions - Congestive heart failure, elderly, pulmonary oedema; withdraw if ischaemic pain occurs or worsens within 30 minutes of treatment. Side Effects - (IV use): Atrioventricular block, erythema, hepatic disorders, paralytic ileus. (Oral): Abdominal discomfort, angina, asthenia, depression, drowsiness, dyspnoea, erectile dysfunction, hepatic impairment, renal impairment, skin reactions, increased urinary frequency. Avoid - Pregnancy, breastfeeding, severe hepatic or renal impairment. Trade Names - Cardene cap:®, inj:® Drug Interactions - May increase plasma levels of cyclosporine; enhanced hypotensive effect with other antihypertensives. Adult: Oral: 20–40 mg 3 times daily. IV: Initial 5 mg/hr, increase by 2.5 mg/hr every 5 min if needed (max 15 mg/hr). Child: IV: 0.5–3 mcg/kg/min; adjust per BP response (specialist use).
Imidapril HCl (Angiotensin-converting enzyme (ACE) inhibitor) Indications - Hypertension, especially in patients with angina or congestive heart failure. Cautions - Renal impairment, hypotension, hyperkalemia, dehydration, elderly. Trade Names - Tanatril tab:® Drug Interactions - Increased risk of hyperkalemia with potassium-sparing diuretics or supplements; additive hypotensive effect with other antihypertensives. Adult: Initial: 5–10 mg once daily; maximum: 20 mg once daily. Child: Safety and efficacy not established in children.
Carvedilol (Beta-blocker) Indications - Hypertension, angina pectoris, chronic heart failure. Contraindications - Acute or decompensated heart failure, bronchial asthma, severe bradycardia, heart block, cardiogenic shock. Avoid - Severe hepatic impairment. Side Effects - Anemia, asthma exacerbation, dyspepsia, eye irritation, fluid retention, genital edema, hypercholesterolemia, hyper/hypoglycemia, infection risk, peripheral edema, pulmonary edema, renal dysfunction, urinary disorders, weight gain. Trade Names - Carvil 3.125 mg tab:®, Carvecard 6.25 mg tab:®, Carvipress 3.125 mg tab:® Drug Interactions - May enhance the effect of other antihypertensives; caution with CYP2D6 inhibitors; risk of bradycardia with digoxin. Adult: Hypertension: 12.5–25 mg once daily; Heart failure: Start at 3.125 mg twice daily, titrate gradually. Child: Dosage to be determined by a specialist; limited pediatric data.
Co-amilozide (Potassium-sparing and thiazide diuretic combination) Indications - Hypertension, congestive heart failure, oedema and ascites due to liver cirrhosis. Contraindications - Anuria, hyperkalemia, severe renal impairment. Cautions - Diabetes mellitus, elderly, liver disease, risk of electrolyte imbalance. Avoid - Breastfeeding. Trade Names - Moduretic tab:® Drug Interactions - Increased risk of hyperkalemia with ACE inhibitors, ARBs, NSAIDs, and potassium supplements. Adult: Usually 1 tab daily (containing 5 mg amiloride + 50 mg hydrochlorothiazide). Child: Not recommended unless under specialist supervision.
Indapamide (Thiazide-like diuretic) Indications - Hypertension, edema associated with congestive heart failure. Contraindications - Severe renal or hepatic impairment, sulfonamide allergy. Cautions - Electrolyte imbalance, gout, diabetes, acute porphyrias. Avoid - Breastfeeding. Trade Names - Natrilix tab:® Drug Interactions - May enhance effects of other antihypertensives; risk of hypokalemia with corticosteroids, digitalis toxicity. Adult: 1.5 mg modified-release once daily or 2.5 mg standard tab once daily. Child: Not recommended.
Fosinopril sodium (Angiotensin-converting enzyme (ACE) inhibitor) Indications - Hypertension, congestive heart failure (adjunct). Contraindications - History of angioedema, pregnancy, bilateral renal artery stenosis. Cautions - Hepatic impairment, renal impairment, elderly, dehydration. Avoid - In pregnancy and during breastfeeding. Trade Names - Monopril tab:® Drug Interactions - Increased risk of hyperkalemia with potassium-sparing diuretics or supplements; NSAIDs may reduce antihypertensive effect. Adult: Initial: 10 mg once daily; maintenance: 10–40 mg once daily. Child: Safety and efficacy not established.
Azilsartan medoxomil (Angiotensin II receptor blocker, ARB) Indications - Hypertension, including in patients with intravascular volume depletion. Contraindications - Pregnancy, severe hepatic impairment, biliary obstructive disorders. Cautions - Heart failure, renal artery stenosis, renal impairment, volume depletion. Avoid - Pregnancy, breastfeeding. Trade Names - Edarbi tab:® Drug Interactions - May increase serum potassium with potassium-sparing diuretics; NSAIDs may reduce effect and impair renal function. Adult: Initial: 40 mg once daily; may be increased to 80 mg if needed. Child: Not recommended due to insufficient data.
Candesartan cilexetil (Angiotensin II receptor blocker, ARB) Indications - Hypertension, hypertension with intravascular volume depletion, heart failure (adjunct). Contraindications - Pregnancy, severe hepatic impairment, cholestasis, biliary obstructive disorders. Cautions - Renal artery stenosis, volume depletion, renal impairment. Avoid - In pregnancy and in patients with severe hepatic dysfunction. Trade Names - Atacand tab:® Drug Interactions - Risk of hyperkalemia with potassium-sparing diuretics; NSAIDs may reduce efficacy and impair renal function. Adult: Initially 8 mg once daily, can be increased to 16–32 mg once daily depending on response. Child: Children 1–17 years: 0.2–0.4 mg/kg once daily; adjust as needed under specialist supervision.
Eprosartan (Angiotensin II receptor blocker, ARB) Indications - Hypertension. Contraindications - Pregnancy, bilateral renal artery stenosis. Cautions - Renal impairment, volume depletion, hepatic impairment. Avoid - In pregnancy and in severe hepatic dysfunction. Trade Names - Teveten tab:® Drug Interactions - Additive hypotension with diuretics; risk of hyperkalemia with potassium supplements or potassium-sparing diuretics. Adult: 600–800 mg once daily or in divided doses. Child: Not recommended due to lack of safety data.
Aliskiren (Direct Renin Inhibitor) Indications - Essential hypertension. Contraindications - Pregnancy, severe renal impairment, concomitant use with ACE inhibitors or ARBs in patients with diabetes. Cautions - Mild to moderate renal impairment, volume depletion, electrolyte imbalance. Avoid - Use with potassium-sparing diuretics or potassium supplements without monitoring. Trade Names - Rasilez tab:® Drug Interactions - May increase serum potassium with ACE inhibitors, ARBs, or potassium supplements; reduced bioavailability with high-fat meals. Adult: 150 mg once daily; may increase to 300 mg once daily if needed. Child: Not recommended due to limited safety data.
Minoxidil (Direct-acting Peripheral Vasodilator) Indications - Severe hypertension resistant to conventional therapy. Contraindications - Pheochromocytoma, acute myocardial infarction, aortic dissection. Cautions - Must be used with a beta-blocker and diuretic to prevent reflex tachycardia and fluid retention; use caution in heart failure and renal impairment. Avoid - Monotherapy, abrupt withdrawal. Trade Names - Loniten tab:® Drug Interactions - Additive hypotension with other antihypertensives; enhanced fluid retention with NSAIDs. Adult: Initially 5 mg daily; usual range 10–40 mg daily in 1–2 divided doses. Child: 200–1000 mcg/kg/day in 2–3 divided doses; adjust based on response and tolerance.
Phentolamine Mesilate (Alpha-Adrenergic Blocker) Indications - Pheochromocytoma (diagnosis and management), hypertensive crisis due to MAOI or stimulant overdose, extravasation of vasoconstrictors. Contraindications - Coronary artery disease, hypotension. Cautions - Tachycardia, gastric or duodenal ulcers, elderly patients; monitor BP closely. Avoid - Use in patients with angina or recent MI without specialist advice. Trade Names - Regitine inj:® Drug Interactions - May potentiate effects of other antihypertensives; additive hypotensive effects with nitrates and diuretics. Adult: 2.5–5 mg IV, may repeat every few minutes as needed. Child: 0.05–0.1 mg/kg IV (maximum 5 mg per dose).
Ambrisentan (Endothelin Receptor Antagonist) Indications - Pulmonary arterial hypertension. Contraindications - Pregnancy, breastfeeding, severe hepatic impairment. Cautions - Renal impairment, requires effective contraception before and during treatment. Avoid - Use in pregnancy and lactation. Trade Names - Volibris tab:® (Under specialist supervision) Drug Interactions - CYP3A4 inducers/inhibitors may affect plasma levels; avoid with strong inhibitors. Adult: 5 mg once daily, may increase to 10 mg once daily if tolerated. Child: Not recommended.
Bosentan (Endothelin Receptor Antagonist) Indications - Pulmonary arterial hypertension. Contraindications - Pregnancy, breastfeeding, moderate to severe hepatic impairment, concurrent cyclosporine use. Cautions - Liver function abnormalities, anaemia; requires contraception before and during treatment. Avoid - Use in pregnancy, breastfeeding, and in moderate to severe hepatic impairment. Trade Names - Tracleer tab:® (Under specialist supervision) Drug Interactions - CYP3A4 and CYP2C9 inducers/inhibitors may alter plasma levels; interacts with cyclosporine and glyburide. Adult: 62.5 mg twice daily for 4 weeks, then 125 mg twice daily. Child: Initially 2 mg/kg twice daily (adjust per specialist).
Macitentan (Endothelin Receptor Antagonist) Indications - Pulmonary arterial hypertension. Contraindications - Pregnancy, breastfeeding, severe hepatic impairment. Cautions - Anaemia, hepatic dysfunction; requires effective contraception before and during treatment. Avoid - Use in pregnancy and breastfeeding. Trade Names - Opsumit tab:® (Under specialist supervision) Drug Interactions - May interact with CYP3A4 inducers/inhibitors affecting plasma concentrations. Adult: 10 mg once daily. Child: Not recommended.
Midodrine HCl (Alpha-1 agonist) Indications - Severe orthostatic hypotension due to autonomic dysfunction. Avoid - Severe organic heart disease, acute renal disease, urinary retention, thyrotoxicosis. Cautions - Hypertension while lying down, renal impairment; regular blood pressure monitoring required. Trade Names - tab: Bramox® (Under specialist supervision) Adult: 2.5 mg 2–3 times daily; maximum 10 mg three times daily. Child: Not recommended.
Co-flumactone (Aldosterone antagonist + thiazide diuretic) Indications - Oedema, congestive heart failure, hypertension (when potassium conservation is needed). Avoid - Addison’s disease, hyperkalaemia, severe renal impairment. Cautions - Diabetes, gout, electrolyte disturbances, hepatic impairment. Trade Names - tab:® (Under specialist supervision) Adult: One tablet daily (contains 50 mg potassium canrenoate + 20 mg hydrochlorothiazide). Child: Not recommended.
Eplerenone (Aldosterone antagonist) Indications - Hypertension, heart failure post-myocardial infarction. Avoid - Hyperkalaemia, severe renal impairment, Addison’s disease. Cautions - Diabetes, electrolyte disturbances, hepatic impairment. Trade Names - tab: Inspra® (Under specialist supervision) Adult: 25–50 mg once daily. Child: Not recommended.
Cholic acid (Bile acid) Indications - Bile acid synthesis disorders, cerebrotendinous xanthomatosis. Avoid - Hypersensitivity to cholic acid. Cautions - Liver impairment. Trade Names - oral granules: Orphacol® (Under specialist supervision) Adult: 15 mg/kg daily in divided doses. Child: 15 mg/kg daily in divided doses.
Lenalidomide (Immunomodulatory agent) Indications - Multiple myeloma, myelodysplastic syndromes. Avoid - Pregnancy, breastfeeding, hypersensitivity. Cautions - Thrombosis risk, haematological toxicity, renal impairment. Trade Names - cap: Revlimid® (Under specialist supervision) Adult: Depends on indication and regimen. Child: Not recommended.
Naloxegol (Peripherally acting opioid antagonist) Type of Drug - Peripherally acting μ-opioid receptor antagonist (PAMORA), used for opioid-induced constipation. Indications - Opioid-induced constipation in adults with chronic non-cancer pain. Contraindications - Suspected or known gastrointestinal obstruction, hypersensitivity to naloxegol or its components, use with strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole). Avoid - Pregnancy, breastfeeding, severe hepatic impairment, advanced ovarian cancer. Cautions - Alzheimer’s disease, cardiovascular disease, congestive heart failure, Crohn’s disease, diverticulitis, peptic ulcer disease, recent myocardial infarction (within 6 months), moderate hepatic or renal impairment. Side Effects - Abdominal pain, diarrhea, nausea, flatulence, headache, vomiting, potential opioid withdrawal symptoms. Trade Names - Movantik tab:® Drug Interactions - Avoid strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin), caution with moderate inhibitors (e.g., diltiazem), avoid inducers like rifampin. Adult: 25 mg once daily on an empty stomach; consider 12.5 mg if using a moderate CYP3A4 inhibitor or in renal impairment. Child: Not recommended for pediatric use.
Prucalopride (Laxative, selective 5-HT4 receptor agonist) Indications - Chronic constipation, especially in patients with inadequate response to laxatives. Contraindications - Intestinal obstruction, severe inflammatory bowel disease (e.g., ulcerative colitis, Crohn’s disease), hypersensitivity to prucalopride. Avoid - Pregnancy, breastfeeding, intestinal obstruction, severe ulcerative colitis. Cautions - History of arrhythmias, ischemic heart disease, severe renal impairment, need for contraception in women of childbearing potential. Drug Interactions - Use with caution with other drugs affecting QT interval, serotoninergic drugs (risk of serotonin syndrome). Trade Names - Resolor® tab:® Adult: 2 mg orally once daily, may be reduced to 1 mg in renal impairment. Child: Not recommended.
Macrogol (Osmotic laxative) Indications - Chronic constipation, bowel cleansing prior to colonoscopy. Contraindications - Intestinal obstruction, known or suspected bowel perforation, toxic megacolon. Avoid - Intestinal obstruction. Cautions - Electrolyte imbalance with prolonged use, caution in renal impairment. Drug Interactions - May reduce absorption of other oral medications if taken simultaneously; separate dosing recommended. Trade Names - Movicol® powder for oral solution:® Adult: Typically 2 sachets daily, dissolved in water, can be adjusted as per clinical response. Child: Dose individualized according to age and weight, often lower than adult dosing.
Sterculia (Laxative, Bulk-forming) Indications - Constipation, especially in patients where straining should be avoided (e.g., hemorrhoids, post-surgery). Contraindications - Fecal impaction, intestinal obstruction, colonic atony, infective bowel disease, difficulty swallowing. Cautions - Ensure adequate fluid intake to prevent intestinal obstruction; use with caution in the elderly and those with gastrointestinal motility disorders. Avoid - Use in patients with difficulty swallowing or those at risk of esophageal blockage. Trade Names - Normacol® granules, Regulan® tab Drug Interactions - May reduce absorption of other oral medications; separate doses by at least 1–2 hours. Adult: Typically 1–2 sachets (granules) or tablets once or twice daily with plenty of water. Child: Half adult dose; adjust according to age and response, ensure high fluid intake.
Sterculia with Frangula (Laxative, Bulk-forming with stimulant) Indications - Constipation, particularly suitable after haemorrhoidectomy or in patients requiring a gentle stimulant effect. Contraindications - Fecal impaction, intestinal obstruction, colonic atony, acute surgical abdomen, inflammatory bowel disease, undiagnosed abdominal pain. Cautions - Ensure adequate fluid intake to prevent intestinal obstruction; use with caution in the elderly and those with gastrointestinal motility disorders. Avoid - Use in patients with difficulty swallowing or dehydration; long-term use without medical supervision. Trade Names - Normacol Plus® granules Drug Interactions - May reduce absorption of other oral medications; separate doses by at least 1–2 hours. Adult: 1–2 sachets or heaped teaspoons of granules once or twice daily with a full glass of water. Child: Use under medical supervision; generally half the adult dose depending on age.
Methylcellulose (Laxative, Bulk-forming agent) Indications - Constipation, adjunct in the management of diarrhoea (to increase stool bulk). Contraindications - Fecal impaction, intestinal obstruction, colonic atony, undiagnosed abdominal pain, acute surgical abdomen, difficulty swallowing. Cautions - Ensure adequate fluid intake to avoid esophageal or intestinal obstruction; use with caution in elderly or debilitated patients. Avoid - Use in patients with dehydration or difficulty in maintaining fluid intake. Trade Names - Citrucel® tab, Celevac® tab Drug Interactions - May interfere with absorption of other oral medications—administer at least 1–2 hours apart. Adult: 1 g three times daily with a full glass of water. Child: 500 mg up to 6 times daily, with adequate fluids; use under medical supervision.
Balsalazide Sodium (5-aminosalicylic acid prodrug, Anti-inflammatory) Indications - Treatment and maintenance of remission in mild to moderate ulcerative colitis. Contraindications - Hypersensitivity to salicylates or aminosalicylates, severe hepatic or renal impairment, intestinal obstruction. Avoid - Use during pregnancy and in patients with known renal impairment unless clearly necessary. Cautions - History of asthma, hepatic impairment, blood dyscrasias, elderly patients. Drug Interactions - Nephrotoxic agents (e.g., NSAIDs), azathioprine, 6-mercaptopurine (increased risk of myelosuppression). Trade Names - Colazide® cap Adult: 2.25 g (three 750 mg capsules) twice daily or as directed. Child: Over 5 years: typically 750 mg three times daily; dosage may vary based on age and weight under specialist supervision.
Venlafaxine HCl (Serotonin-Norepinephrine Reuptake Inhibitor - SNRI, Antidepressant) Indications - Major depressive disorder, generalised anxiety disorder, social anxiety disorder, menopausal symptoms (off-label). Contraindications - Concurrent use with MAO inhibitors, uncontrolled hypertension, cardiac arrhythmias. Avoid - Pregnancy, breastfeeding, severe cardiac disease. Cautions - Hepatic impairment, renal impairment, bleeding disorders, seizure risk, glaucoma, history of mania or bipolar disorder. Drug Interactions - MAO inhibitors (risk of serotonin syndrome), anticoagulants (increased bleeding risk), SSRIs/SNRIs, CNS depressants, CYP2D6 and CYP3A4 inhibitors. Trade Names - VENICE® 75 mg cap Adult: Initial: 75 mg/day in divided doses; may increase up to 150–225 mg/day depending on response and tolerability. Child: Not recommended (efficacy and safety not established).
Amitriptyline HCl (Tricyclic antidepressant) Indications - Abdominal pain or discomfort (in patients who have not responded to laxatives, loperamide, or antispasmodics), major depressive disorder especially in patients with cardiovascular disease, enuresis, neuropathic pain, migraine prophylaxis, chronic tension-type headache prophylaxis. Avoid - Arrhythmias, during manic phase of bipolar disorder, heart block, immediate recovery period after myocardial infarction. Contraindications - Hypersensitivity to amitriptyline, recent myocardial infarction, concomitant use with MAO inhibitors. Cautions - Seizure disorders, angle-closure glaucoma, urinary retention, elderly patients, hepatic impairment. Drug Interactions - MAO inhibitors (risk of serotonin syndrome), CNS depressants, alcohol, other serotonergic drugs, antihypertensives (may enhance hypotensive effect), QT prolonging drugs. Trade Names - Tripnatol FC-25 tab: Adult: Typically 25–150 mg daily in divided doses or at night, adjusted according to response. Child: Use with caution, usually lower doses; specific pediatric dosing depends on indication and clinical judgment.
Duloxetine (Antidepressant) Indications - Major depressive disorder, Generalised anxiety disorder, Diabetic peripheral neuropathy, Stress urinary incontinence. Avoid - Pregnancy, breastfeeding, hepatic or severe renal impairment. Cautions - Bleeding disorders, cardiac disease, elderly, history of mania or seizures, hypertension, raised intraocular pressure. Duzela 20 mg Cap:® Adult: Initial: 30–60 mg once daily; max 120 mg/day. Child: Not recommended for most indications.
Citalopram (Antidepressant) Indications - Depressive illness, panic disorder. Avoid - Abrupt withdrawal. Cautions - Hepatic impairment, QT prolongation, electrolyte imbalance. tab:®, Cap:® Adult: Initial: 20 mg daily; max 40 mg/day (elderly: max 20 mg/day). Child: Not routinely recommended.
Escitalopram (Antidepressant) Indications - Depressive illness, panic disorder, social anxiety disorder, generalised anxiety disorder. Avoid - Pregnancy, breastfeeding, abrupt withdrawal. Cautions - Hepatic and renal impairment (adjust dose), seizure risk. Side Effects - May cause sinusitis, nausea, insomnia. Esirav-5 tab:®, Esirav-10 tab:®, Esirav-20 tab:®, Nexito tab:®, Escivex tab:® Adult: Initial: 10 mg daily; may increase to 20 mg/day. Child: For selected indications only, under specialist supervision.
Moclobemide (Antidepressant, MAO-A inhibitor) Indications - Depressive illness, Social anxiety disorder. Contraindications - Use with non-selective MAO inhibitors, pethidine, SSRIs within 14 days. Avoid - Pregnancy, Breastfeeding. Cautions - Hepatic impairment. Trade Names - Aurorix®, Manerix® Adult: Initial: 300 mg/day in divided doses; may increase to 600 mg/day. Child: Not recommended.
Reboxetine (Antidepressant, NRI) Indications - Major depressive disorder. Contraindications - Concurrent MAO inhibitors. Avoid - Abrupt withdrawal. Cautions - Bipolar disorder, cardiovascular disease, epilepsy, prostatic hypertrophy, hepatic/renal impairment. Trade Names - Edronax®, Vestra® Adult: 4 mg twice daily; may increase to 10–12 mg/day. Child: Not recommended.
Isocarboxazid (Antidepressant, MAOI) Indications - Depressive illness when other treatments have failed. Contraindications - Concurrent tyramine‑rich diet, SSRIs, dextromethorphan. Avoid - Breastfeeding. Cautions - Renal impairment, hypertension, epilepsy. Trade Names - Marplan® Adult: 10 mg twice daily; max 60 mg/day. Child: Not recommended.
Phenelzine (Antidepressant, MAOI) Indications - Treatment-resistant depressive illness. Contraindications - Breastfeeding, pheochromocytoma, cardiovascular disease. Avoid - Tyramine-rich foods. Cautions - Renal impairment, cardiovascular disease. Trade Names - Nardil®, Metatens® Adult: 15 mg three times daily; max 90 mg/day. Child: Not recommended.
Tranylcypromine (Antidepressant, MAOI) Indications - Depressive illness (especially atypical features). Contraindications - Breastfeeding, congestive HF, hepatic disease, hyperthyroidism. Avoid - Tyramine-rich foods. Cautions - Elderly, renal impairment, dietary restrictions. Trade Names - Parnate®, Jatrosom® Adult: 10 mg twice daily; max 60 mg/day. Child: Not recommended.
Agomelatine (Antidepressant, Melatonergic agonist & 5‑HT₂C antagonist) Indications - Major depressive disorder. Contraindications - Dementia, age > 75, pregnancy, breastfeeding. Avoid - Severe hepatic impairment. Cautions - Hepatic/renal impairment, alcoholism, bipolar disorder, diabetes, obesity, fatty liver. Trade Names - Valdoxan®, Thymorel® Adult: 25 mg at bedtime; may increase to 50 mg after 2 weeks. Child: Not recommended.
Acenapine (Atypical Antipsychotic) Indications - Manic episodes associated with bipolar I disorder, Schizophrenia. Avoid - Breastfeeding. Cautions - Dementia with Lewy Bodies, Pregnancy, Hepatic and Renal impairment. Trade Names - Saphris® Adult: 5–10 mg sublingually twice daily. Child: Not established.
Benzodiazepines (Sedative, Hypnotic, Anxiolytic) Indications - Anxiety, Insomnia, Status epilepticus, Muscle spasms, Premedication. Avoid - Acute pulmonary insufficiency, Neuromuscular weakness, Sleep apnoea, Prolonged use, Pregnancy. Cautions - Debilitated patients, Hepatic and Renal impairment, Elderly, History of substance abuse. Trade Names - Diazepam (Valium®), Lorazepam (Ativan®), Alprazolam (Xanax®), Clonazepam (Klonopin®) Adult: Varies by agent. Example: Diazepam 2–10 mg orally 2–4 times daily. Child: Weight-based; e.g., Diazepam 0.12–0.8 mg/kg/day in divided doses.
Vigabatrin (Antiepileptic) Indications - Refractory focal seizures, Infantile spasms (West syndrome). Avoid - Visual field defects, Breastfeeding. Cautions - Pregnancy, Renal impairment, Elderly, History of psychosis, Depression, Behavioural issues. Trade Names - Sabril® Adult: Initial: 500 mg twice daily; max 3 g/day. Child: 40–50 mg/kg/day in divided doses (for infantile spasms).
Tiagabine (Antiepileptic) Indications - Adjunct for focal seizures. Avoid - Acute porphyrias. Cautions - Hepatic impairment. Trade Names - Gabitril® Adult: 4–56 mg/day in divided doses; start low, titrate weekly. Child: Safety and efficacy not established.
Stiripentol (Antiepileptic) Indications - Dravet syndrome (severe myoclonic epilepsy in infancy). Avoid - History of psychosis, Hepatic or Renal impairment. Cautions - Pregnancy, Breastfeeding. Trade Names - Diacomit® Adult: Not typically used in adults; dosing based on body weight. Child: 50 mg/kg/day in 2–3 divided doses.
Perampanel (Antiepileptic) Indications - Adjunctive treatment of focal seizures and primary generalized tonic-clonic seizures. Avoid - Pregnancy, Breastfeeding, Severe renal impairment. Cautions - Hepatic impairment. Trade Names - Fycompa® Adult: 2–12 mg once daily at bedtime. Child: ≥4 years: Start 2 mg/day, titrate to max 12 mg/day.
Phenytoin (Antiepileptic) Indications - Focal and generalized tonic-clonic seizures, Status epilepticus, Post-traumatic seizure prophylaxis. Avoid - Acute porphyrias, Heart block, Sinus bradycardia. Cautions - Heart failure, Hypotension, Respiratory depression, Hepatic impairment, Pregnancy, IM administration. Trade Names - Dilantin®, Eptoin® Adult: 300–400 mg/day orally in divided doses; loading dose: 15–20 mg/kg IV. Child: 5 mg/kg/day in 2–3 divided doses; adjust per plasma levels.
Brivaracetam (Antiepileptic) Indications - Adjunctive therapy for focal seizures with or without secondary generalisation. Avoid - Pregnancy, Breastfeeding, Abrupt withdrawal. Cautions - Hepatic impairment. Trade Names - Briviact® Adult: Initial 50 mg twice daily; adjust between 25–100 mg twice daily. Child: ≥4 years: 1–2 mg/kg twice daily; max 100 mg/day.
Memantine HCl (NMDA receptor antagonist) Indications - Moderate to severe dementia in Alzheimer's disease. Avoid - Pregnancy, Breastfeeding, Severe hepatic impairment. Cautions - Renal impairment, Epilepsy, History of seizures. Trade Names - Namenda®, Ebixa®, Admenta® Adult: Start 5 mg once daily; increase weekly to 20 mg/day (10 mg twice daily). Child: Not recommended.
Rivastigmine (Cholinesterase inhibitor) Indications - Mild to moderate dementia in Alzheimer’s and Parkinson’s disease. Avoid - Bladder outflow obstruction, Peptic ulcers, Asthma, COPD. Cautions - Conduction abnormalities, History of seizures, Risk of overdose with patch use, Susceptibility to ulcers. Interactions - Centrally acting anticholinesterases. Side Effects - Anxiety, Appetite loss, Arrhythmia, Diarrhea, Dizziness, Fall risk, GI discomfort, Tremor, UTI, Vomiting, Weight loss. Trade Names - Exelon®, Rivamer®, Rivamer Patch® Adult: Oral: 1.5 mg twice daily; max 6 mg twice daily. Patch: start with 4.6 mg/24h; max 13.3 mg/24h. Child: Not recommended.
Erdosteine (Mucolytic, Expectorant) Indications - Symptomatic treatment of acute exacerbations of chronic bronchitis. Avoid - Pregnancy, Breastfeeding. Cautions - Peptic ulcer history, Hepatic impairment. Trade Names - Erdotin®, Erdomed®, Mucolite® Adult: 300 mg twice daily. Child: Children >2 years: 150 mg twice daily (adjusted per age).
Chlorphenamine Maleate (Antihistamine) Indications - Emergency treatment of anaphylaxis, symptomatic relief of allergy (e.g., hay fever, urticaria, food allergy, drug reactions). Avoid - Newborns, breastfeeding (relative), narrow-angle glaucoma. Cautions - Elderly, epilepsy, urinary retention, prostatic hypertrophy. Trade Names - Piriton®, Allerest®, Histal® Adult: 4 mg every 4–6 hours; max 24 mg/day. Child: 2–6 years: 1 mg every 4–6 hours. 6–12 years: 2 mg every 4–6 hours. Max 12 mg/day.
Rupatadine (Antihistamine) Indications - Symptomatic relief of allergic rhinitis and urticaria. Avoid - Hepatic impairment, Renal impairment, Pregnancy, Breastfeeding. Cautions - Elderly, hypokalaemia, history of QT prolongation. Trade Names - Rupanex®, Rupall®, Rinialer® Adult: 10 mg once daily. Child: 2–11 years: 5 mg once daily (oral solution).
Mizolastine (Antihistamine) Indications - Relief of allergic conditions such as hay fever and urticaria. Avoid - Cardiac disease, Hypokalaemia, Pregnancy, Breastfeeding. Trade Names - Mizollen® Adult: 10 mg once daily. Child: Not recommended under 12 years.
Bilastine (Antihistamine) Indications - Symptomatic treatment of allergic rhinitis and urticaria. Avoid - Acute porphyrias, Pregnancy, Breastfeeding. Cautions - Elderly, renal impairment. Trade Names - Bilano®, Bilaxten®, Bilasure® Adult: 20 mg once daily. Child: 6–11 years: 10 mg once daily.
Acrivastine (Antihistamine) Indications - Hay fever, chronic idiopathic urticaria. Avoid - Acute porphyrias, Pregnancy, Breastfeeding, Renal impairment. Trade Names - Benadryl Allergy Relief® Adult: 8 mg up to 3 times daily. Child: Not recommended under 12 years.
Theophylline (Bronchodilator) Indications - Chronic asthma, Severe acute asthma, Reversible airway obstruction. Cautions - Arrhythmias, Elderly, Fever, Hypertension, Hyperthyroidism, Peptic ulcer. Trade Names - Deriphylline Retard 300®, Unicontin®, Theodur® Adult: 200–400 mg 12 hourly (modified-release); adjusted per serum level. Child: 10–16 mg/kg/day in 2 divided doses.
Ciclesonide (Inhaled corticosteroid) Indications - Prophylaxis of asthma. Cautions - Hepatic impairment. Trade Names - Alvesco®, Omnaris® (nasal) Adult: 80–320 mcg once daily. Child: ≥12 years: same as adults; under 12 years: dose per physician.
Olodaterol (Long-acting β2 agonist) Indications - Maintenance treatment of chronic obstructive pulmonary disease (COPD). Avoid - Pregnancy, Breastfeeding. Cautions - Aneurysm, Seizure disorders, Hepatic impairment. Trade Names - Striverdi Respimat® Adult: 5 mcg once daily via inhaler. Child: Not recommended under 18 years.
Indacaterol (Long-acting β2 agonist) Indications - Chronic obstructive pulmonary disease (COPD). Avoid - Breastfeeding. Cautions - Hepatic impairment, Pregnancy. Trade Names - Onbrez Breezhaler®, Arcapta Neohaler® Adult: 150–300 mcg once daily via inhalation. Child: Not recommended under 18 years.
Umeclidinium (Anticholinergic) Indications - Chronic obstructive pulmonary disease (COPD). Avoid - Cardiac disorders, Breastfeeding. Cautions - Pregnancy, Hepatic impairment. Trade Names - Incruse Ellipta® Adult: 62.5 mcg once daily via inhalation. Child: Not established.
Tiotropium (Anticholinergic, Muscarinic Antagonist) Indications - Chronic obstructive pulmonary disease (COPD), Severe asthma. Avoid - Pregnancy, Breastfeeding. Cautions - Arrhythmia, Heart failure, Myocardial infarction, Renal impairment. Trade Names - Spiriva Respimat®, Spiriva HandiHaler® Adult: 18 mcg once daily via inhalation. Child: Not recommended under 6 years.
Glycopyrronium bromide (Glycopyrrolate) (Anticholinergic) Indications - Maintenance treatment of chronic obstructive pulmonary disease (COPD); iontophoretic treatment of hyperhidrosis. Avoid - Not specified. Cautions - Arrhythmia, Heart failure, Unstable ischaemic heart disease, Myocardial infarction, Pregnancy, Breastfeeding, Renal impairment. Trade Names - Seebri Breezhaler®, Lonhala Magnair®, Inhalation powder® Adult: 44 mcg once daily via inhalation. Child: Not established.
Clidinium bromide (Berclomine) (Anticholinergic) Indications - Maintenance treatment of COPD; symptomatic relief of abdominal pain, cramps, bloating, and diarrhea in IBS. Avoid - Infants, Children. Contraindications - Hypersensitivity, Urinary retention, Glaucoma, Myasthenia gravis, Severe ulcerative colitis, Obstructive uropathy. Cautions - Arrhythmia, Heart failure, Myocardial infarction, Pregnancy, Breastfeeding. Side Effects - Dry mouth, Blurred vision, Constipation, Urinary retention, Drowsiness, Dizziness, Nausea, Vomiting, Tachycardia, Confusion. Trade Names - Barclomine Syrup®, Inhalation powder® Adult: As directed by a physician. Child: Not recommended.
Sodium tetradecyl sulfate (Sclerosant) Indications - Vein malformation, varicose veins, spider veins in legs, reticular veins in legs. Avoid - Acute infection, Asthma, Blood disorders, Deep vein thrombosis, Hyperthyroidism, Neoplasm, Respiratory disease, Uncontrolled diabetes mellitus, Varicose vein caused by tumours, Pregnancy. Cautions - Arterial disease, History of migraine, Breastfeeding. Trade Names - Sotradecol®, Fibro-Vein®, Trombovar® Adult: 0.1–2 mL of 1% or 3% solution injected per vein (maximum 10 mL per session). Child: Not established; use not recommended.
Pentoxifylline (Oxpentifylline) (Hemorrheologic agent) Indications - Peripheral vascular disease, venous leg ulcer. Avoid - Acute myocardial infarction, Cerebral haemorrhage, Cardiac arrhythmia, Retinal haemorrhage, Pregnancy. Cautions - Acute porphyrias, Coronary artery disease, Diabetes, Hypotension, Hepatic impairment, Breastfeeding, Reduce dose in renal impairment. Trade Names - Trental tab:®, Trental SR tab:®, Pentox tab:® Adult: 400 mg orally 2–3 times daily with meals. Child: Not established.
Naftidrofuryl oxalate (Vasodilator) Indications - Peripheral vascular disease, cerebral vascular disease. Avoid - Not specified. Cautions - Not specified. Trade Names - Dusodril cap:®, Nafronyl SR cap:®, Praxilene tab:® Adult: 100–200 mg orally 3 times daily with food. Child: Not established.
Oxerutins (Vasoprotective agent) Indications - Oedema due to chronic venous insufficiency, Varicose veins, Hemorrhoidal disease, Microcirculatory disorders (including diabetic microangiopathy). Contraindications - Known hypersensitivity to oxerutins or any component of the formulation. Avoid - Active liver disease, Use during pregnancy and lactation unless clearly indicated. Cautions - Diabetes mellitus, Renal impairment, Hepatic impairment. Side Effects - Gastrointestinal disturbances (nausea, diarrhea), Headache, Skin rash, Pruritus, Fatigue. Trade Names - Venoruton tab:®, Paroven Cap:®, Relvène Cap:® Drug Interactions - May alter absorption of other oral medications; minimal interaction reported, but monitor if taken with anticoagulants or antiplatelets. Adult: 500 mg orally 2–3 times daily or 1000 mg once daily; adjust based on clinical response. Child: Not established; use not recommended in pediatric populations.
Inositol nicotinate (Lipid modifying drug) Indications - Antithrombotic, peripheral vascular disease. Avoid - Acute phase of cerebrovascular accident, Recent myocardial infarction. Cautions - Cerebrovascular insufficiency, Unstable angina. Trade Names - Hexopal tab:®, Nicotinate SR tab:®, Ronositol tab:® Adult: 500 mg orally 2–3 times daily or as directed by physician. Child: Not established.
Antazoline with xylometazoline (Antihistamine & Decongestant) Indications - Allergic conjunctivitis. Avoid - Not specified. Cautions - Cardiovascular disease, Hypertension, Diabetes mellitus, Angle-closure glaucoma. Trade Names - Otrivine-Antistin eye drops:®, Xylometazoline-Antazoline nasal spray:® Adult: 1 drop in each eye up to 2–3 times daily or as directed. Child: Use with caution in children above 6 years, consult specialist.
Tiaprofenic acid (NSAID) Indications - Pain and inflammation in rheumatic disease and other musculoskeletal disorders. Avoid - Active GI ulcer, Active bladder/prostatic disease, Severe heart failure, Pregnancy, Renal impairment. Cautions - Allergic disorders, Elderly, Heart failure, Ulcerative colitis, Hypertension, Breastfeeding, Hepatic impairment. Trade Names - Surgam tab:®, Surgam retard tab:®, Tiaprofen tab:® Adult: 300 mg orally twice daily or as prescribed. Child: Not recommended.
Sulindac (NSAID) Indications - Pain and inflammation in rheumatic disease, musculoskeletal disorders, acute gout. Avoid - Active GI ulcer or bleeding, Heart failure, Pregnancy, Renal impairment. Cautions - Allergic disorders, Elderly, Heart disease, Ulcerative colitis, Hypertension, Breastfeeding, Hepatic impairment. Trade Names - Lindac100 tab® Adult: 150–200 mg orally twice daily or as directed. Child: Not recommended.
Tenoxicam (NSAID) Indications - Pain and inflammation in rheumatic diseases and other musculoskeletal disorders. Avoid - Active gastrointestinal ulcer or bleeding, Severe heart failure, Pregnancy, Renal impairment. Cautions - Allergic disorders, Elderly, Cardiovascular disease, Ulcerative colitis, Hypertension, Breastfeeding, Hepatic impairment. Trade Names - Mobiflam®, Tilnolac® Drug Interactions - Anticoagulants, other NSAIDs, corticosteroids, ACE inhibitors, diuretics, methotrexate. Adult: 20 mg once daily with food. Child: Not recommended in children under 15 years.
Zolpidem tartrate (Hypnotic, Sedative) Indications - Short-term management of insomnia. Avoid - Severe respiratory insufficiency, Myasthenia gravis, Sleep apnoea syndrome, Pregnancy, Breastfeeding. Cautions - Elderly, Hepatic impairment, History of substance abuse, Depression or suicidal ideation. Trade Names - Sove-5®, Stilnoct® Drug Interactions - Other CNS depressants (alcohol, opioids, benzodiazepines), CYP3A4 inhibitors (ketoconazole, erythromycin), rifampicin. Adult: 5 mg at bedtime (women, elderly), 5–10 mg at bedtime (men) for up to 4 weeks. Child: Not established (use not recommended).
Valaciclovir (Antiviral) Indications - Treatment and prophylaxis of herpes simplex and zoster infections; management of herpes labialis and genital herpes; prevention of CMV disease post-transplant when alternatives are unsuitable. Avoid - Severe renal impairment without dose adjustment. Cautions - Elderly (risk of neurotoxicity), ensure adequate hydration, hepatic impairment. Trade Names - Valavir®, Valtrex® Drug Interactions - Probenecid (increases levels), nephrotoxic agents (e.g., aminoglycosides, NSAIDs), zidovudine. Adult: 500 mg orally twice daily for 5 days for herpes zoster; 500 mg twice daily for 3–5 days for HSV; prophylaxis 500 mg once daily. Child: 5–10 mg/kg twice daily (max 500 mg per dose) for 5 days in children ≥2 years.
Felbinac (Topical NSAID) Indications - Relief of musculoskeletal pain and inflammation, adjunct in osteoarthritis of knee or hand. Avoid - Pregnancy, Renal impairment, Active gastrointestinal ulcer or bleeding, Heart failure, Breastfeeding. Cautions - Allergic disorders, Elderly, Heart failure, Ulcerative colitis. Trade Names - Traxam® Drug Interactions - Other NSAIDs, corticosteroids (increased risk of GI effects). Adult: Apply 1–5 g to affected area 2–4 times daily. Child: Not recommended.
Dexketoprofen (NSAID) Indications - Short-term treatment of mild to moderate pain, including dysmenorrhoea, dental, or musculoskeletal pain. Avoid - Active bleeding, GI ulcers, Severe dehydration, Heart failure, Ulcerative colitis, Pregnancy, Renal impairment. Cautions - Allergic disorders, Asthma, Coagulation defects, Dehydration, Elderly, History of GI disease, Breastfeeding, Hepatic impairment. Trade Names - Enantyum®, Ketesse® Drug Interactions - Anticoagulants, other NSAIDs, lithium, diuretics, methotrexate. Adult: 25 mg every 8 hours orally (max 75 mg/day). Child: Not established.
Lactic Acid (Vaginal antiseptic) Indications - Treatment and prevention of bacterial vaginosis. Avoid - Shellfish allergy. Cautions - Avoid concurrent vaginal treatments, mucosal irritation. Trade Names - Relactagel® Drug Interactions - Avoid with spermicides or vaginal douches. Adult: 5 mL intravaginally once daily at bedtime for up to 7 days. Child: Not recommended.
Dequalinium Chloride (Topical antiseptic) Indications - Bacterial vaginosis. Avoid - Vaginal ulceration, Pregnancy. Cautions - Irritation of vaginal mucosa. Trade Names - Fluomizin® Drug Interactions - Avoid concurrent intravaginal products. Adult: 1 vaginal tablet daily for 6 days. Child: Not established.
Misoprostol (Prostaglandin E1 analog) Indications - Termination of pregnancy, cervical ripening, prevention of NSAID-induced gastric ulcers. Avoid - Breastfeeding, confirmed/suspected ectopic pregnancy. Cautions - Inflammatory bowel disease, cardiovascular disease, elderly. Trade Names - Cytotec® Drug Interactions - Oxytocin (additive uterotonic effect). Adult: 400–800 mcg orally, vaginally, or sublingually as per protocol. Child: Not indicated.
Carbetocin (Oxytocin analog) Indications - Prevention of uterine atony post-caesarean section. Avoid - Eclampsia, Epilepsy. Cautions - Cardiac disease, Asthma, Migraine, Hyponatraemia. Trade Names - Pabal® Drug Interactions - Other uterotonics (additive effect). Adult: 100 mcg IV as a slow bolus over 1 minute after delivery. Child: Not applicable.
Beraprost (Prostacyclin analog) Indications - Pulmonary arterial hypertension (PAH). Avoid - Severe hepatic/renal impairment, Pregnancy, Breastfeeding, Concomitant vasodilators. Cautions - Bleeding disorders, Elderly, Cardiovascular instability. Trade Names - Dorner® Drug Interactions - Other vasodilators (excessive hypotension), anticoagulants (increased bleeding risk). Adult: 20–60 mcg orally 3–4 times daily. Child: Not established.
Vardenafil (PDE5 inhibitor) Indications - Erectile dysfunction, Pulmonary hypertension, Polycythemia (off-label). Avoid - Nitrate use, Severe hypotension, Recent MI, Degenerative retinal disorders. Cautions - Elderly, Liver disease, Peptic ulcer, Bleeding disorders. Trade Names - Levitra®, Staxyn® Drug Interactions - Nitrates (contraindicated), alpha-blockers, CYP3A4 inhibitors (e.g., ketoconazole). Adult: 10 mg orally ~1 hour before sexual activity (max 20 mg/day). Child: Not indicated.
Alprostadil (Prostaglandin E₁ analogue) Indications - Erectile dysfunction, including neurogenic. Contraindications - Priapism, penile implants, anatomically deformed penis. Cautions - Sexual partner must ensure contraception; penis deformity. Avoid - None absolute; specialist initiation required. Trade Names - Caverject®, Edex® Drug Interactions - Antihypertensives, anticoagulants, PDE‑5 inhibitors, other vasodilators. Adult: Intracavernosal: 2.5–20 μg per injection; intraurethral: 125–1000 μg. Child: Not established; not recommended.
Tadalafil (PDE‑5 inhibitor) Indications - Pulmonary arterial hypertension; erectile dysfunction; benign prostatic hyperplasia. Contraindications - Concurrent nitrates or riociguat. Cautions - Hypotension, penis deformity, bleeding disorders, hepatic impairment. Avoid - Pregnancy, breastfeeding, recent MI, uncontrolled arrhythmia or angina. Trade Names - Cialis® Drug Interactions - Alpha-blockers, nitrates, CYP3A4 inhibitors (e.g., ketoconazole), antihypertensives. Adult: Pulmonary HTN: 40 mg daily; ED/BPH: 5–20 mg before intercourse or 2.5–5 mg daily. Child: Not established; not recommended.
Avanafil (PDE‑5 inhibitor) Indications - Erectile dysfunction. Contraindications - Concurrent nitrates, severe cardiovascular disorders. Cautions - Hepatic or renal impairment, bleeding disorders, penis deformity. Avoid - Significant hypotension, history of severe arrhythmia or heart failure. Trade Names - Spedra® Drug Interactions - Nitrates, alpha-blockers, CYP3A4 inhibitors/inducers. Adult: 50–200 mg taken ~15 minutes before sexual activity. Child: Not established; not recommended.
Doxazosin (Alpha‑1 blocker) Indications - Hypertension; benign prostatic hyperplasia. Contraindications - Known hypersensitivity. Cautions - Postural hypotension, hepatic impairment, co‑existing prostate hypertrophy. Avoid - Breastfeeding; caution in history of significant orthostatic hypotension. Trade Names - Cardura® Drug Interactions - Antihypertensives, phosphodiesterase inhibitors, diuretics. Adult: 1–4 mg once daily, may increase to 8 mg. Child: Not established; not recommended.
Mirabegron (β₃‑agonist) Indications - Overactive bladder: urinary frequency, urgency, incontinence. Contraindications - Severe uncontrolled hypertension, end-stage renal failure. Cautions - Moderate hepatic or renal impairment; history of hypertension; pregnancy or breastfeeding. Avoid - Severe uncontrolled hypertension, pregnancy, breastfeeding. Trade Names - Myrbetriq® Drug Interactions - CYP2D6 substrates (e.g., metoprolol), digoxin, antihypertensives. Adult: 50 mg once daily; reduce to 25 mg if needed. Child: Not established; not recommended.
Solifenacin succinate (Antimuscarinic) Indications - Overactive bladder: urinary frequency, urgency, incontinence. Contraindications - Narrow-angle glaucoma, urinary retention, gastric retention, myasthenia gravis. Cautions - Hepatic impairment, bladder outflow obstruction, dementia. Avoid - Pregnancy, breastfeeding, severe hepatic impairment. Trade Names - Vesicare® Drug Interactions - CYP3A4 inhibitors, other anticholinergics. Adult: 5 mg once daily; may increase to 10 mg. Child: Not established; not recommended.
Fesoterodine fumarate (Antimuscarinic) Indications - Overactive bladder: urinary frequency, urgency, incontinence. Contraindications - Urinary retention, gastric retention, uncontrolled angle-closure glaucoma. Cautions - Hepatic or severe renal impairment; elderly; central nervous system disorders. Avoid - Pregnancy, breastfeeding, severe hepatic/renal impairment. Trade Names - Toviaz® Drug Interactions - CYP3A4 inhibitors, other anticholinergics. Adult: 4 mg once daily; may increase to 8 mg. Child: Not established; not recommended.
Citicholine (Neuroprotective agent) Indications - Adjunct in cognitive impairment, stroke recovery, traumatic brain injury, Alzheimer’s/Parkinson’s disease. Contraindications - Hypersensitivity; pregnancy and breastfeeding; uncontrolled epilepsy; bleeding disorders. Cautions - Peptic ulcer, hypotension. Avoid - Pregnancy, breastfeeding without specialist advice. Trade Names - Cognizin®, Citicholine 500® Drug Interactions - Anticholinergics, antihypertensives, carbidopa. Adult: 500–2,000 mg daily (oral or IV) depending on indication. Child: Not established; use only under specialist supervision.
Pentamidine isetionate (Antiprotozoal) Indications - Pneumocystis jirovecii pneumonia, Visceral leishmaniasis, Cutaneous leishmaniasis, Trypanosomiasis. Contraindications - None absolute; use with extreme caution in cardiac and metabolic disorders. Cautions - Anaemia, bradycardia, coronary heart disease, history of ventricular arrhythmias, hyperglycaemia, hypoglycaemia, hypertension, hypotension, hypokalaemia, hepatic impairment. Avoid - Pregnancy, breastfeeding. Trade Names - Pentacarinat®, Nebupent® (Specialist use) Drug Interactions - Other nephrotoxic or ototoxic agents (e.g., aminoglycosides), antidiabetics (additive risk of hypoglycaemia), QT‑prolonging drugs. Adult: Pneumocystis pneumonia: IV 4 mg/kg once daily for 14–21 days. Leishmaniasis: IM/IV 2–4 mg/kg daily or on alternate days for up to 20 doses. Child: Similar to adults (dose adjusted per weight); specialist supervision required.
Posaconazole (Triazole antifungal) Indications - Invasive aspergillosis, Fusariosis, Chromoblastomycosis, Mycetoma, Coccidioidomycosis (when intolerant to itraconazole/amphotericin), Oropharyngeal candidiasis, Prophylaxis of invasive fungal infections in immunocompromised patients. Contraindications - Known hypersensitivity to azoles. Cautions - Hepatic impairment, renal impairment, electrolyte imbalances (correct before initiation), avoid use in acute porphyria. Avoid - Pregnancy, breastfeeding, acute porphyrias; effective contraception required during therapy. Trade Names - Noxafil® Drug Interactions - CYP3A4 substrates (e.g., statins, midazolam), immunosuppressants (e.g., cyclosporine, tacrolimus), QT‑prolonging drugs, rifampin, phenytoin, carbamazepine. Adult: Oropharyngeal candidiasis: 100–200 mg TID; prophylaxis: 300 mg BID on day 1, then 300 mg OD. Child: Not routinely recommended; specialist discretion in ≥13 years.
Isavuconazole (Antifungal - Triazole) Indications - Invasive aspergillosis, Mucormycosis (when amphotericin B is inappropriate). Contraindications - Hypersensitivity to isavuconazole or similar azoles. Cautions - Hepatic impairment, QT prolongation, electrolyte disturbances. Avoid - Acute porphyrias. Trade Names - Cresemba® Drug Interactions - CYP3A4 substrates and inducers (rifampin, carbamazepine, phenytoin), statins, tacrolimus, sirolimus, midazolam. Adult: Loading dose: 200 mg every 8 hours for 6 doses, then 200 mg once daily. Child: Not routinely recommended (safety not established).
Micafungin (Echinocandin Antifungal) Indications - Invasive candidiasis, Oesophageal candidiasis, Prophylaxis of Candida infections in patients undergoing hematopoietic stem cell transplantation. Contraindications - Known hypersensitivity to echinocandins. Cautions - Monitor liver function, electrolyte balance, avoid in severe hepatic impairment. Avoid - Pregnancy, breastfeeding, hepatic impairment, renal impairment. Trade Names - Mycamine® Drug Interactions - Sirolimus, nifedipine, itraconazole (may increase exposure); monitor closely. Adult: 100–150 mg IV once daily for candidiasis; 50 mg/day for prophylaxis. Child: 2–4 mg/kg IV once daily, depending on indication and age.
Lercanidipine (Calcium channel blocker) Indications - Mild to moderate hypertension. Contraindications - Hypersensitivity, severe hepatic impairment, obstructive cardiomyopathy, pregnancy, breastfeeding. Cautions - Unstable angina, recent myocardial infarction, renal impairment. Avoid - Aortic stenosis, uncontrolled heart failure, unstable angina. Trade Names - Zanidip® Drug Interactions - CYP3A4 inhibitors (e.g., ketoconazole, erythromycin), beta-blockers, cyclosporine, grapefruit juice. Adult: 10 mg once daily, increased to 20 mg after 2 weeks if needed. Child: Not recommended (safety not established).
Fidaxomicin (Macrolide antibiotic) Indications - Clostridium difficile infection. Contraindications - Hypersensitivity to fidaxomicin. Cautions - Moderate to severe hepatic impairment, history of GI disorders (e.g., IBD). Avoid - Pregnancy, Breastfeeding. Side Effects - Nausea, vomiting, abdominal pain, anemia, neutropenia, rash. Trade Names - Dificlir tab:®, Dificid tab:® Drug Interactions - Minimal systemic absorption; unlikely to interact significantly, but monitor if used with cyclosporine or antacids. Adult: 200 mg orally twice daily for 10 days. Child: Over 6 months: 16 mg/kg/day divided every 12 hrs (max 200 mg/dose).
Lymecycline (Tetracycline antibiotic) Indications - Chlamydia, Rickettsia, Mycoplasma, Acne. Contraindications - Hypersensitivity to tetracyclines, severe hepatic or renal impairment. Cautions - Photosensitivity, avoid antacids and dairy products near dose. Avoid - Use in renal impairment, pregnancy, children under 8 years. Side Effects - GI upset, dizziness, photosensitivity, rash, esophagitis. Trade Names - Tetralysal®, Lymecin® Drug Interactions - Antacids, iron, dairy (reduce absorption); oral contraceptives (may reduce efficacy). Adult: 300 mg once daily. Child: Not recommended under 12 years.
Mianserin HCl (Antidepressant – specialist use advised) Indications - Tetracyclic antidepressant used in depressive illness, particularly where sedation is beneficial. Contraindications - Acute porphyrias, arrhythmias, manic phase of bipolar disorder, pregnancy. Cautions - Hepatic or renal impairment, cardiovascular disease, chronic constipation, diabetes, epilepsy, history of bipolar disorder or psychosis, hyperthyroidism, urinary retention. Avoid - Pregnancy, manic states. Trade Names - Tolvon® Adult: Oral: 30–40 mg daily in divided doses, may increase up to 90 mg/day based on response. Child: Not recommended (safety and efficacy not established).
Bedaquiline (Antimycobacterial) Indications - Multidrug-resistant pulmonary tuberculosis (MDR-TB), in combination with other antimycobacterial agents. Contraindications - Prolonged QT interval, History of ventricular arrhythmias, Co-administration with strong CYP3A4 inducers. Cautions - Liver impairment, Alcoholism, Risk of QT prolongation, Co-administration with other QT-prolonging drugs. Avoid - Use in ventricular arrhythmia, Severe hepatic or renal impairment, Pregnancy, Breastfeeding unless benefit outweighs risk. Side Effects - QT prolongation, Nausea, Arthralgia, Headache, Hepatotoxicity, Chest pain, Increased liver enzymes. Trade Names - Sirturo tab:® Drug Interactions - Avoid co-administration with strong CYP3A4 inducers (e.g. rifampicin), Increased risk of QT prolongation with other QT-prolonging drugs, Caution with CYP3A4 inhibitors. Adult: 400 mg once daily for 2 weeks, then 200 mg three times a week for 22 weeks. Child:
Aminosalicylic acid (Antimycobacterial) Indications - Multi-drug resistant tuberculosis (MDR-TB), always in combination with other antitubercular agents. Contraindications - Severe renal impairment, Known hypersensitivity to aminosalicylates, Pregnancy (unless absolutely necessary). Cautions - Peptic ulcer disease, Hepatic impairment, Renal impairment, Gout, Monitor liver function and for signs of hypersensitivity. Avoid - Use in pregnancy and breastfeeding unless benefits outweigh risks. Side Effects - Nausea, Vomiting, Diarrhea, Hepatitis, Hypersensitivity reactions (fever, rash, lymphadenopathy), Goitre, Hypothyroidism, Agranulocytosis. Trade Names - Paser granules:®, PASER tab:® Drug Interactions - May reduce absorption of rifampicin, Avoid with digoxin due to reduced absorption, May increase INR with warfarin. Adult: 4 g orally every 8 hours (total daily dose 12 g), usually continued for up to 24 months in MDR-TB treatment. Child: 200–300 mg/kg/day divided into 2–3 doses; maximum 12 g/day.
Daptomycin (Lipopeptide antibiotic) Indications - Complicated skin and soft-tissue infections caused by Gram-positive bacteria, Right-sided infective endocarditis due to Staphylococcus aureus, Bacteremia associated with Staphylococcus aureus. Contraindications - Hypersensitivity to daptomycin. Use in pregnancy and renal or hepatic impairment only if benefits outweigh risks. Cautions - Obesity, Renal impairment, Monitor for muscle toxicity (CPK elevation), Eosinophilic pneumonia. Avoid - Concomitant use with statins unless clearly necessary. Side Effects - Anemia, Anxiety, Asthenia, Constipation, Diarrhea, Dizziness, Fever, GI discomfort, Headache, Insomnia, Hypotension, Hypertension, Myopathy, Increased creatine phosphokinase (CPK). Trade Names - Cubicin inj:®, Dapmicin inj:® Drug Interactions - Increased risk of myopathy with statins, Possible interference with INR levels. Adult: 4–6 mg/kg IV once daily for 7–14 days depending on the infection type (higher doses for endocarditis and bacteremia). Child: ≥1 year: 5–10 mg/kg IV once daily, depending on indication and weight.
Lymecycline (Tetracycline antibiotic) Indications - Chlamydia, Rickettsial infections, Mycoplasma infections, Acne vulgaris. Contraindications - Hypersensitivity to tetracyclines, Severe hepatic impairment, Children under 8 years. Cautions - Renal impairment, Myasthenia gravis, Systemic lupus erythematosus (SLE). Avoid - Concurrent use with retinoids, Antacids or iron supplements close to dosing. Side Effects - Nausea, Diarrhoea, Photosensitivity, Headache, Rash. Trade Names - Tetralysal cap:®, Lymecycline cap:® Drug Interactions - Reduced absorption with antacids, iron, calcium; increased effect of warfarin; decreased oral contraceptive efficacy. Adult: 300 mg to 408 mg orally once daily, usually for 8–12 weeks in acne treatment. Child: Not recommended for children under 8 years due to risk of tooth discoloration and bone effects.
Demeclocycline HCl (Tetracycline antibiotic) Indications - Syndrome of inappropriate antidiuretic hormone (SIADH) secretion, infections caused by Chlamydia, Rickettsia, and Mycoplasma, treatment of hyponatraemia due to SIADH. Contraindications - Pregnancy, breastfeeding, children under 8 years (due to tooth discoloration), severe renal impairment. Avoid - Use in children, pregnancy, breastfeeding unless essential. Cautions - Photosensitivity, hepatic impairment, renal impairment, long-term use. Drug Interactions - Antacids, iron supplements, dairy products (reduce absorption); may enhance effect of anticoagulants; reduces efficacy of oral contraceptives. Trade Names - Declomycin® tab/cap Adult: 600–1,200 mg daily in 2–4 divided doses (usual dose for SIADH: 300 mg BID). Child: Not recommended under 8 years; use with caution in older children if necessary.
Colistimethate sodium (Polymyxin antibiotic) Indications - Gram-negative bacterial infections including those caused by Pseudomonas aeruginosa, especially in cystic fibrosis; treatment of multidrug-resistant organisms. Contraindications - Known hypersensitivity to colistin or polymyxins. Avoid - Myasthenia gravis due to risk of neuromuscular blockade. Cautions - Renal impairment, neurotoxicity risk, under 1 year of age (limited safety data), concurrent use of neuromuscular blocking agents. Drug Interactions - Increased nephrotoxicity with aminoglycosides or vancomycin; neuromuscular blockade enhanced with muscle relaxants. Trade Names - Coly-Mycin M® inj, Promixin® powder for nebuliser Adult: IV: 2–2.5 mg/kg/day in 2–3 divided doses (based on colistin base activity); inhalation dose: typically 1–2 million IU twice daily. Child: IV: 50,000–75,000 IU/kg/day in 3 divided doses; inhalation use under specialist guidance.
Temocillin (Beta-lactam antibiotic, Penicillin derivative) Indications - Septicaemia, urinary tract infections (including ESBL-producing strains), lower respiratory tract infections, biliary tract infections, infections caused by Enterobacteriaceae resistant to other beta-lactams. Contraindications - Hypersensitivity to penicillins or beta-lactam antibiotics. Avoid - Do not use in cases of known severe beta-lactam allergy. Cautions - Renal impairment (dose adjustment required), elderly, history of allergy. Drug Interactions - May interact with aminoglycosides (increased nephrotoxicity risk), anticoagulants (monitor INR if on warfarin). Trade Names - Negaban® inj Adult: IV: 2 g every 12 hours; in severe infections or resistant strains, 2 g every 8 hours. Child: IV: 25–50 mg/kg every 8–12 hours depending on severity and renal function.
Pivmecillinam HCl (Beta-lactam antibiotic, Penicillin class) Indications - Acute uncomplicated cystitis, urinary tract infections, chronic or recurrent bacteriuria, gastrointestinal infections (off-label), oesophageal strictures (off-label). Contraindications - Hypersensitivity to penicillins, acute porphyrias. Avoid - Avoid in patients with known penicillin allergy, acute porphyrias. Cautions - Renal impairment, prolonged use may cause vitamin B6 deficiency, gastrointestinal disease. Drug Interactions - Probenecid (increases serum levels), oral contraceptives (reduced efficacy), other beta-lactams. Trade Names - Selexid® tab, Coactabs® Adult: 400 mg three times daily for 3–7 days (depending on infection severity). Child: 20–40 mg/kg/day in divided doses; duration and dose vary with infection severity and age.
Co-fluampicil (Combination of Ampicillin and Flucloxacillin - Beta-lactam antibiotics) Indications - Mixed infections involving beta-lactamase-producing staphylococci, severe mixed infections including respiratory tract infections, skin and soft tissue infections, bone and joint infections. Contraindications - Penicillin allergy, previous cholestatic jaundice associated with flucloxacillin. Cautions - Hepatic dysfunction, renal impairment, history of antibiotic-associated colitis. Side Effects - Arthralgia, bronchospasm, coma, dyspnea, gastrointestinal disturbances, hallucinations, rash, hepatitis (rare). Drug Interactions - Probenecid (increases plasma concentration), methotrexate, oral contraceptives (reduced efficacy). Trade Names - Co-fluampicil 250 mg powder for injection:® Adult: 500 mg every 6 hours via IM, slow IV, or IV infusion. Child: 25–50 mg/kg/day in divided doses every 6 hours; maximum dose adjusted by weight and clinical condition.
Telavancin (Lipoglycopeptide antibiotic) Indications - Hospital-acquired bacterial pneumonia (including ventilator-associated pneumonia) caused by susceptible strains, complicated skin and soft tissue infections, resistant Staphylococcus aureus infections. Contraindications - Known hypersensitivity to telavancin, vancomycin, or other glycopeptides. Avoid - Pregnancy (Category C), breastfeeding, use in patients with congenital long QT syndrome. Cautions - Heart failure, renal impairment, hepatic impairment, elderly, concurrent nephrotoxic drugs, prolonged QT interval. Drug Interactions - Additive nephrotoxicity with aminoglycosides, loop diuretics; QT prolongation with other QT-prolonging drugs. Trade Names - Vibativ® inj Adult: 10 mg/kg IV once daily for 7–21 days depending on infection severity; adjust in renal impairment. Child: Not established; not recommended in pediatric patients.
Dalbavancin (Lipoglycopeptide antibiotic) Indications - Acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible Gram-positive organisms including MRSA. Contraindications - Known hypersensitivity to dalbavancin or other glycopeptide antibiotics. Cautions - Use cautiously in patients with hepatic impairment; monitor liver function. Adjust dose in severe renal impairment (creatinine clearance <30 mL/min). Risk of infusion-related reactions (“red man syndrome”); infuse slowly. Use with caution in elderly patients and those with pre-existing renal dysfunction. Monitor renal function and electrolytes during treatment. Avoid - Pregnancy and breastfeeding unless potential benefits outweigh risks. Avoid concomitant use with other nephrotoxic or ototoxic drugs if possible. Drug Interactions - No significant cytochrome P450 interactions known; caution with nephrotoxic or ototoxic agents. Trade Names - Dalvance® inj Adult: 1000 mg IV on Day 1 followed by 500 mg IV on Day 8, or a single 1500 mg IV dose. Child: Not established; use not recommended.
Pirenoxine 0.005% (Cataract treatment agent) Indications - Used to prevent or slow the progression of senile and diabetic cataracts by inhibiting lens protein aggregation and protecting the lens from oxidative damage. Contraindications - Known hypersensitivity to pirenoxine or any component of the formulation. Cautions - Use with caution in patients with active eye infections or inflammation. Do not touch dropper tip to any surface to avoid contamination. Discontinue use if irritation or allergic reaction occurs. Avoid - Do not use in acute ophthalmic infections unless prescribed. Avoid contact lens use during administration. Drug Interactions - No significant drug interactions reported; however, avoid mixing with other ophthalmic preparations unless directed by a physician. Trade Names - Padtetra® eye drops Adult: 1–2 drops in the affected eye(s), 3–4 times daily. Child: Safety and efficacy not well established; use only under medical supervision.
Ceftobiprole (Cephalosporin antibiotic) Indications - Community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) excluding ventilator-associated pneumonia. Effective against MRSA and other resistant Gram-positive and Gram-negative pathogens. Contraindications - Known hypersensitivity to ceftobiprole, other cephalosporins, or beta-lactam antibiotics. Cautions - History of seizures, gastrointestinal disease (especially colitis), renal impairment, elderly patients. Monitor renal function in prolonged therapy. Avoid - Use with caution or avoid during pregnancy and breastfeeding unless absolutely necessary. Avoid in patients with a history of severe beta-lactam allergy. Drug Interactions - May enhance nephrotoxic effects of aminoglycosides. Monitor if used with loop diuretics or other nephrotoxic agents. Trade Names - Zevtera® inj Adult: 500 mg IV every 8 hours infused over 2 hours for 7–14 days, adjusted for renal impairment. Child: Safety and efficacy not established in pediatric patients; not recommended for children under 18 years.
Ceftaroline fosamil (Cephalosporin antibiotic) Indications - Community-acquired pneumonia (CAP), complicated skin and soft tissue infections (cSSTIs) including MRSA-related infections. Contraindications - Known hypersensitivity to ceftaroline or other cephalosporins. Cautions - Renal impairment, history of seizures, gastrointestinal diseases such as colitis, elderly patients. Avoid - Use with caution during pregnancy and breastfeeding due to limited safety data. Drug Interactions - May interact with nephrotoxic drugs; monitor renal function if co-administered. Trade Names - Zinforo® inj Adult: 600 mg IV every 12 hours over 60 minutes for 5–14 days; adjust in renal impairment. Child: Infants and children ≥2 months: 8–12 mg/kg IV every 8 hours (max 400 mg/dose), under specialist supervision.
Chloramphenicol Eye Drops (Broad-spectrum antibiotic) Indications - Bacterial conjunctivitis (especially purulent conjunctivitis). Contraindications - Hypersensitivity to chloramphenicol or any component of the formulation, history of blood dyscrasias. Cautions - Long-term or repeated use may increase the risk of bone marrow suppression. Avoid prolonged use. Use with caution in those with a history of hematologic disorders. Avoid - Avoid in pregnancy and breastfeeding unless essential; avoid contact lenses during treatment. Drug Interactions - May interact with bone marrow suppressant drugs; avoid concomitant use. Trade Names - Chloramphenicol 0.5% Eye Drops® Adult: Instill 1–2 drops into the affected eye every 2 hours for 2 days, then reduce frequency; continue for 5 days. Child: Same as adult dose in children over 2 years; not generally recommended under 2 years unless directed by a physician.
Amoxicillin (Beta-lactam antibiotic) Indications - Bacterial infections including otitis media, sinusitis, respiratory tract infections, urinary tract infections, Helicobacter pylori eradication. Contraindications - Hypersensitivity to penicillins or beta-lactam antibiotics. Cautions - Renal impairment, history of antibiotic-associated colitis, pregnancy, epilepsy. Avoid - In known penicillin allergy, avoid unnecessary use to prevent resistance. Drug Interactions - May interact with allopurinol (increased risk of rash), anticoagulants (enhanced INR), methotrexate (increased toxicity). Trade Names - Amoxil®, Trimox®, Moxatag® Adult: 500 mg every 8 hours for 5–7 days (e.g., otitis media). Child: 20–40 mg/kg/day in divided doses every 8 hours, or 25–45 mg/kg/day in divided doses every 12 hours depending on severity and age.
Ciprofloxacin (Fluoroquinolone antibiotic) Indications - Otitis externa (especially with suspected Pseudomonas), urinary tract infections, respiratory tract infections, gastrointestinal infections, bone and joint infections. Contraindications - Hypersensitivity to quinolones, history of tendon disorders related to fluoroquinolone use. Cautions - Epilepsy, CNS disorders, renal impairment, QT prolongation, myasthenia gravis. Avoid - In children and adolescents unless benefits outweigh risks (due to risk of arthropathy), pregnancy, breastfeeding. Drug Interactions - Antacids, iron, dairy (reduce absorption), NSAIDs (increase seizure risk), warfarin (enhanced anticoagulant effect). Trade Names - Ciproxin®, Ciloxan®, Cipro® Adult: 500 mg orally twice daily (systemic), or ciprofloxacin ear drops twice daily (topical). Child: Topical use only: Ciprofloxacin ear drops as prescribed; systemic use only under specialist advice.
Cefotaxime (Third-generation cephalosporin antibiotic) Indications - Bacterial meningitis, septicaemia, lower respiratory tract infections, urinary tract infections, gonorrhoea, intra-abdominal infections. Contraindications - Known hypersensitivity to cephalosporins or severe penicillin allergy. Cautions - Renal impairment, history of colitis, prolonged treatment (risk of superinfection), neonates (dose adjustment needed). Avoid - In patients with severe penicillin allergy unless essential. Drug Interactions - Increased nephrotoxicity with aminoglycosides, loop diuretics; may enhance anticoagulant effects of warfarin. Trade Names - Claforan® inj Adult: 2–3 g IV every 6–8 hours for meningitis. Child: 50–75 mg/kg IV every 6–8 hours (max: 12 g/day) depending on age and severity.
Flucloxacillin (Penicillinase-resistant penicillin) Indications - Septic arthritis, skin and soft tissue infections, osteomyelitis, endocarditis, pneumonia, surgical prophylaxis. Contraindications - Hypersensitivity to beta-lactam antibiotics. Cautions - Hepatic impairment, renal impairment, history of jaundice or liver dysfunction associated with flucloxacillin. Avoid - In patients with previous flucloxacillin-associated cholestatic jaundice. Drug Interactions - May reduce efficacy of oral contraceptives; enhances effects of methotrexate; probenecid increases flucloxacillin levels. Trade Names - Floxapen®, Flopen® Adult: Oral: 500 mg 4×/day; IV: 1–2 g every 6 hours (often for 4–6 weeks in septic arthritis). Child: Oral: 12.5–25 mg/kg 4×/day; IV: 50–100 mg/kg/day in divided doses. (Specialist supervision required)
Fusidic Acid (Steroid-like antibiotic) Indications - Osteomyelitis, skin infections, staphylococcal infections, adjunct with other antibiotics. Contraindications - Hypersensitivity to fusidic acid. Cautions - Liver dysfunction, prolonged use may increase resistance risk. Avoid - Monotherapy in serious infections (resistance risk). Drug Interactions - Statins (risk of rhabdomyolysis), cyclosporine (increased levels), warfarin (enhanced anticoagulation). Trade Names - Fucidin® tab, inj Adult: Oral: 500 mg TID; IV: 500 mg every 8–12 hours with another antibiotic. Child: Oral: 20 mg/kg/day divided every 8 hours; max 1.5 g/day.
Rifampicin (Rifamycin antibiotic) Indications - Osteomyelitis, tuberculosis, staphylococcal infections in combination therapy. Contraindications - Jaundice, rifampicin hypersensitivity. Cautions - Hepatic impairment, alcohol use, elderly. Avoid - Monotherapy in serious infections (resistance risk), pregnancy unless benefits outweigh risks. Drug Interactions - Strong CYP450 inducer—interacts with warfarin, oral contraceptives, antiretrovirals, anticonvulsants. Trade Names - Rifadin® cap, inj Adult: Oral: 600 mg once daily or 300 mg BID. Often used with fusidic acid or clindamycin. Child: Oral: 10–20 mg/kg/day (max 600 mg/day).
Vancomycin (Glycopeptide antibiotic) Indications - Osteomyelitis, MRSA infections, endocarditis, C. difficile colitis (oral), septic arthritis. Contraindications - Hypersensitivity to vancomycin. Cautions - Renal impairment, elderly, hearing impairment (risk of ototoxicity). Avoid - Rapid IV infusion (risk of "red man syndrome"). Drug Interactions - Increased nephrotoxicity with aminoglycosides, loop diuretics. Trade Names - Vancocin® inj Adult: IV: 15–20 mg/kg every 8–12 hours; adjust based on renal function and serum levels. Child: IV: 10–15 mg/kg every 6–12 hours.
Teicoplanin (Glycopeptide antibiotic) Indications - Osteomyelitis, MRSA infections, endocarditis, skin and soft tissue infections. Contraindications - Hypersensitivity to teicoplanin. Cautions - Renal impairment, monitor for blood dyscrasias, auditory function. Avoid - Use caution in neonates and elderly without monitoring drug levels. Drug Interactions - Increased ototoxicity/nephrotoxicity risk with aminoglycosides, loop diuretics. Trade Names - Targocid® inj Adult: Loading: 400 mg IV every 12h for 3 doses; Maintenance: 6–12 mg/kg daily. Child: 10–15 mg/kg IV once daily.
Metronidazole (Nitroimidazole antimicrobial)Indications - Bacterial vaginosis, trichomoniasis, pelvic inflammatory disease, anaerobic infections, amoebiasis, giardiasis, Clostridium difficile infection, dental infections, rosacea (topical). Contraindications - Hypersensitivity to metronidazole or other nitroimidazoles. Cautions - Hepatic impairment, severe renal impairment, pre-existing CNS disorders (e.g., epilepsy), history of blood dyscrasias. Avoid - Alcohol (disulfiram-like reaction), during first trimester of pregnancy unless clearly necessary. Drug Interactions - Alcohol, warfarin (increased anticoagulant effect), phenytoin, phenobarbital (reduced efficacy), cimetidine (increased plasma levels), lithium (toxicity). Trade Names - Flagyl®, Metrogyl®, Metrozin® Adult: 400–500 mg orally 2–3 times daily for 5–10 days; IV 500 mg every 8 hours for anaerobic infections. Child: 7.5 mg/kg every 8 hours (max 400 mg/dose); amoebiasis: up to 10 days.
Clevidipine (Calcium channel blocker)Indications - Hypertension in the peri-operative setting, rapid blood pressure control. Contraindications - Allergy to egg or soy products, defective lipid metabolism, severe aortic stenosis. Cautions - Heart failure, reflex tachycardia, elderly, renal impairment, hepatic impairment. Avoid - Obstructive cardiomyopathy, pregnancy, breastfeeding. Drug Interactions - Beta-blockers (additive effects), antihypertensives, general anesthetics. Trade Names - Cleviprex® inj (Specialist use only) Adult: IV infusion: Start at 1–2 mg/h; double dose at short intervals (90 sec) up to 16 mg/h as needed. Child: Not established; use only under specialist supervision.
Acebutolol (Beta-blocker)Indications - Hypertension, Angina pectoris, Cardiac arrhythmias including ventricular and supraventricular tachycardia. Contraindications - Severe bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure, severe peripheral arterial disorders. Cautions - Renal impairment, hepatic impairment, myasthenia gravis, bronchospasm, diabetes mellitus (may mask hypoglycaemia), breastfeeding. Avoid - Abrupt withdrawal, especially in patients with ischemic heart disease. Drug Interactions - Other antihypertensives, calcium channel blockers (e.g., verapamil), digoxin, clonidine (risk of rebound hypertension on withdrawal). Trade Names - Sectral® tab/cap Adult:> 400–800 mg daily in divided doses; up to 1.2 g/day in severe cases. Child: Not routinely recommended; consult specialist if use required.
Pindolol (Beta-blocker)Indications - Hypertension, Angina pectoris. Contraindications - Severe bradycardia, heart block greater than first degree, cardiogenic shock, untreated pheochromocytoma, overt cardiac failure, asthma. Cautions - Diabetes mellitus (may mask hypoglycemia), hepatic impairment, peripheral vascular disease, thyrotoxicosis, elderly. Avoid - Use with caution in renal impairment and avoid abrupt withdrawal. Drug Interactions - May enhance effects of other antihypertensives; interacts with verapamil, diltiazem (risk of heart block); caution with insulin or oral hypoglycemics. Trade Names - Visken® tab/cap Adult: 5–15 mg daily in divided doses; max 60 mg/day. Child: Not routinely recommended; specialist use only.
Nadolol (Beta-blocker)Indications - Hypertension, Angina pectoris, Cardiac arrhythmias, Migraine prophylaxis, Thyrotoxicosis. Contraindications - Sinus bradycardia, greater than first-degree heart block, cardiogenic shock, overt cardiac failure, bronchial asthma, hypersensitivity to Nadolol. Cautions - Hepatic impairment, renal impairment (dose adjustment needed), diabetes mellitus, peripheral vascular disease, myasthenia gravis, elderly, thyroid disorders (may mask symptoms). Avoid - Abrupt withdrawal (may worsen angina or precipitate myocardial infarction). Trade Names - Corgard® tab/cap Drug Interactions - Increased risk of bradycardia with digoxin or calcium channel blockers; reduced effect with NSAIDs; may enhance effects of other antihypertensives. Adult: 40–320 mg once daily depending on condition; initial dose typically 40–80 mg/day. Child: 0.5–2 mg/kg once daily; max 5 mg/kg/day or 320 mg/day, under specialist supervision.
Moxonidine (Antihypertensive – Imidazoline receptor agonist) Indications - Mild to moderate essential hypertension (alone or in combination with other antihypertensives). Contraindications - Cautions - Mild to moderate renal impairment, heart failure (stable), depression, elderly, driving or operating machinery (may cause dizziness), risk of rebound hypertension if stopped abruptly. Avoid - Concomitant use with tricyclic antidepressants (reduces efficacy); abrupt withdrawal. Trade Names - Physiotens® tab Drug Interactions - Potentiates effects of other antihypertensives, sedatives, and alcohol; reduced efficacy with tricyclic antidepressants; may interact with beta-blockers and benzodiazepines. Adult: Initial dose: 200 mcg once daily; may increase after 3 weeks to 400 mcg once or divided twice daily. Max: 600 mcg/day. Child: Not recommended in children (safety and efficacy not established).
Methyldopa (Centrally acting antihypertensive) Indications - Management of hypertension, including use in pregnancy-induced hypertension. Contraindications - Acute liver disease, active hepatic disorders, depression, pheochromocytoma, acute porphyria. Cautions - History of hepatic impairment, hemolytic anemia, Parkinson’s disease, renal impairment, elderly patients, history of depression. Avoid - Use during breastfeeding unless benefits outweigh risks; avoid abrupt withdrawal; caution in hepatic impairment. Trade Names - Eldimax® 250 mg tab Drug Interactions - May enhance hypotensive effect with other antihypertensives; increased risk of sedation with CNS depressants; may interfere with MAO inhibitors; lithium toxicity risk increased. Side Effects - Sedation, headache, fatigue, dry mouth, bradycardia, depression, fever, liver function abnormalities, hemolytic anemia, amenorrhea, breast enlargement, arthralgia. Adult: Initial: 250 mg 2–3 times daily; may increase gradually every 2 days to a usual maintenance dose of 500 mg to 2 g/day in divided doses. Max: 3 g/day. Child: Initial: 10 mg/kg/day in 2–4 divided doses; adjust gradually. Usual: 20–40 mg/kg/day; Max: 65 mg/kg/day or 3 g/day (whichever is lower).
Bivalirudin (Direct thrombin inhibitor) Indications - Unstable angina undergoing percutaneous coronary intervention (PCI), anticoagulation in patients with or at risk of heparin-induced thrombocytopenia (HIT), and during coronary procedures. Contraindications - Active major bleeding, severe uncontrolled hypertension, hypersensitivity to bivalirudin, bacterial endocarditis. Cautions - Renal impairment (dose adjustment needed), increased bleeding risk (e.g., recent surgery or trauma), elderly patients, hepatic impairment. Avoid - Use in severe bleeding disorders, avoid combination with other anticoagulants unless necessary. Trade Names - Angiomax® (injection) Drug Interactions - Enhanced bleeding risk with anticoagulants (e.g., warfarin, heparin), antiplatelets (e.g., clopidogrel), thrombolytics (e.g., alteplase). Adult: Initial: 0.75 mg/kg IV bolus followed by 1.75 mg/kg/h IV infusion during PCI; reduce infusion rate in renal impairment. Child: Not routinely recommended; limited data in pediatric population—specialist guidance required.
Edoxaban (Anticoagulant, Factor Xa Inhibitor) Indications - Prophylaxis of systemic embolism in non-valvular atrial fibrillation in patients with at least one risk factor (e.g., congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or TIA); treatment and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). Contraindications - Active bleeding, recent gastrointestinal ulcer, hepatic disease associated with coagulopathy, known or suspected oesophageal varices, malignant neoplasms at high risk of bleeding, recent brain or spinal injury, recent intracranial haemorrhage, uncontrolled severe hypertension, vascular aneurysms. Cautions - Moderate to severe mitral stenosis, increased risk of bleeding (especially with surgery or invasive procedures), hepatic impairment, elderly patients, low body weight. Avoid - Side effects - Anaemia, haemorrhage (including gastrointestinal and intracranial), nausea, elevated liver enzymes, skin rash. Trade names - Lixiana® tab Drug interactions - Increased bleeding risk with NSAIDs, antiplatelets, SSRIs/SNRIs, other anticoagulants. P-gp inhibitors (e.g., dronedarone, ciclosporin) may increase plasma concentration. Adult: Oral: 60 mg once daily. If CrCl 15–50 mL/min, body weight ≤60 kg, or concurrent use of certain P-gp inhibitors: 30 mg once daily. Child: Not recommended; safety and efficacy not established in pediatric patients.
Apixaban (Anticoagulant, Factor Xa Inhibitor) Indications - Prophylaxis of venous thromboembolism (VTE) in patients undergoing elective hip or knee replacement surgery; treatment of deep-vein thrombosis (DVT) and pulmonary embolism (PE); prevention of recurrent DVT and PE; prophylaxis of stroke and systemic embolism in non-valvular atrial fibrillation, particularly in patients with risk factors such as diabetes mellitus, hypertension, or age ≥75 years. Contraindications - Active clinically significant bleeding, severe hepatic impairment with coagulopathy, conditions associated with increased risk of major bleeding (e.g., recent brain or spinal injury), prosthetic heart valves, hypersensitivity to apixaban. Cautions - Avoid - Trade names - Eliquis® tab Drug interactions - Increased bleeding risk with NSAIDs, SSRIs/SNRIs, antiplatelet agents, other anticoagulants. Strong CYP3A4 and P-gp inhibitors (e.g., ketoconazole, itraconazole, ritonavir) increase apixaban levels. CYP3A4 inducers (e.g., rifampicin, phenytoin) may reduce efficacy. Adult: Atrial fibrillation: 5 mg twice daily (2.5 mg twice daily if ≥80 years old, weight ≤60 kg, or serum creatinine ≥1.5 mg/dL); DVT/PE treatment: 10 mg twice daily for 7 days, then 5 mg twice daily; VTE prophylaxis (post-op): 2.5 mg twice daily. Child: Not recommended; safety and efficacy not established in pediatric patients.
Dipyridamole (Antiplatelet agent, Vasodilator) Indications - Prophylaxis of thromboembolism (particularly with prosthetic heart valves), secondary prevention of ischaemic stroke (often combined with aspirin), adjunct in the diagnosis of coronary artery disease (as a coronary vasodilator in stress testing). Contraindications - Hypersensitivity to dipyridamole, severe hypotension, unstable angina, recent myocardial infarction. Cautions - Heart failure, hypotension, myasthenia gravis, hepatic impairment, bleeding disorders, patients undergoing surgery. Avoid - Severe coronary artery disease without medical supervision, hypotension, breastfeeding. Trade names - Persantin®, Asasantin® (when combined with aspirin) Drug interactions - Enhanced effect with anticoagulants or antiplatelet drugs (increased bleeding risk); may reduce effectiveness of anticholinesterases in myasthenia gravis; adenosine effects may be increased due to inhibition of adenosine uptake. Adult: Oral: 75–100 mg four times daily; Modified-release: 200 mg twice daily (usually combined with aspirin). Child: Not routinely recommended; if used (specialist only), consult pediatric dosing guidelines for specific indication and monitoring.
Idarucizumab (Antidote and Chelator) Indications - Reversal of anticoagulant effects of dabigatran in patients requiring emergency surgery or urgent procedures, or in life-threatening or uncontrolled bleeding. Contraindications - Known hypersensitivity to idarucizumab or any excipients. Cautions - Risk of thrombosis due to reversal of anticoagulation. Consider re-initiating anticoagulant therapy as soon as medically appropriate. Dabigatran can be resumed 24 hours after administration; other anticoagulants can be started at any time. Use caution in patients with hereditary fructose intolerance (contains sorbitol). Avoid - Use only when dabigatran is the suspected cause of bleeding or anticoagulation. Not a general reversal agent for other NOACs. Trade names - Praxbind® injection Drug interactions - Specifically binds to dabigatran; no known interactions with other drugs. Not expected to affect other anticoagulants. Adult: 5 g intravenous infusion (administered as two consecutive 2.5 g/50 mL infusions no more than 15 minutes apart or as a bolus injection). Child: Not established; use under specialist supervision only. (Store in a refrigerator at 2–8°C; use under specialist supervision)
Asenapine (Second-generation antipsychotics) Indications - Treatment of moderate to severe manic episodes associated with bipolar I disorder in adults and adolescents (10–17 years); schizophrenia in adults. Contraindications - Severe hepatic impairment, known hypersensitivity to asenapine or any component of the formulation. Cautions - Cardiovascular disease, history of seizures, diabetes mellitus or risk factors for diabetes, elderly patients (especially with dementia-related psychosis), Parkinson’s disease, conditions that may cause hypotension, swallowing difficulties (sublingual route), hepatic impairment. Avoid - Pregnancy, breastfeeding, use in dementia with Lewy bodies (increased risk of adverse reactions and mortality). Trade names - Saphris® (sublingual tablets), Sycrest® Drug interactions - CYP1A2 inhibitors (e.g. fluvoxamine), CNS depressants, alcohol, QT-prolonging drugs, antihypertensives (additive hypotensive effect), dopamine agonists (antagonistic effects). Adult: 5–10 mg twice daily (sublingual); do not swallow or take with food or drink for at least 10 minutes after administration. Child: Adolescents (10–17 years): initially 2.5 mg twice daily, titrated up to 10 mg twice daily based on response and tolerability.
Meprobamate (Sedative, Hypnotic) Indications - Short-term management of anxiety disorders and tension; muscle relaxation. Contraindications - Acute porphyrias, acute pulmonary insufficiency, respiratory depression, hypersensitivity to meprobamate. Cautions - Hepatic impairment, renal impairment, abrupt withdrawal risk (dependence and withdrawal symptoms), debilitated patients, elderly, muscle weakness, respiratory diseases including COPD and asthma. Avoid - Pregnancy, breastfeeding. Trade names - Meprotab® (tab), Meprobamate® (cap) Drug interactions - Central nervous system depressants (alcohol, benzodiazepines, opioids), other sedatives, muscle relaxants. Adult: 400–600 mg three to four times daily, adjusted according to response. Child: Not generally recommended for children.
Clobazam (Hypnotic, Sedative, Anxiolytic) Indications - Epilepsy (especially Lennox–Gastaut syndrome), severe anxiety, adjunct in acute alcohol withdrawal. Contraindications - Severe respiratory insufficiency, myasthenia gravis, sleep apnea syndrome, hypersensitivity to benzodiazepines. Cautions - Muscle weakness, renal and hepatic impairment, history of drug or alcohol abuse, elderly (risk of sedation and falls), depression (may increase risk of suicide). Avoid - Chronic psychosis, hyperkinesis, respiratory depression, obsessional states, phobic states, breastfeeding. Trade names - Frisium®, Urbanol®, Onfi® Drug interaction - Increased sedation with alcohol, opioids, and CNS depressants; metabolism affected by CYP3A4 and CYP2C19 inhibitors/inducers (e.g., fluconazole, carbamazepine). Adult: Initially 20–30 mg daily in divided doses; maintenance 10–30 mg daily; max 60 mg/day depending on condition. Child: For epilepsy: 0.1–0.3 mg/kg/day initially, increase as needed (max 1 mg/kg/day or 40 mg/day).
Rufinamide (Antiepileptic) Indications - Adjunctive treatment of seizures associated with Lennox–Gastaut syndrome in patients aged 1 year and older. Contraindications - Familial short QT syndrome, hypersensitivity to triazole derivatives. Cautions - Hepatic impairment, history of suicidal ideation, status epilepticus, QT shortening on ECG. Avoid - Pregnancy, breastfeeding. Trade names - Inovelon®, Banzel® Drug interaction - May reduce levels of oral contraceptives; enzyme-inducing antiepileptics (e.g., carbamazepine, phenytoin) may lower rufinamide levels; increased risk of CNS depression with other antiepileptics. Adult: Initiate at 400–800 mg/day in two divided doses; increase by 400–800 mg every 2 days up to a max of 3200 mg/day (in divided doses). Child: Children ≥1 year: Start at 10 mg/kg/day in two divided doses; increase by 10 mg/kg/day every other day; usual maintenance 45 mg/kg/day (max 3200 mg/day).
Lacosamide (Antiepileptic) Indications - Adjunctive therapy in the treatment of focal (partial-onset) seizures in patients with epilepsy aged 4 years and older; monotherapy in adults with focal seizures. Contraindications - Second or third-degree AV block without a pacemaker, hypersensitivity to lacosamide. Cautions - Elderly, severe cardiac disease (including conduction disorders), pregnancy, hepatic impairment, suicidal ideation. Avoid - Breastfeeding. Trade names - Vimpat® Drug interaction - May increase PR interval with other sodium channel blockers or drugs that slow cardiac conduction (e.g., beta-blockers, calcium channel blockers); CNS depressants may enhance sedation. Adult: Initially 50 mg twice daily; increase by 100 mg/day at weekly intervals to max 400 mg/day (200 mg twice daily). Child:
Tedizolid (Oxazolidinone antibiotic) Indications - Acute bacterial skin and skin structure infections. Contraindications - Known hypersensitivity to oxazolidinones. Cautions - Myelosuppression, neuropathy, serotonin syndrome (especially with SSRIs). Avoid - Use in pregnancy; safety not established. Side effects - Nausea, headache, diarrhea, neutropenia, elevated liver enzymes. Trade names - Sivextro® Drug interactions - SSRIs, MAO inhibitors, tyramine-rich foods (risk of serotonin syndrome). Adult: 200 mg once daily for 6 days (oral or IV). Child: Limited data; not approved for pediatric use.
Lamotrigine (Antiepileptic) Indications - Focal seizures, Generalized seizures, Bipolar disorder (maintenance of mood stabilization). Contraindications - Known hypersensitivity to lamotrigine. Cautions - Parkinson's disease, Hepatic impairment, Renal failure, Pregnancy, Risk of rash (including Stevens-Johnson syndrome). Avoid - Breastfeeding (unless benefits outweigh risks); abrupt withdrawal. Side effects - Skin rash, dizziness, diplopia, headache, ataxia, nausea, somnolence, insomnia. Trade names - Lamictal®, Lamidus® Drug interactions - Valproate (increases lamotrigine levels), enzyme inducers (e.g., carbamazepine, phenytoin) reduce effectiveness. Adult: Start with 25 mg once daily, gradually titrated to 100–200 mg daily (depending on monotherapy or combination). Child: 1–5 years: 0.3 mg/kg/day starting dose; 5–12 years: 0.6 mg/kg/day, titrated based on response and co-medications.
Levetiracetam (Antiepileptic) Indications - Focal seizures, Epilepsy (adjunct therapy), Myoclonic seizures, Tonic-clonic seizures, Alzheimer’s disease (off-label), Iron deficiency anaemia (off-label), Neuropathic pain (off-label). Contraindications - Hypersensitivity to levetiracetam or any excipient. Cautions - Renal impairment (dose adjustment required), Hepatic impairment (use half dose initially), Pregnancy, Psychiatric history (risk of behavioral changes). Avoid - Breastfeeding (use with caution if benefits outweigh risks). Side effects - Somnolence, dizziness, asthenia, irritability, agitation, mood changes, headache, infection. Trade names - Levipil XR 1g Extended Release tab: Drug interactions - Few significant interactions; caution with CNS depressants and alcohol. Adult: Initial dose: 500 mg twice daily; may be increased to 1000–1500 mg twice daily based on response. Child: 6 months–17 years: 10 mg/kg twice daily, titrated up to 30–40 mg/kg/day.
Ethosuximide (Antiepileptic) Indications - Absence seizures (primary indication), Myoclonic seizures (off-label). Contraindications - Hypersensitivity to succinimides. Cautions - Hepatic impairment, Renal impairment, History of psychiatric disorders, Pregnancy (use only if clearly needed). Avoid - Acute porphyrias. Side effects - Nausea, vomiting, abdominal cramps, fatigue, dizziness, headache, behavioral disturbances (aggression, irritability). Trade names - Zarontin® tab, cap Drug interactions - May interact with other antiepileptic drugs (e.g., valproate, phenytoin); enzyme-inducing agents may alter levels. Adult: Oral 500 mg/day initially; increase by 250 mg every 4–7 days to a usual maintenance dose of 1000–1500 mg/day in 1–2 divided doses. Child: Oral 10–20 mg/kg/day in 1–2 divided doses; adjust up to 30 mg/kg/day if needed.
Eslicarbazepine acetate (Antiepileptic) Indications - Focal seizures (as monotherapy or adjunctive therapy). Contraindications - Hypersensitivity to eslicarbazepine, oxcarbazepine, or carbamazepine. Cautions - Elderly, Hyponatraemia, Hepatic impairment, Pregnancy (use only if clearly needed). Avoid - Breastfeeding, Severe renal impairment (CrCl <30 mL/min). Side effects - Dizziness, somnolence, nausea, headache, diplopia, hyponatraemia, rash. Trade names - Zebinix® tab Drug interactions - Reduces efficacy of hormonal contraceptives; interacts with phenytoin, warfarin, and other enzyme-modulating drugs. Adult: Initially 400 mg once daily, increased after 1–2 weeks to 800 mg once daily; max 1200 mg once daily. Child: For children ≥6 years: Initially 10 mg/kg once daily, increase based on response to max 30 mg/kg/day (not exceeding 1200 mg/day).
Nepafenac (Nonsteroidal anti-inflammatory drug - NSAID) Indications - Prophylaxis and treatment of postoperative pain and inflammation associated with cataract surgery; Reduction in the risk of postoperative macular oedema associated with cataract surgery in diabetic patients. Contraindications - Hypersensitivity to nepafenac or other NSAIDs, known NSAID-induced asthma or allergic reactions. Cautions - Bleeding disorders, use with other NSAIDs, ocular surface disease, delayed healing, corneal defects. Avoid - Direct sunlight exposure to eyes, contact lens use during treatment. Side effects - Eye pain, irritation, blurred vision, corneal edema, headache. Trade names - Nevanac® eye drops Drug interactions - Topical corticosteroids (increased risk of healing delay), systemic NSAIDs (additive effect). Adult: 1 drop three times daily beginning 1 day before surgery, continued on the day of surgery and for 14 days post-op. Child: Safety and efficacy not established in children under 10 years.
Sodium Cromoglicate (Mast cell stabilizer)Indications - Prophylaxis of bronchial asthma, Food allergy, Allergic conjunctivitis, Seasonal allergic keratoconjunctivitis, Prophylaxis of allergic rhinitis. Contraindications - Hypersensitivity to sodium cromoglicate or any of its components. Cautions - Hepatic and renal impairment (systemic use), discontinue if hypersensitivity reactions occur, not for relief of acute bronchospasm. Avoid - Use in acute asthma attacks (not a bronchodilator); avoid abrupt withdrawal in chronic use. Side effects - Cough, throat irritation, unpleasant taste (inhaled); eye irritation (ophthalmic); GI discomfort (oral). Trade names - Intal® (inhaler), Opticrom® (eye drops), Nalcrom® (oral capsules) Drug Interactions - No major known interactions; may be used with antihistamines or corticosteroids. Adult: Inhalation: 20 mg four times daily. Oral (food allergy): 200 mg four times daily before meals. Eye drops: 1-2 drops in each eye 4-6 times daily. Nasal spray: 1 spray in each nostril 4-6 times daily. Child: Inhalation: Same as adult. Oral: 100–200 mg four times daily (adjust based on response and age). Eye drops: Same as adult. Nasal spray: Use under medical advice.
Nedocromil Sodium (Mast cell stabilizer)Indications - Prophylaxis of bronchial asthma, Seasonal and perennial allergic conjunctivitis, Seasonal keratoconjunctivitis. Contraindications - Hypersensitivity to nedocromil or any component of the formulation. Cautions - Not effective for acute asthma attacks; discontinue if signs of hypersensitivity occur; use with caution in hepatic or renal impairment. Avoid - Use in acute asthma episodes; abrupt discontinuation after long-term use. Side effects - Headache, unpleasant taste, cough, throat irritation (inhalation); eye irritation, burning, or stinging (eye drops). Trade names - Tilade® Inhaler, Alocril® Eye Drops Drug Interactions - No major interactions; may be used with corticosteroids or bronchodilators. Adult: Inhalation: 4 mg (2 puffs) twice daily; may increase to 4 times daily. Eye drops: 1–2 drops in each eye twice daily. Child: Inhalation: Same as adult (usually for children >6 years). Eye drops: 1 drop in each eye twice daily (for children ≥3 years).
Lodoxamide (Mast cell stabilizer)Indications - Allergic conjunctivitis, Vernal keratoconjunctivitis, Seasonal allergic conjunctivitis. Contraindications - Hypersensitivity to lodoxamide or any of its components. Cautions - Use with caution in patients wearing contact lenses; remove lenses before application and wait 15 minutes before reinsertion. Avoid - Use in children under 2 years unless prescribed by a specialist. Side effects - Eye irritation, burning or stinging, blurred vision, eye dryness. Trade names - Alomide® Eye Drops Drug Interactions - No significant interactions known; avoid using other eye medications within 10 minutes of lodoxamide drops. Adult: 1–2 drops in the affected eye(s) 4 times daily. Child: Same as adult dose for children ≥2 years.
Abiraterone acetate (Antineoplastic)Indications - Metastatic castration-resistant prostate cancer, Metastatic high-risk castration-sensitive prostate cancer. Contraindications - Hypersensitivity to abiraterone or excipients, severe hepatic impairment, pregnancy (in women). Cautions - Diabetes, hypertension, history of cardiovascular disease, liver function abnormalities, risk of mineralocorticoid excess (fluid retention, hypokalaemia, hypertension). Avoid - Use in women, especially pregnant or breastfeeding; avoid food within 2 hours before and 1 hour after dose. Side effects - Hypertension, hypokalaemia, fluid retention, liver enzyme elevation, fatigue, joint swelling or pain. Trade names - Zytiga®, Xbira® Drug Interactions - CYP3A4 inhibitors/inducers, warfarin, digoxin, strong CYP2D6 substrates, corticosteroids. Adult: Oral 1 g (four 250 mg tablets) once daily on an empty stomach with prednisone 5 mg twice daily. Child: Not recommended for use in children.
Vinflunine (Antineoplastic)Indications - Advanced or metastatic urothelial tract cancer after failure of platinum-containing therapy. Contraindications - Severe hepatic impairment, neutropenia, pregnancy, breastfeeding, hypersensitivity to vinca alkaloids. Cautions - Cardiovascular disease, hepatic and renal impairment, risk of constipation and paralytic ileus, myelosuppression. Avoid - Use during pregnancy or lactation. Side effects - Neutropenia, anaemia, constipation, fatigue, nausea, stomatitis, peripheral neuropathy. Trade names - Javlor® Drug Interactions - CYP3A4 inhibitors/inducers (e.g., ketoconazole, rifampin), other myelosuppressive agents, laxatives (caution due to GI effects). Adult: IV 320 mg/m² over 20 minutes every 21 days. Child: Not recommended; safety and efficacy not established in pediatric patients.
Vindesine sulfate (Antineoplastic)Indications - Acute lymphoblastic leukemia, lymphoma, breast cancer, lung cancer, melanoma, and other solid tumors. Contraindications - Severe leukopenia, active infection, hypersensitivity to vinca alkaloids, pregnancy. Cautions - Requires specialized handling (cytotoxic), hepatic impairment, neuromuscular disease, breastfeeding. Avoid - Pregnancy, breastfeeding. Side effects - Myelosuppression, neurotoxicity, nausea, alopecia, constipation, local extravasation reactions. Trade names - Eldesine® Drug Interactions - CYP3A4 inhibitors/inducers, other neurotoxic or myelosuppressive agents, live vaccines. Adult: IV 3 mg/m² once weekly (adjusted based on patient response and toxicity). Child: IV 2.5–3 mg/m² once weekly (under specialist supervision).
Vincristine sulfate (Antineoplastic)Indications - Acute lymphoblastic leukemia, Hodgkin and non-Hodgkin lymphoma, neuroblastoma, Wilms tumor, breast cancer, lung cancer, and other solid tumors. Contraindications - Demyelinating form of Charcot-Marie-Tooth syndrome, hypersensitivity to vincristine or other vinca alkaloids. Cautions - Requires careful handling (cytotoxic, vesicant), neuromuscular disorders, hepatic impairment, elderly, constipation. Avoid - Pregnancy, breastfeeding. Side effects - Peripheral neuropathy, constipation, alopecia, myelosuppression (less than other vinca alkaloids), SIADH. Trade names - Oncovin®, Vincasar® Drug Interactions - CYP3A4 inhibitors, itraconazole, phenytoin (reduced effect), live vaccines. Adult: IV 1.4 mg/m² once weekly (max 2 mg/dose). Child: IV 1.5–2 mg/m² once weekly, based on age and condition (specialist supervision).
Topotecan (Antineoplastic)Indications - Metastatic ovarian cancer, cervical cancer, small cell lung cancer. Contraindications - Severe bone marrow depression, known hypersensitivity to topotecan. Cautions - Hepatic impairment, renal impairment, elderly, prior radiotherapy or chemotherapy, myelosuppression. Avoid - Pregnancy, breastfeeding. Side Effects - Myelosuppression, neutropenia, anemia, thrombocytopenia, nausea, vomiting, diarrhea, fatigue. Trade Names - Hycamtin® Drug Interactions - Drugs causing bone marrow suppression, nephrotoxic agents, live vaccines. Adult: IV: 1.5 mg/m² once daily for 5 days every 21 days; Oral: 2.3 mg/m² once daily for 5 days every 21 days. Child: IV: 1.4–2 mg/m²/day for 5 days every 21 days (under specialist supervision).
Ribavirin (Antiviral) Indications - Bronchiolitis caused by respiratory syncytial virus (RSV), Parainfluenza virus infections, Chronic hepatitis C (in combination with interferon or other antiviral agents). Contraindications - Severe cardiac disease, autoimmune hepatitis, hemoglobinopathies (e.g., thalassemia major, sickle cell anemia), pregnancy, hypersensitivity to ribavirin. Cautions - Renal impairment, hepatic dysfunction, older adults, anemia, history of psychiatric disorders, male partners of pregnant women (teratogenic risk). Avoid - Pregnancy (highly teratogenic), breast feeding, monotherapy for hepatitis C (ineffective), severe unstable cardiac disease. Side Effects - Hemolytic anemia, fatigue, headache, nausea, cough, depression, insomnia. Trade Names - Virazole®, Copegus®, Rebetol®, Ribasure® Drug Interactions - Didanosine (risk of mitochondrial toxicity), azathioprine (increased risk of pancytopenia), zidovudine (increased hematologic toxicity). Adult: For hepatitis C (oral): 800–1200 mg/day in divided doses based on weight, usually for 24–48 weeks in combination with interferon. For RSV (inhalation): 6 g/day via aerosol for 12–18 hours/day for 3–7 days. Child: For RSV (inhalation): 20 mg/mL via aerosol (dose and duration depend on age and clinical severity, typically 3–7 days); not recommended for hepatitis C in children unless under specialist care.
Tribavirin (Antiviral) Indications - Bronchiolitis caused by respiratory syncytial virus (RSV), Parainfluenza virus infection, Chronic hepatitis C (in combination therapy). Contraindications - Severe cardiac disease, autoimmune hepatitis, hemoglobinopathies (e.g., thalassemia, sickle cell anemia), pregnancy, hypersensitivity to ribavirin. Cautions - Renal impairment, hepatic dysfunction, anemia, psychiatric history, elderly patients, teratogenic risk (in men and women). Avoid - Pregnancy, breast feeding, monotherapy in hepatitis C, unstable cardiovascular conditions. Side Effects - Hemolytic anemia, depression, irritability, nausea, rash, fatigue, insomnia. Trade Names - Tribavirin®, Ribavirin®, Rebetol®, Copegus® Drug Interactions - Didanosine (risk of fatal mitochondrial toxicity), azathioprine (bone marrow suppression), zidovudine (increased anemia risk). Adult: Hepatitis C (oral): 800–1200 mg/day in divided doses depending on weight, for 24–48 weeks with interferon. RSV (inhalation): 6 g/day via aerosol for 12–18 hrs/day for 3–7 days. Child: RSV (inhalation): 20 mg/mL via aerosol; typical course 3–7 days depending on age and severity. Chronic hepatitis C only under specialist care.
Ritonavir (Antiviral, Pharmacokinetic Enhancer) Type of Drug - Antiviral (HIV protease inhibitor); used as a booster for other antiviral agents in HCV and HIV therapy. Indications - Chronic Hepatitis C Genotype 1 (in combination with paritaprevir, ombitasvir, and dasabuvir); Genotype 4 (with paritaprevir, ombitasvir, and ribavirin); also used in HIV therapy as a booster. Contraindications - Severe hepatic impairment, hypersensitivity to ritonavir, use with certain medications (e.g., amiodarone, alfuzosin, ergot derivatives, lovastatin). Avoid - HIV co-infection (when used only for HCV), breastfeeding, use in patients with significant liver disease. Cautions - Hepatic dysfunction, cardiac conduction abnormalities, co-administration with other hepatotoxic or enzyme-inducing drugs. Side Effects - Nausea, vomiting, diarrhea, taste perversion, hepatotoxicity, lipid abnormalities. Trade Names - Norvir tab:® Drug Interactions - Extensive CYP3A4 and P-gp inhibitor – interacts with statins, sedatives, anticonvulsants, hormonal contraceptives, antiarrhythmics, and others. Adult: 100 mg once daily (as pharmacokinetic enhancer in combination therapy). Child: Dose varies by weight and indication in HIV; not typically used in pediatric HCV regimens.
Paritaprevir (Antiviral) Type of Drug - NS3/4A protease inhibitor antiviral agent used in combination therapy for Hepatitis C. Indications - Chronic Hepatitis C virus (HCV) infection, Genotype 1 (with ombitasvir, ritonavir, and dasabuvir), Genotype 4 (with ombitasvir, ritonavir, and ribavirin). Contraindications - Moderate to severe hepatic impairment (Child-Pugh B or C), hypersensitivity to any component, use with drugs highly dependent on CYP3A for clearance. Avoid - HIV co-infection, pregnancy if combined with ribavirin. Cautions - Hepatic enzyme elevations, potential drug interactions, patients with liver transplant history. Side Effects - Fatigue, nausea, pruritus, insomnia, increased bilirubin, rash. Trade Names - Viekira Pak tab:® Drug Interactions - Avoid strong CYP3A inhibitors or inducers; interactions with statins, antiretrovirals, hormonal contraceptives containing ethinyl estradiol. Adult: 150 mg once daily (in fixed-dose combination). Child: Not recommended for pediatric use.
Ombitasvir (Antiviral) Type of Drug - NS5A inhibitor antiviral agent used in combination therapy for Hepatitis C. Indications - Chronic Hepatitis C virus (HCV) infection, Genotype 1 (with paritaprevir/ritonavir and dasabuvir), Genotype 4 (with paritaprevir/ritonavir and ribavirin). Contraindications - Severe hepatic impairment (Child-Pugh C), known hypersensitivity to any component of the regimen. Avoid - HIV co-infection, moderate to severe liver impairment. Cautions - Hepatic enzyme elevation, potential drug interactions, prior liver transplant. Side Effects - Fatigue, nausea, pruritus, insomnia, elevated bilirubin levels, rash. Trade Names - Viekira Pak tab:® Drug Interactions - Caution with CYP3A inducers/inhibitors, statins, antiretrovirals, and hormonal contraceptives containing ethinyl estradiol. Adult: 25 mg ombitasvir once daily (as part of combination therapy). Child: Not recommended for pediatric use.
Lopinavir Indications - HIV-1 infection in combination with other antiretrovirals. Contraindications - Severe hepatic impairment, concurrent use with drugs highly dependent on CYP3A for clearance (e.g., ergot derivatives, rifampin, midazolam). Cautions - Hepatitis B or C co-infection, pancreatitis, diabetes mellitus, QT prolongation, hemophilia, lipid abnormalities. Avoid - Pregnancy (use only if potential benefit justifies potential risk), Breastfeeding in HIV-positive mothers. Interactions - CYP3A inhibitors/inducers, antiarrhythmics, benzodiazepines, statins (especially simvastatin, lovastatin), oral contraceptives. Trade names - Kaletra® (Lopinavir + Ritonavir) Adult: 400 mg lopinavir/100 mg ritonavir orally twice daily, or 800 mg/200 mg once daily in selected patients. Child: Dose based on body weight or surface area; typically 300 mg/m² of lopinavir + 75 mg/m² ritonavir twice daily. Use oral solution in young children.
Hydrocortisone (Corticosteroid) Type of Drug - Corticosteroid (glucocorticoid) Indications - Thyrotoxic crisis, Adrenocortical insufficiency (including septic shock), Acute hypersensitivity reactions (e.g. angioedema, anaphylaxis with adrenaline), Severe inflammatory bowel disease, Ulcerative colitis, Severe acute asthma, Local joint and soft-tissue inflammation, Oral and perioral lesions, Mild inflammatory skin disorders (e.g. eczema). Contraindications - Untreated systemic infections (unless life-saving), hypersensitivity to hydrocortisone or excipients. Avoid - Long-term use, use in untreated infections, viral skin infections (if topical), breastfeeding unless benefits outweigh risks. Cautions - Diabetes mellitus, hypertension, peptic ulcer, osteoporosis, epilepsy, glaucoma, tuberculosis, recent myocardial infarction, immunosuppression. Side Effects - Fluid retention, hypertension, hyperglycemia, osteoporosis, mood changes, adrenal suppression, increased infection risk, skin thinning (topical). Trade Names - Hydrokant cream:®, Hydrotopic cream:® Drug Interactions - NSAIDs (increased ulcer risk), live vaccines (avoid), antidiabetics (reduced efficacy), enzyme inducers (e.g., rifampicin), contraceptives (may affect metabolism). Adult: IV: 100–500 mg every 6–8 hours (crisis); topical: apply 1–2 times daily (short-term use). Child: IV: 1–2 mg/kg every 6–8 hours (acute); topical: apply thinly 1–2 times daily under medical supervision.
Chenodeoxycholic acid (Bile acid) Indications - Cerebrotendinous xanthomatosis, Gallstone dissolution in selected non-calcified, radiolucent cholesterol gallstones in patients unsuitable for surgery. Contraindications - Known hypersensitivity to bile acids, Obstructive liver disease, Active peptic ulcer, Calcified or pigmented gallstones, Chronic liver disease, Inflammatory bowel disease, Severe hepatic impairment. Avoid - Use in pregnancy and breastfeeding unless essential and under specialist supervision. Cautions - Monitor liver function regularly, Risk of diarrhea, Use with caution in patients with liver dysfunction, Not recommended in patients with radiopaque stones. Side Effects - Diarrhea, liver enzyme abnormalities, nausea, abdominal pain, pruritus (in cholestasis). Trade Names - cap: Chenofalk® (Specialist use only) Drug Interactions - Avoid aluminum-based antacids (may bind bile acids), bile acid sequestrants (e.g., cholestyramine), estrogens and oral contraceptives (may promote gallstone formation). Adult: 250 mg three times daily with meals; adjusted by specialist according to indication and response. Child: Specialist-determined dose based on age, weight, and indication (commonly 5–15 mg/kg/day in divided doses).
Alverine citrate (Spasmolytic) Indications - Irritable bowel syndrome, Abdominal pain and discomfort associated with intestinal spasm, including diverticular disease. Contraindications - Hypersensitivity to alverine or any excipients, paralytic ileus, intestinal obstruction, or dynamic ileus. Avoid - Use in children, known hypersensitivity. Cautions - Use during pregnancy and breastfeeding only if clearly needed; hepatic impairment; long-term use not recommended without medical supervision. Side Effects - Nausea, dizziness, headache, allergic skin reactions, hepatitis (rare). Trade Names - tab: Spasmonal® Drug Interactions - No significant interactions reported, but caution with other antispasmodics or sedatives. Adult: 60 mg three times daily; may be increased to 120 mg three times daily if required. Child: Not recommended for pediatric use.
Simeticone (Antiflatulent) Indications - Relief of bloating, flatulence, functional dyspepsia, and abdominal discomfort. Contraindications - Known hypersensitivity to simeticone or any component of the formulation. Avoid - Hypersensitivity, use in cases of intestinal perforation or obstruction. Cautions - Use with caution in infants; evaluate underlying causes of persistent symptoms. Side Effects - Rare; occasionally mild gastrointestinal disturbances. Trade Names - cap: Infacol®, liquid: Wind-eze® Drug Interactions - No significant interactions known; can be co-administered with most medications. Adult: 40–125 mg up to four times daily, typically after meals and at bedtime. Child: 20 mg up to four times daily, usually after feeds.
Alginic acid (Gastro-oesophageal reflux suppressant) Indications - Gastro-oesophageal reflux disease (GORD), Heartburn, Acid regurgitation. Contraindications - Known hypersensitivity to alginic acid or formulation components. Avoid - Hypersensitivity, use in patients with swallowing difficulties. Cautions - Avoid in cases of phenylketonuria (some formulations may contain aspartame), monitor sodium intake in patients on sodium-restricted diets. Side Effects - Rare; may include nausea, constipation, or hypersensitivity reactions. Trade Names - liquid: Gaviscon® Drug Interactions - May interfere with the absorption of other oral medications—separate administration by at least 2 hours. Adult: 10–20 mL after meals and at bedtime. Child: Dose varies by age: typically 5–10 mL after meals and at bedtime; consult specialist for infants or toddlers.
Ursodeoxycholic Acid (Bile acid – hepatobiliary agent) Indications - Dissolution of cholesterol-rich gallstones (in patients with functioning gallbladder), Primary biliary cholangitis (formerly primary biliary cirrhosis), Intrahepatic cholestasis. Contraindications - Non-functioning gall bladder, Calcified (radio-opaque) gallstones, Acute inflammation of the gall bladder or biliary tract, Obstruction of bile ducts, Circulatory disturbances of bile, Hypersensitivity to bile acids. Avoid - Pregnancy (unless essential), Breastfeeding, Severe hepatic impairment. Cautions - Monitor liver function regularly during therapy, Use with caution in liver disease, May require dose adjustment in renal impairment. Side Effects - Diarrhea (most common), Nausea, Vomiting, Abdominal pain, Pruritus, Elevated liver enzymes (rare). Trade Names - Udchol Forte tab:®, Ursocol 300 tab:®, Ursocol 150 tab:®, Sulgidam cap:® Drug Interactions - May reduce effectiveness of bile acid sequestrants (e.g., cholestyramine), aluminium-based antacids; separate doses by at least 2 hours. Estrogens and oral contraceptives may increase cholesterol levels in bile and counteract the effects. Adult: Gallstone dissolution: 8–12 mg/kg/day in 2–3 divided doses; PBC: typically 13–15 mg/kg/day in 2–4 divided doses. Child: Dose varies by indication and body weight; typically 10–20 mg/kg/day in divided doses under specialist supervision.
Gemfibrozil (Serum triglyceride reducer – lipid-regulating agent) Indications - Hyperlipidaemia (adjunct to diet) in primary hypercholesterolaemia if statin is contraindicated or not tolerated. Adjunct to diet in the primary prevention of cardiovascular disease in men with hyperlipidaemia if statins are contraindicated or not tolerated. Contraindications - History of gallbladder disease or biliary tract disease including gallstones, Severe renal or hepatic impairment, Known hypersensitivity to gemfibrozil. Cautions - Correct hypothyroidism before initiating treatment, Monitor liver function and blood counts periodically, Use with caution in patients with history of gallstones. Avoid - Pregnancy, Breastfeeding, Severe hepatic or renal impairment. Side Effects - Constipation, Diarrhea, Fatigue, Gastrointestinal discomfort, Vomiting, Headache, Skin rash or reactions, Myopathy (rare). Trade Names - tab: Lopid®, cap: Gemfibrozil® Drug Interactions - Increased risk of myopathy with statins (especially simvastatin), anticoagulants (e.g., warfarin – enhanced effect), antidiabetic agents (potentiation of effect), cyclosporine (increased toxicity). Adult: 600 mg twice daily, 30 minutes before morning and evening meals. Child: Not recommended for pediatric use.
Teduglutide (GLP-2 analogue) Indications - Short bowel syndrome in patients dependent on parenteral nutrition, including those with chronic intestinal failure. Contraindications - Known or suspected malignancy in the gastrointestinal tract, liver, gallbladder or pancreas; hypersensitivity to teduglutide or any of its excipients. Avoid - Use during pregnancy and breastfeeding, Active or suspected gastrointestinal malignancies. Cautions - History of gastrointestinal obstruction, Active gallbladder or biliary tract disease, Pancreatic disease, Cardiovascular disease due to risk of fluid overload, Monitor electrolytes, fluid balance, and signs of intestinal neoplasia during therapy. Side Effects - Abdominal pain, nausea, injection site reactions, gastrointestinal polyps, fluid overload, stoma complications, respiratory infections. Trade Names - inj: Revestive® (Specialist use only) Drug Interactions - May alter absorption of concomitantly administered oral medications; monitor clinical response of critical-dose drugs (e.g., digoxin, antiepileptics). Adult: 0.05 mg/kg once daily by subcutaneous injection, same time each day. Child: 0.05 mg/kg once daily by subcutaneous injection; dose adjustment may be required based on tolerance and clinical response.
Linaclotide (Guanylate cyclase-C agonist) Indications - Irritable bowel syndrome with constipation (IBS-C), Chronic idiopathic constipation (CIC). Contraindications - Known or suspected mechanical gastrointestinal obstruction, Hypersensitivity to linaclotide or any excipients. Avoid - Use during pregnancy, Inflammatory bowel disease (e.g., Crohn’s disease, ulcerative colitis), Intestinal obstruction. Cautions - Monitor for severe or prolonged diarrhoea, Use with caution in the elderly and patients with renal impairment due to dehydration risk. Side Effects - Diarrhoea, abdominal pain, flatulence, abdominal distension, headache, fatigue. Trade Names - cap: Constella® Drug Interactions - May affect absorption of orally administered drugs due to increased GI transit; monitor if co-administered with drugs of narrow therapeutic index. Adult: 290 micrograms once daily at least 30 minutes before food. Child: Not recommended for pediatric use.
Vedolizumab (Integrin receptor antagonist)Indications - Moderate to severe ulcerative colitis, Crohn’s disease in adults who have had an inadequate response with, lost response to, or were intolerant to conventional therapy or TNFα inhibitors. Contraindications - Hypersensitivity to vedolizumab or any of its excipients. Avoid - Severe active infections, use in pregnancy and breastfeeding unless benefits outweigh risks. Cautions - Monitor for infections during and after treatment, Perform tuberculosis screening prior to initiation, Risk of progressive multifocal leukoencephalopathy (PML), Hypersensitivity or infusion-related reactions. Side Effects - Nasopharyngitis, headache, arthralgia, nausea, pyrexia, upper respiratory tract infection, fatigue. Trade Names - inj: Entyvio® (Specialist use only) Drug Interactions - Limited data available; caution advised with concomitant immunosuppressants or biologic agents. Adult: 300 mg IV at 0, 2, and 6 weeks, then every 8 weeks thereafter. Child: Not recommended (safety and efficacy not established in pediatric patients).
Mesalazine (Aminosalicylate anti-inflammatory)Indications - Treatment of mild to moderate ulcerative colitis, maintenance of remission in ulcerative colitis, Crohn’s ileo-colitis, and ulcerative proctitis. Contraindications - Severe renal impairment, hypersensitivity to salicylates or mesalazine. Avoid - Children with blood clotting abnormalities. Cautions - Use with caution in elderly patients, those with pulmonary disease (especially asthma), hepatic or renal impairment. Side Effects - Nausea, abdominal pain, headache, flatulence, rash, rare blood dyscrasias. Trade Names - tab: Pentasa®, Asacol®, Salofalk® cap: Mezavant® Drug Interactions - Caution with nephrotoxic drugs (e.g., NSAIDs), azathioprine, mercaptopurine (risk of myelosuppression). Adult: 2–4 g/day in divided doses for active disease; 1.2–2.4 g/day for maintenance. Child: Varies by age and formulation; typically 20–30 mg/kg/day in divided doses under specialist supervision.
Urea hydrogen peroxide (Cerumenolytic agent)Indications - Softening and removal of earwax (cerumen). Contraindications - Perforated eardrum, ear infection, inflammation, or eczema of the ear canal. Avoid - Use in case of known hypersensitivity, avoid contact with eyes. Cautions - Discontinue if irritation or inflammation occurs; use under medical supervision if ear surgery history exists. Side Effects - Mild stinging, itching, irritation, or temporary hearing changes. Trade Names - ear-drop: Exterol®, Otex® Drug Interactions - None known when used as directed. Adult: 5 drops into affected ear(s) once or twice daily for up to 3–4 days. Child: Same as adults; under supervision in children under 12 years.
Methoxyflurane (General anaesthetic)Indications - Short-term relief of moderate to severe pain associated with trauma in conscious adult and adolescent patients. Contraindications - Significant renal impairment, cardiovascular instability, respiratory depression, impaired consciousness, known or suspected genetic susceptibility to malignant hyperthermia, history of liver damage after prior use. Avoid - Use in patients with cardiovascular disease, impaired consciousness, or respiratory depression. Cautions - Use with caution in elderly, hypotension, concurrent use of nephrotoxic drugs, prolonged use increases toxicity risk. Side Effects - Dizziness, headache, nausea, somnolence, hypotension, renal toxicity (dose-related). Trade Names - inhaler: Penthrox® Drug Interactions - Avoid concurrent use with nephrotoxic agents (e.g., aminoglycosides), CNS depressants, or enzyme inducers. Adult: 3 mL via inhaler, may repeat once; maximum 6 mL/day and 15 mL/week. Child: Not recommended in children under 12 years.
Cinchocaine with Hydrocortisone (Local anaesthetic and corticosteroid combination)Indications - Haemorrhoids, Pruritus ani. Contraindications - Hypersensitivity to ingredients, untreated bacterial/fungal/viral anorectal infections. Avoid - Prolonged use, use in broken or infected skin. Cautions - Topical or intra-anal administration may lead to systemic absorption, especially with prolonged use or on broken skin. Side Effects - Local irritation, allergic reactions, thinning of perianal skin with prolonged use. Trade Names - supp: Proctosedyl®, oint: Uniroid HC® Drug Interactions - Avoid concomitant use with other topical corticosteroids or anaesthetics unless advised. Adult: Apply or insert into the rectum twice daily, morning and evening, and after each bowel movement. Child: Not recommended without medical supervision.
Rifaximin (Antibiotic – rifamycin class) Indications - Traveller’s diarrhoea (non-invasive strains of E. coli), Hepatic encephalopathy (to reduce recurrence), Irritable bowel syndrome with diarrhoea (IBS-D). Contraindications - Hypersensitivity to rifaximin or other rifamycins, history of pseudomembranous colitis. Avoid - Intestinal obstruction, pregnancy, breastfeeding, significant hepatic impairment (especially for hepatic encephalopathy indication). Cautions - Prolonged use may lead to bacterial resistance or C. difficile-associated diarrhoea. Side Effects - Nausea, flatulence, abdominal pain, headache, peripheral oedema. Trade Names - tab: Xifaxan®, cap: Zaxine® Drug Interactions - May affect efficacy of warfarin (monitor INR), cyclosporine may increase rifaximin levels. Adult: Traveller’s diarrhoea: 200 mg 3 times daily for 3 days; Hepatic encephalopathy: 550 mg twice daily. Child: Not recommended under 12 years; dosing in adolescents must be guided by a specialist.
Daunorubicin (Antineoplastic – Anthracycline class) Indications - Acute myelogenous leukaemia (AML), Acute lymphocytic leukaemia (ALL), Advanced AIDS-related Kaposi’s sarcoma. Contraindications - Severe myocardial insufficiency, recent myocardial infarction, uncontrolled infection, marked myelosuppression. Avoid - Pregnancy, breastfeeding, severe hepatic or renal impairment. Cautions - Pre-existing cardiac disease, previous anthracycline therapy, bone marrow suppression, elderly, hepatic/renal impairment. Side Effects - Cardiotoxicity, myelosuppression, alopecia, mucositis, nausea, vomiting, red discoloration of urine. Trade Names - inj: Cerubidine®, DaunoXome® Drug Interactions - Increased cardiotoxicity with other cardiotoxic agents (e.g. trastuzumab), increased toxicity with cyclophosphamide, avoid live vaccines. Adult: AML: 45–60 mg/m² IV once daily for 1–3 days in combination regimens (adjust per protocol). Child: Commonly 25–45 mg/m² IV per dose depending on regimen and protocol – specialist supervision required.
Siltuximab (Antineoplastic – IL-6 inhibitor) Indications - Multicentric Castleman’s disease (MCD) in HIV-negative and HHV-8-negative patients. Contraindications - Severe infections, hypersensitivity to siltuximab or its components. Avoid - Pregnancy, breastfeeding, active severe infections, GI perforation risk. Cautions - Monitor for infusion-related reactions, neutropenia, thrombocytopenia, gastrointestinal perforation, lipid changes, and infections. Side Effects - Infections, pruritus, rash, upper respiratory tract infections, weight gain, hyperlipidemia, infusion reactions. Trade Names - inj: Sylvant® Drug Interactions - May alter CYP450 activity—monitor drugs with narrow therapeutic index (e.g. warfarin, cyclosporine). Adult: 11 mg/kg IV over 1 hour every 3 weeks. Child: Not recommended – safety and efficacy not established.
Pixantrone (Antineoplastic – Anthracenedione derivative) Indications - Relapsed or refractory aggressive non-Hodgkin's B-cell lymphomas in adults who have failed two or more prior lines of therapy. Contraindications - Severe hepatic impairment, baseline neutrophil count <1500/mm³, baseline platelet count <100,000/mm³, severe cardiac disease, recent myocardial infarction, hypersensitivity to pixantrone or excipients. Avoid - Active severe infections, pregnancy, breastfeeding. Cautions - Cardiac monitoring (risk of cardiotoxicity), myelosuppression, secondary malignancies, hepatic and renal function monitoring. Side Effects - Neutropenia, anemia, thrombocytopenia, nausea, vomiting, fatigue, infections, cardiotoxicity. Trade Names - inj: Pixuvri® Drug Interactions - Avoid concomitant use with other cardiotoxic agents; increased toxicity risk with live vaccines. Adult: 50 mg/m² IV on days 1, 8, and 15 of a 28-day cycle, for up to 6 cycles. Child: Not recommended – safety and efficacy not established in pediatric patients.
Idarubicin HCl (Antineoplastic)Indications - Acute non-lymphocytic leukemias (ANLL), Acute myeloid leukemia (AML), Advanced breast cancer. Contraindications - Hypersensitivity to Idarubicin or other anthracyclines, Recent myocardial infarction, Severe arrhythmias, Myocardial insufficiency, Persistent myelosuppression, Severe hepatic or renal impairment, Uncontrolled infection. Caution - Use with caution in patients with cardiac disease, liver/kidney dysfunction, bone marrow suppression, prior radiation therapy, or prior anthracycline treatment. Monitor cardiac function before and during treatment. Avoid - Live vaccines, concomitant use with other cardiotoxic agents unless benefits outweigh risks, pregnancy and breastfeeding. Trade Names - Zavedos®, Idamycin®, Idarubicin Sandoz®. Drug Interaction - Increased toxicity with other cytotoxic drugs; enhanced cardiotoxicity with cyclophosphamide, trastuzumab, or paclitaxel. Reduced effect with concomitant use of hepatically metabolized drugs. Additive myelosuppression with radiation or other chemotherapy agents. Adult: AML (IV): 12 mg/m² daily for 3 days in combination with cytarabine (induction). For breast cancer (off-label): 10-12 mg/m² IV every 3-4 weeks as monotherapy or with other agents. Child: AML: 10-12 mg/m² IV daily for 3 days (adjusted per protocol and BSA); requires close monitoring of cardiac function and blood counts.
Temozolomide (Antineoplastic)Indications - Malignant glioblastoma multiforme (GBM) in adults, Anaplastic astrocytoma, Newly diagnosed glioblastoma in combination with radiotherapy followed by maintenance therapy. Contraindications - Hypersensitivity to temozolomide or dacarbazine, Severe myelosuppression. Cautions - Risk of Pneumocystis jirovecii pneumonia (especially when given with radiotherapy), Hepatic/renal impairment, History of myelosuppression, Opportunistic infections, Secondary malignancies, Infertility risk. Avoid - Live vaccines, Pregnancy, Breastfeeding, Concomitant use with other myelosuppressive agents without proper monitoring. Trade Names - Temodar®, Temodal®, Temcad®, Temonat®. Drug Interaction - Additive myelosuppressive effects with other cytotoxic drugs, Possible reduced effectiveness with enzyme-inducing antiepileptics (e.g., phenytoin, carbamazepine), Increased hematologic toxicity with radiation. Adult: Newly diagnosed GBM: 75 mg/m² orally once daily with radiotherapy for 42 days, followed by 150–200 mg/m² once daily for 5 days every 28 days for up to 6 cycles. Child: Recurrent brain tumors: 150–200 mg/m² orally once daily for 5 days every 28 days (adjust based on tolerance and protocol). Tab: ®, Cap: ®
Framycetin Sulphate (Aminoglycoside Antibiotic)Indications - Trauma, Abrasions, Cut wounds, Ulcers, Burns, Skin graft donor sites, Infected dermatoses. Contraindications - Hypersensitivity to framycetin or other aminoglycosides, Extensive application on large areas especially in renal impairment, Deep or puncture wounds, Otitis externa with perforated eardrum. Cautions - Use with caution in prolonged treatments or over large surface areas; risk of systemic absorption especially in renal impairment. Avoid - Ocular use, Inhalation, Application to perforated tympanic membrane, Use in neonates unless prescribed. Trade Names - Soframycin® (cream/skin ointment), Framygen® (ointment), Framycort® (ointment with corticosteroids), Sofradex® (ear/eye drops). Drug Interaction - Potential additive nephrotoxicity or ototoxicity if absorbed systemically and used with other nephrotoxic/ototoxic drugs (e.g., vancomycin, furosemide). Minimal interaction with topical use unless systemic absorption occurs. Adult: Apply thin layer of cream or ointment 2–3 times daily. For wound care, MB-tulle dressing soaked with framycetin solution may be used. Child: Same as adults; apply with caution in infants and young children. Avoid prolonged or extensive use. Cream: Soframycin®, Ointment: Framygen®, Drops: Sofradex®
Gramicidin (Topical Polypeptide Antibiotic)Indications - Topical treatment of skin infections, Wounds, Burns, Minor cuts, Eye and ear infections (in combination). Contraindications - Hypersensitivity to gramicidin or combination components, Perforated tympanic membrane (in ear use), Deep or puncture wounds, Systemic infection requiring systemic antibiotics. Cautions - Avoid contact with eyes (unless ophthalmic preparation), prolonged use may promote resistance or secondary infection. Use cautiously in large areas or broken skin. Avoid - Systemic use, Long-term use without supervision, Use in neonates unless prescribed. Trade Names - Sofradex® (ear/eye drops: with dexamethasone and framycetin), Neosporin® (ointment: with neomycin, polymyxin B), Gramyderm® (topical cream/ointment). Drug Interaction - Minimal with topical use; additive ototoxicity or nephrotoxicity if absorbed systemically and combined with other ototoxic drugs. Avoid use with other topical antibiotics that may cause cross-sensitivity. Adult: Apply a thin layer 2–3 times daily to affected skin. For otic/ophthalmic use: 2–3 drops in affected ear/eye 3–4 times daily (as per product label). Child: Same as adult. Use with caution in young children, especially in otic preparations. Ointment: Neosporin®, Drops: Sofradex®, Cream: Gramyderm®
Pentostatin (Antineoplastic)Indications - Hairy cell leukaemia (HCL), particularly in patients intolerant or unresponsive to interferon alfa. Contraindications - Severe renal impairment (CrCl < 60 mL/min), Active infections, Hypersensitivity to pentostatin. Cautions - Monitor renal function and blood counts before and during treatment; Risk of immunosuppression, opportunistic infections, and pulmonary toxicity (especially with prior chemotherapy or radiotherapy). Avoid - Concomitant use with fludarabine (severe pulmonary toxicity risk), Live vaccines during and after treatment, Use in pregnancy and breastfeeding. Side Effects - Myelosuppression (anemia, leukopenia, thrombocytopenia), Nausea, Vomiting, Rash, Fever, Fatigue, Respiratory symptoms (cough, dyspnea), Risk of opportunistic infections. Trade Names - Inj: Nipent® (Specialist use only) Drug Interaction - Severe pulmonary toxicity with fludarabine, Increased risk of immunosuppression when combined with other cytotoxic drugs, Avoid live vaccines. Adult: 4 mg/m² IV every other week. Adjust based on renal function and hematologic response. Monitor CBC and renal function prior to each dose. Child: Safety and efficacy not well established. Use only under expert supervision in pediatric oncology settings.
Etoposide (Antineoplastic)Indications - Small cell lung carcinoma, Testicular cancer (usually in combination chemotherapy), Hodgkin and non-Hodgkin lymphomas, Acute myeloid leukemia, Kaposi sarcoma (AIDS-related). Contraindications - Hypersensitivity to etoposide or polysorbate 80 (used in IV form), Severe hepatic or renal impairment unless adjusted, Pregnancy and breastfeeding. Cautions - Bone marrow suppression, Renal or hepatic dysfunction (dose adjustment needed), Elderly patients, Risk of secondary leukemia with long-term use, Monitor CBC and liver/kidney function regularly. Avoid - Live vaccines during and after treatment, Concomitant use with other myelosuppressive drugs without close monitoring. Adverse Effects - Alopecia, Nausea, Vomiting, Myelosuppression, Hypotension (IV form), Mucositis, Anorexia. Trade Names - Cap: Vepesid®, Inj: Etopophos®, Etoposide Ebewe® (Specialist use only) Drug Interaction - Increased toxicity with cyclosporine (elevated plasma levels), Additive myelosuppression with other cytotoxics, Possible reduced effectiveness with warfarin, Caution with live vaccines. Adult: Cap/Oral: 100–200 mg/m²/day for 5 days in 21-day cycles. IV: 50–100 mg/m²/day for 5 days or 100 mg/m² on alternate days. Adjust for renal/hepatic function. Child: Oral/IV: 100–200 mg/m²/day for 5 days every 21–28 days. Dose modifications required based on toxicity and response; use under oncologist supervision.
Fludarabine (Antineoplastic)Indications - Chronic lymphocytic leukaemia (CLL), Low-grade non-Hodgkin lymphoma, Hairy cell leukaemia (off-label), Acute myeloid leukaemia (as part of conditioning regimens). Contraindications - Cautions - Bone marrow suppression, Autoimmune hemolytic anemia, CNS toxicity (rare but serious), Risk of opportunistic infections, Monitor CBC and renal function. Avoid - Concomitant use with pentostatin (increased risk of fatal pulmonary toxicity), Live vaccines, Use in children unless under expert supervision. Side Effects - Myelosuppression (anemia, neutropenia, thrombocytopenia), Nausea, Vomiting, Fatigue, Fever, Infections, Neurotoxicity (confusion, seizures at high doses). Trade Names - Tab: Fludara®, Inj: Fludara® IV (Specialist use only) Drug Interaction - Fatal pulmonary toxicity when combined with pentostatin, Additive immunosuppression with other cytotoxic agents, decreased efficacy of vaccines, Caution with other nephrotoxic or neurotoxic agents. Adult: CLL: 25 mg/m² IV or orally once daily for 5 consecutive days, every 28 days. Adjust dose for renal function. Child: Not routinely recommended; specialist pediatric oncology dosing required if used (e.g., 25 mg/m²/day IV for 5 days every 28 days).
Cladribine (Antineoplastic)Indications - Hairy cell leukaemia, B-cell chronic lymphocytic leukaemia (off-label), Relapsing forms of multiple sclerosis (MS). Contraindications - Active chronic infections (e.g., tuberculosis, HIV), Pregnancy and breastfeeding, Moderate to severe renal impairment (CrCl < 60 mL/min), Hypersensitivity to cladribine. Cautions - Risk of prolonged lymphopenia and infection, Monitor blood counts and renal function, Avoid in patients with malignancy history unless benefit outweighs risk, Avoid conception during and 6 months after treatment. Avoid - Live vaccines, Concomitant use with other immunosuppressants or myelosuppressives without close monitoring, Sun exposure (photosensitivity). Side Effects - Lymphopenia, Headache, Nausea, Fever, Fatigue, Increased risk of infections (e.g., herpes zoster), Hepatotoxicity, Hair thinning. Trade Names - Tab: Mavenclad®, Inj: Leustatin® (Specialist use only) Drug Interaction - Increased immunosuppression with other cytotoxics or corticosteroids, Avoid live vaccines, Potentially reduced vaccine efficacy. Adult: Hairy Cell Leukaemia: 0.09 mg/kg/day IV for 7 consecutive days OR 0.14 mg/kg/day IV for 5 days. Multiple Sclerosis: 3.5 mg/kg total oral dose over 2 years (divided in 2 treatment weeks per year). Child: Not routinely recommended; pediatric use only under specialist oncology or neurology supervision.
Raltitrexed (Antineoplastic)Indications - Advanced colorectal cancer (especially in patients intolerant to 5-fluorouracil or in combination therapy). Contraindications - Severe renal impairment (CrCl < 40 mL/min), Pregnancy and breastfeeding, Hypersensitivity to raltitrexed. Cautions - Moderate renal impairment (dose adjustment required), Bone marrow suppression, Monitor renal function and liver enzymes, Use with caution in elderly or debilitated patients. Avoid - Concurrent use with nephrotoxic agents or other antifolates, Live vaccines, Use in pregnancy without specialist supervision. Side Effects - Myelosuppression (anemia, leukopenia, thrombocytopenia), Nausea, Vomiting, Diarrhea, Mucositis, Hepatotoxicity, Fatigue. Trade Names - Inj: Tomudex® (Specialist use only) Drug Interaction - Enhanced toxicity with other cytotoxic drugs, Increased risk of renal toxicity with NSAIDs or nephrotoxic drugs, Reduced efficacy with folinic acid or folic acid (avoid during treatment). Adult: 3 mg/m² IV over 15 minutes every 3 weeks. Dose adjustments required for renal function and toxicity. Child: Not routinely recommended in children; pediatric use only under oncology specialist supervision.
Acetazolamide (Carbonic Anhydrase Inhibitor)Indications - Reduction of intraocular pressure in open-angle glaucoma, Epilepsy (as adjunctive therapy), Acute mountain sickness, Edema due to congestive heart failure or drug-induced causes, Idiopathic intracranial hypertension. Contraindications - Severe renal or hepatic impairment, Hypersensitivity to sulfonamides or acetazolamide, Adrenal gland failure, Hyperchloremic acidosis, Hypokalemia or hyponatremia. Cautions - Elderly patients, Diabetes mellitus, Respiratory acidosis, Electrolyte imbalance, Gout, Concurrent use with high-dose aspirin (risk of metabolic acidosis). Avoid - Use in pregnancy (unless benefit outweighs risk), Breastfeeding, Prolonged use without monitoring of electrolytes and blood counts. Side Effects - Paresthesia, Fatigue, Dizziness, Nausea, Vomiting, Diarrhea, Electrolyte imbalance (especially hypokalemia), Renal stones, Metabolic acidosis, Skin rash, Depression. Trade Names - Tab: Terocec®, Diamox® Drug Interaction - Increased risk of hypokalemia with corticosteroids or diuretics, May enhance toxicity of salicylates, May alter effects of anticonvulsants, Risk of CNS depression with other sedatives. Adult: Glaucoma: 250–1000 mg/day in divided doses. Epilepsy: 250–1000 mg/day in divided doses as adjunct. Altitude sickness: 500–1000 mg/day in divided doses starting 1–2 days before ascent. Child: Epilepsy: 8–30 mg/kg/day in divided doses. Maximum: 750 mg/day. Use under specialist guidance.
Terpene Mixture (Urinary Antispasmodic & Litholytic Agent)Indications - Supportive treatment of urinary calculi (kidney stones), Relief of urinary tract discomfort and colic. Contraindications - Severe renal impairment, Hypersensitivity to any component of the preparation, Acute glomerulonephritis. Cautions - Use in patients with gastrointestinal disorders, Pregnancy and breastfeeding (safety not established), Avoid in patients with known gallstones or bile duct obstruction. Avoid - Use in children under 6 years unless prescribed by a physician, Concurrent use with other urological antispasmodics without monitoring. Side Effects - Mild gastrointestinal discomfort, Nausea, Stomach pain, Rare allergic reactions (rash, itching). Trade Names - Cap: Rowatinex® Drug Interaction - May enhance the effects of other urinary tract agents, Unknown interaction profile—use with caution with anticoagulants or antihypertensives. Adult: 1 capsule 3–4 times daily, before meals. Child: Children >6 years: 1 capsule twice daily, before meals. Not recommended for children under 6 years.
Spironolactone (Potassium-Sparing Diuretic, Aldosterone Antagonist)Indications - Oedema (including in congestive heart failure), Ascites due to liver cirrhosis, Nephrotic syndrome, Malignant ascites, Moderate to severe heart failure (NYHA Class III–IV), Primary hyperaldosteronism, Resistant hypertension, Hirsutism and acne in women (off-label). Contraindications - Addison’s disease, Anuria, Acute renal insufficiency, Hyperkalemia, Hypersensitivity to spironolactone. Cautions - Elderly, Diabetes mellitus, Hepatic impairment, Risk of gynecomastia, Acute porphyria, Feminization of male fetus (seen in animal studies). Avoid - Potassium supplements, Other potassium-sparing diuretics, Salt substitutes containing potassium. Side Effects - Hyperkalemia, Hyponatremia, Gynecomastia, Menstrual irregularities, Gastrointestinal upset, Drowsiness, Rash, Impotence. Trade Names - Tab: Aldactone® Drug Interaction - Increased risk of hyperkalemia with ACE inhibitors, ARBs, NSAIDs, potassium supplements; may reduce clearance of digoxin and lithium; additive hypotensive effects with antihypertensives. Adult: Oedema/Ascites: 25–100 mg daily in divided doses; up to 400 mg/day if needed. Heart failure: 25 mg once daily, titrated up to 50 mg if tolerated. Hyperaldosteronism (diagnostic): 400 mg/day for 4 days. Child: 1–3.3 mg/kg/day in divided doses; adjust per response and monitoring. Use under specialist supervision.
Acitretin (Oral Retinoid – Dermatological agent) Indications - Severe extensive Psoriasis (Chronic skin disease) resistant to other forms of therapy (under expert supervision), Palmoplantar pustular psoriasis (under expert supervision), Severe congenital ichthyosis (under expert supervision), Severe Darier’s disease (keratosis follicularis) (under expert supervision). Contraindications - Pregnancy, women planning pregnancy within 3 years, severe liver or kidney impairment, chronic abnormally elevated blood lipid levels, hypersensitivity to acitretin or other retinoids. Avoid - Alcohol use (prolongs teratogenic potential), breastfeeding. Cautions - Monitor liver function and lipid levels regularly, risk of psychiatric effects (e.g. depression), bone abnormalities with long-term use, photosensitivity. Side Effects - Dry skin, cheilitis, hair thinning, elevated liver enzymes, hyperlipidemia, mood changes, musculoskeletal symptoms. Trade Names - tab: Neotigason® Drug Interactions - Avoid tetracyclines (risk of intracranial hypertension), methotrexate (hepatotoxicity), and vitamin A supplements (additive toxicity). Adult: Initially 25–30 mg once daily; adjusted according to response (max 75 mg/day). Child: Use only under specialist supervision; dose based on body weight.
Acyclovir (Antiviral) Indications - Viral conjunctivitis, Herpes simplex infections (including genital herpes, cold sores, and herpes keratitis), Varicella (chickenpox), Herpes zoster (shingles). Contraindications - Hypersensitivity to acyclovir or valacyclovir. Avoid - Use with caution during pregnancy and lactation (only if potential benefit justifies the risk). Cautions - Renal impairment (dose adjustment required), elderly, adequate hydration recommended to prevent renal toxicity. Side Effects - Nausea, vomiting, diarrhea, headache, dizziness, renal impairment (high IV doses), local irritation (topical). Trade Names - Vivir cream:®, Virless tab:® Drug Interactions - Probenecid increases plasma concentration; caution with other nephrotoxic agents (e.g. cyclosporine, tacrolimus). Adult: Oral: 200 mg 5 times daily for 5 days (Herpes simplex); Topical: apply 5 times daily for 5–10 days. Child: Dose depends on weight and indication; e.g. 20 mg/kg orally 4 times daily for 5 days (chickenpox, max 800 mg per dose).
Fomivirsen Sodium (Antiviral – antisense oligonucleotide) Indications - Cytomegalovirus (CMV) retinitis in immunocompromised patients (e.g., AIDS patients) intolerant or unresponsive to other therapies. Contraindications - Hypersensitivity to fomivirsen or any component of the formulation. Avoid - Use in pregnancy and lactation unless clearly needed. Cautions - Monitor intraocular pressure; use with caution in patients with ocular inflammation or recent ocular surgery. Side Effects - Iritis, vitritis, increased intraocular pressure, visual disturbances, retinal detachment. Trade Names - Vitravene® (intraocular injection) Drug Interactions - No significant systemic drug interactions reported (administered intravitreally). Adult: 165 mcg intravitreal injection once every 2 weeks for 3 doses, then once monthly as maintenance. Child: Not recommended for pediatric use.
Ganciclovir (Antiviral) Indications - Acute herpetic keratitis (HSV), Cytomegalovirus (CMV) retinitis in immunocompromised patients, CMV prophylaxis in transplant recipients. Contraindications - Hypersensitivity to ganciclovir, valganciclovir or acyclovir. Avoid - Pregnancy, Breastfeeding (unless benefits outweigh risks), Severe neutropenia or thrombocytopenia. Cautions - Renal impairment (dose adjustment required), Elderly, Bone marrow suppression. Side Effects - Myelosuppression (neutropenia, anemia), GI upset, CNS effects (confusion, seizures), Visual disturbances. Trade Names - tab: Cymevene®, inj: Cytovene®, eye gel: Virgan® Drug Interactions - Increased risk of bone marrow suppression with zidovudine, didanosine, or other myelotoxic agents; nephrotoxicity risk with cyclosporine or amphotericin B. Adult: CMV retinitis: 5 mg/kg IV every 12 hours for 14–21 days, then maintenance 5 mg/kg/day IV 5–7 days/week. For keratitis: apply eye gel 5 times daily until healing, then 3 times daily. Child: Dose adjusted based on age, weight, renal function – specialist use only.
Aglepristone (Antiprogestin) Indications - Pregnancy termination (primarily veterinary use, e.g., dogs). Contraindications - Known hypersensitivity to aglepristone or excipients. Cautions - Should be used only by professionals trained in its use; monitor for incomplete abortion or uterine infection. Avoid - Use in humans (not approved); do not use in animals with hepatic or renal impairment unless under supervision. inj: Alizin® Adult: : Not for human use. Child: Not for human use.
Alfaxalone (Neuroactive steroid – General Anaesthetic, Veterinary use) Indications - Sedative and induction agent prior to inhalation anaesthesia (primarily veterinary use in dogs and cats). Contraindications - Known hypersensitivity to alfaxalone or excipients; use caution in animals with cardiovascular instability. Cautions - Monitor respiratory and cardiovascular function closely; administer slowly to reduce risk of apnea. Avoid - Use in humans (not approved); use with caution in animals with hepatic impairment. inj: Alfaxan® Adult: Not for human use. Child: Not for human use.
Codeine phosphate (Opioid analgesic and antitussive) Indications - Acute diarrhoea, Mild to moderate pain, Cough suppression. Contraindications - Respiratory depression, Acute asthma, Children under 12 years, Post-operative pain management in children following tonsillectomy and/or adenoidectomy, Known ultra-rapid metabolizers of codeine. Cautions - Elderly, Renal or hepatic impairment, History of drug abuse, Head injury, Constipation, Hypotension. Avoid - Use in breastfeeding and pregnancy unless absolutely necessary. Oral use: Pardale-V tab:®, Codeine tab:® Adult: : 15–60 mg every 4–6 hours as needed; maximum 240 mg/day. Child:: Not recommended for children under 12 years; 12–18 years only if benefit outweighs risk – 0.5–1 mg/kg every 6 hours (max 240 mg/day).
Co-Trimoxazole (Antibacterial – Sulfonamide + Trimethoprim)Indications - Chronic obstructive pulmonary disease (COPD) exacerbations, Treatment and prophylaxis of Pneumocystis jirovecii pneumonia, Urinary tract infections (UTIs), Nocardiosis, Toxoplasmosis (adjunct). Contraindications - Hypersensitivity to sulfonamides or trimethoprim, Infants under 6 weeks, Acute porphyria, Severe hepatic impairment, Severe renal impairment (unless dosage adjusted), Blood dyscrasias. Cautions - Elderly, G6PD deficiency, Asthma, Folate deficiency, HIV infection, Renal or hepatic dysfunction. Avoid - Use during pregnancy (especially first trimester) and breastfeeding unless necessary. Bactomed-480 tab:®, Mb-tran suspension:® Adult: : 960 mg (800 mg sulfamethoxazole + 160 mg trimethoprim) every 12 hours; in Pneumocystis pneumonia: 15–20 mg/kg/day trimethoprim component in divided doses. Child:: Based on trimethoprim component: 6 mg/kg twice daily (adjust per condition and weight).
Almotriptan (5-HT_1B/1D receptor agonist – Antimigraine)Indications - Acute treatment of migraine with or without aura. Contraindications - Ischaemic heart disease, uncontrolled hypertension, cerebrovascular disease, severe hepatic impairment, use of ergotamine within 24 hours. Cautions - Elderly, renal or mild to moderate hepatic impairment, known risk factors for coronary artery disease. Avoid - Pregnancy, breastfeeding, concurrent MAO inhibitors or within 2 weeks of stopping them. Drug Interactions - MAO inhibitors, SSRIs, SNRIs, ergot derivatives, other triptans. Trade names - Almotriptan 12.5 mg tab:® Adult: : 12.5 mg orally at onset of migraine; if needed, a second dose may be taken after 2 hours (max 25 mg/day). Child:: Not recommended under 18 years.
Naratriptan (5-HT_1B/1D receptor agonist – Antimigraine)Indications - Acute treatment of migraine with or without aura. Contraindications - Coronary vasospasm, ischaemic heart disease, moderate or severe hypertension, peripheral vascular disease, previous cerebrovascular accident, previous myocardial infarction, previous transient ischaemic attack, Prinzmetal’s angina, uncontrolled hypertension. Cautions - Conditions predisposing to coronary artery disease, elderly. Avoid - Pregnancy, breastfeeding, concurrent use with other triptans or ergotamine within 24 hours. Drug Interactions - Ergot derivatives, MAO inhibitors, SSRIs, SNRIs, other triptans. Side Effects - Dizziness, drowsiness, fatigue, feeling hot, malaise, nausea, paraesthesia, vomiting. Trade names - Naratriptan 2.5 mg tab:® Adult: : 2.5 mg orally at onset of migraine; may repeat once after at least 4 hours if needed (max 5 mg/day). Child:: Not recommended under 18 years.
Rizatriptan (5-HT_1B/1D receptor agonist – Antimigraine)Indications - Acute treatment of migraine with or without aura. Contraindications - Ischaemic heart disease, uncontrolled hypertension, cerebrovascular disease, severe hepatic impairment, use of ergotamine within 24 hours. Cautions - Elderly, renal or mild to moderate hepatic impairment, known risk factors for coronary artery disease. Avoid - Pregnancy, breastfeeding, concurrent MAO inhibitors or within 2 weeks of stopping them. Drug Interactions - MAO inhibitors, SSRIs, SNRIs, ergot derivatives, other triptans. Trade names - Rizatriptan 10 mg tab:® Adult: : 10 mg orally at onset of migraine; may repeat once after at least 2 hours if needed (max 30 mg/day). Child:: Not recommended under 18 years.
Sumatriptan (5-HT_1B/1D receptor agonist – Antimigraine)Indications - Acute treatment of migraine and cluster headache. Contraindications - Ischaemic heart disease, uncontrolled hypertension, cerebrovascular disease, severe hepatic impairment, use of ergotamine within 24 hours. Cautions - Elderly, renal or mild to moderate hepatic impairment, known risk factors for coronary artery disease. Avoid - Pregnancy, breastfeeding, concurrent MAO inhibitors or within 2 weeks of stopping them. Drug Interactions - MAO inhibitors, SSRIs, SNRIs, ergot derivatives, other triptans. Trade names - Sumatriptan 50–100 mg tab:®, Sumatriptan 50 mg cap:® Adult: : 50–100 mg orally at onset; may repeat after 2 hours if needed (max 200 mg/day). Child:: Not recommended under 18 years.
Zolmitriptan (5-HT_1B/1D receptor agonist – Antimigraine)Indications - Acute treatment of migraine and cluster headache. Contraindications - Ischaemic heart disease, uncontrolled hypertension, cerebrovascular disease, severe hepatic impairment, use of ergotamine within 24 hours. Cautions - Elderly, renal or mild to moderate hepatic impairment, known risk factors for coronary artery disease. Avoid - Pregnancy, breastfeeding, concurrent MAO inhibitors or within 2 weeks of stopping them. Drug Interactions - MAO inhibitors, SSRIs, SNRIs, ergot derivatives, other triptans. Trade names - Zolmitriptan tab:®, Zolmitriptan cap:® Adult: : 2.5 mg orally at onset; may repeat after 2 hours if needed (max 10 mg/day). Child:: Not recommended under 18 years.
Ergotamine tartrate (Ergot alkaloid – Antimigraine)Indications - Management of cluster headache. Contraindications - Acute porphyrias, coronary heart disease, hyperthyroidism, inadequately controlled hypertension, obliterative vascular disease, peripheral vascular disease, Raynaud’s syndrome, sepsis, severe hypertension, temporal arteritis. Cautions - Anaemia, cardiac disease, dependence, elderly, risk of peripheral vasospasm. Side effects - Abdominal pain, dizziness, nausea, vomiting. Trade names - Ergotamine tartrate tab:®, Ergotamine tartrate cap:® Adult: : 1 mg orally once daily for 6 nights, dose to be taken at night. Child:: Not recommended.
Ibuprofen (Nonsteroidal anti-inflammatory drug - NSAID)Indications - Pain and inflammation in rheumatic disease and other musculoskeletal disorders, mild to moderate pain including dysmenorrhoea, postoperative analgesia, migraine, dental pain, pain and inflammation of soft tissue injuries, pyrexia with discomfort, juvenile idiopathic arthritis, post-immunisation pyrexia in infants (on doctor’s advice), pain relief in musculoskeletal conditions, treatment in knee or hand osteoarthritis (adjunct). Avoid - Gastro-intestinal bleeding or ulceration, heart failure, contact with eyes and broken skin. Cautions - Allergic disorders, coagulation defects, elderly, heart failure, hypertension, heart diseases. Trade names - CEFEN-600 tab:®, Alaxan tab:®, BUFLEX 600 mg tab:®, PACFEN-200 mg tab:®, Ibuprofen DENK Adult: : Dose varies according to indication; commonly 200-400 mg orally every 6-8 hours. Child:: Dose based on weight, typically 5-10 mg/kg every 6-8 hours.
Dexibuprofen (Nonsteroidal anti-inflammatory drug – NSAID) Indications - Relief of mild to moderate pain (e.g., musculoskeletal pain, dental pain), dysmenorrhoea, and osteoarthritis. Contraindications - Active or recurrent peptic ulceration or bleeding, severe heart failure, severe renal or hepatic impairment, third trimester of pregnancy. Cautions - Asthma, history of GI disorders, elderly, cardiovascular disease, hypertension, hepatic or renal dysfunction, avoid long-term use in women trying to conceive. Avoid - Pregnancy (especially third trimester), breastfeeding unless benefits outweigh risks, use with other NSAIDs. Drug Interactions - Anticoagulants, antiplatelet agents, corticosteroids, SSRIs, ACE inhibitors, diuretics, lithium, methotrexate. Trade names - Seractil® tab, Dexofen® tab, Dexium® cap Adult: : 200–400 mg orally every 6–8 hours as needed; maximum 1200 mg/day. Child:: Not generally recommended in children under 18 years unless under medical supervision.
Clonidine (Alpha-2 adrenergic agonist - Antihypertensive, adjunct use in several conditions) Indications - Hypertension, menopausal flushing, migraine prophylaxis, opioid and alcohol withdrawal symptoms, attention-deficit hyperactivity disorder (ADHD), diagnostic aid for growth hormone deficiency. Contraindications - Severe bradyarrhythmia, recent myocardial infarction, severe coronary artery disease, hypersensitivity to clonidine. Cautions - Renal impairment, heart failure, bradycardia, depression, elderly, constipation, risk of rebound hypertension on sudden withdrawal. Avoid - Pregnancy, breastfeeding unless benefits clearly outweigh risks, abrupt discontinuation. Drug Interactions - Beta-blockers, tricyclic antidepressants, CNS depressants, MAO inhibitors, other antihypertensives, alcohol. Trade names - Catapres® tab, Dixarit® tab Adult: Initially 100 mcg twice daily; maintenance 100-300 mcg/day in divided doses. Maximum: 900 mcg/day in resistant hypertension. Child:: Used for ADHD and other indications under specialist guidance; typical starting dose 25-50 mcg/day in divided doses, titrated as needed.
Apraclonidine Eye Drop (Alpha-2 adrenergic agonist - Antiglaucoma agent) Indications - Short-term adjunctive treatment of glaucoma, prevention and treatment of post-operative intraocular pressure elevation following anterior segment laser surgery. Contraindications - Hypersensitivity to apraclonidine or clonidine, severe cardiovascular disease, concurrent use of monoamine oxidase inhibitors (MAOIs). Cautions - Renal impairment, cardiovascular disease, depression, dry mouth, elderly patients, avoid prolonged use due to tachyphylaxis. Avoid - Pregnancy, breastfeeding unless absolutely necessary, use in infants due to serious adverse effects. Drug Interactions - Tricyclic antidepressants, MAO inhibitors, beta-blockers, CNS depressants. Trade names - Iopidine® 0.5% eye drops Adult: : 1 drop into the affected eye(s) 1 hour before and immediately after laser eye surgery; for glaucoma, 1 drop two to three times daily. Child:: Not recommended in children under 12 years due to risk of severe adverse effects.
Tramadol HCl (Analgesic - Centrally acting opioid) Indications - Moderate to severe pain, including postoperative and musculoskeletal pain. Contraindications - Acute intoxication with alcohol, hypnotics, analgesics, or psychotropic drugs; uncontrolled epilepsy; respiratory depression. Cautions - History of seizures or head trauma, renal or hepatic impairment, respiratory disorders, elderly, risk of dependence or abuse. Avoid - Concomitant use with MAO inhibitors (within 14 days), pregnancy and breastfeeding unless essential. Drug Interactions - MAO inhibitors, SSRIs, tricyclic antidepressants, other CNS depressants, carbamazepine, serotonergic drugs. Trade names - Tramadol 50 mg Cap®, Tramamed® Cap, Pharmadol® Inj Adult: : 50-100 mg orally every 4-6 hours as needed; maximum 400 mg/day. Child:: Not recommended in children under 12 years; use with caution in older children only under medical supervision.
Lorazepam (Hypnotic - Sedative - Anxiolytic, Benzodiazepine class) Indications - Premedication before surgery or procedures, conscious sedation, febrile convulsions, seizures due to poisoning, status epilepticus, short-term use in insomnia associated with anxiety, acute panic attacks. Contraindications - Chronic psychosis, CNS depression, respiratory depression, sleep apnea syndrome, acute narrow-angle glaucoma, known hypersensitivity to benzodiazepines. Cautions - Muscle weakness, respiratory disease, renal or hepatic impairment, elderly or debilitated patients, mechanical ventilation facilities required before parenteral use. Avoid - Breastfeeding, use in patients with obsessional states, personality disorders, and compromised airways. Drug Interactions - CNS depressants (e.g., opioids, alcohol, antipsychotics), antidepressants, antihistamines, valproate, theophylline. Trade names - Lotax-2® tab Adult: : 1-4 mg orally per day in divided doses for anxiety; 4 mg IM/IV for premedication or seizures, adjusted per indication. Child:: Dosage individualized; typically 0.05-0.1 mg/kg IV for status epilepticus (under specialist supervision).
Temazepam (Hypnotic, Sedative, Anxiolytic) Indications - Short-term treatment of insomnia, anxiety, status epilepticus, convulsions, and as premedication before procedures. Contraindications - Severe respiratory insufficiency, sleep apnea syndrome, myasthenia gravis, hypersensitivity to benzodiazepines, severe hepatic impairment. Cautions - Elderly, renal or hepatic impairment, history of substance abuse, depression, risk of dependence with prolonged use. Avoid - Pregnancy, breastfeeding, alcohol use, long-term use without medical supervision. Drug Interactions - CNS depressants, opioids, alcohol, antipsychotics, antidepressants, antihistamines, muscle relaxants. Trade names - Lotax-2® tab Adult:: 7.5–30 mg orally at bedtime as needed for insomnia. Child:: Not generally recommended; use only under strict medical supervision.
Modafinil (CNS Stimulant) Indications - Excessive daytime sleepiness associated with narcolepsy, obstructive sleep apnea (adjunct), and shift work sleep disorder. Contraindications - Known hypersensitivity to modafinil or armodafinil, uncontrolled hypertension, cardiac arrhythmias. Cautions - Cardiovascular disease, hepatic or renal impairment, psychiatric disorders (e.g., anxiety, mania), elderly, pregnancy. Avoid - Use in children unless specifically prescribed, abrupt discontinuation in long-term use. Drug Interactions - Oral contraceptives (reduced efficacy), CYP3A4 substrates, warfarin, phenytoin, SSRIs, MAO inhibitors. Trade names - Modalert® tab, Provigil® tab Adult: 200 mg once daily in the morning or 1 hour before shift work. Maximum: 400 mg/day. Child: Not recommended unless under specialist supervision.
Orlistat (Gastrointestinal lipase inhibitor – Anti-obesity agent) Indications - Adjunct in the management of obesity in adults with a BMI ≥30 kg/m², or ≥28 kg/m² with risk factors (e.g., type 2 diabetes, hypertension, hypercholesterolaemia); used alongside a mildly hypocaloric diet. Contraindications - Chronic malabsorption syndrome, cholestasis, hypersensitivity to orlistat. Cautions - Pregnancy, chronic kidney disease, history of hyperoxaluria or oxalate nephropathy, concurrent use with cyclosporine or levothyroxine (requires monitoring). Avoid - Use during breastfeeding, high-fat diets (increases GI side effects). Drug Interactions - Cyclosporine, warfarin, levothyroxine, fat-soluble vitamins (A, D, E, K), antiepileptics. Trade names - ORLIT® tab, Xenical® cap, Alli® cap Adult: 120 mg orally three times daily with each main meal containing fat. Omit dose if a meal is missed or contains no fat. Child: Approved in adolescents ≥12 years: 120 mg orally three times daily with meals (specialist guidance advised).
Cinnarizine (Antihistamine – Vestibular suppressant, vasodilator) Indications - Management of nausea and vomiting, motion sickness, vertigo due to Ménière’s disease or other vestibular disorders, and peripheral vascular disease. Contraindications - Hypersensitivity to cinnarizine or related compounds, Parkinson’s disease (may worsen symptoms). Cautions - Elderly, hepatic or renal impairment, hypotension, concurrent use with CNS depressants. Avoid - Use in patients with Parkinsonism unless benefits outweigh risks; avoid alcohol and driving during therapy due to drowsiness. Drug Interactions - Alcohol, sedatives, hypnotics, tricyclic antidepressants, antihypertensives (may increase sedation or hypotensive effects). Trade names - Vertinil® 25 mg tab, Cinazin tab:® , Vertigon® tab Adult: 25–75 mg orally 2–3 times daily depending on indication (e.g., 30 minutes before travel for motion sickness). Child: 5–15 mg orally up to 3 times daily (age-specific and under medical advice).
Cyclizine (Antiemetic, Antinauseant – Antihistamine) Indications - Prevention and treatment of nausea and vomiting, including motion sickness, postoperative nausea, drug-induced nausea (e.g. opioid use), and vestibular disorders (e.g. vertigo, labyrinthitis). Contraindications - Hypersensitivity to cyclizine or related antihistamines, severe liver disease. Cautions - Hepatic impairment, epilepsy, prostatic hypertrophy, angle-closure glaucoma, urinary retention, elderly patients. Avoid - Alcohol use (may increase drowsiness), operating machinery or driving during treatment, use in infants under 6 months. Drug Interactions - CNS depressants (e.g. opioids, benzodiazepines), anticholinergics, tricyclic antidepressants, MAO inhibitors. Trade names - Valoid® tab, Cyclivert® tab, Cyclizine® tab/cap Adult: 50 mg orally up to 3 times daily. Max: 150 mg/day. Child: 6–12 years: 25 mg orally up to 3 times daily. Not recommended under 6 years unless prescribed.
Granisetron (Antiemetic, Antinauseant – 5-HT₃ receptor antagonist) Indications - Prevention and treatment of nausea and vomiting associated with cytotoxic chemotherapy and radiotherapy; postoperative nausea and vomiting. Contraindications - Known hypersensitivity to granisetron or other 5-HT₃ receptor antagonists. Cautions - Hepatic impairment, risk of QT prolongation, electrolyte imbalance, use in combination with other serotonergic drugs (risk of serotonin syndrome). Avoid - Use in patients with gastrointestinal obstruction unless under close supervision. Drug Interactions - Serotonergic agents (e.g. SSRIs, SNRIs), QT-prolonging drugs, CYP3A4 inhibitors. Trade names - Navom® IV Solution, Kytril® Injection, Grani-Denk® 1 mg/mL Injection Adult: 1–3 mg IV before chemotherapy; oral: 1 mg twice daily. Child: 10–40 mcg/kg IV (max 3 mg), given prior to chemotherapy.
Alfentanil (Opioid Analgesic - Short-acting) Indications - Analgesia and enhancement of anaesthesia during short surgical procedures requiring assisted ventilation; used in monitored anaesthesia care (MAC). Contraindications - Severe respiratory depression without resuscitative equipment, known hypersensitivity to opioids. Cautions - Hepatic impairment, renal impairment, bradyarrhythmias, elderly or debilitated patients, repeated intra-operative dosing may prolong respiratory depression. Avoid - Use in patients without appropriate respiratory support; pregnancy unless benefits outweigh risks. Drug Interactions - CNS depressants, MAO inhibitors, benzodiazepines, muscle relaxants, CYP3A4 inhibitors. Side effects - Respiratory depression, chest wall and jaw muscle rigidity, hypotension, bradycardia, nausea, vomiting. Trade names - Rapifen® Injection Adult: 10–50 mcg/kg IV bolus; may follow with continuous infusion 0.5–1 mcg/kg/min depending on procedure. Child: Use with caution; dosing individualized by anaesthesiologist in controlled settings.
Acetaminophen (Paracetamol) (Non-opioid Analgesic and Antipyretic) Indications - Mild to moderate pain (e.g., headache, migraine, musculoskeletal pain), fever, pain relief in patients with contraindications to NSAIDs. Contraindications - Severe hepatic impairment, known hypersensitivity to paracetamol. Cautions - Liver disease, chronic alcohol use, dehydration, malnutrition. Use with caution in asthmatic patients sensitive to aspirin or NSAIDs. Avoid - Exceeding recommended dosage, concurrent use with other products containing paracetamol, long-term use without medical advice. Drug Interactions - Alcohol, isoniazid, warfarin (long-term use), enzyme-inducing drugs (e.g., carbamazepine, phenytoin). Trade names - Biogesic® tab, Hedex® tab, Paramol® syrup 60 mL, Parazox® uncoated tab, Len Sen® suspension Adult: 500–1000 mg orally every 4–6 hours as needed; maximum 4000 mg/day. Child: 15 mg/kg per dose every 4–6 hours; do not exceed 60 mg/kg/day in children.
Diclofenac Potassium (Nonsteroidal Anti-inflammatory Drug - NSAID) Indications - Pain and inflammation in rheumatic disease and other musculoskeletal disorders, acute gout, postoperative pain, migraine, fever in ENT infections, painful inflammatory conditions of the oral cavity and throat, and after dental treatment or extraction. Contraindications - Active gastrointestinal bleeding or ulceration, ischemic heart disease, heart failure, pregnancy (especially third trimester), severe renal impairment. Cautions - History of allergic disorders, cardiac impairment, coagulation defects, elderly patients, hypertension, oedema, history of cardiac failure, ulcerative colitis, hepatic impairment, breastfeeding, long-term use may impair female fertility. Avoid - Concurrent use with other NSAIDs, late pregnancy, chronic kidney disease without supervision. Drug Interactions - Anticoagulants, corticosteroids, SSRIs, diuretics, ACE inhibitors, lithium, methotrexate. Trade names - Difelene® tab, Voltaren SR® 75 tab, Voren® Inj, Dicloran® Gel, Dynapar® QPS Adult: 50 mg orally two to three times daily; maximum 150 mg/day. Modified-release forms: 75–100 mg once daily. Child: Not generally recommended unless prescribed by a specialist; dosage based on weight and indication.
Acepromazine Maleate (Phenothiazine derivative - Tranquilizer, Antiemetic) Indications - Preoperative sedation, control of nausea and vomiting, management of anxiety and agitation, adjunctive therapy in insomnia (rare human use; primarily veterinary). Contraindications - Severe hypotension, CNS depression, Parkinson’s disease, hepatic dysfunction, hypersensitivity to phenothiazines. Cautions - Elderly, cardiovascular disease, respiratory disorders, history of seizures, pregnancy. Avoid - Pregnancy unless essential, use in patients with severe liver dysfunction, combination with other CNS depressants. Drug Interactions - CNS depressants (e.g. alcohol, opioids), anticholinergics, antihypertensives, anticoagulants. Trade names - Atravet® tab, Aceprotabs® tab (primarily veterinary use) Adult: Rarely used in humans; veterinary doses vary by species and indication. Child: Not recommended for pediatric use in humans.
Alprazolam (Anxiolytic, Sedative, Hypnotic – Benzodiazepine) Indications - Short-term treatment of anxiety disorders, panic disorders, and generalized anxiety with or without depression. Contraindications - Acute narrow-angle glaucoma, severe respiratory insufficiency, sleep apnea syndrome, hypersensitivity to benzodiazepines. Cautions - Elderly, renal or hepatic impairment, history of substance abuse, depression, respiratory disorders, muscle weakness. Avoid - Pregnancy, breastfeeding, chronic psychosis, respiratory depression, obesity, abrupt withdrawal after long-term use. Drug Interactions - CNS depressants (e.g. alcohol, opioids), antifungals (e.g. ketoconazole), macrolide antibiotics, HIV protease inhibitors. Trade names - Zolium® 0.5 mg tab, Xanax® tab, Alzolam® tab Adult: Initial dose 0.25–0.5 mg orally two to three times daily; may be increased gradually if needed. Max: 4 mg/day in divided doses. Child: Not recommended in children under 18 years unless specifically indicated and closely supervised.
Amantadine HCl (Antiviral, Antiparkinsonian agent, NMDA receptor antagonist) Indications - Parkinson’s disease, drug-induced extrapyramidal symptoms, post-herpetic neuralgia, fatigue in multiple sclerosis, and prophylaxis/treatment of influenza A virus infections. Contraindications - Untreated angle-closure glaucoma, severe renal impairment, history of seizures (caution). Cautions - Elderly, renal or hepatic impairment, psychiatric illness, history of heart failure or orthostatic hypotension. Avoid - Abrupt discontinuation (risk of neuroleptic malignant-like syndrome), breastfeeding (unless clearly needed). Drug Interactions - CNS stimulants, anticholinergics, antihistamines, other antiparkinsonian agents. Trade names - Symmetrel® tab/cap, Parkitidin® cap Adult: 100 mg once or twice daily; may increase to 300 mg/day if tolerated for Parkinsonism. Child: Not generally recommended under 10 years; 5–8 mg/kg/day in divided doses under specialist supervision (for antiviral use).
Amikacin (Aminoglycoside antibiotic) Indications - Serious Gram-negative infections, neonatal sepsis, respiratory tract infections, urinary tract infections, meningitis, peritonitis, endometritis, mycobacterial infections (as part of combination therapy). Contraindications - Hypersensitivity to aminoglycosides, myasthenia gravis. Cautions - Renal impairment, elderly, dehydration, hearing impairment, concurrent use with nephrotoxic or ototoxic drugs, obesity (requires dose adjustment). Avoid - Pregnancy (unless clearly needed), prolonged use, concurrent neurotoxic or ototoxic agents. Drug Interactions - Loop diuretics, amphotericin B, cisplatin, vancomycin, other aminoglycosides. Trade names - Amikin® Inj, Bikacin® Inj, Mikasin® Inj Adult: 15 mg/kg/day IV/IM in divided doses every 8–12 hours; adjust in renal impairment. Child: 15–22.5 mg/kg/day IV/IM in 2–3 divided doses; neonates: 10 mg/kg loading, then 7.5 mg/kg every 12 hours.
Amino Acid (Dietary supplement) Indications - Used as a dietary supplement for nutritional support, recovery after illness or surgery, muscle repair, and general well-being. Contraindications - Hypersensitivity to any component of the formulation. Cautions - Renal impairment, hepatic dysfunction, use in patients on protein-restricted diets. Avoid - Use in patients with severe metabolic disorders unless prescribed by a physician. Trade names - AMINOVIT® Syrup, Collagen® Cap Adult: As directed, typically 10–15 mL syrup once or twice daily, or 1–2 capsules daily with meals. Child: Dose should be adjusted based on age and weight; typically 5–10 mL syrup daily.
Amiodarone HCl (Antiarrhythmic agent) Indications - Management of life-threatening ventricular arrhythmias, including ventricular tachycardia and ventricular fibrillation; treatment of supraventricular arrhythmias including atrial fibrillation and atrial flutter. Contraindications - Severe sinus-node dysfunction, heart block without pacemaker, iodine hypersensitivity, thyroid dysfunction. Cautions - Elderly, electrolyte imbalance (e.g., hypokalaemia), hepatic impairment, pulmonary toxicity risk, acute porphyrias. Avoid - Pregnancy (especially during the first trimester), breastfeeding unless benefits outweigh risks. Drug Interactions - Increased risk of toxicity with digoxin, warfarin, phenytoin, beta-blockers, and other antiarrhythmics. Trade names - Cordarone® tab, Amiotone® tab, Amiodar® Inj Adult: Loading: 800–1600 mg/day orally for 1–3 weeks; maintenance: 100–400 mg/day. Child: Dosage should be determined by a pediatric cardiologist based on weight and clinical condition.
Xylometazoline HCl (Nasal decongestant, Sympathomimetic) Indications - Relief of nasal congestion due to colds, sinusitis, allergic rhinitis, or upper respiratory tract infections. Contraindications - Closed-angle glaucoma, dry nasal mucosa (rhinitis sicca), recent nasal surgery. Cautions - Hypertension, cardiovascular disease, diabetes mellitus, hyperthyroidism, prostatic hypertrophy, pregnancy. Avoid - Prolonged use beyond 5–7 days due to risk of rebound congestion (rhinitis medicamentosa). Drug Interactions - MAO inhibitors, tricyclic antidepressants (may enhance pressor effects). Trade names - Otrivin® nasal drop/spray, Xylorin® nasal spray, Nasivion® Adult: 0.1% solution: 1–2 drops or sprays into each nostril up to 2–3 times daily. Child: 0.05% solution for children aged 2–12 years: 1–2 drops into each nostril up to 2–3 times daily.
Trifluoperazine (First-generation antipsychotic - Phenothiazine derivative) Indications - Schizophrenia and other psychotic disorders, short-term management of anxiety, psychomotor agitation, severe nausea and vomiting, violent or dangerously impulsive behavior. Contraindications - Comatose states, CNS depression, blood dyscrasias, bone marrow suppression, hypersensitivity to phenothiazines. Cautions - Cardiovascular disease, hepatic or renal impairment, epilepsy, Parkinson’s disease, elderly, risk of neuroleptic malignant syndrome (NMS). Avoid - Use in dementia-related psychosis (increased risk of death), abrupt withdrawal after prolonged use. Drug Interactions - CNS depressants, anticholinergics, QT-prolonging agents, lithium, MAO inhibitors. Trade names - Stelazine® tab, Trifluoperazine Sandoz® tab Adult: 2–5 mg/day in divided doses, adjusted based on response; up to 15 mg/day for severe symptoms. Child: Use with caution; typically under specialist care. Usual starting dose: 1 mg twice daily (6–12 years), adjusted as needed.
Ergometrine maleate (Ergot alkaloid – Uterotonic agent) Indications - Prevention and treatment of postpartum haemorrhage due to uterine atony (administered IM or slow IV). Contraindications - Hypertension, eclampsia, pre-eclampsia, first or second stage of labour, ischaemic heart disease, severe hepatic or renal impairment, sepsis. Cautions - Multiple pregnancy, malnutrition, vascular disease, history of migraine, cardiac disease, acute porphyrias. Avoid - Breastfeeding (within 12 hours of dose), use with vasoconstrictors or during labour. Drug Interactions - Other vasoconstrictors (e.g., sympathomimetics), macrolide antibiotics, protease inhibitors, triptans. Trade names - Methergine® tab, Ergotrate® Inj Adult: 0.2–0.4 mg IM or slow IV after delivery of the anterior shoulder or placenta. Oral dose: 0.2 mg 2–4 times daily for up to 1 week. Child: Not recommended for pediatric use.
Phenobarbitone (Phenobarbital) (Barbiturate – Antiepileptic, Sedative) Indications - Epilepsy (generalized tonic-clonic and partial seizures), status epilepticus (emergency use), sedation in certain cases. Contraindications - Acute porphyrias, hypersensitivity to barbiturates, severe respiratory depression, history of addiction to sedatives/hypnotics. Cautions - Children, elderly, debilitated patients, history of alcohol or substance abuse, hepatic or renal impairment, respiratory depression, during pregnancy (risk of fetal harm), risk of tolerance and dependence. Avoid - Use in breastfeeding unless benefits outweigh risks, abrupt withdrawal after prolonged use. Drug Interactions - CYP450 inducers/inhibitors, other CNS depressants, oral contraceptives, anticoagulants, corticosteroids, doxycycline. Trade names - Gardenal tab:®, Luminal tab:®, Luminal inj:® Adult: 60–180 mg/day orally in divided doses or as a single bedtime dose depending on indication. Child: Usual range 3–5 mg/kg/day in divided doses (adjusted by age and weight).
Diazepam (Sedative, Hypnotic, Anxiolytic, Anticonvulsant) Indications - Insomnia, anxiety disorders, muscle spasms, premedication before procedures, status epilepticus, febrile convulsions, seizures due to poisoning, epilepsy, tetanus. Contraindications - Severe respiratory insufficiency, sleep apnea syndrome, myasthenia gravis, hepatic insufficiency, hypersensitivity to benzodiazepines. Avoid - Chronic psychosis, CNS depression, hyperkinesis, obesity, respiratory depression, phobic states, breastfeeding. Cautions - Muscle weakness, renal or hepatic impairment, elderly or debilitated patients, risk of dependence and withdrawal symptoms. Drug Interactions - Other CNS depressants (alcohol, opioids), antiepileptics, cimetidine, omeprazole, antifungals, rifampicin, theophylline. Trade names - Sedil® Inj, Valium® tab/inj, Relanium® tab/inj Adult: 2–10 mg orally 2–4 times daily depending on indication; for status epilepticus: 5–10 mg IV slowly. Child: Oral: 0.12–0.8 mg/kg/day in divided doses; IV/rectal: dose adjusted by weight and condition.
Metoclopramide HCl (Antiemetic, Prokinetic Agent) Indications - Nausea and vomiting (including associated with acute migraine, chemotherapy, radiotherapy, or post-operative), gastroesophageal reflux, hiccup, delayed gastric emptying (gastroparesis). Contraindications - Gastrointestinal hemorrhage, mechanical obstruction or perforation, pheochromocytoma, epilepsy, history of tardive dyskinesia with neuroleptics or metoclopramide. Cautions - Parkinson’s disease, renal impairment, elderly, children and young adults (risk of extrapyramidal side effects), prolonged use (>5 days). Side Effects - Drowsiness, fatigue, restlessness, extrapyramidal symptoms, tardive dyskinesia (with prolonged use), hypotension. Drug Interactions - Antipsychotics, antidepressants, opioids, digoxin, cyclosporine, levodopa, CNS depressants. Trade names - Maxomet® tab, Mesalon® Inj, Pai Meto® Inj, Metoperan® Inj, Maxalon® Inj Adult: 10 mg up to three times daily (oral, IM, or slow IV); max 30 mg/day; short-term use only. Child: 0.1–0.15 mg/kg up to three times daily; max 0.5 mg/kg/day; use only in children >1 year and for ≤5 days.
Promethazine HCl (Antihistamine, Antiemetic, Sedative) Indications - Symptomatic relief of allergic conditions (e.g., hay fever, urticaria), anaphylactic reactions (as adjunct), short-term insomnia, preoperative sedation, nausea and vomiting (including motion sickness), vertigo, labyrinthine disorders. Avoid - Children under 2 years (risk of respiratory depression), pregnancy unless necessary, breastfeeding. Cautions - Hepatic impairment, renal impairment, epilepsy, prostatic hypertrophy, pyloroduodenal obstruction, urinary retention, cardiovascular disease, angle-closure glaucoma, elderly (risk of confusion, sedation). Side effects - Drowsiness, dizziness, dry mouth, blurred vision, confusion (especially in elderly), extrapyramidal symptoms (rare). Drug Interactions - CNS depressants (e.g., opioids, sedatives), anticholinergics, monoamine oxidase inhibitors (MAOIs), alcohol. Trade names - Axcel Promethazine-5®, Phenergan® (oral), Phenergan® (rectal), Antinaus 50® (IV) Adult: 10–25 mg 2–3 times daily orally; for sedation: 25–50 mg at night. Motion sickness: 25 mg 1–2 hours before travel, then 6–8 hourly if needed. Child: 2–5 years: 5–15 mg/day in divided doses. 6–12 years: 10–25 mg/day in divided doses. Use caution and adjust per weight.
Doxorubicin HCl (Antineoplastic, Anthracycline antibiotic)Indications - Treatment of various cancers including breast cancer, acute leukemia, lymphomas, soft tissue and bone sarcomas, advanced ovarian cancer, bladder cancer (superficial and papillary), small cell lung cancer, and Wilms' tumor. Contraindications - Severe myocardial insufficiency, recent myocardial infarction, severe hepatic impairment, persistent myelosuppression. Cautions - Monitor cardiac function (risk of cardiotoxicity), previous anthracycline therapy, hepatic impairment, subacute intestinal obstruction, myelosuppression, extravasation risk during IV administration. Side effects - Myelosuppression, cardiotoxicity (dose-related), alopecia, nausea, vomiting, mucositis, red-colored urine (non-pathologic). Drug Interactions - Increased toxicity with cyclophosphamide, paclitaxel, and other cardiotoxic drugs; avoid live vaccines. Oncodria 50® Solution for Inj, Doxulip® Inj, Doxorubin 10® Powder for Inj, Naprodox 10® Inj, Naprodox 50® Powder for Inj Adult: Usual IV dose: 60–75 mg/m² every 21 days or 20–30 mg/m² on days 1–3 every 21 days (adjust per protocol and indication). Child: Dose based on body surface area (e.g., 25 mg/m² weekly); reduce in hepatic impairment or when combining with other myelosuppressive agents.
Oxaliplatin (Antineoplastic, Platinum-based chemotherapy agent)Indications - Metastatic colorectal cancer (in combination with fluorouracil and folinic acid), adjuvant treatment of stage III colon cancer after complete resection of the primary tumor. Contraindications - Hypersensitivity to oxaliplatin or other platinum compounds. Cautions - Pre-existing neuropathy, renal impairment, hepatic dysfunction, bone marrow suppression, infections, avoid cold exposure (due to risk of cold-induced neuropathy). Side effects - Peripheral neuropathy, neutropenia, thrombocytopenia, anemia, nausea, vomiting, diarrhea, fatigue, allergic reactions. Drug Interactions - Enhanced toxicity with other nephrotoxic or ototoxic agents; potential interaction with anticoagulants. Belloxa 100mg Inj®, Belloxa 50mg Inj®, Xalipat-100 Inj® Adult:: 130 mg/m² IV over 2 hours every 3 weeks (as monotherapy) or 85 mg/m² IV every 2 weeks (in combination with fluorouracil and folinic acid). Child:: Use in children is not routinely recommended; dosing under clinical trials or specialist care only.
Paclitaxel (Antineoplastic, Mitotic Inhibitor)Indications - Breast cancer, Ovarian cancer, Non-small cell lung cancer (NSCLC), Metastatic adenocarcinoma of the pancreas, AIDS-related Kaposi's sarcoma. Contraindications - Pregnancy, Severe hypersensitivity to paclitaxel or polyoxyl castor oil (Cremophor EL). Cautions - Use effective contraception during and for 6 months after treatment (men and women). Monitor for myelosuppression, peripheral neuropathy, and hypersensitivity reactions. Use with caution in hepatic impairment. Side effects - Neutropenia, alopecia, arthralgia, myalgia, nausea, vomiting, diarrhea, peripheral neuropathy, hypersensitivity reactions. Paclitaxel Inj®, Mitotax Inj® 5ml, Napro-Tax® (IV, Infusion), Panataxel® 100mg Solution for Inj Adult:: 175 mg/m² IV over 3 hours every 3 weeks or 80 mg/m² weekly depending on indication and protocol. Child:: Not routinely recommended; use only in clinical trials or specialized pediatric oncology settings.
Ondansetron (Antiemetic, Antinauseant)Indications - Prevention and treatment of postoperative nausea and vomiting (PONV), Moderate to severe emetogenic chemotherapy, Radiotherapy-induced nausea and vomiting, Labyrinthine disorders. Dosage - Oral: 8 mg every 12 hours or as directed by physician. Ondansetron 4 mg/8 mg tab®, Emeset tab®, Onda Syrup®, Zofran tab®, Inj® Adult:: 4–8 mg orally/IV every 8–12 hours as needed depending on indication. Child:: 0.1–0.15 mg/kg IV (max 8 mg) every 8–12 hours depending on age and indication.
Adrenaline (Epinephrine) (Sympathomimetic, Cardiac stimulant) Indications - Vasoconstrictor, Coronary resuscitation, Acute hypotension, Acute anaphylaxis, Angioedema, Bradycardia with arrhythmia after myocardial infarction. Contraindications - Narrow-angle glaucoma, Non-anaphylactic shock, Use during labor (may delay second stage), Hypersensitivity (unless in life-threatening situation). Cautions - Arteriosclerosis, Arrhythmias, Cerebrovascular disease, Diabetes mellitus, Elderly, Hypercalcaemia, Hyperthyroidism, Hypokalaemia, Ischaemic heart disease, Obstructive cardiomyopathy, Occlusive vascular disease, Phaeochromocytoma, Prostate disorders, Psychoneurosis, Severe angina, Susceptibility to angle-closure glaucoma. Trade Names - Adrenaline Inj:®, Epipen Auto-Injector®, Adrena Tab® Adult: Anaphylaxis: 0.3–0.5 mg IM every 5–15 min as needed; Cardiac arrest: 1 mg IV/IO every 3–5 min during resuscitation. Child: Anaphylaxis: 0.01 mg/kg IM every 5–15 min as needed (max 0.3 mg/dose); Cardiac arrest: 0.01 mg/kg IV/IO every 3–5 min (max 1 mg/dose).
Noradrenaline (Norepinephrine) (Sympathomimetic) Indications - Acute hypotension, Septic shock, Cardiogenic shock. Contraindications - Hypotension due to blood volume deficit (except as emergency life-saving measure), Mesenteric or peripheral vascular thrombosis. Cautions - Hypertension, Hyperthyroidism, Diabetes mellitus, Pregnancy, Elderly, Angina, Use with MAO inhibitors. Trade Names - Norad Inj:®, Levophed Inj:®, Norepiwin Inj:® Adult: IV infusion: Start at 0.05–0.1 mcg/kg/min; usual range 2–30 mcg/min, titrated to response. Child: IV infusion: 0.05–0.1 mcg/kg/min, adjusted based on clinical condition and blood pressure.
Doxapram HCl (Respiratory stimulant) Indications - Used to stimulate respiration in post-operative respiratory depression, drug-induced respiratory depression (e.g. from opioids or anesthetics), and acute respiratory failure associated with chronic obstructive pulmonary disease (COPD). Contraindications - Epilepsy, severe hypertension, pre-eclampsia or eclampsia, mechanical obstruction of the airways, cerebrovascular accidents (stroke), coronary artery disease, status asthmaticus, cerebral edema, hyperthyroidism. Cautions - Use with caution in neonates, elderly, patients with impaired renal or hepatic function, or those with cardiac arrhythmias. Avoid - Avoid in patients with known convulsive disorders, cerebral edema, or recent myocardial infarction. Trade Names - Dopram Injection®, Respiram® Drug Interactions - May interact with monoamine oxidase inhibitors (MAOIs), anesthetic agents (potentiating arrhythmias), sympathomimetics (increased risk of hypertension and arrhythmias). Adult: Initially 1–2 mg/kg IV over 30 seconds. May repeat every 5 minutes as needed. Maximum total dose: 4 mg/kg or 400 mg/day. Child: 0.5–1 mg/kg IV slowly; may repeat once if needed. Not recommended for neonates due to potential for intracranial hemorrhage and seizures.
Hydrogen Peroxide 3% (Oral/Topical) (Antiseptic, Oxidizing agent) Indications - Used topically for skin disinfection, cleaning wounds, ulcers, and abscesses. Also used as a mouth rinse (oral hygiene) for minor mouth irritations and gingivitis. Occasionally considered for emetic use in animal poisoning (not recommended in humans). Contraindications - Hypersensitivity to hydrogen peroxide. Avoid ingestion due to risk of gas embolism or gastrointestinal injury. Do not use in deep wounds, body cavities, or surgical incisions. Cautions - Avoid prolonged or excessive use on mucous membranes or open wounds; risk of tissue irritation or delayed healing. Use caution in patients with respiratory conditions if inhaled. Avoid - Do not swallow. Avoid contact with eyes. Not for internal use unless specifically prescribed. Trade Names - Peroxyl® (Oral Rinse), Hydrox® 3% Solution Drug Interactions - No major drug interactions, but can deactivate some topical agents or interact with organic substances to produce foam and oxygen gas. Adult: For oral hygiene: Dilute 3% solution (usually half strength with water); rinse mouth for up to 1 minute up to 4 times daily. For wound cleansing: Apply directly or via soaked gauze 1–3 times/day. Child: Use with caution. For children over 6 years, same oral rinse instructions as adults with supervision. Avoid use in young children due to swallowing risk.
Atropine Sulphate (Anticholinergic, Antispasmodic) Indications - Organophosphate poisoning, Bradycardia, Pre-anaesthetic to reduce secretions, Cardiac arrhythmias (especially after myocardial infarction), Asthma, Cardiopulmonary resuscitation, Choroiditis, Reversal of neostigmine effects, Diarrhoea, Dysentery, Iridocyclitis, Irritable bowel syndrome, Myocardial infarction, Peptic ulcer, Tetanus, Pyloric spasm. Contraindications - Hypersensitivity to atropine, Narrow-angle glaucoma, Tachycardia due to cardiac insufficiency, Myasthenia gravis (except when used to reduce muscarinic side effects of anticholinesterases), Severe ulcerative colitis. Avoid - Obstructive uropathy, Prostatic hypertrophy, Paralytic ileus, Ulcerative colitis, Elderly with cognitive decline. Cautions - Children (high sensitivity), Elderly, Hepatic or renal impairment, Hyperthyroidism, Hypertension. Trade Names - Atropine Sulphate Inj®, AtroPen® (auto-injector) Drug Interactions - May increase anticholinergic effects when used with antihistamines, tricyclic antidepressants, MAO inhibitors, and other anticholinergic drugs. Reduced effect of pilocarpine. May alter absorption of other drugs due to reduced GI motility. Adult: Organophosphate poisoning: 1–2 mg IV every 5–15 minutes until muscarinic symptoms subside. Bradycardia: 0.5–1 mg IV every 3–5 minutes (maximum total dose 3 mg). Pre-anaesthetic: 0.3–0.6 mg IM or IV 30–60 minutes before anaesthesia. Child: Organophosphate poisoning: 0.02 mg/kg IV every 5–10 minutes until symptoms resolve. Bradycardia: 0.01–0.02 mg/kg IV every 5 minutes (maximum single dose 0.5 mg).)
Propantheline Bromide (Anticholinergic, Antispasmodic, Antispasmodic) Indications - Symptomatic relief of gastrointestinal disorders characterized by smooth muscle spasm, hyperhidrosis, adult enuresis, urinary incontinence. Contraindications - Glaucoma, obstructive uropathy, paralytic ileus, myasthenia gravis, severe ulcerative colitis. Cautions - Ulcerative colitis, breastfeeding, suppresses lactation, hepatic impairment, renal impairment. Avoid - Use in pregnancy. Interactions - May enhance effects of other anticholinergics and tricyclic antidepressants; may reduce effects of prokinetic agents. Trade names - Prokind tab: Adult: 15 mg 3–4 times daily, 30 minutes before meals and at bedtime. Child: Not recommended unless under specialist supervision.
Propyphenazone (Non-opioid analgesic and antipyretic) Indications - Mild to moderate pain such as headaches, dental pain, and musculoskeletal pain. Contraindications - Hypersensitivity to pyrazolone derivatives, history of drug-induced agranulocytosis, porphyria. Cautions - Renal or hepatic impairment, elderly patients, alcohol use. Avoid - Long-term use, breastfeeding, use with other NSAIDs. Interactions - May interact with anticoagulants, other NSAIDs, alcohol (increased risk of GI bleeding). Trade names - tab:®, Cap:® Adult: 150–300 mg orally every 6–8 hours as needed. Maximum: 900 mg/day. Child: Use not recommended in children under 12 years; consult a physician for pediatric dosing.
Acetylcysteine (Antidote, Mucolytic) Indications - Paracetamol (acetaminophen) poisoning, Reduction of sputum viscosity in respiratory tract infections, Keratoconjunctivitis sicca (topical use). Contraindications - Hypersensitivity to acetylcysteine or any component of the formulation. Avoid - Nebulization in patients with active bronchospasm without bronchodilator pre-treatment. Cautions - History of peptic ulcer, Asthma, Hepatic impairment, Elderly. Trade Names - Acetylcysteine Inj: 200 mg/ml®, Actein®, Musol Tab®, Spalung Granules®, Muclear Tab®, Mucoclean Cap® Drug Interactions - Activated charcoal may reduce efficacy when used concurrently; may enhance hypotensive effects of nitroglycerin; avoid mixing with certain antibiotics in nebulizer. Adult: Paracetamol overdose (IV): 150 mg/kg over 1 hr, then 50 mg/kg over 4 hr, then 100 mg/kg over 16 hr (total 300 mg/kg over 21 hr). Mucolytic (oral): 600 mg once daily or 200 mg two to three times daily. Child: Paracetamol overdose (IV): Same as adult protocol; adjust fluid volume based on weight. Mucolytic (oral): 10–15 mg/kg/day in two to three divided doses.
Enoximone (Phosphodiesterase type-3 inhibitor) Indications - Congestive heart failure where cardiac output is reduced and filling pressure increased. Cautions - Heart failure associated with hypertrophic cardiomyopathy, stenotic or obstructive valvular disease, or other cardiac outlet stenosis and obstruction. Side effects - Headache, hypotension, insomnia, arrhythmias. Trade Names - Perfan inj:® Drug Interactions - Increased risk of arrhythmia when used with other inotropes or drugs that prolong QT interval. Use caution with diuretics or antihypertensives (may enhance hypotensive effect). Contraindications - Severe aortic or pulmonic valvular disease, obstructive cardiomyopathy, known hypersensitivity. Adult: Initially 0.5–1 mg/kg IV over 10 minutes, then maintenance dose of 500 mcg/kg every 30 minutes or continuous infusion based on response. Child: Not routinely recommended; if used, specialist supervision required.)
Loperamide HCl (Antidiarrheal) Indications - Acute diarrhea, Chronic diarrhea, Diarrhea associated with bowel colic or inflammatory bowel disease. Contraindications - Intestinal obstruction, Intestinal atony, Acute dysentery with blood and high fever, Pseudomembranous colitis, Antibiotic-associated colitis. Avoid - Ulcerative colitis, Urinary retention, Children under 2 years. Cautions - Hepatic impairment, Elderly, Dehydration, History of drug abuse or overdose. Trade Names - Dicotil tab®, Amerol tab®, Holdamide tab®, Eldoper®, Imodium®, Lormide cap® Drug Interactions - Increased CNS depression with opioid analgesics. May interact with saquinavir (decreased saquinavir levels). Risk of constipation with anticholinergics. Adult : Initially 4 mg orally, then 2 mg after each loose stool (maximum 16 mg/day). Child: 6–8 years: 2 mg twice daily; 8–12 years: 2 mg three times daily (max 6 mg/day). Not recommended for children under 6 years.)
Carboplatin (Platinum-based cytotoxic agent) Indications - Ovarian cancer, Lung cancer, Head and neck cancer, Other solid tumors. Contraindications - Severe myelosuppression, Hypersensitivity to platinum compounds, Pregnancy, Breastfeeding. Avoid - Pregnancy, Breastfeeding, Severe bone marrow suppression. Cautions - Renal impairment, Myelosuppression, Ototoxicity, Elderly, Monitor blood counts and renal function. Trade Names - Paraplatin® Inj: (Specialist use only) Drug Interactions - Additive nephrotoxicity and ototoxicity with aminoglycosides and other nephrotoxic agents. Enhanced myelosuppression with other cytotoxic drugs. Adult : Dose calculated using Calvert formula: Dose (mg) = AUC × (GFR + 25). AUC typically ranges from 4 to 6 depending on indication. Child: Administered under specialist supervision only, dosage individualized based on body surface area and renal function.)
Carbocisteine (Mucolytic) Indications - Chronic obstructive pulmonary disease (COPD), Bronchiectasis, Viscid respiratory secretions. Contraindications - Active peptic ulceration. Avoid - Use in patients with active GI bleeding or ulceration. Cautions - History of peptic ulcer, Monitor for gastrointestinal bleeding, Elderly. Trade Names - Mucodyne® cap, syrup Drug Interactions - May interact with antitussives (reduces mucolytic effectiveness), monitor if combined with other expectorants. Adult : 750 mg three times daily, reduced to 500 mg three times daily once a response is obtained. Child: 2–5 years: 100 mg three times daily (syrup) 5–12 years: 250 mg three times daily (syrup)
Tamoxifen (Selective oestrogen receptor modulator) Indications - Oestrogen receptor-positive breast cancer, Risk reduction in high-risk women. Contraindications - Hypersensitivity to tamoxifen, Pregnancy, History of thromboembolic disease (DVT, PE), Concurrent warfarin therapy in patients with breast cancer. Avoid - Pregnancy, History of deep vein thrombosis or pulmonary embolism (unless benefits outweigh risks). Cautions - Hepatic impairment, Risk of endometrial cancer, Visual disturbances, Periodic gynaecological assessments recommended. Trade Names - Nolvadex®, generic (Specialist use may be required depending on indication) Drug Interactions - May reduce effect of anticoagulants like warfarin. Interacts with CYP2D6 inhibitors (e.g., paroxetine, fluoxetine), reducing efficacy. Caution with SSRIs. Adult: 20 mg once daily. Child: Not recommended unless under specialist supervision).
Soframycin Indications - Conjunctivitis, Bacterial infection of eye or ear. Contraindications - Hypersensitivity to framycetin or other aminoglycosides. Avoid - Use with caution in patients with known aminoglycoside sensitivity. Cautions - Avoid contact with the middle ear if the tympanic membrane is perforated. Use cautiously in renal impairment when systemic absorption is possible. Trade Names - Soframycin eye drop®, Sofradect eye drop®, Soframycin skin cream® Drug Interactions - No significant systemic interactions when used topically. Adult : Apply as eye drops or skin cream as directed by physician. Child: Apply as eye drops or skin cream as directed by physician).
Azithromycin (Macrolide antibiotic) Indications - Uncomplicated genital chlamydial infection, Shigella enteritis, Typhoid fever, Respiratory tract infections, Otitis media, Skin and soft tissue infections, Lyme disease (early), Uncomplicated gonorrhoea, Community-acquired pneumonia, Trachomatous conjunctivitis caused by Chlamydia trachomatis, Purulent bacterial conjunctivitis. Contraindications - Hypersensitivity to azithromycin or other macrolides, History of cholestatic jaundice/hepatic dysfunction associated with prior use. Avoid - Use in patients with severe hepatic impairment or significant renal impairment without dose adjustment. Cautions - Pregnancy, Breastfeeding, Hepatic impairment, Renal impairment, Prolonged QT interval, Myasthenia gravis. Trade Names - Azimil-Kid 100 mg tab®, ALIMAX 250 mg Film-Coated tab®, Tridosil 500 mg tab® Drug Interactions - Increased risk of QT prolongation with other QT-prolonging agents (e.g., amiodarone), Antacids may reduce absorption (separate doses by 1–2 hours), May increase levels of digoxin and cyclosporine. Adult : 500 mg once daily for 3 days or 500 mg on day 1, then 250 mg once daily for 4 days (respiratory infections). Child: 10 mg/kg once daily for 3 days (e.g., otitis media, pneumonia), or 20 mg/kg as a single dose for uncomplicated genital infections).
Bleomycin (Antineoplastic antibiotic) Indications - Carcinoma of the cervix, Uterine cancer, Squamous cell carcinoma (head, neck, skin), Metastatic germ cell tumors (testicular, ovarian), Non-Hodgkin's lymphoma, Hodgkin’s lymphoma. Contraindications - Hypersensitivity to bleomycin, Pulmonary fibrosis, Severe pulmonary impairment. Avoid - Concomitant oxygen therapy, especially at high concentrations (due to risk of pulmonary toxicity). Cautions - Elderly, Renal impairment, Pre-existing lung disease, Monitor pulmonary function during treatment. Trade Names - Bleon® Powder for Injection (Specialist use only) Drug Interactions - Increased risk of pulmonary toxicity with oxygen therapy and other chemotherapeutic agents; reduced renal clearance with nephrotoxic drugs (e.g., cisplatin). Adult : Usual dose: 10–20 units/m² IV, IM, or SC twice weekly (max cumulative dose ~400 units to reduce risk of lung toxicity). Child: Dosing varies by protocol; typically 5–10 units/m² per dose; specialist supervision required).
Clarithromycin (Macrolide antibiotic) Indications - Respiratory tract infections, Skin and soft-tissue infections, Chronic obstructive pulmonary disease (COPD) exacerbations, Bronchiectasis, Acute cough, Acute otitis media, Prevention of pertussis, Acute sinusitis, Helicobacter pylori eradication (with amoxicillin or metronidazole). Contraindications - Hypersensitivity to macrolides, History of QT prolongation or ventricular arrhythmia, Concomitant use with drugs metabolized by CYP3A4 (e.g., ergotamine, cisapride), Severe hepatic impairment. Avoid - Pregnancy (unless benefit outweighs risk), Breastfeeding, Severe renal or hepatic impairment. Cautions - Mild-to-moderate renal or hepatic dysfunction, Elderly, Risk of QT prolongation, Myasthenia gravis. Trade Names - Clafax 250 mg tab®, Clari tab®, Clarifast 250 mg film-coated tab® Drug Interactions - Inhibits CYP3A4: may increase levels of statins, carbamazepine, warfarin, theophylline, digoxin. Risk of QT prolongation with other QT-prolonging drugs. Adult : 250–500 mg twice daily for 5–14 days depending on infection; for H. pylori: 500 mg twice daily with other antibiotics and PPI for 7–14 days. Child: 7.5 mg/kg twice daily (max 500 mg twice daily) for up to 10 days depending on infection).
Streptomycin (Aminoglycoside antibiotic) Indications - Tuberculosis (as part of multi-drug regimen), Brucellosis (with doxycycline), Plague, Tularemia, Endocarditis (off-label). Contraindications - Hypersensitivity to aminoglycosides, Myasthenia gravis, Pregnant women (risk of fetal ototoxicity), Pre-existing hearing loss. Avoid - Pregnancy unless life-threatening indication, Prolonged use in renal impairment. Cautions - Renal impairment, Elderly, Neuromuscular disorders (e.g., Parkinson’s disease), Concurrent use of ototoxic or nephrotoxic drugs. Trade Names - Streptomycin Inj® Drug Interactions - Increased risk of ototoxicity or nephrotoxicity with loop diuretics, vancomycin, amphotericin B, cisplatin. Neuromuscular blockade potentiated by anaesthetics and muscle relaxants. Adult : 15 mg/kg daily (usually 0.75–1 g) IM, max 1 g/day; dose may be reduced in renal impairment. Child: 20–40 mg/kg/day IM as a single dose or divided (max 1 g/day).
Capreomycin (Second-line antitubercular agent) Indications - Multidrug-resistant tuberculosis (MDR-TB), particularly in combination regimens when resistance to first-line agents is present. Contraindications - Hypersensitivity to capreomycin, Pre-existing significant hearing loss. Avoid - Breastfeeding, Concurrent use of other ototoxic or nephrotoxic drugs. Cautions - Renal impairment, Elderly, Hearing impairment, Electrolyte disturbances (e.g., hypokalemia, hypomagnesemia), Monitor renal and auditory function during therapy. Trade Names - Capastat® Sulfate Inj Drug Interactions - Increased risk of ototoxicity and nephrotoxicity with aminoglycosides, loop diuretics, amphotericin B, and other nephrotoxic drugs. Adult : 15 mg/kg (usually 0.75–1 g) IM once daily; reduce frequency in renal impairment. Child: 15–30 mg/kg/day IM once daily (max 1 g/day); adjust in renal impairment).
Cycloserine (Second-line antitubercular agent) Indications - Resistant tuberculosis (MDR-TB), typically as part of a combination regimen. Contraindications - Hypersensitivity to cycloserine, Epilepsy, Severe depression or anxiety, History of psychosis, Alcoholism. Avoid - Depression, Epilepsy, Severe anxiety, Alcohol use. Cautions - Renal impairment, Psychiatric history, Monitor serum drug levels in renal dysfunction, Perform regular neuropsychiatric evaluations. Trade Names - Cycloserine Cap® Drug Interactions - May increase CNS toxicity when used with isoniazid or alcohol. Use with caution alongside other neurotoxic drugs. Adult : 250–500 mg orally twice daily (max: 1 g/day), adjusted in renal impairment. Child: 10–20 mg/kg/day in 2 divided doses (max: 1 g/day), specialist supervision advised).
Quinine (Antimalarial and muscle relaxant)Indications - Falciparum malaria (treatment), Nocturnal leg cramps (short-term use). Contraindications - Hypersensitivity to quinine or related compounds, Haemoglobinuria, Myasthenia gravis, Optic neuritis, Tinnitus, G6PD deficiency. Cautions - Cardiac disease (risk of arrhythmia), Hepatic or renal impairment, Elderly, Monitor blood glucose (risk of hypoglycemia in malaria treatment). Avoid - Prolonged use for leg cramps, Use in patients with tinnitus or visual disturbances. Trade names - Quinimax tab:®, Quinate cap:®, Quinine Sulfate tab:®, Quinine Dihydrochloride inj:® Drug interactions - Anticoagulants, Digoxin, Antacids, Cimetidine, Rifampicin, Carbamazepine, CYP3A4 inhibitors/inducers. Adult : Leg cramps: 200–300 mg at bedtime (max 4 weeks); Malaria: 600 mg every 8 hours for 7 days (oral), or 20 mg/kg loading dose IV over 4 hours, then 10 mg/kg every 8 hours. Child: Malaria: 10 mg/kg oral every 8 hours for 7 days or per WHO/local protocols (specialist supervision required).qqq
Primaquine (Antimalarial – tissue schizonticide)Indications - Radical cure of P. vivax and P. ovale malaria (prevention of relapse), Adjunct in treatment of mild to moderate Pneumocystis jirovecii* pneumonia (PCP) in combination with clindamycin. Contraindications - Glucose-6-phosphate dehydrogenase (G6PD) deficiency, Pregnancy, Breastfeeding (unless infant G6PD status known), Granulocytopenia, Severe hepatic impairment. Cautions - Mild to moderate G6PD variants (monitor closely), Autoimmune disorders (e.g., rheumatoid arthritis), Elderly, Concurrent myelosuppressive drugs. Avoid - Use without G6PD testing, Combination with hemolysis-inducing agents. Trade names - Primaquine Phosphate tab:®, Primacin tab:® Drug interactions - Clozapine (increased risk of agranulocytosis), Hematotoxic drugs (additive effects), Rifampin (decrease efficacy), CYP450 inhibitors or inducers. Adult : 15–30 mg base (26.3–52.6 mg salt) orally once daily for 14 days (for P. vivax and P. ovale eradication); For PCP: 15–30 mg base/day in divided doses with clindamycin for 21 days. Child: 0.25–0.5 mg/kg base (max 15 mg/day) orally once daily for 14 days (malaria); For PCP: specialist-directed dosing with clindamycin.
Mefloquine (Antimalarial – blood schizonticide) Indications - Treatment of uncomplicated P. falciparum malaria (when artemisinin-based therapy is not available), Prophylaxis of malaria in endemic areas (adults and children). Contraindications - History of psychiatric disorders (e.g. depression, anxiety, psychosis), History of seizures or epilepsy, History of blackwater fever, Hypersensitivity to quinoline compounds. Cautions - Hepatic impairment, Concomitant use of drugs that prolong QT interval, Cardiac conduction abnormalities, Elderly, Visual disturbances, Driving or operating machinery (neuropsychiatric effects possible). Avoid - Use in patients with active depression, generalized anxiety disorder, or psychosis; use in pregnancy unless benefits outweigh risks. Trade names - Lariam tab:®, Mephaquin tab:® Drug interactions - Other antimalarials (e.g., quinine, chloroquine – increased QT prolongation risk), Beta-blockers and calcium channel blockers (additive cardiac effects), Anticonvulsants (decreased seizure threshold), CNS depressants (Increased neurotoxicity risk). Adult : Treatment: 20–25 mg/kg total dose orally (usually 1250 mg once, or split over 6–8 hours); Prophylaxis: 250 mg once weekly, starting 1–2 weeks before travel and continuing for 4 weeks after leaving endemic area. Child: Prophylaxis: 5 mg/kg orally once weekly; Treatment: total dose 20–25 mg/kg (divided into 2 doses 6–8 hours apart); dosing by body weight under specialist guidance.
Atovaquone with Proguanil HCl (Antimalarial combination) Indications - Prophylaxis of P. falciparum malaria, especially in areas with drug-resistant strains; Treatment of acute uncomplicated P. falciparum malaria. Contraindications - Avoid - Use in patients with known bradycardia, history of arrhythmia, family history of sudden cardiac death, or congestive heart failure unless essential and closely monitored. Cautions - Hepatic impairment, Gastrointestinal disorders affecting drug absorption, Concomitant QT-prolonging drugs. Trade names - Malarone tab:®, Malanil tab:®, Atova-Pro tab:® Drug interactions - Metoclopramide (decreased atovaquone levels), Rifampicin/rifabutin (decreased atovaquone), Tetracycline (decreased atovaquone), Warfarin (increased anticoagulant effect), Antiretrovirals (possible altered levels). Adult : Treatment: 4 tablets once daily for 3 consecutive days (each tab: atovaquone 250 mg + proguanil 100 mg). Prophylaxis: 1 tablet daily, starting 1–2 days before travel, continued during stay and for 7 days after leaving endemic area. Child: Dosing by weight: 11–20 kg: 1 tab once daily 21–30 kg: 2 tabs once daily 31–40 kg: 3 tabs once daily >40 kg: adult dose.
Atovaquone (Antiprotozoal) Indications - Pneumocystis jirovecii pneumonia (for patients intolerant to co-trimoxazole), Toxoplasmosis (off-label), Babesiosis, Malaria (in combination with proguanil). Contraindications - Known hypersensitivity to atovaquone or formulation components. Avoid - Pregnancy, Breastfeeding, Severe hepatic impairment, Severe renal impairment. Cautions - Mild to moderate hepatic or renal impairment; administer with fatty food to enhance absorption. Trade Names - Susp: Mepron® Tab: Atovaquone® Drug Interactions - May interact with rifampicin, rifabutin (reduced plasma levels); enhanced levels of zidovudine; interaction with tetracyclines and metoclopramide may reduce absorption. Adult : 750 mg orally twice daily with food for 21 days (Pneumocystis pneumonia). Child: 15–20 mg/kg orally twice daily with food (for Pneumocystis pneumonia).
Artenimol with Piperaquine (Antimalarial combination) Indications - Treatment of uncomplicated P. falciparum malaria, particularly in children in endemic areas. Contraindications - Prolonged QT interval, Severe cardiac disorders (including recent myocardial infarction, symptomatic arrhythmias), Electrolyte disturbances (e.g., hypokalemia, hypomagnesemia), Known hypersensitivity to artenimol or piperaquine. Avoid - Use in patients with bradycardia, family history of sudden cardiac death, or heart failure unless under specialist supervision. Cautions - Hepatic or renal impairment, Patients on QT-prolonging drugs, Malnourished children, Electrolyte imbalances (correct before use). Trade names - Eurartesim tab:®, Duo-Cotecxin tab:® Drug interactions - QT-prolonging drugs (e.g., macrolides, fluoroquinolones, antipsychotics), Antiretrovirals, Antimalarials (chloroquine, quinine), CYP3A4 inhibitors or inducers. Adult : Not routinely used in adults; specialist recommendation only. Typical dose: 3 tablets once daily for 3 days (each containing artenimol 80 mg + piperaquine 640 mg). Child: Dosing based on body weight:
Artemether with Lumefantrine (Antimalarial combination) Indications - Treatment of acute uncomplicated P. falciparum malaria, including cases due to chloroquine-resistant strains; also effective against mixed infections involving non-falciparum species. Contraindications - History of cardiac arrhythmia, Congestive heart failure, Family history of sudden death, Known QT prolongation, Severe hepatic impairment, Allergy to artemether or lumefantrine. Avoid - Use with drugs that prolong QT interval, Use in patients with acute porphyrias. Cautions - Hepatic or renal impairment, Malnutrition, Electrolyte disturbances (hypokalemia, hypomagnesemia), Concomitant use of CYP3A4 inhibitors/inducers, Patients with bradycardia. Trade names - Coartem tab:®, Riamet tab:®, Falcynate-LF tab:® Drug interactions - QT-prolonging drugs (e.g., macrolides, fluoroquinolones, antipsychotics), CYP3A4 inhibitors (e.g., ketoconazole), CYP inducers (e.g., rifampin, phenytoin), Antiretrovirals. Adult : 4 tablets (each containing artemether 20 mg + lumefantrine 120 mg) at 0, 8, 24, 36, 48, and 60 hours (total of 6 doses). Child: Dosing based on body weight: ≥35 kg: 4 tablets per dose (6 doses)
Chloroquine (Antimalarial, Antirheumatic) Indications - Prophylaxis and treatment of P. vivax, P. ovale, P. malariae, and P. knowlesi malaria (non-falciparum); Active rheumatoid arthritis (on specialist advice); Systemic and discoid lupus erythematosus (on specialist advice). Contraindications - Pre-existing maculopathy or retinal changes, Known hypersensitivity to chloroquine or related compounds. Cautions - Elderly, Hepatic or renal impairment, Epilepsy, G6PD deficiency, Psoriasis, Porphyria, Diabetes (may affect glucose regulation), Severe GI disorders, Visual disturbances (regular ophthalmic exams advised with long-term use). Avoid - Concurrent use with other QT-prolonging agents unless essential and monitored. Trade names - Nivaquine tab:®, Aralen tab:®, Resochin tab:® Drug interactions - QT-prolonging drugs (e.g., amiodarone), Antiepileptics (decreased seizure threshold), Digoxin (Increase levels), Antacids (decrease absorption), Cimetidine, Cyclosporine. Adult : Prophylaxis: 300 mg base (usually 500 mg salt) once weekly; Treatment: 600 mg base initially, followed by 300 mg base after 6–8 hours, then 300 mg base daily for 2 days (total dose: 1.5 g base). Rheumatic diseases: 200–400 mg daily. Child: Prophylaxis: 5 mg base/kg (max 300 mg base) once weekly; Treatment: 10 mg base/kg initially, then 5 mg base/kg at 6, 24, and 36 hours (total 25 mg/kg base over 3 days). Not to exceed adult dosing.
Lumefantrine (Antimalarial – aryl amino alcohol) Indications - Used in combination with artemether for the treatment of acute uncomplicated P. falciparum malaria, including chloroquine-resistant strains. Contraindications - Known hypersensitivity to lumefantrine or artemether, QT prolongation, Severe malaria (use IV artesunate instead). Cautions - Cardiac disorders (QT prolongation), Hepatic or renal impairment, Electrolyte disturbances (e.g., hypokalemia, hypomagnesemia), Avoid use with strong CYP3A4 inhibitors or inducers. Trade names - Lumiter tab:®, Coartem tab:® (in combination with artemether) Drug interactions - QT-prolonging drugs (e.g., macrolides, quinolones), CYP3A4 inhibitors/inducers, Rifampicin, Antiretrovirals. Adult : Usually given in fixed-dose combination with artemether: 20 mg artemether + 120 mg lumefantrine per tablet. Standard dosing is 4 tablets at 0, 8, 24, 36, 48, and 60 hours (total 24 tablets over 3 days). Child: Weight-based dosing when used in combination with artemether: • 5–14 kg: 1 tablet per dose • 15–24 kg: 2 tablets per dose • 25–34 kg: 3 tablets per dose • ≥35 kg: adult dosing (4 tablets per dose)
Proguanil HCl (Antimalarial – folate antagonist)Indications - Prophylaxis of malaria (especially in areas with chloroquine-sensitive Plasmodium falciparum). Contraindications - Severe renal impairment, Hypersensitivity to proguanil or related compounds. Cautions - Mild to moderate renal impairment, Pregnancy (only if clearly needed), Hepatic impairment, Use with folic acid in deficiency states. Avoid - Monotherapy in areas with high resistance; not effective alone for treatment of malaria. Trade names - Paludrine tab:®, Proguanil Hydrochloride cap:®, Paludrine/Avloclor Combo tab:® Drug interactions - Warfarin ( increase anticoagulant effect), Methotrexate (additive antifolate toxicity), Metoclopramide (decreased absorption), Antacids (decreased efficacy). Adult : 200 mg once daily, starting 1 week before travel and continuing for 4 weeks after leaving endemic area. Child: 3–4 mg/kg once daily (max 200 mg/day); start 1 week before travel and continue for 4 weeks post-exposure.
Clindamycin (Lincosamide antibiotic) Indications - Bacterial vaginosis, Osteomyelitis, Peritonitis, Septic arthritis, Intra-abdominal sepsis, Bronchiectasis, Bone and joint infections, Skin and soft tissue infections, Falciparum malaria (as adjunct), Acne vulgaris. Contraindications - Hypersensitivity to clindamycin or lincomycin, History of antibiotic-associated colitis. Avoid - History of diarrheal states (e.g., pseudomembranous colitis), Use with caution in elderly women. Cautions - Hepatic or renal impairment, History of gastrointestinal disease, Elderly, Neonates. Trade Names - Climycin cream®, Tidact Cap® Drug Interactions - May enhance effects of neuromuscular blockers. Antagonistic interaction with erythromycin. Monitor with other hepatotoxic drugs. Adult: 150–450 mg orally every 6 hours. Severe infections: up to 600 mg IV/IM every 6–8 hours. Child: 8–25 mg/kg/day orally in 3–4 divided doses (max: 1.8 g/day), depending on severity of infection).
Dactinomycin (Cytotoxic antibiotic, Antineoplastic) Indications - Paediatric cancers including Wilms' tumor, Ewing's sarcoma, Rhabdomyosarcoma, Gestational trophoblastic neoplasia, Testicular cancer (in combination regimens). Contraindications - Hypersensitivity to dactinomycin, Existing severe infection, Recent or ongoing radiotherapy (due to risk of increased toxicity). Avoid - Live vaccines during treatment, Breastfeeding, Concurrent radiotherapy (unless carefully monitored). Cautions - Bone marrow suppression, Hepatic or renal impairment, Avoid extravasation (vesicant), Immunosuppressed patients. Trade Names - Cosmegen® (injectable form) Drug Interactions - Increased risk of toxicity with concurrent radiotherapy. Avoid with other bone marrow suppressant agents unless necessary. Adult: Generally used in combination chemotherapy regimens; dose individualized based on protocol and body surface area. Child: 250–1500 mcg/m² IV every 1–3 weeks, depending on treatment protocol and indication (specialist supervision required).
Erythromycin (Macrolide antibiotic) Indications - Penicillin hypersensitivity, Respiratory tract infections, Skin and oral infections, Campylobacter enteritis, Acute cough, Acute otitis media, Early syphilis, Uncomplicated genital chlamydia, Chronic prostatitis, Pertussis, Diphtheria, Acne, Gastrointestinal stasis. Contraindications - Hypersensitivity to erythromycin, Acute porphyria. Avoid - In acute porphyria, Hepatic impairment, Severe renal impairment. Cautions - QT prolongation risk, Myasthenia gravis, Moderate hepatic or renal dysfunction, Elderly patients, Drug interactions via CYP3A4. Trade Names - RYTHRO-250 tab®, Trinpac Gel 10g/15g®, Eryko-250 Tab®, MAC Powder for Suspension® Drug Interactions - May increase plasma levels of theophylline, carbamazepine, warfarin, and digoxin. Risk of QT prolongation with other QT-prolonging agents (e.g., cisapride, pimozide). Avoid strong CYP3A4 inhibitors or inducers. Adult: 250–500 mg every 6 hours, or 500 mg–1 g every 12 hours, depending on infection. Child: 30–50 mg/kg/day in divided doses every 6–12 hours (oral), dose depends on infection and formulation. Note: Take with food to reduce gastrointestinal discomfort.
Fosfomycin Tromethamine (Broad-spectrum antibiotic) Indications - Acute uncomplicated lower urinary-tract infections, Prophylaxis of urinary-tract infections, Osteomyelitis, Complicated urinary-tract infections, Bacterial meningitis. Contraindications - Hypersensitivity to fosfomycin or any component of the formulation. Avoid - In patients with severe renal impairment (unless dose is adjusted), Hypersensitivity to fosfomycin. Cautions - Renal impairment, Sodium-restricted diets (IV formulation contains sodium), Monitor liver and renal function during prolonged use. Trade Names - Monurol® (granules), Urofos® sachet, Fosfocina® IV Drug Interactions - May reduce absorption of other oral medications if taken concomitantly; separate administration by at least 2 hours. Use with metoclopramide may reduce urinary concentrations. Adult: Uncomplicated UTI (oral): 3 g as a single dose (sachet, dissolved in water). Complicated infections (IV): 12–16 g/day in 2–3 divided doses. Child: IV (complicated infections): 100–300 mg/kg/day in divided doses every 8 hours (specialist supervision recommended).
Gentamicin (Aminoglycoside antibiotic) Indications - Conjunctivitis, Neonatal sepsis, Acute pyelonephritis, Biliary-tract infection, Listerial meningitis, CNS infections, Gram-positive bacterial endocarditis, Bacterial eye infections, Bacterial infection in otitis externa, Peritoneal dialysis-associated peritonitis (with Vancomycin). Contraindications - Hypersensitivity to gentamicin or other aminoglycosides. Avoid - In patients with neuromuscular disorders (e.g., myasthenia gravis), Severe renal impairment unless monitored closely. Cautions - Renal impairment, Elderly, Neonates, Prolonged use increases risk of ototoxicity and nephrotoxicity, Monitor drug levels and renal function. Trade Names - Gentamycin Eye Drops®, Gentamycin Ear Drops® Drug Interactions - Increased risk of nephrotoxicity with loop diuretics, amphotericin B, or other nephrotoxic drugs. May enhance neuromuscular blockade with muscle relaxants. Adult: Systemic infections: 3–5 mg/kg/day IV/IM in divided doses every 8 hours. Topical (eye/ear): 1–2 drops every 4–6 hours. Child: Neonates: 2.5 mg/kg every 12 hours. Children: 2–2.5 mg/kg every 8 hours IV/IM (adjust based on infection severity and renal function).
Tobramycin (Aminoglycoside antibiotic) Indications - Neonatal sepsis, Urinary tract infection, Acute pyelonephritis, Prostatitis, Chronic pulmonary Pseudomonas aeruginosa infection, Meningitis, CNS infections, Biliary tract infection, Listerial meningitis, Local treatment of infections (eye, ear). Contraindications - Hypersensitivity to tobramycin or other aminoglycosides. Cautions - Renal impairment, Elderly, Neuromuscular disorders (e.g., myasthenia gravis), Monitor serum drug levels and renal function regularly. Trade Names - Gentob Eye Drops®, Tobcol-Dex Eye Drops®, Tobramycin Eye Drops® Drug Interactions - Increased risk of nephrotoxicity and ototoxicity when used with other nephrotoxic agents (e.g., loop diuretics, amphotericin B). Enhanced neuromuscular blockade when used with muscle relaxants. Adult: Systemic infections: 3–5 mg/kg/day IV/IM in divided doses every 8 hours. Ophthalmic (eye drops): 1–2 drops every 4–6 hours (may increase to every 2 hours for severe infections). Child: Neonates: 2.5 mg/kg every 12 hours IV/IM. Children: 2–2.5 mg/kg every 8 hours IV/IM (adjust according to renal function and severity).
Netilmicin (Aminoglycoside antibiotic) Indications - Serious Gram-negative infections resistant to gentamicin, including urinary tract infections, respiratory tract infections, skin and soft tissue infections, and septicemia. Contraindications - Hypersensitivity to aminoglycosides. Cautions - Renal impairment, Elderly, Neuromuscular disorders (e.g., myasthenia gravis), Concurrent use with nephrotoxic or ototoxic drugs. Monitor renal function and serum drug levels. Trade Names - Netromycin Inj® Drug Interactions - Increased risk of nephrotoxicity with other nephrotoxic agents (e.g., vancomycin, amphotericin B). Risk of ototoxicity. Neuromuscular blockade risk when combined with muscle relaxants. Adult: 4–6 mg/kg/day IV/IM in 2–3 divided doses. Child: 6–7.5 mg/kg/day IV/IM in 2–3 divided doses.
Kanamycin (Aminoglycoside antibiotic) Indications - Tuberculosis (including MDR-TB), Septicaemia, Meningitis, Gonorrhoea, Urinary tract infection, Hepatic encephalopathy (as adjunct), Enteritis. Contraindications - Hypersensitivity to aminoglycosides. Cautions - Renal impairment, Elderly, Neuromuscular disorders, Ototoxicity risk. Monitor renal function and hearing. Trade Names - Pai Kana Inj® Drug Interactions - Increased nephrotoxicity with other nephrotoxic drugs (e.g., amphotericin B, vancomycin). Enhanced neuromuscular blockade with muscle relaxants. Adult: 15 mg/kg/day IM/IV in 1–2 divided doses. Child: 15–30 mg/kg/day IM/IV in 2 divided doses.
Lincomycin HCl (Lincosamide antibiotic) Indications - Anaerobic infections, Osteomyelitis, Otitis media, Pneumonia, Colitis (with caution). Contraindications - Hypersensitivity to lincomycin or clindamycin. Cautions - History of gastrointestinal disease, especially colitis. Use cautiously in hepatic/renal impairment. Trade Names - LINCOLECIN 500 mg Cap®, Lincocin Cap®, Lincomycin 500 mg Cap®, PADLINCOCAPS BP 500 mg Cap® Drug Interactions - Antagonistic with erythromycin. Enhances effects of neuromuscular blocking agents. Adult: 500 mg every 6–8 hours orally or IM. Child: 30–60 mg/kg/day in 3–4 divided doses orally or IM.
Budesonide (Corticosteroid) Indications - Mild to moderate Crohn’s disease (ileum/colon), Collagenous colitis, Autoimmune hepatitis, Ulcerative colitis (rectal/sigmoid), Microscopic colitis, Asthma prophylaxis, Allergic and vasomotor rhinitis, Nasal polyps. Contraindications - Hypersensitivity to budesonide or components of formulation. Cautions - Tuberculosis, infections, hepatic impairment, prolonged use may cause adrenal suppression. Trade Names - Budesonide®, Budesonide + Formoterol®, Formonide® Drug Interactions - CYP3A4 inhibitors (e.g., ketoconazole) may increase systemic exposure. Monitor with other corticosteroids. Adult: Oral: 9 mg once daily (Crohn’s); Inhalation: 200–800 mcg daily in divided doses (asthma). Child: Varies by indication. Inhalation: 100–800 mcg/day in divided doses (asthma).
Beclomethasone dipropionate (Corticosteroid) Indications - Adjunct to aminosalicylates in mild to moderate ulcerative colitis, Prophylaxis and treatment of asthma, Allergic and vasomotor rhinitis, Management of oral ulceration, Severe inflammatory skin disorders such as eczema. Contraindications - Hypersensitivity to beclomethasone, Active untreated infections, Systemic fungal infections. Avoid - Use with caution in active tuberculosis, untreated infections, ocular herpes simplex. Cautions - Hepatic impairment, Immunosuppression, Recent live vaccines, Children (growth monitoring). Trade Names - Inhaler: Beclazone®, Qvar®, Clenil®; Tab: Beclomethasone dipropionate tablets Drug Interactions - May increase effects of systemic corticosteroids; CYP3A4 inhibitors (e.g., ketoconazole) may increase plasma levels. Adult: Inhaler: 100-400 mcg twice daily; Ulcerative colitis: 5 mg rectal foam or enema daily. Child: Inhaler: 100-200 mcg twice daily; Use lowest effective dose and monitor growth.
Natamycin (Antifungal) Indications - Fungal infections of the eye, including fungal blepharitis, conjunctivitis, and keratitis caused by susceptible organisms (e.g., Fusarium, Aspergillus, Candida). Contraindications - Hypersensitivity to natamycin or any component of the formulation. Avoid - Use in deep stromal fungal infections without ophthalmic supervision. Cautions - Not for intraocular injection; use with caution in pregnant or breastfeeding women only under medical supervision. Trade Names - Eye drop: Natapro Ophthalmic Suspension®, Pima-F Eye Drop® Drug Interactions - No major systemic drug interactions; avoid concurrent use with other topical ophthalmic medications without medical advice. Adult: 1 drop to the affected eye(s) every 1–2 hours initially; reduce frequency as infection improves. Child: Same as adult dose; use under specialist supervision.
Neomycin sulfate (Aminoglycoside antibiotic) Indications - Bowel sterilisation before surgery, Hepatic coma, Bacterial infections of the skin and external ear canal, Eye and ear infections. Contraindications - Intestinal obstruction, Myasthenia gravis, Pregnancy, Hypersensitivity to neomycin or other aminoglycosides. Avoid - Pregnancy, Renal impairment, Prolonged use on large wounds or broken skin. Cautions - Hepatic impairment, Renal impairment, Avoid use in conditions with impaired intestinal motility. Trade Names - Lozenges: Mybacin® Cream: Neopac® Eye/Ear/Nasal Drops: Betason-N®, Itrodex® Topical Powder: Neocin® Drug Interactions - Ototoxicity may be enhanced by loop diuretics; avoid concurrent nephrotoxic agents (e.g., amphotericin B, vancomycin). Adult: Oral: 1 g 6 hourly for 5–6 doses before surgery. Topical: Apply thin layer 2–3 times daily. Child: Topical: Apply under specialist advice; oral use not generally recommended in children.
Roxithromycin (Macrolide antibiotic) Indications - Genito-urinary tract infections, Respiratory tract infections including pneumonia, Skin and soft tissue infections. Contraindications - Hypersensitivity to macrolides, Severe hepatic impairment. Avoid - Use in patients with known QT prolongation, or on drugs that prolong QT interval. Cautions - Mild to moderate hepatic impairment, Cardiac arrhythmias, Elderly patients. Trade Names - Tab: Rocin®, Roxitem-300® (film-coated) Drug Interactions - May increase serum concentrations of theophylline, warfarin, and ergot derivatives. Avoid concurrent use with QT-prolonging agents. Adult: 150 mg twice daily or 300 mg once daily for 5–10 days depending on infection severity. Child: 5–8 mg/kg/day in two divided doses, use under medical supervision.
Spectinomycin (Aminocyclitol antibiotic) Indications - Uncomplicated gonorrhoea, Gonococcal urethritis, Cervicitis, Prostatitis, Urethritis (when first-line therapies are unsuitable). Contraindications - Hypersensitivity to spectinomycin. Avoid - Use in neonates, Pregnancy (unless benefits outweigh risks). Cautions - Renal impairment, Monitor for superinfection with prolonged use. Trade Names - Inj: Tinobicin® Powder for Injection (IM) Drug Interactions - May interact with other nephrotoxic drugs; limited significant interactions reported. Adult: 2 g intramuscularly as a single dose for uncomplicated gonorrhoea. Child: Not routinely recommended; specialist advice required for dosing.
Viper Antivenin (Antivenom) Indications - Treatment of envenomation following viper snake bite. Contraindications - Known hypersensitivity to equine proteins or antivenin components (unless benefits outweigh risks). Avoid - Unnecessary delay in administration; administer as soon as possible after envenomation. Cautions - History of allergies or asthma, Risk of anaphylaxis, Serum sickness, Use under medical supervision with resuscitation support available. Trade Names - Inj: Vins Viper Antivenin®, Polyvalent Snake Antivenom® Drug Interactions - May interact with other biologicals or immunoglobulin therapies; avoid co-administration without clinical guidance. Adult: 10–20 mL by slow IV infusion, repeat if needed depending on severity of envenomation. Child: Same dose as adults (not weight-based); adjust based on clinical response.
Asparaginase (Antineoplastic enzyme) Indications - Treatment of acute lymphoblastic leukaemia (ALL), often in combination chemotherapy protocols. Contraindications - History of hypersensitivity to asparaginase or Erwinia-derived asparaginase, Pancreatitis, Severe hepatic impairment, Bleeding disorders. Avoid - Use in patients with active thrombosis, pancreatitis, or uncontrolled infection. Cautions - Monitor for hypersensitivity reactions, hyperglycaemia, pancreatitis, coagulation abnormalities, and hepatic dysfunction. Trade Names - Inj: Leunase®, Oncaspar® (Specialist use only) Drug Interactions - May enhance toxicity of vincristine, interferes with coagulation-modifying agents, increased risk of hepatotoxicity with other chemotherapeutics. Adult: Usually 5,000–10,000 units/m² IM or IV, 3 times weekly, based on regimen. Child: Same as adult on body surface area basis; adjust according to treatment protocol.
Azapropazone Indications - Acute gout, Rheumatoid arthritis Contraindications - Active peptic ulcer, Severe heart failure, Severe renal or hepatic impairment, Hypersensitivity to NSAIDs. Avoid - During pregnancy and breastfeeding, in elderly with renal impairment. Cautions - History of gastrointestinal bleeding, asthma, coagulation disorders. Trade Names - Tab: Rheumox® Cap: Azaprin® Drug Interactions - May increase plasma levels of warfarin, phenytoin, sulfonylureas; avoid with other NSAIDs; reduces diuretic and antihypertensive efficacy. Adult: 600–900 mg daily in divided doses after food. Child: Not recommended for pediatric use.
Azathioprine (Immunosuppressant) Indications - Severe acute Crohn’s disease, Maintenance of remission of Crohn’s disease and ulcerative colitis, Rheumatoid arthritis unresponsive to other DMARDs, Systemic lupus erythematosus, Polymyositis (steroid-resistant), Autoimmune conditions, Prevention of transplant rejection, Refractory eczema, Generalised myasthenia gravis. Contraindications - Hypersensitivity to azathioprine or mercaptopurine, Severe infections, Severe hepatic or bone marrow impairment. Cautions - TPMT deficiency, Hepatic or renal impairment, Concurrent use with allopurinol (dose adjustment needed), Risk of infections. Avoid - Live vaccines during treatment, Pregnancy unless essential, Breastfeeding. Trade Names - Tab: Azoran 50 mg®, IMURAN® Drug Interactions - Allopurinol (requires dose reduction), warfarin, ACE inhibitors, myelosuppressive agents, live vaccines. Adult: Initially 1–3 mg/kg daily, adjusted based on response and tolerance. Child: 1–3 mg/kg daily, depending on indication and body surface area.
Aztreonam (Monobactam Antibiotic) Indications - Infections due to gram-negative bacteria including Pseudomonas aeruginosa, Haemophilus influenzae, Neisseria meningitidis; Gonorrhoea, Cystitis, Urinary tract infection, Chronic pulmonary infections, Septicaemia, Intra-abdominal infections. Contraindications - Hypersensitivity to aztreonam or other beta-lactam antibiotics, Pregnancy (unless clearly needed). Cautions - Renal impairment (dose adjustment needed), Hepatic impairment, History of penicillin allergy (cross-reactivity rare but possible). Avoid - Use with caution in breastfeeding unless benefits outweigh risks. Trade Names - Inj: Azactam®, Aztreonam Injection® Drug Interactions - May interact with aminoglycosides (nephrotoxicity risk), furosemide, probenecid (delays excretion). Adult: 500 mg to 2 g every 6–8 hours IV/IM depending on severity and site of infection. Child: 30–50 mg/kg every 6–8 hours IV/IM; maximum 8 g/day.
Bethanechol chloride (Parasympathomimetic, Muscarinic agonist, Cholinergic agonist) Indications - Urinary retention (especially postoperative or postpartum), Neurogenic bladder, Gastroesophageal reflux (off-label). Contraindications - Intestinal obstruction, Urinary tract obstruction, Bradycardia, Hypotension, Peptic ulcer, Asthma, Recent myocardial infarction. Cautions - Parkinsonism, Epilepsy, Cardiac arrhythmias, Pregnancy and breast-feeding. Avoid - Use with other parasympathomimetic drugs, Avoid abrupt posture changes (risk of hypotension). Drug Interactions - Increased effects with cholinesterase inhibitors; additive effects with other cholinergic agonists. Trade Names - Tab: Urecholine®, Myotonachol® Adult: 10–50 mg orally 3–4 times daily, taken 1 hour before or 2 hours after meals. Child: 0.6 mg/kg per dose orally 3–4 times daily (adjust per response and weight).
Carbachol (Parasympathomimetic drug, Cholinergic agonist) Indications - Treatment of glaucoma (especially open-angle and during eye surgery), Induction of miosis, Occasionally used in urinary retention. Contraindications - Urinary or intestinal obstruction, Acute iritis, Bradycardia, Asthma, Peptic ulcer, Cardiovascular instability. Cautions - In patients with epilepsy, Parkinsonism, coronary insufficiency, or hyperthyroidism. Avoid - Use with other parasympathomimetic agents, Pregnancy, Breast-feeding, Recent myocardial infarction. Drug Interactions - May potentiate effects of other cholinergic drugs; antagonized by anticholinergics. Trade Names - Eye Drops: Isopto Carbachol®, Carbastat® Adult: Ophthalmic: 1.5–3% solution instilled into the eye (as directed). Child: Use not routinely recommended in pediatric patients; use under specialist supervision.
Propiverine HCl Indications - Overactive bladder, Urinary urgency, Frequency, Urge incontinence, Neurogenic bladder instability. Contraindications - Urinary retention, Severe gastrointestinal disorders (e.g., toxic megacolon), Myasthenia gravis, Narrow-angle glaucoma. Cautions - Elderly, Hepatic or renal impairment, Autonomic neuropathy. Avoid - Pregnancy, Breast-feeding, Severe hepatic or renal impairment. Drug Interactions - Potentiated by anticholinergics, tricyclic antidepressants; may reduce effect of prokinetics. Trade Names - Tab: Mictonorm®, Cap: Mictoryl® Adult: 15–30 mg daily in divided doses (e.g., 5 mg three times daily or 15 mg twice daily, depending on formulation). Child: Children over 5 years: Usually 0.3–0.5 mg/kg twice daily, under specialist supervision.
Flavoxate HCl Indications - Urinary frequency, Urgency, Urinary incontinence, Dysuria, Nocturia, Bladder spasms (e.g. from catheterization or cystitis). Contraindications - Gastrointestinal obstruction, Bleeding peptic ulcer, Achalasia, Obstructive uropathy. Cautions - Glaucoma, Prostatic hypertrophy, Hepatic or renal impairment. Avoid - Pregnancy, Breast-feeding. Drug Interactions - May enhance effects of anticholinergics; use caution with CNS depressants. Trade Names - Tab: Urispas®, Bladderon®, Genurin® Adult: 100–200 mg three to four times daily. Child: Not recommended for children under 12 years.
Oxybutynin HCl (Anticholinergic, Muscarinic Antagonist) Indications - Urinary frequency, Urgency, Urinary incontinence, Overactive bladder, Nocturnal enuresis. Contraindications - Urinary retention, Gastric retention, Uncontrolled narrow-angle glaucoma. Cautions - Hepatic impairment, Renal impairment, Elderly, Cardiovascular disease. Avoid - Pregnancy, Breast-feeding, Acute porphyrias. Drug Interactions - Increased anticholinergic effects with other antimuscarinics; may increase sedation with CNS depressants. Trade Names - Tab: Ditropan®, Cap: Lyrinel® XL, Syrup: Oxybutynin Syrup® Adult: Oral: 5 mg 2–3 times daily (max 20 mg/day). Child: Children over 5 years: 2.5–5 mg 2–3 times daily.
Tolterodine Tartrate (Anticholinergic drug, Muscarinic Antagonist) Indications - Urinary frequency, Urinary urgency, Urinary incontinence due to overactive bladder. Contraindications - Urinary retention, Gastric retention, Uncontrolled narrow-angle glaucoma. Cautions - Hepatic impairment, Renal impairment, Elderly, Cardiovascular disease. Avoid - Pregnancy, Breast-feeding. Drug Interactions - CYP3A4 inhibitors (e.g., ketoconazole) may increase plasma levels. Increased anticholinergic effect with other antimuscarinics. Trade Names - Tab: Detrusitol®, Cap (ER): Detrusitol LA® Adult: Immediate-release: 2 mg twice daily; reduce to 1 mg twice daily in hepatic/renal impairment. Child: Not recommended under 18 years.
Trospium Chloride (Anticholinergic, Muscarinic Antagonist) Indications - Urinary frequency, Urinary urgency, Urinary incontinence due to overactive bladder. Contraindications - Urinary retention, Gastric retention, Uncontrolled narrow-angle glaucoma. Cautions - Use with caution in pregnancy, breast-feeding, hepatic impairment, renal impairment, elderly patients. Drug Interactions - May interact with anticholinergic agents, CYP2D6 inhibitors, or drugs that prolong gastric emptying time. Trade Names - Tab: Sanctura®, Cap: Regurin® Adult: 20 mg twice daily, at least 1 hour before meals. Reduce dose in renal impairment. Child: Not recommended under 18 years.
Bisacodyl (Laxative, Purgative) Indications - Constipation, Bowel evacuation prior to surgery or radiological procedures. Contraindications - Intestinal obstruction, Acute surgical abdomen, Severe dehydration. Cautions - Use with caution in elderly, renal impairment, prolonged use may cause electrolyte imbalance. Drug Interactions - May interact with diuretics, corticosteroids (risk of hypokalemia). Avoid - Long-term use without medical supervision. Trade Names - Tab: Bicolax-5®, Dulcolax 5 mg®, BISACODYL 5 mg®, Delax® Adult: 5–10 mg orally at bedtime; or 10 mg rectally (suppository) in the morning. Child: 6–12 years: 5 mg orally at bedtime or 5–10 mg rectally. Under 6 years: Use only under medical advice.
Benazepril (Angiotensin-converting enzyme (ACE) inhibitor) Indications - Arterial hypertension, Congestive heart failure. Contraindications - Pregnancy, History of angioedema related to previous ACE inhibitor therapy, Bilateral renal artery stenosis, Severe hypotension. Cautions - Renal impairment, Hepatic impairment, Aortic stenosis, Hyperkalemia, Elderly patients. Avoid - Concurrent use with potassium-sparing diuretics or potassium supplements without monitoring. Trade names - Tab: Lotensin®, Benace® Drug Interactions - Increased risk of hyperkalemia with potassium-sparing diuretics, NSAIDs may reduce antihypertensive effect, Risk of hypotension with diuretics, Increased lithium levels when co-administered. Adult: Initial: 10 mg once daily; Maintenance: 20–40 mg/day in 1–2 divided doses. Child: ≥6 years (with hypertension): 0.2 mg/kg once daily (max 10 mg/day); adjust based on response and tolerability.
Nebivolol (Beta-1 selective adrenergic receptor blocker) Indications - Hypertension (including in renal impairment), Adjunct in mild to moderate heart failure. Contraindications - Severe bradycardia, Cardiogenic shock, Severe hepatic impairment, Sick sinus syndrome, 2nd or 3rd-degree heart block (without pacemaker), Decompensated heart failure, Hypersensitivity to Nebivolol. Cautions - Bronchospastic disease (e.g., asthma), Diabetes mellitus, Peripheral vascular disorders, Thyrotoxicosis, Renal impairment, Elderly patients. Avoid - Abrupt withdrawal (may cause rebound hypertension or angina), Use with non-dihydropyridine calcium channel blockers like verapamil or diltiazem (risk of AV block or bradycardia). Trade names - Tab: Bipinor-5®, Nebilong®, Nebilet® Drug Interactions - May increase effects of other antihypertensives, Enhanced bradycardia with digoxin or non-dihydropyridine CCBs, Risk of hypotension with general anesthetics, Decreased efficacy with NSAIDs. Adult: Start with 5 mg once daily; in heart failure, start with 1.25 mg once daily and titrate slowly to a max of 10 mg once daily. Child: Not routinely recommended; safety and efficacy not established.
Buprenorphine HCl (Opioid Analgesic) Indications - Moderate to severe pain, Chronic cancer pain, Advanced breast cancer, Post-operative analgesia, Premedication before surgery. Contraindications - Respiratory depression, Acute alcoholism, Head injury, Severe hepatic impairment, Hypersensitivity to buprenorphine. Cautions - Hepatic impairment, Elderly, History of drug abuse, Respiratory disorders, CNS depression. Avoid - Renal impairment, Use with other CNS depressants. Trade names - Tab: Temgesic®, Cap: Not commonly available, Inj: Buprenex®, Patch: Butrans® Drug Interactions - Increased CNS and respiratory depression with benzodiazepines, alcohol, antihistamines, antidepressants; possible serotonin syndrome with serotonergic drugs. Adult: - Sublingual: 200–400 mcg every 6–8 hours as needed (max 2 mg/day for acute pain). - Transdermal patch: 5–20 mcg/hour (changed every 7 days) for chronic pain. Child: Not routinely recommended; safety and efficacy not well established in children.
Tegafur (Antineoplastic Agent, Prodrug of 5-Fluorouracil) Indications - Advanced gastric cancer, Colorectal cancer, Breast cancer, Pancreatic cancer (as part of combination therapy). Contraindications - Known hypersensitivity to tegafur or other fluoropyrimidines, DPD (dihydropyrimidine dehydrogenase) deficiency, Severe bone marrow suppression. Cautions - Hepatic impairment, Renal impairment, Elderly patients, Patients with active infections, History of gastrointestinal bleeding. Avoid - Pregnancy, Breastfeeding, Live vaccines. Trade names - Cap: Tegafur®, UFT®, Futrafur® Drug Interactions - Increased toxicity with leucovorin, interferes with warfarin anticoagulation; increased toxicity risk with other myelosuppressive agents. Adult: Oral: 300–600 mg/day in divided doses, depending on combination regimen and patient factors. Child: Not routinely used in pediatric patients; dose not well established—specialist consultation required.
Gimeracil (DPD inhibitor, Antineoplastic adjunct) Indications - Used in combination therapy for advanced gastric cancer, colorectal cancer, and other solid tumors. Contraindications - Hypersensitivity to gimeracil or related drugs, Severe bone marrow suppression. Cautions - Hepatic impairment, Renal impairment, Elderly patients. Avoid - Pregnancy, Breastfeeding. Trade names - tab: S-1 (combination with tegafur and oteracil) Drug Interactions - May increase toxicity of fluoropyrimidines; caution with anticoagulants and other myelosuppressive drugs. Adult: As part of combination formulations; dosing varies by regimen, specialist guidance required. Child: Not established; use in children generally not recommended.
Oteracil (Antineoplastic adjunct) Indications - Used in combination chemotherapy for advanced gastric cancer and other solid tumors. Contraindications - Hypersensitivity to oteracil or related drugs. Cautions - Hepatic impairment, Renal impairment. Avoid - Pregnancy, Breastfeeding. Trade names - tab: S-1 (combined with tegafur and gimeracil) Drug Interactions - May interact with fluoropyrimidines; monitor for enhanced toxicity. Adult: Used as part of combination therapy; dosing per specialist advice. Child: Not established; generally not recommended in children.
Busulfan (Busulphan) (Antineoplastic) Indications - Chronic myeloid leukemia. Contraindications - Hypersensitivity to busulfan, severe bone marrow suppression. Cautions - Hepatic impairment, renal impairment, pulmonary fibrosis risk. Avoid - Pregnancy, breastfeeding. Trade names - Myleran tab:®, Busulfex inj:® Drug interactions - May increase toxicity with phenytoin, allopurinol, and other myelosuppressive agents. Adult: Individualized; typically oral dosing 0.8 mg/kg daily in divided doses. Child: Adjusted per body surface area; specialist supervision required.
Butorphanol (Opioid analgesic) Indications - Moderate to severe perioperative pain, migraine, labor pain, postoperative shivering. Contraindications - Hypersensitivity to butorphanol or other opioids, respiratory depression, acute asthma, paralytic ileus. Cautions - Hepatic or renal impairment, elderly patients, head injury, history of drug abuse. Avoid - Pregnancy (late stage), breastfeeding, use with other CNS depressants. Trade names - Stadol Nasal Spray:®, Butrum inj:®, Stadol NS:® Drug interactions - May interact with CNS depressants (alcohol, sedatives), MAO inhibitors, and other opioids. Adult: 1 mg IV or 1 spray (1 mg) intranasally; may repeat in 3–4 hours if needed. Child: Safety and efficacy not established for children under 18 years.
Cabergoline (Dopamine receptor stimulant) Indications - Prevention and suppression of physiological lactation, Hyperprolactinaemia-associated disorders (e.g. amenorrhea, infertility, galactorrhoea), Parkinson’s disease (as adjunct therapy), False pregnancy, Induction of abortion in select cases. Contraindications - Hypersensitivity to ergot derivatives, uncontrolled hypertension, pre-eclampsia, history of pulmonary, pericardial, or retroperitoneal fibrotic disorders. Cautions - Cardiovascular disease, hepatic impairment, history of psychiatric disorders, renal impairment. Avoid - Pregnancy (unless specifically indicated), breast-feeding. Trade names - Dostinex tab:®, Cabgoline tab:®, Caberdost tab:® Drug interactions - May interact with macrolide antibiotics (e.g. erythromycin), antipsychotics, dopamine antagonists (e.g. metoclopramide), and other ergot alkaloids. Adult: For hyperprolactinaemia: 500 micrograms per week in 1 or 2 doses; may increase up to 1–2 mg/week. For lactation suppression: single dose of 1 mg on the first postpartum day. Child: Safety and efficacy not established in children.
Bismuth Salt (Gastrointestinal agent, Antacid, Protective) Indications - Gastric and duodenal ulcers, Helicobacter pylori eradication (as part of combination therapy), Diarrhea, Oral poisoning (as a protective agent). Contraindications - Hypersensitivity to bismuth compounds, severe renal impairment, pregnancy (in high doses or prolonged use). Cautions - Use with caution in patients with renal insufficiency, prolonged use may cause neurotoxicity. Avoid - Prolonged use, concurrent use with other salicylates in children (risk of Reye’s syndrome), pregnancy, breast-feeding. Trade names - De-Nol tab:®, Gastrodenol tab:®, Pylera cap:® Drug interactions - May interact with tetracyclines (reduces their absorption), other salicylates, and anticoagulants. Adult: 120–240 mg 4 times daily before meals and at bedtime for 4–8 weeks; or as directed in H. pylori eradication regimens. Child: Not routinely recommended in children due to risk of Reye’s syndrome; if used, under close supervision only.
Carbamazepine (Antiepileptic) Indications - Partial and secondary generalized tonic-clonic seizures, Trigeminal neuralgia, Diabetic neuropathy, Prophylaxis of bipolar disorder. Contraindications - Hypersensitivity to carbamazepine or tricyclic antidepressants, bone marrow suppression, acute porphyrias, use with MAO inhibitors. Cautions - Cardiac disease, hepatic impairment, renal impairment, pregnancy, breast-feeding, elderly, glaucoma, history of blood dyscrasias. Avoid - Use in acute porphyrias, abrupt withdrawal. Trade names - Carbamazepine tab:®, Tegretol 200 tab:®, Carbatol-200 tab:® Drug interactions - Induces hepatic enzymes, may reduce efficacy of warfarin, oral contraceptives, phenytoin, theophylline; interacts with erythromycin, isoniazid, verapamil, lithium. Adult: Initially 100–200 mg 1–2 times daily, increased gradually to 800–1200 mg daily in divided doses (max 1600 mg/day). Child: Initially 5 mg/kg/day in divided doses, increased gradually to 10–20 mg/kg/day.
Carbimazole (Antithyroid drug) Indications - Hyperthyroidism, Preparation for thyroidectomy in hyperthyroid patients, Hyperthyroidism (blocking-replacement regimen) in combination with levothyroxine. Contraindications - Hypersensitivity to carbimazole or other thionamides, serious blood disorders (e.g., agranulocytosis), hepatic impairment. Cautions - Liver disease, bone marrow depression, pregnancy (especially 1st trimester), breast-feeding, elderly. Avoid - Use in patients with a history of pancreatitis related to carbimazole. Trade names - Neo-Mercazole tab:®, Carbimazole tab:® Drug interactions - May enhance effects of anticoagulants (e.g., warfarin); caution with other drugs that affect bone marrow (e.g., clozapine). Adult: Initially 15–40 mg daily in divided doses, then maintenance dose of 5–15 mg daily. In blocking-replacement regimen: 40–60 mg daily with levothyroxine. Child: Initially 0.4–0.5 mg/kg/day in divided doses; maintenance adjusted based on thyroid function tests.
Carbomer Indications - Tear replacement in dry eye conditions, Keratoconjunctivitis sicca (dry eye syndrome), Eye irritation due to wind, sun, or other environmental factors. Contraindications - Hypersensitivity to carbomer or any component of the formulation. Cautions - Avoid contact lens use during application, Use with caution in eye infections unless specifically prescribed. Avoid - Avoid if allergic to preservatives such as benzalkonium chloride (common in eye drops). Trade names - Viscotears gel:®, GelTears:®, Lubrithal Eye Gel:® Drug interactions - May affect absorption of other eye medications; apply other drops at least 5 minutes apart. Adult: 1 drop in the affected eye(s) 3–4 times daily or as needed. Child: Same as adult dosing, under supervision of a healthcare provider.
Polyacrylic acid (Artificial tear substitute, Lubricant) Indications - Dry eyes including keratoconjunctivitis sicca, Unstable tear film, Relief of ocular irritation due to wind, sun, or environmental factors. Contraindications - Hypersensitivity to polyacrylic acid or any component of the formulation. Cautions - Use with caution in patients with known allergies to preservatives (e.g., benzalkonium chloride), Avoid contamination of the dropper tip. Avoid - Avoid use with contact lenses unless preservative-free formulation is used. Trade names - Lacrinorm eye gel:®, Viscotears eye gel:®, Liquifilm gel:® Drug interactions - May interfere with absorption of other ophthalmic drugs; separate applications by at least 5 minutes. Adult: 1 drop in the affected eye(s) 3–4 times daily or as needed. Child: Same as adult dosing under supervision of a healthcare provider.
Carprofen (NSAID – Nonsteroidal Anti-inflammatory Drug) Indications - Post-operative pain, Degenerative joint disease (e.g., osteoarthritis), Musculoskeletal disorders. Contraindications - Hypersensitivity to carprofen or other NSAIDs, Active gastrointestinal bleeding or ulcers, Severe hepatic or renal impairment. Cautions - Use with caution in elderly patients, patients with a history of GI disorders, hepatic or renal dysfunction, or cardiovascular disease. Avoid - Pregnancy (especially 3rd trimester), Breastfeeding, Concomitant use with other NSAIDs or corticosteroids. Trade names - Rimadyl:®, Carprieve:®, Norocarp:®, Vetprofen:® Drug interactions - Increased risk of GI toxicity with corticosteroids, bleeding with anticoagulants; monitor with nephrotoxic drugs. Adult: Not typically used in humans (primarily veterinary use). Child: Not indicated for use in children (used in veterinary medicine).
Caspofungin (Antifungal – Echinocandin class) Indications - Invasive aspergillosis (in patients refractory to or intolerant of other therapies), Invasive candidiasis (including candidemia), Empirical therapy for presumed fungal infections in febrile neutropenic patients. Contraindications - Hypersensitivity to caspofungin or any component of the formulation. Cautions - Hepatic impairment, History of allergic reactions to echinocandins, Pregnancy, Breastfeeding. Avoid - Use with caution in pregnancy and breastfeeding due to limited human data; avoid unless clearly necessary. Trade names - Cancidas® (IV lyophilized powder) Drug interactions - May interact with cyclosporine (increased liver enzymes), tacrolimus (reduced levels), and enzyme inducers (e.g., rifampin, dexamethasone) may decrease caspofungin levels. Adult: Loading dose: 70 mg IV on day 1, then 50 mg IV once daily. Increase to 70 mg daily in invasive aspergillosis if needed. Child: 1 month to 18 years: 50 mg/m² IV once daily (max 70 mg/day); loading dose 70 mg/m² may be used depending on condition.
Cefixime (Third-generation cephalosporin) Indications - Acute bacterial infections due to Gram-positive and Gram-negative organisms, Otitis media, Pharyngitis, Tonsillitis, Bronchitis, Urinary tract infections, Uncomplicated gonorrhoea. Contraindications - Known hypersensitivity to cephalosporins or penicillins. Avoid - Breastfeeding unless clearly needed. Cautions - Renal impairment, History of colitis, Allergy to β-lactam antibiotics. Side effects - Acute kidney injury, Drug fever, Dyspnea, Facial edema, Genital pruritus, Jaundice, Diarrhea, Nausea. Trade names - CEFIMIC 100 mg tab:, Afix Powder for Oral Suspension® Drug interactions - May interact with anticoagulants (e.g., warfarin), carbamazepine (increased levels), and may reduce efficacy of oral contraceptives. Adult: 200–400 mg once daily or in 2 divided doses. Child: 8 mg/kg/day in 1 or 2 divided doses.
Cefpirome (Fourth-generation cephalosporin) Indications - Complicated urinary tract infections, Lower respiratory tract infections (including pneumonia), Skin and soft tissue infections, Intra-abdominal infections, Febrile neutropenia. Contraindications - Hypersensitivity to cephalosporins or β-lactam antibiotics. Avoid - Pregnancy (unless clearly indicated), Breastfeeding, Known allergy to penicillins or other cephalosporins. Cautions - Renal impairment, History of gastrointestinal disease (especially colitis). Side effects - Diarrhea, Rash, Nausea, Vomiting, Elevated liver enzymes, Eosinophilia, Superinfection. Trade names - Cefrom IV inj:, Kefox IV inj: Drug interactions - May interact with nephrotoxic drugs (e.g., aminoglycosides), loop diuretics; may reduce efficacy of oral contraceptives. Adult: 1–2 g IV every 12 hours (depending on infection severity). Child: 50–100 mg/kg/day in 2 divided doses (IV).
Cefamandole (Second-generation cephalosporin) Indications - Surgical prophylaxis, Infections caused by Gram-positive and Gram-negative bacteria including respiratory tract infections, urinary tract infections, skin and soft tissue infections, and bone/joint infections. Contraindications - Hypersensitivity to cephalosporins or β-lactam antibiotics. Avoid - Use in patients with penicillin allergy (due to cross-sensitivity), Neonates (contains sodium benzoate). Cautions - Renal impairment, History of colitis, Pregnancy, Breastfeeding. Side effects - Diarrhea, Rash, Eosinophilia, Elevated liver enzymes, Pain at injection site, Bleeding tendency (due to hypoprothrombinaemia). Trade names - Mandol IV inj:, Cefamandole Nafate inj: Drug interactions - Alcohol (disulfiram-like reaction), Anticoagulants (may increase bleeding), Nephrotoxic drugs (additive renal effects). Adult: 500 mg to 2 g IV or IM every 4–8 hours, depending on severity. Child: 50–100 mg/kg/day in divided doses IV or IM, up to 150 mg/kg/day in severe infections.
Cefradine (Cephradine) (First-generation cephalosporin antibiotic) Indications - Broad-spectrum antibiotic for respiratory tract infections, urinary tract infections, skin and soft tissue infections, otitis media, and surgical prophylaxis. Contraindications - Hypersensitivity to cephalosporins or β-lactam antibiotics. Cautions - Renal impairment, history of gastrointestinal disease (especially colitis), known penicillin allergy (possible cross-reactivity). Avoid - Not recommended in severe renal impairment without dose adjustment. Side effects - Diarrhea, nausea, rash, eosinophilia, superinfection with prolonged use. Trade names - Velosef tab:, Cephradine tab:, Cefracin tab:, Sofradin tab:, Sofradin 250 mg Cap: Drug interactions - May reduce efficacy of oral contraceptives, enhances nephrotoxicity with aminoglycosides. Adult: 250–500 mg every 6 hours orally; up to 1 g every 6 hours in severe infections. Child: 25–50 mg/kg/day in 2–4 divided doses; up to 100 mg/kg/day in severe infections.
Cefaclor (Second-generation cephalosporin) Indications - Broad-spectrum antibiotic for lower urinary tract infections, otitis media, pharyngitis, pneumonia, bronchitis, and skin/soft tissue infections. Contraindications - Hypersensitivity to cephalosporins or beta-lactam antibiotics. Cautions - Renal impairment, gastrointestinal disease (especially colitis), history of penicillin allergy (cross-sensitivity may occur). Avoid - Use with caution in penicillin-sensitive patients and those with significant renal impairment. Side effects - Diarrhea, rash, nausea, vomiting, serum sickness-like reactions, Stevens-Johnson syndrome (rare). Trade names - Axcel Cefaclor, Soficlor, Distaclor, Ceclor Drug interactions - May reduce efficacy of oral contraceptives; increased risk of nephrotoxicity when used with aminoglycosides or loop diuretics. Adult: 250–500 mg every 8 hours; up to 1 g every 8 hours for severe infections. Child: 20–40 mg/kg/day in 3 divided doses; max 1 g/day.
Cefalexin (First-generation cephalosporin) Indications - Broad-spectrum antibiotic used for respiratory tract infections, otitis media, skin and soft tissue infections, bone infections, dental infections, and prophylaxis of recurrent urinary tract infections. Contraindications - Hypersensitivity to cephalosporins or beta-lactam antibiotics. Cautions - Renal impairment, history of gastrointestinal disease (especially colitis), hypersensitivity to penicillin (due to possible cross-reactivity). Avoid - Severe renal impairment without dose adjustment. Side effects - Diarrhea, nausea, vomiting, abdominal pain, rash, allergic reactions, eosinophilia, interstitial nephritis (rare). Trade names - Sporidex 250 mg Cap, Sporidex 125 mg/5 ml Suspension, Cephadex 500 mg Cap, Keflex 250 mg Tab, Oriphex 250 mg Cap, Blucef 250 mg DT Tab Drug interactions - May enhance the effect of warfarin; absorption may be reduced by antacids. Adult: 250–500 mg every 6–12 hours; for prophylaxis, 125–250 mg once daily. Child: 25–50 mg/kg/day in divided doses every 6–12 hours.
Roflumilast (Phosphodiesterase-4 (PDE4) inhibitor)Indications - Maintenance treatment of severe chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis and a history of exacerbations. Avoid - Moderate to severe liver impairment, active cancer, congestive cardiac failure, acute infectious diseases. Cautions - History of depression or suicidal ideation, weight loss, tuberculosis, viral hepatitis, herpes infection, underweight patients. Side effects - Diarrhea, nausea, weight loss, headache, insomnia, back pain, decreased appetite, mood disturbances. Drug interactions - Increased levels when used with CYP1A2/3A4 inhibitors (e.g., erythromycin, ketoconazole), decreased levels with enzyme inducers (e.g., rifampicin, phenobarbital). Trade names - Daxas 500 mcg Tab, Rofaday 500 mcg Tab, Roflu 500 mcg Tab Adult: 500 micrograms once daily. Child: Not recommended for children under 18 years due to lack of safety and efficacy data.
Cefovecin (Third-generation cephalosporin antibiotic) Indications - Skin infections caused by susceptible bacteria. Contraindications - Hypersensitivity to cephalosporins or β-lactam antibiotics. Avoid - Pregnancy, Breastfeeding. Cautions - Renal impairment, Hepatic impairment. Side effects - Allergic reactions, Gastrointestinal upset. Trade names - Convenia inj: Drug interactions - May interact with nephrotoxic drugs and warfarin. Adult: 8 mg/kg subcutaneously as a single dose. Child: Not applicable.
Chlorambucil (Antineoplastic agent, Alkylating agent) Indications - Chronic lymphocytic leukaemia (CLL), Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma, Waldenström’s macroglobulinaemia. Contraindications - Hypersensitivity to chlorambucil or other alkylating agents, Severe bone marrow suppression. Avoid - Pregnancy, Breastfeeding. Cautions - Hepatic impairment, Renal impairment, History of seizures or head trauma, Bone marrow depression. Side effects - Bone marrow suppression, Nausea, Vomiting, Seizures, Rash, Hepatotoxicity, Secondary malignancies. Trade names - Leukeran tab: Drug interactions - Increased toxicity with other myelosuppressive agents; live vaccines may increase risk of infection. Adult: 0.1–0.2 mg/kg daily for 3–6 weeks; dose adjustments based on response and toxicity. Child: Similar to adult dosing; typically 0.1 mg/kg daily under specialist supervision.
Chlordiazepoxide HCl (Sedative, Hypnotic, Benzodiazepine) Indications - Short-term management of anxiety disorders, Acute alcohol withdrawal symptoms, Preoperative sedation. Contraindications - Hypersensitivity to benzodiazepines, Severe respiratory insufficiency, Sleep apnea syndrome, Myasthenia gravis, Severe hepatic insufficiency. Avoid - Chronic psychosis, Hyperkinesis, Obesity, Respiratory depression, Phobic states, Breastfeeding. Cautions - Muscle weakness, Organic brain disease, Hepatic impairment, Renal impairment, Elderly patients (increased sensitivity), History of substance abuse. Side effects - Drowsiness, Ataxia, Confusion, Hypotension, Tolerance, Dependence, Withdrawal symptoms upon discontinuation. Trade names - Librium tab:, Elenium tab: Drug interactions - Enhanced CNS depression with alcohol, opioids, antipsychotics, and other sedatives; may interact with cimetidine, disulfiram, and oral contraceptives. Adult: 5–30 mg/day in divided doses for anxiety; 50–100 mg (may require up to 300 mg/day) for alcohol withdrawal. Child: Not generally recommended; if used, 0.5 mg/kg/day in divided doses under strict medical supervision.
Chlorpromazine HCl (First-generation antipsychotic, Phenothiazine derivative) Indications - Schizophrenia and other psychotic disorders, Mania, Short-term adjunct in severe anxiety, Psychomotor agitation, Violent or dangerously impulsive behavior, Intractable hiccup, Nausea and vomiting in palliative care. Contraindications - Comatose states, CNS depression, Bone marrow suppression, Pheochromocytoma, Severe cardiovascular disease. Avoid - Acute alcohol intoxication, Breastfeeding, Children under 1 year (especially during surgery). Cautions - Epilepsy, Parkinson’s disease, Hypothyroidism, Myasthenia gravis, Renal or hepatic impairment, Elderly (increased risk of orthostatic hypotension and sedation). Side effects - Sedation, Extrapyramidal symptoms, Tardive dyskinesia, Orthostatic hypotension, Dry mouth, Constipation, Weight gain, Photosensitivity. Trade names - Prozine tab: Drug interactions - Potentiates CNS depressants (e.g., alcohol, opioids), interacts with anticholinergics, lithium, and antihypertensives; may reduce the efficacy of levodopa. Adult: 25 mg three times daily, increased if needed to 75–300 mg/day in divided doses (oral); IM/IV for acute cases: 25–50 mg as needed. Child: 500 µg/kg every 4–6 hours orally; maximum 75 mg/day in divided doses under specialist supervision.
Cytarabine (Antineoplastic, Antimetabolite - Pyrimidine analogue) Indications - Acute myeloblastic leukaemia (AML), Acute lymphoblastic leukaemia (ALL), Chronic myeloid leukaemia (CML) in blast crisis, Meningeal leukaemia and lymphomatous meningitis. Contraindications - Hypersensitivity to cytarabine or any component of the formulation, Severe hepatic or renal impairment, Pre-existing bone marrow suppression (unless in controlled settings). Avoid - Live vaccines during therapy, Breastfeeding, Pregnancy unless absolutely necessary. Cautions - Hepatic impairment, Renal impairment, Bone marrow suppression, Pre-existing infections, Elderly patients (increased risk of neurotoxicity). Side effects - Bone marrow suppression, Nausea, Vomiting, Stomatitis, Fever, Rash, Neurotoxicity (e.g., cerebellar toxicity), Hepatotoxicity, Conjunctivitis. Trade names - Cytosar-U inj:, DepoCyt inj: Drug interactions - May enhance toxicity of other bone marrow suppressants, digoxin absorption may be reduced, may increase risk of toxicity with cyclophosphamide or doxorubicin. Adult: Induction: 100–200 mg/m²/day continuous IV infusion for 7 days; High-dose regimens may be up to 2–3 g/m² IV every 12 hours for 2–6 doses. Child: 100–200 mg/m²/day IV or SC in divided doses; adjust based on protocol and clinical condition.
Cefoxitin (Second-generation cephalosporin) Indications - Peritonitis, Intra-abdominal infections, Lower respiratory tract infections, Gynecological infections, Urinary tract infections, Septicemia, Bone and joint infections, Skin and soft tissue infections, Prophylaxis in colorectal surgery. Contraindications - Hypersensitivity to cefoxitin, other cephalosporins, or β-lactam antibiotics. Avoid - Severe hypersensitivity to penicillin or cephalosporins, Breastfeeding unless essential. Cautions - Renal impairment, History of gastrointestinal disease (especially colitis), Elderly, Prolonged use may result in superinfection. Side effects - Diarrhea, Nausea, Vomiting, Rash, Eosinophilia, Elevated liver enzymes, Local injection site reactions, Superinfection (e.g., C. difficile colitis). Trade names - Mefoxin IV inj:, Foxocef IV inj: Drug interactions - May enhance nephrotoxicity of aminoglycosides, reduces efficacy of oral contraceptives, may prolong bleeding time with anticoagulants. Adult: 1–2 g IV or IM every 6–8 hours depending on severity of infection. Child: 80–160 mg/kg/day divided every 6–8 hours (IV or IM), maximum 12 g/day.
Dacarbazine (Antineoplastic agent - Alkylating agent) Indications - Metastatic malignant melanoma, Hodgkin's disease (as part of combination chemotherapy), Soft-tissue sarcomas, Neuroblastoma, Medulloblastoma, Ewing's sarcoma. Contraindications - Hypersensitivity to dacarbazine, Severe hepatic or renal impairment, Pregnancy and lactation (unless benefits outweigh risks). Avoid - Live vaccinations during treatment, Breastfeeding. Cautions - Bone marrow suppression, Hepatic impairment, Renal impairment, History of seizures, Monitor blood counts frequently. Side effects - Nausea, Vomiting, Anorexia, Myelosuppression, Hepatic necrosis, Flu-like syndrome, Photosensitivity, Injection site pain. Trade names - Dacazid IV inj:, Detimed IV inj: Drug interactions - Increased risk of hepatotoxicity with other hepatotoxic drugs, myelosuppression risk increases with other cytotoxics, may reduce efficacy of vaccines. Adult: 2–4.5 mg/kg/day IV for 10 days every 4 weeks, or 250 mg/m²/day for 5 days every 3 weeks (based on protocol and indication). Child: 2–4.5 mg/kg/day IV for 10 days or 150–250 mg/m²/day IV for 5 days every 3–4 weeks (dose adjusted per protocol and tolerance).
Danazol (Synthetic androgen - Gonadotropin inhibitor) Indications - Endometriosis, Menorrhagia, Fibrocystic breast disease, Gynaecomastia, Hereditary angioedema, Precocious puberty. Contraindications - Pregnancy, Breastfeeding, Severe hepatic, renal or cardiac impairment, Undiagnosed genital bleeding, Androgen-dependent tumors, Porphyria. Avoid - Use in women attempting to conceive, Patients with thromboembolic disorders. Cautions - Hypertension, Diabetes mellitus, Epilepsy, Migraine, Lipid disorders, Long-term use. Side effects - Weight gain, Acne, Hirsutism, Voice changes, Menstrual disturbances, Mood changes, Hepatic dysfunction, Elevated liver enzymes. Trade names - Danogen Cap:, Cyclodan Cap: Drug interactions - May increase effects of warfarin and carbamazepine; reduced effectiveness with insulin or oral antidiabetics; increases cyclosporine toxicity. Adult: 200–800 mg/day in divided doses depending on the condition treated (e.g., endometriosis: 200–400 mg/day for 3–6 months). Child: Not routinely recommended; specialist supervision required in off-label pediatric use.
Dantrolene Sodium (Skeletal muscle relaxant) Indications - Treatment and prophylaxis of malignant hyperthermia, Chronic severe spasticity of voluntary muscle due to cerebral palsy, spinal cord injury, stroke, or multiple sclerosis. Contraindications - Active hepatic disease, Liver dysfunction, Hypersensitivity to dantrolene. Avoid - Use in patients with impaired cardiac or pulmonary function unless absolutely necessary. Cautions - Hepatic impairment, Renal impairment, Elderly, Patients with respiratory depression or muscle weakness. Side effects - Drowsiness, Dizziness, Fatigue, Diarrhea, Muscle weakness, Hepatotoxicity, Photosensitivity, Rash. Trade names - Dantrium Cap:, Dantrelax Cap: Drug interactions - Increased risk of hepatotoxicity with other hepatotoxic drugs (e.g., isoniazid), potentiates CNS depression with alcohol or other sedatives, may increase effects of calcium channel blockers. Adult: For malignant hyperthermia: 2.5 mg/kg IV, repeated as needed up to 10 mg/kg total. For chronic spasticity: Initially 25 mg orally once daily, increased gradually to 75–100 mg 3–4 times daily as tolerated. Child: For malignant hyperthermia: 1 mg/kg IV, repeated up to 10 mg/kg. For spasticity: Start with 0.5 mg/kg/day orally in divided doses, increase gradually under specialist supervision.
Dapsone (Antileprotic, Anti-inflammatory, Antiprotozoal) Indications - Multibacillary and paucibacillary leprosy (as part of multidrug therapy), Dermatitis herpetiformis, Pneumocystis jirovecii pneumonia (in combination with trimethoprim), Toxoplasmosis (off-label). Contraindications - Severe anemia, Severe G6PD deficiency, Known hypersensitivity to dapsone or sulfone drugs. Avoid - Patients with significant cardiac or pulmonary disease unless benefits outweigh risks. Cautions - G6PD deficiency, Hepatic impairment, Renal impairment, Elderly, Pregnancy, Breastfeeding. Side effects - Hemolysis, Methemoglobinemia, Rash, Headache, Insomnia, Peripheral neuropathy, Hepatitis, Agranulocytosis. Trade names - Aczone tab:, Avlosulfon tab: Drug interactions - May interact with rifampicin (increased hepatotoxicity), trimethoprim (used synergistically but increases risk of hematologic toxicity), probenecid (increases plasma levels), antiretrovirals (increased risk of rash and hepatotoxicity). Adult: Leprosy: 100 mg orally once daily (as part of combination therapy). Dermatitis herpetiformis: Initial 50 mg/day orally, may increase to 300 mg/day in divided doses. Child: Leprosy: 1–2 mg/kg/day orally (not exceeding 100 mg/day), under supervision.
Epoetin alfa (Erythropoiesis-stimulating agent) Indications - Symptomatic anaemia associated with chronic renal failure in patients on haemodialysis or peritoneal dialysis, Severe anaemia of renal origin in adults with renal insufficiency not yet on dialysis, Symptomatic anaemia in adults receiving chemotherapy for cancer, Reduction of allogeneic blood transfusion in elective surgery patients with moderate anaemia. Contraindications - Uncontrolled hypertension, Hypersensitivity to epoetin alfa or albumin (human), Pure red cell aplasia following erythropoietin treatment. Avoid - Patients with a history of thromboembolic events unless benefit outweighs risk. Cautions - Hypertension, Seizure disorders, Iron deficiency, Folate or vitamin B12 deficiency, Chronic liver disease, History of cancer. Side effects - Hypertension, Headache, Arthralgia, Injection site pain, Flu-like symptoms, Thromboembolic events, Pure red cell aplasia (rare). Trade names - Hemapo inj:, Eprex 2000 Inj: Drug interactions - No major interactions, but response can be reduced by iron, folate, or vitamin B12 deficiency. Monitor with concurrent cytotoxic therapy. Adult: 50–150 IU/kg 3 times per week IV or SC, adjusted based on haemoglobin response and clinical condition. Child: Initially 50 IU/kg 3 times per week IV or SC; may be increased gradually to maintain haemoglobin 10–12 g/dL.
Darbepoetin Alfa (Erythropoiesis-stimulating agent) Indications - Symptomatic anaemia associated with chronic renal failure in patients on dialysis or not on dialysis, Symptomatic anaemia in adults with non-myeloid malignancies receiving chemotherapy. Contraindications - Uncontrolled hypertension, Known hypersensitivity to darbepoetin alfa or excipients. Avoid - Use during breastfeeding unless clearly necessary. Cautions - Hepatic impairment, History of seizures, Poorly controlled hypertension, Risk of thromboembolic events, Iron or vitamin deficiencies. Side effects - Hypertension, Thromboembolism, Headache, Injection site reactions, Edema, Increased risk of tumour progression (in cancer patients), Pure red cell aplasia (rare). Trade names - Aranesp inj:, Cresp inj: Drug interactions - No significant drug interactions known. Effectiveness may be reduced in presence of iron, folate, or B12 deficiency. Adult: 0.45 mcg/kg once weekly or 0.75 mcg/kg every 2 weeks subcutaneously; titrate based on haemoglobin response. Child: 0.45 mcg/kg once weekly (SC or IV); adjust based on clinical response and haemoglobin levels.
Deferoxamine Mesylate (Iron chelating agent) Indications - Acute iron poisoning, Chronic iron overload due to frequent blood transfusions (e.g., in thalassemia), Adjunct for removal of certain heavy metals such as aluminium in dialysis patients. Contraindications - Severe renal disease not on dialysis, Hypersensitivity to deferoxamine. Avoid - Use in pregnancy unless clearly necessary, Use with caution in lactating women. Cautions - Renal impairment, Visual or auditory disturbances, Pediatric patients (monitor growth), Infection (e.g., Yersinia or fungal infections may worsen). Side effects - Visual and auditory disturbances, Hypotension (especially with rapid IV infusion), Rash, Acute respiratory distress, Local pain at injection site, Growth retardation (in children with prolonged use). Trade names - Desferal inj: Drug interactions - Increased risk of nephrotoxicity with nephrotoxic agents; may reduce effectiveness of vitamin C when taken concurrently. Adult: 0.5–1 g IM/IV/SC every 8–12 hours; for chronic iron overload: 20–60 mg/kg/day SC infusion over 8–12 hours. Child: 20–40 mg/kg/day by SC infusion over 8–12 hours; adjust based on ferritin levels and response.
Desflurane (Inhalational general anesthetic) Indications - Maintenance of general anaesthesia in adults and children; induction of anaesthesia in adults (not recommended for routine induction in pediatric patients due to risk of laryngospasm). Contraindications - Patients with known or suspected susceptibility to malignant hyperthermia, Patients in whom general anesthesia is contraindicated. Avoid - Induction in non-intubated pediatric patients due to airway complications; avoid in patients with increased intracranial pressure unless mechanically ventilated. Cautions - Renal or hepatic impairment, Hypovolemia, Elderly, Cardiovascular instability, Pregnancy (only if clearly necessary). Side effects - Cough, Breath-holding, Laryngospasm (especially in children), Hypotension, Nausea, Bradycardia, Malignant hyperthermia (rare). Trade names - Suprane inhalation: Drug interactions - Potentiates effects of non-depolarizing muscle relaxants and other CNS depressants; interaction with sympathomimetics or beta-blockers may cause arrhythmias. Adult: 2–6% end-tidal concentration for maintenance (individualized based on patient response). Child: 5.2–10% end-tidal concentration for maintenance (monitor airway response closely).
Dexmedetomidine (Selective alpha-2 adrenergic agonist, Sedative) Indications - Sedation of initially intubated and mechanically ventilated patients during treatment in an intensive care setting; procedural sedation for non-intubated patients before and/or during surgical and other procedures. Contraindications - Hypersensitivity to dexmedetomidine or any component of the formulation. Avoid - Advanced heart block (unless paced), severe ventricular dysfunction, patients with hemodynamic instability unless closely monitored. Cautions - Bradycardia, Hypotension, Hepatic impairment, Elderly, Neurological disorders (may reduce cerebral blood flow). Side effects - Hypotension, Bradycardia, Dry mouth, Nausea, Atrial fibrillation, Fever, Hypertension (transient, especially with loading dose). Trade names - Dexdor inj:, Precedex inj: Drug interactions - Enhanced effects with other CNS depressants (e.g., opioids, benzodiazepines); may potentiate bradycardic or hypotensive effects of beta-blockers or calcium channel blockers. Adult: Loading dose: 1 mcg/kg IV over 10 min (optional); Maintenance: 0.2–0.7 mcg/kg/h IV infusion. Child: Not approved for routine pediatric use; off-label: 0.2–1 mcg/kg/h IV infusion under specialist supervision.
Metformin HCl (Biguanide, Blood glucose lowering drug) Indications - Type 2 diabetes mellitus (especially in overweight patients when diet and exercise alone do not result in adequate glycaemic control), Polycystic ovary syndrome (off-label use). Contraindications - Avoid - Acute or chronic conditions that may cause tissue hypoxia (e.g., cardiac or respiratory failure), Alcohol abuse, Severe hepatic impairment. Cautions - Moderate renal impairment, Elderly patients, Concurrent use of nephrotoxic drugs, Surgical procedures requiring anesthesia, Radiologic studies with iodinated contrast materials. Side effects - Gastrointestinal disturbances (nausea, vomiting, diarrhea), Metallic taste, Vitamin B12 deficiency with long-term use, Lactic acidosis (rare but serious). Trade names - Metformin Stada 850mg tab:, Ziglip-M tab:, Metaxy tab: Drug interactions - Increased risk of lactic acidosis with alcohol, Cimetidine, and iodinated contrast agents; may reduce absorption of vitamin B12. Adult: Initially 500–850 mg once or twice daily with meals; max: 2,000–3,000 mg/day in divided doses. Child: ≥10 years: Initially 500 mg once or twice daily with meals; max: 2,000 mg/day in divided doses.
Nateglinide (Meglitinide class, Blood glucose lowering drug) Indications - Type 2 diabetes mellitus, particularly in combination with metformin when metformin alone is insufficient for glycaemic control. Contraindications - Type 1 diabetes mellitus, Diabetic ketoacidosis, Hypersensitivity to nateglinide. Avoid - Use in pregnancy and breastfeeding unless essential. Cautions - Hepatic impairment, Elderly, Risk of hypoglycemia (especially with irregular meals), Not recommended for use with insulin. Side effects - Hypoglycemia, Upper respiratory tract infection, Back pain, Dizziness, Arthralgia. Trade names - Starlix tab:®, Fastic tab:® Drug interactions - Increased risk of hypoglycemia with other antidiabetic drugs; affected by CYP2C9 and CYP3A4 inhibitors/inducers (e.g., fluconazole, rifampicin). Adult: 60–120 mg orally 3 times daily before meals. Start with 60 mg if risk of hypoglycemia. Child: Not recommended (safety and efficacy not established in children).
Saxagliptin (Blood glucose lowering drug, DPP-4 inhibitor) Indications - Type 2 diabetes mellitus (as monotherapy if metformin inappropriate or in combination with other antidiabetic agents). Contraindications - Hypersensitivity to saxagliptin or any DPP-4 inhibitor. Avoid - Use during pregnancy and breastfeeding unless clearly needed. Cautions - Elderly, History of pancreatitis, Renal impairment, Heart failure. Side effects - Upper respiratory tract infection, Headache, Urinary tract infection, Hypoglycemia (especially with sulfonylureas), Pancreatitis. Trade names - Onglyza 2.5mg tab:®, Onglyza 5mg tab:® Drug interactions - Strong CYP3A4/5 inhibitors (e.g., ketoconazole) can increase saxagliptin levels; caution with sulfonylureas or insulin due to hypoglycemia risk. Adult: 5 mg orally once daily (2.5 mg once daily if moderate to severe renal impairment). Child: Not recommended (safety and efficacy not established in children).
Chlorpropamide (Sulfonylurea Antidiabetic) Indications - Management of type 2 diabetes mellitus in adults when diet and exercise alone are not sufficient to control blood glucose. Contraindications - Diabetic ketoacidosis, Type 1 diabetes, Severe renal or hepatic impairment, Pregnancy, Hypersensitivity to sulfonylureas. Caution - Elderly, Adrenal or pituitary insufficiency, Malnutrition, Alcoholism, Mild to moderate hepatic or renal impairment. Avoid - Alcohol intake (due to disulfiram-like reaction), Breastfeeding, Abrupt withdrawal. Drug interaction - Increased risk of hypoglycemia with NSAIDs, sulfonamides, warfarin; reduced effect with corticosteroids, thiazides, and sympathomimetics. Trade names - Diabinese 250 mg tab:, Insochlor 250 mg tab:, Chlorprop 250 mg tab: Adult: Initial dose: 100–250 mg once daily with breakfast. Maintenance: 100–500 mg daily. Child: Not recommended for pediatric use.
Tolbutamide (Sulfonylurea Antidiabetic) Indications - Management of type 2 diabetes mellitus when diet alone is insufficient. Contraindications - Type 1 diabetes mellitus, diabetic ketoacidosis, severe liver or kidney impairment, known hypersensitivity to sulfonylureas. Caution - Elderly patients, those with adrenal or pituitary insufficiency, and patients prone to hypoglycemia. Avoid - Alcohol use (increased risk of hypoglycemia), breastfeeding, use during pregnancy unless necessary. Drug interaction - Potentiated by NSAIDs, anticoagulants, MAOIs, beta-blockers; reduced effect with corticosteroids, thiazides, and estrogens. Trade names - Orinase 500 mg tab:, Tolbutamide tab: Adult: Oral: 0.5–1.5 g daily in divided doses before meals. Max: 2 g/day. Child: Not recommended for pediatric use.
Sitagliptin (Blood glucose lowering drug, DPP-4 inhibitor) Indications - Type 2 diabetes mellitus (as monotherapy or in combination with metformin, sulfonylureas, or insulin). Contraindications - Hypersensitivity to sitagliptin or any component of the formulation. Avoid - Diabetic ketoacidosis. Cautions - History of pancreatitis, Renal impairment, Heart failure. Side effects - Headache, Nasopharyngitis, Upper respiratory tract infection, Pancreatitis, Joint pain, Hypoglycemia (especially when combined with insulin or sulfonylureas). Trade names - Januvia 100mg tab:®, Ziglip-50 tab:®, Ziglip-100 tab:®, Sitagil 100mg tab:® Drug interactions - May interact with digoxin (increased serum levels); monitor when co-administered. Adult: Child: Not recommended (safety and efficacy not established in children).
Gliquidone (Sulfonylurea Antidiabetic) Indications - Management of type 2 diabetes mellitus, especially in patients with mild to moderate renal impairment. Contraindications - Type 1 diabetes mellitus, diabetic ketoacidosis, severe renal or hepatic impairment, hypersensitivity to sulfonylureas. Caution - Elderly, patients with adrenal or pituitary insufficiency, malnourished individuals. Avoid - Alcohol consumption (risk of hypoglycemia), breastfeeding, use in pregnancy unless clearly needed. Drug interaction - Enhanced effect with NSAIDs, MAOIs, beta-blockers, and alcohol; reduced effect with corticosteroids, diuretics, and oral contraceptives. Trade names - Glurenorm 30 mg tab:, Gliquidone 30 mg tab: Adult: 15–60 mg daily in divided doses, usually before meals. Max: 120 mg/day. Child: Not recommended for pediatric use.
Dexrazoxane (Antidote and Chelator) Indications - Prevention of chronic cumulative cardiotoxicity associated with anthracycline chemotherapy (e.g., doxorubicin or epirubicin), Management of anthracycline extravasation. Contraindications - Hypersensitivity to dexrazoxane or EDTA derivatives, Pregnancy (unless essential). Avoid - Use in children unless clearly indicated, Concomitant use with live vaccines. Cautions - Myelosuppression, Hepatic impairment, Renal impairment, Secondary malignancies with long-term use. Side Effects - Nausea, Vomiting, Myelosuppression (leukopenia, neutropenia, thrombocytopenia), Injection site reactions, Diarrhea, Increased liver enzymes. Trade Names - Totect inj:®, Zinecard inj:® Drug Interactions - May enhance the myelosuppressive effects of chemotherapy; use with caution in combination with other nephrotoxic or hepatotoxic drugs. Adult: For cardioprotection: 10:1 ratio to doxorubicin dose (e.g., 500 mg/m² if doxorubicin is 50 mg/m²) given IV over 15 minutes, 30 minutes prior to chemotherapy. For extravasation: 1000 mg/m² IV on Day 1 and Day 2, followed by 500 mg/m² IV on Day 3. Child: Not routinely recommended; if used, dosing must be based on body surface area (same as adult ratio) with close monitoring.
Diazoxide (Glycogenolytic hormone, Antihypoglycemic agent) Indications - Chronic intractable hypoglycaemia (e.g., due to insulinoma or congenital hyperinsulinism), Hypertensive emergencies (rarely used today). Contraindications - Hypersensitivity to diazoxide, Functional hypoglycaemia, Sulfonamide allergy. Avoid - Use during breastfeeding, Severe fluid retention states, Pregnancy unless clearly necessary. Cautions - Cardiac disease, Renal impairment, Gout, Hyperuricaemia, Diabetes mellitus. Side Effects - Fluid retention, Hyperuricaemia, Hyperglycaemia, Hypotension, Tachycardia, Nausea, Vomiting, Hypertrichosis (especially in children). Trade Names - Proglycem tab:®, Eudemine cap:® Drug Interactions - May interact with thiazide diuretics, corticosteroids (enhanced hyperglycaemia), or antihypertensive agents (additive hypotension). Adult: 100–300 mg/day orally in divided doses for hypoglycaemia (adjust based on response). Child: 3–8 mg/kg/day orally in 2–3 divided doses (maximum 15 mg/kg/day), titrated according to blood glucose response.
Diethylstilbestrol (Synthetic nonsteroidal estrogen) Indications - Breast cancer in postmenopausal women, Prostate cancer (palliative treatment), Prevention of miscarriage (historically, but no longer recommended). Contraindications - Known or suspected estrogen-dependent tumors (except for specific indications), History of thromboembolic disorders, Undiagnosed abnormal genital bleeding, Severe liver dysfunction, Pregnancy (Category X). Avoid - Use during pregnancy and breastfeeding due to teratogenic effects, History of estrogen-sensitive cancers (unless used as palliative therapy). Cautions - Cardiovascular disease, Hypertension, Epilepsy, Migraine, Diabetes mellitus, Hepatic impairment. Side Effects - Nausea, Vomiting, Thromboembolism, Edema, Gynecomastia (in men), Hepatic dysfunction, Depression, Increased risk of endometrial cancer. Trade Names - Stilboestrol tab:®, Synestrol tab:®, Estrostil cap:® Drug Interactions - May interact with anticoagulants (enhanced or reduced effect), corticosteroids (enhanced toxicity), and other hormonal agents. Adult: 1–5 mg orally daily for prostate cancer; 5–15 mg daily for breast cancer (doses may vary by protocol). Child: Not recommended for use in children.
Dihydrotachysterol (Vitamin D analog) Indications - Acute, chronic, and latent hypocalcemic tetany due to hypoparathyroidism, Pseudohypoparathyroidism, Post-surgical or idiopathic hypoparathyroidism. Contraindications - Hypercalcemia, Vitamin D toxicity, Severe renal impairment, Malabsorption syndrome. Avoid - Use in patients with hyperphosphatemia or evidence of vitamin D overdose. Cautions - Renal impairment, Cardiac disease, Elderly patients, Frequent monitoring of serum calcium is required. Side Effects - Hypercalcemia, Nausea, Vomiting, Weakness, Headache, Polyuria, Nephrocalcinosis. Trade Names - A.T.10 tab:®, DHT tab:® Drug Interactions - Thiazide diuretics (increased risk of hypercalcemia), Magnesium-containing antacids (risk of hypermagnesemia), Digitalis glycosides (increased risk of arrhythmias). Adult: Initially 0.2–0.8 mg orally once daily, adjusted based on serum calcium; maintenance: 0.1–0.5 mg/day. Child: Initially 0.05–0.2 mg orally daily; adjust according to calcium levels.
Diphenhydramine HCl (First-generation antihistamine) Indications - Anaphylactic reactions, Angioneurotic edema, Allergic rhinitis, Conjunctivitis, Motion sickness, Nausea, Vomiting, Cough, Parkinsonism, Poisoning (as adjunct), Seasonal allergic rhinitis, Insomnia, Antiemetic. Contraindications - Neonates or premature infants, Breastfeeding, Severe liver disease. Avoid - Use with other CNS depressants, Alcohol, Elderly (increased risk of sedation and confusion). Cautions - Asthma, Hyperthyroidism, Cardiovascular disease, Hypertension, Glaucoma, Urinary retention, Hepatic or renal impairment, Seizure disorders. Side Effects - Drowsiness, Dizziness, Dry mouth, Blurred vision, Constipation, Urinary retention, Confusion (especially in elderly). Trade Names - Diphenhydramine tab:®, Axcel Flemin Expectorant:®, Cap:® Drug Interactions - Potentiates effects of alcohol and other CNS depressants, MAO inhibitors prolong and intensify anticholinergic effects. Adult: 25–50 mg orally every 4–6 hours; maximum 300 mg/day. Child: 6–12 years: 12.5–25 mg every 4–6 hours; maximum 150 mg/day. Under 6 years: 6.25–12.5 mg every 4–6 hours (with caution).
Diloxanide Furoate (Luminal amebicide) Indications - Chronic intestinal amoebiasis (asymptomatic cyst carriers), Used as follow-up treatment after metronidazole in invasive amoebiasis. Contraindications - Hypersensitivity to diloxanide or excipients. Avoid - Pregnancy (especially first trimester), Breastfeeding. Cautions - Use in children under 2 years, Liver impairment (co-administration with metronidazole), Gastrointestinal disorders. Side Effects - Flatulence, Nausea, Vomiting, Abdominal cramps, Urticaria, Pruritus. Trade Names - Furamide tab:®, Entamizole tab:®, Amodiaquine-DF tab:®, Dilomide tab:® Drug Interactions - Limited known interactions; usually given after metronidazole (sequentially, not concurrently). Adult: 500 mg orally three times daily for 10 days. Child: 20 mg/kg/day in three divided doses for 10 days.
Tinidazole (Antiprotozoal and Antibacterial agent) Indications - Anaerobic infections, Bacterial vaginosis, Acute ulcerative gingivitis, Surgical prophylaxis (especially abdominal), Intestinal amoebiasis, Hepatic amoebiasis, Giardiasis, Urogenital trichomoniasis, Protozoal infections, Eradication of Helicobacter pylori (in combination therapy). Contraindications - Hypersensitivity to nitroimidazole derivatives. Avoid - Pregnancy (especially first trimester), Breastfeeding, CNS disorders (e.g., epilepsy). Cautions - Hepatic impairment, Alcohol use (due to disulfiram-like reaction), History of blood dyscrasias. Side Effects - Metallic taste, Nausea, Vomiting, Diarrhea, Headache, Dizziness, Peripheral neuropathy, Seizures (rare). Trade Names - TINITAB-N tab:® Drug Interactions - Alcohol (disulfiram-like reaction), Warfarin (may increase INR), CYP3A4 inhibitors or inducers. Adult: 2 g orally as a single dose for trichomoniasis or giardiasis; or 600 mg–2 g daily in divided doses for 5–10 days depending on infection type. Child: 50–75 mg/kg/day (max 2 g/day) in divided doses for 3–5 days depending on infection.
Benzatropine Mesilate (Anticholinergic, Antiparkinsonian agent) Indications - Parkinsonism (idiopathic, postencephalitic, arteriosclerotic types), Drug-induced extrapyramidal symptoms (except tardive dyskinesia). Contraindications - Hypersensitivity, Narrow-angle glaucoma, Tardive dyskinesia, GI obstruction, Urinary retention. Avoid - Elderly with dementia, Breastfeeding. Cautions - Cardiovascular disease, Hypertension, Renal/hepatic impairment, Prostatic hypertrophy, Children under 3 years. Side Effects - Dry mouth, Blurred vision, Constipation, Urinary retention, Confusion, Hallucinations, Tachycardia. Trade Names - Cogentin tab:®, Benzatropine injection:®, Kemadrin tab:® Drug Interactions - Enhanced effects with other anticholinergics, antihistamines, tricyclic antidepressants; reduced by antacids. Adult: 1–2 mg once or twice daily orally; max 6 mg/day. Child: Not recommended under 3 years. In older children: 0.02–0.05 mg/kg/day orally in 1–2 divided doses.
Biperiden HCl (Anticholinergic, Antiparkinsonian agent) Indications - Idiopathic Parkinson’s disease, Drug-induced extrapyramidal symptoms (except tardive dyskinesia). Contraindications - Narrow-angle glaucoma, GI obstruction, Urinary retention, Myasthenia gravis. Avoid - Use in elderly with cognitive impairment, Breastfeeding. Cautions - Cardiovascular disease, Hepatic/renal impairment, Prostatic hypertrophy, Elderly, Children. Side Effects - Dry mouth, Constipation, Blurred vision, Urinary retention, Confusion, Tachycardia. Trade Names - Akineton tab:®, Biperiden inj:®, Parkinil tab:® Drug Interactions - Potentiated by other anticholinergics, tricyclics, MAO inhibitors; antagonized by cholinesterase inhibitors. Adult: 2 mg 1–3 times daily orally; max 16 mg/day. Child: Not routinely recommended; consult specialist if needed.
Orphenadrine citrate (Antimuscarinic, Centrally acting muscle relaxant) Indications - Musculoskeletal pain, Drug-induced extrapyramidal symptoms, Parkinson’s disease, Leg cramps, Vertigo. Contraindications - Glaucoma, Myasthenia gravis, GI or urinary obstruction, Prostatic hypertrophy. Avoid - Pregnancy unless clearly needed, Breastfeeding. Cautions - Elderly, Cardiovascular disorders, Hepatic or renal impairment. Side Effects - Dry mouth, Blurred vision, Constipation, Drowsiness, Dizziness, Tachycardia, Confusion (especially in elderly). Trade Names - NORGESIC tab:®, Suniton tab:® (Paracetamol + Orphenadrine), Cap:® Drug Interactions - Enhanced sedation with CNS depressants; anticholinergic effects may be potentiated by other anticholinergics. Adult: 100 mg orally twice daily, max 200 mg/day. Child: Not recommended in children under 12 years.
Procyclidine HCl (Antimuscarinic) Indications - Parkinsonism, Drug-induced extrapyramidal symptoms, Acute dystonia. Contraindications - Untreated urinary retention, Angle-closure glaucoma, Gastrointestinal obstruction. Avoid - Pregnancy unless clearly needed, Breastfeeding. Cautions - Elderly, Cardiovascular disease, Hepatic or renal impairment, Susceptibility to angle-closure glaucoma. Side Effects - Dry mouth, Blurred vision, Constipation, Nausea, Dizziness, Confusion (especially in elderly), Tachycardia. Trade Names - Kemadrin tab:®, Kemadrin inj:® Drug Interactions - May enhance anticholinergic effects of other drugs (e.g. antihistamines, tricyclics); may antagonize effects of antipsychotics. Adult: 2.5–5 mg orally three times daily; in severe cases, up to 30 mg/day. Child: 0.04–0.1 mg/kg orally 3 times daily (under specialist supervision).
Benzhexol HCl (Antimuscarinic) Indications - Parkinsonism (including post-encephalitic, idiopathic, arteriosclerotic), Drug-induced extrapyramidal symptoms. Contraindications - Untreated urinary retention, Angle-closure glaucoma, Gastrointestinal obstruction. Avoid - Pregnancy unless clearly indicated, Breastfeeding. Cautions - Elderly, Cardiovascular disease, Hepatic or renal impairment, Susceptibility to glaucoma, History of seizures. Side Effects - Dry mouth, Blurred vision, Constipation, Nausea, Dizziness, Confusion, Nervousness, Urinary retention. Trade Names - Artane tab:®, Pacitane tab:® Drug Interactions - Enhanced anticholinergic effects with other anticholinergics; may reduce effect of levodopa if dosage is not adjusted. Adult: Initially 1 mg orally at bedtime; maintenance 5–15 mg daily in divided doses. Child: 0.1–0.3 mg/kg/day in divided doses (under specialist supervision).
Disopyramide (Antiarrhythmic) Indications - Prevention and treatment of ventricular and supraventricular arrhythmias, including after myocardial infarction, maintenance of sinus rhythm after cardioversion. Avoid - Severe heart failure, Bundle-branch block, Renal impairment. Cautions - Heart failure, Myasthenia gravis, Elderly, Prostatic enlargement, Hepatic impairment. Trade Names - Rythmodan cap:®, Rythmodan tab:®, Norpace cap:® Drug Interactions - Increased risk of arrhythmias with other antiarrhythmics, quinolones, macrolides, and drugs that prolong QT interval; reduced effect with phenytoin or rifampicin. Adult: 100–150 mg orally 3 times daily; up to 300 mg every 6 hours in severe cases (immediate-release). Child: Not routinely recommended; specialist use only if benefits outweigh risks.
Docusate Sodium (Laxative) Indications - Chronic constipation, Adjunct in abdominal radiological procedures, Removal of ear wax (topical). Avoid - Children under 12 years (oral use), Intestinal obstruction, Nausea, Vomiting, Undiagnosed abdominal pain. Cautions - Pregnancy, Breastfeeding, Prolonged use may cause dependency. Trade Names - Colace tab:®, Docusol cap:®, Dioctyl tab:® Drug Interactions - May increase absorption of liquid paraffin; avoid use with other stool softeners to reduce the risk of hepatotoxicity. Adult: 100–300 mg daily in divided doses orally; for bowel evacuation: 120 mg as a single dose. Child: 6–12 years: 50–150 mg daily in divided doses (oral) Under 6 years: Not recommended without medical advice
Dopamine HCl (Sympathomimetic) Indications - Cardiogenic shock (especially post-myocardial infarction), Heart failure, Septic shock, Hypotension due to low cardiac output. Avoid - Pheochromocytoma, Uncorrected tachyarrhythmias, Ventricular fibrillation. Cautions - Hyperthyroidism, Hypertension, Correct hypovolaemia before administration, Use low dose in acute myocardial infarction, Occlusive vascular disease, Elderly. Trade Names - Intropin Inj:®, Dopamin Inj:® Drug Interactions - MAO inhibitors (enhance effect), General anesthetics (arrhythmia risk), Alpha and beta blockers (antagonistic effects). Adult: IV infusion: 2–5 mcg/kg/min initially; may increase gradually to 5–10 mcg/kg/min, max 20–50 mcg/kg/min depending on response. Child: IV infusion: 1–5 mcg/kg/min; titrate according to blood pressure and clinical response.
Bromocriptine (Dopamine agonist) Indications - Prevention and suppression of lactation, Hypogonadism, Galactorrhoea, Infertility due to hyperprolactinaemia, Acromegaly, Prolactinoma, Parkinson’s disease. Avoid - Uncontrolled hypertension, Severe cardiovascular disease, Postpartum women with a history of coronary artery disease or severe psychiatric disorders. Cautions - Peptic ulcer, Fibrotic disorders (pulmonary, retroperitoneal, or cardiac), Elderly, Liver dysfunction, History of psychosis. Trade Names - Parlodel tab:®, Cycloset Cap:®, Dibor R tab:® Drug Interactions - Erythromycin and other CYP3A4 inhibitors (increased bromocriptine levels), Antipsychotics (decreaseeffect), Alcohol (increased side effects), Dopamine antagonists. Adult: 1.25–2.5 mg once or twice daily, titrated gradually up to 5–10 mg/day as tolerated and indicated. Child: Start with 1.25 mg/day; titrate based on response and tolerability.
Levodopa (Dopamine precursor) It works by replenishing the depleted dopamine levels in the brain. Indications - Parkinson's disease, Parkinsonism, Relief of tremors, stiffness, and slowness of movement. Avoid - Narrow-angle glaucoma, History of malignant melanoma, Use with non-selective MAO inhibitors. Cautions - Cardiac disease, Psychiatric illness, Peptic ulcer disease, Orthostatic hypotension, Liver or kidney impairment. Trade Names - SYNDOPA 250mg tab:® Drug Interactions - MAO inhibitors (risk of hypertensive crisis), Antipsychotics (reduce efficacy), Antihypertensives (additive hypotension), Iron salts (reduce absorption). Adult: Initial: Levodopa 100 mg with Carbidopa 25 mg 2–3 times/day; adjust as needed (max: ~800 mg levodopa/day). Child: Not generally recommended; use only under specialist advice.
Carbidopa (Peripheral decarboxylase inhibitor) Carbidopa is a medication often used in combination with levodopa to treat Parkinson's disease. It works by preventing the breakdown of levodopa before it reaches the brain, allowing more levodopa to reach the brain and be converted into dopamine. Indications - Parkinson's disease (in combination with levodopa), Parkinsonism. Avoid - Use as monotherapy, Hypersensitivity to carbidopa. Cautions - Glaucoma, Cardiovascular disease, Psychiatric disorders, Peptic ulcer. Trade Names - Syndopa Plus tab:®, Sinemet tab:®, Atamet tab:® Drug Interactions - MAO inhibitors, Antihypertensives, Antipsychotics, Iron salts. Adult: Usually given in combination with levodopa (e.g., Carbidopa 25 mg with Levodopa 100 mg, 3–4 times daily). Child: Not established; use only under specialist supervision.
Metaraminol (Sympathomimetic vasopressor) Indications - Emergency treatment of acute hypotension, including during anesthesia. Avoid - Hypertension, Pheochromocytoma. Cautions - Cirrhosis, Diabetes mellitus, Elderly, Myocardial infarction, Hyperthyroidism, Mesenteric vascular thrombosis, Hypovolaemia, Angina. Trade Names - Aramine Inj:®, Metaramin Inj:® Drug Interactions - MAO inhibitors (risk of hypertensive crisis), tricyclic antidepressants, beta-blockers, anesthetics (increased sensitivity). Adult: IV bolus: 0.5–5 mg repeated as necessary; IV infusion: 15–100 mg in 500 mL of suitable diluent at a rate adjusted to blood pressure response. Child: Not established; use with caution under specialist supervision.
Doxepin (Tricyclic antidepressant and antihistamine) Indications - Depressive illness, Anxiety, Pruritus associated with eczema and other skin conditions, Insomnia (short-term use). Avoid - Acute porphyrias, Arrhythmias, During manic phase of bipolar disorder, Heart block, Immediate recovery period after myocardial infarction, Glaucoma, Urinary retention. Cautions - Elderly, Hepatic impairment, History of seizures, Suicidal thoughts, Cardiovascular disease, Hyperthyroidism. Trade Names - Sinequan tab:®, Doxepin cream:®, Adapin cap:® Drug Interactions - MAO inhibitors (risk of serotonin syndrome), CNS depressants, SSRIs, Anticholinergics, Alcohol. Adult: Depression: 75 mg/day in divided doses or at bedtime; may increase to 150–300 mg/day. Pruritus (topical): Apply thin film (up to 3 g) 3–4 times daily. Child: Not recommended for depression under age 12; Topical use may be considered for pruritus with caution.
Tetracycline (Tetracycline antibiotic) Indications - Chlamydia infections, Rickettsial infections, Mycoplasma pneumonia, Rosacea, Acne vulgaris, Diabetic diarrhoea in autonomic neuropathy, Non-gonococcal urethritis, Brucellosis (with streptomycin). Avoid - Pregnancy, Breastfeeding, Children under 8 years (due to teeth discoloration and bone growth inhibition). Cautions - Renal impairment, Hepatic impairment, Esophageal irritation (advise upright posture and full glass of water). Trade Names - Achromycin tab:®, Sumycin cap:®, Panmycin cap:® Drug Interactions - Antacids, Iron, Calcium, and dairy products (decrease absorption), Warfarin (increased anticoagulant effect), Oral contraceptives (decrease efficacy). Adult: 250–500 mg orally every 6 hours; duration depends on condition (typically 7–14 days). Child: Not recommended under 8 years; if essential: 25–50 mg/kg/day in 4 divided doses.
Chlortetracycline (Tetracycline antibiotic) Indications - Used primarily in veterinary medicine. In humans: Acne, Genito-urinary tract infections, Respiratory tract infections, Gastrointestinal infections, Ophthalmic infections, Pneumonia, Soft tissue infections. Avoid - Pregnancy, Breastfeeding, Children under 8 years (due to risk of teeth discoloration and impaired bone development). Cautions - Renal impairment, Hepatic impairment, Esophageal irritation (take with water while sitting or standing). Trade Names - Chlorsol Cap:®, Spimetryl Cap:® Drug Interactions - Iron, Calcium, Antacids, Dairy products (decrease absorption); Oral contraceptives (decreased effectiveness); Warfarin (increased bleeding risk). Adult: 250–500 mg orally every 6 hours depending on infection type and severity. Child: Not recommended under 8 years. If necessary: 25–50 mg/kg/day in 4 divided doses.
Eravacycline (Tetracycline antibiotic) Eravacycline is a novel fluorocycline antibiotic. Indications - Complicated intra-abdominal infections (cIAIs) caused by organisms such as Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis. Complicated urinary tract infections (cUTIs) due to susceptible strains. Also used in skin and soft tissue infections (Staphylococcus aureus, Streptococcus pyogenes) and community-acquired bacterial pneumonia. Avoid - Pregnancy, Breastfeeding, Children under 8 years (risk of permanent teeth discoloration and bone growth inhibition). Cautions - Liver impairment, History of hypersensitivity to tetracyclines, Risk of superinfection with prolonged use. Trade Names - Xerava inj:® Drug Interactions - May interact with anticoagulants (increased bleeding risk), oral contraceptives (decrease effectiveness), and P-glycoprotein inhibitors. Avoid co-administration with antacids and multivitamins containing iron or calcium. Adult: 1 mg/kg every 12 hours via IV infusion over 60 minutes for 4–14 days depending on severity. Child: Not established.
Minocycline (Tetracycline antibiotic) Indications - Acne vulgaris, Rickettsial infections, Chlamydial infections, Mycoplasma infections, Meningococcal carrier state, Respiratory tract infections, Urinary tract infections, Skin and soft tissue infections. Avoid - Pregnancy, Breastfeeding, Children under 8 years (due to risk of permanent teeth discoloration and enamel hypoplasia). Cautions - Renal impairment, Hepatic impairment, Systemic lupus erythematosus, Long-term use may cause hepatotoxicity and skin pigmentation. Trade Names - Minocin tab:®, Solodyn tab:®, Arestin cap:® Drug Interactions - Antacids, Iron supplements, Warfarin, Oral contraceptives, Retinoids (increased risk of intracranial hypertension). Adult: 200 mg initially, then 100 mg every 12 hours; for acne: 50–100 mg twice daily. Child: >8 years: 4 mg/kg initially, then 2 mg/kg every 12 hours (max 200 mg/day).
Glycylcyclines (Tigecycline) (Tetracycline antibiotic) Tigecycline is a derivative of minocycline and belongs to the glycylcycline class. Indications - Complicated skin and soft tissue infections, Complicated intra-abdominal infections, Community-acquired bacterial pneumonia (when other alternatives are not suitable). Avoid - Pregnancy, Breastfeeding, Children under 8 years (risk of teeth discoloration and inhibited bone growth). Cautions - Hepatic impairment, History of tetracycline hypersensitivity, Use in severely ill patients with caution due to increased mortality risk. Trade Names - Tygacil inj:® Drug Interactions - Warfarin (increased INR), Oral contraceptives (decrease efficacy), Anticoagulants (monitor coagulation status). Adult: Initial 100 mg IV, then 50 mg IV every 12 hours for 5–14 days depending on infection type. Child: Not routinely recommended; off-label use: 1.2 mg/kg IV every 12 hours (max 50 mg/dose).
Sarecycline (Tetracycline antibiotic) Sarecycline is a newer tetracycline-class antibiotic specifically developed for acne with fewer gastrointestinal side effects. Indications - Moderate to severe acne vulgaris in patients aged 9 years and older. Avoid - Pregnancy, Breastfeeding, Children under 9 years (due to risk of permanent tooth discoloration and bone growth inhibition). Cautions - Photosensitivity, Liver impairment, History of intracranial hypertension, Superinfection with prolonged use. Trade Names - Seysara tab:®, Drug Interactions - May decrease effectiveness of oral contraceptives. Avoid concomitant use with antacids, iron, calcium, magnesium, or bismuth-containing products. Adult: Once daily based on body weight (60 mg–150 mg), usually 1.5 mg/kg/day orally. Child: Same as adult for children ≥9 years; not recommended under 9 years.
Omadacycline (Tetracycline antibiotic) Omadacycline is a newer tetracycline-class antibiotic effective against a broad spectrum of bacteria, including resistant strains. Indications - Community-acquired bacterial pneumonia (CABP), Acute bacterial skin and skin structure infections (ABSSSI). Avoid - Pregnancy, Breastfeeding, Children under 8 years. Cautions - Photosensitivity, Liver impairment, History of intracranial hypertension. Trade Names - Nuzyra tab:® Drug Interactions - Avoid concomitant use with multivalent cations (antacids, calcium, magnesium, iron, zinc, bismuth). May reduce effectiveness of oral contraceptives. Adult: 100 mg orally once daily or 200 mg on day 1 (loading dose), then 100 mg daily. Child: Not established.
Drofenine HCl (Antispasmodic, Anticholinergic) Indications - Used in treating irritable bowel syndrome (IBS), functional bowel disorders, and abdominal cramping. It works by relaxing smooth muscles and relieving spasmodic pain. Contraindications - Glaucoma, severe ulcerative colitis, obstructive uropathy, myasthenia gravis, severe hepatic impairment. Cautions - Elderly, prostatic hypertrophy, tachyarrhythmias, partial intestinal obstruction. Avoid - Use in pregnancy and lactation unless clearly necessary. Side Effects - Dry mouth, blurred vision, constipation, urinary retention, dizziness, drowsiness, nausea, confusion, tachycardia. Trade Names - Spasmodex tab:®, Spasfon tab:®, Drofenta tab:® Drug Interactions - Additive anticholinergic effects with other antimuscarinics (e.g., atropine, antihistamines), may reduce the efficacy of prokinetic agents (e.g., metoclopramide). Adult: Typically 200 mg/day divided into 2–3 doses, adjust based on response. Child: Not commonly recommended in children due to limited safety data; consult specialist.
Enalapril Maleate (Angiotensin-converting enzyme (ACE) inhibitor) Indications - Hypertension, heart failure, prevention of symptomatic heart failure in patients with asymptomatic left ventricular dysfunction. Contraindications - History of angioedema related to previous ACE inhibitor therapy, hereditary or idiopathic angioedema, bilateral renal artery stenosis, pregnancy. Cautions - Renal impairment, hypotension, hypovolemia, aortic stenosis, elderly, liver dysfunction. Avoid - During pregnancy and breastfeeding, and in the first few weeks after delivery. Trade Names - Enam tab:®, Vasotec tab:®, Renitec tab:® Drug Interactions - Potassium-sparing diuretics (e.g., spironolactone), NSAIDs, lithium, other antihypertensives, diuretics, and potassium supplements (increased risk of hyperkalemia or renal impairment). Adult: Initially 5 mg once daily; maintenance dose usually 10–20 mg daily in 1–2 divided doses; max 40 mg/day. Child: 0.08 mg/kg once daily (max initial dose 5 mg), adjust according to response; max 0.6 mg/kg/day or 40 mg/day.
Ephedrine HCl (Sympathomimetic vasoconstrictor) Indications - Reversible airway obstruction, neuropathic edema, reversal of hypotension from spinal or epidural anesthesia, nasal congestion, sinusitis affecting the maxillary antrum. Contraindications - Severe hypertension, closed-angle glaucoma, thyrotoxicosis, during or within 14 days of MAOI therapy. Cautions - Diabetes mellitus, elderly, hypertension, hyperthyroidism, ischemic heart disease, prostatic hypertrophy. Avoid - Excessive prolonged use due to risk of tolerance and rebound effects. Trade Names - Efedrina tab:®, Ephetonin inj:® Drug Interactions - MAOIs (increased hypertensive crisis risk), beta-blockers (decreased efficacy), other sympathomimetics (additive effects), anesthetics (arrhythmia risk). Adult: Oral: 25–50 mg every 4–6 hours as needed (max 150 mg/day); IV: 5–25 mg slowly, repeat as needed. Child: Oral: 0.5 mg/kg/dose every 4–6 hours (max 25 mg/dose).
Ertapenem (Carbapenem antibiotic) Indications - Abdominal infections, Acute gynaecological infections, Community-acquired pneumonia, Colorectal surgery prophylaxis, Complicated urinary tract infections, Skin and soft tissue infections. Contraindications - Known hypersensitivity to carbapenems or beta-lactam antibiotics, severe shock or atrioventricular block (IM route with lidocaine). Cautions - History of seizures or CNS disorders, elderly, pregnancy, breastfeeding, renal impairment (dose adjustment required). Avoid - Avoid unnecessary use to prevent resistance; avoid in patients with severe penicillin allergy unless benefits outweigh risks. Trade Names - Invanz inj:®, Ertazem inj:® Drug Interactions - May reduce valproate levels (increased risk of seizures), probenecid (increased ertapenem levels), use with other nephrotoxic drugs increases toxicity risk. Adult: 1 g IV/IM once daily for 3–14 days depending on infection. Child: ≥3 months: 15 mg/kg IV once daily (max 1 g/day); duration depends on indication.
Estradiol (Estrogen hormone) Indications - Postmenopausal urogenital conditions (e.g. vaginal atrophy), Improvement of the vaginal epithelium in menopausal atrophic vaginitis, Hormone replacement therapy (HRT) in estrogen deficiency states, Female hypogonadism, Prevention of osteoporosis. Contraindications - Known or suspected breast cancer, Estrogen-dependent neoplasia, Undiagnosed abnormal genital bleeding, Active or history of venous or arterial thromboembolic disorders (e.g. DVT, PE, MI, stroke), Liver dysfunction or disease, Pregnancy. Cautions - Hypertension, Diabetes mellitus, Gallbladder disease, Migraine, Asthma, Epilepsy, History of depression, Benign breast disease, Endometriosis, Uterine fibroids. Avoid - Active arterial thromboembolic disease (e.g. angina, MI), Recurrent VTE, Untreated endometrial hyperplasia, Undiagnosed vaginal bleeding. Trade Names - Estrabet tab:®, Estrofem tab:®, Progynova tab:® Drug Interactions - Enzyme inducers (e.g. phenytoin, carbamazepine, rifampin) may decrease efficacy. Increased risk of thromboembolism with tamoxifen. May alter effects of corticosteroids or thyroid medications. Adult: Oral: 1–2 mg daily (adjusted as needed). Vaginal cream: 0.5–1 g daily for 1–2 weeks, then maintenance 1–3 times per week. Child: In female hypogonadism: typically 2 mcg/kg/day orally, titrated based on response and puberty stage.
Dienogest (Progestin hormone) Indications - Used in combination oral contraceptives for contraception, Treatment of endometriosis, Management of menstrual symptoms such as dysmenorrhea and heavy menstrual bleeding. Contraindications - Active venous thromboembolic disorder, Severe hepatic disease, Known or suspected hormone-dependent tumors, Undiagnosed vaginal bleeding, Pregnancy. Cautions - History of depression, Cardiovascular risk factors (smoking, hypertension, diabetes), Liver enzyme inducers, Migraine with aura, Hyperlipidemia. Avoid - Use in women with current or past breast cancer unless clearly needed, Severe hepatic impairment. Trade Names - Visanne tab:®, Dinagest tab:®, Dienorette tab:® Drug Interactions - Rifampin, phenytoin, carbamazepine, and other CYP3A4 inducers may reduce effectiveness. Avoid concurrent use with St. John's Wort. Adult: 2 mg orally once daily, at the same time each day, for endometriosis. In contraceptive use: 2 mg with estradiol valerate in a 28-day cycle. Child: Not recommended for children under 18 years without specialist guidance.
Ethambutol HCl (Antitubercular agent) Indications - Tuberculosis (TB), always in combination with other antitubercular drugs. Contraindications - Optic neuritis, significant visual impairment. Cautions - Elderly, Young children (due to difficulty in monitoring visual acuity), Renal impairment (requires dose adjustment). Avoid - Breastfeeding, Severe renal impairment without proper monitoring. Side Effects - Hyperuricaemia, Peripheral neuropathy, Visual disturbances (including optic neuritis). Trade Names - Myambutol tab:®, Combutol tab:® Drug Interactions - Caution with other neurotoxic drugs; increased risk of optic neuritis. Concurrent use with uricosuric agents may affect uric acid levels. Adult: 30 mg/kg 3 times a week for 2 months (intermittent therapy); or 15–25 mg/kg/day once daily depending on regimen. Child: 30 mg/kg 3 times a week for 2 months (intermittent); or 15–25 mg/kg/day once daily.
Etodolac (Nonsteroidal Anti-inflammatory Drug - NSAID) Indications - Management of pain and inflammation associated with rheumatoid arthritis, osteoarthritis, and other musculoskeletal disorders. Contraindications - Active peptic ulcer, GI bleeding, Severe heart failure, Hypersensitivity to NSAIDs, History of asthma induced by NSAIDs. Cautions - Elderly, Hypertension, Fluid retention, Hepatic or renal impairment, Coagulation disorders, History of GI disorders. Avoid - Late pregnancy (3rd trimester), Breastfeeding, Concomitant use with other NSAIDs. Side Effects - Dyspepsia, Nausea, Headache, Dizziness, Edema, GI ulceration or bleeding, Elevated liver enzymes. Trade Names - Lodine tab:®, Etogesic tab:®, Etova tab:® Drug Interactions - May increase toxicity of lithium, methotrexate, and anticoagulants. Decreases efficacy of antihypertensives. Increased risk of GI bleeding with corticosteroids or SSRIs. Adult: 200–400 mg two to three times daily, max 1000 mg/day. Child: Not generally recommended; safety and efficacy not established.
Chloramphenicol (Broad-spectrum antibiotic) Indications - Purulent conjunctivitis, Bacterial infections in otitis externa, Haemophilus influenzae, Meningitis, Typhoid fever, Superficial eye infections. Contraindications - Bone marrow depression, Hypersensitivity to chloramphenicol, Pregnancy (except topical use), Neonates (systemic use). Cautions - Hepatic or renal impairment, Blood dyscrasias, Long-term or repeated use. Avoid - Systemic use in neonates and infants unless life-threatening condition, Prolonged use. Side Effects - Aplastic anemia, Bone marrow suppression, Grey baby syndrome, Nausea, Vomiting, Diarrhea, Rashes, Optic neuritis (long-term use). Trade Names - Chloromycetin tab:®, Optomycin Eye Drops:®, Parnicol Inj:®, Sinpole:®, Optaphenicol 1% Eye Ointment:®, Optaphenicol 0.5% Eye Drops:® Drug Interactions - Inhibits hepatic metabolism of drugs like phenytoin, tolbutamide, warfarin. Increased risk of hematologic toxicity with other bone marrow depressants. Adult: 500 mg orally every 6 hours; IV 50–100 mg/kg/day in 4 divided doses for serious infections. Child: 50–100 mg/kg/day orally or IV in 4 divided doses; reduce dose in neonates and monitor closely.
Famciclovir (Antiviral agent) Indications - Herpes zoster (shingles), Genital herpes (initial and recurrent episodes), Herpes labialis (cold sores), Herpes simplex virus suppression. Contraindications - Hypersensitivity to famciclovir or penciclovir. Cautions - Renal impairment (dose adjustment required), Elderly, Immunocompromised patients. Avoid - Use in patients with severe renal dysfunction unless adjusted; unnecessary prolonged therapy. Side Effects - Headache, Nausea, Diarrhea, Fatigue, Rash, Confusion (especially in elderly), Hepatic enzyme elevation. Trade Names - Famvir tab:®, Famcimac tab:®, Virovir tab:® Drug Interactions - Probenecid (increases plasma concentration), Drugs affecting renal function (e.g., aminoglycosides), Other antivirals. Adult: Herpes zoster: 500 mg orally every 8 hours for 7 days. Genital herpes: 250 mg orally twice daily for 5 days (recurrent) or 250 mg 3 times/day for 7–10 days (initial). Child: Not routinely recommended; safety and efficacy not established in children.
Famotidine (H2-receptor antagonist) Indications - Benign gastric and duodenal ulceration, Reflux oesophagitis, Zollinger-Ellison syndrome, Dyspepsia. Contraindications - Hypersensitivity to famotidine or other H2-receptor antagonists. Cautions - Renal impairment (dose adjustment needed), Elderly, History of gastric malignancy (may mask symptoms). Avoid - Pregnancy, Breast feeding unless benefits outweigh risks. Side Effects - Headache, Dizziness, Constipation, Diarrhea, Confusion (especially in elderly), Rare: bradycardia, thrombocytopenia. Trade Names - Famocid 20 tab:®, Famopsin 40 tab:®, Famotidine tab:®, FAMO TACK tab:® Drug Interactions - Ketoconazole, Itraconazole (absorption reduced), Atazanavir, Delavirdine (reduced efficacy), May increase serum concentration of certain drugs like procainamide. Adult: Usual dose: 20–40 mg daily (once or divided), taken at bedtime for ulcers or before meals for reflux. Maintenance: 20 mg at night. Child: 1 mg/kg/day orally in 2 divided doses (max 40 mg/day); dose varies by indication and age.
Fentanyl (Analgesic, Opioid) Indications - Analgesia during operations, Chronic intractable pain, Assisted ventilation in intensive care, Breakthrough cancer pain. Contraindications - Severe respiratory depression, Acute or severe bronchial asthma, Hypersensitivity to fentanyl or other opioids. Cautions - Elderly, Hepatic or renal impairment, Head injury, Hypothyroidism, Bradyarrhythmias, Myasthenia gravis, Alcoholism. Avoid - In non-opioid tolerant patients for high-dose formulations, Concomitant CNS depressants unless closely monitored. Side Effects - Respiratory depression, Bradycardia, Hypotension, Constipation, Nausea, Vomiting, Sedation, Dependence. Trade Names - Durogesic patch®, Fentanyl Citrate Inj®, Abstral®, Actiq® Drug Interactions - CNS depressants (benzodiazepines, alcohol), MAO inhibitors (contraindicated), CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) increase fentanyl levels. Adult: IV: 50–100 mcg as needed; Transdermal: 12–100 mcg/hr patch changed every 72 hours; Buccal: 100–200 mcg per episode of breakthrough pain. Child: IV: 1–2 mcg/kg per dose; Transdermal and buccal use not generally recommended for children under 2 years or opioid-naive.
Ferrous Sulfate (Haematinic) Indications - Iron-deficiency anaemia. Contraindications - Haemochromatosis, Haemosiderosis, Hemolytic anaemia, Iron overload syndromes. Cautions - Peptic ulcer disease, Intestinal strictures, Elderly, Patients with a history of GI disorders. Avoid - Concomitant use with other iron supplements unless advised. Side Effects - Constipation, Dark stools, Nausea, Abdominal discomfort, Diarrhoea. Trade Names - Ferrous Sulphate & Folic acid tab®, Fervita syrup® Drug Interactions - Tetracyclines, Quinolones, Antacids, Levothyroxine, Calcium supplements (may reduce absorption). Adult: Oral: 200 mg once to three times daily depending on severity. Child: Oral: 3–6 mg/kg elemental iron daily in divided doses.
Ferrous Fumarate (Haematinic) Indications - Iron-deficiency anaemia. Contraindications - Haemochromatosis, Haemosiderosis, Hemolytic anaemia, Iron overload conditions. Cautions - Peptic ulcer disease, Elderly, Intestinal strictures or narrowing, Patients with inflammatory bowel disease. Avoid - Unnecessary prolonged use, Concomitant use with other iron supplements. Side Effects - Constipation, Nausea, Vomiting, Dark stools, Abdominal discomfort. Trade Names - Oralcon-F tab®, Fesozinc tab®, Dofervit Cap® Drug Interactions - Tetracyclines, Quinolones, Calcium salts, Antacids, Levothyroxine, Zinc supplements. Adult: Oral: 200 mg once or twice daily (providing ~65 mg elemental iron per dose). Child: Oral: 3–6 mg/kg elemental iron daily in 1–2 divided doses.
Flavoxate HCl (Urinary Antispasmodic) Indications - Bladder spasm, Dysuria, Nocturia, Prostatitis, Urethritis. Contraindications - Obstructive uropathy, Gastrointestinal obstruction or hemorrhage, Achalasia, Glaucoma, Myasthenia gravis. Cautions - Use with caution in elderly, Hepatic impairment. Avoid - Use in children under 12 years unless prescribed. Side Effects - Dry mouth, Nausea, Blurred vision, Drowsiness, Headache, Confusion (especially in elderly). Trade Names - No product available right now. Drug Interactions - May enhance effects of anticholinergics; potential additive CNS effects with alcohol or sedatives. Adult: 200 mg 3–4 times daily. Child: Not recommended for children under 12 years.
Flavonoid (Venoactive/Capillary-protective agent) Indications - Hepatitis, Glaucoma, Leg swelling, Chronic Venous Insufficiency, Dysmenorrhoea, Menopause, Diabetic retinopathy, Haemorrhoids, Lymphoedema. Contraindications - Known hypersensitivity to flavonoids or excipients in the formulation. Cautions - Pregnancy, Breastfeeding, Hepatic impairment, Coagulopathy. Avoid - Use in patients with documented allergy to citrus-derived bioflavonoids. Side Effects - Mild gastrointestinal upset, Skin rash, Headache, Dizziness. Trade Names - Daflon 500 mg tab: Drug Interactions - May interfere with anticoagulants or antiplatelet drugs; monitor INR when used with warfarin. Adult: 500 mg twice daily, preferably with meals. Child: Safety and efficacy not established.
Fludrocortisone Acetate (Corticosteroid) Indications - Neuropathic postural hypotension, Mineralocorticoid replacement in adrenocortical insufficiency (e.g., Addison’s disease). Contraindications - Systemic fungal infections, Hypersensitivity to fludrocortisone or any component of the formulation. Cautions - Hypertension, Congestive heart failure, Renal impairment, Diabetes mellitus, Osteoporosis, Peptic ulcer, Epilepsy, Elderly. Avoid - Abrupt withdrawal after prolonged use, use in untreated systemic infections. Side Effects - Sodium and fluid retention, Hypertension, Edema, Hypokalemia, Muscle weakness, Headache, Allergic skin reactions. Trade Names - Florinef tab: Drug Interactions - Diuretics (increased risk of hypokalemia), Antidiabetic drugs (decreased effectiveness), Antihypertensives (decrease effectiveness), Digoxin (increased risk of arrhythmia with hypokalemia). Adult: 100–400 micrograms once daily orally. Child: 50–200 micrograms once daily orally (adjusted by condition and response).
Flumazenil (Antidote) Indications - Reversal of benzodiazepine sedation (e.g. post-anesthesia), Management of benzodiazepine overdose. Contraindications - Patients who are dependent on benzodiazepines or with mixed overdose (especially with tricyclic antidepressants), seizures, hypersensitivity to flumazenil. Cautions - History of seizures, head injury, hepatic impairment, panic disorders. Avoid - In mixed-drug overdose due to risk of seizures, especially with TCA co-ingestion. Side Effects - Seizures, agitation, anxiety, dizziness, nausea, vomiting, arrhythmias (rare). Trade Names - Romazicon Inj: Drug Interactions - May precipitate withdrawal in patients on chronic benzodiazepine therapy; avoid use with TCA overdose. Adult: Initial dose 200 micrograms IV over 15 seconds; may repeat at 60-second intervals if needed, up to a total of 1 mg. Child: Initial 10 micrograms/kg IV over 15 seconds; may repeat at 60-second intervals up to a maximum total dose of 1 mg.
Fluorouracil (Antimetabolite, Anticancer) Indications - Gastrointestinal cancers (colorectal, gastric, pancreatic), Breast cancer, Advanced colorectal cancer, Superficial malignant and pre-malignant skin lesions (topical). Contraindications - Severe bone marrow suppression, Severe infections, Poor nutritional status, Pregnancy, Hypersensitivity to fluorouracil. Caution - Hepatic or renal impairment, Myelosuppression, History of cardiac disease. Avoid - During pregnancy and breastfeeding; live vaccinations. Side Effects - Myelosuppression, Diarrhea, Stomatitis, Nausea, Vomiting, Hand-foot syndrome, Alopecia. Trade Names - Efudex Cream, Adrucil Inj: Drug Interactions - Leucovorin (enhances effect), Warfarin (increased bleeding), Live vaccines (avoid), Phenytoin (toxicity risk). Adult: Typical IV dose: 425 mg/m²/day for 5 days every 4 weeks, or as part of combination therapy. Topical: Apply 1–2 times daily. Child: Not routinely recommended; dosage must be individualized under specialist supervision.
Fluoxetine (Selective serotonin reuptake inhibitor, Antidepressant) Indications - Major depressive disorder, Panic disorder, Bulimia nervosa, Obsessive-compulsive disorder (OCD), Premenstrual dysphoric disorder (PMDD), Menopausal symptoms (particularly hot flushes in women with breast cancer). Contraindications - Concurrent use with MAO inhibitors or pimozide, Known hypersensitivity to fluoxetine. Cautions - Hepatic impairment, Epilepsy, Diabetes, History of suicidal ideation, Elderly, Bleeding disorders. Avoid - Breastfeeding, Abrupt discontinuation, Use with other serotonergic drugs unless monitored. Side Effects - Insomnia, Anxiety, Nausea, Dry mouth, Headache, Sexual dysfunction, Weight loss, Increased risk of suicidal thoughts in young patients. Trade Names - Fluoxetine 20 mg Cap:®, PROZAC Cap:® Drug Interactions - MAOIs (contraindicated), Triptans, Tricyclic antidepressants, NSAIDs (bleeding risk), Warfarin, Lithium, Anticonvulsants. Adult: Oral 20 mg once daily, may be increased after several weeks if needed; max 80 mg/day. Child: For OCD in children ≥8 years: start with 10 mg/day, may increase to 20 mg/day after 2 weeks under supervision.
Fluvoxamine maleate (Antidepressant) Indications - Depressive illness, Obsessive-compulsive disorder (OCD), Social anxiety disorder. Contraindications - Concomitant use with MAO inhibitors or tizanidine, Hypersensitivity to fluvoxamine. Cautions - Hepatic impairment, Renal impairment, Seizure disorders, History of mania/hypomania, Suicidal ideation. Avoid - Breastfeeding, Abrupt discontinuation, Use with other serotonergic drugs without monitoring. Side Effects - Nausea, Somnolence, Insomnia, Headache, Dry mouth, Dizziness, Gastrointestinal upset, Sexual dysfunction. Trade Names - Luvox tab:, Faverin tab:®, Fluvoxin tab: Drug Interactions - MAOIs (contraindicated), Tizanidine (contraindicated), Theophylline (increased levels), Tricyclic antidepressants, Warfarin, Benzodiazepines, Serotonergic agents. Adult: Start with 50 mg at bedtime, may increase in 50 mg increments every few days; usual range 100–300 mg/day in divided doses. Child: For OCD in children ≥8 years: initial 25 mg/day; may increase in 25 mg increments weekly; max 200 mg/day in divided doses.
Fomepizole (Antidote, Alcohol Dehydrogenase Inhibitor) Indications - Treatment of methanol and ethylene glycol poisoning. Contraindications - Known hypersensitivity to fomepizole. Cautions - Renal impairment, Liver impairment. Avoid - Use in pregnancy unless benefits outweigh risks. Side Effects - Headache, Nausea, Dizziness, Rash, Increased liver enzymes. Trade Names - Antizol (Pro) Drug Interactions - May interact with alcohol, methanol, or ethylene glycol metabolism; monitor for additive CNS depression with sedatives. Adult: 15 mg/kg IV over 30 min, then 10 mg/kg every 12 hours for 4 doses, then 15 mg/kg every 12 hours until ethylene glycol or methanol levels fall below toxic threshold and patient is asymptomatic. Child: Same as adult dose, based on weight.
Furazolidone (Nitrofuran Antibacterial Agent) Indications - Bacillary dysentery, Diarrhoea caused by bacterial infections, Giardiasis, Typhoid fever. Contraindications - Hypersensitivity to nitrofuran derivatives, Pregnancy, G6PD deficiency, Infants under 1 month old. Cautions - Renal impairment, Hepatic impairment. Avoid - Concomitant use with tyramine-rich foods (cheese, wine), MAO inhibitors, and alcohol due to risk of hypertensive crisis or disulfiram-like reaction. Side Effects - Nausea, Vomiting, Abdominal pain, Headache, Dizziness, Hemolysis in G6PD-deficient patients. Trade Names - Furoxone®, Furamide® Drug Interactions - MAO inhibitors, Antidepressants, Alcohol, Adrenergic drugs. Adult: 100 mg 4 times daily for 5–7 days. Child: 1.25 mg/kg 4 times daily for 5–7 days.
Furosemide, Frusemide (Loop diuretics) Indications - Pulmonary oedema, Congestive heart failure, Hypertension, Oedema due to renal or hepatic disease, Resistant oedema, Resistant hypertension. Contraindications - Anuria, Severe electrolyte depletion, Hepatic coma, Hypovolemia. Cautions - Diabetes mellitus, Gout, Hypotension, Elderly, Renal and hepatic impairment. Avoid - Concomitant use with aminoglycosides due to ototoxicity risk, Avoid in pregnancy unless clearly needed. Side Effects - Hypokalaemia, Hypomagnesaemia, Hyperuricaemia, Dizziness, Hypotension, Ototoxicity (at high doses), Hyperglycaemia. Trade Names - Furomide 500mg tab:, Fusid Inj: 2ml, Lasix tab:, Lasix inj: Drug Interactions - Aminoglycosides, Lithium, Digoxin, NSAIDs, Antihypertensives. Adult: 20–80 mg orally daily or in divided doses; IV/IM: 20–40 mg; dose may be increased up to 600 mg/day in severe cases. Child: 1–3 mg/kg/dose once or twice daily (max 6 mg/kg/day).
Fluconazole (Antifungal) Indications - Vaginal candidiasis, Candidal balanitis, Vulvovaginal candidiasis, Mucosal candidiasis, Tinea pedis, Tinea corporis, Tinea cruris, Pityriasis versicolor, Dermal candidiasis, Systemic candidiasis, Cryptococcal infection, Prevention of fungal infection in immunocompromised patients. Contraindications - Hypersensitivity to azole antifungals. Cautions - Hepatic impairment, Renal impairment, Prolonged QT interval, Electrolyte disturbances. Avoid - Acute porphyrias, Pregnancy unless necessary, Coadministration with drugs that prolong QT interval. Side Effects - Headache, Nausea, Abdominal pain, Diarrhea, Elevated liver enzymes, Rash, QT prolongation, Hepatotoxicity (rare). Trade Names - Flucona-Denk 150 Cap:, Difluvid Cap:, Fukole Cap:, Fluconazol Stada 150 mg Cap:, Alonazole Inj: Drug Interactions - Warfarin, Phenytoin, Rifampicin, Sulfonylureas, Theophylline, Cyclosporine, Zidovudine, Oral contraceptives, QT-prolonging agents. Adult: 150 mg single dose for vaginal candidiasis; 50–400 mg once daily depending on indication. Child: 3–6 mg/kg/day depending on infection type and severity.
Voriconazole (Antifungal) Indications - Invasive aspergillosis, Fluconazole-resistant candidiasis, Scedosporium species infection. Contraindications - Known hypersensitivity to voriconazole or other azoles. Cautions - Hepatic impairment, Renal impairment, Electrolyte imbalance, Cardiomyopathy, QT prolongation, Pancreatitis, Bradycardia, Symptomatic arrhythmias. Avoid - Acute porphyrias, Breastfeeding, Pregnancy. Avoid excessive sunlight exposure. Effective contraception required during treatment. Side Effects - Visual disturbances, Rash, Hepatotoxicity, Photosensitivity, Hallucinations, QT prolongation, Nausea. Trade Names - Vfend tab:®, Vfend inj:®, Vorier tab:®, Vorier inj:® Drug Interactions - Carbamazepine, Rifampin, St. John's Wort, Quinidine, Warfarin, Tacrolimus, Cyclosporine, Statins, Benzodiazepines. Adult: Loading dose: 400 mg every 12 hours for 2 doses, then 200 mg every 12 hours. Child: Loading dose: 9 mg/kg every 12 hours for 2 doses, then 8 mg/kg every 12 hours.
Folic Acid (Vitamin B9) Indications - Folate-deficient megaloblastic anaemia, Prevention of neural tube defects, Prophylaxis in chronic haemolytic states, Prevention of methotrexate-induced side-effects in rheumatic disease, Pregnancy. Important Note - Should never be given alone in pernicious anaemia (may mask vitamin B12 deficiency). Trade Names - Folic Acid tab: Adult: Usually 5 mg daily, up to 15 mg daily in malabsorption syndromes. Child: Typically 250 micrograms–1 mg daily depending on indication.
Insulin (Antidiabetic Hormone) Indications - Diabetes mellitus (Type 1 and 2), Diabetic ketoacidosis, Hyperglycaemia during surgery or illness. Common Preparations - Insulin Glargine (Lantus SoloStar inj:), Regular Insulin, NPH Insulin, Insulin Lispro, Insulin Aspart, etc. inj:®, Pen:® Adult: Dosage individualized based on blood glucose monitoring; typical total daily dose ranges from 0.2–1.0 units/kg/day. Child: Similar to adult on weight basis; requires close monitoring and titration.
Glipizide (Sulfonylurea Antidiabetic) Indications - Non-insulin dependent Type 2 diabetes mellitus (NIDDM), particularly in adults who cannot be controlled by diet and exercise alone. Common Brand - Glip-5 tab (5 mg) Minidiab tab:®, Gliben tab:®, Glipizide ER tab:®, Glucotrol tab:® Adult: Initially 2.5–5 mg once daily before breakfast; usual maintenance dose 5–20 mg daily in divided doses. Child: Not recommended for pediatric use.
Glucagon (Glycogenolytic Hormone)Indications: Insulin-induced hypoglycaemia, beta-blocker overdose, diagnostic aid. Contraindications: Pheochromocytoma, insulinoma. Cautions: Adrenal insufficiency, hypoglycaemia due to starvation. Avoid: Hypersensitivity to glucagon or any of its components. Trade Names: GlucaGen® (injection), Glucagon® (injection) Drug Interactions: May interact with oral anticoagulants and beta-blockers. Adult: 2–10 mg administered subcutaneously or intravenously in 5% glucose solution. Child: Dose varies with weight; typically 0.03 mg/kg SC or IV.
GanirelixIndications: Used as part of controlled ovarian hyperstimulation during assisted reproduction techniques (ART) such as in vitro fertilization (IVF) to prevent premature luteinizing hormone (LH) surges. Contraindications: Known hypersensitivity to ganirelix acetate or any of its components, known or suspected pregnancy, lactation, severe renal or hepatic impairment. Cautions: History of allergic reactions to gonadotropin-releasing hormone (GnRH) or its analogues, ovarian enlargement, risk of ovarian hyperstimulation syndrome (OHSS). Avoid: Use during pregnancy and breastfeeding; avoid in patients with severe renal or hepatic dysfunction. Trade Names: Orgalutran® (injection) Drug Interactions: No significant drug interactions reported, but concurrent use with other fertility drugs should be carefully monitored by a specialist. Adult: 250 mcg administered subcutaneously once daily, starting on day 5 or 6 of ovarian stimulation and continued until the day of hCG administration. Child: Not recommended for pediatric use.
Glycopyrrolate, Glycopyrronium bromide (Anticholinergic drug)Indications: Used to reduce salivary, respiratory, and gastric secretions during surgery; manage peptic ulcers; control excessive saliva production (sialorrhea); treat intra-operative bradycardia; manage chronic severe drooling in conditions like cerebral palsy; and as adjunct therapy in hyperhidrosis. Contraindications: Hypersensitivity to glycopyrrolate or related compounds, glaucoma, myasthenia gravis, obstructive uropathy, paralytic ileus, toxic megacolon associated with ulcerative colitis. Cautions: Elderly patients, patients with cardiac disease, hypertension, renal impairment, autonomic neuropathy, or prostatic hypertrophy; use with caution in children with spastic conditions. Avoid: Use during breastfeeding unless clearly necessary; avoid in patients with known hypersensitivity or severe ulcerative colitis. Trade Names: Robinul® (tablet/injection), Avert® (tablet), Cuvposa® (oral solution), Glycopyrrolate® (injection) Drug Interactions: May enhance effects of other anticholinergics; may decrease the effect of medications that rely on gastrointestinal absorption; caution with potassium chloride tablets, antacids, and certain psychiatric medications. Adult: Oral: 1–2 mg 2–3 times daily for peptic ulcers; IV/IM: 0.1–0.2 mg before anesthesia or intraoperatively as needed. Child: Oral: 0.02 mg/kg 2–3 times daily (maximum 3 mg/day) for drooling; IV/IM: 4–10 mcg/kg as a single dose preoperatively or intraoperatively as needed.
Guaifenesin (Mucolytic, Expectorant)Indications: Used to relieve chest congestion in productive coughs by thinning and loosening mucus in the airways; commonly used in acute bronchitis, common cold, and other respiratory conditions involving thick mucus. Contraindications: Hypersensitivity to guaifenesin or any component of the formulation. Cautions: Persistent or chronic cough (e.g., associated with smoking, asthma, or emphysema), cough accompanied by excessive phlegm, or if symptoms persist longer than 7 days or are accompanied by fever, rash, or headache. Avoid: Use in children under 2 years unless prescribed; avoid use in case of known allergy to guaifenesin. Trade Names: Altarussin® (tablet/syrup), Ascoril Expectorant® (syrup), Benylin-E® (syrup), Mucinex® (extended-release tablet), Robitussin® (syrup), Cap® (capsule) Drug Interactions: No significant drug interactions reported; use cautiously with other cough/cold medications to avoid duplication of ingredients. Adult: 200–400 mg orally every 4 hours as needed (maximum 2400 mg/day). Extended-release: 600–1200 mg every 12 hours (maximum 2400 mg/day). Child: Children 6–12 years: 100–200 mg every 4 hours (maximum 1200 mg/day); Children 2–6 years: 50–100 mg every 4 hours (maximum 600 mg/day).
Cadiphen(Expectorant)Indications: Relief of productive cough associated with common cold, bronchitis, and other respiratory tract infections. Contraindications: Hypersensitivity to any of the components (guaifenesin, diphenhydramine, or phenylephrine); severe hypertension or coronary artery disease; monoamine oxidase inhibitor (MAOI) use within 14 days. Cautions: Use with caution in patients with glaucoma, hypertension, hyperthyroidism, diabetes, prostatic hypertrophy, or asthma; may cause drowsiness. Avoid: Use in children under 2 years unless directed by a physician; avoid alcohol and other CNS depressants during use. Trade Names: Cadiphen Expectorant® (syrup), Respira® (oral liquid), Cap® (capsule) Drug Interactions: May interact with CNS depressants, alcohol, MAOIs, and antihypertensives; increased risk of serotonin syndrome with serotonergic drugs. Adult: 5–10 mL orally every 6–8 hours as needed (maximum 40 mL/day). Child: Children 6–12 years: 2.5–5 mL every 6–8 hours (maximum 20 mL/day); Children 2–6 years: 1.25–2.5 mL every 6–8 hours (under physician guidance).
Gonadorelin (Gonadotropin-releasing hormone)Indications: Assessment of pituitary gonadotropin function; diagnosis of hypothalamic-pituitary-gonadal axis disorders; evaluation of delayed puberty or amenorrhea. Contraindications: Hypersensitivity to gonadorelin or its components; pregnancy and lactation (unless specifically indicated). Cautions: Patients with hormone-sensitive tumors, severe organic intracranial lesions, or epilepsy. Avoid: Use during pregnancy and breastfeeding unless clearly necessary. Trade Names: Gonadorelin® (tablet, capsule, injection) Drug Interactions: May interact with hormonal therapies; use with caution alongside dopamine antagonists and other pituitary affecting drugs. Adult: 100 mcg subcutaneously or intravenously for stimulation testing. Child: Dose varies by weight and indication; typically lower than adult dose and determined by specialist.
Hydralazine HCl (Antihypertensive, Vasodilator)Indications: Management of moderate to severe hypertension, including hypertensive emergencies; adjunct treatment in heart failure, especially in combination with nitrates in patients intolerant to ACE inhibitors. Contraindications: Coronary artery disease, mitral valve rheumatic heart disease, dissecting aortic aneurysm. Cautions: Pregnancy, breastfeeding, hepatic impairment, renal impairment, elderly patients, systemic lupus erythematosus (SLE). Avoid: Acute porphyrias, severe tachycardia, known hypersensitivity to hydralazine. Trade Names: Apresoline® (tablet), Hydralazine® (injection) Drug Interactions: May interact with other antihypertensives, beta-blockers, and diuretics; additive hypotensive effects; NSAIDs may reduce its efficacy. Adult: Initial: 25–50 mg orally 2–4 times daily; maintenance: up to 300 mg/day in divided doses. IV: 5–20 mg every 4–6 hours as needed for hypertensive crisis. Child: Oral: 0.75–1 mg/kg/dose every 6–8 hours (max 7.5 mg/kg/day); IV: 0.1–0.2 mg/kg/dose every 4–6 hours as needed.
Hydromorphone (Opioid Analgesic)Indications: Management of severe pain, especially in cancer patients, when alternative treatments are inadequate. Contraindications: Severe respiratory depression, acute or severe bronchial asthma, known or suspected gastrointestinal obstruction (including paralytic ileus), hypersensitivity to hydromorphone. Cautions: Elderly or debilitated patients, hepatic or renal impairment, history of substance use disorder, hypotension, head injury, or increased intracranial pressure. Avoid: Use during pregnancy or breastfeeding unless essential; avoid alcohol or other CNS depressants; not for mild pain or short-term use. Trade Names: Dilaudid® (tablet, injection), Palladone® (extended-release capsule), Hydromorph Contin® (extended-release capsule) Drug Interactions: May interact with other CNS depressants (e.g., benzodiazepines, alcohol), MAO inhibitors, serotonergic drugs, and anticholinergics. Adult: Oral: 2–4 mg every 4–6 hours as needed; adjusted based on response. Severe cases may require extended-release formulations. Child: Use with caution; dosing individualized based on weight and clinical condition under specialist supervision.
Benzylpenicillin sodium (Natural Penicillin, Beta-lactam Antibiotic)Indications: Throat infection, Otitis media, Pneumonia, Endocarditis, Anthrax, Meningitis, Meningococcal disease, Syphilis, Diphtheria, Actinomycosis. Contraindications: Hypersensitivity to penicillins or other beta-lactam antibiotics. Cautions: History of allergy or asthma, renal impairment, epilepsy (high doses may cause CNS toxicity), prolonged use may lead to superinfection. Avoid: In penicillin-allergic patients; use Vancomycin or alternative antibiotics. Trade Names: Crystapen® (injection), Penicillin G Sodium® (IV), Pfizerpen® (powder for injection) Drug Interactions: May reduce efficacy of oral contraceptives; may increase methotrexate toxicity; use with caution with aminoglycosides and probenecid. Adult: 1.2–2.4 million units IM or IV every 4–6 hours, depending on severity and infection site. Child: 50,000–100,000 units/kg/day IV/IM in divided doses every 4–6 hours, depending on severity.
Phenoxymethylpenicillin, Penicillin V (Beta-lactam Antibiotic)Indications: Tonsillitis, Otitis media, Erysipelas, Rheumatic fever prophylaxis, Prevention of pneumococcal and streptococcal infections, Acute sinusitis, Dental infections. Contraindications: Hypersensitivity to penicillins or other beta-lactams. Cautions: History of allergy, asthma, renal impairment; prolonged use may lead to superinfection or C. difficile-associated diarrhea. Avoid: Use in penicillin-allergic patients; consider alternatives like macrolides or clindamycin. Trade Names: Padpenici-VP® (tablet), Pen-Vee K® (tablet), Veetids® (tablet, oral solution) Drug Interactions: May reduce efficacy of oral contraceptives; probenecid increases penicillin levels; antagonized by bacteriostatic antibiotics (e.g., tetracyclines). Adult: 250–500 mg orally every 6 hours; dosage and duration depend on infection type and severity. Child: 25–50 mg/kg/day in divided doses every 6–8 hours, depending on age and severity.
Hydroxyzine HCl (Sedating Antihistamine)Indications: Pruritus, anxiety, tension, sedation prior to surgery, adjunctive therapy in allergic conditions such as urticaria and atopic dermatitis. Contraindications: Prolonged QT interval, known hypersensitivity to hydroxyzine or cetirizine, pregnancy (especially first trimester). Cautions: Bladder outflow obstruction, cardiovascular disease, children, decreased gastrointestinal motility, dementia, elderly, epilepsy, hypertension, hyperthyroidism, prostatic hypertrophy, pyloroduodenal obstruction, urinary retention, stenosing peptic ulcer, angle-closure glaucoma. Avoid: Use in patients with bradycardia, cardiovascular disease, family history of sudden cardiac death; avoid alcohol and CNS depressants. Trade Names: Atarax® (tablet, syrup), Vistaril® (capsule, injection) Drug Interactions: Additive CNS depression with alcohol, benzodiazepines, opioids; QT prolongation risk with macrolides and antifungals; caution with other anticholinergic agents. Adult: 25–100 mg daily in divided doses (oral); for anxiety or pruritus, typically 25 mg 3–4 times daily. Child: 0.5–1 mg/kg/dose orally every 6–8 hours, maximum 50–100 mg/day depending on age and indication.
Imipramine HCl (Tricyclic Antidepressant)Indications: Depressive illness (major depression), nocturnal enuresis in children (when organic causes have been ruled out). Contraindications: Recent myocardial infarction, arrhythmias, heart block, mania, hypersensitivity to imipramine or other tricyclics. Cautions: Cardiovascular disease, epilepsy, diabetes, chronic constipation, urinary retention, hyperthyroidism, angle-closure glaucoma, history of psychosis or bipolar disorder, elderly patients. Avoid: Use during the manic phase of bipolar disorder, patients with significant arrhythmias or heart block; avoid alcohol and other CNS depressants. Trade Names: Tofranil® (tablet), Imipramine® (tablet) Drug Interactions: May interact with MAO inhibitors (risk of serotonin syndrome), SSRIs, CNS depressants, anticholinergics, and antiarrhythmics; potentiates effect of sympathomimetics. Adult: Depression: Initially 25 mg 1–3 times daily orally, increased gradually to 75–150 mg/day in divided doses; max 200–300 mg/day if needed under supervision. Child: Enuresis (age >6 years): 10–25 mg orally at bedtime; may increase to 50 mg (ages 6–12) or 75 mg (ages >12) if needed. Use lowest effective dose for shortest duration.
Interferon alfa (Cytokine, Immunostimulant) Indications - Chronic myeloid leukemia (CML), Hairy cell leukemia, Follicular lymphoma, Liver metastases of carcinoid tumor, Chronic hepatitis B and C, Malignant melanoma, Renal cell carcinoma, Kaposi’s sarcoma. Contraindications - Autoimmune hepatitis, decompensated liver disease, severe psychiatric disorders, hypersensitivity to interferon alfa or its components. Cautions - History of depression or suicidal ideation, cardiovascular disease, bone marrow suppression, renal or hepatic impairment, epilepsy, autoimmune disorders. Avoid - Pregnancy unless benefits outweigh risks; breastfeeding; concurrent use with other immunosuppressive therapy (unless indicated). Trade names - Intron A®, Roferon-A® Drug Interactions - May interact with theophylline (increased levels), zidovudine (enhanced toxicity), CNS depressants (additive effects); caution with hepatotoxic drugs. Adult: Varies by indication: e.g., CML – 5 million IU/m²/day SC or IM; Hepatitis B/C – 3–10 million IU 3 times weekly SC/IM. Child: Individualized based on body surface area or weight and indication; specialist supervision required.
Peginterferon alfa (Pegylated Cytokine, Immunomodulator) Indications - Chronic hepatitis C (in combination with ribavirin or other antivirals), chronic hepatitis B (in compensated liver disease). Contraindications - Autoimmune hepatitis, decompensated hepatic disease, severe psychiatric disorders, hypersensitivity to interferon or polyethylene glycol. Cautions - History of depression, cardiovascular disease, diabetes, thyroid dysfunction, seizure disorders, hepatic or renal impairment, bone marrow suppression. Avoid - Pregnancy (especially when used with ribavirin), breastfeeding, uncontrolled psychiatric illness. Trade names - Pegasys® (Peginterferon alfa-2a), PegIntron® (Peginterferon alfa-2b) Drug Interactions - May interact with theophylline, zidovudine (increased toxicity), and drugs causing myelosuppression; additive CNS effects with depressants. Adult: Pegasys®: 180 mcg subcutaneously once weekly; PegIntron®: 1.0–1.5 mcg/kg SC once weekly (dose varies with indication and body weight). Child: PegIntron®: 60 mcg/m² SC once weekly in children ≥3 years; Pegasys®: 180 mcg/1.73 m² SC once weekly; dosing individualized by weight/BSA and indication.
Interferon beta (Immunomodulator for Multiple Sclerosis) Indications: Relapsing-remitting multiple sclerosis (RRMS) characterized by at least two attacks of neurological dysfunction over the past 2–3 years followed by complete or incomplete recovery; also indicated for a single demyelinating event with active inflammation (if severe enough to require IV corticosteroids and high risk of MS development). Contraindications: Severe depression, history of suicidal ideation, hypersensitivity to interferon beta or human albumin. Cautions: Liver dysfunction, depression, seizure disorders, bone marrow suppression, autoimmune disorders, thyroid dysfunction. Avoid: Pregnancy unless benefits outweigh risks; avoid in patients with severe psychiatric disorders. Trade Names: Navas Interferon® (injection), Avonex® (IM), Rebif® (SC), Betaferon® / Betaseron® (SC) Drug Interactions: Caution with other hepatotoxic or myelosuppressive drugs; potential interaction with antiepileptics and psychotropic medications. Adult: Avonex®: 30 mcg IM once weekly; Rebif®: 22 or 44 mcg SC three times weekly; dosage depends on brand and patient response. Child: Not routinely recommended; safety and efficacy not well established in children—specialist consultation required.
Interferon gamma-1b (Cytokine, Immunostimulant) Indications - Severe malignant osteopetrosis, Chronic granulomatous disease (CGD). Contraindications - Hypersensitivity to interferon gamma or any component of the formulation. Cautions - Cardiac disease, hepatic impairment, history of seizures, bone marrow suppression; monitor liver enzymes and CBC regularly during treatment. Avoid - Concurrent use with immunosuppressive agents unless clearly indicated; avoid in patients with decompensated liver disease. Trade names - Actimmune® Drug Interactions - May enhance myelosuppressive effects of other cytotoxic drugs; caution with hepatotoxic agents; potential interaction with CNS-active medications. Adult: 50 mcg/m² subcutaneously three times weekly (maximum dose: 1.5 million IU/m²). Child: Same as adult, based on body surface area (50 mcg/m² SC three times weekly); dosing adjustments may be needed based on response and tolerability.
Ipratropium Bromide (Anticholinergic drug, Muscarinic Antagonist) Indications - Reversible airway obstruction, chronic obstructive pulmonary disease (COPD), acute bronchospasm, acute asthma exacerbations, rhinorrhea associated with allergic and non-allergic rhinitis (nasal spray). Contraindications - Hypersensitivity to ipratropium bromide or atropine derivatives. Cautions - Prostatic hyperplasia, urinary retention, narrow-angle glaucoma, bladder neck obstruction. Avoid - Spraying near eyes (may cause pupil dilation and glaucoma), use cautiously in patients with glaucoma or prostatic hypertrophy. Trade names - Atrovent® (inhaler, nebuliser solution), Ipraxa® (inhaler) Drug Interactions - May have additive anticholinergic effects with other anticholinergic drugs; caution with other inhaled bronchodilators. Adult: Inhaler: 20 mcg (2 puffs) 3–4 times daily; Nebuliser solution: 500 mcg 3–4 times daily. Child: Not routinely recommended for children under 12 years without specialist advice; dosing individualized for children >12 years.
Irbesartan (Angiotensin II Receptor Blocker – ARB) Indications - Hypertension, diabetic nephropathy in patients with type 2 diabetes and hypertension, renal disease in hypertensive patients. Contraindications - Pregnancy, breastfeeding, hypersensitivity to irbesartan or any ARB, bilateral renal artery stenosis, severe hepatic impairment. Cautions - Renal impairment, hepatic dysfunction, volume-depleted patients, elderly, patients with heart failure or hyperkalemia. Avoid - Concurrent use with aliskiren in diabetic patients or with ACE inhibitors in patients with renal impairment (unless clearly indicated). Trade names - IROVEL-H® 12.5 mg tab, Irbesartan 150® tab, Irbesartan 300® tab Drug Interactions - Additive hypotensive effect with other antihypertensives, increased risk of hyperkalemia with potassium-sparing diuretics or potassium supplements, NSAIDs may reduce antihypertensive effect and impair renal function. Adult: Initial dose: 150 mg once daily; maintenance: 150–300 mg once daily. Lower dose may be needed in volume-depleted patients. Child: Not generally recommended in children under 6 years; in children ≥6 years, dose individualized (typically starting at 75 mg once daily, based on weight).
Iron Dextran (Parenteral Iron Preparation) Indications - Iron-deficiency anaemia when oral iron is ineffective or not tolerated, and in cases requiring rapid iron repletion (e.g. chronic kidney disease, malabsorption, ongoing blood loss). Contraindications - Anemia not due to iron deficiency, hypersensitivity to iron dextran or its components, hemochromatosis, hemosiderosis. Cautions - History of asthma, eczema, or other atopic allergies; liver dysfunction, systemic infections. Avoid - Use in the first trimester of pregnancy, severe hepatic impairment, acute renal failure, active infection. Trade names - Infed® (injection), Dexferrum® (injection) Drug Interactions - May reduce absorption of oral iron if given concurrently; avoid using with other parenteral iron products; use caution with ACE inhibitors (may increase risk of anaphylaxis). Adult: IM or IV: Dose based on calculated iron deficit; commonly 100–200 mg IV over several sessions or total dose infusion depending on formulation. Child: IM or IV: Dose individualized based on weight and iron deficit; typically 5–7 mg/kg body weight IV in divided doses.
Isoniazid (Antitubercular Agent) Indications - Treatment and prevention of tuberculosis (TB), latent TB infection (LTBI), part of combination therapy for active TB, prophylaxis in high-risk individuals. Contraindications - Hypersensitivity to isoniazid, history of isoniazid-induced hepatotoxicity, acute liver disease, previous isoniazid-associated liver injury. Cautions - Hepatic impairment, history of alcoholism, seizure disorders, diabetes mellitus, malnutrition, HIV infection, age >35 (increased hepatotoxicity risk). Avoid - Use with alcohol, avoid in patients with active liver disease unless essential. Trade names - Isolin® tab, Isoniazid® tab, Macox Plus® tab, Tritab® tab Drug Interactions - May increase toxicity of phenytoin, carbamazepine, theophylline; reduced efficacy when combined with aluminum-containing antacids; increased risk of hepatotoxicity with rifampicin or alcohol. Adult: 300 mg once daily for latent TB; 5 mg/kg (max 300 mg/day) as part of combination therapy for active TB. Child: 10–15 mg/kg once daily (max 300 mg/day) as part of combination therapy.
Isoproterenol HCl (Sympathomimetic) Indications - Management of bradycardia, heart block, Adams-Stokes attacks, and cardiac arrest; used in bronchospasm during anesthesia, bronchial asthma, and chronic bronchitis; reversible airways obstruction. Contraindications - Tachyarrhythmias, digitalis-induced tachycardia, angina pectoris, hypersensitivity to isoproterenol. Cautions - Coronary artery disease, hypertension, diabetes mellitus, hyperthyroidism, elderly patients, during anesthesia with halogenated hydrocarbons. Avoid - Use in patients with ventricular arrhythmias or those with recent myocardial infarction. Trade names - Chericof Flu Plus® tab, Coldrid® tab, Coldzap® tab, Decolgen® tab, Flemnil® tab, Fluza® tab, LenSen Cold® tab Drug Interactions - Potentiated by monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, beta-blockers; may cause additive cardiovascular effects with other sympathomimetics. Adult: IV infusion: 2–10 mcg/min titrated based on heart rate and rhythm; inhalation: 0.5 mg via nebulizer every 4 hours if needed. Child: IV: 0.1 mcg/kg/min initially; titrate to response. Inhalation and other routes per clinical judgment and weight.
Phenylephrine HCl (Sympathomimetic) Indications - Acute hypotension, nasal congestion, mydriasis induction, and as a vasopressor in shock and anesthesia. Contraindications - Severe hypertension, ventricular tachycardia, hypersensitivity to phenylephrine. Cautions - Coronary artery disease, coronary vascular thrombosis, diabetes mellitus, hyperthyroidism, elderly patients, renal impairment. Avoid - Use in patients with severe hypertension or severe hyperthyroidism. Trade names - Disophrol® tab, Neo-Synephrine® inj, Zyramin® cap, Coldrin® tab, Sinex® spray Drug Interactions - MAO inhibitors (can cause hypertensive crisis), tricyclic antidepressants, oxytocic drugs, beta-blockers may increase pressor effects. Adult: IV: 100–180 mcg/min initially, then maintenance dose of 40–60 mcg/min; orally for nasal decongestion: 10 mg every 4 hours as needed. Child: Nasal decongestant: 2.5–5 mg orally every 4 hours (age-dependent); IV use not generally recommended except under specialist supervision.
Kaolin (Adsorbent Antidiarrheal) Indications - Used for the symptomatic treatment of mild, chronic diarrhoea; sometimes used in combination with pectin or other antidiarrheals. Not recommended for acute infectious diarrhoea due to limited efficacy. Contraindications - Intestinal obstruction, hypersensitivity to kaolin or formulation components. Cautions - Chronic use may interfere with absorption of nutrients and other medications; avoid prolonged use without medical supervision. Avoid - Use in acute diarrhoea of infectious origin, especially in children, and during dehydration without fluid replacement. Trade names - Kaopectate® suspension, Kaodene® tab, K-C® Cap Drug Interactions - May interfere with the absorption of digoxin, clindamycin, lincomycin, and other oral medications. Adult: Typically 26.2 g (30 mL of suspension) after each loose stool, up to 6 doses/day. Child: Dosing varies with age; usually 15 mL for children over 12 years; not recommended for children under 6 without medical supervision.
Pectin (Adsorbent Antidiarrheal) Indications - Used in combination with kaolin for the symptomatic treatment of mild, non-infectious diarrhoea. Not recommended for acute infectious diarrhoea. Contraindications - Hypersensitivity to pectin or any excipients in the formulation, intestinal obstruction. Cautions - May affect absorption of orally administered drugs; use caution in patients with chronic gastrointestinal conditions. Avoid - Use in acute infectious diarrhoea, dehydration without fluid replacement, and in children under 6 years unless advised by a doctor. Trade names - Kaopectate® suspension (with kaolin), Donnagel® tab, Pectin-K® Cap Drug Interactions - May reduce absorption of tetracyclines, digoxin, and certain other oral drugs if taken together. Adult: Usually combined with kaolin; typical dose is 30 mL orally after each loose stool, up to 6 doses daily. Child: Typically 15 mL orally after each loose stool in children over 6 years; not recommended for younger children without supervision.
Lactulose (Laxative) Indications - Treatment of chronic constipation; management of hepatic encephalopathy (portal systemic encephalopathy) to reduce blood ammonia levels. Contraindications - Intestinal obstruction, galactosaemia. Cautions - Patients with lactose intolerance, diabetes mellitus (due to sugar content), electrolyte imbalance during prolonged use. Avoid - Use in patients with galactosaemia or bowel perforation/suspected obstruction without medical supervision. Trade names - Duphalac® syrup, Kristalose® powder, Lactugal® syrup Drug Interactions - May reduce efficacy of other orally administered drugs due to altered intestinal transit time. Adult: Constipation: 15–30 mL orally once or twice daily; Hepatic encephalopathy: 30–45 mL orally 3–4 times daily, adjusted to produce 2–3 soft stools per day. Child: Constipation: 5–15 mL orally daily (based on age); Hepatic encephalopathy: dosing individualized based on severity and age.
Lanthanum (Phosphate binder) Indications - Hyperphosphataemia in patients with chronic kidney disease on haemodialysis or peritoneal dialysis (CAPD); also used in patients not on dialysis with serum phosphate ≥1.78 mmol/L unresponsive to dietary phosphate restriction. Contraindications - Hypophosphataemia, bowel obstruction, ileus. Cautions - Active peptic ulcer, ulcerative colitis, Crohn's disease, history of bowel surgery, gastrointestinal motility disorders. Avoid - Severe gastrointestinal disorders unless clearly indicated. Trade names - Fosrenol® chewable tablets Drug Interactions - May reduce absorption of tetracyclines and fluoroquinolones; separate administration by at least 2 hours. Adult: Initial: 250–500 mg orally with each meal; titrated up to 1500–3000 mg/day based on serum phosphate levels. Child: Not recommended due to lack of sufficient data on safety and efficacy.
Leflunomide (Disease-modifying antirheumatic drug - DMARD) Indications - Active rheumatoid arthritis, Active psoriatic arthritis. Contraindications - Severe immunodeficiency, severe infections, moderate to severe hepatic impairment, pregnancy, breastfeeding. Cautions - History of liver disease, blood dyscrasias, chronic infections (e.g., TB), respiratory disorders, hypertension, elderly patients. Avoid - Concurrent use with other hepatotoxic or immunosuppressive drugs unless necessary; avoid alcohol. Trade names - Arava® tablets Drug Interactions - Increased risk of liver toxicity with methotrexate; enhances warfarin effect; interacts with rifampicin, cholestyramine (increases elimination). Adult: Loading dose: 100 mg once daily for 3 days (optional), then maintenance: 10–20 mg once daily. Child: Not routinely recommended; off-label use should be supervised by a specialist. (Specialist use only)
Levothyroxine sodium, Thyroxine sodium (Thyroid hormone) Indications - Hypothyroidism, Hyperthyroidism (as part of blocking-replacement regimen with carbimazole), Myxedema coma, Goiter suppression, Thyroid cancer suppression. Contraindications - Untreated adrenal insufficiency, Thyrotoxicosis, Hypersensitivity to levothyroxine or excipients. Cautions - Cardiovascular disease, Diabetes mellitus, Elderly, Osteoporosis, History of seizures. Avoid - Abrupt discontinuation, Use in acute myocardial infarction, Uncorrected adrenal disorders. Trade names - Evosum® tab, Levosum® tab, T4 50 Montpellier®, T4 100 Montpellier®, T4 50 Montpellier Multi-scored® tab, T4 100 Montpellier Multi-scored® tab Drug Interactions - May interact with calcium/iron supplements, antacids, warfarin, digoxin, insulin, and oral hypoglycemics. Adult: Initial: 25–50 mcg/day; Maintenance: 100–200 mcg/day depending on response and TSH levels. Child: Neonates: 10–15 mcg/kg/day; older children: adjust dose according to age, weight, and thyroid function tests.
Liothyronine Sodium, L-Tri-iodothyronine Sodium (Thyroid hormone) Indications - Hypothyroidism, Myxedema coma (hypothyroid coma), as adjunct in thyroid cancer treatment (to suppress TSH). Trade names - Cytomel®, Tertroxin® Dosage Forms - Tab: Cytomel® 5 mcg, 25 mcg; Tertroxin® 20 mcg Adult: Initial: 5–25 mcg daily; maintenance: 25–75 mcg/day (adjusted based on response). In myxedema coma: 25–50 mcg IV initially, followed by 10–20 mcg IV every 8–12 hours. Child: Neonates: 5 mcg/day; Infants/children: 5–25 mcg/day based on age and response.
Lidocaine HCl (Local anesthetic, Antiarrhythmic) Indications - Antiarrhythmic (ventricular arrhythmias), Local anesthesia (infiltration, nerve block, epidural, spinal, surface anesthesia), Dental procedures, Relief of pain in oral lesions, Oropharyngeal anesthesia (e.g., bronchoscopy, laryngoscopy, oesophagoscopy, endotracheal intubation), Maxillary sinus puncture, Pain relief in anal fissures, hemorrhoids, pruritus ani/vulvae, herpes zoster/labialis, Lubrication for cystoscopy and proctoscopy, Intravenous regional anesthesia. Contraindications - Severe sinoatrial, AV, or intraventricular block (without pacemaker), Hypersensitivity to amide-type local anesthetics. Avoid - Severe myocardial depression. Cautions - Acute porphyrias, Hepatic impairment, Renal impairment, Congestive heart failure, Elderly, Pregnancy. Trade names - Xylocaine® inj/gel, Kamistad® gel, Lignox® jelly, Lox® spray, Lox® injection Drug interactions - Interacts with beta-blockers, cimetidine, amiodarone, phenytoin, other antiarrhythmics; may increase risk of CNS or cardiovascular toxicity. Adult: Arrhythmia: IV bolus 50–100 mg, followed by infusion 1–4 mg/min; Local anesthesia: varies by procedure and route, max dose ~4.5 mg/kg (not exceeding 300 mg without epinephrine). Child: 1–5 mg/kg depending on route and indication; max 3–5 mg/kg for local anesthesia.
Lisinopril (Angiotensin-converting enzyme (ACE) inhibitor) Indications - Hypertension, Adjunct treatment in heart failure, Renal protection in diabetic nephropathy, Post-myocardial infarction management. Trade names - Zestril®, Prinivil®, Hipril®, Linvas® Dosage Forms - Tab: 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg Adult: Hypertension: Initial 5–10 mg once daily, usual maintenance: 10–40 mg once daily. Start at 2.5–5 mg in heart failure or renal impairment. Child: (≥6 years, with normal renal function): Initial 0.07 mg/kg once daily (max 5 mg/day), titrated up to max 0.61 mg/kg/day or 40 mg/day.
Lomustine (Antineoplastic) Indications - Hodgkin's disease resistant to conventional therapy, Malignant melanoma, Brain tumors, Certain other solid tumours. Trade names - CeeNU®, Gleostine®, Lomustine 40 mg Cap® Dosage Forms - Cap: 10 mg, 40 mg, 100 mg Adult: 120–130 mg/m² orally as a single dose every 6–8 weeks. Child: Dosing is individualized; typically 80–130 mg/m² orally every 6–8 weeks, adjusted for age, weight, and toxicity.
Mannitol (Osmotic diuretic) Indications - Raised intra-ocular pressure, Cerebral edema. Avoid - Anuria, Intracranial bleeding (except during craniotomy), Severe cardiac failure, Severe dehydration, Severe pulmonary oedema. Trade names - Mannitol 250ml Inj: Dosage Forms - Injection: 10%, 15%, 20% solution Adult: 0.25–2 g/kg IV over 30–60 min; repeat every 6–8 hrs as needed, depending on condition. Child: 0.25–1 g/kg IV over 30–60 min; dosage may vary based on indication and response.
Megestrol Acetate (Progestogen, Antineoplastic)Indications - Palliative treatment of advanced breast cancer and endometrial cancer, management of anorexia, cachexia, or unexplained weight loss in patients with AIDS or cancer. Contraindications - Known hypersensitivity to megestrol or formulation components, pregnancy, active thromboembolic disorders. Caution - Use with caution in patients with diabetes (may elevate blood glucose), adrenal suppression, elderly, or history of thromboembolism. Avoid - Avoid use during pregnancy, abrupt discontinuation in cachexic patients, use in individuals with a history of clotting disorders unless justified. Trade names - Megace® Drug interaction - May interact with indinavir (reduced efficacy), warfarin (potentiated anticoagulation), corticosteroids (additive adrenal suppression). Adult: Breast cancer: 160 mg/day orally; Cachexia: 400–800 mg/day orally in single or divided doses. Child: Not routinely recommended; use only under specialist guidance if benefits outweigh risks.
Melatonin (Hypnotic, Sedative, Anxiolytic)Indications - Short-term treatment of insomnia in adults aged 55 years and older. Contraindications - Hypersensitivity to melatonin or any of its components. Caution - Use with caution in patients with autoimmune diseases, hepatic impairment, or those using CNS depressants. Avoid - Use in pregnancy and lactation unless clearly necessary; operating machinery due to possible drowsiness. Trade names - SOMINO-sleep tab:®, Natrol Melatonin 5mg tab:®, SLEEP AID tab:® Drug interaction - May interact with fluvoxamine (increased melatonin levels), anticoagulants (increased bleeding risk), CNS depressants (additive sedation). Adult: 2 mg orally once daily, 1–2 hours before bedtime, for up to 13 weeks. Child: Not routinely recommended; consult specialist if needed.
Melphalan (Antineoplastic)Indications - Multiple myeloma, Polycythaemia vera, Localised malignant melanoma of extremities, Localised soft-tissue sarcoma of extremities. Contraindications - Hypersensitivity to melphalan, Pregnancy, Lactation, Severe bone marrow suppression. Caution - Renal impairment, Previous or concurrent radiotherapy or chemotherapy, Elderly patients. Avoid - Live vaccines during treatment due to immunosuppression. Trade names - Alkeran tab:®, Alkeran inj:®, Evomela inj:® Drug interaction - May increase toxicity with ciclosporin, immunosuppressants; enhanced bone marrow suppression with other cytotoxics; reduced absorption with antacids. Adult: Oral: 150 micrograms/kg daily for 4 days; dosing may vary by protocol and indication. Child: Dose is weight-based and condition-specific; specialist consultation required.
Meperidine HCl(Pethidine HCl) (Opioid analgesic)Indications - Acute pain, Obstetric analgesia, Premedication, Post-operative pain. Contraindications - Severe respiratory insufficiency, MAOI use (within 14 days), Hypersensitivity to pethidine, Acute alcoholism, Severe hepatic impairment. Cautions - Elderly, Renal impairment, Hepatic impairment, Seizure disorders, Respiratory depression, Head injury, Hypothyroidism, Adrenal insufficiency, Prostatic hypertrophy. Avoid - Use with MAO inhibitors, long-term use due to risk of accumulation of toxic metabolite (normeperidine). Trade names - Pethidine tab:®, Pethidine inj:®, Meperitab tab:®, Demerol inj:®, Demerol tab:® Drug interaction - Additive CNS depression with alcohol, benzodiazepines, antipsychotics; serotonin syndrome with SSRIs, MAOIs; increased sedation with other opioids. Adult: 50–150 mg IM or SC every 3–4 hours as needed; oral dose is less potent. Child: 1–1.5 mg/kg IM or SC every 3–4 hours as needed (max 100 mg/dose); use with caution and only when clearly indicated.
Mercaptopurine (Antimetabolite, Immunosuppressant)Indications - Severe acute Crohn’s disease, Maintenance of remission of Crohn’s disease, Ulcerative colitis, Acute leukaemias, Chronic myeloid leukaemia. Contraindications - Hypersensitivity to mercaptopurine, Severe hepatic impairment. Cautions - Renal impairment, Hepatic impairment, Myelosuppression, TPMT deficiency, Infection risk. Avoid - Concomitant use with allopurinol unless dose of mercaptopurine is reduced; live vaccines. Trade names - tab:®, Cap:® Drug interaction - Increased toxicity with allopurinol, febuxostat; increased myelosuppression with other cytotoxic drugs; reduced efficacy with warfarin. Adult: 2.5 mg/kg daily orally or 75–100 mg/m² daily for leukemia; 1–1.5 mg/kg/day for inflammatory bowel disease. Child: 1–1.5 mg/kg/day orally, adjusted according to response and toxicity (especially in ALL treatment).
Methadone HCl (Opioid analgesic) Indications - Acute pain, Treatment of opioid dependence, Cough in palliative care. Contraindications - Respiratory depression, Acute asthma, Paralytic ileus, Known QT prolongation. Cautions - Hepatic impairment, Renal impairment, Hypothyroidism, Adrenocortical insufficiency, Prostatic hypertrophy, History of drug abuse, Elderly. Avoid - Use with MAO inhibitors or other CNS depressants. Trade names - Methadone tab:®, Methadone syrup:®, Methadone inj:® Drug interaction - Risk of QT prolongation with other QT-prolonging drugs (e.g., amiodarone), enhanced CNS depression with benzodiazepines and alcohol, metabolism affected by CYP3A4 inhibitors and inducers. Adult: For opioid dependence: initial 10–30 mg/day orally, adjusted gradually; for pain: 2.5–10 mg every 8–12 hours. Child: Use in children is specialist-guided; typically 0.1–0.2 mg/kg every 6–12 hours for pain, under close supervision.
Methionine (Hepatoprotective, Antidote) Indications - Paracetamol (acetaminophen) overdose as an alternative when N-acetylcysteine is not available or contraindicated. Contraindications - Known hypersensitivity to methionine. Cautions - Hepatic impairment, Metabolic acidosis, History of peptic ulcer. Avoid - Severe liver disease, Use in children without medical supervision. Side Effects - Nausea, Vomiting, Drowsiness, Irritability, Hypotension (rare), Acidosis (at high doses). Trade Names - Methionine tab:®, Methionine cap:® Drug Interactions - May alter the effect of other hepatotoxic drugs; limited known interactions. Adult: 2.5 g orally every 4 hours for 4 doses (total 10 g) started within 10 hours of paracetamol ingestion. Child: 1 g orally every 4 hours for 4 doses (total 4 g) for children under 6 years; weight-based dosing may be used.
Betaine (Cystadane) (Trimethylglycine) Indications - Homocystinuria (as adjunctive therapy). Contraindications - None known. Cautions - May elevate cholesterol and cause GI upset; specialist monitoring advised. Avoid - Not specified. Trade Names - Cystadane cap:®, Betafin cap:®, Betaine HCl tab:® Drug Interactions - Lowers folate/homocysteine; may interact with methionine metabolism. Adult:3 g orally twice daily. Child: Same, adjusted per body weight.
Methocarbamol (Muscle relaxant) Indications - Short-term symptomatic relief of painful musculoskeletal conditions associated with muscle spasm. Contraindications - Renal impairment, hypersensitivity to methocarbamol or related compounds. Cautions - Hepatic impairment, elderly, history of seizures, use with CNS depressants. Avoid - Alcohol and other sedatives due to additive CNS depression. Trade Names - Robaxin tab:®, Robaxin-750 tab:®, Methocarbamol cap:® Drug Interactions - May enhance effects of CNS depressants (e.g., opioids, alcohol, benzodiazepines). Adult: Initial: 1500 mg four times daily; maintenance: 1000 mg four times daily as needed. Child: Not recommended for use in children under 12 years of age.
Methylphenidate (CNS stimulant) Indications - Attention-deficit hyperactivity disorder (ADHD), Narcolepsy. Contraindications - Marked anxiety, tension, agitation, glaucoma, motor tics, Tourette’s syndrome, severe angina, severe arrhythmia. Cautions - History of drug or alcohol abuse, bipolar disorder, epilepsy, angle-closure glaucoma. Avoid - Severe cardiovascular disease, uncontrolled hypertension, hyperthyroidism, pregnancy, breastfeeding, severe depression. Side Effects - Insomnia, decreased appetite, weight loss, headache, increased blood pressure and heart rate, abdominal pain. Trade Names - Ritalin tab:®, Concerta ER tab:®, Medikinet tab:®, Methylin tab:® Drug Interactions - MAO inhibitors (risk of hypertensive crisis), antihypertensives (reduced efficacy), SSRIs (risk of serotonin syndrome). Adult: 5–10 mg 2–3 times daily, max 60 mg/day (narcolepsy); ADHD use in adults may be off-label in some regions. Child: Initially 5 mg once or twice daily, increased weekly by 5–10 mg; usual range 20–30 mg/day, max 60 mg/day.
Testosterone propionate (Androgen hormone) Indications - Androgen deficiency in males, Delayed puberty in males, Male hypogonadism, Palliative treatment of advanced breast cancer in women. Contraindications - Prostate or breast carcinoma in males, severe hepatic or renal dysfunction, pregnancy, breastfeeding. Cautions - Cardiovascular disease, epilepsy, migraine, renal or hepatic impairment, children (may accelerate bone maturation without increasing linear growth). Avoid - Prostatic hypertrophy, active malignancy, pregnancy, breastfeeding. Side Effects - Acne, gynecomastia, fluid retention, increased libido, hirsutism, mood changes, changes in cholesterol levels. Trade Names - Testoviron inj:®, Virormone inj:®, Testex Elmu Prolongatum inj:® Drug Interactions - May increase effects of oral anticoagulants; may affect blood glucose in diabetics; interacts with corticosteroids (fluid retention). Adult: 25–50 mg intramuscularly every 2–3 days; adjust based on response. Child: Delayed puberty: 25–50 mg intramuscularly every 2–4 weeks for 4–6 months under specialist supervision.
Testosterone enantate (Androgen hormone) Indications - Hypogonadism in males, delayed male puberty, metastatic breast cancer in females. Contraindications - Prostate or male breast cancer, severe hepatic or renal dysfunction, pregnancy. Cautions - Elderly, cardiovascular disease, epilepsy, migraine, sleep apnea, liver dysfunction. Avoid - Pregnancy, breastfeeding. Drug Interactions - Anticoagulants, corticosteroids, insulin, and other antidiabetic medications. Trade Names - Testoviron Depot inj:, Androderm patches: Adult: 250 mg IM every 2–3 weeks. Child: 50–100 mg IM every 2–4 weeks for 4–6 months (consult specialist).
Testosterone undecanoate (Androgen precursor, long-acting ester) Indications - Male hypogonadism (primary or secondary); testosterone deficiency symptoms. Contraindications - Prostate or breast cancer, untreated benign prostatic hyperplasia, severe heart failure, hypersensitivity. Avoid - Pregnancy, breastfeeding. Cautions - Polycythaemia, obstructive sleep apnea, urinary obstruction, cardiovascular disease, liver tumours, lipid disorders. Drug interactions - May increase effects of oral anticoagulants; caution with corticosteroids and insulin. Trade Names - Nebido IM inj (1000 mg/4 mL), Aveed IM inj, Andriol oral cap, Jatenzo oral cap, Kyzatrex oral cap Adult: IM: 1000 mg (4 mL) deep gluteal injection slowly over 2 min; repeat at 6 weeks, then every 10–14 weeks. Oral: 120–160 mg/day for 2–3 weeks, then maintenance 40–120 mg/day with food. Child: Not indicated or clinically evaluated in males under 18 years.
Oestrogen (Female sex hormone) Indications - Menopausal symptoms (e.g., atrophic vaginitis, hot flashes), hormone replacement therapy (HRT), prevention of osteoporosis in postmenopausal women, female hypogonadism, primary ovarian failure. Contraindications - Known or suspected breast cancer, estrogen-dependent tumors, undiagnosed vaginal bleeding, active or history of thromboembolic disorders, liver disease, pregnancy. Avoid - Breastfeeding, severe liver impairment. Cautions - Hypertension, diabetes mellitus, cardiovascular disease, migraine, gallbladder disease, epilepsy, asthma, family history of breast cancer. Drug Interactions - May reduce efficacy of anticoagulants, antiepileptics (e.g., phenytoin, carbamazepine), and some antibiotics (e.g., rifampicin); potentiated by CYP3A4 inhibitors. Trade Names - Premarin tab:, Estrace tab:, Progynova tab:, Estrofem tab:, Vagifem vaginal tab: Adult: Oral: 0.3–1.25 mg daily; Vaginal: 10 mcg intravaginally once daily for 2 weeks, then twice weekly. Child: Individualized in cases of delayed puberty or estrogen deficiency; specialist supervision required.
Conjugated oestrogens with medroxyprogesterone (Hormone Replacement Therapy - HRT) Indications - Management of moderate to severe vasomotor symptoms associated with menopause in women with an intact uterus; prevention of postmenopausal osteoporosis. Contraindications - Known or suspected estrogen- or progesterone-dependent malignancy, active or past thromboembolic disorders, undiagnosed abnormal genital bleeding, liver dysfunction or disease, pregnancy. Avoid - Breastfeeding, known hypersensitivity to estrogens or progestins. Cautions - Cardiovascular disease, hypertension, diabetes, gallbladder disease, epilepsy, asthma, migraine, family history of breast cancer. Drug Interactions - May interact with CYP3A4 inducers (e.g., phenytoin, carbamazepine, rifampin) reducing efficacy; caution with anticoagulants and thyroid hormone therapy. Trade Names - Prempro tab:, Duavee tab:, Activella tab: Adult: Oral: Conjugated estrogen 0.625 mg + medroxyprogesterone acetate 2.5 or 5 mg once daily. Child: Not recommended for pediatric use.
Mexiletine HCl (Antiarrhythmic, Sodium Channel Blocker) Indications - Myotonia in non-dystrophic myotonic disorders; Ventricular arrhythmias (off-label use). Contraindications - Cardiogenic shock, severe sinoatrial, atrioventricular, or intraventricular block (without pacemaker), hypersensitivity to mexiletine. Cautions - Hepatic impairment, seizure disorders, heart failure, conduction abnormalities, electrolyte imbalances. Avoid - Pregnancy (unless clearly needed), breastfeeding (caution advised). Drug Interactions - May interact with antiarrhythmics, beta-blockers, CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine), theophylline, and caffeine. Trade Names - Mexitil Cap:, Mexon Cap:, Naquidex Cap:, Mexitina Cap: Adult: Oral: Initially 200–250 mg every 8 hours; maintenance 200–300 mg three times daily. Max: 1200 mg/day. Child: Not routinely recommended; specialist consultation required.
Meropenem (Carbapenem Antibiotic) Indications - Broad-spectrum antibiotic used for chronic lower respiratory tract infections, bacterial meningitis, intra-abdominal infections, septicaemia, skin and soft tissue infections, and endocarditis. Contraindications - Hypersensitivity to meropenem or other beta-lactam antibiotics. Cautions - Renal impairment, history of seizures, central nervous system disorders. Avoid - Breastfeeding (caution advised), hypersensitivity reactions. Drug Interactions - May interact with valproic acid (reduced serum levels), probenecid (increased serum meropenem levels). Trade Names - Meronem Inj:, Meropen Inj:, Meroxan Inj:, Merotrol Inj: Adult: Usual dose: 500 mg to 1 g every 8 hours IV; meningitis: 2 g every 8 hours. Child: 20–40 mg/kg every 8 hours IV; meningitis: 40 mg/kg every 8 hours (max 2 g).
Anhydrous Meropenem (Carbapenem Antibiotic) Indications - Abdominal sepsis, adult febrile neutropenia, gynecological infections, meningitis, obstetric infections, pneumonia, serious infections, pulmonary infections in cystic fibrosis. Contraindications - Hypersensitivity to meropenem or other beta-lactam antibiotics. Cautions - Renal impairment, history of seizures, central nervous system disorders. Avoid - Hypersensitivity reactions, breastfeeding (if unavoidable, use with caution). Drug Interactions - May reduce serum levels of valproic acid; interaction with probenecid may increase meropenem levels. Trade Names - Q-PEM Powder for Inj:, Eupen 1g Powder for Inj: (IV/IV infusion), Mepran-1000 IV Powder for IV infusion Adult: 500 mg to 1 g every 8 hours IV; for meningitis: 2 g every 8 hours. Child: 20–40 mg/kg every 8 hours IV; for meningitis: 40 mg/kg every 8 hours (max 2 g).
Midazolam (Hypnotic, Sedative, Anxiolytic) Indications - Epilepsy, conscious sedation for procedures, premedication before anesthesia, sedation in intensive care, convulsions in palliative care. Contraindications - Hypersensitivity to benzodiazepines, acute narrow-angle glaucoma. Cautions - Hepatic impairment, renal impairment, respiratory disorders, cardiac disease, elderly, debilitated patients, hypothermia, children with cardiovascular impairment. Avoid - Severe respiratory depression, CNS depression, breast feeding. Drug Interactions - Potentiated by CNS depressants (e.g., opioids, alcohol), erythromycin, ketoconazole, verapamil; reduced effect with theophylline. Trade Names - Dormicum inj:, Midacum inj:, Hypnovel inj: Adult: Sedation: 2.5–5 mg IV slowly; anesthesia: 0.15–0.2 mg/kg IV. Dose varies with indication. Child: 0.05–0.1 mg/kg IV or IM; max dose varies by indication and weight.
Mirtazapine (Antidepressant) Indications - Major depressive disorder, especially with associated anxiety or insomnia. Contraindications - Hypersensitivity to mirtazapine or any component of the formulation. Cautions - Cardiac disorders, diabetes mellitus, elderly patients, hypotension, history of bipolar disorder, history of seizures, history of urinary retention, pregnancy, breastfeeding, hepatic or renal impairment. Avoid - Use with MAO inhibitors, abrupt withdrawal. Side Effects - Sedation, increased appetite, weight gain, dry mouth, dizziness, constipation. Drug Interactions - MAO inhibitors, CNS depressants, alcohol, CYP inhibitors (e.g. fluvoxamine), CYP inducers (e.g. carbamazepine). Trade Names - Remeron® tab:, Mirtaz® tab:, Mirtazapine Actavis® tab: Adult: Oral 15–30 mg once daily (preferably at bedtime); may be increased up to 45 mg/day based on response. Child: Not routinely recommended in children under 18 years due to lack of safety data and increased risk of suicidal ideation.
Mitotane (Antineoplastic) Indications - Symptomatic treatment of advanced or inoperable adrenocortical carcinoma. Contraindications - Hypersensitivity to mitotane or any component of the formulation. Cautions - Hepatic impairment, renal impairment, CNS disorders, hypothyroidism, prolonged use in elderly. Avoid - Use in acute porphyrias, pregnancy, and breastfeeding. Side Effects - Nausea, vomiting, dizziness, CNS depression, ataxia, rash, lethargy, adrenal insufficiency. Drug Interactions - CYP3A4 inducers/inhibitors, anticoagulants (e.g. warfarin), CNS depressants, hormonal agents (especially corticosteroids). Trade Names - Lysodren® tab:, Mitotane Eusa® tab: Adult: Oral: Start with 2–6 g/day in divided doses; may increase gradually to 8–10 g/day based on tolerance and response. Maintenance usually 2–6 g/day. Child: Dose not well established; consult specialist. Use with caution and only in specialist centers.
Mitoxantrone (Antineoplastic) Indications - Metastatic breast cancer, Non-resectable primary hepatocellular carcinoma, Non-Hodgkin's lymphoma, Adult acute non-lymphocytic leukemia, Progressive multiple sclerosis. Contraindications - Hypersensitivity to mitoxantrone, existing myelosuppression, severe hepatic impairment, severe cardiac impairment. Cautions - Cardiac disease, prior anthracycline therapy, hepatic dysfunction, bone marrow suppression, infection risk. Avoid - Pregnancy, breastfeeding, live vaccines during treatment. Side Effects - Myelosuppression, cardiotoxicity, nausea, vomiting, alopecia, menstrual disorders, infections. Drug Interactions - Other myelosuppressive agents, cardiotoxic drugs (e.g., doxorubicin), vaccines, CYP450 inhibitors. Trade Names - Novantrone® inj:, Onkotrone® inj: Adult: IV: 12–14 mg/m² every 21 days (for cancer); 12 mg/m² every 3 months (for MS), adjusted based on response and toxicity. Child: Use with caution; dose based on BSA and specialist supervision required.
Naltrexone HCl (Opioid antagonist) Indications - Adjunct in preventing relapse in opioid dependence, Alcohol dependence, Obesity (investigational), Adjunct in some antidepressant regimens. Contraindications - Acute hepatitis, Severe hepatic impairment, Current opioid use or opioid withdrawal, Hypersensitivity to naltrexone. Avoid - Uncontrolled hypertension, Hepatic impairment, Renal impairment. Cautions - History of depression or suicidal ideation, Mania, Liver disease, Hypertension. Drug Interactions - Opioid analgesics (e.g. morphine, codeine), Antidiarrheals containing opioids (e.g. loperamide), Disulfiram (risk of hepatotoxicity), Other CNS agents. Side Effects - Nausea, headache, dizziness, fatigue, anxiety, liver enzyme abnormalities, insomnia. Trade Names - Revia® tab:, Nalorex® tab:, Vivitrol® inj: (Initiate under specialist supervision) Adult: Oral: 25 mg once daily initially (test dose), then 50 mg once daily. Child: Not routinely recommended; consult specialist if used.
Nandrolone (Anabolic steroid) Indications - Osteoporosis in postmenopausal women (not recommended routinely), certain types of anaemia, adjunct in wasting syndromes (e.g. HIV-related cachexia), convalescence in some chronic diseases. Contraindications - Male breast cancer, prostate cancer, pregnancy, nephrosis, hypercalcemia, severe hepatic impairment. Cautions - Cardiovascular disease, epilepsy, migraine, children (premature epiphyseal closure), elderly (risk of prostatic hypertrophy), hepatic dysfunction. Avoid - Use in pregnancy and breastfeeding, active or suspected hormone-dependent tumors. Side Effects - Acne, fluid retention, virilization in women, hepatotoxicity, changes in libido, voice deepening, menstrual irregularities, growth disturbances in children. Drug Interactions - Anticoagulants (increased effect), insulin (may require dose adjustment), hepatotoxic drugs, corticosteroids (increased edema risk). Trade Names - Deca-Durabolin® Inj: (25 mg/mL, 50 mg/mL), Dynabolon® Inj:, Retabolil® Inj: Adult: 50 mg deep intramuscular injection every 3 weeks for osteoporosis; up to 100–200 mg weekly for other indications (under specialist supervision). Child: Not routinely recommended; specialist use only in selected cases with close monitoring.
Sumatriptan (Selective 5-HT1 receptor agonist) Indications - Acute treatment of migraine attacks with or without aura, Cluster headache. Contraindications - Ischaemic heart disease, cerebrovascular disease, peripheral vascular disease, uncontrolled hypertension, severe hepatic impairment, use with ergotamine or MAOIs. Cautions - Hepatic/renal impairment, history of seizures, risk factors for coronary artery disease, elderly patients. Avoid - Concurrent use with SSRIs, SNRIs, ergot derivatives; pregnancy and breastfeeding unless essential. Side Effects - Chest discomfort, flushing, dizziness, fatigue, nausea, paresthesia, elevated blood pressure, throat tightness. Drug Interactions - MAOIs, SSRIs, ergot alkaloids, lithium, linezolid. Trade Names - Imitrex® tab/inj/nasal spray, Suminat® tab: 50 mg, 100 mg, Sumitrex® tab: Adult: Oral: 50–100 mg at onset of migraine; may repeat after ≥2 hours if needed (max: 300 mg/day). Subcutaneous: 6 mg, may repeat once after ≥1 hour (max: 12 mg/day). Child: Not routinely recommended; use under specialist guidance in adolescents ≥12 years for migraine (oral 25–50 mg in some cases).
Butylscopolamine (Antispasmodic, Anticholinergic) Indications - Abdominal cramps, Irritable bowel syndrome, Ureteric or biliary colic, Gastrointestinal spasm, Diarrhoea, Urinary obstruction. Contraindications - Myasthenia gravis, Megacolon, Narrow-angle glaucoma, Tachycardia, Prostatic hypertrophy. Cautions - Elderly, Renal/hepatic impairment, Cardiovascular disorders. Avoid - Use in children under 6 years without medical advice, Breastfeeding. Drug Interactions - Other anticholinergics, tricyclic antidepressants, antihistamines, antipsychotics, opioids (may increase risk of paralytic ileus). Trade Names - Buscopan® tab/inj, Spanil® tab Adult: Oral: 10–20 mg 3–5 times daily. Parenteral (IM/IV): 20 mg 1–2 times daily. Child: Children >6 years: Oral 10 mg 3 times daily. Parenteral (IM): 0.3–0.6 mg/kg/day in divided doses.
Nitrofurantoin (Antibiotic - urinary antiseptic)Indications - Uncomplicated urinary-tract infections, prophylaxis of recurrent UTIs. Contraindications - Creatinine clearance < 45 mL/min, anuria, oliguria, neonatal period (< 3 months), previous nitrofurantoin-induced hepatic dysfunction, G6PD deficiency with haemolysis, hypersensitivity to nitrofurantoin. Cautions - Elderly, diabetes, anaemia, pulmonary disease, peripheral neuropathy, hepatic impairment, vitamin B deficiency. Avoid - Late pregnancy (≥ 38 weeks) and labour (neonatal haemolysis risk), breastfeeding if infant is G6PD-deficient. Drug Interactions - Antacids (decreased absorption), probenecid & sulfinpyrazone (decreased renal clearance), live typhoid vaccine (decreased efficacy). Trade Names - Macrobid® cap, Furadantin® tab, Uvamin® cap Adult: 100 mg MR every 12 h for 5–7 days (acute); 50–100 mg at bedtime (prophylaxis). Child: ≥ 3 months: 5–7 mg/kg/day in 4 divided doses (acute); 1 mg/kg once daily (prophylaxis).
Methenamine Hippurate, Hexamine Hippurate (Urinary antiseptic)Indications - Prophylaxis and long-term treatment of lower urinary tract infections. Contraindications - Severe renal impairment, severe hepatic impairment, dehydration, metabolic acidosis, gout, sulfa allergy (if combined with sulfonamides). Avoid - Gout, metabolic acidosis, severe dehydration, pregnancy, hepatic impairment, renal impairment. Cautions - Elderly, concurrent sulfonamides, low urinary acidity. Drug Interactions - Sulfonamides (increased risk of crystalluria), urinary alkalinizers (decreased efficacy), live typhoid vaccine. Trade Names - Hiprex® tab, Uro-Tac® tab, Methiprex® tab Adult: 1 g twice daily, taken after meals and at bedtime. Child: 6–12 years: 500 mg twice daily; <6 years: not recommended.
Nizatidine (H2-receptor antagonist)Indications - Benign gastric ulcer, Duodenal ulcer, NSAID-associated ulceration, Gastro-oesophageal reflux disease (GORD). Contraindications - Known hypersensitivity to nizatidine or other H2-receptor antagonists. Avoid - Pregnancy (unless clearly necessary). Cautions - Hepatic impairment, reduce dose in renal impairment. Drug Interactions - May affect absorption of drugs dependent on gastric pH (e.g., ketoconazole, atazanavir), risk with warfarin (monitor INR). Trade Names - Axid® tab, Nizac® cap, Zidine® tab Adult: 150 mg twice daily or 300 mg once at bedtime, for up to 8 weeks depending on indication. Child: Not routinely recommended (safety and efficacy not established).
Nystatin (Polyene antifungal)Indications - Candidiasis including oral thrush (oral candidiasis), intestinal candidiasis, vaginal candidiasis, cutaneous candidiasis (skin fungal infections). Contraindications - Hypersensitivity to Nystatin or any component of the formulation. Avoid - Systemic use (not absorbed from gastrointestinal tract), avoid use in eye. Cautions - Prolonged use may result in overgrowth of non-susceptible organisms. Drug Interactions - No significant systemic interactions due to minimal absorption. Trade Names - Exovate-N® cream, Mycostatin® oral suspension, Nilstat® vaginal tablet, Mytrex® cream Adult: Oral: 100,000–400,000 units 4 times daily; Topical: apply to affected area 2–4 times daily; Vaginal: 100,000 units daily at bedtime for 14 days. Child: Oral suspension: 100,000 units 4 times daily (infants and children); Topical: apply 2–4 times daily as needed.
Olsalazine Sodium (Anti-inflammatory, Aminosalicylate) Indications - Mild ulcerative colitis, Maintenance of remission of mild ulcerative colitis. Contraindications - Hypersensitivity to salicylates, severe renal or hepatic impairment, intestinal obstruction. Avoid - Use in pregnancy unless essential. Cautions - Renal impairment, hepatic impairment, breast feeding. Drug Interactions - May interact with other nephrotoxic agents, anticoagulants, and salicylates. Trade Names - Dipentum® 250 mg cap Adult: Oral 500 mg twice daily, may increase to 1 g twice daily if needed. Child: Not generally recommended; safety and efficacy not established.
Oxazepam (Sedative, Hypnotic - Benzodiazepine) Indications - Anxiety, Insomnia, Alcohol withdrawal syndrome. Contraindications - Severe respiratory insufficiency, sleep apnea syndrome, myasthenia gravis, hypersensitivity to benzodiazepines. Avoid - Obesity, respiratory depression, hyperkinesis, phobic states, breast feeding. Cautions - Muscle weakness, organic brain changes, renal impairment, hepatic impairment, elderly, history of substance abuse. Drug Interactions - CNS depressants, alcohol, opioids, antipsychotics, antidepressants, antihistamines. Trade Names - Serapax® tab, Serepax® cap Adult: Anxiety: 10–15 mg up to 3–4 times/day. Insomnia: 15–25 mg at bedtime. Child: Not generally recommended; use only under specialist advice.
Racecadotril (Antidiarrhoeal) Indications - Symptomatic treatment of uncomplicated acute diarrhoea. Contraindications - Hypersensitivity to Racecadotril or any component of the formulation. Avoid - Antibiotic-associated diarrhoea, pregnancy, breast feeding, children under 3 months. Cautions - Hepatic impairment, renal impairment, dehydration, prolonged or bloody diarrhea. Drug Interactions - No significant interactions reported; caution with ACE inhibitors due to angioedema risk. Trade Names - Hidrasec® granules, Tiorfan® capsules Adult: 100 mg capsule three times daily before meals until diarrhea stops (maximum 7 days). Child: 1.5 mg/kg per dose three times daily before meals (dose form: granules).
Pamidronate Disodium (Bisphosphonate) Indications - Hypercalcaemia of malignancy, osteolytic lesions and bone pain in bone metastases associated with breast cancer or multiple myeloma, Paget’s disease of bone. Contraindications - Hypersensitivity to bisphosphonates. Avoid - Pregnancy, breast feeding. Cautions - Hepatic impairment, cardiac disease, renal impairment, atypical femoral fractures, dental procedures (risk of osteonecrosis of jaw). Drug Interactions - Aminoglycosides, loop diuretics, NSAIDs (increased nephrotoxicity risk). Trade Names - Aredia® IV infusion, Pamitor® IV injection Adult: 15–90 mg IV infusion over 2–24 hours depending on indication and severity; repeat every 3–4 weeks as needed. Child: Not routinely recommended; specialist use only.
Lipase (Pancreatic enzyme supplement) Indications - Pancreatic exocrine insufficiency (e.g., cystic fibrosis, chronic pancreatitis, pancreatic surgery). Avoid - Acute pancreatitis, hypersensitivity to pork proteins. Cautions - Monitor for fibrosing colonopathy with high doses in children, ensure adequate hydration. Trade Names - cap, tab: Creon®, Nutrizym®, Pancrease® Adult: Individualized dosing based on lipase units per meal/snack (e.g., 25,000–80,000 units with meals). Child: Dosing based on weight and age; typically 500–2,500 units/kg/meal.
Gamolenic acid (Omega-6 fatty acid supplement) Indications - Mastalgia (cyclical breast pain), Atopic eczema (adjunct), Other conditions with suspected essential fatty acid deficiency. Avoid - Bleeding disorders (caution with anticoagulants), Epilepsy (high doses may lower seizure threshold). Cautions - Monitor in patients with epilepsy, Use with caution in those taking anticoagulants. Trade Names - cap: Efamast®, evening primrose oil products Adult: Usually 160–240 mg daily (in divided doses), depending on product and indication. Child: Doses vary; not routinely recommended without specialist advice.
Thioguanine (Tioguanine) (Antineoplastic)Indications - Acute leukaemia, Chronic myeloid leukaemia. Contraindications - Hypersensitivity to thioguanine, Severe hepatic impairment, Pregnancy, Breastfeeding. Cautions - Hepatic impairment, Bone marrow suppression, Infection risk. Avoid - Pregnancy, Breastfeeding, Live vaccines. Trade names - Lanvis® tab, Tioguanine® tab Drug interactions - Allopurinol (may increase toxicity), Warfarin, Other myelosuppressive agents. Adult: 2 mg/kg/day orally; dosage individualized. Child: 2–3 mg/kg/day orally under specialist guidance.
Procaine Penicillin G (Long-acting penicillin antibiotic)Indications - Syphilis, Rheumatic fever prophylaxis, Streptococcal infections (when prolonged low-dose therapy is needed). Contraindications - Penicillin hypersensitivity. Avoid - Severe renal impairment without dose adjustment. Cautions - Monitor for allergic reactions, Use caution in renal impairment, CNS effects with high doses. Trade names - inj: Crysticillin®, Inj: Wycillin® (Specialist use may be required) Drug interactions - Methotrexate (increased toxicity), Oral contraceptives (reduced effectiveness), Probenecid (increased levels), Tetracyclines (antagonistic effect). Adult: 600,000 to 1.2 million units IM daily or as a single dose depending on indication. Child: Dosed by weight and indication (e.g., 50,000 units/kg/day IM).
Mifepristone (Antiprogestogen)Indications - Medical termination of intrauterine pregnancy, Cervical ripening prior to surgical abortion, Cushing’s syndrome (unlicensed use). Contraindications - Chronic adrenal failure, Ectopic pregnancy, Hemorrhagic disorders, Inherited porphyria, Long-term corticosteroid use, Allergy to mifepristone. Avoid - Severe uncontrolled asthma, Ongoing pregnancy (if continuation is intended). Cautions - Bleeding disorders, Anticoagulant therapy, Hepatic or renal impairment, Cardiovascular disease. Trade names - tab: Mifegyne®, Korlym® (for Cushing’s) (Specialist use only) Drug interactions - CYP3A4 inhibitors (e.g., ketoconazole, erythromycin increase mifepristone levels), CYP3A4 inducers (e.g., rifampicin reduce effectiveness), corticosteroids (antagonism), anticoagulants (increased bleeding risk). Adult: 200 mg orally as a single dose (for pregnancy termination, followed by misoprostol); up to 600 mg/day for Cushing’s syndrome (specialist only). Child: Not recommended.
Misoprostol (Prostaglandin E1 analogue)Indications - Benign gastric ulcer, Benign duodenal ulcer, NSAID-induced peptic ulcer, Medical termination of pregnancy following mifepristone (gestation up to 49 days), Induction of labour, Cervical ripening prior to surgical abortion, Postpartum hemorrhage prevention and treatment. Contraindications - Confirmed or suspected ectopic pregnancy (when used for abortion), Hypersensitivity to prostaglandins, Cardiovascular disease (relative contraindication), History of cesarean section or uterine surgery (for labor induction). Avoid - Pregnancy (when used for gastric ulcer treatment), Breast feeding (with high doses or repeated use in postpartum settings). Cautions - Renal or hepatic impairment, Inflammatory bowel disease, Elderly (for ulcer treatment), Multiple gestation or uterine scarring (for obstetric use). Trade names - tab: MITHOEASE® 0.2 mg, Cynomax® (Under specialist supervision in hospital) Drug interactions - Oxytocin (may increase risk of uterine rupture when used concurrently), NSAIDs (reduce gastroprotective effect), Magnesium-containing antacids (may worsen diarrhea). Adult: For ulcer prevention: 200 mcg 2–4 times daily with food; For pregnancy termination: 800 mcg vaginally or sublingually after mifepristone; For labor induction: 25 mcg vaginally every 4–6 hours (specialist use). Child: Not recommended for pediatric use.
Pergolide (Dopamine receptor agonist – ergoline derivative)Indications - Parkinson’s disease (adjunct to levodopa, in countries where still approved), Hyperprolactinaemia (off-label), Restless Legs Syndrome (off-label), Equine Cushing’s Disease (veterinary use). Contraindications - Hypersensitivity to ergoline derivatives, History of cardiac valvulopathy, Pulmonary, retroperitoneal or pericardial fibrosis. Avoid - Pregnancy, Breastfeeding, Uncontrolled hypertension, Use in children. Cautions - Monitor for cardiac valvular disease (echocardiography recommended), History of psychiatric illness, Impulse control disorders, Hepatic or renal impairment. Drug interactions - Additive effects with dopamine agonists, Increased risk of hypotension with antihypertensives, Possible antagonism with dopamine antagonists (e.g., antipsychotics). Trade names - tab: Celance®, Permax®, Nopar®, Parkotil®, Pharken®, Prascend® (veterinary) (Specialist use only; human use withdrawn in some countries) Adult: Initially 50 mcg daily, increased gradually to maintenance dose of 0.15–1.5 mg/day in divided doses; maximum 5 mg/day (Parkinson’s disease). Child: Not recommended. Veterinary dose - 2–4 mcg/kg orally once daily (e.g., for equine Cushing's disease – Prascend®).
Phenoxybenzamine HCl (Alpha‑adrenergic blocker)Indications - Phaeochromocytoma (preoperative blood pressure control), malignant hypertension due to catecholamine‑secreting tumors. Contraindications - Hypersensitivity to phenoxybenzamine; significant hypotension. Avoid - Congestive heart failure, history of cerebro‑ or cardiovascular accident. Cautions - Elderly; cardiovascular disease; monitor blood pressure; hepatic or renal impairment; pregnancy, lactation—use only if benefits outweigh risks. Trade names - tab: Dibenzyline®, Dibenyline®; cap: Dibenzyran®; inj: Fenoxene® Drug interactions - Enhanced hypotensive effect with other antihypertensives; may interact with epinephrine/phenylephrine; use caution with alcohol. Adult: Initially 10 mg orally twice daily, titrate up to 20–40 mg twice daily based on response. Child: 0.2 mg/kg/day in divided doses under specialist supervision.
Neostigmine (Anticholinesterase – specialist use may be required)Indications - Myasthenia gravis, reversal of non-depolarising neuromuscular blockade, postoperative urinary retention, abdominal distension. Avoid - Mechanical obstruction of gastrointestinal or urinary tract, peritonitis. Cautions - Bradycardia, asthma, epilepsy, peptic ulcer disease, vagotonia. tab: Prostigmin®; inj: Neostigmine methylsulfate (generic) (Specialist use may be required) Adult: : 0.5–2.5 mg IM/SC every 2–3 hours for myasthenia; 2.5 mg IV with atropine for reversal of blockade. Child:: Dose by weight and indication (e.g., 0.02–0.07 mg/kg IV with atropine for blockade reversal).
Distigmine Bromide (Anticholinesterase)Indications - Chronic constipation due to neurogenic bowel, urinary retention due to hypotonia of the bladder. Contraindications - Mechanical gastrointestinal or urinary obstruction, asthma, bradycardia, epilepsy, hypersensitivity to distigmine. Cautions - Monitor for cholinergic crisis, hepatic or renal impairment, peptic ulcer, elderly (increased sensitivity). Avoid - Mechanical gastrointestinal or urinary obstruction, asthma, bradycardia, epilepsy. Trade names - Ubretid® tab:, Distigmine® tab:, Bromostigmine® tab: Drug Interactions - Anticholinergics, muscle relaxants, beta-blockers, corticosteroids. Adult: : 5 mg once daily or on alternate days (maintenance dose). Child:: Not recommended.
Sulfinpyrazone (Uricosuric agent)Indications - Chronic gout, hyperuricaemia. Contraindications - Active peptic ulcer, blood dyscrasias, severe renal impairment, hypersensitivity to sulfinpyrazone. Cautions - Monitor renal function, use with care in patients with history of peptic ulcer or renal stones. Avoid - Active peptic ulcer, severe renal impairment. Trade names - Anturanetab:® tab:, Sulfinid® tab:, Urazene® tab: Drug Interactions - Anticoagulants, aspirin, diuretics, other uricosuric agents. Adult: : 200–400 mg twice daily after meals; maintenance 200–800 mg daily in divided doses. Child:: Not recommended.
Physostigmine Salicylate (Anticholinesterase )Indications - Reversal of anticholinergic toxicity (e.g., atropine or tricyclic antidepressant overdose), Glaucoma (rare or historic use). Contraindications - Asthma, cardiovascular disease, mechanical gastrointestinal or urinary tract obstruction, diabetes, gangrene. Cautions - Seizure risk, bradycardia, Parkinsonism, peptic ulcer disease, epilepsy, and extreme caution in elderly; monitor cardiac status closely. Avoid - Use in patients with known hypersensitivity, severe asthma, or mechanical obstruction of bowel or bladder. Trade names - inj: Antilirium® Drug Interactions - Cholinergic agents (additive effects), anticholinergics (opposing effects), beta-blockers (enhanced bradycardia), neuromuscular blockers. Adult: : 0.5–2 mg IV slowly over at least 5 minutes; repeat every 10–30 minutes if needed; max dose typically 2 mg per administration. Child:: 0.02 mg/kg IV slowly over 5 minutes; max single dose 0.5 mg; repeat every 10–30 minutes as required (under specialist supervision).
Piroxicam (Nonsteroidal anti-inflammatory drug - NSAID)Indications - Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis. Contraindications - Active peptic ulcer, History of gastrointestinal bleeding or perforation, Severe heart failure, Severe hepatic or renal impairment, Known hypersensitivity to NSAIDs. Cautions - Elderly (higher risk of GI and renal adverse effects), Hypertension, Asthma, Cardiovascular disease, Hepatic dysfunction, History of GI disorders, Concurrent use of anticoagulants or corticosteroids. Avoid - Use in patients with known NSAID allergy, third trimester of pregnancy, and during breastfeeding unless advised by specialist. Trade names - tab: Feldene®, cap: Brexin®, gel: Feldene Gel® Drug interactions - Anticoagulants (increased bleeding risk), Corticosteroids (increased GI ulceration), ACE inhibitors and diuretics (decreased renal function), Lithium and Methotrexate (increased toxicity), SSRIs. Adult: : 20 mg once daily (may be reduced to 10 mg daily for maintenance or if GI risks are high). Child:: Not recommended due to safety concerns and lack of data.
Betaxolol (Beta-blocker)Indications - Hypertension, Ocular hypertension, Chronic open-angle glaucoma. Contraindications - Severe bradycardia, Second- or third-degree AV block (without pacemaker), Cardiogenic shock, Uncontrolled heart failure, Severe asthma or history of bronchospasm, Hypersensitivity to betaxolol. Cautions - Diabetes mellitus (may mask hypoglycemia), Peripheral vascular disease, Myasthenia gravis, Renal or hepatic impairment, History of severe allergic reactions. Avoid - Abrupt withdrawal, Use in patients with severe reactive airway disease, and combination with other beta-blockers unless closely monitored. Trade names - Kerlone tab:®; Betoptic eye drops:®, Betoptic S eye drops:® Drug interactions - Verapamil, Diltiazem (increased bradycardia risk), Clonidine (hypertensive rebound if stopped), Amiodarone (increased bradycardia/AV block), Insulin and oral hypoglycemics (may mask symptoms of hypoglycemia), Other beta-blockers (increased risk of additive effects). Adult: : 10–20 mg orally once daily (for systemic use); 1 drop of 0.5% or 0.25% ophthalmic solution in affected eye twice daily (for ocular use). Child:: Not recommended for systemic or ophthalmic use without specialist supervision.
Prazosin HCl (Alpha-1 adrenergic blocker)Indications - Hypertension, Raynaud’s phenomenon, Benign prostatic hyperplasia (off-label). Contraindications - History of postural hypotension, Hypersensitivity to prazosin or other quinazolines. Cautions - Elderly, Heart failure, Renal impairment, Monitor for first-dose hypotension (especially with initial dose or dose increases). Avoid - Abrupt position changes after dosing (to reduce risk of syncope), Use in patients with known orthostatic hypotension. Trade names - Minipress tab:®; Prazopress tab:®; Vasofix tab:® Drug interactions - Other antihypertensives (additive hypotensive effect), Beta-blockers, Phosphodiesterase type 5 inhibitors (e.g. sildenafil – increased hypotension risk), NSAIDs (may reduce antihypertensive effect), Alcohol (increased sedation and hypotension). Adult: : Initially 0.5 mg at bedtime, gradually increased to 1–5 mg two or three times daily depending on response. Child:: Not routinely recommended; use only under specialist supervision if required.
Pregabalin (Anticonvulsant / Neuropathic pain agent)Indications - Epilepsy (adjunctive therapy for partial seizures), Generalised anxiety disorder, Neuropathic pain (e.g. diabetic neuropathy, postherpetic neuralgia), Fibromyalgia. Contraindications - Hypersensitivity to pregabalin or any excipient in the formulation. Cautions - Renal impairment (dose adjustment required), History of substance use disorder (risk of abuse and dependence), Monitor for suicidal thoughts or behavior, Avoid abrupt discontinuation (risk of withdrawal symptoms), Elderly (increased risk of dizziness and falls). Avoid - Pregnancy unless benefit outweighs risk, Concomitant use with strong CNS depressants without supervision. Trade names - cap: Lyrica®; Pregaba-M cap:®; Nervalin cap:®; Alzain cap:® Drug interactions - CNS depressants (e.g., opioids, benzodiazepines, alcohol – additive sedation), Antihistamines, Thiazolidinediones (increased risk of fluid retention), May potentiate effects of other sedating drugs. Adult: : Initial dose 150 mg/day in 2–3 divided doses; may increase to 300–600 mg/day based on response and tolerability. Child:: Not recommended (safety and efficacy not established).
Procarbazine (Alkylating agent – antineoplastic)Indications - Hodgkin’s lymphoma (as part of combination chemotherapy, e.g., MOPP regimen), Brain tumors (e.g., gliomas – off-label). Contraindications - Severe hepatic or renal impairment, Bone marrow suppression, Pregnancy and breastfeeding, Hypersensitivity to procarbazine. Cautions - Hepatic or renal impairment, Elderly patients, History of seizures, Alcohol use (disulfiram-like reaction), Monitor blood counts closely. Avoid - Tyramine-rich foods, Alcohol, MAO inhibitors, and other serotonergic drugs. Trade names - Natulan cap:®; Procarbazine Hydrochloride cap:® Drug interactions - Alcohol (may cause disulfiram-like reaction), MAO inhibitors (risk of hypertensive crisis), SSRIs and TCAs (serotonin syndrome risk), Sympathomimetics, Tyramine-containing foods (increased hypertensive crisis risk), CNS depressants. Adult: : Dosing varies with regimen; e.g., 100 mg/m² daily for 14 days as part of MOPP protocol. Child:: Dosing individualized by specialist based on weight, surface area, and regimen – specialist supervision required.
Prochlorperazine (Dopamine antagonist – antiemetic, antipsychotic)Indications - Nausea and vomiting, Vertigo, Schizophrenia, Acute psychosis, Short-term anxiety management. Contraindications - Comatose states, CNS depression, Pheochromocytoma, Severe liver disease, Bone marrow suppression, Children under 1 year (except under specialist advice for chemotherapy-induced nausea/vomiting). Cautions - Elderly, Parkinson’s disease, Epilepsy, Cardiovascular disease, Hepatic impairment, History of QT prolongation. Avoid - Abrupt withdrawal after high-dose or prolonged use, Use in dementia-related psychosis in elderly (increased mortality risk), Combination with other QT-prolonging agents. Trade names - Stemetil tab:®, Stemetil inj:®, Stemetil buccal:® Drug interactions - CNS depressants (e.g. alcohol, opioids, benzodiazepines), Anticholinergics (increased anticholinergic effects), Antihypertensives (increased hypotension), QT-prolonging agents (e.g. amiodarone, sotalol). Adult: : 5–10 mg orally 2–3 times daily for nausea/vertigo; up to 100 mg/day in divided doses for psychosis. Child:: 250 mcg/kg orally 2–3 times daily (for nausea/vomiting, under specialist supervision).
Propofol (General anaesthetic – IV)Indications - Induction and maintenance of general anaesthesia, Sedation for ventilated patients in intensive care, Procedural sedation. Contraindications - Hypersensitivity to propofol or any excipients (e.g. soy, egg lecithin), Disorders of fat metabolism, Pregnancy (unless essential). Cautions - Elderly, Hypovolaemia, Cardiac, hepatic, or renal impairment, Increased intracranial pressure, Lipid metabolism disorders, Respiratory depression risk. Avoid - Use outside of hospital or specialist settings, Rapid bolus in elderly or hypovolaemic patients. Trade names - Diprivan inj:®, Propofol-Lipuro inj:®, Fresofol inj:® (Specialist use only) Drug interactions - CNS depressants (e.g. opioids, benzodiazepines, alcohol), Anaesthetic agents, Antihypertensives (increased hypotension risk), Muscle relaxants. Adult: : Induction: 1.5–2.5 mg/kg IV; Maintenance: 4–12 mg/kg/hour IV infusion. Child:: Specialist use only; typical induction dose: 2.5–3.5 mg/kg IV (adjust per age and indication).
Brinzolamide (Carbonic anhydrase inhibitor – ophthalmic)Indications - Ocular hypertension, Open-angle glaucoma. Contraindications - Severe renal impairment (CrCl < 30 mL/min), Hyperchloraemic acidosis, Hypersensitivity to brinzolamide or sulfonamides. Cautions - Hepatic impairment, Corneal abnormalities, Avoid use with contact lenses (contains benzalkonium chloride), Long-term use (monitor for corneal effects). Avoid - Use in neonates or infants, Simultaneous use of systemic and topical carbonic anhydrase inhibitors unless necessary. Trade names - Azopt eye drops:®, Simbrinza eye drops:® (with brimonidine) Drug interactions - Other carbonic anhydrase inhibitors (increased systemic effects), Salicylates (increased acidosis risk), Topical beta-blockers or other antiglaucoma agents (monitor intraocular pressure). Adult: : 1 drop in affected eye(s) twice daily; some may require 3 times daily. Child:: Not recommended under 18 years (safety and efficacy not established).
Protamine Sulfate (Heparin antidote) Indications - Reversal of unfractionated heparin anticoagulation, Partial reversal of low molecular weight heparins (e.g., enoxaparin). Contraindications - Severe hypersensitivity to protamine (especially in patients with fish allergy), History of vasectomy or infertility treatment (risk of antibodies and hypersensitivity). Cautions - Cardiovascular disease, Pulmonary hypertension, Diabetes mellitus (especially if previously treated with protamine-containing insulin), Monitor for hypotension and anaphylaxis during administration. Drug interactions - Heparin (dose titration essential), Other anticoagulants (may not be reversed), Enhanced hypotension risk with anesthetics or vasodilators. Trade names - Protamine inj:®, Protam® inj, Protam Sulphate inj:® (Specialist use only) Adult : 1 mg neutralizes approximately 100 units of heparin if given within 15 minutes of heparin administration; max dose usually 50 mg. Child : Dose based on weight and amount of heparin administered; specialist advice required.
Phytomenadione (Vitamin K₁ – Antidote for anticoagulants) Indications - Reversal of anticoagulation due to vitamin K antagonists (e.g., warfarin), Vitamin K deficiency bleeding (VKDB) in neonates, Hypoprothrombinaemia. Avoid - Hypersensitivity to phytomenadione or formulation excipients. Cautions - Severe hepatic impairment, Risk of anaphylactoid reactions (especially via IV route), Use with caution in neonates with liver dysfunction. Drug interactions - Vitamin K antagonists (e.g., warfarin – effect antagonised), Antiepileptics (may lower vitamin K levels), Broad-spectrum antibiotics (reduce gut flora that synthesize vitamin K). Trade names - Konakion MM inj:®, Phytonadione inj:®, Mephyton tab:® Adult : 0.5–10 mg by slow IV injection depending on INR level and severity of bleeding. Child : Neonatal prophylaxis: 1 mg IM at birth or 2 mg orally (may require repeated doses). For treatment: dose per specialist advice based on weight and condition.
Pyridostigmine Bromide (Anticholinesterase) Indications - Myasthenia gravis, Reversal of non-depolarising neuromuscular blockade, Ileus, Urinary retention. Avoid - Mechanical gastrointestinal or urinary obstruction. Cautions - Asthma, Bradycardia, Epilepsy, Peptic ulcer, Cardiac arrhythmias, Recent coronary occlusion. Drug interactions - Anticholinergics (antagonise effects), Corticosteroids (dose adjustment may be needed), Beta-blockers (increased bradycardia risk), Neuromuscular blockers (effects may be enhanced or antagonised). Trade names - Mestinon tab:®, Regonol inj:®, Mestinon Timespan tab:® Adult : 60–120 mg orally 4–6 times daily (dose individualized based on response) Child : Dose adjusted according to age, weight, and response (under specialist supervision)
Ramipril (ACE inhibitor)Indications - Hypertension, Heart failure post-myocardial infarction, Prevention of cardiovascular events, Diabetic nephropathy. Contraindications - History of angioedema related to previous ACE inhibitor therapy, Pregnancy, Breastfeeding, Bilateral renal artery stenosis. Cautions - Renal impairment, Hypotension, Electrolyte imbalance (especially hyperkalaemia), Hepatic impairment, Aortic stenosis, Elderly. Drug interactions - Potassium-sparing diuretics (increased risk of hyperkalaemia), NSAIDs (decreased antihypertensive effect), Lithium (increased toxicity risk), Diuretics (increased risk of hypotension), Aliskiren (increased risk of renal impairment and hyperkalaemia in diabetic or renal-impaired patients). Trade names - Tritace tab:®, Ramace tab:®, Hopace tab:®, Cardace tab:®, Altace cap:® Adult: Initially 1.25–2.5 mg once daily; adjusted gradually up to a maximum of 10 mg daily, taken as a single dose or in two divided doses depending on response and indication. Child: Not recommended; off-label use may occur under specialist guidance based on individual weight and condition.
Trandolapril (ACE inhibitor)Indications - Hypertension, Heart failure (post-myocardial infarction). Contraindications - Pregnancy, History of angioedema, Bilateral renal artery stenosis. Cautions - Renal impairment, Hypotension, Electrolyte imbalance, Hepatic impairment. Drug interactions - Potassium-sparing diuretics (increased risk of hyperkalaemia), NSAIDs (decreased antihypertensive effect), Lithium (increased toxicity), Diuretics (increased risk of hypotension). Trade names - Gopten cap:® Adult: Initial 0.5–1 mg once daily; adjusted up to 2–4 mg daily based on response. Child: Not recommended.
Quinapril (ACE inhibitor)Indications - Hypertension, Heart failure (adjunct). Contraindications - Pregnancy, History of angioedema, Bilateral renal artery stenosis. Cautions - Renal impairment, Electrolyte imbalance, Hepatic impairment, Hypotension. Drug interactions - Potassium-sparing diuretics (increased hyperkalaemia risk), NSAIDs (decreased antihypertensive effect), Lithium (increased toxicity), Diuretics (increased risk of hypotension). Trade names - Accupro tab:® Adult: Initial 5–10 mg once daily; adjusted up to 20–40 mg daily in 1–2 doses. Child: Not recommended.
Perindopril arginine (ACE inhibitor)Indications - Hypertension, Heart failure, Stable coronary artery disease. Contraindications - Pregnancy, History of angioedema, Bilateral renal artery stenosis. Cautions - Renal impairment, Electrolyte disturbances, Hepatic impairment, Hypotension. Drug interactions - Potassium-sparing diuretics (increased risk of hyperkalaemia), NSAIDs (decreased antihypertensive effect), Lithium (increased toxicity), Diuretics (increased risk of hypotension). Trade names - Coversyl Arginine tab:®, Acertil tab:®, Prenessa tab:®, Aruzid tab:®, Perindo tab:® Adult: Initial 2.5–5 mg once daily; adjusted up to 10 mg once daily. Child: Not recommended.
Perindopril erbumine (ACE inhibitor)Indications - Hypertension, Heart failure, Stable coronary artery disease. Contraindications - Pregnancy, History of angioedema, Bilateral renal artery stenosis. Cautions - Renal impairment, Electrolyte disturbances, Hepatic impairment, Hypotension. Drug interactions - Potassium-sparing diuretics (increased risk of hyperkalaemia), NSAIDs (decreased antihypertensive effect), Lithium (increased toxicity), Diuretics (increased risk of hypotension). Trade names - Coversyl tab:®, Prexum tab:®, Reaptan tab:® (with amlodipine), Prelectal tab:® (with indapamide) Adult: Initial 2–4 mg once daily; adjusted up to 8 mg once daily. Child: Not recommended.
Remifentanil HCl (Ultra-short-acting opioid analgesic)Indications - Induction and maintenance of analgesia during general anaesthesia, Analgesia for mechanically ventilated patients in intensive care. Contraindications - Respiratory depression, Severe hepatic impairment (use with caution), Hypersensitivity to opioids. Cautions - Bradycardia, Hypotension, Renal impairment, Elderly patients, History of substance abuse. Drug interactions - Other CNS depressants (increased sedation/respiratory depression), MAOIs (increased risk of serotonin syndrome), Muscle relaxants (additive effects), Volatile anaesthetics (increased hypotensive effects). Trade names - Ultiva inj:® (Specialist use only) Adult: 0.05–2 mcg/kg/min IV infusion, adjusted per anaesthetic requirement. Child: Not recommended outside specialist settings.
Rocuronium Bromide (Non-depolarising neuromuscular blocker)Indications - Muscle relaxation during surgery, Facilitation of endotracheal intubation, ICU paralysis for ventilation. Contraindications - Hypersensitivity to rocuronium or other neuromuscular blockers. Cautions - Electrolyte imbalance, Acid-base disturbances, Myasthenia gravis, Hepatic or renal impairment. Drug interactions - Inhalational anaesthetics (increased effect), Aminoglycosides (increased neuromuscular block), Magnesium salts (increased blockade), Phenytoin (decreased effect). Trade names - Esmeron inj:® (Specialist use only) Adult: 0.6–1.2 mg/kg IV bolus for intubation; maintenance 0.15 mg/kg as needed or continuous infusion. Child: 0.6 mg/kg IV bolus; maintenance dosing similar to adults, adjust per response.
Sevoflurane (Inhalational general anaesthetic)Indications - Induction and maintenance of general anaesthesia. Contraindications - Known or suspected susceptibility to malignant hyperthermia, Hypersensitivity to sevoflurane or other halogenated agents, Severe liver dysfunction. Cautions - Increased intracranial pressure, Hypotension, Respiratory depression, Renal impairment (due to fluoride ions), Paediatric patients with recent upper respiratory infections. Drug interactions - Additive CNS depression with other anaesthetics or sedatives, Enhanced neuromuscular blockade with muscle relaxants, Caution with adrenergic agonists due to arrhythmia risk. Trade names - Sevorane inh:®, Ultane inh:®, Sojourn inh:®, Sevocris inh:® (Specialist use only) Adult: Induction: 5–8% inhaled; Maintenance: 1–4% inhaled. Child: Induction: up to 8% inhaled; Maintenance: 1–3% inhaled.
Sugammadex (Selective relaxant binding agent)Indications - Immediate reversal of neuromuscular blockade induced by rocuronium or vecuronium. Contraindications - Hypersensitivity to sugammadex. Cautions - Renal impairment, Coagulation disorders, Bradycardia, Pregnancy and breastfeeding. Drug interactions - Hormonal contraceptives (decreased effectiveness), Toremifene (delayed reversal), Interference with coagulation parameters. Trade names - Bridion inj:® (Specialist use only) Adult: IV 2–4 mg/kg depending on depth of blockade; 16 mg/kg for immediate reversal after high-dose rocuronium. Child: IV 2 mg/kg for shallow blockade (≥2 years); not recommended below 2 years.
Sevelamer HCl (Phosphate binder)Indications - Hyperphosphataemia in chronic kidney disease (especially in patients on haemodialysis). Contraindications - Bowel obstruction, Hypophosphataemia, Difficulty swallowing. Cautions - Gastrointestinal motility disorders, Active inflammatory bowel disease, Recent major gastrointestinal surgery. Drug interactions - May reduce absorption of ciprofloxacin, levothyroxine, ciclosporin, tacrolimus, and fat-soluble vitamins—administer at separate times. Trade names - Renagel tab:®, Renvela tab:® (Under specialist supervision) Adult: 800–1600 mg three times daily with meals; dose adjusted based on serum phosphate levels. Child: Not recommended.
Sildenafil (Phosphodiesterase type 5 inhibitor)Indications - Erectile dysfunction, Pulmonary arterial hypertension. Contraindications - Nitrate use, Severe hypotension, Recent stroke or myocardial infarction, Severe hepatic impairment. Cautions - Cardiovascular disease, Renal/hepatic impairment, Deformity of the penis, Bleeding disorders, Retinitis pigmentosa. Drug interactions - Potentiated by CYP3A4 inhibitors (e.g. ketoconazole, erythromycin), Risk of severe hypotension with nitrates or alpha-blockers, Enhanced effects with other antihypertensives. Trade names - Viagra tab:®, Revatio tab:® (Under specialist supervision for pulmonary hypertension) Adult: Erectile dysfunction: 50 mg once about 1 hour before sexual activity (range: 25–100 mg); max once daily. Pulmonary hypertension (specialist use): initially 20 mg 3 times daily; adjusted by specialist. Child: Not routinely recommended outside specialist care.
Sodium Polystyrene Sulfonate (Potassium-binding resin)Indications - Hyperkalaemia. Contraindications - Obstructive bowel disease, Neonates with reduced gut motility, Hypokalaemia, History of intestinal necrosis. Cautions - Elderly, Chronic constipation, Electrolyte imbalance, Concomitant use of aluminium or magnesium antacids. Drug interactions - May bind other orally administered drugs; separate administration by at least 3 hours. Trade names - Kalimate powder:®, Resonium A powder:® Adult: 15 g 1–4 times daily orally or as enema, adjusted per serum potassium level. Child: Dosage determined by specialist based on weight and clinical condition.
Sodium Stibogluconate (Antileishmanial)Indications - Leishmaniasis (cutaneous, mucocutaneous, and visceral). Contraindications - Severe cardiac, renal, or hepatic impairment. Cautions - Monitor for pancreatitis, ECG changes (QT prolongation), electrolyte imbalance. Drug interactions - Increased risk of cardiotoxicity with other QT-prolonging agents; monitor ECG closely. Trade names - Pentostam inj:® (Specialist use only) Adult: 20 mg/kg once daily IV or IM for 20–28 days (specialist dosing required). Child: Same as adult dose (based on body weight); under specialist supervision.
Sotalol HCl (Beta-blocker with class III antiarrhythmic activity)Indications - Supraventricular arrhythmias, Ventricular arrhythmias. Contraindications - Bradycardia, Second- or third-degree AV block (without pacemaker), Congenital or acquired long QT syndrome, Uncontrolled heart failure. Cautions - Renal impairment, Electrolyte disturbances (especially hypokalaemia), Diabetes, Elderly, History of asthma or bronchospasm. Drug interactions - Other QT-prolonging drugs, Class I antiarrhythmics, Calcium channel blockers (e.g., verapamil), Digoxin. Trade names - Sotacor tab:® Adult: 80–160 mg daily in 1–2 divided doses, adjusted based on response and renal function. Child: Dosing by specialist only.
Propafenone (Class 1C antiarrhythmic)Indications - Supraventricular arrhythmias (e.g., paroxysmal atrial fibrillation), Ventricular arrhythmias. Contraindications - Heart failure, Cardiogenic shock, Severe bradycardia, Significant hypotension, AV block (without pacemaker), Severe obstructive pulmonary disease. Cautions - Electrolyte imbalance, Hepatic impairment, Renal impairment, Conduction disorders. Drug interactions - Beta-blockers, Digoxin, Warfarin, CYP2D6 inhibitors, Other antiarrhythmics. Trade names - Rythmol tab:®, Rytmonorm tab:®, Arythmol tab:®, Propanorm tab:®, Sobiral tab:®, Pronon tab:® (Specialist use only) Adult: 150–300 mg every 8 hours; adjust based on clinical response. Child: Not recommended except under specialist supervision.
Streptokinase (Fibrinolytic agent)Indications - Acute myocardial infarction, Pulmonary embolism, Deep vein thrombosis, Arterial thrombosis and embolism. Avoid - Active bleeding, History of hemorrhagic stroke, Recent surgery or trauma, Severe uncontrolled hypertension, Known bleeding disorders. Cautions - Recent invasive procedures, Peptic ulcer disease, Diabetic retinopathy, Elderly. Drug interactions - Anticoagulants (e.g., warfarin, heparin), Antiplatelets (e.g., aspirin, clopidogrel), Other thrombolytics. Streptase inj:®, Kabikinase inj:®, Thromboflux inj:®, Streptokinase Medac inj:® (Specialist use only) Adult: 1.5 million units IV over 60 minutes (acute MI); dose may vary with indication. Child: Dose must be determined by a specialist.
Cilostazol (Antiplatelet and vasodilator) Indications - Intermittent claudication in peripheral arterial disease (to improve walking distance). Avoid - Heart failure, Severe renal or hepatic impairment, Known bleeding disorders. Cautions - Risk of bleeding, Atrial or ventricular arrhythmias, Concomitant use with other antiplatelets or anticoagulants. Drug interactions - CYP3A4 and CYP2C19 inhibitors (e.g., erythromycin, omeprazole), Antiplatelets, Anticoagulants. Pletal tab:®, Cilodex tab:®, Cilosprin tab:® Adult: 100 mg twice daily, at least 30 minutes before or 2 hours after meals. Child: Not recommended.
Streptozocin (Antineoplastic agent – alkylating) Indications - Pancreatic neuroendocrine tumours (particularly metastatic or inoperable islet cell carcinoma). Avoid - Pregnancy, Breast feeding, Severe renal impairment, Hypersensitivity to streptozocin. Cautions - Renal function impairment, Hepatic dysfunction, Diabetes mellitus, Myelosuppression. Drug interactions - Nephrotoxic drugs, Other cytotoxic agents, Immunosuppressants. Zanosar inj:®, Streptozotocin inj:® (Specialist use only) Adult: 500 mg/m² IV daily for 5 days every 6 weeks, or as directed by specialist protocol. Child: Not recommended.
Sucralfate (Gastrointestinal protectant) Indications - Duodenal ulcer, Gastric ulcer, Prophylaxis of stress ulcers. Avoid - Hypersensitivity to sucralfate, Intestinal obstruction. Cautions - Chronic renal impairment (risk of aluminium accumulation), Elderly patients, Difficulty swallowing (risk of bezoar formation). Drug interactions - Reduces absorption of tetracyclines, digoxin, fluoroquinolones, phenytoin – give 2 hours apart. Trade names - Antepsin® tab/susp, Carafate® tab/susp Adult : 1 g four times daily, 1 hour before meals and at bedtime, or 2 g twice daily on an empty stomach. Child : Not routinely recommended (specialist advice required).
Sufentanil Citrate (Opioid analgesic) Indications - Adjunct in anaesthesia, Analgesia during surgery, Postoperative pain (under specialist protocols). Avoid - Severe respiratory depression, Acute asthma, Known hypersensitivity to opioids, Paralytic ileus. Cautions - Respiratory disorders, Elderly or debilitated patients, Hepatic or renal impairment, Concomitant CNS depressants. Drug interactions - Other CNS depressants, MAO inhibitors, CYP3A4 inhibitors may increase plasma levels. Trade names - Sufenta® inj, Dsuvia® sublingual (US) (Specialist use only) Adult : IV 0.5–10 mcg/kg depending on procedure and anaesthetic technique. Child : Not routinely recommended (specialist setting only).
Terbinafine HCl (Antifungal) Indications - Fungal infections of the skin, nails (onychomycosis), and scalp; tinea corporis, cruris, and pedis. Avoid - Chronic or active liver disease, Known hypersensitivity to terbinafine. Cautions - Renal impairment, Psoriasis or lupus (may exacerbate), Hepatic impairment. Drug interactions - CYP2D6 substrates (e.g. tricyclic antidepressants, SSRIs, beta-blockers), Rifampicin (decreased levels), Cimetidine (increased levels). Trade names - Lamisil tab:®, Terbinafine Teva tab:®, Terbicip tab:® Adult : 250 mg once daily; duration depends on infection site (2–6 weeks for skin, up to 12 weeks for nails). Child : Oral not routinely recommended; topical use under medical advice.
Flucytosine (Antifungal Agent) Indications - Systemic yeast and fungal infections (used with fluconazole), Cryptococcal meningitis, Severe systemic candidiasis (used with Amphotericin B). Contraindications - Severe bone marrow depression, Hypersensitivity to flucytosine. Cautions - Blood disorders, Renal impairment, Pregnancy. Avoid - Breastfeeding. Side Effects - Bone marrow suppression, Nausea, Vomiting, Diarrhoea, Hepatotoxicity, Rash. Trade names - Ancobon tab:® Drug interactions - Amphotericin B (may increase toxicity), Cytarabine (antagonistic effects), Nephrotoxic agents (increase risk of renal impairment). Adult: 100–150 mg/kg/day orally in divided doses every 6 hours. Child: Same as adult dose (adjusted by weight and renal function).
Aminocaproic Acid (Antifibrinolytic) Indications - Control of bleeding due to fibrinolysis, Surgical bleeding (especially in cardiac surgery), Haemorrhagic conditions (e.g., menorrhagia, haematuria). Avoid - Active intravascular clotting, Disseminated intravascular coagulation (DIC) without heparin, Hypersensitivity to aminocaproic acid. Cautions - Renal impairment, Cardiovascular disease, History of thrombosis, Hypotension with rapid IV administration. Drug interactions - Combined use with factor IX complex concentrates or anti-inhibitor coagulant complex increases risk of thrombosis. Amicar inj: ® Adult: 5 g IV initially, then 1–1.25 g hourly for 8 hours or until bleeding is controlled. Child: 100 mg/kg IV every 6 hours (max: 30 g/day).
Methylcobalamin (Vitamin B₁₂ analogue) Indications - Vitamin B₁₂ deficiency, Peripheral neuropathy, Megaloblastic anaemia. Avoid - Hypersensitivity to cobalamins. Cautions - Optic nerve atrophy in Leber’s disease, Monitor for hypokalaemia during initial treatment of severe anaemia. Drug interactions - Chloramphenicol (may reduce hematologic response), Alcohol and neomycin (may impair absorption). Nurokind tab:®, Meconerv inj:®, Neurobion cap:® Adult: 500–1500 mcg daily orally or via IM/IV injection depending on indication and severity. Child: Dose individualised by age, weight, and clinical condition (specialist advice recommended).
Belatacept (Selective T-cell co-stimulation blocker) Indications - Prophylaxis of organ rejection in kidney transplant (in combination with other immunosuppressants). Avoid - Liver transplant recipients, EBV-seronegative patients, Active or latent tuberculosis, Known hypersensitivity. Cautions - Increased risk of infection and malignancy, Monitor for post-transplant lymphoproliferative disorder (PTLD), Monitor for neurological symptoms (e.g., progressive multifocal leukoencephalopathy – PML). Drug interactions - Concurrent use with other immunosuppressants increases risk of over-immunosuppression; monitor closely. Nulojix inj:®, Belapeg inj:® (Under specialist supervision) Adult: 10 mg/kg IV on days 1, 5, end of weeks 2, 4, 8, and 12 post-transplant, then 5 mg/kg every 4 weeks. Child: Not recommended.
Fampridine (Potassium channel blocker) Indications - Improvement of walking ability in adults with multiple sclerosis. Avoid - History of seizures, Moderate to severe renal impairment (CrCl ≤50 mL/min). Cautions - Monitor for seizure risk, Assess renal function before and during treatment. Drug interactions - Increased seizure risk with other drugs that lower seizure threshold; avoid concurrent use with other forms of 4-aminopyridine. Fampyra tab:® (Under specialist supervision) Adult: 10 mg every 12 hours. Child: Not recommended.
Glatiramer acetate (Immunomodulator) Indications - Relapsing-remitting multiple sclerosis. Avoid - Hypersensitivity to glatiramer acetate. Cautions - Monitor for injection site reactions and immediate post-injection systemic reactions (e.g., chest pain, flushing, palpitations). Drug interactions - No significant interactions known. Copaxone inj:® (Under specialist supervision) Adult: 20 mg subcutaneously once daily or 40 mg three times weekly. Child: Not recommended.
Dimethyl fumarate (Immunomodulator) Indications - Relapsing-remitting multiple sclerosis. Avoid - Severe gastrointestinal disorders, Known hypersensitivity, Pregnancy (unless clearly necessary). Cautions - Monitor liver function, lymphocyte counts; consider GI tolerance and risk of PML (progressive multifocal leukoencephalopathy). Drug interactions - Caution with immunosuppressants or vaccines; increased risk of infections. Tecfidera cap:®, Skilarence cap:®, Bafiertam cap:® (Under specialist supervision) Adult: 120 mg twice daily for 7 days, then 240 mg twice daily. Child: Not recommended.
Fingolimod (Sphingosine-1-phosphate receptor modulator) Indications - Relapsing-remitting multiple sclerosis. Avoid - Severe hepatic impairment, Immunocompromised states, Active infections, Pregnancy. Cautions - Monitor heart rate (especially after first dose), liver function, and white cell counts; risk of macular oedema. Drug interactions - Caution with antiarrhythmics, immunosuppressants, and vaccines (especially live vaccines). Gilenya cap:®, Fingya cap:®, Fingomod cap:®, Finlep cap:® (Under specialist supervision) Adult: 0.5 mg once daily. Child: Not recommended.
Alemtuzumab (Anti-CD52 monoclonal antibody) Indications - Relapsing-remitting multiple sclerosis, B-cell chronic lymphocytic leukaemia. Avoid - Active infections, HIV, Pregnancy, Breastfeeding. Cautions - Monitor for autoimmune conditions, infections, malignancy risk, and infusion-related reactions; premedicate as advised. Drug interactions - Immunosuppressants, vaccines (avoid live vaccines), corticosteroids (monitor closely). Lemtrada inj:®, Campath inj:®, MabCampath inj:® (Specialist use only) Adult: 12 mg IV daily for 5 consecutive days, then 12 mg daily for 3 consecutive days after 12 months. Child: Not recommended.
Natalizumab (Anti-α4 integrin monoclonal antibody) Indications - Relapsing-remitting multiple sclerosis. Avoid - History of progressive multifocal leukoencephalopathy (PML), Immunocompromised state, Active serious infections. Cautions - Monitor for PML, hepatic dysfunction, and hypersensitivity reactions; screen for JC virus. Drug interactions - Other immunosuppressants, live vaccines (avoid), corticosteroids (monitor for immunosuppression). Tysabri inj:®, Antegren inj:® (Specialist use only) Adult: 300 mg IV every 4 weeks. Child: Not recommended.
Ocrelizumab (Anti-CD20 monoclonal antibody) Indications - Relapsing forms and primary progressive multiple sclerosis. Avoid - Active infections, Hepatitis B infection, Pregnancy, Breastfeeding. Cautions - Pre-screen for hepatitis B; monitor for infusion-related reactions, malignancy risk, and immunosuppression. Drug interactions - Other immunosuppressants, live vaccines (avoid), corticosteroids (monitor effects). Ocrevus inj:®, Briumvi inj:® (biosimilar) (Specialist use only) Adult: 300 mg IV, then 300 mg IV 2 weeks later, followed by 600 mg IV every 6 months. Child: Not recommended.
Teriflunomide (Pyrimidine synthesis inhibitor) Indications - Relapsing-remitting multiple sclerosis. Avoid - Pregnancy, Severe hepatic impairment, Immunodeficiency states. Cautions - Monitor liver function, blood pressure, and blood counts; may take months to clear after discontinuation. Drug interactions - Leflunomide (same active metabolite), warfarin (INR changes), live vaccines (avoid), CYP2C8 inhibitors/inducers. Aubagio tab:®, Teriflo tab:®, Terifrac tab:®, Teflaro tab:® (Specialist use only) Adult: 14 mg once daily. Child: Not recommended.
Bevacizumab (Anti–VEGF monoclonal antibody) Indications - Colorectal cancer (with fluoropyrimidine), Metastatic breast cancer (with paclitaxel), Renal cell carcinoma (with interferon), Lung cancer, Ovarian cancer. Avoid - Uncontrolled hypertension, Pregnancy, Recent major surgery. Cautions - Risk of bleeding, thromboembolism, GI perforation; monitor blood pressure and urine protein. Drug interactions - Anticoagulants (additive bleeding risk), other cytotoxic agents (enhanced toxicity), surgery (increased wound healing complications). Avastin inj:®, BevaciRel inj:®, Zybev inj:®, Bryxta inj:®, Krabeva inj:® (Specialist use only) Adult: 5–15 mg/kg IV every 2–3 weeks (depending on indication). Child: Not recommended.
Avelumab (Anti–PD-L1 monoclonal antibody) Indications - Metastatic Merkel cell carcinoma. Avoid - Severe hypersensitivity, Pregnancy, Breastfeeding. Cautions - Immune-related adverse events (e.g. colitis, pneumonitis, hepatitis); premedication recommended to reduce infusion reactions. Drug interactions - Avoid live vaccines; immunosuppressants may diminish response. Bavencio inj:®, Avelunat inj:®, Avelumab Glenmark inj:® (Specialist use only) Adult: 10 mg/kg IV every 2 weeks. Child: Not recommended.
Atezolizumab (Anti–PD-L1 monoclonal antibody) Indications - Urothelial carcinoma (monotherapy), Non-small cell lung cancer (monotherapy). Avoid - Severe hypersensitivity to atezolizumab, Pregnancy, Breastfeeding. Cautions - Monitor for immune-related adverse reactions (e.g. pneumonitis, hepatitis, endocrinopathies), hepatic or renal impairment. Drug interactions - Immunosuppressants (may reduce efficacy), live vaccines (avoid). Tecentriq inj:®, Atezira inj:®, Atezozest inj:® (Specialist use only) Adult: 1200 mg IV every 3 weeks. Child: Not recommended.
Blinatumomab (Bispecific T-cell engager – Antineoplastic) Indications - Acute lymphoblastic leukaemia (Philadelphia chromosome-negative relapsed or refractory B-precursor). Avoid - Hypersensitivity, active central nervous system (CNS) leukaemia. Cautions - Cytokine release syndrome, neurologic toxicity, infections, tumour lysis syndrome; premedicate as per protocol. Drug interactions - Immunosuppressants, live vaccines (avoid), corticosteroids. Blincyto inj:®, Blinatumomab Sandoz inj:®, Cytoblin inj:® (Initiate by a specialist) Adult: 9 mcg/day continuous IV infusion for 7 days, then 28 mcg/day for remaining 21 days (cycle = 28 days); adjusted per protocol. Child: Dosage based on body surface area; follow specialist guidance.
Brentuximab vedotin (Anti-CD30 antibody-drug conjugate – Antineoplastic) Indications - CD30-positive Hodgkin lymphoma, systemic anaplastic large cell lymphoma, CD30-positive cutaneous T-cell lymphoma. Avoid - Hypersensitivity, concurrent use with bleomycin. Cautions - Peripheral neuropathy, neutropenia, infections, infusion-related reactions; monitor liver function. Drug interactions - CYP3A4 inhibitors/inducers, immunosuppressants. Adcetris inj:®, Brentodac inj:®, Brenzova inj:® (Specialist use only) Adult: 1.8 mg/kg IV every 3 weeks (max 180 mg/dose), up to 16 cycles. Child: Not routinely recommended outside specialist settings.
Brentuximab vedotin (Anti-CD30 antibody-drug conjugate – Antineoplastic) Indications - CD30-positive Hodgkin lymphoma, Systemic anaplastic large cell lymphoma, CD30-positive cutaneous T-cell lymphoma. Avoid - Hypersensitivity, Concurrent use with bleomycin. Cautions - Peripheral neuropathy, Neutropenia, Infections, Infusion-related reactions; monitor liver function. Drug interactions - CYP3A4 inhibitors/inducers, Immunosuppressants. inj: Adcetris®, Brentodac®, Brenzova® (Specialist use only) Adult: 1.8 mg/kg IV every 3 weeks (max 180 mg/dose), up to 16 cycles. Child: Not routinely recommended outside specialist settings.
Brentuximab vedotin (Anti-CD30 antibody-drug conjugate – Antineoplastic)Indications - CD30-positive Hodgkin lymphoma, systemic anaplastic large-cell lymphoma, CD30-positive cutaneous T-cell lymphoma. Contraindications - Hypersensitivity to brentuximab vedotin or excipients, concurrent use with bleomycin, pregnancy or breastfeeding (unless clearly necessary). Avoid - Live vaccines during treatment, use in patients with severe infections not under control. Cautions - Monitor for peripheral neuropathy, neutropenia, thrombocytopenia, infusion-related reactions, hepatotoxicity; assess liver function and CBC regularly. Drug interactions - CYP3A4/5 inhibitors or inducers (affect drug levels), immunosuppressants (enhanced myelosuppression), avoid concurrent P-gp substrates. Trade names - Adcetris inj:®, Brentodac inj:®, Brenzova inj:® (Specialist use only) Adult: 1.8 mg/kg IV every 3 weeks (max 180 mg per dose), for up to 16 cycles; reduce to 1.2 mg/kg in pre-existing neuropathy. Child: Not routinely recommended outside specialist paediatric oncology protocols.
Daratumumab (Anti-CD38 monoclonal antibody – Antineoplastic)Indications - Multiple myeloma (monotherapy or in combination with other agents for newly diagnosed, relapsed, or refractory disease). Contraindications - Known hypersensitivity to daratumumab or formulation components. Avoid - Live vaccines during treatment and for 3 months after, use in pregnant or breastfeeding women (unless deemed essential). Cautions - Infusion-related reactions (especially with first dose), risk of hepatitis B reactivation (screen and monitor), neutropenia, thrombocytopenia; may interfere with blood typing (cross-match before starting therapy). Drug interactions - May affect serologic testing, additive effects with other immunosuppressants, avoid live vaccines. Trade names - Darzalex inj:®, Darzalex SC inj:®, Darzalex Faspro inj:® (Specialist use only) Adult: 16 mg/kg IV weekly for 8 weeks, then every 2–4 weeks as per regimen; SC 1800 mg fixed dose may be used on same schedule. Child: Not recommended; use only in clinical trials or under specialist paediatric haematology guidance.
Durvalumab (Anti-PD-L1 monoclonal antibody – Antineoplastic)Indications - Unresectable stage III non-small cell lung cancer (NSCLC) following chemoradiation; extensive-stage small cell lung cancer in combination with chemotherapy. Contraindications - Hypersensitivity to durvalumab or any excipients. Avoid - Active autoimmune disease, history of severe immune-related adverse reactions, use of live vaccines during treatment. Cautions - Monitor for immune-related toxicities including pneumonitis, colitis, hepatitis, endocrinopathies; assess liver, renal, and thyroid function periodically. Drug interactions - Immunosuppressants (may reduce efficacy), corticosteroids (monitor use), avoid live vaccines. Trade names - Imfinzi inj:®, Durvalomab Glenmark inj:® (where available) (Initiate by a specialist) Adult: 10 mg/kg IV every 2 weeks or 1500 mg IV every 4 weeks depending on protocol and indication. Child: Not established; use in paediatric patients is not recommended.
Elotuzumab (Anti-SLAMF7 monoclonal antibody – Antineoplastic)Indications - Multiple myeloma in combination with lenalidomide and dexamethasone (for relapsed/refractory cases). Contraindications - Hypersensitivity to elotuzumab or any component. Avoid - Use in patients with severe hypersensitivity history; avoid live vaccines during therapy. Cautions - Monitor for infusion-related reactions, infections, hepatic impairment; premedication (e.g. corticosteroids, antipyretics, antihistamines) is necessary. Drug interactions - Concurrent immunosuppressants may increase infection risk; live vaccines may be ineffective or unsafe. Trade names - Empliciti inj:®, Elotuzumab Glenmark inj:® (where available) (Specialist use only) Adult: 10 mg/kg IV weekly for the first 2 cycles, then every 2 weeks thereafter in combination with lenalidomide and dexamethasone. Child: Not recommended; safety and efficacy not established in paediatric patients.
Gemtuzumab ozogamicin (Anti-CD33 antibody-drug conjugate – Antineoplastic)Indications - CD33-positive acute myeloid leukaemia (newly diagnosed or relapsed/refractory). Contraindications - Hypersensitivity to gemtuzumab ozogamicin or calicheamicin, severe hepatic impairment. Avoid - Concurrent use with live vaccines, active infections, severe hepatic disease. Cautions - Monitor for hepatotoxicity (including veno-occlusive disease), myelosuppression, infusion-related reactions, and tumour lysis syndrome; regular liver function and blood count monitoring required. Drug interactions - Increased risk of toxicity with other hepatotoxic or myelosuppressive agents; avoid live vaccines. Trade names - Mylotarg inj:®, Gemtuz inj:® (Specialist use only) Adult: 3 mg/m² IV infusion on days 1, 4, and 7 of induction therapy; may be repeated in consolidation (up to 5 cycles). Child: Dose and frequency depend on treatment protocol; typically 3 mg/m² IV; consult paediatric oncology guidance.
Inotuzumab ozogamicin (Anti-CD22 antibody-drug conjugate – Antineoplastic)Indications - CD22-positive B-cell precursor acute lymphoblastic leukaemia (relapsed or refractory). Contraindications - Severe hepatic impairment, history of hepatic veno-occlusive disease (VOD) post-transplant. Avoid - Live vaccines, hepatotoxic drugs, concurrent use in severe hepatic dysfunction. Cautions - Risk of hepatotoxicity (especially VOD), QT prolongation, infusion reactions, tumour lysis syndrome, and myelosuppression; monitor LFTs and ECG regularly. Drug interactions - Hepatotoxic agents, other myelosuppressants (additive toxicity); avoid live vaccines. Trade names - Besponsa inj:® (Under expert supervision) Adult: 1.8 mg/m² per cycle IV in divided doses (0.8 mg/m² on day 1, 0.5 mg/m² on days 8 and 15 of a 21–28 day cycle). Child: Use not routinely recommended; dosing per specialist paediatric haematology protocols.
Ipilimumab (Anti-CTLA-4 monoclonal antibody – Antineoplastic)Indications - Unresectable or metastatic melanoma; used in combination regimens for advanced renal cell carcinoma and non-small cell lung cancer. Contraindications - Severe immune-related adverse events, life-threatening autoimmune disease, known hypersensitivity to ipilimumab. Avoid - Live vaccines during treatment, use in patients with uncontrolled autoimmune disorders. Cautions - Monitor for immune-mediated adverse effects such as colitis, hepatitis, hypophysitis, thyroid dysfunction, and dermatologic toxicity; manage promptly with immunosuppressants if severe. Drug interactions - Concurrent use with immunosuppressants may reduce efficacy; corticosteroids may attenuate immune response and should be used cautiously. Trade names - Yervoy inj:®, Ipilimumab BMS inj:® (Specialist use only) Adult: 3 mg/kg IV every 3 weeks for 4 doses as monotherapy; in combination (e.g., with nivolumab) dosing may vary based on protocol. Child: Dosing guided by specialist protocols; limited data, not routinely used in children.
Necitumumab (Anti-EGFR monoclonal antibody – Antineoplastic)Indications - Squamous non-small-cell lung cancer in combination with gemcitabine and cisplatin. Contraindications - Known hypersensitivity to necitumumab or any component of the formulation, uncontrolled electrolyte abnormalities. Avoid - Use in patients with significant hypomagnesemia, known QT prolongation, or recent thromboembolic events. Cautions - Monitor for infusion reactions, electrolyte imbalances (especially hypomagnesemia and hypocalcemia), thromboembolism, and cardiac toxicity; correct electrolytes before and during treatment. Drug interactions - Cisplatin (increased risk of hypomagnesemia), other EGFR inhibitors (additive toxicity), agents that prolong QT interval. Trade names - Portrazza inj:® (Specialist use only) Adult: 800 mg IV on days 1 and 8 of each 21-day cycle in combination with gemcitabine and cisplatin, for up to 6 cycles; may continue as monotherapy. Child: Not recommended; safety and efficacy not established.
Nivolumab (Anti–PD-1 monoclonal antibody – Antineoplastic)Indications - Unresectable or metastatic melanoma, non-small cell lung cancer, advanced renal cell carcinoma, Hodgkin lymphoma, head and neck squamous cell carcinoma, urothelial carcinoma, MSI-H/dMMR colorectal cancer. Contraindications - Severe hypersensitivity to nivolumab or its excipients. Avoid - Use in active severe autoimmune disease, pregnancy unless clearly needed, and avoid live vaccines. Cautions - Monitor for immune-mediated adverse events (pneumonitis, colitis, hepatitis, endocrinopathies, nephritis); premedication not routinely required but may be used for infusion-related symptoms. Drug interactions - Concomitant use of immunosuppressants may reduce efficacy; avoid live attenuated vaccines during treatment. Trade names - Opdivo inj:® (Specialist use only) Adult: 240 mg IV every 2 weeks or 480 mg IV every 4 weeks, depending on indication and protocol. Child: Dosage based on body surface area and indication; refer to paediatric oncology protocols.
Cisplatin (Platinum-based antineoplastic agent)Indications - Testicular cancer, ovarian cancer, bladder cancer, cervical cancer, head and neck cancers, non-small cell and small cell lung cancer. Contraindications - Hypersensitivity to cisplatin or platinum-containing compounds, pre-existing renal impairment, hearing impairment, myelosuppression. Avoid - Pregnancy (teratogenic), breastfeeding, inadequate contraception in both men and women. Cautions - Ototoxicity, nephrotoxicity, myelosuppression, electrolyte imbalance (especially hypomagnesemia and hypokalemia), peripheral neuropathy; ensure adequate hydration and antiemetic cover. Drug interactions - Nephrotoxic drugs (e.g. aminoglycosides), ototoxic agents, live vaccines, phenytoin (may reduce its plasma concentration). Trade names - Cisplatin inj:®, Cisteen inj:® 10 mg/10 mL, Cisteen inj:® 50 mg/50 mL (Specialist use only) Adult: 50–100 mg/m² IV every 3–4 weeks, depending on regimen and tumour type; requires pre- and post-hydration. Child: Dose varies by protocol and body surface area (60–100 mg/m² IV every 3–4 weeks); consult paediatric oncology guidelines.
Olaratumab (Anti–PDGFRα monoclonal antibody – Antineoplastic)Indications - Advanced soft tissue sarcoma (in combination with doxorubicin in patients unsuitable for surgery or radiotherapy). Contraindications - Known hypersensitivity to olaratumab or any of its excipients. Avoid - Use during pregnancy or breastfeeding unless clearly necessary; caution in patients with known hypersensitivity reactions. Cautions - Monitor for infusion-related reactions (may require premedication with antihistamines and corticosteroids), hepatic impairment, and tumour-related bleeding risk. Drug interactions - Limited clinical data available; caution with concurrent cytotoxic chemotherapeutic agents; monitor closely when co-administered with doxorubicin due to overlapping toxicities. Trade names - Lartruvo inj:® (Specialist use only) Adult: 15 mg/kg IV on days 1 and 8 of each 21-day cycle, in combination with doxorubicin (up to 8 cycles), then monotherapy if tolerated. Child: Safety and efficacy in paediatric population not established; use only in clinical trials or specialist centres.
Panitumumab (Anti-EGFR monoclonal antibody – Antineoplastic)Indications - Metastatic colorectal cancer (KRAS wild-type, EGFR-expressing) in patients who have failed prior chemotherapy. Contraindications - Known hypersensitivity to panitumumab or any excipients, KRAS-mutant colorectal cancer. Avoid - Live vaccines, use in KRAS-mutant tumors, and use during pregnancy unless benefits outweigh risks. Cautions - Monitor for dermatologic toxicity (e.g. acneiform rash), electrolyte disturbances (especially magnesium), interstitial lung disease, and infusion reactions. Drug interactions - Avoid concurrent live vaccines; use caution with nephrotoxic agents due to increased risk of hypomagnesemia. Trade names - Vectibix inj:® (Specialist use only) Adult: 6 mg/kg IV every 2 weeks as monotherapy or in combination with chemotherapy (FOLFOX/FOLFIRI). Child: Not recommended for use in paediatrics due to limited safety and efficacy data.
Pembrolizumab (Anti-PD-1 monoclonal antibody – Antineoplastic)Indications - Melanoma, Non-small-cell lung cancer, Urothelial carcinoma, Head-and-neck squamous-cell carcinoma, MSI-H/dMMR solid tumours, Classical Hodgkin lymphoma. Contraindications - Severe hypersensitivity to pembrolizumab or excipients. Avoid - Active autoimmune disease requiring systemic immunosuppression, Pregnancy unless benefit outweighs risk. Cautions - Monitor for immune-related adverse events (pneumonitis, colitis, hepatitis, endocrinopathies, nephritis); interrupt or discontinue per toxicity guidelines; check hepatic & renal function and thyroid profile before each dose. Drug interactions - Systemic corticosteroids or other immunosuppressants may reduce efficacy; avoid live vaccines during therapy and for ≥5 months after the last dose. Trade names - Keytruda inj:® (Specialist use only) Adult: 200 mg IV every 3 weeks or 400 mg IV every 6 weeks (30-min infusion). Child: 2 mg/kg (max 200 mg) IV every 3 weeks for approved paediatric indications under specialist supervision.
Pertuzumab (Anti-HER2 monoclonal antibody – Antineoplastic)Indications - HER2-positive early breast cancer (neoadjuvant/adjuvant), metastatic breast cancer (in combination with trastuzumab and docetaxel). Contraindications - Known hypersensitivity to pertuzumab or any component of the formulation. Avoid - Pregnancy, breastfeeding, severe hypersensitivity reactions. Cautions - Cardiotoxicity (especially with trastuzumab/anthracyclines); monitor LVEF prior to and during treatment; infusion-related reactions. Drug interactions - Anthracyclines (additive cardiotoxicity), trastuzumab (requires co-monitoring), avoid live vaccines. Trade names - Perjeta inj:® (Specialist use only) Adult: Initial dose 840 mg IV, followed by 420 mg IV every 3 weeks (in combination regimen). Child: Not recommended due to lack of safety and efficacy data.
Ramucirumab (Anti-VEGFR-2 monoclonal antibody – Antineoplastic) Indications - Advanced or metastatic gastric cancer or gastro-oesophageal junction adenocarcinoma (with or without paclitaxel), metastatic colorectal cancer, non-small cell lung cancer, hepatocellular carcinoma. Contraindications - Hypersensitivity to ramucirumab or formulation components. Avoid - Uncontrolled hypertension, recent arterial thromboembolic events, active GI bleeding. Cautions - Monitor for hypertension, bleeding, gastrointestinal perforation, proteinuria, impaired wound healing. Drug interactions - Anticoagulants and antiplatelets (increased bleeding risk), antihypertensives (adjust monitoring), live vaccines (avoid). Trade names - Cyramza inj:® (Specialist use only) Adult: 8 mg/kg IV every 2 weeks (as monotherapy or with paclitaxel depending on indication). Child: Safety and efficacy not established; not routinely recommended in paediatrics.
Telotristat ethyl (Antidiarrhoeal, tryptophan hydroxylase inhibitor) Indications - Carcinoid syndrome diarrhoea inadequately controlled by somatostatin analogues alone. Contraindications - Severe hepatic impairment, known hypersensitivity to telotristat ethyl or any excipient. Avoid - Severe hepatic impairment, concomitant use with potent serotonergic drugs without close monitoring. Cautions - Monitor for new or worsening depression, constipation, hepatic enzyme elevations; use cautiously in mild to moderate hepatic impairment. Drug interactions - SSRIs, SNRIs, MAOIs (risk of serotonin syndrome); opioids and other constipating agents (increase constipation risk); CYP enzyme substrates (possible metabolic alterations). Trade names - Xermelo tab:®; Lyalda compounding/alternative:® (in some regions) Adult: 250 mg orally three times daily with food. Child: Not recommended due to lack of safety and efficacy data.
Bendamustine HCl (Antineoplastic) Indications - Chronic lymphocytic leukaemia (CLL), indolent Non-Hodgkin’s lymphoma (NHL) refractory to rituximab, Multiple myeloma (in combination regimens). Contraindications - Hypersensitivity to bendamustine or excipients, recent severe infections, breastfeeding. Avoid - Live vaccines, severe bone marrow suppression, uncontrolled infections. Cautions - Myelosuppression, infection risk, tumour lysis syndrome, renal and hepatic impairment; regular monitoring required. Drug interactions - Other myelosuppressants (additive effects), live vaccines (risk of severe infection), CYP1A2 substrates (monitor for altered metabolism). Trade names - Ribomustin inj:®, Treanda inj:®, Bendeka inj:® (Specialist use only) Adult: Usual regimen: 100 mg/m² IV on days 1 and 2 of a 28-day cycle (adjust based on indication and tolerance). Child: Not recommended; safety and efficacy not established in paediatrics.
Carmustine (Antineoplastic – nitrosourea) Indications - High-grade malignant glioma (including recurrent glioblastoma multiforme), primary or metastatic brain tumours, relapsed or refractory Non-Hodgkin’s lymphomas, Multiple myeloma. Contraindications - Severe bone-marrow depression, pulmonary fibrosis, uncontrolled infection, hypersensitivity to carmustine or ethanol, pregnancy/lactation. Avoid - Pregnancy, breastfeeding, live vaccines, concomitant high-dose radiotherapy to chest. Cautions - Cumulative pulmonary toxicity (increased risk if lifetime IV dose > 1 200 mg/m²), delayed myelosuppression (4–6 weeks post-dose), hepatic or renal impairment, elderly, pre-existing lung disease; monitor FBC, LFTs, U&Es, PFTs. Drug interactions - Other myelosuppressive or pulmonary-toxic agents (additive toxicity), cimetidine (increased carmustine levels), phenytoin/warfarin (decreased effect from marrow suppression), radiotherapy (enhanced toxicity). Trade names - BiCNU inj:®, Gliadel wafer:® (Specialist use only) Adult: IV 150–200 mg/m² as a single dose (or 75–100 mg/m² on 2 consecutive days) every 6–8 weeks; intracranial implant – 8 × 7.7 mg wafers (61.6 mg total) placed in tumour bed at resection. Child: IV 150 mg/m² every 6 weeks (or protocol-specific); wafer use off-label – specialist decision only.
Estramustine phosphate (Antineoplastic – antimicrotubule agent with estrogenic properties) Indications - Progressive or metastatic prostate cancer (especially with bone metastases). Contraindications - Hypersensitivity to estradiol, mustard agents, or estrogen; severe cardiovascular disease; thromboembolic disorders; estrogen-dependent tumors (e.g., breast cancer); uncontrolled hypertension. Avoid - Concurrent estrogen therapy, pregnancy (category X), breastfeeding. Cautions - Thromboembolic events, gynecomastia, fluid retention, impaired hepatic function, seizure risk; monitor BP, weight, signs of thrombosis. Drug interactions - Warfarin (increased bleeding risk), calcium/iron/magnesium supplements, antacids (decreased absorption), corticosteroids (increased fluid retention), CYP450 modulators. Trade names - Emcyt cap:® Adult: 140 mg/m² orally 3–4 times daily, preferably on empty stomach; adjust dose based on tolerance and response. Child: Not recommended.
Ifosfamide (Antineoplastic – Alkylating agent) Indications - Testicular cancer, soft tissue sarcoma, osteosarcoma, lymphoma, and other advanced solid tumors. Avoid - Severe bone marrow suppression, urinary tract obstruction, hypersensitivity to ifosfamide or excipients. Cautions - Risk of hemorrhagic cystitis (prophylactic mesna and hydration essential), CNS toxicity (encephalopathy), renal/hepatic dysfunction, electrolyte imbalance. Drug interactions - CYP3A4 inducers/inhibitors, nephrotoxic agents (e.g., aminoglycosides), other myelosuppressants. Trade names - Holoxan inj:®, Ifex inj:® Adult: 1.2–2.4 g/m² IV daily for 5 consecutive days every 3–4 weeks, with mesna and adequate hydration. Child: Dose based on BSA and protocol; typically 1.6–2.4 g/m²/day IV for 2–5 days per cycle (specialist-directed).
Treosulfan (Antineoplastic – Alkylating agent) Indications - Advanced ovarian cancer (oral), conditioning regimen before allogeneic hematopoietic stem cell transplantation (IV). Avoid - Severe bone marrow suppression, active uncontrolled infections, hypersensitivity to treosulfan. Cautions - Monitor for myelosuppression, gastrointestinal toxicity, hepatotoxicity, and effects on fertility. Drug interactions - Other myelosuppressive or immunosuppressive agents; avoid live vaccines. Trade names - tab: Ovastat®, Trecondi inj:® Adult: Ovarian cancer: 600 mg orally twice daily for 28 days in a 56-day cycle (adjust per response). HSCT conditioning: 10–14 g/m² IV once daily for 3 consecutive days (as part of conditioning regimen). Child: Dosing based on BSA; typically 10–14 g/m² IV once daily for 3 days (conditioning for HSCT – specialist-directed).
Azacitidine (Antineoplastic – Hypomethylating agent) Indications - Myelodysplastic syndromes (MDS), Chronic myelomonocytic leukaemia (CMML), Acute myeloid leukaemia (AML) in patients not eligible for intensive therapy. Avoid - Advanced hepatic malignancy, hypersensitivity to azacitidine or mannitol. Cautions - Bone marrow suppression, renal or hepatic impairment, bleeding risk, monitor full blood counts and electrolytes regularly. Drug interactions - Live vaccines (avoid); caution with nephrotoxic drugs and other myelosuppressants. Trade names - Vidaza inj:® Adult: 75 mg/m² SC or IV once daily for 7 consecutive days every 28 days (may be repeated up to 6 cycles or longer if benefit seen). Child: Safety and efficacy not established; use only under specialist haematology/oncology supervision.
Doxycycline (Tetracycline antibiotic) Indications - Nose infections, brucellosis, rickettsia infection, long-term treatment of healed gastro-oesophageal reflux disease, chronic prostatitis, uncomplicated genital chlamydial infection, non-specific genital infection, ehrlichiosis, mycoplasma, acute sinusitis, acute cough, acute bronchiectasis, COPD, urinary tract infections, respiratory tract infections, acne, Lyme disease, STIs, rosacea, syphilis, pelvic inflammatory disease, malaria prophylaxis, Rocky Mountain spotted fever, papulopustular facial rosacea, recurrent aphthous ulceration, anthrax prophylaxis. Contraindications - Hypersensitivity to tetracyclines, pregnancy, children under 8 years. Cautions - Alcohol dependence, renal impairment. Avoid - Use in pregnancy and children under 8 years. Side Effects - Dyspnea, hypotension, peripheral edema, tachycardia. Trade Names - Doxacil® tab:, Microdox® cap: Drug Interactions - Antacids, iron, oral contraceptives, warfarin, retinoids. Adult: Initially oral 200 mg daily for 1 dose, then 100 mg once daily for 5 days. Take with plenty of water, not with meals. Child: Not recommended under 8 years due to teeth discoloration and bone growth inhibition.aaaaa
Clofarabine (Antineoplastic) Indications - Acute lymphoblastic leukaemia in patients who have received at least two previous regimens. Avoid - Severe renal impairment, uncontrolled infections. Cautions - Monitor for capillary leak syndrome, hepatotoxicity, and myelosuppression. Drug interactions - Other myelosuppressive agents. inj: Evoltra® Adult: : Not routinely used; consult specialist. Child:: 52 mg/m² IV once daily for 5 days (specialist use only).
Decitabine (Antineoplastic) Indications - Acute myeloid leukaemia in patients over 65 years of age. Avoid - Hypersensitivity, advanced hepatic impairment. Cautions - Bone marrow suppression, infections, renal/hepatic dysfunction. Drug interactions - Live vaccines, immunosuppressants. inj: Dacogen® Adult: : 20 mg/m² IV over 1 hour daily for 5 days every 4 weeks. Child:: Not established; use under specialist supervision only.
Fludarabine phosphate (Antineoplastic) Indications - Advanced B-cell chronic lymphocytic leukaemia. Avoid - Severe renal impairment, active infections. Cautions - Myelosuppression, autoimmune effects, neurotoxicity. Drug interactions - Pentostatin (contraindicated), cytotoxic drugs. inj: Fludara® Adult: : 25 mg/m² IV once daily for 5 days (cycle every 28 days). Child:: Not routinely recommended; specialist protocol required.
Nelarabine (Antineoplastic) Indications - T-cell acute lymphoblastic leukaemia, T-cell lymphoblastic lymphoma. Avoid - Severe renal impairment, known hypersensitivity. Cautions - Neurotoxicity (dose-limiting), myelosuppression. Drug interactions - Other neurotoxic or cytotoxic agents. inj: Arranon® Adult: : 1,500 mg/m² IV on days 1, 3, and 5 every 21 days. Child:: 650 mg/m² IV daily for 5 days (under expert supervision).
Trifluridine with tipiracil (Antineoplastic) Indications - Metastatic colorectal cancer. tab:®, Cap:® (Specialist use only) Adult: : 35 mg/m² orally twice daily on days 1–5 and 8–12 of each 28-day cycle. Child:: Safety and efficacy not established.
Thiopental Sodium (Antiepileptic, Barbiturate) Indications - Epilepsy, Short duration anaesthesia, Reduce intracranial pressure. Avoid - Acute porphyrias, Myotonic dystrophy. Cautions - Acute circulatory failure or shock, Cardiovascular diseases, Elderly, Hypovolaemia, During delivery in pregnant women, Hepatic impairment. tab:®, Cap:® Adult: : 100–250 mg IV for induction (adjust based on response). Child:: 2–7 mg/kg IV (individualized per clinical context).
Thiotepa (Antineoplastic) Indications - Before stem cell transplantation in the treatment of haematological diseases and solid tumours. (IV) infusion tab:®, Cap:® Adult: : 15 mg/m² IV every 12 hours for 3 days (total 90 mg/m²). Child:: Dose adjusted by body surface area, usually similar to adult dosing.
Tolfenamic Acid (Analgesic) Indications - Acute migraine. Oral 200 mg Avoid - Active GI bleeding, Gastric ulcer. tab:®, Cap:® Adult: : 200 mg orally as a single dose during migraine attack. Child:: Not routinely recommended or dosage not established.
Trazodone HCl (Antidepressant) Indications - Depressive illness, Anxiety. Avoid - Arrhythmia, During manic phase of bipolar disorder, Pregnancy. Cautions - Cardiovascular disease, Chronic constipation, Diabetes, Epilepsy, Hyperthyroidism, Urinary retention, Hepatic impairment, Renal impairment, History of bipolar disorder, History of psychosis. tab:®, Cap:® Adult: : Starting 150 mg daily in divided doses; max 400 mg/day. Child:: Use with caution; no established pediatric dose.
Trimebutine maleate Trimebutine maleate is used to treat functional gastrointestinal disorders such as irritable bowel syndrome (IBS). It reduces spasms and pain in the gastrointestinal tract. Contraindications - Severe liver impairment, Severe kidney impairment, During pregnancy, Breastfeeding. NEWBUTIN tab:® Adult: : 200 mg three times daily before meals. Child:: Not routinely recommended or dosage not established.
Trimethoprim Indications - Urinary-tract infection, Respiratory-tract infection, Pneumocystis jirovecii pneumonia, Acne resistant to other antibacterials, Prostatitis, Shigellosis, Invasive salmonella infection. Renal impairment, Pregnancy, Breastfeeding Avoid - Do not use in blood dyscrasias. tab:®, Cap:® Adult: : 200 mg twice daily for infections, 100 mg once daily for prophylaxis. Child:: 4 mg/kg twice daily (adjusted by weight).
Valproic Acid (Antiepileptic) Indications - Bipolar disorder, Epilepsy, Migraine prophylaxis. ENCORATE Avoid - Acute porphyrias, Family history of hepatic dysfunction. Cautions - Systemic lupus erythematosus, Contraception must be done during treatment. tab:®, Cap:® Adult: : Initial 250 mg twice daily, maintenance 1000-2000 mg/day in divided doses. Child:: 10-15 mg/kg/day initially, may increase to 60 mg/kg/day.
Oxcarbazepine (Antiepileptic) Indications - Focal seizures. Oxetol, Oxcarbazepine, Kusapin Avoid - Acute porphyrias, Cardiac disorders, Heart failure, Hyponatraemia. Cautions - Hepatic impairment, Renal impairment, Pregnancy, Breastfeeding. tab:®, Cap:® Adult: : Starting 300 mg twice daily, up to 1200-2400 mg/day. Child:: Initial 8-10 mg/kg/day, max 60 mg/kg/day.
Desmopressin Indications - Diabetes insipidus, Bleeding from oesophageal varices, Primary nocturnal enuresis, Idiopathic nocturnal polyuria, Post-operative polyuria. Cautions - Heart failure, Hypertension, Asthma, Renal impairment, Pregnancy, Elderly. Desmopressin inj: Adult: : 10 mcg intranasally once daily; IV 1-4 mcg/day in divided doses. Child:: 5-10 mcg intranasally once daily.
Terlipressin Indications - Bleeding from oesophageal varices. Avoid - Pregnancy, Breastfeeding. Cautions - Arrhythmia, Elderly, Heart disease, Respiratory disease, Hypertension, Electrolyte disturbance, Heart failure, Asthma, Renal impairment. Glypressin inj: Adult: : 1–2 mg IV every 4–6 hours; max 8 mg/day. Child:: Safety and dose not well established; use under specialist supervision.
Verapamil HCl (Calcium channel blocker) Indications - Supraventricular arrhythmias, Angina, Tachyarrhythmias, Hypertension, Tachycardia, Migraine, Prophylaxis of cluster headache. Vasopten-40 tab: tab:®, Cap:® Adult: : 80–120 mg three times daily, max 480 mg/day. Child:: Not routinely recommended; limited pediatric dosing.
Vinblastine Sulfate (Antineoplastic) Indications - Breast cancer, Lung cancer, Variety of cancers. Cautions - Handling precautions, Pregnancy, Breastfeeding. inj:® Adult: : 3–6 mg/m² IV once weekly. Child:: 3–6 mg/m² IV once weekly; dose adjusted by body surface area.
Zidovudine, Azidothymidine, AZT (Antiviral) Indications - HIV infection in combination with other antiretroviral drugs. 0.8–1 mg/kg every 4 hours (IV). Retrovir tab:®, Cap:® Adult: : 600 mg/day in 2–3 divided doses orally, or 1–2 mg/kg every 4 hours IV. Child:: 180–240 mg/m² every 6–8 hours orally or 120 mg/m² IV every 6 hours.
Zonisamide (Antiepileptic) Indications - Focal seizures. Avoid - Breastfeeding, Hepatic impairment. Cautions - Renal impairment, Pregnancy, Elderly, Metabolic acidosis. Zonegran tab:®, Cap:® Adult: : Start with 100 mg/day, increase by 100 mg every 2 weeks; usual dose 300–500 mg/day. Child:: Start with 1–2 mg/kg/day; may increase to 8 mg/kg/day in 1–2 divided doses.
Sulfasalazine, Sulphasalazine Indications - Mild to severe ulcerative colitis, Active rheumatoid arthritis (under expert advice). Oral 1–2 g 4 times a day. Cautions - Hepatic impairment, Renal impairment, History of asthma, History of allergy, Risk of hepatic toxicity. Salazopyrin tab:®, Cap:® Adult: : Initial 1–2 g/day in divided doses; maintenance 500 mg 4 times a day. Child:: 40–60 mg/kg/day in 3–6 divided doses.
Benzathine Penicillin Indications - Acute otitis media, Gonorrhoea, Syphilis, Streptococcal impetigo. Avoid - Penicillin allergy, Severe hypersensitivity reactions, Neonates with hyperbilirubinemia. Cautions - Asthma, Renal impairment, Seizure disorders, History of cephalosporin allergy (cross-reactivity possible), Pregnancy (use only if clearly needed). Penidure LA inj: Adult: : 1.2–2.4 million units IM single dose or weekly as needed. Child:: 600,000 to 1.2 million units IM depending on age and condition.
Sulphamethoxazole & Trimethoprim Indications - Respiratory tract infection, Urinary tract infection. Avoid - Megaloblastic anaemia due to folate deficiency, Severe renal or hepatic impairment, Sulfonamide hypersensitivity, Neonates. Cautions - G6PD deficiency, Elderly, Renal impairment, HIV infection, Allergic reactions, Pregnancy. Navatrim syrup (100 ml), Padsmzco tab, Oriprim DS Tab: Adult: : 800 mg sulfamethoxazole + 160 mg trimethoprim every 12 hours. Child:: Based on body weight: 40 mg/kg/day sulfamethoxazole + 8 mg/kg/day trimethoprim in two divided doses.
Sarolaner Indications - Mite infestation (used in veterinary medicine for dogs, commonly for fleas, ticks, and mites). Avoid - Use in animals with known hypersensitivity to sarolaner. Cautions - Use in breeding, pregnant or lactating animals has not been evaluated. Simparica tab: Adult: : Veterinary use only – dosage depends on animal weight. Child:: Not applicable.
Ivermectin (Anthelmintic) Indications - Scabies, Onchocerciasis, Chronic strongyloides infection, Lymphatic filariasis, Strongyloides stercoralis, Papulopustular rosacea, External and internal parasites. Avoid - Children under 15 kg body weight, Pregnancy (unless benefit outweighs risk), Meningitis, Hypersensitivity. Cautions - Severe hepatic impairment, Elderly, Co-infection with Loa loa (may lead to encephalopathy), Monitor CNS effects. Vermectin tab, Ivermectin inj: Adult: : 150–200 mcg/kg as a single dose; may repeat depending on condition. Child:: Same dosing (150–200 mcg/kg) if ≥15 kg; use with caution.
EXTERNAL PARASITES CONTROL Sarolaner, Ivermectin, Amitraz, Cypermethrin, Flumethrin, Deltamethrin.
Amitraz (Acaricide) Indications - Demodicosis (mite infestation), Sarcoptic mange, Flea and tick infestations (veterinary use). Avoid - Use in cats, Hypersensitivity to amitraz. Cautions - Avoid ingestion or contact with eyes and mucous membranes; use gloves when handling; avoid use on sick or debilitated animals. Aludex, Preventic®, Certifect®, Mitaban® Adult: : Veterinary topical application — dosage varies per product and animal weight. Child:: Not applicable (veterinary use).
Divalproex Sodium Indications - Epilepsy, Bipolar disorder, Migraine prophylaxis. Avoid - Liver disease, Urea cycle disorders, History of pancreatitis. Cautions - Pregnancy (teratogenic risk), Hepatic impairment, Elderly, Bleeding disorders. Dicorate ER 250 tab: Adult: : Initial 250–500 mg/day in divided doses; titrate as needed. Child:: 15 mg/kg/day in divided doses; adjust based on clinical response.
Pyrantel Pamoate (Anthelmintic) Indications - Helminth infections, Gastrointestinal nematodes (e.g., roundworm, pinworm, hookworm). Avoid - Hypersensitivity to pyrantel. Cautions - Use with caution in liver dysfunction; possible GI upset. tab:®, Cap:® Adult: : 11 mg/kg (max 1 g) single dose orally. Child:: Same dose (11 mg/kg) for children ≥6 months.
Praziquantel (Anthelmintic) Indications - Tapeworm infections, Taenia solium, Hymenolepis nana, Schistosomiasis (S. japonicum, S. haematobium). Avoid - Ocular cysticercosis, Hypersensitivity, Severe hepatic impairment. Cautions - Epilepsy, Cardiac arrhythmias, Pregnancy (use only if clearly needed), Breastfeeding (avoid nursing for 72 hours post-dose). Praziquantel 150 mg tab, Praziquantel 500 mg tab Adult: : 5–75 mg/kg/day depending on infection type, in divided doses. Child:: Same dosing per kg as adults.
Levamisole (Anthelmintic) Indications - Roundworm infections. Avoid - Blood disorders, Pregnancy, Hepatic impairment, Epilepsy, Sjogren's syndrome. Cautions - Use with caution in patients with impaired renal function, history of seizures. Trade names - Ketrax tab:, Levamisole tab: Adult: : Single oral dose of 150 mg. Child:: 2.5 mg/kg orally as a single dose.
Mupirocin Indications - Nasal infections, Bacterial skin infections (especially Gram-positive), MRSA decolonization. Avoid - Hypersensitivity to mupirocin or excipients, Nasal formulations in children under 1 year. Cautions - Avoid prolonged use to prevent resistance; not for ophthalmic use. Trade names - Supirocin ointment, Supirocin cream, Supirocin gel Adult: : Apply topically 2–3 times daily for up to 10 days. Child:: Same as adult dosage if over 1 year; under medical supervision.
Tolnaftate (Topical Antifungal) Indications - Ringworm, Athlete's foot (tinea pedis), other dermatophytoses. Avoid - Hypersensitivity to tolnaftate. Cautions - For external use only; avoid contact with eyes or mucous membranes. Trade names - ALBER-T ointment®, Ezon-T 10ml solution® Adult: : Apply topically 1–2 times daily for 2–4 weeks. Child:: Same as adult under supervision; safety in very young children not established.
Clotrimazole (Antifungal) Indications - Vaginal and vulval candidiasis, Recurrent vulvovaginal candidiasis, Fungal skin infections, Otitis externa. Avoid - Hypersensitivity to clotrimazole or formulation components. Cautions - Reduce intravaginal dose in pregnancy; external use only for otic and dermal forms. Trade names - Gentalene-C cream®, Mecloderm-BN cream®, SKDERM cream, Candid Ear Drop, Candid (15ml) lotion Adult: : Apply 2–3 times daily to affected area. Child:: As directed by a physician, depending on formulation.
Ketoconazole (Enzyme Inhibitor / Antifungal) Indications - Cushing's syndrome, Vaginal and cutaneous candidiasis, Seborrhoeic dermatitis, Dandruff, Pityriasis versicolor, GI mycoses, Dermatophyte infections. Avoid - Use in systemic infections unless no alternatives; oral form not first-line for fungal infections. Cautions - Risk of fatal hepatotoxicity; liver function should be monitored. Trade names - Ketoz cream®, SKINEAL cream®, Diazon Cream 5 gm, NINAZOL tab®, Ketovid Shampoo 2% w/w, Dezor Shampoo (Specialist use only) Adult: : Dosage depends on formulation and indication. Child:: Use only under medical supervision.
Amphotericin B (Polyene Antifungal) Indications - Severe invasive candidiasis, Systemic fungal infections, Vaginal candidiasis, Invasive aspergillosis, Cryptococcal meningitis, Visceral leishmaniasis, Oral fungal infections. Avoid - Rapid IV infusion; hypersensitivity to amphotericin. Cautions - Perform a test dose due to risk of anaphylaxis. Monitor renal and hepatic function regularly. Side effects - Anemia, appetite loss, chills, diarrhea, dyspnea, fever, headache, hepatic dysfunction (discontinue if severe). Trade names - Amphonex Lyophilized Powder for Inj® Adult: : Usually 0.25–1 mg/kg/day IV depending on formulation. Child:: Dosage adjusted per body weight and infection severity.
Ceftriaxone (Third-generation Cephalosporin) Indications - Community-acquired pneumonia, Complicated urinary tract infection, COPD, Bacterial endocarditis, Bacterial meningitis, Surgical prophylaxis, Gonorrhoea, PID, Syphilis, Lyme disease (arthritis, carditis), Otitis media, Secondary prevention of H. influenzae and Meningococcal meningitis. Avoid - Neonates with hyperbilirubinemia, Concurrent IV calcium in neonates. Cautions - Pregnancy, Renal impairment, History of hypersensitivity to beta-lactam antibiotics. Trade names - TY-Oxone 1g Powder for Inj:, Oframax TZ inj:, Becef inj:, Ceftima inj:, Ceftriax inj: Adult: : 1–2 g IV/IM once daily or in 2 divided doses (max 4 g/day). Child:: 50–75 mg/kg/day IV/IM in 1 or 2 divided doses (max 2 g/day).
Serratiopeptidase (Proteolytic Enzyme) Indications - Pain and inflammation in arthritis, sinusitis, trauma, musculoskeletal disorders, edema, osteoarthritis, rheumatoid arthritis, thrombosis, bronchial asthma, bronchitis, tuberculosis. Avoid - Bleeding disorders, Use with anticoagulants. Cautions - Gastrointestinal ulcers, Liver dysfunction, History of bleeding disorders. Trade names - VISERAM 10mg tab:®, MEDIMOS tab:, Septase tab:® Adult: : 10–20 mg 2–3 times daily, preferably on an empty stomach. Child:: Not well established; use under medical supervision.
Ginkgo Biloba Extract (Herbal/Cognitive Enhancer) Indications - Cerebral circulatory disorders, Cerebral insufficiency, Peripheral vascular disease, Alzheimer’s disease. Avoid - Bleeding disorders, Pregnancy, Before surgery. Cautions - Concomitant use with anticoagulants/antiplatelets; may increase bleeding risk. Trade names - Senin tab: Adult: : 120–240 mg daily in divided doses. Child:: Safety and efficacy not established.
Clavulanic Acid (β-lactamase Inhibitor) Indications - Respiratory tract infections, Urinary tract infections, and other bacterial infections in combination with beta-lactam antibiotics. Avoid - History of hepatic dysfunction associated with previous clavulanic acid use. Cautions - Hepatic impairment, Monitor liver function with prolonged use. Trade names - Sanmox Powder for Oral Adult: : Varies depending on combination antibiotic (e.g., 500/125 mg amoxicillin-clavulanate every 8 hours). Child:: Dosed according to amoxicillin component, typically 20–40 mg/kg/day in divided doses.
Proanthocyanidin (Polyphenolic Compound) Indications - Cardiovascular health, Anti-inflammatory effects, Potential anticancer properties. Avoid - Hypersensitivity to polyphenols (rare). Cautions - Use with caution in patients with bleeding disorders or those taking anticoagulants. Trade names - Pileum tab: Adult: : Typically 75–150 mg daily in divided doses (based on supplement formulation). Child:: Not established; consult physician before use.
Risperidone (Second-generation Antipsychotic) Indications - Schizophrenia, Acute and chronic psychosis, Mania, Persistent aggression in Alzheimer’s dementia. Avoid - Severe CNS depression, Parkinson’s disease, Hypersensitivity to risperidone. Cautions - Renal/hepatic impairment, Cardiovascular disease, Elderly (increased mortality risk), Risk of extrapyramidal symptoms. Trade names - Rispond-2 tab: Adult: : 2–4 mg/day initially; maintenance 4–6 mg/day (max 16 mg/day). Child:: 0.5–3 mg/day depending on condition and weight (consult specialist).
Itraconazole (Triazole Antifungal) Indications - Oesopharyngeal candidiasis, Vulvovaginal candidiasis, Histoplasmosis, Systemic aspergillosis, Cryptococcal meningitis. Avoid - Patients with congestive heart failure, Concomitant use with drugs metabolized by CYP3A4 (e.g., quinidine, cisapride). Cautions - Liver disease, Renal impairment, Requires monitoring of hepatic function during long-term use. Trade names - Itraconazole cap: Adult: : 100–200 mg once or twice daily depending on indication. Child:: 5 mg/kg/day in divided doses (specialist supervision required).
Griseofulvin (Antifungal) Indications - Dermatophyte infections of skin, scalp, hair, and nails (e.g., Tinea pedis). Avoid - Acute porphyrias, Pregnancy, Breastfeeding, Hepatic impairment. Effective contraception is required during treatment due to teratogenicity. Cautions - Photosensitivity; monitor liver function in long-term use. Trade names - Fulcin 500mg tab:, Griseofulvin 125mg tab:, Grisovin 250mg tab: Adult: : 500 mg–1 g daily in single or divided doses, preferably after meals. Child:: 10–20 mg/kg/day in single or divided doses.
Omeprazole (Proton Pump Inhibitor) Indications - Helicobacter pylori eradication (with antibiotics), Duodenal and gastric ulcers, NSAID-induced ulcers, GERD, Zollinger-Ellison syndrome, Acid reflux disease. Avoid - Known hypersensitivity to omeprazole or other PPIs. Cautions - Long-term use may increase fracture risk, monitor for hypomagnesemia. Trade names - Asmozol-20 cap:, Omez:, Omeprone:, Omel:, Omeprazole: Adult: : 20–40 mg once daily, usually before meals. Child:: 0.7–3.5 mg/kg/day depending on age and indication.
Esomeprazole (Proton Pump Inhibitor) Indications - NSAID-induced ulcers, Severe peptic ulcer bleeding, GERD, Helicobacter pylori eradication (with clarithromycin and amoxicillin). Avoid - Breastfeeding. Cautions - Hepatic impairment, Renal impairment, Long-term use may cause B12 deficiency. Trade names - Sompraz tab:, Esomep 40 tab:, Esoswift 40 tab: Adult: : 20–40 mg once daily. Child:: 10–20 mg once daily depending on age and weight.
Cefdinir (Third-generation Cephalosporin) Indications - Otitis media, Pharyngitis, Pneumonia, Sinusitis, Tonsillitis, Skin infections. Avoid - Known allergy to cephalosporins. Cautions - Renal impairment, History of colitis. Trade names - Omnicef Cap: Adult: : 300 mg every 12 hours or 600 mg once daily for 5–10 days. Child:: 14 mg/kg/day in 1 or 2 doses (max 600 mg/day).
Calcium Disodium Edetate (Heavy metal chelator) Indications - Chelation therapy for lead poisoning, also considered in cases of poisoning with neurotoxic agents like nerve gas. Cautions - Renal impairment, essential mineral depletion. Trade names - Calcium Diso, Cap: Adult: : 1 g every 8–12 hours IV/IM for 5 days (max 3 g/day). Child:: 50–75 mg/kg/day IV/IM in divided doses for 5 days (max 1 g/day).
Calcium Polystyrene Sulphonate (Potassium-binding resin) Indications - Hyperkalemia due to renal dysfunction; reduces serum potassium. Avoid - Bowel obstruction, hypokalemia. Cautions - Electrolyte disturbances, fecal impaction (especially in children or elderly). Trade names - K+Lock Powder sachet, Cap: Adult: : 15 g 1–4 times daily orally or rectally. Child:: 1 g/kg daily orally or rectally in divided doses.
Calcium Acetate (Phosphate binder) Indications - Hyperphosphatemia in patients with chronic kidney disease on dialysis. Avoid - Hypercalcemia, digitalis toxicity. Cautions - Monitor calcium-phosphate product to prevent calcification. Trade names - tab:, Cap: Adult: : 1334 mg with each meal, titrate to serum phosphate levels. Child:: Dosage not routinely established; individualize under specialist guidance.
Calcium Gluconate (Calcium supplement) Indications - Severe hyperkalemia, hypocalcemia, calcium channel blocker overdose, osteoporosis, calcium deficiency. Avoid - Hypercalcemia, digitalis therapy. Cautions - Extravasation may cause tissue necrosis; use central line if possible for IV. Trade names - tab:, Cap: Adult: : 10–20 mL of 10% solution IV slowly over 10 min. Child:: 0.5 mL/kg of 10% solution IV slowly (max 10 mL).
Ketoprofen (NSAID) Indications - Pain and inflammation in musculoskeletal disorders, dysmenorrhea, acute gout, adjunct in osteoarthritis. Avoid - Gastrointestinal ulcer, bleeding, severe heart failure, pregnancy (3rd trimester), renal impairment. Cautions - Elderly, coagulation disorders, cardiovascular risks, hepatic impairment. Trade names - tab:, Cap: Adult: : 50–100 mg 2–3 times daily with food. Max 300 mg/day. Child:: Not typically recommended; consult pediatric dosing references if needed.
Mefenamic Acid (NSAID) Indications - Pain and inflammation in rheumatoid arthritis and osteoarthritis, postoperative pain, dysmenorrhoea, menorrhagia. Avoid - GI ulcers and bleeding, heart failure, pregnancy (3rd trimester), renal impairment. Cautions - Breastfeeding, hepatic impairment, allergic disorders, epilepsy, porphyria, hypertension, ulcerative colitis. Trade names - Asmef-500 caplet®, Dolarac 250mg tab®, Alfoxan 500 tab:, Meftal 500 tab: Adult: : 500 mg 3 times daily, initially 500 mg, then 250 mg every 6 hours if needed. Child:: 6 months–12 years: 25 mg/kg/day in divided doses every 8 hours (max 500 mg per dose).
Naproxen (NSAID) Indications - Pain and inflammation in musculoskeletal and rheumatic disorders, dysmenorrhoea, acute gout. Avoid - Active GI ulcer/bleed, heart failure, renal impairment, pregnancy (3rd trimester). Cautions - Allergic disorders, elderly, heart disease, ulcerative colitis, hepatic impairment, breastfeeding. Trade names - Naproxen, Aleve, Soproxen tab:, Cap: Adult: : 250–500 mg twice daily; max 1,000 mg/day. Child:: 5 mg/kg/dose twice daily (juvenile arthritis); max 15 mg/kg/day or 1,000 mg/day.
Meloxicam (NSAID) Indications - Osteoarthritis exacerbation, rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis (JIA). Avoid - Active GI ulcer/bleeding, heart failure, renal impairment, pregnancy (3rd trimester). Cautions - Elderly, allergic disorders, hepatic impairment, ulcerative colitis, hypertension, breastfeeding. Trade names - Mexicam tab:, Melogesic 7.5 tab:, Nelocam-15 tab:, Nelocam-7.5 tab: Adult: : 7.5–15 mg once daily; max 15 mg/day. Child:: ≥2 years (JIA): 0.125 mg/kg once daily; max 7.5 mg/day.
Cetirizine HCl (Antihistamine) Indications - Perennial rhinitis, Seasonal allergic rhinitis, Allergy, Cough, Hay fever, Chronic idiopathic urticaria, Atopic dermatitis. Avoid - Renal impairment, Pregnancy, Breast feeding. Cautions - Epilepsy. Trade names - CERTEC tab:, Cetihis tab:, Cetiriz tab:, Cetirizine HCl tab: Adult: : 10 mg once daily. Child:: 2–6 years: 2.5 mg once or twice daily; 6–12 years: 5 mg twice daily or 10 mg once daily.
Levocetirizine HCl (Antihistamine) Indications - Symptomatic relief of allergy such as hay fever, Urticaria. Avoid - Acute porphyrias, Pregnancy. Cautions - Renal impairment, elderly, CNS depression. Trade names - Levorex tab:, Lecet-5 tab: Adult: : 5 mg once daily in the evening. Child:: 6 months–5 years: 1.25 mg twice daily; 6–12 years: 2.5 mg twice daily or 5 mg once daily.
Fluticasone (Nebuliser liquid) (Corticosteroid) Indications - Prophylaxis of asthma, Allergic and perennial rhinitis, Severe inflammatory skin disorders, Psoriasis. Avoid - Untreated infections, active tuberculosis, hypersensitivity. Cautions - Use lowest effective dose, monitor growth in children, risk of adrenal suppression. Trade names - FLONASPRAY Inhalation powder Adult: : 100–250 mcg twice daily via inhalation or as prescribed. Child:: 50–100 mcg twice daily; dosage based on age and severity.
Chlorpheniramine Maleate (Antihistamine) Indications - Atopic dermatitis, Allergy, Cough, Allergic diarrhea, Allergic pneumonitis. Trade names - Burmeton tab:, Burmeton inj:, Epilan Syrup: Adult: : 4 mg orally every 4–6 hours; max 24 mg/day. Child:: 2–6 years: 1 mg every 4–6 hours; 6–12 years: 2 mg every 4–6 hours.
Glimepiride (Sulfonylurea Antidiabetic) Indications - Type 2 diabetes mellitus; stimulates release of endogenous insulin. Contraindications - Type 1 diabetes mellitus, diabetic ketoacidosis, severe hepatic or renal impairment. Cautions - Elderly, hepatic impairment, renal impairment. Avoid - Pregnancy, lactation, hypersensitivity to sulfonylureas. Drug Interactions - May interact with insulin, other hypoglycemic agents, beta-blockers, diuretics, corticosteroids. Trade Names - Axylim-1 tab: (Sulfonylurea) Adult: Initially 1–2 mg once daily with breakfast; maximum 6 mg/day. Child: Not recommended (limited data).
Gliclazide (Sulfonylurea) Indications - Type 2 Diabetes mellitus. Trade names - Gliclashin 80mg tab:, DIAMICRON 30 mg tab:, Reclide 30 mg tab:, Diasafe 80 mg tab: Adult: : Initially 40–80 mg once daily, up to 160 mg twice daily; modified-release: 30–120 mg once daily. Child:: Not recommended.
Prednisolone / Prednisone (Corticosteroid) Indications - Inflammatory and allergic disorders, COPD exacerbation, Asthma, ITP, Ulcerative colitis, Neuropathic pain, Myasthenia gravis, Rheumatoid arthritis, Adrenal insufficiency, Joint and local inflammations, Eczematous otitis externa. Cautions - Elderly, Hypertension, Myocardial infarction, Congestive heart failure, Liver/renal impairment, Diabetes mellitus, Osteoporosis, Glaucoma, Peptic ulcer, Pregnancy, Breastfeeding, Hypothyroidism. Trade names - PLONE-5 tab:, Prednisolon 5mg tab:, Dopred 5mg tab: Adult: : 5–60 mg/day in divided doses depending on condition. Child:: 0.5–2 mg/kg/day in divided doses; adjust per severity and age.
Methylprednisolone (Corticosteroid) Indications - Inflammatory and allergic disorders, Cerebral edema due to malignancy, Graft rejection, Autoimmune diseases, Termination of pregnancy (13–24 weeks), Ulcerative colitis, Joint/soft tissue inflammation. Trade names - Medison 16mg tab:, Medison 4mg tab: Adult: : 4–48 mg/day depending on indication and severity. Child:: 0.5–1.7 mg/kg/day in divided doses or single dose.
Phenylbutazone (NSAID) Indications - Ankylosing spondylitis. Trade name - Butazolidin tab:, Butazone tab: tab:®, Cap:® Adult: : 100–200 mg 2–3 times daily; maintenance 100 mg twice daily. Use only short term. Child:: Not recommended due to risk of serious adverse effects.
Tetrahydrozoline (Sympathomimetic agent) Indications - Conjunctival congestion, Nasal congestion. Trade name - Sinpole nasal drop, Etryzoline eye drop Adult: : Eye/nasal: 1–2 drops every 4–6 hours as needed (max 4 times/day). Child:: Not recommended under 6 years (nasal); eye drops: 1 drop in each eye every 6 hours (use caution in children).
Oxymetazoline (Alpha-adrenergic agonist) Indications - Ophthalmic antihistamines, Acute nasal congestion, Otitis media (adjunct), Rhinitis, Sinusitis, Conjunctivitis. Trade name - Afrin Nasal Drop, Nazolin Nasal Drop, Zycks Nasal Drop. Adult: : 0.05% nasal spray/drop: 2–3 sprays/drops into each nostril twice daily; max 3 days. Child:: Ages 6–12: 0.025% solution 2–3 drops/sprays per nostril twice daily.
Oxetacaine (Topical anesthetic) Indications - Gastritis, Peptic ulcer, Heartburn, Esophagitis, Hiatus hernia. Trade name - Coligon-O tab:®, Cap:® Adult: : 10–20 mg orally 2–3 times daily before meals or as directed. Child:: Not commonly used in children; use only under physician guidance.
Magaldrate (Antacid) Indications - Heartburn, Indigestion, Hyperphosphatemia, Magnesium deficiency, Gastric ulcers, Duodenal ulcers, Gastroesophageal reflux disease. Trade name - Coligon-O tab:®, Cap:® Adult: : 540 mg to 1080 mg (usually with simethicone), 1–2 tablets or 10 mL suspension after meals and at bedtime. Child:: Not routinely recommended; if used, under strict medical supervision.
Magnesium Carbonate (Antacid, Laxative) Indications - Dyspepsia. Avoid - Hypophosphataemia. Trade name - tab:®, Cap:® Adult: : 500 mg to 1 g orally 1–3 times a day as an antacid, preferably between meals. Child:: Not commonly used; consult pediatric dosage guidelines if needed.
Magnesium Trisilicate (Antacid) Indications - Dyspepsia. Trade name - Magnomint Tab:, Fourrts 250mg tab:, Siloxogene 250mg tab: Avoid - Hypophosphataemia. Adult: : 500 mg–2 g orally after meals and at bedtime. Child:: Not recommended routinely; use only under medical supervision.
Triamcinolone Acetonide (Glucocorticoid) Indications - Suppression of inflammatory and allergic disorders, local inflammation of joints and soft tissues, prophylaxis and treatment of allergic rhinitis, pregnancy termination (13–24 weeks). Avoid - Chronic therapy and high doses. Trade names - TRANSTON inj:® Adult: : 40–100 mg IM into gluteal muscle; repeat if necessary. Child:: Dosage to be determined by physician based on severity and condition.
Diacerein (Anthraquinone derivative anti-osteoarthritic agent) Indications - Osteoarthritis. Trade names - Aceren Cap: Adult: : 50 mg once daily for 2–4 weeks, then 50 mg twice daily with food. Child:: Not recommended.
Erythropoietin (Erythropoiesis-stimulating agent) Indications - Anemia associated with chronic kidney disease, chemotherapy-induced anemia, HIV-related anemia, to reduce transfusion requirements in surgery. Trade names - Erythropoietin Alfa 10000 IU, Repoitin 2000 Inj:, ior Epocim 10000 IU Injectable Solution, Alvoetin Inj:, Zyrop 10000 Inj:, Zyrop 4000 Inj: Adult: : 50–100 IU/kg IV or SC three times weekly; titrate per response. Child:: 50 IU/kg IV or SC three times weekly; adjust based on clinical response and hemoglobin levels.
Duloxetine HCl (SNRI Antidepressant) Indications - Anxiety, Depression, Urinary incontinence. Trade names - Ambidext-30 tab:, Duzela Cap: Adult: : 40–60 mg daily in 1–2 divided doses; max 120 mg/day. Child:: Not routinely recommended; consult physician.
Cefadroxil (Cephalosporin Antibiotic) Indications - Soft-tissue infections, Uncomplicated urinary tract infections, Skin infections, Tonsillitis. Cautions - Renal impairment. Trade names - Zidro Cap:, Amcef-Plus Cap:, Bicef Cap:, Cefat Cap:, Sandrox Cap: Adult: : 500 mg–1 g orally every 12–24 hours. Child:: 30 mg/kg/day in divided doses every 12 hours.
Anastrozole (Aromatase Inhibitor) Indications - Hormone receptor-positive breast cancer in postmenopausal women. Trade names - Anadex 1 mg tab:, Aremed 1 mg Film Coated tab: Adult: : 1 mg orally once daily. Child:: Not recommended for pediatric use.
Zinc Oxide (Topical Skin Protectant) Indications - Dandruff, Dermatological conditions, Eczema, Minor skin irritations. Trade names - Anucare Ointment: Adult: : Apply topically 1–3 times daily to affected area. Child:: Safe for use in infants and children; apply as directed.
Etoricoxib (Selective COX-2 Inhibitor) Indications - Pain and inflammation in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gout. Avoid - Pregnancy, Renal impairment, Active GI bleeding or ulceration, Heart failure, Uncontrolled hypertension, Peripheral arterial disease. Cautions - Allergic disorders, Breastfeeding, Hepatic impairment, Coagulation defects, Dehydration, Elderly, Ulcerative colitis, Oedema. Trade names - Mexib 120 tab:, Aristo Etocox-60 tab:, Mexib 60 tab:, Mexib 90 tab: Adult: : 60–120 mg once daily depending on indication. Child:: Not recommended.
Aceclofenac (NSAID) Indications - Pain and inflammation in rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Avoid - Acute porphyrias, GI bleeding or ulceration, History of GI bleeding, Ischaemic heart disease, Heart failure. Cautions - Cardiac impairment, Hypertension, Edema, Ulcerative colitis, Elderly, History of cardiac failure. Trade names - Acel 100 mg tab:®, Aceclofenac BP 100 mg tab:® Adult: : 100 mg orally twice daily. Child:: Not recommended.
Etamsylate (Hemostatic Agent) Indications - Control of capillary bleeding, Short-term treatment of menorrhagia. Avoid - Acute porphyrias, Breastfeeding. Trade names - Axystat-250 tab: Adult: : 250–500 mg orally every 6 hours as needed. Child:: 10–25 mg/kg/day in 2–4 divided doses.
Azelastine HCl (Antihistamine) Indications - Seasonal allergic conjunctivitis, Perennial conjunctivitis, Allergic rhinitis. Trade names - Duonase spray®, Azelamark-F Nasal Spray® Adult: : 1–2 sprays per nostril twice daily. Child:: 6–11 years: 1 spray per nostril twice daily.
Menthol (Topical Counterirritant) Indications - Bronchitis, Cough, Headache, Insect bite, Nasal congestion, Sinusitis, Sore throat, Urticaria, Dandruff, Itching, Seborrheic conditions. Trade names - Balsem AKTIV Balm Adult: : Apply topically 2–3 times daily. Child:: Use with caution; apply thin layer to affected area under supervision.
Methyl Salicylate (Topical Analgesic) Indications - Musculoskeletal disorders, Peripheral vascular diseases, Respiratory tract infections, Soft tissue disorders. Trade names - Balsem Otot Geliga Balm, Balsem AKTIV Balm Adult: : Apply thinly to affected area 3–4 times daily. Child:: Use with caution in children above 6 years under adult supervision.
Calcium Citrate (Mineral Supplement) Indications - Osteoporosis, Rickets, Hypoparathyroidism, Latent tetany. Trade names - B-Cal tab: Adult: : 500–1,200 mg/day in divided doses. Child:: 250–500 mg/day depending on age and condition.
Peppermint Oil (Herbal Antispasmodic)Indications - Relief of abdominal colic and distension, especially in irritable bowel syndrome. Contraindications - Gallstones, bile duct obstruction, severe liver damage, hypersensitivity to menthol or peppermint oil. Cautions - GERD, hiatal hernia, avoid use in patients with known sensitivity to menthol. Avoid - Use in infants, pregnancy, and breastfeeding without medical advice. Interactions - May reduce absorption of some medications due to increased GI motility; avoid concurrent use with antacids which may dissolve enteric coating prematurely. Trade names - Balsem Otot Geliga Balm Adult - 0.2–0.4 mL enteric-coated capsule 2–3 times daily (do not chew capsules). Child - Not recommended below 12 years without medical supervision.
Salicylic Acid (Keratolytic Agent) Indications - Common and plantar warts, Sand crack. Avoid - Broken skin, Impaired peripheral circulation, Application to anogenital region, Face, Large areas, Diabetic patients at risk of neuropathic ulcers. Trade names - Beprosalic ointment, Euroderm cream®, Betacylic Ointment Adult: : Apply once or twice daily to affected area as directed. Child:: Use with caution; consult physician for dosage and duration.
Betahistine DiHCl (Histamine Analogue) Indications - Vertigo, Tinnitus, Hearing loss associated with Ménière’s disease. Trade names - Betahist tab: Adult: : 8–16 mg orally three times daily; maintenance 24–48 mg/day in divided doses. Child:: Not recommended due to limited data on safety and efficacy.
Mebeverine HCl (Antispasmodic)Indications - Irritable bowel syndrome, adjunct in gastrointestinal disorders characterized by smooth muscle spasm. Contraindications - Paralytic ileus, known hypersensitivity to Mebeverine. Cautions - Administer before meals; caution in elderly and those with hepatic or renal impairment. Avoid - Use in breastfeeding women and children unless prescribed. Interactions - No significant interactions reported, but caution with anticholinergic agents. Trade names - Bevarin tab:, Colospas tab: Adult: 135 mg three times daily, preferably 20 minutes before meals. Child: Not recommended for use in children.
Pseudoephedrine (Decongestant) Indications - Bronchospasm, Nasal congestion, Rhinitis. Trade names - Ascodex, Ofkof Syrup Adult: : 60 mg every 4–6 hours; max 240 mg/day. Child:: 6–12 years: 30 mg every 4–6 hours; max 120 mg/day. Not recommended under 6 years.
Bortezomib (Antineoplastic) Indications - Multiple myeloma. Trade names - Egybort Lyophilized for Bolus, Bortemib Inj:, Velcade 1mg Lyophilized Powder for Inj: Adult: : 1.3 mg/m² IV or SC on days 1, 4, 8, and 11 of a 21-day cycle. Child:: Safety and efficacy not established.
Carbocysteine (Mucolytic) Indications - Glue ear, Respiratory tract infections. (Note: Advanced metastatic breast cancer seems unrelated and may be a misclassification) Trade names - Broncal Oral Suspension Adult: : 750 mg three times daily (tablets); or as syrup: 15 mL three times daily. Child:: 2–5 years: 100 mg three times daily; 6–12 years: 250 mg three times daily.
Calcium Hydrophosphate (Mineral supplement) Indications - Osteoporosis, Osteomalacia, Rickets, Hypoparathyroidism, Latent tetany. Trade names - Canogrow Cap: Adult: : Usual dose: 500–1500 mg elemental calcium daily in divided doses. Child:: Dose adjusted according to age and nutritional needs.
Cefazolin, Cefradine (First-generation cephalosporins) Indications - Biliary tract infections, Bone and joint infections, Endocarditis, Genito-urinary infections, Prostatitis, Respiratory tract infections, Skin infections, Urinary tract infections. Trade names - Cefazolin Powder for Inj: Adult: : Cefazolin: 500 mg to 1 g IV/IM every 8 hours; max 6 g/day. Child:: Cefazolin: 25–50 mg/kg/day in divided doses every 8 hours.
Citicoline (Nootropic/Neuroprotective agent) Indications - Stroke, Head trauma, Ischemic heart disease, Paralysis, Parkinson’s disease. Trade names - Ciaxon 1000 tab:, Ciaxon 500 tab:, Sancit 500 Cap:, Cercolin tab:, Neurocoline Inj:, Jeclin Inj:, Strocit 2ml Inj:, Strocit 4ml Inj: Adult: : 500–2000 mg/day PO or IV in divided doses. Child:: Not established; use with caution under medical supervision.
Cefpodoxime (Third-generation cephalosporin) Indications - Gonorrhoea, Gynecological infections, Lower respiratory tract infections, Otitis media, Sinusitis, Skin and soft tissue infections, Urinary tract infections. Trade names - Cefpomed 100mg tab:, Ampodox-100 tab:, Ampodox-200 tab:, Cefpodoxime 100mg tab:, Forenza CV 200 tab:, Vexpod 200 Film Coated tab:, Theopoxime-100 DT tab:, Theopoxime-200 tab:, Maxitil 200 tab:, Cepovex 50 Suspension Adult: : 100–400 mg/day in 2 divided doses depending on infection type. Child:: 10 mg/kg/day divided every 12 hours; max dose varies by age/weight.
Ceftibuten (Third-generation cephalosporin) Indications - Respiratory tract infections, Urinary tract infections, Acute otitis media, Skin and soft tissue infections. Contraindications - Known allergy or hypersensitivity, Severe renal impairment, Colitis, Pregnancy, Breastfeeding. Trade names - tab:®, Cap:®, Suspension:® Adult: : 400 mg orally once daily for 7–10 days depending on infection. Child:: 9 mg/kg once daily (max 400 mg/day); duration 5–10 days depending on condition.
Hexachlorophene (Disinfectant) Indications - Disinfectant (primarily for skin cleansing and hospital hygiene). Trade Names - Free Zone (500 ml)® Adult: : Apply topically as directed; avoid prolonged use or use over large areas. Child:: Use with caution; avoid in neonates due to neurotoxicity risk.
Capecitabine (Antimetabolite, Chemotherapeutic) Indications - Stage-3 colon cancer, Metastatic colorectal cancer, Advanced gastric cancer, Breast cancer. Citabin tab: Adult: : 1250 mg/m² orally twice daily for 14 days, followed by a 7-day rest (21-day cycle). Child:: Not recommended; safety and efficacy not established.
Celecoxib (Nonsteroidal anti-inflammatory drug - NSAID) Indications - Pain and inflammation in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis. Celib, Cox B-Coxib, Dorsiflex, Dymazol Avoid - Active GI bleeding and ulceration, Ischaemic heart disease. Cautions - Allergic disorders, Coagulation defects, Elderly, Hypertension, Oedema, Ulcerative colitis, Hepatic/renal impairment, Long-term NSAID use may reduce female fertility. Trade Names - tab:®, Cap:® Adult: : 200 mg once daily or 100 mg twice daily. Child:: Not typically recommended.
Amlodipine (Calcium channel blocker) Indications - Hypertension, Prophylaxis of Angina. Avoid - Unstable angina, Breastfeeding. Trade Names - Amlong 5 mg tab:®, Amlodipine 5 mg tab:®,Amlong tab:, Amlotop-5 tab:, Corvadil 5 mg uncoated tab:,Amlotop-5 tab:, Corvadil 5 mg uncoated tab: Adult: : 5–10 mg orally once daily. Child:: 6–17 years: 2.5–5 mg orally once daily.
Cyproterone Acetate (Anti-androgen, Progestin) Indications - Hyper-sexuality in males, Sexual deviation in males, Prevention of tumour flare during initial gonadorelin analogue therapy, Long-term palliative therapy when gonadorelin analogues/orchidectomy are contraindicated, Hot flushes with gonadorelin analogue therapy or post-orchidectomy. Trade Names - Cypress Sugar Coated tab:, Daphne 2mg-0.035mg tab:® Adult: : 50–300 mg orally per day depending on condition. Child:: Not routinely recommended.
Triptorelin Acetate (Gonadotropin-releasing hormone analogue) Indications - Advanced prostate cancer, Uterine fibroids, Central precocious puberty (off-label). Trade Names - Decapeptyl 0.1mg Solution for Inj:® Adult: : 3.75 mg IM every 28 days. Child:: 100 mcg/kg IM every 28 days for central precocious puberty.
Calcium Carbonate (Calcium supplement/Antacid) Indications - Calcium deficiency, Heartburn, Hypocalcaemia, Peptic ulcer, Stomach upset, Hyperphosphataemia. Trade Names - CALNEED 500mg tab:®, Rennie tab:, DHA-Cal 500+D tab:® Adult: : 500–1500 mg orally once or twice daily with food. Child:: 250–500 mg/day depending on age and indication.
Dinoprostone (Synthetic prostaglandin, Prostacyclin analog) Indications - Cervical ripening and induction of labour at term, Induction of labour. Avoid - Hepatic impairment, Renal impairment, Cardiac disease, Fetal malpresentation, History of caesarean section, History of major uterine surgery, Multiple pregnancy, History of difficult delivery. Cautions - History of asthma or epilepsy Trade Names - Cervidil®, Prostin E2®, Propess® Adult: : 10 mg vaginal insert for 12 hours or as per protocol. Child:: Not applicable.
Dobutamine (Sympathomimetic agent) Indications - Cardiomyopathies, Septic shock, Cardiogenic shock, Positive end expiratory pressure ventilation. Avoid - Obstructive cardiomyopathy, Constrictive pericarditis. Trade Names - Dobuzef (IV), DOBUSTAT inj: Adult: : 2.5–15 mcg/kg/min IV infusion, titrated as per response. Child:: Dose adjusted per weight and clinical response.
Arginine (Amino acid) Indications - Liver disease. Trade Names - Eganin Cap: Adult: : Dosage as per physician's direction. Child:: Dose individualized.
Glutamine (Amino acid) Indications - Nutrition support, Sickle cell disease, Reduction in hospital stay. Trade Names - LifeExtension 500mg Cap:, GLUTAHENZ oral powder, Elemune Inj: Adult: : 5–10 g daily in divided doses. Child:: Adjust according to weight and need.
Desogestrel (Progestin) Indications - Contraception, Menstrual disorders. Trade Names - Desirett tab:, Embevin 28 tab:, Marvelon-28 tab: Adult: : 75 mcg once daily continuously. Child:: Not recommended unless prescribed for specific indications.
Ofloxacin (Quinolone antibiotic) Indications - Urinary tract infections, Respiratory infections, Skin infections, Prostatitis, Chlamydial infections, Pelvic inflammatory disease, Urethritis. Avoid - Breastfeeding, Renal impairment, Myocardial infarction, Bradycardia. Trade Names - Flox-O tab:, Oflox tab:, Ofoxin tab:, Hipoflox IV, Oven Eye Drops Adult: : 200–400 mg twice daily. Child:: Use with caution; not typically first-line in pediatrics.
Levofloxacin (Quinolone antibiotic) Indications - UTIs, Sinusitis, Bronchitis, Pneumonia, Prostatitis, COPD, Pseudomonas infections, Skin infections, Eye infections, Inhalation anthrax. Cautions - Psychiatric history, Cardiac conditions, Renal impairment (adjust dose). Avoid - Breastfeeding. Side effects - Bronchial secretion changes, Dyspnea, Hemoptysis, Weight loss (inhalation). Trade Names - Evo 750 tab:®, Levobact-750 tab:®, Levofloxacin 500mg tab:®, Laviflox tab:®, Leflox tab:®, Floxavian tab:®, VOLEQUIN infusion® Adult: : 250–750 mg once daily depending on infection. Child:: Not generally recommended unless no alternatives exist.
Curcumin extract (Herbal anti-inflammatory) Indications - Tendonitis. Trade Names - Flexofytol 42mg capsule Adult: : Typically 2 capsules twice daily (follow product instructions). Child:: Consult physician; not generally recommended under 6 years.
Moxifloxacin (Quinolone antibiotic) Indications - Sinusitis, Community-acquired pneumonia, Chronic bronchitis, Pelvic inflammatory disease, Complicated skin and soft-tissue infections, Local treatment of infection. Contra-indications - Acute myocardial infarction, Bradycardia, Congenital long QT syndrome, Electrolyte disturbances, Heart failure with reduced ejection fraction, History of symptomatic arrhythmias. Trade Names - Molox tab:, Mofoxin tab:, Moxiwin 400mg tab:, Eyemox Eye Drops 5ml, Avelox inj: Adult: : 400 mg orally once daily for 7 days. Child:: Use only if benefits outweigh risks; dose by physician.
Norfloxacin (Quinolone antibiotic) Indications - Urinary tract infection, Chronic prostatitis. Trade Names - NORFLOX 400mg Cap:®, N-Flox tab:, Uronor-400 tab:, Uroflox 400 tab:, Norfloxacin tab: Adult: : 400 mg twice daily for 7–10 days (UTI). Child:: Not typically recommended due to joint toxicity.
Nalidixic acid (Quinoline antibiotic) Indications - Urinary tract infections. Trade Names - Negram tab:, Ulix-P tab:, Mictral powder, Uriben syrup® Adult: : 1 g four times daily for 7 days. Child:: 50–55 mg/kg/day in divided doses (age >3 months).
Lomefloxacin (Quinolone antibiotic) Indications - Acute bacterial diarrhea, Pyelonephritis, Surgical infections. Trade Names - Maxaquin Adult: : 400 mg once daily. Child:: Use not recommended; safety not established.
Zinc Sulfate Indications - Zinc deficiency or supplementation in zinc-losing conditions, Additional elemental zinc for intravenous nutrition. E-Zinc 27.5mg/ml Syrup (Oral Drops), E-Zinc 55mg/5ml Syrup Trade Names - E-Zinc® Adult: : Child::
Tamsulosin Hcl (Alpha-1 blocker, Alpha-1 adrenergic antagonist) Indications - Benign prostatic hyperplasia. Trade Names - TAMCONTIN 0.4 tab®, Tamsolin Cap®, Tamlosin tab®, Floezy Prolonged Release tab® Adult: : Child::
Fluorometholone Indications - Local treatment of inflammation (short term). Trade Names - Seroflo 125 Inhaler®, Seroflo 250 Inhaler®, Flusort Nasal Spray®, Fluticon Nasal Spray®, Flutimark Nasal Spray®, Flumetholon 0.1% Ophthalmic Suspension (5ml)® Adult: : Child::
Zinc Sulfate (aaa) Indications - Zinc deficiency or supplementation in zinc-losing conditions, Additional elemental zinc for intravenous nutrition. Trade Names - E-Zinc 27.5mg/ml Syrup®, E-Zinc 55mg/5ml Syrup® Adult: : As directed by physician. Child:: As directed by physician.
Tamsulosin Hcl (Alpha-1 blocker, Alpha-1 adrenergic antagonist) Indications - Benign prostatic hyperplasia. Trade Names - TAMCONTIN 0.4 tab®, Tamsolin Cap®, Tamlosin tab®, Floezy Prolonged Release tab® Adult: : 0.4 mg once daily after the same meal each day. Child:: Not recommended.
Fluorometholone (aaa) Indications - Local treatment of inflammation (short-term). Trade Names - Flumetholon 0.1% Ophthalmic Suspension 5ml®, Seroflo 125 Inhaler®, Seroflo 250 Inhaler®, Flusort Nasal Spray®, Fluticon Nasal Spray®, Flutimark Nasal Spray® Adult: : Instill 1–2 drops into the affected eye(s) 2–4 times daily. Child:: Use with caution under medical supervision.
Fondaparinux Sodium Indications - Prophylaxis of venous thromboembolism, Superficial-vein thrombosis, Pulmonary embolism, Unstable angina, Myocardial infarction. Avoid - Active bleeding, Bacterial endocarditis. Cautions - Gastric ulcer, Bleeding disorders. Trade Names - Fondaparinux DRL®, Fondaparinux Sodium Inj® Adult: : 2.5 mg subcutaneously once daily. Child:: Not recommended.
Latanoprost (Synthetic prostaglandin, Prostacyclin analog) Indications - Raised intra-ocular pressure in open-angle glaucoma, Ocular hypertension. Trade Names - Latoprost RT 0.005% Eye Drops® Adult: : 1 drop into the affected eye(s) once daily in the evening. Child:: Use under specialist supervision.
Pilocarpine (Parasympathomimetic, Muscarinic agonist, Cholinergic agonist) Indications - Primary angle-closure glaucoma, Some secondary glaucomas, Xerostomia following irradiation for head and neck cancer, Dry mouth and dry eyes in Sjögren’s syndrome. Trade Names - Optacarpine Eye Drops®, Piloptic-2 Eye Drops® Adult: : 1–2 drops in the affected eye(s) up to 4 times daily. Child:: As directed by physician.
Epinastine HCl (H1-antihistamine, Mast cell stabilizer) Indications - Seasonal allergic conjunctivitis. Trade Names - Epitin Eye Drops® Adult: : 1 drop in each affected eye twice daily for up to 8 weeks. Child:: Use under medical supervision.
Ketotifen (Non-competitive H1-antihistamine, Mast cell stabilizer) Indications - Seasonal allergic conjunctivitis, Allergic rhinitis. Avoid - Acute porphyrias, Pregnancy, Breastfeeding. Cautions - Epilepsy, Prostatic hypertrophy, Pyloduodenal obstruction, Urinary retention, Angle-closure glaucoma. Trade Names - Ketof tab®, Prosma Eye Drops®, Zadit Eye Drops®, Ketolerg® Adult: : 1 drop twice daily in the affected eye(s). Child:: Above 3 years: same as adult dose.
Vismodegib (Hedgehog pathway inhibitor) Indications - Symptomatic metastatic basal cell carcinoma, Locally advanced basal cell carcinoma not appropriate for surgery or radiotherapy. Trade Names - Erivedge Cap® Adult: : 150 mg once daily orally. Child:: Not recommended.
Nonoxynol (Spermicidal surfactant) Indications - Spermicide used for birth control. Trade Names - Evenol Pessaries®, Nonoxynol Cervical Cap® Adult: : Insert 1 pessary or use cap before intercourse as directed. Child:: Not applicable.
Lutein (Carotenoid antioxidant) Indications - Blindness and vision impairment prevention. Trade Names - Eyean Cap® Adult: : 10–20 mg daily orally with food. Child:: As directed by physician.
Alfuzosin HCl (Alpha-1 blocker, Alpha-1 adrenergic antagonist) Indications - Benign prostatic hyperplasia, Acute urinary retention associated with benign prostatic hyperplasia. Avoid - History of postural hypotension, Severe renal impairment. Trade Names - Xatral XL 10 mg tab® Adult: : 10 mg once daily immediately after the same meal each day. Child:: Not recommended.
Disodium Etidronate (Bisphosphonate) Indications - Paget’s disease of bone. Trade Names - Didronel tab® Adult: : 20 mg/kg daily orally for 14 days of each 90-day cycle. Child:: Not recommended.
Disodium Pamidronate (Bisphosphonate) Indications - Hypercalcaemia, Osteolytic lesions, Paget’s disease of bone. Trade Names - Aredia Dry Powder® Adult: : 15–90 mg by slow IV infusion over 2–24 hours depending on condition. Child:: Use under specialist advice only.
Ulinastatin (Protease inhibitor, Serine protease inhibitor) Indications - Acute pancreatitis. Trade Names - U-TRYP 1,000,000 IU injection (IV infusion)® Adult: : 100,000–200,000 IU twice daily IV infusion. Child:: Dosage as per specialist advice.
Polymyxin B (Polypeptide antibiotic) Indications - Pseudomonas aeruginosa, Bacterial skin infections. Trade Names - Forus Ophthalmic Ointment®, Cap:® Adult: : Topical or ophthalmic use 2–4 times daily as directed. Child:: Same as adult under supervision.
Colistin (aaa) Indications - Pseudomonas aeruginosa and Gram-negative organisms, Nebulised solution, Bowel sterilisation. Avoid - Renal impairment, Pregnancy, Breastfeeding, Myasthenia gravis. Trade Names - Colomycin tab® Adult: : 2 million to 5 million units 3 times daily depending on severity (IV/IM/inhalation). Child:: Dose adjusted by weight and infection severity.
Sodium Fusidate (Steroid antibiotic) Indications - Penicillin-resistant staphylococcal infection, Bone infections, Staphylococcal endocarditis. Trade Names - Fusitop Ointment® Adult: : 500 mg orally 2–3 times daily; topically 2–3 times daily. Child:: Dosage as per body weight and clinical judgement.
Isoflurane (Inhalational general anaesthetic) Indications - Induction of anaesthesia, Maintenance of anaesthesia. Trade Names - Forane Inhalation Liquid®, Cap:® Adult: : Induction: 0.5–3%; Maintenance: 1–2.5% inhaled. Child:: Similar to adult; dose titrated carefully by anaesthetist.
Immunoglobulin (Passive immunizing agent, Immune globulin) Indications - Autoimmune diseases, Hepatitis, Idiopathic thrombocytopenic purpura, Measles. Trade Names - Gamma-I.V 5 Injectable Solution® Adult: : 0.4 g/kg/day IV for 5 days (depends on indication). Child:: Same as adult on weight-based calculation.
Mosapride Citrate (Gastroprokinetic agent, 5-HT4 receptor agonist) Indications - Acid reflux diseases; long-term treatment recommended. Trade Names - Gasmotin 5mg tab®, Mosac-5 tab®, Cap:® Adult: : 5 mg orally three times daily before meals. Child:: As directed by physician.
Acarbose (Alpha-glucosidase inhibitor) Indications - Diabetes mellitus. Avoid - Hernia, Inflammatory bowel disease. Trade Names - Garbose tab®, Cap:® Adult: : 25–100 mg orally three times daily with meals. Child:: Not recommended.
Simethicone (Anti-foaming agent, Antiflatulent) Indications - Colic, Wind pain. Trade Names - Gaso-Aid chewable tab®, Mylom Drops Oral Suspension® Adult: : 40–125 mg orally after meals and at bedtime. Child:: 20 mg orally 3–4 times daily (infants); dose per age/weight.
Sodium Diatrizoate (Radiographic contrast agent) Indications - Diagnostic use: Angiography, Arthrography, CT enhancement, Excretion urography, Splenography, Venography, Cutaneous leishmaniasis. Trade Names - Gastrografin Gastroenteral Solution®, Diatrizoate meglumine and Sodium Inj® Adult: : Dose varies per procedure; administered under supervision. Child:: Adjusted per weight and imaging requirement.
Obinutuzumab (Monoclonal antibody, Antineoplastic) Indications - Advanced follicular lymphoma, Chronic lymphocytic leukemia. Trade Names - Gazyva Concentrate for Solution for Infusion®, Cap:® Adult: : 1000 mg IV on days 1, 8, and 15 of first cycle; then day 1 of each 28-day cycle. Child:: Not recommended.
Gemcitabine (Antineoplastic agent, Antimetabolite) Indications - Lung cancer, Ovarian cancer, Pancreatic cancer, Bladder cancer (with Cisplatin). Gemcitabine should be discontinued if signs of haemolytic anaemia occur. Trade Names - Gemtan Inj®, Biogem 1000 Inj®, Biogem 200 Inj®, Gemcitabine for Inj®, Gemtabin Powder for IV Infusion®, Gemtan Inj® Adult: : 1000 mg/m² IV once weekly for 3 weeks followed by 1 week rest (varies by cancer type). Child:: Not established; use only under specialist oncology guidance.
Amylase (Digestive enzyme) Indications - Edema, Iron deficiency anaemia, Respiratory tract inflammation. Trade Names - Glopancrin-2000 Cap® Adult: : As per formulation, typically 1–2 capsules with meals. Child:: Dose based on age and weight; consult physician.
Protease (Digestive enzyme) Indications - To digest the protein in food. Trade Names - Glopancrin-2000 Cap® Adult: : 1–2 capsules with meals. Child:: Dose to be determined by physician.
Glucosamine (Amino sugar, Dietary supplement) Indications - Bone and joint injury, Osteoarthritis, Rheumatoid arthritis. Trade Names - Arthrostop tab®, Glucosamine Chondroitin tab®, Joint Guard Cap®, Triflex Caplet®, Cosamine 500mg Cap® Adult: : 500–1500 mg daily in divided doses. Child:: Not recommended unless prescribed by physician.
Pancreatin (Digestive enzyme, Pancreatic enzyme replacement) Indications - Pancreatic insufficiency. Trade Names - Abinta tab®, Digelase Cap®, Digezyme Soft Cap®, Meipropan Cap®, Glopancrin-450 Cap® Adult: : 500–2500 lipase units/kg/meal; maximum 10,000 units/kg/day. Child:: Dosage varies based on age and condition; consult specialist.
Deferiprone (Iron chelating agent) Indications - Treatment of iron overload in patients with thalassaemia major in whom desferrioxamine is contraindicated or is inadequate. Avoid - Pregnancy, Breastfeeding. Cautions - Hepatic impairment, Renal impairment, Neutropenia. Trade Names - GPO-L-ONE tab: Adult: : 75 mg/kg/day orally in 3 divided doses. Child:: Same as adult if body weight ≥20 kg; otherwise adjust per kg.
Galantamine (Anticholinesterase, Acetylcholinesterase inhibitor) Indications - Mild to severe dementia in Alzheimer's disease. Avoid - Breastfeeding, Gastrointestinal obstruction, Urinary obstruction. Cautions - COPD, Bradycardia, Cardiac disease, Peptic ulcer, Pregnancy, Hepatic impairment. Trade Names - Galantamine Hydrobromide tab:® Adult: : Start with 4 mg twice daily, increase gradually. Child:: Not recommended.
Ornithine (Amino acid supplement) Indications - To increase levels of the amino acid arginine, Enhance cardiac muscle hormone levels. Avoid - Severe liver disease without hyperammonemia. Cautions - Hepatic encephalopathy. Trade Names - Helpovin Infusion Adult: : 500–2000 mg daily in divided doses. Child:: Use under specialist advice.
Lamivudine (3TC) (Nucleoside reverse transcriptase inhibitor – NRTI) Indications - Chronic hepatitis-B, HIV infection in combination therapy. Avoid - Hypersensitivity. Cautions - Pancreatitis, Hepatic disease, Renal impairment, Lactic acidosis risk. Trade Names - Heptavir-150 tab:, Eletec tab:®, Cap:® Adult: : 100–150 mg once daily depending on condition. Child:: 4 mg/kg once daily (max 150 mg/day).
Filgrastim (Granulocyte colony-stimulating factor – G-CSF analog) Indications - Neutropenia from chemotherapy, HIV infection, Bone marrow transplant, etc. Avoid - Hypersensitivity to E. coli-derived proteins. Cautions - Sickle cell disease, Myeloid malignancies, Pulmonary toxicity. Trade Names - Colstim Inj:, Ior Leuko Cim 300µg Injectable Solution Adult: : 5 µg/kg/day SC or IV. Child:: Same as adult, weight-based dosing.
Isotretinoin (Retinoid, Dermatological agent) Indications - Severe nodular acne unresponsive to conventional therapy. Avoid - Pregnancy (teratogenic), Breastfeeding. Cautions - Liver disease, Lipid disorders, Depression, Suicidal ideation. Trade Names - Isotrevic 30 Cap: Adult: : 0.5–1 mg/kg/day orally in divided doses (systemic use). Child:: Over 12 years: same as adult under medical supervision.
Isosorbide Dinitrate (Nitrate, Antianginal agent) Indications - Prophylaxis of angina, Congestive heart failure. Avoid - Hypotension, Severe anemia, Concomitant PDE-5 inhibitors. Cautions - Glaucoma, Head trauma, Hypothyroidism. Trade Names - tab:®, Cap:® Adult: : 5–40 mg orally 2–3 times daily. Child:: Not recommended.
Isosorbide 5-Mononitrate (Nitrate, Antianginal agent) Indications - Angina prophylaxis, CHF. Avoid - Hypotension, Concomitant nitrates or PDE-5 inhibitors. Cautions - Glaucoma, Severe liver impairment, Alcohol use. Trade Names - Ibimo C.R.F.C tab: 60mg Adult: : 20–60 mg once or twice daily. Child:: Not recommended.
Gabapentin (Antiepileptic) Indications - Migraine prophylaxis, Peripheral neuropathic pain, Focal seizure, Menopausal symptoms. Avoid - Sudden withdrawal, Pregnancy. Cautions - Diabetes mellitus, Elderly, Renal impairment, Adults with low body weight, Mixed seizures. Side effects - Anxiety, Abnormal appetite, Arthralgia, Asthenia, Abnormal behavior, Depression, Dry mouth, GI discomfort, Increased risk of infection, Tremors, Abnormal thinking. Trade Names - GABACEN 300mg Cap®, GABIX 100mg Cap® Adult: 300 mg once daily initially, titrated to 900–1800 mg/day in 3 divided doses. Child: Start with 10–15 mg/kg/day in 3 divided doses, titrate as needed.
Deferiprone Indications - Treatment of iron overload in thalassemia major when desferrioxamine is contraindicated or inadequate. Avoid - Pregnancy, Breastfeeding. Cautions - Hepatic impairment, Renal impairment. Trade Names - GPO-L-ONE Tab (100 Tabs Bottle) Adult: 75 mg/kg/day in 3 divided doses. Child: Same as adult if age >6 years; monitor closely.
Galantamine (Anticholinesterase, Acetylcholinesterase inhibitor) Indications - Mild to severe dementia in Alzheimer's disease. Avoid - Breastfeeding, GI obstruction, Urinary obstruction. Cautions - COPD, Cardiac disease, Unstable angina, Peptic ulcer, Pregnancy, Hepatic impairment. Trade Names - Galantamine Hydrobromide Tab® Adult: 4 mg twice daily initially, up to 8–12 mg twice daily. Child: Not recommended.
Ornithine Indications - Increase arginine levels, Support growth hormone production, Detoxification. Trade Names - Helpovin Infusion Adult: 5–10 g daily IV or oral depending on indication. Child: Not routinely recommended; consult specialist.
Lamivudine (3TC) Indications - Chronic Hepatitis B, HIV (in combination with other antiretrovirals). Trade Names - Heptavir-150 Tab, Eletec Tab® Adult: 100–150 mg once or twice daily. Child: 3 mg/kg twice daily, max 300 mg/day.
Filgrastim (G-CSF Analog) Indications - Reduce duration of neutropenia and febrile neutropenia during chemotherapy, Neutropenia in HIV. Trade Names - Colstim Inj, Ior Leuko Cim 300µg Inj Adult: 5 mcg/kg/day SC or IV. Child: Same as adult; dose by weight.
Isotretinoin Indications - Topical treatment of mild to moderate acne. Trade Names - Isotrevic 30 Cap Adult: 0.5–1 mg/kg/day in divided doses orally. Child: Use not recommended under 12 years.
Isosorbide Dinitrate Indications - Prophylaxis of angina, Adjunct in CHF. Trade Names - Tab®, Cap® Adult: 5–40 mg orally 2–3 times/day. Child: Not recommended.
Isosorbide 5-Mononitrate Indications - CHF, Angina prophylaxis, Scurvy. Trade Names - Ibimo C.R.F.C Tab 60 mg Adult: 20–60 mg once or twice daily. Child: Not established.
Clomifene Citrate (Ovulation Stimulant) Indications - Female infertility due to ovulatory dysfunction, Secondary amenorrhea. Trade Names - PROVULA Tab, Jesper-50 Tab, Clomitab Tab Adult: 50 mg/day for 5 days starting on day 2–5 of cycle, may increase to 100 mg. Child: Not indicated.
Ketamine HCl Indications - Induction and maintenance of anesthesia. Trade Names - Ketalar IM/IV, Ketanir Inj Adult: 0.5–2 mg/kg IV; 4–10 mg/kg IM. Child: Same as adult by weight.
Metolazone Indications - Edema, Hypertension. Cautions - Acute porphyrias. Trade Names - Lazon 2.5 Tab, Lazon 5 Tab Adult: 2.5–10 mg once daily. Child: 0.1–0.2 mg/kg/day.
Linezolid Indications - Pneumonia, Skin and soft tissue infections when other antibiotics are unsuitable. Cautions - Confusion, Bipolar disorder, Cancer, Elderly, Thyrotoxicosis, Hypertension, Schizophrenia. Trade Names - Linzol 600 Tab Adult: 600 mg every 12 hours. Child: 10 mg/kg every 8–12 hours.
Lithium Carbonate (Antipsychotic) Indications - Mania, Bipolar disorder, Aggressive or self-harming behavior, Recurrent depression. Avoid - Addison's disease, Cardiac insufficiency, Dehydration, Arrhythmia, Hypothyroidism, Pregnancy, Breastfeeding. Cautions - Abrupt withdrawal, Cardiac disease, Elderly, Diuretic therapy, Epilepsy, Myasthenia gravis, Psoriasis, Long-term use, Require contraception, Renal impairment. Trade Names - Lithocent-CR Tab, Lithium Carbonate 250 mg Tabs Adult: 200–600 mg 2–3 times/day; dose adjusted to serum lithium level. Child: Not routinely used; specialist advice required.
Lithium Citrate (Antipsychotic) Indications - Mania, Bipolar disorder, Aggressive or self-harming behavior, Recurrent depression. Avoid - Addison's disease, Cardiac insufficiency, Dehydration, Arrhythmia, Hypothyroidism, Pregnancy, Breastfeeding. Cautions - Abrupt withdrawal, Cardiac disease, Elderly, Diuretic therapy, Epilepsy, Myasthenia gravis, Psoriasis, Long-term use, Require contraception, Renal impairment. Trade Names - Lithocent-CR Tab Adult: 8–10 mEq 2–3 times daily; adjust by serum lithium levels. Child: Specialist only; dosing by serum level and weight.
Losartan Potassium (ARB - Angiotensin II Receptor Blocker)Indications - Hypertension, Diabetic nephropathy in type 2 diabetes, Chronic heart failure. Contraindications - Hypersensitivity to losartan or any ARBs, Pregnancy (especially second and third trimester), Severe hepatic impairment. Avoid - Pregnancy, breastfeeding, concomitant use with aliskiren in diabetes or renal impairment. Cautions - Renal artery stenosis, hypotension, electrolyte imbalance (especially hyperkalemia), volume depletion, hepatic impairment. Drug interactions - Potassium supplements, potassium-sparing diuretics, NSAIDs (may reduce antihypertensive effect), lithium (risk of toxicity), other antihypertensives (additive effect). Trade Names - Losartan Potassium USP 50mg tab:®, Vazortan-H tab:® Adult: 50 mg once daily; may increase to 100 mg daily in 1 or 2 divided doses depending on response. Child: 6–16 years: 0.7 mg/kg once daily (max 50 mg/day).
Leuprorelin Acetate (GnRH Agonist) Indications - Prostate cancer, Endometriosis, Uterine fibroids, Endometrial thinning before intrauterine surgery. Avoid - Pregnancy, Undiagnosed vaginal bleeding, Hypersensitivity to GnRH analogs. Cautions - Osteoporosis risk, Cardiovascular disease, Diabetes. Trade Names - Luprodex Powder for Injection Adult: 3.75 mg IM monthly or 11.25 mg every 3 months depending on indication. Child: Central precocious puberty: 7.5–15 mg IM monthly depending on weight.
Mitomycin (Antineoplastic Antibiotic) Indications - Superficial bladder tumors, Upper gastrointestinal cancers, Breast cancer. Avoid - Pregnancy, Breastfeeding, Thrombocytopenia, Severe myelosuppression. Cautions - Bone marrow suppression, Renal impairment, Pulmonary toxicity. Trade Names - Mitomycin Injection Adult: IV: 10–20 mg/m² every 6–8 weeks; Intravesical: 20–40 mg weekly. Child: Specialist use only.
Epirubicin HCl (Anthracycline Antineoplastic) Indications - Breast cancer, Superficial bladder cancer. Avoid - Severe cardiac disease, Pregnancy, Breastfeeding. Cautions - Hepatic impairment, Myelosuppression, Risk of cardiotoxicity. Trade Names - Epirubicin Injection Adult: IV: 60–100 mg/m² every 3 weeks; Intravesical: 50 mg weekly for 8 weeks. Child: Specialist use only.
Rituximab (Monoclonal Antibody – Anti-CD20) Indications - Chronic lymphocytic leukemia, Rheumatoid arthritis, Pemphigus vulgaris. Avoid - Active severe infections, Known hypersensitivity, Live vaccines, Pregnancy. Cautions - Cardiac disease, Risk of hepatitis B reactivation, Infusion-related reactions. Trade Names - Mabthera Solution for S/C (Specialist use only) Adult: CLL: 375 mg/m² IV weekly x 4; RA: 1 g IV on Days 1 and 15, repeated every 6 months. Child: Specialist use only.
Betamethasone (Corticosteroid) Indications - Local treatment of inflammation and allergic disorders (short-term), Congenital adrenal hyperplasia, Eczematous inflammation in otitis externa, Non-infected inflammatory conditions of nose, Oral ulceration, Severe inflammatory skin disorders such as eczema, Psoriasis. Side Effects - Hiccups, Myocardial rupture (following recent myocardial infarction), Oedema, Stevens-Johnson syndrome. Trade Names - DIPGEN Cream®, Be Topic Cream 10g, BET-GM Skin Cream®, Betamethasone Cream® Adult: Initially up to 120 mg daily (systemic); apply thin layer 1–2 times daily (topical). Child: 1 month–11 years: 0.25–1.5 mg/kg once daily or on alternate days; max 2.4 mg/kg daily (systemic); apply sparingly 1–2 times daily (topical).
Miconazole Nitrate (Antifungal) Indications - Oral and intestinal candidiasis, Oral fungal infections, Vaginal and vulval candidiasis, Fungal skin infections and Fungal nail infections. Avoid - Acute porphyrias, Pregnancy, Breastfeeding. Cautions - Liver disease, Drug interactions (e.g. warfarin), Prolonged use. Trade Names - BET-GM Skin Cream®, BECOZINC Cap®, Micozole Cream 20mg, Micora Gel Adult: Topical: Apply twice daily. Oral gel: 2.5 mL (half a teaspoon) 4 times daily. Vaginal cream: Once daily for 7 days or as prescribed. Child: Oral gel: 1.25 mL (¼ teaspoon) 4 times daily; topical: apply 1–2 times daily.
Medroxyprogesterone Acetate (Progestin Hormone) Indications - Dysfunctional uterine bleeding, Secondary amenorrhoea, Endometriosis, Endometrial and renal cell cancer, Breast cancer, Long-term contraception, Hot flushes in prostate cancer patients. Avoid - Active thromboembolic disorders, Liver disease, Undiagnosed vaginal bleeding, Pregnancy. Cautions - Depression, Diabetes, Cardiovascular disease, Epilepsy, Migraine, Asthma. Trade Names - Medroxy 5mg Tab® Adult: 2.5–10 mg daily for 5–10 days for uterine bleeding; 150 mg IM every 3 months or 104 mg SC every 3 months for contraception. Child: Specialist use only, particularly in adolescents for contraception or endometriosis.
Parathyroid Hormone (Hormonal Agent) Indications - Chronic hypoparathyroidism. Avoid - Patients with increased risk of osteosarcoma, Paget's disease, Unexplained elevations of alkaline phosphatase, Prior radiation therapy involving the skeleton. Cautions - Hypercalcemia, Severe renal impairment, Hypotension after injection. Trade Names - Megapth Inj® (Specialist use only) Adult: 50–100 mcg subcutaneously once daily, adjusted based on serum calcium. Child: Not recommended; use in children has not been established.
Hydroquinone (Depigmenting Agent) Indications - Hyperpigmentation, Melasma. Avoid - Application to broken or irritated skin, Pregnancy, Breastfeeding. Cautions - Prolonged use, Sun exposure (use sunscreen), Skin irritation. Trade Names - Melacare Cream®, Melashine Cream 4% w/w Adult: Apply a thin layer to affected area once or twice daily for up to 2 months. Child: Not recommended for use in children under 12 years.
Thymomodulin (Immunomodulator) Indications - Diabetes mellitus, Immune disorders, Skin diseases, Rheumatoid arthritis. Avoid - Hypersensitivity to thymic extracts. Cautions - Autoimmune diseases, Use with immunosuppressants. Trade Names - Mivopin Cap® Adult: 60–120 mg orally once daily for 1–3 months, depending on indication. Child: 30–60 mg daily depending on age and weight (specialist supervision advised).
Cetrorelix (GnRH Antagonist) Indications - Adjunct in assisted reproduction techniques to inhibit premature LH surges. Avoid - Severe renal impairment, Hypersensitivity to cetrorelix or GnRH analogs, Pregnancy, Lactation. Cautions - History of allergic conditions, Close monitoring in ART cycles. Trade Names - Cetrotide 0.25mg Powder for Inj® (Initiate under specialist supervision) Adult: 0.25 mg subcutaneously once daily during controlled ovarian stimulation. Child: Not indicated for pediatric use.
Montelukast Sodium (Leukotriene Receptor Antagonist) Indications - Prophylaxis of asthma, Seasonal allergic rhinitis in patients with asthma. Avoid - Pregnancy, Breastfeeding. Cautions - Neuropsychiatric events, Hepatic impairment. Trade Names - Montimax-5 Tab®, Montene 10 mg Tab®, Montek 5 mg Tab®, Montek 10 mg Tab®, Montiget 10 mg Tab®, Monteka 10 mg Tab®, MOKAST 5 mg Tab®, Montas 5 Chewable Tab®, Mayakast 10 Tab® Adult: 10 mg once daily in the evening. Child: 6 months–5 years: 4 mg once daily; 6–14 years: 5 mg once daily; ≥15 years: 10 mg once daily.
Mometasone Furoate (Corticosteroid) Indications - Prophylaxis of asthma, Seasonal or perennial allergic rhinitis, Nasal polyps, Severe inflammatory skin disorders such as eczemas, Psoriasis. Avoid - Untreated skin infections, Rosacea, Perioral dermatitis, Pregnancy, Breastfeeding. Cautions - Prolonged use, Pediatric patients (growth suppression), Skin thinning. Trade Names - Momate Cream®, Zynovate Ointment®, Mosal Ointment 10g® Adult: Inhaler: 400 mcg once daily; Cream/Ointment: Apply thin layer once or twice daily. Child: 2–11 years: 100 mcg inhaled once daily; topical use with caution.
Mepolizumab (Monoclonal Antibody) Indications - Severe eosinophilic asthma. Avoid - Pregnancy, Breastfeeding, Active helminth infections. Cautions - Use only under specialist supervision. Trade Names - Nucala Inj® Adult: 100 mg subcutaneously every 4 weeks. Child: 6–11 years: 40 mg SC every 4 weeks; 12–17 years: 100 mg SC every 4 weeks.
Omalizumab (Monoclonal Antibody) Indications - Prophylaxis of severe persistent allergic asthma, Chronic spontaneous urticaria unresponsive to antihistamines. Avoid - Pregnancy, Breastfeeding. Cautions - Helminth infections, Hepatic and renal impairment, Autoimmune disease. Trade Names - Xolair Inj® Adult: 75–600 mg subcutaneously every 2–4 weeks, based on IgE levels and body weight. Child: 6–11 years: 75–375 mg SC every 2–4 weeks; urticaria use ≥12 years only.
Benralizumab (Monoclonal Antibody) Indications - Severe eosinophilic asthma. Avoid - Pregnancy, Breastfeeding, Active helminth infections. Cautions - Specialist use only, Half-life ~15 days, Monitor eosinophil count. Trade Names - Fasenra Inj® (Specialist use only) Adult: 30 mg subcutaneously every 4 weeks for first 3 doses, then every 8 weeks. Child: 12–17 years: same as adult dose; not recommended under 12 years.
Acebrophylline (Bronchodilator) Indications - Prevention and treatment of asthma, Chronic obstructive pulmonary disease (COPD). Trade Names - Neovan Syrup®, Acebrophylline Tab®, Cap® Adult: 100 mg twice daily after meals. Child: Not recommended below 18 years; pediatric use not established.
Vecuronium Bromide (Neuromuscular Blocking Agent) Indications - Muscle relaxation for surgery, Facilitation of endotracheal intubation, Mechanical ventilation. Trade Names - Neovec 10 mg Powder for Inj® Adult: Initial dose: 80–100 mcg/kg IV; Maintenance: 20–30 mcg/kg IV every 20–40 min or continuous infusion 0.8–1.2 mcg/kg/min. Child: Neonates and children: 100–200 mcg/kg IV initially; adjust per response and monitoring.
Mycophenolate Mofetil (Immunosuppressant) Indications - Prophylaxis of renal, cardiac, and hepatic transplant rejection; Symptoms associated with carcinoid tumours. Trade Names - Mycept-500 Tab®, Mycophenolate Mofetil Inj®, Mycovex 500 Tab®, Mofetyl 500 Tab®, Mycovex 250 Cap®, My-Rept Cap® Adult: 1 g twice daily orally or IV (adjust per organ type and patient response). Child: Renal transplant (3 months–18 years): 600 mg/m² orally twice daily (max 1 g twice daily).
Mycophenolate Sodium (Immunosuppressant) Indications - Prophylaxis of renal, cardiac, and hepatic transplant rejection; Symptoms associated with carcinoid tumours. Trade Names - Myfortic 180 mg Tab®, Cap® Adult: 360–720 mg twice daily orally depending on indication and tolerance. Child: Safety and efficacy not established in children under 18 years.
Ketorolac Trometamol (NSAID) Indications - Short-term management of moderate to severe postoperative pain; Ocular inflammation after surgery. Trade Names - Minolac Film Coated Tab® Adult: 10 mg orally every 4–6 hours as needed; max duration 5 days. Child: Not recommended for children under 16 years (oral). Use specialist guidance for IV/IM.
Nevirapine (Antiviral) Indications - HIV infection (in combination with other antivirals). Avoid - Acute porphyrias. Trade Names - Vira 200 Tab®, Cap® Adult: 200 mg once daily for 14 days, then 200 mg twice daily. Child: Dosage based on body surface area (e.g., 150–200 mg/m²/day in divided doses).
Vinpocetine (Cerebral Vasodilator) Indications - Hearing loss, Ear-related vascular problems. Trade Names - Vinpotin 5 Tab®, Cap® Adult: 5–10 mg orally three times daily. Child: Use not recommended due to lack of data.
Carbonyldiamide (Topical anti-inflammatory) Indications - Atopic Dermatitis, Cerebral Edema. Contraindications (Avoid) - None specified. Cautions - Use with caution in sensitive skin or allergy-prone patients. Trade Names - UO Cream 20 g Adult: Apply topically 1–2 times daily as directed. Child: Use with caution; same as adult dose unless otherwise directed.
Sulfametopyrazine (Sulfonamide antibiotic) Indications - Urinary tract infection, Chronic bronchitis. Contraindications (Avoid) - Hepatic impairment, Pregnancy, Breastfeeding, Infants under 6 weeks. Cautions - Monitor for hypersensitivity and renal function. Trade Names - tab:®, Cap:® Adult: Typically 1–2 g daily in divided doses; adjust per severity. Child: Use weight-based dosing cautiously under medical supervision.
Trimetazidine DiHCl (Anti-anginal agent) Indications - Prophylaxis of angina, Prevention of hypokalaemia. Contraindications (Avoid) - Severe renal impairment. Cautions - Use cautiously in Parkinson’s disease, movement disorders. Trade Names - VASTAREL Cap:®, CARDIMAX-SR tab:, Metagem 20 tab:, Angidine tab:, Angimet tab:, Vastadine-20 tab: Adult: 35–70 mg daily in divided doses (e.g., 20 mg 2–3 times daily or 35–50 mg SR once or twice daily). Child: Not recommended.
Folinic acid (Antidote, Antineoplastic agent) Indications - Prevention of methotrexate-induced adverse effects, Methotrexate overdosage, Adjunct to fluorouracil in colorectal cancer. Avoid - Simultaneous administration of methotrexate without supervision. Cautions - Use with caution in patients with folate metabolism disorders. Trade Names - tab:®, Cap:® Adult: Dose depends on methotrexate regimen; usually 10–30 mg orally or IV daily. Child: Dose adjusted by weight and methotrexate level; specialist supervision required.
Levofolinic acid (Antidote, Antineoplastic agent) Indications - Prevention of methotrexate-induced adverse effects, Methotrexate overdosage, Adjunct to fluorouracil in colorectal cancer. Avoid - Unsupervised simultaneous use with methotrexate. Cautions - Patients with folate metabolism abnormalities. Trade Names - tab:®, Cap:® Adult: Typically 10–30 mg orally or IV daily, adjusted per treatment protocol. Child: Weight-based dosing under specialist care.
Rasburicase (Detoxifying enzyme) Indications - Prophylaxis and treatment of acute hyperuricaemia, Before and during initiation of chemotherapy, Patients with haematological malignancy and high tumour burden at risk of tumour lysis syndrome. Avoid - Known hypersensitivity to rasburicase or E. coli proteins. Cautions - G6PD deficiency, risk of haemolysis. Trade Names - Powder for Injection:® Adult: 0.2 mg/kg IV once daily, duration based on uric acid levels. Child: 0.2 mg/kg IV once daily; adjust per clinical response.
Trabectedin (Antineoplastic agent) Indications - Advanced soft-tissue sarcoma, Ovarian cancer. Avoid - Severe hepatic impairment, Pregnancy, Breastfeeding. Cautions - Hepatic dysfunction, Myelosuppression, Cardiotoxicity. Trade Names - tab:®, Cap:® Adult: 1.5 mg/m² IV infusion every 3 weeks. Child: Not established; specialist use only.
Cabazitaxel (Antineoplastic agent) Indications - Metastatic prostate cancer. Avoid - Severe neutropenia, Pregnancy, Breastfeeding. Cautions - Myelosuppression, Hepatic impairment. Trade Names - tab:®, Cap:® Adult: 25 mg/m² IV infusion every 3 weeks, combined with prednisone. Child: Not established; specialist use only.
Gadolinium (Contrast agent)Indications - Enhanced MRI scans. Contraindications - Severe renal impairment, Hypersensitivity to gadolinium contrast. Caution - Risk of nephrogenic systemic fibrosis. Avoid - Pregnancy unless necessary. Trade names - MR-Lux® Solution For Inj: Adult: 0.1 mmol/kg IV. Child: 0.1 mmol/kg IV under specialist supervision.
Acetyl L-carnitine HCl (Nootropic, Nutritional supplement)Indications - Mental disorders, Alzheimer's disease, Memory loss, Depression, Thinking problems in alcoholism. Contraindications - Hypersensitivity. Caution - May worsen seizures in epilepsy. Avoid - Pregnancy and breastfeeding unless necessary. Trade names - Neurocarn tab: Adult: 500–2000 mg/day in divided doses. Child: Not established.
Sorafenib (Antineoplastic agent)Indications - Advanced renal cell carcinoma, Refractory thyroid cancer, Hepatocellular carcinoma. Contraindications - Severe hepatic impairment, Known hypersensitivity. Caution - Risk of bleeding, Cardiac disease. Avoid - Pregnancy, Breastfeeding. Trade names - Nexavar 200mg tab:® Adult: 400 mg twice daily. Child: Not recommended.
Lenvatinib (Antineoplastic agent)Indications - Thyroid cancer (radioiodine-refractory), Renal cell carcinoma, Hepatocellular carcinoma. Contraindications - Hypersensitivity. Caution - Hypertension, QT prolongation. Avoid - Pregnancy, Breastfeeding. Trade names - Lenvatinib 4mg Cap:® (Specialist use only) Adult: 8–24 mg once daily. Child: Not established.
Nicorandil (Vasodilator)Indications - Stable angina (second-line treatment). Contraindications - Cardiogenic shock, Acute pulmonary edema, Severe hypotension. Caution - Gastrointestinal ulceration, Hypovolemia. Avoid - Pregnancy, Breastfeeding, Low systolic BP. Trade names - NICOVEX-5 tab:, Nicoril 20mg tab:®, Cap:® Adult: 5–20 mg twice daily. Child: Not recommended.
Thalidomide (Immunosuppressant) Indications - Immunomodulatory and anti-inflammatory effects, Multiple myeloma in patients aged ≥65 years. Contraindications - Pregnancy, Hypersensitivity to thalidomide. Caution - Thrombosis risk, Peripheral neuropathy, Sedation. Avoid - Pregnancy (high teratogenicity risk), Breastfeeding. Trade names - tab:®, Cap:® Adult: 100–200 mg once daily at bedtime. Child: Not recommended.
Porfimer sodium (Photosensitiser) Indications - Photodynamic therapy for non-small cell lung cancer and obstructing oesophageal cancer. Contraindications - Porphyria, Hypersensitivity to porphyrins. Caution - Photosensitivity reactions, Avoid exposure to direct sunlight for at least 30 days. Avoid - Pregnancy, Lactation, UV therapy. Trade names - tab:®, Cap:® Adult: 2 mg/kg IV, followed by laser light activation 40–50 hours later. Child: Safety and efficacy not established.
Hydroxyethyl Starch (Plasma Volume Expander) Indications - Burns, Hypovolaemia, Low blood volume, Shock, Trauma. Contraindications - Renal failure, Severe coagulopathy, Known hypersensitivity. Caution - Monitor renal function, coagulation parameters, and fluid status. Avoid - Use in critically ill patients, sepsis. Trade names - Nirhes 130 (6%) for IV Infusion, tab:®, Cap:® Adult: 500–1000 mL/day IV (adjusted as per condition). Child: Use with extreme caution; dose individualized.
Glyceryl Trinitrate (Vasodilator) Indications - Anal fissure, Control of hypertension during cardiac surgery, Prophylaxis and treatment of angina. Contraindications - Severe hypotension, Increased intracranial pressure, Use with PDE5 inhibitors. Caution - May cause headache, dizziness, or hypotension. Avoid - Concurrent use with sildenafil or similar drugs. Trade names - Myonit SR 2.6 tab, Nitrosol aerosol spray, Cap:® Adult: Sublingual 0.3–0.6 mg as needed; patch/IV per clinical condition. Child: Not routinely used; consult specialist.
Drospirenone (Progestin Hormone) Indications - Oral contraceptive, Prevention of ovulation and pregnancy. Contraindications - Pregnancy, Hepatic disease, Renal impairment, History of thromboembolic disorders. Caution - Monitor potassium levels in renal impairment. Avoid - Concomitant use with potassium-sparing diuretics. Trade names - Drosperin 3mg tab, tab:®, Cap:® Adult: One tablet daily for 21 days starting on day 1 of cycle. Child: Not recommended before menarche.
Nutritional Supplements (Nutraceuticals) Indications - General nutritional support, Vitamin/mineral deficiency, Immune support, Bone health, Gut health. Contraindications - Hypersensitivity to any components. Caution - Overdose may lead to toxicity (e.g., vitamin A, D). Avoid - Over-supplementation without medical advice. Trade names - BRAND’s Chicken Extract, PROBIOTICS Cap, SUMMER-B12, Supradyn CoQ-10, D3-5 Cap, Chlorophyll Powder, Cartiflex, Icon Fertil, BCAA tab Adult: As per formulation and need (typically once daily). Child: Child-specific formulations only; consult pediatrician.
Nicotine (Smoking Cessation Aid) Indications - Smoking cessation, Nicotine replacement therapy. Contraindications - Non-smokers, Hypersensitivity to nicotine. Caution - Use with caution in cardiovascular disease. Avoid - Concurrent use with other nicotine-containing products. Trade names - Oral Nosmok 2mg Lozenges, Nosmok 4mg Lozenges Adult: Lozenges: 1 every 1–2 hrs (max 15/day). Child: Not recommended under 18 years.
Hydroxyethyl Starch (Plasma Volume Expander) Indications - Burns, Hypovolaemia, Low blood volume, Shock, Trauma. Contraindications - Renal failure, Coagulopathy, Hypersensitivity. Caution - Monitor renal function, avoid long-term use. Avoid - Use in critically ill patients, including sepsis. Trade names - Nirhes 130 (6%) for IV Infusion. Adult: 500–1000 mL/day IV (adjusted per clinical need). Child: Use with caution; dosing individualized.
Glyceryl Trinitrate (Vasodilator) Indications - Anal fissure, Hypertension control during surgery, Angina prophylaxis. Contraindications - Severe anemia, Hypotension, PDE5 inhibitors. Caution - May cause headache or syncope. Avoid - Concomitant sildenafil or alcohol. Trade names - Myonit SR 2.6 tab, Nitrosol aerosol spray. Adult: Sublingual 0.3–0.6 mg as needed. Child: Use with caution in pediatric cardiology.
Drospirenone (Progestin Hormone) Indications - Oral contraceptive, Prevent ovulation and pregnancy. Contraindications - Renal impairment, Hepatic dysfunction, Thrombosis. Caution - Monitor potassium levels. Avoid - Concomitant potassium-sparing agents. Trade names - Drosperin 3mg tab. Adult: One tablet daily for 21 days per cycle. Child: Not recommended before menarche.
Nutritional Supplements (Nutraceutical) Indications - General nutritional support, Vitamin deficiency, Immune and bone health. Contraindications - Hypersensitivity, Iron overload. Caution - Use evidence-based supplements; avoid overuse. Avoid - Excessive multivitamin intake. Trade names - BRAND’s Chicken Extract, PROBIOTICS Cap, SUMMER-B12, Supradyn CoQ10, D3-5 Cap, Chlorophyll Powder, Cartiflex, Icon Fertil, BCAA tab Adult: Usually once daily, per label. Child: Pediatric-specific formulas only.
Nicotine (Smoking Cessation Aid) Indications - Smoking cessation, Nicotine replacement therapy. Contraindications - Hypersensitivity, Non-smokers, Recent MI. Caution - Cardiovascular disease, Pregnancy. Avoid - Dual nicotine products without medical advice. Trade names - Oral Nosmok 2mg, 4mg Lozenges Adult: 1 lozenge every 1–2 hrs (max 15/day). Child: Not recommended under 18 years.
Docetaxel (Antineoplastic) Indications - Breast cancer, Lung cancer, Gastric adenocarcinoma, Head/neck cancer. Contraindications - Neutropenia, Hypersensitivity. Caution - Myelosuppression, Fluid retention. Avoid - Use in hepatic dysfunction. Trade names - tab:®, Cap:® Adult: 75 mg/m² IV every 3 weeks. Child: Not routinely used.
Amsacrine (Antineoplastic) Indications - Acute leukemia. Contraindications - Severe myelosuppression. Caution - Hypokalaemia, Cardiotoxicity. Avoid - Use in hepatic dysfunction. Trade names - tab:®, Cap:® (Specialist use only) Adult: IV infusion based on body surface area. Child: Specialist-directed only.
Arsenic Trioxide (Antineoplastic) Indications - Acute promyelocytic leukemia. Contraindications - QT prolongation, Electrolyte imbalances. Caution - Hypokalaemia, ECG monitoring. Avoid - Use in baseline QTc > 500 ms. Trade names - tab:®, Cap:® Adult: 0.15 mg/kg IV daily until remission. Child: Use under specialist supervision.
Eribulin (Antineoplastic) Indications - Metastatic breast cancer. Contraindications - Hypersensitivity, Severe neutropenia. Caution - Myelosuppression, QT prolongation. Avoid - Concurrent QT-prolonging agents. Trade names - tab:®, Cap:® Adult: 1.4 mg/m² IV on Days 1 and 8 every 21 days. Child: Not established.
Panobinostat (Antineoplastic) Indications - Multiple myeloma. Contraindications - Severe hepatic impairment. Caution - Diarrhea, QT prolongation. Avoid - Use in uncontrolled infection. Trade names - tab:®, Cap:® Adult: 20 mg orally, three times/week. Child: Not approved in pediatric population.
Pegaspargase (Antineoplastic) Indications - Acute lymphoblastic leukaemia. Contraindications - Pancreatitis, history of serious thrombosis, hypersensitivity to pegaspargase. Cautions - Coagulopathy, liver dysfunction. Avoid - Concomitant use with live vaccines. Trade names - Oncaspar® (Specialist use only) Adult: 2500 IU/m² IV or IM every 14 days. Child: 2500 IU/m² IV or IM every 14 days.
Bexarotene (Antineoplastic) Indications - Skin manifestations of cutaneous T-cell lymphoma. Contraindications - Pregnancy, lactation. Cautions - Hyperlipidaemia, hypothyroidism, liver impairment. Avoid - History of pancreatitis, Hypervitaminosis A, uncontrolled lipid disorders. Trade names - Targretin® Adult: 300 mg/m² orally once daily with food. Child: Safety and efficacy not established.
Tretinoin (Antineoplastic) Indications - Acute promyelocytic leukaemia. Contraindications - Pregnancy (unless life-threatening condition), hypersensitivity. Cautions - Increased thromboembolism risk, hepatic impairment. Avoid - Vitamin A supplementation, tetracyclines. Trade names - Vesanoid® Adult: 45 mg/m²/day in 2 divided doses orally until complete remission. Child: Same as adult, adjusted for body surface area.
Mesna (Detoxifying Drug) Indications - Prevention of haemorrhagic cystitis with ifosfamide or cyclophosphamide. Contraindications - Hypersensitivity to mesna. Cautions - Nausea, vomiting, allergic reactions. Avoid - Use in patients not receiving urotoxic chemotherapy. Trade names - Uromitexan® Adult: 20% of the ifosfamide dose, IV at time 0, 4, and 8 hours. Child: Same as adult, based on body surface area and chemotherapy dose.
Apalutamide (Antineoplastic) Indications - Non-metastatic castration-resistant prostate cancer. Contraindications - Hypersensitivity. Cautions - Seizure risk, falls, fractures, hypothyroidism. Avoid - Concomitant strong CYP3A4 inducers. Trade names - Erleada® (Specialist use only) Adult: 240 mg orally once daily (four 60 mg tablets). Child: Not indicated for pediatric use.
Degarelix, Antigonadotrophin releasing hormone (Antineoplastic) Indications - Advanced hormone-dependent prostate cancer. Contraindications - Hypersensitivity to Degarelix or any component of the formulation. Cautions - Diabetes, cardiovascular disease, QT prolongation. Avoid - Use in women, children, or adolescents. Trade names - Firmagon® Adult: Initial dose: 240 mg SC (two 120 mg injections), followed by 80 mg SC every 28 days. Child: Not indicated for use in pediatric patients.
Lanreotide (Somatostatin analogue) Indications - Acromegaly, Neuroendocrine tumours, Unresectable locally advanced or metastatic gastroenteropancreatic neuroendocrine tumours of midgut, pancreatic or unknown origin. Cautions - Cardiac disorders, Bradycardia, Patients with carcinoid tumours, Obstructive intestinal tumour. Trade names - Somatuline Autogel® Adult: 60 to 120 mg every 28 days by deep SC injection. Child: Not established.
Pasireotide (Somatostatin analogue) Indications - Cushing's disease, Acromegaly. Cautions - QT prolongation, Diabetes, Hepatic impairment. Trade names - Signifor®, Signifor LAR® Adult: 600 mcg SC twice daily (Cushing’s), or 40 mg IM every 4 weeks (Acromegaly). Child: Not recommended.
Fulvestrant, Antineoplastic (Selective Estrogen Receptor Degrader) Indications - Oestrogen-receptor-positive breast cancer. Trade names - Faslodex® Adult: 500 mg IM on days 0, 14, 28, then every 28 days. Child: Not indicated.
Toremifene, Antineoplastic (SERM) Indications - Hormone-dependent metastatic breast cancer in postmenopausal women. Trade names - Fareston® Adult: 60 mg orally once daily. Child: Not applicable.
Exemestane (Aromatase inhibitor) Indications - Estrogen receptor-positive early and advanced breast cancer in postmenopausal women, Male hypersexuality. Trade names - Exemestane Alvogen® Adult: 25 mg orally once daily after a meal. Child: Not established.
Letrozole (Aromatase inhibitor) Indications - Hormone-dependent advanced breast cancer, Estrogen-receptor-positive early breast cancer in postmenopausal women. Trade names - Femara® Adult: 2.5 mg orally once daily. Child: Not approved.
Talimogene laherparepvec (Antineoplastic) Indications - Unresectable metastatic melanoma. Trade names - Imlygic® Adult: Up to 4 mL of 10^6 PFU/mL initially, then 10^8 PFU/mL every 2 weeks. Child: Not studied.
Aldesleukin (Immunostimulant, recombinant interleukin-2) Indications - Metastatic renal cell carcinoma, metastatic melanoma. Contraindications - Organ transplant recipients, significant cardiac or pulmonary impairment, active infections, seizures. Cautions - Autoimmune diseases, elderly patients, hypotension, capillary leak syndrome. Avoid - Concomitant corticosteroids unless essential. Trade names - Proleukin® Adult: 600,000 IU/kg (37 mcg/kg) IV over 15 min every 8 hours for up to 14 doses per cycle; repeat cycles per response. Child: Not approved; specialist use in clinical settings only.
Bacillus Calmette-Guerin (BCG) (Immunostimulant, live attenuated mycobacteria) Indications - Intravesical therapy for non-muscle-invasive bladder cancer (e.g., carcinoma in situ, high-risk Ta/T1 tumors). Contraindications - Immunosuppression, active tuberculosis, gross hematuria, recent bladder trauma. Cautions - Elderly, febrile illness, urinary tract infections, bladder catheterization risks. Avoid - Systemic administration, immunocompromised patients. Trade names - OncoTICE®, BCG-Medac® Adult: 50 mg in 50 ml saline intravesically once weekly for 6 weeks (induction), followed by maintenance therapy as required. Child: Not established; use only in clinical trials.
Mifamurtide (Immunostimulant, macrophage activator) Indications - Non-metastatic high-grade osteosarcoma following surgical resection and chemotherapy. Contraindications - Hypersensitivity to mifamurtide or liposomal formulation components. Cautions - Autoimmune disorders, inflammatory conditions, cardiovascular disease. Avoid - Concurrent immunosuppressive therapy (e.g., cyclosporine, corticosteroids). Trade names - Mepact® Adult: Not recommended for adults >30 years. Child: 2 mg/m² IV over 1 hour twice weekly for 12 weeks, then once weekly for 24 weeks (total 48 infusions).
Pomalidomide (Immunosuppressant, thalidomide analogue) Indications - Relapsed/refractory multiple myeloma after ≥2 prior therapies including lenalidomide and a proteasome inhibitor. Contraindications - Pregnancy, hypersensitivity to pomalidomide, thalidomide, or lenalidomide. Cautions - Risk of thrombosis, neutropenia, liver impairment, neuropathy. Avoid - Use in pregnancy, breastfeeding, and live vaccines during therapy. Trade names - Pomalyst® Adult: 4 mg orally once daily on days 1–21 of each 28-day cycle with dexamethasone. Child: Not approved for pediatric use.
Temoporfin (Photosensitiser) Indications - Photodynamic therapy of advanced head and neck squamous cell carcinoma refractory to or unsuitable for other treatments. Contraindications - Hypersensitivity to temoporfin, porphyria. Cautions - Liver impairment, skin photosensitivity, porphyrin metabolism disorders. Avoid - Pregnancy, breastfeeding, strong sunlight for at least 30 days post-treatment. Trade Names - Foscan® Adult: 0.15 mg/kg IV, followed 96 hours later by light activation (~75 J/cm² to tumor). Child: Not established; specialist use only.
Binimetinib (MEK inhibitor ) Indications - Unresectable or metastatic BRAF V600 mutation-positive melanoma in combination with a BRAF inhibitor. Contraindications - Hypersensitivity to binimetinib. Cautions - Cardiotoxicity, interstitial lung disease, ophthalmic events, liver enzyme elevation. Avoid - Pregnancy, breastfeeding. Trade Names - Mektovi® Adult: 45 mg orally twice daily in combination therapy. Child: Not recommended.
Bosutinib (Tyrosine kinase inhibitor) Indications - Chronic myeloid leukaemia in adults resistant or intolerant to prior therapy. Contraindications - Hypersensitivity to bosutinib. Cautions - Hepatic impairment, cardiac arrhythmias, diarrhoea/dehydration risk. Avoid - Pregnancy, breastfeeding. Trade Names - Bosulif® Adult: 400 mg orally once daily; may increase to 500 mg daily based on tolerance. Child: Not established; specialist use only.
Brigatinib (ALK inhibitor) Indications - ALK-positive advanced non-small cell lung cancer resistant to crizotinib. Contraindications - Hypersensitivity. Cautions - Interstitial lung disease, hypertension, bradycardia, hepatic impairment. Avoid - Pregnancy, breastfeeding. Trade Names - Alunbrig® Adult: 90 mg once daily for 7 days, then increase to 180 mg daily. Child: Not recommended.
Cabozantinib (Tyrosine kinase inhibitor) Indications - Metastatic medullary thyroid carcinoma, advanced renal cell carcinoma. Contraindications - Hypersensitivity. Cautions - Gastrointestinal perforation, bleeding risk, hypertension, liver impairment. Avoid - Pregnancy, breastfeeding. Trade Names - Cabometyx® (RCC), Cometriq® (MTC) Adult: 140 mg daily for MTC; 60 mg daily for RCC. Child: Not recommended.
Ceritinib (ALK inhibitor) Indications - ALK-positive advanced non-small cell lung cancer, treatment-naïve or post-crizotinib. Contraindications - Hypersensitivity. Cautions - Hepatotoxicity, gastrointestinal perforation, QT prolongation. Avoid - Pregnancy, breastfeeding. Trade Names - Zykadia® Adult: 450 mg once daily with food. Child: Not recommended.
Cobimetinib (MEK inhibitor ) Indications - BRAF V600 mutation-positive unresectable/metastatic melanoma in combination with vemurafenib. Contraindications - Hypersensitivity. Cautions - Cardiotoxicity, ocular toxicity, photosensitivity, liver enzyme elevations. Avoid - Pregnancy, breastfeeding. Trade Names - Cotellic® Adult: 60 mg once daily on days 1–21 of each 28-day cycle, combined with vemurafenib. Child: Not recommended.
Crizotinib (ALK & ROS1 Tyrosine Kinase Inhibitor) Indications - ALK-positive or ROS1-positive advanced non-small cell lung cancer (NSCLC). Contraindications - Hypersensitivity to crizotinib. Cautions - Hepatic impairment, bradycardia, QT prolongation, visual disturbances. Avoid - Pregnancy, breastfeeding. Trade Names - Xalkori® Adult: 250 mg orally twice daily. Child: Recommended for ≥12 years: 280 mg/m² twice daily (max 250 mg BD).
Dabrafenib (BRAF Inhibitor ) Indications - Unresectable/metastatic melanoma with BRAF V600 mutation (monotherapy or with trametinib), BRAF V600 mutation-positive NSCLC (with trametinib). Contraindications - Hypersensitivity to dabrafenib. Cautions - Hyperglycaemia, fever, cutaneous squamous cell carcinoma, uveitis. Avoid - Pregnancy, breastfeeding. Trade Names - Tafinlar® Adult: 150 mg orally twice daily, on empty stomach. Child: For ≥1 year (with BRAF mutation): 4.5 mg/kg/day in divided doses.
Dasatinib (BCR-ABL Tyrosine Kinase Inhibitor – initiate by specialist) Indications - Chronic phase, accelerated or blast phase CML resistant/intolerant to prior therapy; Ph+ ALL. Contraindications - Hypersensitivity to dasatinib. Cautions - Myelosuppression, fluid retention, pulmonary arterial hypertension. Avoid - Pregnancy, breastfeeding. Trade Names - Sprycel® Adult: 100 mg once daily (CML), 140 mg once daily (Ph+ ALL). Child: 60–100 mg/m² once daily (based on body surface area).
Encorafenib (BRAF Inhibitor) Indications - BRAF V600E mutation-positive unresectable or metastatic melanoma (with binimetinib); metastatic colorectal cancer (with cetuximab). Contraindications - Hypersensitivity to encorafenib. Cautions - QT prolongation, liver enzyme elevation, hemorrhage. Avoid - Pregnancy, breastfeeding. Trade Names - Braftovi® Adult: 450 mg once daily (melanoma); 300 mg once daily (CRC). Child: Not recommended.
Erlotinib (EGFR Tyrosine Kinase Inhibitor) Indications - Advanced NSCLC (with EGFR mutations), Pancreatic cancer (with gemcitabine). Contraindications - Hypersensitivity to erlotinib. Cautions - Interstitial lung disease, hepatic/renal impairment, smoking (decreased efficacy). Avoid - Pregnancy, breastfeeding. Trade Names - Erlotec® Adult: 150 mg daily (NSCLC); 100 mg daily (pancreatic cancer). Child: Not established.
Everolimus (mTOR Inhibitor ) Indications - Neuroendocrine tumors (pancreatic, GI, lung), Renal cell carcinoma, Breast cancer, Organ transplant prophylaxis. Contraindications - Hypersensitivity to everolimus or other rapamycin derivatives. Cautions - Immunosuppression, infection risk, stomatitis, metabolic disturbances. Avoid - Pregnancy, breastfeeding. Trade Names - Afinitor®, Certican® (transplant) Adult: 10 mg once daily (oncology); 0.75–1.5 mg twice daily (transplant). Child: Variable; adjust by indication and body surface area.
Gefitinib (EGFR Tyrosine Kinase Inhibitor ) Indications - Locally advanced or metastatic non-small cell lung cancer with EGFR activating mutations. Contraindications - Hypersensitivity to gefitinib. Cautions - Interstitial lung disease, hepatic impairment, eye disorders. Avoid - Pregnancy, breastfeeding. Trade Names - Iressa® Adult: 250 mg orally once daily, with or without food. Child: Not established.
Ibrutinib (Bruton's Tyrosine Kinase Inhibitor ) Indications - Relapsed/refractory mantle cell lymphoma, chronic lymphocytic leukaemia (CLL), Waldenström’s macroglobulinemia. Contraindications - Hypersensitivity to ibrutinib. Cautions - Bleeding disorders, atrial fibrillation, hypertension, infections. Avoid - Pregnancy, breastfeeding. Trade Names - Imbruvica® Adult: 420 mg to 560 mg orally once daily depending on indication. Child: Not recommended (under investigation for pediatric use).
Idelalisib (PI3Kδ Inhibitor) Indications - Chronic lymphocytic leukaemia (with rituximab), follicular lymphoma (relapsed). Contraindications - Severe hepatic impairment. Cautions - Colitis, pneumonitis, hepatotoxicity, neutropenia. Avoid - Pregnancy, breastfeeding. Trade Names - Zydelig® Adult: 150 mg orally twice daily. Child: Not recommended.
Imatinib (BCR-ABL Tyrosine Kinase Inhibitor ) Indications - Chronic myeloid leukaemia, acute lymphoblastic leukaemia (Ph+), GIST (gastrointestinal stromal tumors), dermatofibrosarcoma protuberans. Contraindications - Hypersensitivity to imatinib. Cautions - Hepatic/renal impairment, fluid retention, myelosuppression. Avoid - Pregnancy, breastfeeding. Trade Names - Glivec®, Imatib® Adult: 400–600 mg/day depending on indication. Child: 260–340 mg/m²/day depending on condition.
Lapatinib (HER2 & EGFR Tyrosine Kinase Inhibitor) Indications - HER2-positive advanced or metastatic breast cancer (in combination with capecitabine or letrozole). Contraindications - Hypersensitivity to lapatinib. Cautions - Hepatotoxicity, cardiac toxicity, diarrhea, pulmonary toxicity. Avoid - Pregnancy, breastfeeding. Trade Names - Tykerb® Adult: 1,250 mg orally once daily (breast cancer regimen). Child: Not recommended.
Midostaurin (FLT3 Inhibitor ) Indications - FLT3 mutation-positive acute myeloid leukaemia, aggressive systemic mastocytosis, systemic mastocytosis with associated hematologic neoplasm, mast cell leukemia. Contraindications - Hypersensitivity to midostaurin. Cautions - QT prolongation, neutropenia, nausea/vomiting, infections, renal impairment. Avoid - Pregnancy, breastfeeding. Trade Names - Rydapt® Adult: 50 mg twice daily with food (mastocytosis); 50 mg twice daily (days 8–21 of induction/consolidation chemotherapy for AML). Child: Not recommended.
Nilotinib (BCR-ABL Tyrosine Kinase Inhibitor – initiate by specialist) Indications - Newly diagnosed Ph+ chronic phase CML, chronic/accelerated phase CML resistant to prior therapy (e.g., imatinib). Contraindications - Hypersensitivity, long QT syndrome, hypokalaemia/hypomagnesaemia. Cautions - QT prolongation, hepatic impairment, metabolic disturbances. Avoid - Pregnancy, breastfeeding. Trade Names - Tasigna® Adult: 300 mg twice daily (newly diagnosed), 400 mg twice daily (resistant/intolerant cases). Child: ≥1 year: dosing based on body surface area, max 400 mg/m²/day.
Nintedanib (Antineoplastic) Indications - Treatment of idiopathic pulmonary fibrosis; treatment of locally advanced, metastatic or locally recurrent non-small cell lung cancer of adenocarcinoma histology after first-line chemotherapy (in combination with docetaxel). Avoid - Not specified. Cautions - Initiate under specialist supervision. Trade Names - Ofev®, Vargatef® Adult: 150 mg twice daily orally (or as directed by a specialist). Child: Not established.
Osimertinib (Antineoplastic) Indications - Locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer. Avoid - Not specified. Cautions - Specialist use only. Trade Names - Tagrisso® Adult: 80 mg once daily orally. Child: Not established.
Palbociclib (Antineoplastic) Indications - Locally advanced or metastatic breast cancer. Avoid - Not specified. Cautions - Initiate by a specialist. Trade Names - Ibrance® Adult: 125 mg once daily orally for 21 days followed by 7 days off (28-day cycle). Child: Not established.
Pazopanib (Antineoplastic) Indications - First-line treatment of advanced renal cell carcinoma; treatment of advanced renal cell carcinoma in patients previously treated with cytokine therapy; treatment of selective subtypes of advanced soft-tissue sarcoma. Avoid - Not specified. Cautions - Use with monitoring. Trade Names - Votrient® Adult: 800 mg once daily orally. Child: Not established.
Ponatinib (Antineoplastic) Indications - Treatment of chronic, accelerated, or blast phase chronic myeloid leukaemia with T315I mutation or resistance/intolerance to dasatinib or nilotinib; treatment of Philadelphia chromosome-positive acute lymphoblastic leukaemia with T315I mutation or resistance/intolerance to dasatinib. Avoid - Not specified. Cautions - Specialist initiation required. Trade Names - Iclusig® Adult: 45 mg once daily orally. Child: Not established.
Ribociclib (Antineoplastic, CDK4/6 inhibitor) Indications - Hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer. Contraindications - None absolute, but avoid in patients with QT prolongation or strong CYP3A4 inhibitors. Cautions - QT prolongation, hepatic impairment, neutropenia, infections. Avoid - Pregnancy, breastfeeding; strong CYP3A4 modulators. Trade Names - Kisqali® Drug Interactions - CYP3A4 substrates/inhibitors/inducers, QT‑prolonging drugs, tamoxifen, hormonal therapies. Adult: 600 mg orally once daily for 21 days on, 7 days off per 28-day cycle. Child: Not established; not recommended under 18 years.
Ruxolitinib (Antineoplastic, JAK1/2 inhibitor) Indications - Splenomegaly or symptoms from primary myelofibrosis, post–polycythaemia vera or post–essential thrombocythaemia myelofibrosis. Contraindications - None absolute, avoid in severe cytopenias. Cautions - Infections, cytopenias (anemia, thrombocytopenia), hepatic impairment. Avoid - Pregnancy, breastfeeding; strong CYP3A4 and CYP2C9 inhibitors. Trade Names - Jakavi® Drug Interactions - CYP3A4/2C9 inhibitors/inducers, live vaccines. Adult: 15–20 mg twice daily orally (dose adjusted by platelet count). Child: Not established; use only in clinical trials.
Methotrexate (Antineoplastic, Immunosuppressant) Indications - Severe Crohn's disease, active rheumatoid arthritis, severe psoriasis, neoplastic diseases (various cancers including leukemia, lymphoma, breast cancer). Contraindications - Pregnancy, breastfeeding, severe renal or hepatic impairment, immunodeficiency, bone marrow suppression, active infections. Cautions - Renal impairment, hepatic impairment, elderly patients, alcoholism, peptic ulcer disease, ulcerative stomatitis. Avoid - Pregnancy, breastfeeding. Trade names - Methotrexate® tab, Cap Drug interactions - NSAIDs, penicillins, sulfonamides, proton pump inhibitors, trimethoprim, live vaccines. Adult: Varies by indication; typical rheumatoid arthritis dose: 7.5–25 mg once weekly (oral or injectable). Child: Depends on indication; often 10–15 mg/m² once weekly, dose adjusted per disease.
Sunitinib (Antineoplastic, multikinase inhibitor) Indications - Unresectable/metastatic GIST post-imatinib failure; advanced/metastatic renal cell carcinoma; unresectable/metastatic pancreatic neuroendocrine tumours. Contraindications - None absolute; severe hepatic impairment. Cautions - Cardiac dysfunction, hypertension, hemorrhage, thyroid dysfunction, hepatic/renal impairment. Avoid - Pregnancy, breastfeeding; strong CYP3A4 inhibitors/inducers. Trade Names - Sutent® Drug Interactions - CYP3A4 modulators, QT‑prolonging agents, anticoagulants. Adult: 50 mg orally once daily for 4 weeks on, 2 weeks off per 6-week cycle. Child: Not established; pediatric dosing in trials only.
Temsirolimus (Antineoplastic, mTOR inhibitor) Indications - Advanced renal cell carcinoma; relapsed/refractory mantle cell lymphoma. Contraindications - Hypersensitivity to temsirolimus, severe hepatic impairment. Cautions - Infections, hyperglycemia, hyperlipidemia, interstitial lung disease. Avoid - Pregnancy, breastfeeding; strong CYP3A4 inhibitors/inducers. Trade Names - Torisel® Drug Interactions - CYP3A4 modulators, live vaccines, P-gp substrates. Adult: 25 mg IV once weekly. Child: Not established; not recommended under 18 years.
Tivozanib (Antineoplastic, VEGFR tyrosine kinase inhibitor) Indications - Advanced renal cell carcinoma. Contraindications - None absolute; severe hepatic impairment. Cautions - Hypertension, cardiac events, hepatotoxicity, proteinuria. Avoid - Pregnancy, breastfeeding; strong CYP3A4 inhibitors/inducers. Trade Names - Fotivda® Drug Interactions - CYP3A4 modulators, anticoagulants. Adult: 1.34 mg orally once daily on 21 days on, 7 days off per 28-day cycle. Child: Not established.
Trametinib (Antineoplastic, MEK inhibitor) Indications - Advanced non-small cell lung cancer; stage III melanoma. Contraindications - None absolute: avoid in cardiac dysfunction. Cautions - Cardiomyopathy, retinal disorders, interstitial lung disease, hepatic impairment. Avoid - Pregnancy, breastfeeding; strong CYP3A4 inducers. Trade Names - Mekinist® Drug Interactions - CYP3A4 modulators, antibiotics, anticoagulants. Adult: 2 mg orally once daily. Child: Not established.
Vandetanib (Antineoplastic, RET/VEGFR/EGFR inhibitor) Indications - Aggressive or symptomatic medullary thyroid cancer. Contraindications - Congenital long QT syndrome, uncontrolled arrhythmias. Cautions - QT prolongation, diarrhea, hypertension, hepatic impairment. Avoid - Pregnancy, breastfeeding; strong CYP3A4 modulators. Trade Names - Caprelsa® Drug Interactions - QT‑prolonging drugs, CYP3A4 modulators, warfarin. Adult: 300 mg orally once daily. Child:
Vemurafenib (Antineoplastic, BRAF inhibitor) Indications - BRAF V600 mutation-positive unresectable or metastatic melanoma. Contraindications - QT prolongation, prior non-melanoma skin cancer. Cautions - Photosensitivity, dermatologic reactions, hepatic impairment. Avoid - Pregnancy, breastfeeding; strong CYP3A4 modulators. Trade Names - Zelboraf® Drug Interactions - CYP3A4 modulators, rifampicin, warfarin. Adult: 960 mg orally twice daily. Child: Not established.
Lymecycline (Tetracycline antibiotic) Indications - Chlamydia, Rickettsia, Mycoplasma, Acne. Contraindications - Renal impairment. Cautions - Not specified. Avoid - Renal impairment. Trade Names - tab:®, Cap:® Drug Interactions - Not specified. Adult:Not specified. Child:Not specified.
Epoetin zeta (Erythropoiesis‑stimulating agent) Indications - Symptomatic anaemia associated with chronic renal failure; severe symptomatic renal anaemia in adults not yet on dialysis; anaemia in adults receiving chemotherapy for non‑myeloid malignancies. Contraindications - Pure red cell aplasia; uncontrolled hypertension; known hypersensitivity. Cautions - Hypertension; risk of thrombosis; iron deficiency; cardiovascular disease; seizure disorders. Avoid - Active malignancy (may accelerate tumour progression); inadequate iron stores. Trade Names - Binocrit®, Silapo®, Retacrit® Drug Interactions - May reduce efficacy of ACE inhibitors; monitor during simultaneous use of warfarin or other anticoagulants. Adult:Initial: 25–50 IU/kg subcutaneously 3× weekly or 4000 IU once weekly; adjust based on Hb response; avoid >13 g/dL. Child:Limited data; dosing individualised (approx. 25 IU/kg 3× weekly) with close monitoring.
Eculizumab (Immunosuppressant) Indications - Reduce haemolysis in paroxysmal nocturnal haemoglobinuria; treat atypical haemolytic uraemic syndrome (aHUS). Contraindications - Active unresolved Neisseria meningitidis infection; hypersensitivity. Cautions - Infection risk—especially meningococcal; vaccination status; monitor renal/hematologic status. Avoid - Unvaccinated against meningococcus; pregnancy unless benefit outweighs risk; breastfeeding. Trade Names - Soliris®, Ultomiris® Drug Interactions - No significant CYP interactions; immunosuppressants may increase infection risk. Adult:Initial 600 mg IV weekly × 4 doses, then 900 mg IV every 2 weeks for PNH; for aHUS: 900 mg IV weekly × 4, then 1200 mg IV every 2 weeks. Child:
Sodium feredetate (Sodium iron edetate) Indications - Oral treatment of iron deficiency anaemia. Contraindications - Iron overload; hypersensitivity to iron edetate. Cautions - Gastrointestinal disorders; chronic disease; monitor iron indices. Avoid - Use with high dietary calcium or antacids; separate dosing. Trade Names - Feraccru®, Ferrex® (oral solutions) Drug Interactions - Antacids, H₂-blockers, proton-pump inhibitors reduce absorption. Adult:100–200 mg elemental iron daily; adjust based on response. Child: 1–3 mg/kg/day elemental iron; specialist guidance recommended.
Hydroxocobalamin (Vitamin B₁₂ analogue) Indications - Prophylaxis/treatment of B₁₂ deficiency‑related macrocytic anaemias; pernicious anaemia; tobacco amblyopia; Leber’s optic atrophy; cyanide poisoning. Contraindications - Hypersensitivity; early Leber’s disease (risk optic atrophy progression). Cautions - Monitor folate status; may interfere with some lab tests (e.g. folate, creatinine). Avoid - No special avoidance; pregnancy/breastfeeding beneficial. Trade Names - Cobalin‑M®, Hydroxocobex® Drug Interactions - No significant known interactions; chloramphenicol may antagonize effect. Adult: 1000 µg IM or IV daily ×7 days, then weekly ×4 weeks, then monthly. Child: IM 50–100 µg/kg (max 1000 µg) daily for 7 days, then monthly maintenance.
Deferasirox (Iron chelator) Indications - Chronic iron overload due to blood transfusions or excessive iron absorption. Contraindications - Severe renal/hepatic impairment; hypersensitivity. Cautions - Monitor renal and hepatic function; GI ulcer history; skin rash; elderly higher risk. Avoid - Pregnancy and breastfeeding unless benefits outweigh risk. Trade Names - Exjade®, Jadenu® Drug Interactions - May increase levels of hepatotoxic agents; avoid NSAIDs/aminoglycosides; monitor concomitant chelation. Adult: 20 mg/kg orally once daily; adjust per serum ferritin or liver iron (range 5–30 mg/kg). Child:
Lenograstim (Recombinant G‑CSF) Indications - Neutropenia reduction post‑BMT; peripheral blood progenitor cell mobilization; adjunct myelosuppressive chemotherapy. Contraindications - Hypersensitivity to E. coli‑derived proteins; myeloid malignancies. Cautions - Bone pain; splenomegaly; sickle cell disease; monitor CBC. Avoid - Active leukemia progression. Trade Names - Granocyte®, Lenos®, Neutrograst® Drug Interactions - May mask infection signs in antibiotics; use cautiously with chemotherapeutics. Adult: 5–10 µg/kg/day SC starting 24 h after chemo until neutrophil recovery. Child: 5 µg/kg/day SC (up to 10 µg/kg) under specialist pediatric protocols.
Pegfilgrastim (Pegylated G‑CSF) Indications - Reduction of neutropenia duration and febrile neutropenia risk during cytotoxic chemotherapy. Contraindications - Hypersensitivity to filgrastim or pegfilgrastim. Cautions - Monitor CBC and spleen size; bone pain; caution with sickle cell anaemia. Avoid - None specified beyond contraindications. Trade Names - Neulasta®, Lonquex® Drug Interactions - No known significant interactions. Adult: 6 mg SC once per chemotherapy cycle (24 h post‑chemo). Child: Not routinely recommended (limited pediatric use).
Plerixafor (CXCR4 antagonist) Indications - Mobilization of hematopoietic stem cells for autologous transplantation in lymphoma or multiple myeloma. Contraindications - Hypersensitivity to plerixafor or excipients. Cautions - Splenic enlargement; monitor WBC and spleen size. Avoid - Pregnancy and breastfeeding unless clearly needed. Trade Names - Mozobil® Drug Interactions - No major CYP interactions; caution with G‑CSF overlapping effects. Adult: 0.24 mg/kg SC daily evening before apheresis, continued until completion of collection. Child: Not established; occasional pediatric use under specialist care.
Anagrelide (Antithrombotic) Indications - Essential thrombocythaemia in patients at risk of thrombo‑haemorrhagic events who have not responded adequately to or cannot tolerate other drugs. Contraindications - Severe cardiac disease, uncontrolled hypertension. Cautions - Heart failure, tachyarrhythmias, hepatic or renal impairment. Avoid - Pregnancy, Breastfeeding. Trade Names - Agrylin® Drug Interactions - CYP1A2 inhibitors (e.g. fluvoxamine), other antiplatelet/anticoagulant agents. Adult: 0.5 mg orally twice daily, may increase to 1–3 mg/day (max 10 mg/day) under specialist supervision. Child: Not established (not recommended).
Eltrombopag (Thrombopoietin receptor agonist) Indications - Chronic immune thrombocytopenic purpura refractory to other treatments; thrombocytopenia in chronic hepatitis C; acquired severe aplastic anaemia refractory to immunosuppression. Contraindications - Pregnancy unless benefit outweighs risk; hepatic impairment. Cautions - Hepatotoxicity; thromboembolism risk; cataracts; monitor liver function. Avoid - Breastfeeding. Trade Names - Revolade® Drug Interactions - Calcium‑containing products (reduce absorption), eltrombopag levels inhibited; avoid concurrent hepatotoxic drugs. Adult: 50 mg orally once daily; adjust to 25–75 mg based on platelet response. Child: Not routinely recommended; specialist pediatric dosing when used.
Romiplostim (Thrombopoietin receptor agonist) Indications - Chronic immune thrombocytopenic purpura refractory to other treatments. Contraindications - Hypersensitivity to romiplostim or its components. Cautions - Risk of bone marrow fibrosis; rebound thrombocytopenia; monitor platelet counts. Avoid - Pregnancy, Breastfeeding unless benefit outweighs risk. Trade Names - Nplate® Drug Interactions - No significant CYP interactions; concurrent antiplatelet/anticoagulant use needs caution. Adult: 1 μg/kg subcutaneously weekly; adjust up to 10 μg/kg to maintain platelet counts ≥50×10⁹/L. Child: 2–5 μg/kg/week subcutaneously under specialist supervision.
Sodium chloride (Lubricant/Irrigant) Indications - Tear deficiency; ocular irrigant; wound cleaning agents; chronic renal salt wasting; corneal oedema; DKA fluid replacement; bladder drug diluent; oral hygiene. Contraindications - None absolute—but systemic use caution in fluid retention states. Cautions - Cardiac failure, hypertension, pulmonary or peripheral oedema; monitor fluid status. Avoid - Use conservatively in fluid-overloaded states. Trade Names - Normal Saline®, Physioneal® Drug Interactions - May dilute effect of other topical medications; no systemic drug interactions. Adult: Topical/ocular: as required; IV: 0.9% saline per clinical need. Child: As per weight-based maintenance or clinical indication.
Glucose (Simple carbohydrate solution) Indications - Gestational diabetes testing; oral glucose tolerance; hypoglycaemia; energy source; water replacement; DKA management adjunct; persistent neonatal cyanosis. Contraindications - None relative when clinically indicated; hyperglycaemia states avoided unless treat hypoglycaemia. Cautions - Use cautiously in uncontrolled diabetes; monitor blood glucose levels. Avoid - Not part of fluid replacement in hyperglycaemia conditions. Trade Names - Glucol®, Dex4® Drug Interactions - May affect absorption or action of oral hypoglycaemics; adjust insulin therapy. Adult: Oral: 15–20 g (approx. 3–4 teaspoons) for hypoglycaemia; IV DKA: as part of D5W/normal saline per protocol. Child: Hypoglycaemia: 0.5–1 g/kg oral; neonatal DKA: weight-based IV per guidelines.
Cinacalcet (Calcium regulation drug) Indications - Secondary hyperparathyroidism in end-stage renal disease on dialysis; hypercalcaemia in parathyroid carcinoma; primary hyperparathyroidism when surgery inappropriate. Contraindications - Hypersensitivity to cinacalcet; hypocalcaemia. Cautions - Monitor calcium; risk of hypocalcaemia. Avoid - Severe hypocalcaemia; pregnancy; breastfeeding. Trade Names - Sensipar®, Mimpara® Drug Interactions - CYP3A4, CYP2D6, and CYP1A2 inhibitors/inducers may alter levels; co‑admin with calcium or vitamin D alters effect. Adult: Initially 30 mg orally once daily; titrate to 60–180 mg daily based on PTH and calcium. Child: Not established (not recommended under 18 years).
Etelcalcetide (Calcium regulation drug) Indications - Secondary hyperparathyroidism in chronic kidney disease patients on haemodialysis. Contraindications - Hypersensitivity to etelcalcetide; hypocalcaemia. Cautions - Monitor calcium post-dose; adjust dialysate calcium. Avoid - Hypocalcaemia; pregnancy; breastfeeding. Trade Names - Parsabiv® Drug Interactions - May enhance hypocalcaemic effect of other calcium-lowering agents. Adult: 5 mg IV three times weekly at end of haemodialysis; titrate up to 15 mg. Child: Not established (not recommended under 18 years).
Calcium chloride (Mineral supplement) Indications - Severe acute hypocalcaemia; hypocalcaemic tetany. Contraindications - Hypercalcaemia; ventricular fibrillation. Cautions - IV extravasation risk; cardiac monitoring advised. Avoid - Respiratory failure; digoxin therapy. Trade Names - CalciCl®, Calcium Chloride Injection USP Drug Interactions - May potentiate digitalis; antagonizes tetracyclines, bisphosphonates. Adult: 100–200 mg elemental calcium IV slowly (2–4 mL of 10% solution over 5–10 min); repeat as needed. Child: 20 mg/kg elemental calcium IV slowly (max 1 g/dose).
Albumin solution (Colloid volume expander) Indications - Decreased plasma volume (e.g., pancreatitis, trauma); severe hypoalbuminaemia with edema; post-paracentesis in ascites. Contraindications - None absolute; avoid in severe anemia without volume need. Cautions - Cardiac failure; severe anemia; use cautiously to avoid volume overload. Avoid - Severe fluid overload without circulatory need. Trade Names - Albutein®, Plasbumin® Drug Interactions - No significant drug binding; may affect albumin-bound drug levels. Adult: 100–200 mL IV 20% or 4–5% depending on indication; repeat per clinical response. Child: 10–20 mL/kg IV depending on volume deficit.
Gelatin solution (Colloid volume expander) Indications - Hypovolaemic shock due to acute blood loss when crystalloids insufficient. Contraindications - Known allergy to gelatin products. Cautions - Cardiac disease; liver failure; renal impairment; monitor coagulation. Avoid - Pregnancy; hepatic impairment; severe coagulopathy. Trade Names - Voluven®, Gelofusine® Drug Interactions - May interfere with blood typing and coagulation tests. Adult: 500–1000 mL of 3.5–4% solution IV; repeat as needed. Child: 10–20 mL/kg IV; monitor hemodynamics.
Tetrastarch (Colloid volume expander) Indications - Hypovolaemia due to acute blood loss when crystalloids alone are inadequate. Contraindications - Burns; cerebral hemorrhage; sepsis; severe coagulopathy; renal failure requiring dialysis. Cautions - Critically ill; dehydration; cardiac failure; monitor coagulation and renal function. Avoid - Intracranial hemorrhage; burns; sepsis; pulmonary edema. Trade Names - Tetraspan®, Hextend® Drug Interactions - May potentiate anticoagulants and affect acid-base balance. Adult: 250–500 mL IV per bolus; total up to 20 mL/kg/day. Child: Not routinely recommended; specialist guidance required.
Magnesium aspartate (Electrolyte supplement) Indications - Treatment and prevention of magnesium deficiency. Contraindications - Severe renal impairment. Cautions - Use with caution in mild renal impairment. Avoid - Severe renal impairment. Trade Names - MagnesiTab®, AspaMag® Drug Interactions - May interact with antibiotics (e.g., tetracyclines, quinolones), bisphosphonates, levothyroxine. Adult: Typically 250–500 mg elemental magnesium daily in divided doses. Child: Not established; use pediatric formulations based on weight.
Magnesium sulfate (Electrolyte and anticonvulsant) Indications - Severe acute asthma; seizure prophylaxis in pre-eclampsia/eclampsia; hypomagnesaemia; emergency arrhythmia treatment; rapid bowel evacuation. Contraindications - High-degree heart block; myocardial damage with calcium deficiency. Cautions - Oral use in elderly/debilitated; monitor renal function and reflexes. Avoid - Oral use in elderly and debilitated patients. Trade Names - EpsomTab®, MagSul® Drug Interactions - Enhances neuromuscular blockade; increased effect with calcium channel blockers, aminoglycosides. Adult: IV: 1–4 g over 15–60 min (as indicated); Oral for bowel prep: ~10–20 g. Child: IV: 25–50 mg/kg (max 2 g/dose); oral not routinely recommended.
Sucroferric oxyhydroxide (Phosphate binder) Indications - Hyperphosphataemia in chronic kidney disease patients on dialysis. Contraindications - Not specified. Cautions - Monitor for iron overload; use caution in bowel obstruction. Avoid - None specified; consult nephrologist. Trade Names - Velphoro® Drug Interactions - May bind other oral medications; separate dosing by ≥2 h. Adult: 500 mg (one tablet) with each meal; titrate to phosphorus. Child: Not established in pediatric patients.
Calcium polystyrene sulfonate (Cation exchange resin) Indications - Hyperkalaemia in anuria, severe oliguria, or dialysis patients. Contraindications - Hypocalcaemia, intestinal obstruction, fecal impaction. Cautions - Use cautiously in edema, CHF, hypertension. Avoid - Hyperparathyroidism; obstructive bowel disease. Trade Names - CalciRes®, Kalimate® Drug Interactions - May reduce absorption of digoxin, lithium, tetracyclines; separate by ≥3 h. Adult: 15 g orally 1–4 times daily. Child: Not routinely recommended; use under specialist guidance.
Patiromer calcium (Potassium binder) Indications - Hyperkalaemia. Contraindications - Hypomagnesaemia; bowel obstruction. Cautions - Monitor electrolytes; separate administration of other oral meds by ≥3 h. Avoid - Not specified; caution with gastrointestinal motility disorders. Trade Names - Veltassa® Drug Interactions - May interact with ciprofloxacin, levothyroxine, metformin; administer ≥3 h apart. Adult: 8.4 g once daily with food; adjust based on serum K⁺. Child: Not established in pediatric patients.
Potassium bicarbonate (Alkali and potassium supplement) Indications - Hypokalaemia; hyperchloraemic acidosis associated with potassium deficiency. Contraindications - Severe renal impairment, hyperkalaemia, metabolic alkalosis. Cautions - Cardiac disease; elderly; caution in sodium-sensitive patients. Avoid - Renal insufficiency with oliguria; untreated heart failure. Trade Names - Kaloride®, Potasforte® Drug Interactions - ACE‑inhibitors, potassium‑sparing diuretics, NSAIDs increase risk of hyperkalaemia. Adult: 20–40 mEq orally 2–4 times daily. Child: Not routinely recommended; use pediatric formulations and monitoring.
Haem arginate (Human hemin) (Heme precursor inhibitor) Indications - Acute porphyrias: acute intermittent porphyria, porphyria variegata, hereditary coproporphyria. Contraindications - None absolute; caution in anaphylaxis to blood products. Cautions - Monitor iron load with repeated use; infusion-related reactions. Avoid - None specified; use immediately on porphyrin attack. Trade Names - Panhematin® Drug Interactions - Phenytoin, barbiturates may reduce effectiveness; avoid triggering agents concurrently. Adult: 3–4 mg/kg IV once daily for 3–4 days. Child: Use weight-based dosing similar to adult (3–4 mg/kg/day); specialist guidance required.
Levocarnitine (Carnitine supplement) Indications - Primary carnitine deficiency; secondary carnitine deficiency (e.g., haemodialysis patients). Contraindications - None specified. Cautions - Diabetes mellitus (may increase insulin requirements). Avoid - Not specified. Trade Names - Carnitor®, Levocardyl® Drug Interactions - L-carnitine may enhance effects of thyroid hormones and anticoagulants. Adult: 50–100 mg/kg/day in divided doses (up to 3 g/day). Child: 50–100 mg/kg/day in divided doses.
Cysteamine (Mercaptamine) Indications - Nephropathic cystinosis; corneal cystine crystal deposits. Contraindications - None specified. Cautions - Gastrointestinal symptoms, CNS effects; specialist monitoring. Avoid - Not specified. Trade Names - Cystagon®, Procysbi® Drug Interactions - Anticholinergics may reduce absorption; caution with proton pump inhibitors. Adult: Immediate release: 1.30 g/m²/day in divided doses every 6 hours; extended-release per label. Child: Same mg/m² dosing, adjusted by weight/age.
Asfotase alfa (Recombinant alkaline phosphatase) Indications - Pediatric-onset hypophosphatasia. Contraindications - None specified. Cautions - Injection site reactions; monitor calcium/phosphate. Avoid - Not specified. Trade Names - Strensiq® Drug Interactions - No major interactions known; monitor use with vitamin D/calcium. Adult: Not established for adults. Child: 2 mg/kg three times per week (subcutaneous) or as specialist-determined.
Elosulfase alfa (Enzyme replacement) Indications - Mucopolysaccharidosis IVA (Morquio A syndrome). Contraindications - None specified. Cautions - Elderly or patients with comorbidities; monitor for infusion reactions. Avoid - Not specified. Trade Names - Vimizim® Drug Interactions - No known drug interactions; monitor carbohydrate-containing infusions. Adult: 2 mg/kg IV once weekly. Child: Same as adult (weight-based dosing).
Galsulfase (Enzyme replacement) Indications - Mucopolysaccharidosis VI (Maroteaux-Lamy syndrome). Contraindications - None specified. Cautions - Monitor for infusion-related hypersensitivity. Avoid - Not specified. Trade Names - Naglazyme® Drug Interactions - No major interactions identified. Adult: 1 mg/kg IV once weekly. Child: 1 mg/kg IV once weekly.
Idursulfase (Enzyme replacement) Indications - Mucopolysaccharidosis II (Hunter syndrome). Contraindications - None specified. Cautions - Infusion-related respiratory illness; monitor for anaphylaxis. Avoid - Not specified. Trade Names - Elaprase® Drug Interactions - No major documented interactions. Adult: 0.5 mg/kg IV once weekly. Child: 0.5 mg/kg IV once weekly.
Laronidase (Enzyme replacement) Indications - Mucopolysaccharidosis I (non-neurological manifestations). Contraindications - None specified. Cautions - Infusion reactions possible—monitor during administration. Avoid - Not specified. Trade Names - Aldurazyme® Drug Interactions - No significant interactions known. Adult: 100 units/kg IV once weekly. Child: 100 units/kg IV once weekly.
Miglustat (Enzyme inhibitor) Indications - Oral treatment of mild to moderate type I Gaucher’s disease unsuitable for enzyme replacement; progressive neurological disease in Niemann–Pick type C (under specialist supervision). Contraindications - None specified. Cautions - Diarrhea, weight loss; monitor gastrointestinal and neurological status. Avoid - Not specified; contraception required during treatment. Trade Names - Zavesca® Drug Interactions - Acarbose (increased GI effects); CYP enzymes not significant. Adult: 200 mg orally three times daily. Child: Not established (use in children requires specialist assessment).
Alglucosidase alfa (Enzyme replacement) Indications - Infantile, juvenile, or adult-onset Pompe disease. Contraindications - None specified. Cautions - Infusion-associated reactions; premedicate as needed; monitor cardiac and respiratory function. Avoid - None specific; specialist use only. Trade Names - Myozyme®, Lumizyme® Drug Interactions - No known major drug interactions. Adult: 20 mg/kg by IV infusion every 2 weeks. Child: 20 mg/kg IV every 2 weeks (same dosing in pediatric patients).
Nitisinone (Tyrosine metabolism inhibitor) Indications - Hereditary tyrosinemia type I, used in combination with dietary restriction of tyrosine and phenylalanine. Contraindications - None specified. Cautions - Elevated tyrosine levels → corneal crystals; monitor ocular health and amino acid levels. Avoid - None specific; specialist use only. Trade Names - Orfadin® Drug Interactions - No significant CYP interactions; monitor hepatotoxic drugs. Adult: 0.5 mg/kg/day orally (often rounded to capsule dose). Child: Same mg/kg dosing; specialist dose adjustment required.
Golimumab (TNF‑alpha inhibitor) Indications - Ulcerative colitis; rheumatoid arthritis; psoriatic arthritis; ankylosing spondylitis; non‑radiographic axial spondyloarthritis. Contraindications - Active severe infection; hypersensitivity to golimumab. Cautions - Active infection (e.g., TB); hepatitis B reactivation; immunosuppression; live vaccines. Avoid - Decompensated heart failure. Trade Names - Simponi® Drug Interactions - Other biologics or immunosuppressants; live vaccines. Adult: 50 mg subcutaneously every 4 weeks. Child: Not established (use only under specialist supervision).
Ferric carboxymaltose (IV iron) Indications - Iron‑deficiency anemia when oral not tolerated or ineffective. Contraindications - Hypersensitivity to IV iron; anemia not from iron deficiency. Cautions - First trimester pregnancy; risk of hypotension; monitor phosphate. Avoid - First trimester use unless essential. Trade Names - Ferinject®, Injectafer® Drug Interactions - May reduce absorption of oral tetracyclines and levothyroxine. Adult: 1000 mg IV single or divided dose. Child: Not established—specialist supervision.
Carglumic acid (Carbamoyl phosphate synthetase I activator)Indications - Hyperammonaemia due to N-acetylglutamate synthase deficiency (NAGS deficiency); Hyperammonaemia due to organic acidaemias such as isovaleric acidaemia, methylmalonic acidaemia, and propionic acidaemia (under expert supervision). Contraindications - Hypersensitivity to carglumic acid or any excipients. Cautions - Monitor plasma ammonia levels; consider dietary protein restriction; use with caution in hepatic or renal impairment. Avoid - Concurrent use with other ammonia-scavenging therapies without medical supervision. Trade Names - tab: Carbaglu® Drug Interactions - No significant known drug interactions, but caution with concurrent ammonia-lowering agents. Adult: Initial: 100–250 mg/kg/day in 2–4 divided doses, adjusted based on plasma ammonia concentration and clinical condition. Child: Same as adult: 100–250 mg/kg/day in 2–4 divided doses; maintenance dose may be lowered individually.
Glycerol phenylbutyrate (Urea cycle disorder treatment)Indications - Management of urea cycle disorders to reduce ammonia levels. Contraindications - Hypersensitivity to glycerol phenylbutyrate or any component of the formulation. Cautions - Monitor ammonia and glutamine levels regularly; use with caution in patients with hepatic impairment. Avoid - Use only under specialist supervision. Trade Names - tab: Buphenyl® (Specialist use only) Drug Interactions - No major interactions known; monitor for additive effects with other ammonia-lowering agents. Adult: Dose individualized based on body surface area and ammonia levels; typical starting dose is approximately 17.4 mL/m²/day divided into 3 doses. Child: Dose individualized similarly to adults; usually based on body surface area with close monitoring.
Sodium phenylbutyrate (Urea cycle disorder treatment)Indications - Long-term adjunctive treatment of urea cycle disorders (in neonatal-onset and late-onset disease with history of hyperammonaemic encephalopathy), under expert supervision. Contraindications - Known hypersensitivity to sodium phenylbutyrate or any excipients. Cautions - Monitor plasma ammonia and amino acid levels regularly; use with caution in hepatic impairment and renal dysfunction. Use Restrictions - To be initiated and supervised by a metabolic or specialist physician only. Trade Names - tab: Buphenyl®, Pheburane® (Specialist use only) Drug Interactions - May interact with corticosteroids, valproate, and haloperidol; may affect potassium levels. Adult: Oral: Typically 9.9–13 g/day in divided doses, based on body surface area (approx. 450–600 mg/kg/day). Child: Oral: 450–600 mg/kg/day in divided doses, based on clinical response and ammonia levels.
Piperacillin + Tazobactam (Antipseudomonal penicillin with β‑lactamase inhibitor)Indications - Severe infections including intra-abdominal infections, skin and soft tissue infections, pneumonia, neutropenic sepsis. Contraindications - Hypersensitivity to penicillins or β-lactam antibiotics. Cautions - Renal impairment, history of seizures, monitor for hypersensitivity reactions and blood dyscrasias. Avoid - Known anaphylaxis to penicillins/β-lactams. Trade Names - inj: Tazocin® (Specialist use may be required) Drug Interactions - May reduce effectiveness of oral contraceptives; increased risk of nephrotoxicity with aminoglycosides; may reduce valproate levels. Adult: 4.5 g IV every 8 hours (dose adjusted in renal impairment). Child: 90 mg/kg IV every 6–8 hours (based on piperacillin content; max 4.5 g per dose)
Zinc Acetate (Trace element supplement, Hepatoprotective agent) Indications - Maintenance treatment of Wilson's disease (after initial chelation therapy); may also be used as primary therapy in asymptomatic patients. Contraindications - Known hypersensitivity to zinc acetate or any of its components. Cautions - Monitor for signs of copper deficiency (e.g. anaemia, leukopenia), renal impairment, gastrointestinal ulceration or irritation. May affect iron absorption with long-term use. Drug interactions - Reduced absorption when taken with iron, calcium, tetracyclines, fluoroquinolones, and food. Administer at least 1 hour before or 2–3 hours after these agents or meals. Trade Names - Galzin® (Capsule: Zinc acetate 25 mg) (Initiate under specialist supervision) Adult: 50 mg orally 3 times daily on an empty stomach (at least 1 hour before or 2–3 hours after meals). Child: Under specialist supervision: Typical dosing is 25 mg 2–3 times daily depending on age and body weight; exact dose must be adjusted by a specialist based on response and copper levels.
Trientine Dihydrochloride(Antidote)Indications - Wilson’s disease in patients intolerant of penicillamine. It helps to remove excess copper from the body by binding to it and promoting it’s excretion through urine. Contraindications - history of penicillamine related toxicity, during pregnancy. Cautions - severe renal impairment. Side effects - nausea, vomiting, diarrhea, headache, dizziness, skin rashes, tremors, anxiety, depression. tab:®, Cap:® Adult: : Oral 750-1250 mg par day daily in 2-4 divided doses. Child:: Adjust dose.
Selenium(aaa)Indications - Selenium deficiency, Seborrhoeic dermatitis, Dandruff, Pityriasis versicolor. Selenium Sulfide lotion:®, Adult: : Oral 100-500micrograms daily. Child::
Cariprazine (Second-generation antipsychotic)Indications - Schizophrenia, Bipolar I disorder (acute manic or mixed episodes), adjunctive treatment of major depressive disorder (MDD) in adults. Contraindications - Hypersensitivity to cariprazine or any component of the formulation. Cautions - History of seizures, cardiovascular disease, risk of orthostatic hypotension, elderly with dementia-related psychosis (increased risk of death), impulse control disorders. Drug Interactions - CYP3A4 inhibitors (e.g., ketoconazole) increase cariprazine levels; avoid use with strong CYP3A4 inducers (e.g., rifampin); additive CNS effects with alcohol or other CNS depressants. Trade Names - Vraylar® (Capsule: 1.5 mg, 3 mg, 4.5 mg, 6 mg) Adult: Start at 1.5 mg once daily; may increase to 3–6 mg/day based on response and tolerability. Child: Not recommended (safety and efficacy not established).
Sapropterin diHcl(aaa)Indications - Metabolic disorder, Phenylketonuria (adjunct to dietary restriction of phenylalanine), Tetrahydrobiopterin deficiency (adjunct to dietary restriction of phenylalanine). Oral 25mg/kg once daily. tab:®, Cap:® (Specialist use only) Adult: : Child::
Penicillamine(aaa)Indications - Severe active rheumatoid arthritis (administered on expert advice), Autoimmune hepatitis (used rarely; after disease controlled with corticosteroids, Prevention and Treatment of Cystinuria. Oral 125-250mg daily for 1 month, Administered on expert advice. tab:®, Cap:® Adult: : Child::
Alfacalcidol, Vitamin D(aaa)Indications - Patients with severe renal impairment requiring vitamin D therapy, Hypophosphataemic rickets, Persistent hypocalcaemia due to hypoparathyroidism or pseudohypoparathyroidism, Prevention of vitamin D deficiency in renal or cholestatic liver disease. tab:®, Cap:® Adult: : Child::
Colecalciferol, Cholecalciferol, Vitamin D3(aaa)Indications - Prevention and treatment of Vitamin D deficiency. Oral 800 units daily Cautions - Ensure correct dose in infants, Renal impairment. tab:®, Cap:® Adult: : Child::
Paricalcitol(aaa)Indications - Prevention and treatment of secondary hyperparathyroidism associated with chronic kidney disease, Prevention and treatment of secondary hyperparathyroidism associated with chronic renal failure in patients on haemodialysis. tab:®, Cap:® Adult: : Child::
Glucosamine (Symptomatic slow-acting drug for osteoarthritis – SYSADOA) Indications - Symptomatic relief of mild to moderate osteoarthritis, especially of the knee. Cautions - Asthma, cardiovascular disease, diabetes (may affect blood glucose), shellfish allergy (product source-dependent). Drug interactions - Warfarin (may increase INR); use with caution. tab: Glucosamine Sulfate®, Glucosamine Hydrochloride cap:® Adult: Oral 1250 mg once daily or 500 mg three times daily (based on formulation). Child: Not recommended (safety and efficacy not established).
Hydroxychloroquine sulfate (Immunomodulator / Antimalarial)Indications - Active rheumatoid arthritis, Systemic and discoid lupus erythematosus, Dermatological conditions aggravated by sunlight, Malaria (treatment and prophylaxis). Contraindications - Hypersensitivity to hydroxychloroquine or related compounds, Retinal or visual field changes from prior 4-aminoquinoline use, Pre-existing maculopathy. Avoid - Long-term use without regular eye exams; use in children without specialist supervision. Cautions - Elderly, Diabetes, Hepatic/renal impairment, Pre-existing eye disease, Neurological disorders, GI disorders. Drug interactions - Increased toxicity risk with digoxin, cyclosporine, antiepileptics; may enhance hypoglycemic effects of insulin and antidiabetics; caution with QT-prolonging drugs. Trade names - Plaquenil tab:®, Hydroquin Cap:®, Quensyl tab:® (Specialist use only) Adult: 200–400 mg orally daily; max 6.5 mg/kg/day based on ideal body weight. Child: 6.5 mg/kg/day (not exceeding 400 mg/day); use only under specialist supervision.
Sodium aurothiomalate(aaa)Indications - Active progressive rheumatoid arthritis (administered on expert advice), Relapse in patients who have previously received sodium aurothiomalate therapy for active progressive rheumatoid arthritis (administered on expert advice. Deep i.m injection 50mg once weekly. Avoid - History of blood disorders, Necrotising enterocolitis, Pulmonary fibrosis, Systemic lupus erythematosus Caution - Colitis, Eczema, Elderly, History of urticaria, Adminisered on expert advice. tab:®, Cap:® Adult : Child::
Anakinra (Immunosuppressant)Indications - Rheumatoid arthritis (in combination with methotrexate) unresponsive to methotrexate alone, Cryopyrin-associated periodic syndromes, Still’s disease. Contraindications - Hypersensitivity to anakinra or any component of the formulation, active infections including tuberculosis. Cautions - Use with caution in patients with a history of recurrent infections, neutropenia, or hepatic impairment. Avoid - Avoid use in patients with active severe infections. Drug interactions - Increased risk of infection when used with other immunosuppressants or TNF inhibitors. Trade names - Kineret Inj:® (Specialist use only) Adult: 100 mg subcutaneously once daily; dose adjustments may be required based on clinical response. Child: Use only under specialist supervision; dosing individualized according to weight and condition.
Sarilumab, Human monoclonal antibody(aaa)Indications - Moderate to severe active rheumatoid arthritis in patient who have had inadequate response to anti-rheumatoid drugs. tab:®, Cap:® (Specialist use only) Adult : Child::
Secukinumab (Immunomodulator / IL-17A inhibitor)Indications - Ankylosing spondylitis, Psoriatic arthritis, Psoriatic arthritis with concomitant moderate to severe plaque psoriasis or inadequate response to anti-TNFα treatment, Plaque psoriasis. Contraindications - Hypersensitivity to secukinumab or any excipients. Avoid - Severe active infection, Pregnancy, Breastfeeding. Cautions - Chronic infections, Use effective contraception during treatment and for a period after. Drug interactions - No formal drug interaction studies; caution with other immunosuppressants. Trade names - Cosentyx Inj:® (Initiate by a specialist) Adult: 150 mg subcutaneously at weeks 0, 1, 2, 3, 4 then monthly. Child: Use only under specialist supervision; dosing individualized.
Tocilizumab(aaa)Indications - Rheumatoid arthritis [severe, Active and progressive, Not previously treated with methotrexate], Rheumatoid arthritis [moderate-to-severe, In combination with methotrexate or alone if methotrexate inappropriate, when response to at least one disease-modifying antirheumatic drug or tumour necrosis factor inhibitor has been inadequate, Or in those who are intolerant of these drugs], Giant cell arteritis [in combination with a tapering course of glucocorticoid or alone following discontinuation of glucocorticoid]. i.v, s/c. tab:®, Cap:® Adult : Child::
Ustekinumab(aaa)Indications - Moderate-to-severe plaque psoriasis that has not responded to other systemic treatments or photochemotherapy, or when these treatments cannot be used because of intolerance or contra-indications, Active psoriatic arthritis (in combination with methotrexate or alone) in patients who have had an inadequate response to one or more disease-modifying antirheumatic drugs, Moderate to severe active Crohn’s disease in patients who have had an inadequate response with, Lost response to, Are intolerant to, Or have contra-indications to either conventional therapy or a tumour necrosis factor alpha inhibitor. tab:®, inj:®(s/c injection) (Specialist use only) Adult: : Child::
Baricitinib(Immunosuppressant)Indications - Moderate-to-severe active rheumatoid arthritis in patients who have had an inadequate response to, Or are intolerant to, One or more disease-modifying anti rheumatic drugs (as monotherapy or in combination with methotrexate). Oral 4mg once daily tab:®, Cap:® (Initiate by a specialist) Adult: : Child::
Tofacitinib(Immunosuppressant)Indications - Moderate to severe active rheumatoid arthritis i, Moderate to severe active ulcerative colitis. tab:®, Cap:®(Oral 5mg twice daily) (Specialist use only) Adult: : Child::
Abatacept (Immunosuppressant)Indications - Moderate-to-severe active rheumatoid arthritis, Active psoriatic arthritis. Contraindications - Hypersensitivity to abatacept or any excipients, active infections. Avoid - Use in patients with active serious infections. Cautions - Patients with history of recurrent infections, COPD, or immunosuppression. Drug interactions - May increase risk of infection when combined with other immunosuppressants or biologics. Trade names - Orencia tab:®, Orencia Inj (IV):® 500 mg every 2 weeks (Specialist use only) Adult: Weight-based IV infusion 500 mg at weeks 0, 2, and 4, then every 4 weeks. Child: Use only under specialist supervision; dosing individualized.
Adalimumab(Immunosuppressant)Indications - Plaque psoriasis, Rheumatoid arthritis, Psoriatic arthritis, Ankylosing spondylitis, Axial spondyloarthritis, Hidradenitis suppurativa, Uveitis. Avoid - Heart failure, Severe infection. Mabura 40 Syrup:® (Initiate by a specialist) Adult: : Child::
Certolizumab pegol (TNF-alpha inhibitor / Immunosuppressant)Indications - Active rheumatoid arthritis, Active ankylosing spondylitis, Moderate to severe plaque psoriasis, Active psoriatic arthritis, Non-radiographic axial spondyloarthritis with objective signs of inflammation. Contraindications - Active serious infections (e.g., tuberculosis, sepsis), hypersensitivity to certolizumab pegol or any excipients. Avoid - Live vaccines during treatment; use in patients with demyelinating diseases or moderate-to-severe heart failure (NYHA class III/IV). Cautions - History of recurrent infections, latent TB (screen before starting), malignancy, hepatitis B, elderly, concurrent immunosuppressants. Drug interactions - Increased risk of infections when used with other immunosuppressants (e.g., methotrexate, corticosteroids); avoid live vaccines. Trade names - Inj: Cimzia® (Prefilled syringe or autoinjector) (Specialist use only) Adult: Initial: 400 mg SC at weeks 0, 2, and 4; maintenance: 200 mg every 2 weeks or 400 mg every 4 weeks. Child: Not recommended; safety and efficacy not established in pediatric population.
Pramipexole (Dopamine agonist)Indications - Parkinson's disease, Restless legs syndrome. Contraindications - Hypersensitivity to pramipexole or any component of the formulation. Avoid - Sudden discontinuation; operating machinery or driving until response is known. Cautions - Renal impairment, history of psychotic disorders, cardiovascular disease, elderly (risk of hallucinations and orthostatic hypotension). Drug interactions - May interact with antipsychotics, sedatives, levodopa (dose adjustments needed), and CNS depressants. Trade names - Tab: Mirapex®, ER Cap: Mirapex ER® Adult: Initial 0.125 mg three times daily; titrate gradually to max 4.5 mg/day (Parkinson’s); for RLS: 0.125 mg once daily 2–3 hours before bedtime. Child: Safety and efficacy not established; not recommended.
Ropinirole (Dopamine agonist)Indications - Parkinson's disease, Restless legs syndrome (RLS). Contraindications - Hypersensitivity to ropinirole or any component of the formulation. Avoid - Sudden discontinuation; activities requiring mental alertness until effects are known. Cautions - Cardiovascular disease, orthostatic hypotension, renal impairment, history of psychotic illness, sleep attacks. Drug interactions - Caution with CYP1A2 inhibitors (e.g., ciprofloxacin); may interact with dopamine antagonists and other CNS depressants. Trade names - Tab: Requip® Adult: Parkinson’s: Start with 0.25 mg three times daily; titrate gradually up to 24 mg/day. RLS: Start with 0.25 mg once daily 1–3 hours before bedtime; max 4 mg/day. Child: Not recommended; safety and efficacy not established.
Rotigotine (Dopamine agonist)Indications - Parkinson's disease, Restless legs syndrome (RLS). Contraindications - Hypersensitivity to rotigotine or patch components (e.g., sulfites), application site reactions. Avoid - Sudden withdrawal; activities requiring alertness until response is known; exposure of patch to external heat sources. Cautions - Severe hepatic impairment, orthostatic hypotension, hallucinations, impulse control disorders, sleep attacks. Drug interactions - Caution with antipsychotics, sedatives, antihypertensives; may interact with dopamine antagonists and alcohol. Trade names - Transdermal patch: Neupro® Adult: Parkinson’s: 2–8 mg/24 hours patch applied once daily; RLS: 1 mg/24 hours patch applied once daily. Child: Not recommended; safety and efficacy not established.
Rasagiline (MAO-B inhibitor)Indications - Parkinson's disease (as monotherapy or as adjunct to levodopa). Contraindications - Severe hepatic impairment, use with other MAO inhibitors, pethidine, or certain antidepressants (e.g., SSRIs, SNRIs, TCAs). Avoid - Tyramine-rich foods (risk of hypertensive crisis), combining with serotonergic or sympathomimetic drugs. Cautions - Mild hepatic impairment, risk of serotonin syndrome when combined with serotonergic agents, hypotension, elderly patients. Drug interactions - CYP1A2 inhibitors (e.g., ciprofloxacin) can increase rasagiline levels; interactions with antidepressants, dextromethorphan, sympathomimetics. Trade names - Tab: Azilect® Adult: 1 mg once daily, with or without levodopa. Child: Not recommended; safety and efficacy not established.
Safinamide (MAO-B inhibitor / Dopaminergic modulator)Indications - Parkinson's disease as add-on therapy to levodopa in patients experiencing "off" episodes. Contraindications - Severe hepatic impairment, concomitant use with other MAO inhibitors, pethidine, certain antidepressants (e.g., SSRIs, SNRIs, TCAs). Avoid - Tyramine-rich foods, serotonergic drugs, abrupt discontinuation. Cautions - Moderate hepatic impairment, retinal disorders, psychotic disorders, impulse control disorders. Drug interactions - Risk of serotonin syndrome with serotonergic drugs; caution with CYP3A4 inducers/inhibitors and dopaminergic agents. Trade names - Tab: Xadago® Adult: Initial dose 50 mg once daily; may increase to 100 mg once daily based on clinical response. Child: Not recommended; safety and efficacy not established.
Selegiline HCl (MAO-B inhibitor / Dopaminergic)Indications - Parkinson's disease (as monotherapy or adjunct to levodopa therapy). Contraindications - Concomitant use with other MAO inhibitors, meperidine, tramadol, certain antidepressants (SSRIs, SNRIs, TCAs); severe hepatic or renal impairment. Avoid - Tyramine-rich foods, serotonergic and sympathomimetic drugs, abrupt withdrawal. Cautions - Peptic ulcer disease, cardiac arrhythmias, psychiatric disorders, risk of serotonin syndrome, orthostatic hypotension. Drug interactions - Risk of severe interactions with serotonergic drugs, sympathomimetics, dextromethorphan, and other MAOIs; caution with levodopa and dopamine agonists. Trade names - Tab: Eldepryl®, Zelapar® Adult: 5 mg twice daily with breakfast and lunch (conventional); 1.25–2.5 mg once daily (orally disintegrating form). Child: Not recommended; safety and efficacy not established.
Doxylamine(aaa)Indications - Nausea and vomitingin pregnancy. Oral 20mg once daily tab:®, Cap:® Adult: : Child::
Nabilone (Cannabinoid / Antiemetic, Antinauseant)Indications - Nausea and vomiting associated with cytotoxic chemotherapy, particularly when conventional antiemetics are ineffective. Contraindications - Hypersensitivity to cannabinoids, psychiatric disorders (e.g., schizophrenia, psychosis), severe cardiovascular disease. Avoid - Use in pregnancy and breastfeeding, operating heavy machinery, alcohol and CNS depressants. Cautions - Elderly, hepatic or renal impairment, history of substance abuse, psychiatric illness, risk of orthostatic hypotension. Drug interactions - Additive CNS depression with alcohol, sedatives, opioids, antihistamines; may interact with anticholinergics and antidepressants. Trade names - Cesamet Cap:® Adult: 1–2 mg twice daily, max 6 mg/day, usually started the night before chemotherapy. Child: Not recommended; safety and efficacy not established in pediatric patients.
Aprepitant(Antiemetic)Indications - Nausea and vomiting associated with emetogenic drugs. Oral 125mg 1 hour before chemotherapy tab:®, Cap:® Adult: : Child::
Fosaprepitant (Neurokinin-1 [NK1] receptor antagonist / Antiemetic)Indications - Prevention of acute and delayed nausea and vomiting associated with highly and moderately emetogenic chemotherapy. Contraindications - Hypersensitivity to fosaprepitant or aprepitant, severe hepatic impairment. Avoid - Use with pimozide, astemizole, cisapride due to risk of serious or life-threatening interactions. Cautions - Hepatic impairment, concurrent use of warfarin (monitor INR), oral contraceptive effectiveness may be reduced. Drug interactions - CYP3A4 interactions (e.g., with dexamethasone, warfarin, hormonal contraceptives); may affect metabolism of drugs like midazolam, ketoconazole. Trade names - Inj: Ivemend® Adult: 150 mg IV infusion over 20–30 minutes, 30 minutes before chemotherapy on day 1 only (used in combination with a corticosteroid and a 5-HT3 antagonist). Child: Dose and safety vary by age and weight; used under specialist supervision.
Rolapitant(Antiemetic)Indications - Nausea and vomiting associated with emetogenic drugs therapy. tab:®, Cap:® Adult: : Child::
Palonosetron (5-HT₃ receptor antagonist / Antiemetic, Antinauseant)Indications - Prevention of acute and delayed nausea and vomiting associated with moderately and highly emetogenic chemotherapy; prevention of postoperative nausea and vomiting (PONV). Contraindications - Hypersensitivity to palonosetron or other 5-HT₃ antagonists. Avoid - Concurrent use with other serotonergic drugs unless necessary; caution in patients with QT prolongation. Cautions - Risk of serotonin syndrome when used with SSRIs, SNRIs; monitor in patients with electrolyte abnormalities or pre-existing cardiac conditions. Drug interactions - Increased risk of serotonin syndrome with serotonergic agents (e.g., SSRIs, SNRIs, MAOIs), caution with QT-prolonging drugs. Trade names - Aloxi Inj:®, Akynzeo Tab:® (in combination with netupitant) Adult: IV: 0.25 mg as a single dose ~30 minutes before chemotherapy; PO (Akynzeo): 1 capsule (palonosetron 0.5 mg + netupitant 300 mg) before chemotherapy. Child: IV: 20 mcg/kg (max 1.5 mg) as single dose before chemotherapy; use under specialist guidance.
Promethazine teoclate (First-generation Antihistamine / Antiemetic)Indications - Nausea and vomiting, motion sickness (prevention and treatment), vertigo, labyrinthine disorders. Contraindications - Children under 2 years (risk of respiratory depression), hypersensitivity to phenothiazines, severe CNS depression. Avoid - Use in patients with narrow-angle glaucoma, prostatic hypertrophy, epilepsy, severe hepatic impairment, during activities requiring alertness (e.g., driving). Cautions - Elderly, cardiovascular disease, asthma, respiratory disorders, urinary retention, potential for QT prolongation. Drug interactions - Additive sedation with alcohol, CNS depressants, anticholinergics, MAOIs; may enhance QT-prolonging effects of other drugs. Trade names - Avomine tab:® Adult: 25 mg at night or 1–2 hours before travel; may repeat every 6–8 hours as needed (max 100 mg/day). Child: Over 5 years: 12.5–25 mg once or twice daily (specialist guidance recommended).<
Hyoscine Hydrobromide (Scopolamine Hydrobromide) (Antimuscarinic, Antispasmodic)Indications - Motion sickness, Hypersalivation due to clozapine therapy, Bowel colic (especially in palliative care), Premedication, Excessive respiratory secretions in palliative care. Contraindications - Myasthenia gravis, Narrow-angle glaucoma, Prostatic hypertrophy with urinary retention, Severe ulcerative colitis, Mechanical gastrointestinal obstruction, Hypersensitivity to hyoscine. Cautions - Elderly, children, hepatic or renal impairment, Down syndrome, pyrexia (risk of heat stroke due to reduced sweating), tachyarrhythmias. Drug Interactions - Enhanced anticholinergic effects with tricyclic antidepressants, antihistamines, antipsychotics; may reduce the effect of prokinetics (e.g. metoclopramide). Trade Names - Kwells® (Tablet: 300 mcg), Scopoderm® (Patch: 1.5 mg/72 hr) Adult: For motion sickness: 300–600 mcg orally 30 minutes before travel, then every 6–8 hours if needed (max 1.8 mg/day). Patch: 1 patch behind the ear every 72 hours. Child: 6–12 years: 150 mcg orally 30 minutes before travel, repeat every 6–8 hours if needed (max 450 mcg/day). Not recommended in children under 6 years without specialist advice.
Droperidol (Antipsychotic, Antiemetic)Indications - Prevention and treatment of postoperative nausea and vomiting (PONV), Prevention of nausea and vomiting associated with opioid analgesics, Sedation in intensive care and during minor surgical and diagnostic procedures. Contraindications - Known QT prolongation, Congenital long QT syndrome, Hypokalemia or hypomagnesemia, Use with Class Ia or III antiarrhythmic agents, Hypersensitivity to droperidol. Cautions - Cardiovascular disease, Elderly, Hepatic or renal impairment, History of seizures, Parkinson’s disease. Drug Interactions - Increased QT prolongation risk with other QT-prolonging drugs (e.g. amiodarone, sotalol, macrolides, antipsychotics), Enhanced CNS depression with CNS depressants (e.g. opioids, benzodiazepines, alcohol). Trade Names - Inapsine Inj:® (2.5 mg/mL) Adult: PONV: 0.625–1.25 mg IV or IM as a single dose near the end of surgery; repeat every 6 hours if necessary (max 5 mg/day). Child: PONV: 20–50 mcg/kg IV or IM as a single dose; max 1.25 mg/dose; not routinely used in children under 2 years.
Levomepromazine (Methotrimeprazine) (Antipsychotic, Antiemetic, Sedative)Indications - Pain management in palliative care, Restlessness and confusion in palliative care, Nausea and vomiting in palliative care, Schizophrenia. Contraindications - Hypersensitivity to phenothiazines, Severe CNS depression, Bone marrow suppression, Pheochromocytoma, Comatose states. Cautions - Elderly, Cardiovascular disease, Hepatic or renal impairment, Risk of hypotension, Epilepsy, Parkinson’s disease. Drug Interactions - Additive sedative effects with CNS depressants (e.g. opioids, alcohol, benzodiazepines), Enhanced anticholinergic effects with antimuscarinics, Increased QT prolongation risk with other QT-prolonging drugs. Trade Names - Nozinan® (Tablet: 25 mg, 100 mg; Injection: 25 mg/mL) Adult: Palliative care (pain, agitation, nausea): 6.25–12.5 mg subcutaneously every 4–8 hours as needed or via continuous infusion (max usually 50–75 mg/day); Schizophrenia: Oral 25–50 mg 1–3 times daily, max 200–400 mg/day. Child: Palliative care use under specialist supervision; dose adjusted by weight and indication.
Betahistine HCl (Histamine analogue)Indications - Vertigo, Tinnitus, and hearing loss associated with Ménière’s disease. Contraindications - Pheochromocytoma, Hypersensitivity to betahistine or any excipients. Cautions - Bronchial asthma, History of peptic ulcer disease, Pregnancy and lactation (use only if necessary). Drug Interactions - Antihistamines (may reduce efficacy), Monoamine oxidase inhibitors (increase betahistine levels). Trade Names - Serc® (Tablet: 8 mg, 16 mg, 24 mg) Adult: Oral 16–24 mg 2–3 times daily; max 48 mg/day, adjusted based on response. Child: Not recommended (safety and efficacy not established).
Nefopam HCl (Non‑opioid analgesic)Indications - Moderate acute or chronic pain, including musculoskeletal pain and postoperative pain. Contraindications - Epilepsy, history of convulsions, use of MAO inhibitors (or within 14 days), closed‑angle glaucoma. Cautions - Elderly, renal or hepatic impairment, urinary retention risk (especially with prostatic hypertrophy), caution with driving or operating machinery. Drug Interactions - Additive sedation with CNS depressants (e.g., opioids, benzodiazepines), anticholinergic effects may be enhanced. Trade names - tab: Acupan®, Nefogesic®; cap: Nefopaine®; inj: Cogentin‑N® Adult: 30–90 mg orally 3 times daily; maximum 180 mg/day. Child: Not recommended for children under 12 years.
Co-codamol, Opioid analgesic(aaa)Indications - Moderate to severe pain. tab:®, Cap:® Adult: : Child::
Diamorphine Hcl, Heroin Hcl, Opioid analgesic(aaa)Indications - Acute pain, Chronic pain, Acute pulmonary oedema, Myocardial infarction. tab:®, Cap:® Adult: : Child::
ihydrocodeine tartrate(aaa)Indications - Moderae tosevere pain. tab:®, Cap:® Adult: : Child::
Dipipanone Hcl + cyclizine(aaa)Indications - Acute pain. tab:®, Cap:® Adult: : Child::
Meptazinol, Analgesic(aaa)Indications - Moderate to severe pain, Post-operative pain, Renal colic, Obstetric analgesia. tab:®, Cap:® Adult: : Child::
Oxycodone HCl (Opioid analgesic)Indications - Severe acute or chronic pain (including post-operative pain), cancer-related pain. Contraindications - Severe respiratory depression, acute or severe bronchial asthma, paralytic ileus, known or suspected gastrointestinal obstruction. Caution - Renal or hepatic impairment, elderly, history of substance abuse, hypotension, epilepsy or seizure disorders. Drug interactions - CNS depressants (e.g. benzodiazepines, alcohol), MAO inhibitors, serotonergic drugs (risk of serotonin syndrome), CYP3A4 inhibitors (e.g. clarithromycin, ketoconazole). Avoid - Abrupt discontinuation after long-term use, combination with other respiratory depressants. Trade names - tab: OxyContin®, Oxynorm®, Reltebon®; cap: Oxynorm®; inj: Oxynorm® injection Adult: 5–10 mg orally every 4–6 hours as needed (adjust according to severity); modified-release: 10 mg every 12 hours. Child: Use only if specifically indicated; specialist supervision required — dosing varies by weight and indication.
papaveretum, Analgesic(aaa)Indications - Post-operative analgesia, Premedication, Severe chronic pain. tab:®, Cap:® Adult: : Child::
Pentazocine (Opioid analgesic)Indications - Moderate to severe pain, including post-operative pain and labor pain. Contraindications - Hypersensitivity to pentazocine, respiratory depression, acute asthma, head injury, increased intracranial pressure, severe hepatic or renal impairment, history of drug abuse or dependence. Caution - Impaired hepatic or renal function, elderly, hypotension, seizure disorders, mental illness. Avoid - Concurrent use with other CNS depressants unless supervised; abrupt withdrawal after prolonged use. Drug interactions - CNS depressants (e.g. alcohol, benzodiazepines), MAO inhibitors, general anesthetics, antihypertensives. Trade names - tab: Fortwin®, Pentazoc®, Fortral®; inj: Fortwin® injection, Pentawin® Adult: Oral: 50–100 mg every 3–4 hours as needed (maximum 600 mg/day). Child: Use with caution; generally not recommended unless under specialist supervision. Dose: 0.5–1 mg/kg IM/IV every 3–4 hours if essential, under specialist care only.
Tapentadol, Analgesic(aaa)Indications - Moderate to severe acute pain, Severe chronic pain. tab:®, Cap:® Adult: : Child::
Pizotifen(Sedating antihistamine)Indications - Prevention of vascular headache, Prevention of migraine. Oral 500micrograms once daily Adult: : Child::
Erenumab(aaa)Indications - Prophylaxis of migraine, s.c injection inj:®, Cap:® (Initiate by a specilist) Adult: : Child::
Eletriptan(aaa)Indications - Acute migraine. . Oral 40mg tab:®, Cap:® Adult: : Child::
Frovatriptan(aaa)Indication & dose: Adult: 2.5 mg PO, Dose to be taken as soon as possible after onset, followed by 2.5 mg after 2 hours if required, Dose to be taken only if migraine recurs (patient not responding to initial dose should not take second dose for same attack); maximum 5 mg per day. Contraindication: Coronary vasospasm . ischaemic heart disease . peripheral vascular disease . previous cerebrovascular attack . previous myocardial infarction . previous transient ischaemic attack . Prinzmetal’s angina . severe hypertension . uncontrolled hypertension. Cautions: Elderly Side effects: Asthenia . chest discomfort. dizziness . drowsiness . dry mouth . flushing . gastrointestinal discomfort. headache . hyperhidrosi nausea . sensation abnormal .throat complaints . vision disorders. tab:®, Cap:® Adult: : Child::
Capsaicin(Analgesic)Indication & dose: AXSAIN ® Post-herpetic neuralgia. To the skin, Adult: Apply 3–4 times a day, Dose to be applied sparingly; important; after lesions have healed, not more often than every 4 hours. Painful diabetic neuropathy (under expert supervision). QUTENZA® Peripheral neuropathic pain in non-diabetic patients(under the supervision of a physician). Bu transdermal application using patches. Adult: (consult product literature) ZACIN® Symptomatic relief in osteoarthritis. To the skin, Adult: Apply 4 times a day, Dose to be applied sparingly, not more often than every 4 hours. Cautions: Avoid contact with broken skin . avoid contact with inflamed skin, With topical use Avoid contact with eyes . avoid hot shower or bath just before or after application (burning sensation enhanced). avoid inhalation of vapours . Not to be used under tight bandages, With transdermal use avoid contact with the face, scalp or in proximity to mucous membranes . avoid holding near eyes or mucous membranes .recent cardiovascular events . uncontrolled hypertension Side effects: Sensation abnormal with transdermal use. tab:®, Cap:® Adult: : Child::
Flurazepam, Hypnotic, Seative, Anxiolytic(aaa)Indications - Insomnia. Oral 15-30mg once daily tab:®, Cap:® Adult: : Child::
Loprazolam, Hypnotic, Seative, Anxiolytic(aaa)Indications - Insomnia. Oral 1mg once daily tab:®, Cap:® Adult: : Child::
Lormetazepam, Hypnotic, Seative, Anxiolytic(aaa)Indications - Insomnia. Oral 1mg once daily tab:®, Cap:® Adult: : Child::
Nitrazepam, Hypnotic, Seative, Anxiolytic(aaa)Indications - Insomnia. Oral 5-10mg once daily tab:®, Cap:® Adult: : Child::
Chloral hydrate, Sedative, Hypnotic(aaa)Indications - Insomnia. Oral solution 430mg once daily tab:®, Cap:® Adult: : Child::
Clomethiazole, Chlormethiazole, Hypnotic, Seative, Anxiolytic(aaa)Indications - Severe insomnia, Restlessnes and agitation, Alchol withdrawl. Oral 200mg once daily Adult: : Child::
Zopiclone, Hypnotic, Seative, Anxiolytic(aaa)Indications - Insomnia. Oral 7.5mg once daily Adult: : Child::
Sodium oxybate(central nervous system depressant)(aaa)Indication & dose: Narcolepsy with cataplexy (under expert supervision). Adult: Initially 2.25 g PO daily, Dose to be taken on retiring and 2.25 g after 2.5–4 hours, then increased in steps of 1.5 g daily in 2 divided doses, Dose adjusted according to response at intervals of 1–2 weeks; dose titration should be repeated if restarting after interval of more than 14 days, maximum 9 g daily in 2 divided doses. Contraindications: Major depression. Cautions: Body mass index of 40 kg/m2 or greater (higher risk of sleep apnoea). elderly . epilepsy . heart failure. history of depression . history of drug abuse . hypertension (high sodium content).respiratory disorders .risk of discontinuation effects including rebound cataplexy and withdrawal symptoms Side effects: Abdominal pain upper. anxiety . appetite abnormal . arthralgia . asthenia . back pain . concentration impaired . confusion . depression . diarrhoea . dizziness . dyspnoea . fall .feeling drunk . headache . hyperhidrosis . hypertension . increased risk of infection . movement disorders . muscle spasms . nasal congestion . nausea . palpitations . peripheral oedema . sedation . sensation abnormal . skin reactions . sleep disorders . sleep paralysis . snoring .taste altered .tremor. urinary disorders . vertigo . vision blurred . vomiting . weight decreased. tab:®, Cap:® Adult: : Child::
Pitolisant (CNS stimulant ‒ Histamine-H₃ receptor inverse agonist)Indications - Treatment of excessive daytime sleepiness (EDS) or cataplexy in adults with narcolepsy, with or without cataplexy. Contraindications - Severe hepatic impairment (Child-Pugh C), pregnancy and breastfeeding, known hypersensitivity to pitolisant or excipients. Avoid - Concomitant use with strong CYP2D6 inhibitors (unless dose reduced) or strong CYP3A4 inducers (may markedly lower efficacy); avoid in patients with congenital long-QT syndrome or with other QT-prolonging medicines. Cautions - Moderate hepatic or renal impairment (dose adjustment needed), history of psychiatric illness or seizures, cardiovascular disease or baseline QT prolongation, women of child-bearing potential not using effective contraception. Drug interactions - Metabolised by CYP2D6 / CYP3A4 and is a moderate CYP3A4 inducer: may reduce levels of oral contraceptives, midazolam, tacrolimus; potent CYP2D6 inhibitors (e.g. paroxetine, fluoxetine) increase exposure—halve pitolisant dose; strong CYP3A4 inducers (e.g. rifampicin, carbamazepine) may require dose increase or are best avoided. Trade Names - Tab: Wakix® 4.45 mg, Wakix® 17.8 mg (Initiate by a specialist) Adult: Start 8.9 mg (two 4.45 mg tablets) once daily in the morning for 1 week, increase to 17.8 mg once daily in week 2; if needed, after ≥3 weeks may increase to a maximum of 35.6 mg once daily. Adjust dose in moderate hepatic/renal impairment. Child: Safety and efficacy not established; use in paediatric patients is not recommended.
Disulfiram, Aldehyde dehydrogenase inhibitor(aaa)Indications - Adjunct in the treatment of alcohol dependence. Chronol 500 Mg tab Under expert supervision. tab:®, Cap:® Adult: : Child::
Acamprosate calcium(aaa)Indications - Maintenance of abstinence in alcohol-dependent patients. Oral 666mg once daily Adult: : Child::
Bupropion Hcl, Amfebutamone Hcl(aaa)Indications - Smoking cessation aid. Oral 150mg daily for 6 days Avoid - Acute alcohol withdrawal . acute benzodiazepine withdrawal . bipolar disorder. CNS tumour . eating disorders . history of seizures . severe hepatic cirrhosis. Cautions - Alcohol abuse . diabetes . elderly . history of head trauma. tab:®, Cap:® Adult: : Child::
Varenicline(aaa)Indications - Smoaking cessation. tab:®, Cap:® Adult: : Child::
Lofexidine Hcl(aaa)Indications - Relief symptomsof opoid withdrawl, Smoaking cessation. tab:®, Cap:® Adult: : Child::
Ceftolozane+Tazobactam(aaa)Indications - Complicated intra-abdominal infection(in combination with metronidazole when anaerobic patghogens is suspected. i.v Avoid - Breast feeding. Cautions - Renal impairment, Pregnancy. tab:®, Cap:® Adult: : Child::
Ingenol mebutate(aaa)Indications - Actinic keratosis on face, scalp, trunk and extremities, Actinic keratosis on face, scalp, trunk and extremities. Cautions - Avoid - contact with broken skin, eye and inside nostril. tab:®, Cap:® Adult: : Child::
Heparinoid(aaa)Indications - Superficial thrombophlebitis, Bruising, Haematoma. Apply up to 4 times a day tab:®, Cap:® Adult: : Child::
Camellia sinensis(Antineoplastic)Indications - Warts (external genital and perianal) in immunocompetent patients. Apply up to 250 mg 3 times a day Adult: : Child::
Podophyllotoxin(Antineoplastic)Indications - Condylomata acuminata affecting the penis or the female external genitalia. Apply twice daily for 3 consecutive days Adult: : Child::
Formaldehyde, Aldehyde (Topical antiseptic and keratolytic agent)Indications - Treatment of warts, particularly plantar warts; also used to reduce foot perspiration. Contraindications - Broken or inflamed skin, Hypersensitivity to formaldehyde. Cautions - External use only, Avoid contact with eyes and mucous membranes, May cause local irritation or dermatitis. Trade Names - Formacide®, Formalin® Adult: Apply topically once or twice daily to affected area for up to 3 weeks; avoid surrounding healthy skin. Child: Use with caution in children over 12 years under medical supervision; same dosage as adults if appropriate.
Glutaraldehyde (Topical antiviral and keratolytic agent)Indications - Treatment of warts, particularly plantar warts. Contraindications - Broken or inflamed skin, Hypersensitivity to glutaraldehyde. Cautions - Avoid contact with eyes and mucous membranes, External use only, May stain skin or clothing. Trade Names - Glutarol®, Glutarex® Adult: Apply twice daily to the wart, allowing to dry; continue until wart is removed (typically up to 12 weeks). Child: Not recommended under 12 years without medical supervision; same application as adults if used.
Silver nitrate(aaa)Indications - Common warts, Umbilical granulomas, Verrucas. Avoid - broken skin . not suitable for application to ano-genital region . not suitable for application to face . not suitable for application to large areas . protect surrounding skin. tab:®, Cap:® Adult: : Child::
Imiquimod(aaa)Indications - External genital and perianal warts, Superficial basal cell carcinoma, Actinic keratosis. Apply 3 times a week Avoid - Autoimmune disease, Broken skin, Contact with eyes, Contact with lips, Contact with nostrils, Open wounds. tab:®, Cap:® Adult: : Child::
Salicylic acid with lactic acid (Keratolytic agents)Indications - Plantar warts, Mosaic warts, Common warts, Corns and calluses. Contraindications - Diabetes mellitus, Peripheral vascular disease, Broken or inflamed skin in treatment area, Hypersensitivity to salicylic or lactic acid. Cautions - Avoid contact with eyes or mucous membranes, Avoid use on facial or anogenital warts, Use with caution in children under 2 years. Trade Names - Duofilm® (Salicylic acid 16.7% + Lactic acid 16.7% topical solution), Wartex®, Verrugon® Adult: Apply topically to the wart once daily after soaking and drying the area; protect surrounding skin. Child: Use under medical supervision in children over 2 years; same dosage as adults.
Etanercept(aaa)Indications - Moderate-to-severe active rheumatoid arthritis, Severe active ankylosing spondylitis, severe plaque psoriasis. Avoid - Active infection. Cautions - Development of malignancy, Diabetes mellitus, heart failure, hepatitis B virus, hepatitis C infection, history of blood disorders, history of malignancy. 25 mg twice weekly(s/c) Adult: : Child::
Infliximab(aaa)Indications - SSevere active Crohn’s disease, Severe active ulcerative colitis, Rheumatoid arthritis (in combination with methotrexate), Ankylosing spondylitis, Psoriatic arthritis (in combination with methotrexate), Plaque psoriasis. Avoid - Moderate or severe heart failure, severe infections. Cautions - development of malignancy . hepatitis B virus, history of colon carcinoma, history of dysplasia, history of malignancy, history of prolonged immunosuppressant or PUVA treatment in patients with psoriasis . mild heart failure. tab:®, Cap:® Adult: : Child::
Co-amoxiclav(aaa)Indications - Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate), Including respiratory tract infections, Bronchiectasis, Chronic obstructive pulmonary disease, Acute sinusitis, Bone and joint infections, Genito-urinary and abdominal infections, Cellulitis and animal bites, Acute otitis media. Oral 250/125 mg every 8 hours, Adult: : Child::
Tigecycline (Glycylcycline antibiotic)Indications - Complicated skin and soft tissue infections, Complicated intra-abdominal infections, Community-acquired bacterial pneumonia (when alternatives are not suitable). Contraindications - Hypersensitivity to tigecycline or tetracycline-class antibiotics. Avoid - Use in diabetic foot infections, pregnancy, breastfeeding. Cautions - Hepatic impairment, history of pancreatitis, superinfection risk including Clostridioides difficile-associated diarrhea. Drug Interactions - May reduce effectiveness of oral contraceptives; use caution with warfarin (monitor INR). Trade Names - Tygacil® (Injection: 50 mg lyophilized powder for IV use) Adult: Initial dose: 100 mg IV, followed by 50 mg IV every 12 hours. Child: Not recommended in patients under 18 years (due to lack of safety data and risk of tooth discoloration).
Colestyramine, Cholestyramine)(aaa)Indications - Hyperlipidaemias, Pruritus associated with partial biliary obstruction and primary biliary cirrhosis, Ileal resection, Vagotomy, Diabetic vagal neuropathy and radiation. tab:®, Cap:® Adult: : Child::
Bumetanide (Loop diuretic)Indications - Oedema associated with heart failure, hepatic cirrhosis, or renal impairment (including nephrotic syndrome). Contraindications - Severe electrolyte depletion, anuria, hepatic coma, hypersensitivity to sulfonamides or bumetanide. Cautions - Elderly, diabetes mellitus, gout, hypotension, risk of electrolyte imbalance (especially hypokalaemia and hyponatraemia), renal impairment, urinary retention in prostatic hypertrophy. Drug Interactions - Increased risk of hypotension with antihypertensives; ototoxicity risk with aminoglycosides; increased risk of hypokalaemia with corticosteroids, amphotericin B, and other diuretics; NSAIDs may reduce diuretic efficacy. Trade Names - Burinex® (Tablet: Bumetanide 1 mg) Adult: Initially 1 mg once daily; may be increased to 5 mg daily in divided doses based on response. Child: 0.03–0.1 mg/kg/day in 1–2 divided doses; adjust according to clinical response and electrolyte monitoring.
Amiloride HCl (Potassium-sparing diuretic)Indications - Oedema, hepatic cirrhosis with ascites, hypertension (used with thiazide or loop diuretics to prevent hypokalaemia), congestive heart failure. Contraindications - Hyperkalaemia, Addison’s disease, severe renal impairment, anuria, concomitant potassium supplements or other potassium-sparing agents. Cautions - Renal impairment, diabetes mellitus, elderly, pregnancy and lactation, electrolyte disturbances (monitor serum potassium and creatinine regularly). Drug Interactions - ACE inhibitors, angiotensin II receptor blockers (ARBs), potassium supplements, NSAIDs may increase the risk of hyperkalaemia; lithium toxicity risk may increase. Trade Names - Moduretic® (Tablet: Amiloride 5 mg + Hydrochlorothiazide 50 mg), Amilamont® (Tablet: Amiloride 5 mg) Adult: 5–10 mg once daily, adjust according to response and potassium levels; maximum 20 mg/day. Child: Safety and efficacy not established (use only if clearly indicated and under specialist supervision).
Moxisylyte, Thymoxamine, Peripheral vasodilator(aaa)Indications - Primary Raynaud’s syndrome. Avoid - Active liver disease. tab:®, Cap:® Adult: : Child::
Reslizumab (Monoclonal antibody, IL-5 antagonist)Indications - Add-on maintenance treatment of severe eosinophilic asthma in adults inadequately controlled with high-dose inhaled corticosteroids plus other asthma medications. Contraindications - Hypersensitivity to reslizumab or any component of the formulation. Cautions - Helminth infections (may reduce treatment efficacy), anaphylaxis risk—monitor during infusion. Avoid - Pregnancy, Breastfeeding (due to limited data). Drug interactions - No significant interactions reported; monitor for hypersensitivity reactions when used with other biologics. Trade names - IV infusion: Cinqair® (US), Cinqaero® (EU) (Specialist use only) Adult: 3 mg/kg by intravenous infusion over 20–50 minutes once every 4 weeks. Child: Not recommended for use under 18 years (safety and efficacy not established).
Alimemazine tartrate, Trimeprazine tartrate(Sedating antihistamine)Indications - Urticaria, Pruritus. tab:®, Cap:® Adult: : Child::
Bee venom extract(aaa)Indications - Hypersensitivity to bee venom. tab:®, Cap:® Adult: : Child::
Grass pollen extract(aaa)Indications - Treatment of seasonal allergic hay fever due to grass pollen in patients who have failed to respond to anti allergy drugs. tab:®, Cap:® Adult: : Child::
Tree pollen extract(aaa)Indications - Treatment of seasonal allergic hay fever due to tree pollen in patients who have failed to respond to anti-allergy drugs. tab:®, Cap:® Adult: : Child::
C1-esterase inhibitor(aaa)Indications - Acute attacks of hereditary angioedema. Under expert supervision. tab:®, Cap:® Adult: : Child::
Conestat alfa(aaa)Indications - Acute attacks of hereditary angioedema. Avoid - Rabbit allergy. tab:®, Cap:® Adult: : Child::
Icatibant(aaa)Indications - Acute attacks of hereditary angioedema. Cautions - Ischaemic heart disease. tab:®, Cap:® Adult: : Child::
Dornase alfa, Mucolytic(aaa)Indications - Management of cystic fibrosis patients with a forced vital capacity. By inhalation in Nebulised solution tab:®, Cap:® Adult: : Child::
Ivacaftor(Mucolytic)Indications - Cystic fibrosis. tab:®, Cap:® (Specialist use only) Adult: : Child::
Pholcodine(Cough suppressant)Indications - Dry cough. Avoid - Bronchiectasis, Bronchiolitis, Chronic bronchitis, Chronic obstructive pulmonary disease, At risk of respiratory failure. tab:®, Cap:® Adult: : Child::
Pirfenidone (Antifibrotic agent)Indications - Treatment of mild to moderate idiopathic pulmonary fibrosis (IPF). Contraindications - Hypersensitivity to pirfenidone, severe hepatic or renal impairment, history of angioedema with pirfenidone. Caution - Liver dysfunction, renal impairment, photosensitivity, smoking (reduces drug levels), elderly. Avoid - Sun exposure without protection; concomitant use with fluvoxamine or strong CYP1A2 inhibitors. Drug interactions - Fluvoxamine (contraindicated), ciprofloxacin, amiodarone, omeprazole, smoking (induces CYP1A2). Trade names - tab: Esbriet®, Pirfenex®, Fibrodone® (Initiate under specialist supervision) Adult: Initial: 267 mg 3 times daily; titrated to 801 mg 3 times daily as tolerated. Child: Not recommended due to lack of safety and efficacy data.
Buspirone Hcl (Antidepressant)Indications - short-term use for anxiety. Oral 5 mg 2–3 times a day Avoid - Epilepsy, Pregnancy, Breast feeding, hepatic impairment, renal impairment. tab:®, Cap:® Adult: : Child::
Atomoxetine (CNS Stimulant)Indications - Attention Deficit Hyperactivity Disorder (ADHD) in children ≥6 years, adolescents, and adults as part of a comprehensive treatment programme. Contraindications - Narrow-angle glaucoma, Severe cardiovascular or cerebrovascular disorders, Phaeochromocytoma or history of it, Hypersensitivity to atomoxetine, Use of MAO inhibitors within the past 14 days. Cautions - Monitor for suicidal thoughts or behaviour (especially in children/adolescents), Liver impairment, Hypertension, Tachycardia, History of seizures, Sudden cardiac death or structural cardiac abnormalities in family history. Drug Interactions - CYP2D6 inhibitors (e.g. fluoxetine, paroxetine may increase levels), MAOIs (contraindicated), Pressor agents (increased BP), Albuterol (increased cardiac effects). Trade Names - Strattera® (Capsule: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg) Adult: Initially 40 mg once daily, increased after ≥3 days to 80 mg once daily; max 100 mg/day. Child:
Methylphenidate HCl (CNS Stimulant)Indications - Attention Deficit Hyperactivity Disorder (ADHD), Narcolepsy. Contraindications - Glaucoma, marked anxiety or agitation, tics or family history of Tourette syndrome, severe depression, history of drug or alcohol abuse, MAO inhibitor use in past 14 days. Caution - Hypertension, epilepsy, history of substance abuse, psychiatric disorders (e.g. bipolar disorder, psychosis), growth monitoring in children. Avoid - Anorexia nervosa, arrhythmias, cardiomyopathy, cardiovascular disease, cerebrovascular disorders, heart failure, hyperthyroidism. Drug interactions - MAO inhibitors (contraindicated), serotonergic drugs (risk of serotonin syndrome), antihypertensives (reduced effect), warfarin, SSRIs, tricyclic antidepressants. Trade names - tab: Ritalin®, Concerta®, Biphentin®, Medikinet® (Initiate under specialist supervision) Adult: 5–10 mg 1–2 times daily, titrated up to max 100 mg/day depending on formulation and patient response. Child: Initially 5 mg once or twice daily; increased gradually by 5–10 mg at weekly intervals; usual dose range 20–60 mg/day in divided doses.
Lofepramine (Antidepressant)Indications - Treatment of depressive illness, especially where sedation is not required. Contraindications - Acute porphyrias, Cardiac arrhythmias, Recent myocardial infarction, Heart block, Manic phase of bipolar disorder, Hypersensitivity to tricyclic antidepressants. Cautions - Elderly, Epilepsy, Cardiovascular disease, Hyperthyroidism, History of urinary retention or glaucoma, Suicidal ideation (requires close monitoring). Drug Interactions - May interact with MAO inhibitors (contraindicated), SSRIs (risk of serotonin syndrome), CNS depressants (additive sedation), anticholinergic drugs (enhanced effects), and antihypertensives (reduced efficacy). Trade Names - Lomont® (Tablet: 70 mg) Adult: 140–210 mg daily in divided doses; maximum 210 mg/day. Child: Not recommended unless specifically advised by a specialist.
Nortriptyline(Antidepressant)Indications - Depressive illness, Neuropathic pain. Initially oral 10 mg once daily Avoid - Arrhythmias, During the manic phase of bipolar disorder, heart block, immediate recovery period after myocardial infarction. tab:®, Cap:® Adult: : Child::
Trimipramine(Antidepressant)Indications - Depressive illness (Especially where sedation required. Oral 50–75 mg daily in divided doses Avoid - Acute porphyrias, Arrhythmias, Heart block, Immediate recovery period after myocardial infarction) Cautions - Cardiovascular disease, Chronic constipation, Diabetes, Epilepsy, History of bipolar disorder, History of psychosis, Hyperthyroidism, Increased intra-ocular pressure, Patients with a significant risk of suicide, Phaeochromocytoma, Prostatic hypertrophy, Urinary retention. tab:®, Cap:® Adult: : Child::
Tryptophan (Antidepressant)Indications - Treatment-resistant depression. Oral 1 g 3 times a day. Avoid - Breast feeding) Cautions - Pregnancy. tab:®, Cap:® Adult: : Child::
Vortioxetine(Antidepressant)Indications - Major depression. Oral 10 mg once daily Cautions - Bleeding disorders, Cirrhosis of the liver, Elderly, History of mania, History of seizures, Unstable epilepsy. tab:®, Cap:® Adult: : Child::
Benperidol(Antipsychotic)Indications - Control of deviant antisocial sexual behaviour. Oral 0.25–1.5 mg daily in divided doses Avoid - CNS depression, Comatose states, Phaeochromocytoma), Cautions - Risk factors for stroke. tab:®, Cap:® Adult: : Child::
Flupentixol(Antipsychotic)Indications - Schizophrenia and other psychoses, Particularly with apathy and withdrawal but not mania or psychomotor hyperactivity, Depressive illness. tab:®, Cap:® Adult: : Child::
Loxapine(Antipsychotic)Indications - Rapid control of mild-to-moderate agitation in patients with schizophrenia or bipolar disorder. tab:®, Cap:® (Under specialist supervision in hospital Adult: : Child::
Pericyazine, Periciazine(Antipsychotic)Indications - Schizophrenia, Psychoses, Short-term adjunctive management of severe anxiety, Psychomotor agitation and violent or dangerously impulsive behaviour. tab:®, Cap:® Adult: : Child::
Pimozide, Antipsychotic(aaa)Indications - Schizophrenia, Monosymptomatic hypochondriacal psychosis, Paranoid psychosis. Oral 2 mg daily Avoid - CNS depression, Comatose states, History of arrhythmias, History or family history of congenital QT prolongation, Phaeochromocytoma. tab:®, Cap:® Adult: : Child::
Sulpiride(Antipsychotic)Indications - Schizophrenia with mainly positive symptoms. tab:®, Cap:® Adult: : Child::
Zuclopenthixol(Antipsychotic)Indications - Schizophrenia and other psychoses. tab:®, Cap:® Adult: : Child::
Zuclopenthixol acetate(aaa)Indications - Short-term management of acute psychosis, Short-term management of mania, Short-term management of exacerbation of chronic psychosis. tab:®, Cap:® Adult: : Child::
Flupentixol decanoate, Flupenthixol Decanoate(Antipsychotic)Indications - Maintenance in schizophrenia and other psychoses. tab:®, Cap:® Adult: : Child::
Fluphenazine decanoate(First-generation antipsychotics)Indications - Maintenance in schizophrenia and other psychoses. tab:®, Cap:® Adult: : Child::
Zuclopenthixol decanoate(Antipsychotic)Indications - Maintenance in schizophrenia and paranoid psychoses. tab:®, Cap:® Adult: : Child::
Clozapine(Antipsychotic)Indications - Schizophrenia in patients unresponsive to, Or intolerant of, Conventional antipsychotic drugs, Psychosis in Parkinson’s disease. tab:®, Cap:® Adult: : Child::
Lurasidone Hcl(Second-generation antipsychotics)Indications - Schizophrenia. tab:®, Cap:® Adult: : Child::
Paliperidone(Second-generation antipsychotics)Indications - Schizophrenia, Psychotic or manic symptoms of schizoaffective disorder, Maintenance of schizophrenia in patients who are clinically stable on once-monthly intramuscular paliperidone, Maintenance in schizophrenia in patients previously responsive to paliperidone or risperidone. tab:®, Cap:® Adult: : Child::
Promazine Hcl(Antipsychotic)Indications - Short-term adjunctive management of psychomotor agitation, Agitation and restlessness in elderly. tab:®, Cap:® Adult: : Child::
Botulinum toxin type A (Muscular relaxant)Indications - Treatment of focal spasticity, blepharospasm, hemifacial spasm, spasmodic torticollis, severe hyperhidrosis of the axillae, prophylaxis of headaches in adults with chronic migraine, temporary improvement of moderate to severe wrinkles between the eyebrows in adults, ankle disability due to lower limb spasticity, management of bladder dysfunctions. Trade Names - Botox inj:®, Dysport inj:®, Xeomin inj:® (Specialist use only) Adult: Dosage depends on indication and muscle group involved; typically 20–200 units IM per session in divided doses, repeated at intervals of ≥12 weeks. Child: For spasticity: 1–4 units/kg/dose IM (max per session varies by brand and age); dosing must be individualized under specialist supervision.
Botulinum toxin type B(Muscular relaxant)Indications - Spasmodic torticollis, Cervical dystonia. tab:®, Cap:® Adult: : Child::
Inotersen(Neuroprotective drug)Indications - Stage 1 or stage 2 polyneuropathy in patients with hereditary transthyretin amyloidosis. tab:®, Cap:® (Initiate by a specialist) Adult: : Child::
Tafamidis, Neuroprotective drug(aaa)Indications - Treatment of transthyretin familial amyloid polyneuropathy (TTR-FAP) in patients with stage 1 symptomatic polyneuropathy to delay peripheral neurological impairment. tab:®, Cap:® Adult: : Child::
Trihexyphenidyl HCl (Benzhexol HCl) (Anticholinergic / Antiparkinsonian agent)Indications - Adjunctive treatment of all forms of Parkinson's disease (idiopathic, postencephalitic, arteriosclerotic); Control of extrapyramidal symptoms (drug-induced parkinsonism) caused by antipsychotic medications. Contraindications - Angle-closure glaucoma, Gastrointestinal obstruction, Urinary retention, Myasthenia gravis, Hypersensitivity to trihexyphenidyl. Cautions - Elderly, Cardiovascular disease, Hepatic or renal impairment, Prostatic hypertrophy, Heat exposure (risk of heatstroke due to reduced sweating), History of psychosis. Drug Interactions - May enhance effects of other anticholinergics, may reduce effects of levodopa (dose adjustment may be needed), may increase CNS effects with alcohol or CNS depressants. Trade Names - Artane® (Tablet: 2 mg, 5 mg) Adult: Initially 1 mg/day, increased gradually by 2 mg at intervals of 3–5 days up to 6–10 mg/day in divided doses; max usually 15 mg/day. Child: Use with caution; generally not recommended unless under specialist supervision.
Entacapone(Dopaminergic)Indications - Adjunct to co-beneldopa or co-careldopa in Parkinson’s disease. Avoid - History of neuroleptic malignant syndrome, History iof non-traumatic rhabdomyolysis, Phaeochromocytoma) Cautions - . tab:®, Cap:® Adult: : Child::
Opicapone (Dopaminergic)Indications - Adjunct therapy to co-beneldopa or co-careldopa in adults with Parkinson’s disease and end-of-dose motor fluctuations not stabilized on those combinations alone. Contraindications - Pheochromocytoma, paraganglioma, other catecholamine-secreting neoplasms, history of neuroleptic malignant syndrome (NMS) or non-traumatic rhabdomyolysis, hypersensitivity to opicapone or any excipient. Cautions - History of severe dyskinesia, hepatic impairment, cardiovascular disease, or psychiatric illness; monitor for signs of NMS after sudden dose reduction or withdrawal. Drug Interactions - Avoid concomitant use with MAO inhibitors (non-selective), interactions with other COMT inhibitors (e.g., entacapone, tolcapone); potentiation of levodopa side effects possible. Trade Names - Ongentys® (Capsule: Opicapone 50 mg) Adult: 50 mg once daily at bedtime, at least 1 hour before or after levodopa/dopa decarboxylase inhibitor dose. Child: Not recommended (safety and efficacy not established).
Tolcapone(Dopaminergic)Indications - Adjunct to co-beneldopa or co-careldopa in Parkinson’s disease. tab:®, Cap:® Adult: : Child::
Co-beneldopa (Dopaminergic)Indications - Parkinson’s disease, including idiopathic Parkinsonism, post-encephalitic Parkinsonism, and symptomatic Parkinsonism that may follow carbon monoxide intoxication or manganese intoxication. Contraindications - Narrow-angle glaucoma, History of malignant melanoma or suspicious undiagnosed skin lesions, Use of non-selective MAO inhibitors within 14 days, Hypersensitivity to levodopa or benserazide. Cautions - History of cardiac disease, Psychiatric illness (including depression), Peptic ulceration, Diabetes mellitus, Open-angle glaucoma (intraocular pressure monitoring recommended), Hepatic or renal impairment. Drug Interactions - Non-selective MAOIs (contraindicated), Antipsychotics (may antagonize effects), Antihypertensives (additive hypotensive effect), Iron salts (reduced absorption), Protein-rich meals (reduced absorption). Trade Names - Madopar® (Tablets and Capsules: Levodopa + Benserazide in ratios such as 100/25 mg, 200/50 mg) Adult: Initial dose: 62.5 mg (levodopa 50 mg + benserazide 12.5 mg) 3–4 times daily, increased gradually; usual maintenance dose: 300–800 mg levodopa daily in divided doses. Child: Not recommended (safety and efficacy not established).
Co-careldopa(Dopaminergic)Indications - Parkinson’s disease. tab:®, Cap:® Adult: : Child::
Apomorphine Hcl(Dopamine agonist)Indications - Refractory motor fluctuations in Parkinson’s disease. tab:®, Cap:® Adult: : Child::
Codeine phosphate, Opioid analgesic(aaa)Indications - Acute diarrhoea, Mild to moderate pain, Dry or painful cough. tab:®, Cap:® Adult: : Child::
Linagliptin(Blood glucose lowering drug, DPP-4 inhibitor )Indications - Type 2 diabetes mellitus . Oral 5 mg once daily. Linglip 5mg tab:® Adult: : Child::
Alogliptin(Blood glucose lowering drug, DPP-4 inhibitor)Indications - Type 2 diabetes mellitus. Oral : 25 mg once daily. Aloja 25mg tab:® Adult: : Child::
Vildagliptin(Blood glucose lowering drug)Indications - Type 2 diabetes mellitus. "Valiant" film coated tab:. Avoid - Ketoacidosis. tab:®, Cap:® Adult: : Child::
Dulaglutide (Blood glucose lowering drug – GLP-1 receptor agonist)Indications - Adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus, including monotherapy or in combination with other antidiabetic agents. Contraindications - Personal or family history of medullary thyroid carcinoma, Multiple endocrine neoplasia syndrome type 2 (MEN 2), Hypersensitivity to dulaglutide. Cautions - History of pancreatitis, Severe gastrointestinal disease (e.g., gastroparesis), Renal impairment, Dehydration risk. Drug Interactions - May delay gastric emptying and affect absorption of oral medications (e.g., antibiotics, oral contraceptives); enhanced hypoglycaemia risk when used with sulfonylureas or insulin. Trade Names - Trulicity® (Prefilled pen: 0.75 mg/0.5 mL, 1.5 mg/0.5 mL, 3 mg/0.5 mL, 4.5 mg/0.5 mL) Adult: Initially 0.75 mg SC once weekly; may increase to 1.5 mg once weekly based on response. Higher doses (3 mg or 4.5 mg) may be considered if needed. Child: Not recommended (Safety and efficacy not established in children under 18 years).
Exenatide (Blood glucose lowering drug – GLP-1 receptor agonist)Indications - Adjunctive treatment of type 2 diabetes mellitus in adults inadequately controlled on oral antidiabetic agents such as metformin, sulfonylurea, or a combination thereof. Contraindications - Hypersensitivity to exenatide or any of its components, Personal or family history of medullary thyroid carcinoma (for extended-release forms), Multiple endocrine neoplasia syndrome type 2 (MEN 2). Cautions - Drug Interactions - May delay gastric emptying and affect absorption of oral medications (e.g. antibiotics, oral contraceptives); risk of hypoglycaemia when combined with sulfonylureas or insulin. Trade Names - Byetta® (Injection: 5 mcg or 10 mcg per dose prefilled pens), Bydureon® (Extended-release once-weekly formulation) Adult: Immediate-release: 5 mcg SC twice daily within 60 minutes before morning and evening meals, may increase to 10 mcg twice daily after 1 month. Extended-release: 2 mg SC once weekly. Child: Not recommended (Safety and efficacy not established in patients under 18 years).
Liraglutide (Blood glucose lowering drug – GLP-1 receptor agonist)Indications - Type 2 diabetes mellitus in adults and children ≥10 years as adjunct to diet and exercise; also indicated for weight management in obese or overweight individuals with weight-related conditions (under specific brand formulations). Contraindications - Personal or family history of medullary thyroid carcinoma, Multiple endocrine neoplasia syndrome type 2 (MEN 2), Hypersensitivity to liraglutide. Cautions - History of pancreatitis, Severe gastrointestinal disease (e.g. gastroparesis), Dehydration, Thyroid disease, Renal impairment. Drug Interactions - Delays gastric emptying and may reduce absorption of oral medications; monitor if used with sulfonylureas or insulin (risk of hypoglycaemia). Trade Names - Victoza® (Injection: 6 mg/mL in 3 mL pre-filled pen), Saxenda® (Weight loss: 3 mg/day SC) Adult: SC: Initially 0.6 mg once daily for at least 1 week, increased to 1.2 mg once daily; may be increased to 1.8 mg based on response and tolerance. Child: ≥10 years: SC: Start with 0.6 mg once daily, titrate up weekly to a maximum of 1.8 mg/day based on clinical response.
Lixisenatide (Blood glucose lowering drug – GLP-1 receptor agonist)Indications - Type 2 diabetes mellitus in adults inadequately controlled by oral antidiabetic drugs or basal insulin. Contraindications - Hypersensitivity to lixisenatide or any excipient in the formulation. Cautions - History of pancreatitis, Severe gastrointestinal disease (e.g. gastroparesis), Use with other glucose-lowering drugs (increased risk of hypoglycaemia), Renal impairment. Drug Interactions - May delay gastric emptying, affecting absorption of oral drugs (e.g. antibiotics, contraceptives); caution with sulfonylureas or insulin (may increase hypoglycaemia risk). Trade Names - Lyxumia® (Injection: 10 mcg/20 mcg per dose pre-filled pen) Adult: Subcutaneous: Initially 10 micrograms once daily for 14 days, then increase to 20 micrograms once daily, within 1 hour before the first meal of the day. Child: Not recommended (safety and efficacy not established in individuals under 18 years).
Semaglutide (Blood glucose lowering drug - GLP-1 receptor agonist)Indications - Type 2 diabetes mellitus (as an adjunct to diet and exercise); also approved for weight management in obese or overweight adults with at least one weight-related comorbidity. Contraindications - Personal or family history of medullary thyroid carcinoma, Multiple endocrine neoplasia syndrome type 2 (MEN2), Hypersensitivity to semaglutide. Cautions - Pancreatitis, Diabetic retinopathy, Gastrointestinal disorders, Pregnancy and lactation. Drug Interactions - May delay gastric emptying and affect absorption of oral medications (e.g. oral contraceptives, antibiotics). Trade Names - Ozempic® (Injection: 0.25 mg, 0.5 mg, 1 mg per dose pen), Rybelsus® (Tablet: 3 mg, 7 mg, 14 mg) Adult: Subcutaneous: 0.25 mg once weekly for 4 weeks, then increase to 0.5 mg once weekly; may increase to 1 mg weekly if needed. Child: Not recommended (safety and efficacy not established in individuals under 18 years).
Canagliflozin (SGLT2 Inhibitor / Blood Glucose Lowering Drug)Indications - Type 2 diabetes mellitus (as monotherapy or in combination), to reduce risk of major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease. Contraindications - Avoid - Use in patients with diabetic gastroparesis, inflammatory bowel disease, severe congestive heart failure, during volume depletion or hypotension. Cautions - Elderly, renal impairment, risk of genital infections, dehydration, ketoacidosis, lower limb amputation risk. Drug interactions - Diuretics (increased risk of volume depletion), insulin or insulin secretagogues (risk of hypoglycemia), digoxin (monitor levels), rifampicin, phenytoin, phenobarbital (may decrease efficacy). Trade Names - Tab: Invokana 100 mg®, Invokana 300 mg® Adult: Starting dose: 100 mg once daily before first meal; may increase to 300 mg once daily if tolerated and eGFR permits. Child: Not recommended in patients under 18 years (safety and efficacy not established).
Dapagliflozin (Blood glucose lowering drug, SGLT2 inhibitor) Indications - Type 1 diabetes mellitus (as adjunct to insulin in select cases), Type 2 diabetes mellitus, Heart failure with reduced ejection fraction, Chronic kidney disease. Contraindications - Type 1 diabetes (unless used under strict specialist supervision), Diabetic ketoacidosis, Severe renal impairment (eGFR < 30 mL/min/1.73 m²), Hypersensitivity to dapagliflozin. Cautions - Risk of hypotension, Volume depletion, Elderly, History of genital infections, Renal impairment, Use with insulin or insulin secretagogues may increase risk of hypoglycaemia. Avoid - Pregnancy, Breastfeeding, Use in patients with active bladder cancer. Interactions - Increased risk of hypoglycaemia with insulin or sulfonylureas; diuretics may enhance risk of volume depletion. Trade Names - DAPAEDGE-10 tab:® Adult: Oral 5 mg once daily; may increase to 10 mg once daily if tolerated and indicated. Child: Safety and efficacy not established.
Empagliflozin (SGLT2 Inhibitor / Blood Glucose Lowering Drug)Indications - Type 2 diabetes mellitus (monotherapy or in combination), to reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease, chronic heart failure with reduced ejection fraction, chronic kidney disease. Contraindications - Avoid - Use in pregnancy, breastfeeding, volume depletion, and in patients with a history of frequent urinary tract infections. Cautions - Elderly (especially >75 years), cardiovascular disease, hypotension, renal impairment, recurrent UTIs, genital infections, dehydration. Drug interactions - Diuretics (increased risk of hypotension), insulin or insulin secretagogues (hypoglycemia risk), rifampicin, phenytoin, phenobarbital (may reduce efficacy), digoxin (monitor levels). Trade Names - Tab: Diajard-MXR® 10 mg, Jardiance® 10 mg, Jardiance® 25 mg Adult: Starting dose 10 mg once daily; may increase to 25 mg once daily if tolerated and renal function permits. Child: Not recommended for patients under 18 years (safety and efficacy not established).
Ertugliflozin (Blood Glucose Lowering Drug, SGLT2 Inhibitor)Indications - Type 2 diabetes mellitus as monotherapy or in combination with metformin, sulfonylureas, or insulin to improve glycemic control; also used in patients with established cardiovascular disease to reduce cardiovascular risk. Contraindications - Type 1 diabetes mellitus, diabetic ketoacidosis, severe renal impairment (eGFR <30 mL/min/1.73 m²), hypersensitivity to Ertugliflozin. Avoid - Pregnancy, breastfeeding, volume depletion, recurrent urinary tract or genital infections. Cautions - Elderly, renal impairment, hypotension, history of genital mycotic infections, dehydration, increased risk of ketoacidosis. Drug interactions - Diuretics (increased risk of hypotension), insulin and secretagogues (increased risk of hypoglycemia), UGT enzyme inducers (e.g. rifampin) may decrease efficacy. Trade Names - Tab: Steglatro® 5 mg, 15 mg; Tab: Steglujan® (Ertugliflozin + Sitagliptin); Tab: Segluromet® (Ertugliflozin + Metformin) Adult: Initially 5 mg once daily; may increase to 15 mg once daily depending on renal function and response. Child: Not recommended under 18 years of age (safety and efficacy not established).
Glibenclamide (Sulfonylurea, Blood Glucose Lowering Drug)Indications - Type 2 diabetes mellitus (non-insulin-dependent), especially when dietary measures alone are inadequate. Contraindications - Type 1 diabetes, diabetic ketoacidosis, severe renal or hepatic impairment, pregnancy, breastfeeding, hypersensitivity to sulfonylureas. Avoid - Use in elderly patients prone to hypoglycemia, avoid alcohol (may enhance hypoglycemic effect). Cautions - Elderly, adrenal or pituitary insufficiency, malnourished patients, impaired renal or hepatic function, patients with G6PD deficiency. Drug interactions - Enhanced effect with NSAIDs, MAOIs, alcohol, beta-blockers, and ACE inhibitors. Reduced effect with corticosteroids, thiazides, and sympathomimetics. Trade Names - Tab: Daonil® 5 mg, Semi-Daonil® 2.5 mg, Euglucon® Adult: Initially 2.5–5 mg once daily with breakfast; may be increased gradually (max 15 mg/day in divided doses). Child: Not recommended (safety and efficacy not established).
Tamsulosin (Alpha-1 blocker, Alpha-1 adrenergic antagonist)Indications - Benign prostatic hyperplasia (BPH), lower urinary tract symptoms associated with BPH. Contraindications - History of orthostatic hypotension, hypersensitivity to Tamsulosin or other alpha-1 blockers, severe hepatic impairment. Avoid - Concomitant use with strong CYP3A4 inhibitors (e.g. ketoconazole), caution when driving or operating machinery. Cautions - Postural hypotension, cataract surgery (risk of Intraoperative Floppy Iris Syndrome), renal or hepatic impairment. Drug interactions - Increased effect with CYP3A4 and CYP2D6 inhibitors; risk of hypotension with other alpha-blockers or antihypertensives. Trade Names - Cap: Flomax®, Urimax®, Contiflo OD®, Tamsure® Adult: 0.4 mg once daily after the same meal each day; may increase to 0.8 mg if needed. Child: Not recommended (safety and efficacy not established).
Dutasteride (5-Alpha Reductase Inhibitor)Indications - Benign prostatic hyperplasia (BPH); may be used alone or in combination with tamsulosin in symptomatic BPH. Contraindications - Women and children, hypersensitivity to dutasteride or other 5-alpha reductase inhibitors. Avoid - Use in women who are or may become pregnant (may be absorbed through the skin and harm a male fetus). Cautions - Hepatic impairment, risk of high-grade prostate cancer (monitor PSA levels). Drug interactions - CYP3A4 inhibitors (e.g., ketoconazole) may increase dutasteride levels; caution with concomitant use. Trade Names - Cap: Avodart®, Dutas®, Duprost®, Dutagen® Adult: 0.5 mg once daily; may be used with tamsulosin. Child: Not recommended (contraindicated in children).
Solifenacin (Antimuscarinic / Anticholinergic)Indications - Overactive bladder with symptoms of urge incontinence, urinary urgency, and frequency; adjunct in benign prostatic hyperplasia when monotherapy is ineffective. Contraindications - Urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, severe hepatic impairment. Avoid - Pregnancy, breastfeeding, use with other anticholinergic drugs without medical advice. Cautions - QT interval prolongation, bladder outflow obstruction, gastrointestinal disorders (e.g., severe constipation), hepatic or renal impairment, elderly. Drug interactions - CYP3A4 inhibitors (e.g., ketoconazole), other anticholinergics may enhance adverse effects. Trade Names - Tab: Vesicare®, Soliten®, Solitrol® Adult: 5 mg once daily, may increase to 10 mg once daily if tolerated. Child: Not recommended unless prescribed by a specialist.
Chlorhexidine (Antiseptic / Disinfectant)Indications - Urethral sounding and catheterisation, Cystoscopy, Preoperative skin disinfection, Oral hygiene and plaque inhibition, Oral candidiasis, Gingivitis, Management of aphthous ulcers, Denture stomatitis. Contraindications - Hypersensitivity to chlorhexidine or any component of the formulation. Avoid - Contact with eyes, ears (perforated eardrum), brain, meninges; ingestion of concentrated solution. Cautions - Can cause severe allergic reactions including anaphylaxis; use with care in oral formulations to avoid staining of teeth. Drug interactions - Incompatible with soaps and other anionic surfactants; avoid use with iodine-based antiseptics. Trade Names - Mouthwash: Peridex®, Corsodyl®; Topical: Hibiscrub®, Chlorhex® Lotion; Oral gel: Hexigel® Adult: Depends on formulation — e.g., 0.12% mouthwash: rinse 15 ml for 30 seconds twice daily; apply gel/solution as directed. Child: Use with caution under medical supervision; dosage varies by formulation and age.
Glycine (Non-essential amino acid / Irrigating solution)Indications - Bladder irrigation during urological surgery, Irrigation for transurethral resection of the prostate (TURP) and bladder tumours. Contraindications - Anuria, severe fluid or electrolyte imbalance, hypersensitivity to glycine or any component of the solution. Avoid - Use in patients with fluid overload or electrolyte disturbances. Cautions - Monitor for fluid retention, electrolyte imbalance, and signs of water intoxication, especially during prolonged irrigation. Drug interactions - None significant when used as irrigation; systemic absorption may interact with diuretics or affect serum electrolytes. Trade Names - Irrigation solution: Glycine 1.5% Irrigation USP®, Glyciran® Irrigation Adult: Irrigation only — administered as needed during procedures; not for intravenous or oral use. Child: Not routinely used in children; use only if specifically indicated under specialist supervision.
Estradiol (Estrogen hormone / Hormonal contraceptive)Indications - Contraception, Hormone replacement therapy (HRT) in menopausal symptoms, Hypoestrogenism due to hypogonadism or premature ovarian failure. Contraindications - Estrogen-dependent tumors, Undiagnosed vaginal bleeding, History of thromboembolic disorders, Severe liver dysfunction, Pregnancy. Avoid - Smoking (especially in women over 35), Use in patients with high risk of cardiovascular or thrombotic disease. Cautions - History of depression, Hypertension, Gallbladder disease, Migraine, Diabetes. Drug interactions - CYP3A4 inducers (e.g., rifampicin, phenytoin) may reduce efficacy; may alter effects of corticosteroids, anticoagulants, and thyroid hormones. Trade Names - Progynova tab:®, Estrabet gel®, Estrofem tab:®, Climara patch® Adult: 0.5–2 mg daily orally (or dose per formulation for HRT or contraception); patch or gel forms available. Child: Use only under specialist guidance, typically in cases of delayed puberty or hypogonadism.
Nomegestrol (Progestin hormone / Hormonal contraceptive)Indications - Contraception, Menstrual disorders, Hormone replacement therapy (in combination with estrogen), Treatment of endometriosis. Contraindications - Active thromboembolic disorders, Liver disease, Hormone-sensitive cancers, Undiagnosed vaginal bleeding, Pregnancy. Avoid - Use in patients with history of cardiovascular disease or stroke without specialist supervision. Cautions - Hypertension, Diabetes, Depression, Migraine, Hyperlipidemia, Smokers over age 35. Drug interactions - Efficacy reduced by CYP3A4 inducers (e.g., rifampicin, carbamazepine); may affect metabolism of other hormone-related drugs. Trade Names - Zoely tab:®, Naemis tab:® Adult: 2.5 mg daily orally (commonly as 2.5 mg nomegestrol with 1.5 mg estradiol in combined contraceptives). Child: Not recommended before menarche; use only under specialist guidance.
Ethinylestradiol (Estrogen / Hormonal contraceptive)Indications - Contraception (in combination with progestins in 21-day preparations), Management of menstrual disorders (e.g. dysmenorrhea, menorrhagia), Acne (hormonal-related), Polycystic ovary syndrome (PCOS) symptoms. Contraindications - History of thromboembolic disorders, Estrogen-dependent tumors, Liver disease, Undiagnosed vaginal bleeding, Pregnancy. Avoid - Use in smokers over 35 years of age, Known thrombophilia, Migraines with aura. Cautions - Hypertension, Diabetes, Hyperlipidemia, Obesity, Gallbladder disease, Close monitoring in long-term therapy. Drug interactions - Reduced efficacy with CYP450 inducers (e.g. rifampin, phenytoin); increased risk of toxicity with lamotrigine, cyclosporine. Trade Names - Microgynon tab:®, Nordette tab:®, Ovral tab:® Adult: 20–35 mcg once daily for 21 days of each cycle, usually in combination with a progestin. Child: Not recommended before menarche; use only under medical supervision in adolescents.
Desogestrel (Progestin / Hormonal contraceptive) Indications - Contraception (as a progestin-only pill or in combination with estrogen in 21-day preparations), Management of menstrual symptoms such as dysmenorrhea, Menorrhagia, Endometriosis-related pain. Contraindications - Active thromboembolic disorders, Severe hepatic disease, Hormone-sensitive cancers, Undiagnosed vaginal bleeding, Pregnancy. Avoid - Use in patients with a history of breast cancer, Severe arterial disease, or unexplained amenorrhea. Cautions - Hypertension, Diabetes, History of depression, Migraine, Gallbladder disease, Liver dysfunction. Drug interactions - Efficacy reduced by enzyme inducers (e.g., rifampicin, carbamazepine, phenytoin); possible interactions with antiretrovirals and antibiotics. Trade Names - Cerazette tab:®, Marvelon (combined) tab:®, Mercilon tab:® Adult: 75 mcg once daily at the same time each day without interruption (progestin-only). Child: Not recommended before menarche; use under specialist supervision in adolescents.
Drospirenone (Progestin / Hormonal contraceptive) Indications - Contraception (usually in combination with ethinylestradiol in 21-day combined oral contraceptives), Treatment of menstrual disorders such as premenstrual dysphoric disorder (PMDD), Acne vulgaris (in contraceptive preparations), Menstrual regulation. Contraindications - Renal insufficiency, Adrenal insufficiency, Hepatic dysfunction, Thromboembolic disorders, Hormone-sensitive cancers, Pregnancy. Avoid - In women with a history of thromboembolic events, uncontrolled hypertension, or migraine with aura. Cautions - Conditions predisposing to hyperkalemia (e.g., renal impairment, use of potassium-sparing drugs), History of depression, Diabetes, Obesity, Smoking (especially over 35 years of age). Drug interactions - Enzyme-inducing drugs (e.g., phenytoin, carbamazepine, rifampicin) may reduce contraceptive effectiveness; possible interactions with potassium-elevating agents (e.g., spironolactone, NSAIDs). Trade Names - Yasmin tab:®, Yaz tab:®, Dronis tab:® Adult: 3 mg daily in combination with ethinylestradiol for 21 consecutive days followed by a 7-day pill-free interval (or 24+4 regimen depending on product). Child: Use from menarche under medical supervision; safety and efficacy established in adolescents.
Etonogestrel (Progestin / Hormonal contraceptive) Indications - Contraception (as subdermal implant), Management of menstrual symptoms such as dysmenorrhea or menorrhagia. Contraindications - Active thromboembolic disorders, Liver tumors or liver disease, Known or suspected hormone-sensitive malignancies, Undiagnosed vaginal bleeding, Pregnancy. Avoid - In women with current or past thrombotic events, severe hepatic impairment, or known/suspected breast cancer. Cautions - History of depression, Hypertension, Diabetes mellitus, Gallbladder disease, Obesity, Smoking in women over 35 years. Drug interactions - Enzyme-inducing drugs (e.g., rifampicin, phenytoin, carbamazepine) may reduce contraceptive efficacy. Trade Names - Implanon NXT® (implant) Adult: One 68 mg subdermal implant inserted under the skin of the upper arm; provides contraception for up to 3 years. Child: Use in post-pubertal adolescents under medical supervision; same dosing as adults.
Gestodene (Progestin / Hormonal contraceptive) Indications - Contraception with 21-day combined oral contraceptive (COC) preparations, Management of menstrual symptoms such as dysmenorrhea, premenstrual syndrome, and cycle regulation. Contraindications - Thromboembolic disorders, History of stroke or myocardial infarction, Liver disease or liver tumors, Hormone-sensitive cancers (e.g., breast cancer), Undiagnosed vaginal bleeding, Pregnancy. Avoid - In women over 35 who smoke, or those with high cardiovascular risk. Cautions - Hypertension, Migraine (especially with aura), Diabetes, Gallbladder disease, Obesity, History of depression. Drug interactions - Enzyme-inducing drugs (e.g., rifampicin, phenytoin, carbamazepine) may reduce contraceptive effectiveness. Trade Names - Femodene tab:®, Meliane tab:® Adult: One tablet daily for 21 consecutive days, followed by a 7-day pill-free interval; repeat cycle. Child: Approved for use in post-pubertal adolescents; same dosage as adults under supervision.
Norelgestromin (Progestin / Hormonal contraceptive) Indications - Contraception (used in combination transdermal patch with ethinylestradiol), Management of menstrual symptoms such as dysmenorrhea and cycle regulation. Contraindications - History of thromboembolic events, Stroke, Coronary artery disease, Liver tumors, Estrogen- or progestin-sensitive cancers, Undiagnosed abnormal vaginal bleeding, Pregnancy. Avoid - Women over 35 who smoke, Severe hypertension, Migraine with aura. Cautions - Obesity, Hyperlipidemia, Gallbladder disease, Diabetes, History of depression, Breastfeeding. Drug interactions - Drugs that induce CYP3A4 (e.g., rifampin, phenytoin, carbamazepine) may reduce effectiveness. Use backup contraception. Trade Names - Evra patch® (Transdermal patch) Adult: Apply one patch weekly for 3 weeks, followed by 1 patch-free week; repeat cycle. Child: Not recommended before menarche; use in adolescents only under clinical supervision.
Ergometrine with Oxytocin (Uterotonic agents) Indications - Active management of the third stage of labour, Postpartum haemorrhage (PPH) due to uterine atony, Bleeding associated with incomplete miscarriage or abortion. Contraindications - Severe hypertension, Preeclampsia, Eclampsia, Known hypersensitivity to ergometrine or oxytocin, Cardiac disease. Cautions - Hepatic or renal impairment, Multiple pregnancy, Overdistended uterus, Elderly or very young mothers. Trade Names - Syntometrine® (Injection: Ergometrine 0.5 mg + Oxytocin 5 IU/mL) Adult: 1 mL by intramuscular injection immediately after delivery of the anterior shoulder or after delivery of the placenta. Child: Not applicable (use restricted to obstetric indications in adults).
Fenticonazole nitrate (Antifungal) Indications - Vaginal and vulva candidiasis. Contraindications - Hypersensitivity to fenticonazole. Cautions - Use with caution in pregnancy and breastfeeding. Avoid - Systemic fungal infections. Drug interaction - No significant drug interactions reported. Trade Names - Canesten® (Cream, pessary), Daktarin® (Cream, gel), Lomexin® (Cream, pessary) Adult: As per formulation and indication. Child: Use under medical supervision only.
Estriol (Estrogen hormone) Indications - Improve the vaginal epithelium in menopausal atrophic vaginitis (short-term use), Vaginal surgery for prolapse when there is epithelial atrophy in postmenopausal women (pre-operative use). Avoid - Active arterial thromboembolic disease (e.g., angina or myocardial infarction), Active thrombophlebitis, History of breast cancer, History of recurrent venous thromboembolism, Oestrogen-dependent cancer, Undiagnosed vaginal bleeding, Untreated endometrial hyperplasia, Venous thromboembolism. Cautions - History of liver disease, Migraine, Epilepsy, Hypertension, Diabetes, Asthma. Trade Names - Ovestin® (Vaginal cream, Pessary 0.5 mg), Evalon® (Tablet 1 mg) Adult: Vaginal cream: 0.5 mg daily for 2–3 weeks, then reduce to maintenance dose (e.g., twice weekly); Tablets: 1–2 mg once daily, as prescribed. Child: Not recommended unless specifically indicated by a specialist.
Prasterone (Steroid hormone, Intravaginal androgen) Indications - Vulvar and vaginal atrophy in postmenopausal women with moderate to severe symptoms. Avoid - Active arterial thromboembolic disease (e.g., angina or myocardial infarction), Active thrombophlebitis, History of breast cancer, History of recurrent venous thromboembolism, Oestrogen-dependent cancer, Undiagnosed vaginal bleeding, Untreated endometrial hyperplasia, Venous thromboembolism. Cautions - History of hormone-sensitive malignancy, Liver impairment, Cardiovascular disease risk factors. Trade Names - Intrarosa® (Vaginal insert: Prasterone 6.5 mg) Adult: One 6.5 mg vaginal insert once daily at bedtime. Child: Not indicated for pediatric use.
Ospemifene (Selective Estrogen Receptor Modulator - SERM) Indications - Moderate to severe symptomatic vulvar and vaginal atrophy in postmenopausal women who are not candidates for local vaginal oestrogen therapy. Contraindications - History of or active venous thromboembolism, Known or suspected oestrogen-dependent neoplasia, Undiagnosed abnormal genital bleeding, Pregnancy. Cautions - History of stroke or cardiovascular disease, Hepatic impairment, Use with other oestrogens or estrogen agonists/antagonists. Trade Names - Osphena® (Tablet: Ospemifene 60 mg) Adult: 60 mg orally once daily with food. Child: Not indicated for use in pediatric patients.
Sirolimus (Immunosuppressant, mTOR inhibitor) Indications - Prophylaxis of organ rejection in kidney allograft recipients (usually in combination with corticosteroids and cyclosporine or tacrolimus). Contraindications - Hypersensitivity to sirolimus or any component of the formulation, Liver impairment (if not properly dose-adjusted), Use with strong CYP3A4 inhibitors/inducers without monitoring. Cautions - Increased risk of infections and malignancies, Impaired wound healing, Hyperlipidemia, Hepatic impairment, Elderly patients, Avoid live vaccines. Trade Names - Rapamune® (Tablet: Sirolimus 1 mg, 2 mg) Adult: Initial loading dose of 6 mg orally once, then 2 mg once daily; adjust based on blood levels and immunosuppressive regimen. Child: ≥13 years: Dosage individualized based on body surface area (BSA) and therapeutic drug monitoring; initial dose approx. 3 mg/m²/day.
Tacrolimus (Immunosuppressant, Calcineurin Inhibitor) Indications - Prophylaxis of graft rejection following organ transplantation, Treatment of allograft rejection resistant to conventional immunosuppressive therapy. Contraindications - Hypersensitivity to tacrolimus or other macrolides, Concurrent use with live vaccines, Uncontrolled infections. Cautions - Impaired renal or hepatic function, QT prolongation, Diabetes mellitus, Risk of lymphoma and other malignancies, Avoid grapefruit juice (CYP3A4 interaction). Trade Names - Prograf® (Capsule: 0.5 mg, 1 mg, 5 mg), Advagraf® (Extended-release capsule: 0.5 mg, 1 mg, 5 mg) Adult: 0.1–0.2 mg/kg/day orally in 2 divided doses, adjusted based on blood levels and clinical response. Child: 0.15–0.2 mg/kg/day orally in 2 divided doses; adjust based on therapeutic drug monitoring.
Canakinumab (Immunosuppressant – IL-1β monoclonal antibody)Indications - Gouty arthritis unresponsive or intolerant to NSAIDs/colchicine or repeated corticosteroids, Cryopyrin-associated periodic syndromes (CAPS), Tumour necrosis factor receptor-associated periodic syndrome (TRAPS), Hyper-IgD syndrome (HIDS), Familial Mediterranean fever (FMF), Still’s disease (SJIA and AOSD). Contraindications - Hypersensitivity to canakinumab or excipients, Active severe infections including tuberculosis. Cautions - History of recurrent infections, Neutropenia, Hepatic impairment, Vaccination status (complete immunisations before therapy), Elderly. Avoid - Live vaccines during treatment, Concomitant use with other biologic immunosuppressants unless specialist directed. Interactions - Additive immunosuppression with TNF-α blockers; cytokine modulation may alter CYP-substrate levels (monitor narrow-therapeutic-index drugs). Trade Names - Ilaris inj:® (Specialist use only) Adult : 150 mg SC every 8 weeks (300 mg SC every 4 weeks in Still’s disease if ≥40 kg or inadequate response). Child : <40 kg: 2 mg/kg SC every 8 weeks for CAPS; 4 mg/kg SC every 4 weeks for SJIA; adjust per weight/indication.
Basiliximab (Immunosuppressant) Indications - Prophylaxis of acute rejection in allogeneic renal transplantation, used in combination with ciclosporin and corticosteroid-containing immunosuppression regimens. Contraindications - Hypersensitivity to basiliximab, murine proteins, or any component of the formulation. Cautions - Increased risk of infection and malignancy with immunosuppressive use, Monitor for hypersensitivity reactions, Use in patients with hepatic or cardiac impairment. Avoid - Live vaccines during treatment and for some time after therapy. Interactions - May interact with other immunosuppressants; increased immunosuppression risk when used with agents like antithymocyte globulin. Trade Names - Simulect Inj:® Adult: 20 mg IV within 2 hours before transplantation, then 20 mg IV on day 4 post-transplant. Child:
Methoxy polyethylene glycol-epoetin beta (Erythropoiesis-Stimulating Agent - ESA) Indications - Symptomatic anaemia associated with chronic kidney disease (CKD), including patients on dialysis and not on dialysis. Contraindications - Uncontrolled hypertension, Known hypersensitivity to epoetin or any component of the formulation. Cautions - Risk of cardiovascular events, stroke, and thromboembolism; Monitor haemoglobin levels closely; Do not exceed target Hb range; Use with caution in patients with a history of seizures or malignancy. Trade Names - Mircera® (Injection: 30 mcg, 50 mcg, 75 mcg, 100 mcg, 150 mcg, 200 mcg, 250 mcg, 360 mcg) Adult: Initial dose 0.6 mcg/kg body weight once every 2 weeks; may adjust dosing based on haemoglobin response. Once stable, can be administered monthly. Child: Not established for paediatric use (safety and efficacy not confirmed).
Iron isomaltoside 1000 (Iron replacement therapy)Indications - Iron-deficiency anaemia in patients who cannot tolerate oral iron or when oral iron is ineffective, or rapid iron repletion is needed (e.g., in chronic kidney disease, inflammatory bowel disease, or perioperative anaemia). Contraindications - Hypersensitivity to iron isomaltoside or excipients, Anaemia not caused by iron deficiency, Iron overload (e.g., haemochromatosis) or disturbances in iron utilisation. Cautions - History of asthma, eczema, or other allergic conditions; Liver dysfunction; Acute or chronic infection; Monitor for anaphylaxis during and after administration. Avoid - Use with other parenteral iron preparations concurrently. Interactions - Reduced absorption if given with oral iron supplements; observe appropriate spacing if switching routes. May interfere with lab tests (e.g., ferritin, transferrin saturation). Trade Names - Monofer Inj:®, Diafer Inj:® Adult: Up to 20 mg/kg body weight IV in single or divided doses based on total iron need. Can be given as slow IV injection or infusion. Child: Limited data; typically 15 mg/kg IV infusion (max 1000 mg per dose) based on individual iron deficit and clinical judgement.
Iron sucrose (Iron supplement) Indications - Iron-deficiency anaemia, especially in chronic kidney disease patients receiving haemodialysis and erythropoietin therapy. Contraindications - Hypersensitivity to iron sucrose or any of its components, Anaemia not caused by iron deficiency, Iron overload, First trimester of pregnancy. Cautions - History of asthma, eczema, or atopic allergies, Liver dysfunction, Acute or chronic infection, Hypotension risk. Avoid - Use in conditions not related to iron-deficiency, Parenteral iron if oral iron is effective. Interactions - Reduced absorption if used with oral iron therapy; delay oral iron for at least 5 days after IV. Trade Names - Venofer Inj:®, Ferinject Inj:®, Sucroferric Inj:® Adult: IV 100–200 mg 1 to 3 times per week depending on haemoglobin level and iron deficit. Child: IV 1–3 mg/kg up to 3 times per week, based on severity and tolerance.
Ferric Ammonium Citrate (Iron supplement) Indications - Iron-deficiency anaemia, Nutritional iron supplementation. Contraindications - Haemochromatosis, Hemosiderosis, Anaemia not due to iron deficiency, Hypersensitivity to iron salts. Cautions - Gastrointestinal disorders, Peptic ulcer, Liver disease, Elderly, Pregnancy. Avoid - Concomitant use with other iron preparations to prevent overdose. Interactions - Reduced absorption with antacids, calcium, magnesium, tetracyclines, and quinolones; separate administration advised. Trade Names - Haematinic tab:®, Livogen tab:® Adult: Oral 100–300 mg elemental iron daily in divided doses after meals. Child: Oral 3–6 mg/kg/day of elemental iron in divided doses.
Ferric maltol (Iron supplement) Indications - Iron-deficiency anaemia, especially in patients with inflammatory bowel disease who cannot tolerate or have failed oral ferrous therapy. Contraindications - Iron overload, Anaemia not related to iron deficiency, Known hypersensitivity to ferric maltol. Cautions - Mild-to-moderate liver impairment, History of gastrointestinal disorders, Concomitant oral iron supplements. Avoid - Use during active peptic ulcer or inflammatory bowel flare-up. Interactions - Reduced absorption with antacids, calcium, magnesium, zinc, tetracyclines, and fluoroquinolones; separate dosing times recommended. Trade Names - Feraccru cap:®, Accrufer cap:® Adult: Oral 30 mg twice daily on an empty stomach. Child: Not recommended for use in children under 18 years due to limited safety and efficacy data.
Ferrous Gluconate (Oral Iron Supplement) Indications - Prophylaxis of iron-deficiency anaemia, Treatment of iron-deficiency anaemia. Contraindications - Haemochromatosis, Haemosiderosis, Anaemia not due to iron deficiency (e.g., haemolytic anaemia), Known hypersensitivity to ferrous salts. Cautions - Gastrointestinal disorders (e.g., peptic ulcer, colitis), May cause constipation or black stools, Risk of iron overload with prolonged use. Trade Names - Fergon® (Tablet: Ferrous gluconate 324 mg ≈ 38 mg elemental iron) Adult: 1 tablet (325 mg) orally 1–3 times daily, depending on the severity of anaemia. Child: 4–6 mg/kg/day of elemental iron in 2–3 divided doses.
Lipegfilgrastim(aaa)Indications - Reduction in duration of neutropenia and incidence of febrile neutropenia in cytotoxic chemotherapy for malignancy. Cancer patients undergoing chemotherapy to reduce the risk of infections associated with low white blood cell counts. tab:®, Cap:® Adult : Child:
Potassium chloride with calcium chloride dihydrate and sodium chloride, Ringer’s solution (Electrolyte solution) Indications - Electrolyte imbalance, Fluid resuscitation, Treatment of dehydration, Maintenance of extracellular fluid volume. Contraindications - Hyperkalaemia, Hypercalcaemia, Severe renal impairment, Metabolic or respiratory alkalosis. Cautions - Renal impairment, Cardiac disease, Hypertension, Edema, Monitor serum electrolytes closely. Avoid - Use with potassium-sparing diuretics or in conditions causing potassium retention. Interactions - May interact with ACE inhibitors, ARBs, potassium-sparing diuretics, corticosteroids. Trade Names - Ringer's Lactate Inj:®, RL Solution® Adult: IV infusion: Dose individualized based on fluid and electrolyte needs (typically 500–1000 mL over 1–2 hours). Child: IV infusion: 20–30 mL/kg as needed, adjusted based on clinical condition and lab values.
Potassium chloride with glucose and sodium chloride(aaa)Indications - Electrolyte imbalance. tab:®, Cap:® Adult : Child:
Magnesium glycerophosphate(aaa)Indications - Treatment and prevention of magnesium deficiency. tab:®, Cap:® Adult : Child:
Agalsidase beta (Enzyme replacement therapy)Indications - Fabry’s disease (long-term enzyme replacement therapy in patients with confirmed diagnosis). Contraindications - Hypersensitivity to agalsidase beta or any excipients. Caution - Infusion-related reactions, patients with advanced renal or cardiac disease, antibody formation (especially in males). Avoid - Use with caution in severe cardiac conditions, close monitoring during infusion in allergic predisposition. Drug interactions - No significant drug interactions known; monitor immunosuppressive therapy if present. Trade names - infusion: Fabrazyme® (Specialist use only) Adult: 1 mg/kg body weight via IV infusion every 2 weeks. Child: Same as adult dosing (1 mg/kg IV every 2 weeks), adjusted based on weight and tolerance.
Migalastat(Pharmacological chaperone for α-galactosidase A)Indications - Fabry’s disease in patients with amenable GLA gene variants. Contraindications - Cautions - Moderate renal impairment, Hepatic impairment, Women of childbearing potential. Avoid - Pregnancy, Breastfeeding unless clearly necessary. Interactions - Avoid use with drugs that reduce gastric pH (may affect absorption). Trade names - Galafold 123 mg Hard Capsule (Specialist use only) Adult: 123 mg orally on alternate days at the same time of day. Child: Not recommended under 12 years; safety and efficacy not established.
Eliglustat(aaa)Indications - Type 1 Gaucher disease (CYP2D6 poor metabolisers) Oral 84 mg once daily under expert supervision. tab:®, Cap:® Adult : Child:
Imiglucerase(aaa)Indications - Non-neurological manifestations of type I Gaucher’s disease, Non-neurological manifestations of type III Gaucher’s disease. inj:®, 60 units/kg (IV) every 2 weeks. (Specialist use only) Adult : Child:
Velaglucerase alfa(aaa)Indications - Type I Gaucher’s disease. tab:®, Cap:® (Specialist use only) Adult : Child:
Potassium aminobenzoate(aaa)Indications - Peyronie’s disease, Scleroderma. tab:®, Cap:® Adult : Child:
Apremilast(aaa)Indications - Active psoriatic arthritis, Moderate to severe chronic plaque psoriasis. tab:®, Cap:® Adult : Child:
Febuxostat(xanthine oxidase inhibitor)Indications - Treatment of chronic hyperuricaemia in gout, Prophylaxis and treatment of acute hyperuricaemia with initial chemotherapy for haematologic malignancies. tab:®, Cap:® Adult : Child:
Ataluren(aaa)Indications - Duchenne muscular dystrophy resulting from a nonsense mutation in the dystrophin gene, In ambulatory patients. tab:®, Cap:® (Initiate by a specialist) Adult : Child:
Nusinersen(aaa)Indications - 5q spinal muscular atrophy. tab:®, Cap:® (Initiate by a specialist) Adult : Child:
Amifampridine (Potassium channel blocker)Indications - Symptomatic treatment of Lambert-Eaton myasthenic syndrome (LEMS) in adults and adolescents aged ≥6 years. Contraindications - History of seizures, hypersensitivity to amifampridine or any of its components. Caution - Epilepsy, asthma, hepatic or renal impairment. Avoid - Use in patients with uncontrolled seizure disorders. Drug interactions - CNS stimulants, other drugs that lower seizure threshold (e.g. bupropion, tramadol). Trade names - tab: Firdapse® (Specialist use only) Adult: Initial: 15–30 mg/day in divided doses; max 60 mg/day. Child: 6–17 years: Start at 7.5–15 mg/day in divided doses; titrate cautiously under specialist supervision.
Cannabis extract(aaa)Indications - Adjunct in moderate to severe spasticity in multiple sclerosis. tab:®, Cap:® (Specialist use only) Adult : Child:
Tizanidine(aaa)Indications - Spasticity associated with multiple sclerosis or spinal cord injury or disease. TINIZE 2mg tab:® Adult : Child:
Triamcinolone hexacetonide(aaa)Indications - Local inflammation of joints and soft-tissues. tab:®, Cap:® Adult : Child:
Collagenase(aaa)Indications - Dupuytren’s contracture in patients with a palpable cord, Peyronie’s disease. tab:®, Cap:® (Specialist use only) Adult : Child:
Hyaluronidase(aaa)Indications - Enhance permeation of subcutaneous or intramuscular injections, Enhance permeation of local anaesthetics, Enhance permeation of ophthalmic local anaesthetic, Hypodermoclysis, ExtravasationmHaematoma. tab:®, Cap:® Adult : Child:
Cenegermin (Human nerve growth factor) Indications - Moderate or severe neurotrophic keratitis. Contraindications - Eye infection, patients requiring immediate corneal surgery. Cautions - In ocular cancer. Side-effects - Eye pain, Eye inflammation, Headache, Photophobia. Avoid - Pregnancy, Breast feeding. Trade Names - Oxervate eye-drop® (Specialist use only) Adult: 1 drop in affected eye every 2 hours (6 times/day) for 8 weeks. Child: Safety and efficacy not established.
Cyclopentolate Hcl(aaa)Indication Cycloplegia, Uveitis, Anterior uveitis. tab:®, Cap:® Adult : Child:
Homatropine hydrobromide(aaa)Indications - Anterior uveitis. tab:®, Cap:® Adult : Child:
Carmellose sodium(aaa)Indications - Dry eye conditions. tab:®, Cap:® Adult : Child:
Hydroxyethylcellulose(aaa)Indications - Tear deficiency. tab:®, Cap:® Adult : Child:
Hypromellose(aaa)Indications - Tear deficiency. Apply as required. Adult : Child:
Polyvinyl alcohol(aaa)Indications - Tear deficiency. tab:®, Cap:® Adult : Child:
soft yellow Paraffin(aaa)Indications - Eye surface lubrication. tab:®, Cap:® Adult : Child:
Sodium hyaluronate(aaa)Indications - Dry eye conditions. tab:®, Cap:® Adult : Child:
Soybean oil(aaa)Indications - Dry eye conditions. tab:®, Cap:® Adult : Child:
Propamidine isetionate (Antimicrobial/Antiprotozoal)Indications - Acanthamoeba keratitis infections, Local treatment of minor eye infections such as conjunctivitis and blepharitis. Contraindications - Hypersensitivity to propamidine or any of the formulation components. Caution - Avoid prolonged use; discontinue if irritation or allergic reaction occurs. Avoid - Contact lens use during treatment. Drug interactions - None of clinical significance reported with topical use. Trade names - eye drops: Brolene®, Golden Eye® (Specialist use only in keratitis) Adult: Instill 1–2 drops into the affected eye(s) up to 4 times daily. Child: Same as adult dosing; under medical supervision.
Ganciclovir(aaa)Indications - Acute herpetic keratitis, Viral eye infections, Prevention of cytomegalovirus disease, Treatment of cytomegalovirus disease. tab:®, Cap:® Adult : Child:
Tropicamide, Antimuscarinic(aaa)Indications - Funduscopy(Checking eye). tab:®, Cap:® Adult : Child:
Povidone-iodine(aaa)Indications - Cutaneous peri-ocular and conjunctival antisepsis before ocular surgery, Skin disinfection. tab:®, Cap:® Adult : Child:
Fluorescein sodium(aaa)Indications - Detection of lesions and foreign bodies in eye. tab:®, Cap:® Adult : Child:
Acetylcholine chloride (Parasympathomimetic) Indications - Cataract surgery, Penetrating keratoplasty, Iridectomy, Anterior segment surgery requiring rapid complete miosis. Contraindications - Hypersensitivity to acetylcholine or any excipients. Caution - Cardiovascular disease, Asthma, Hyperthyroidism, Peptic ulcer. Avoid - Systemic administration, Use in patients with bradycardia or hypotension. Interactions - May be antagonized by anticholinergic agents (e.g., atropine), Potentiated by cholinesterase inhibitors. Trade names - Miochol-E inj:, Miochol-S inj:, Micholine inj:, Acetylcholine IOLab inj: Adult - 0.5–2 mL of 1% solution intraocularly as a single instillation during surgery. Child - Not routinely recommended; use only under specialist guidance.
Oxybuprocaine Hcl(aaa)Indications - Local anaesthetic into the eye. tab:®, Cap:® Adult : Child:
Proxymetacaine Hcl(aaa)Indications - Local anaesthetic into the eye. tab:®, Cap:® Adult : Child:
Tetracaine, Amethocaine(aaa)Indications - Local anaesthetic into the eye, Anaesthesia before venepuncture or venous cannulation. tab:®, Cap:® Adult : Child:
Bromfenac(aaa)Indications - Analgesic and anti-inflammatory drug into the eye, Postoperative inflammation following cataract surgery. tab:®, Cap:® Adult : Child:
Loteprednol etabonate(aaa)Indications - Treatment of post-operative inflammation following ocular surgery. tab:®, Cap:® Adult : Child:
Levobunolol Hcl(aaa)Indications - Primary open-angle glaucoma. tab:®, Cap:® Adult : Child:
Dorzolamide (Carbonic Anhydrase Inhibitor – Antiglaucoma) Indications - Raised intraocular pressure in ocular hypertension, open-angle glaucoma (as monotherapy or adjunct to beta-blockers), pseudo-exfoliative glaucoma (as adjunct to beta-blocker). Contraindications - Hypersensitivity to dorzolamide or sulfonamides, severe renal impairment, hyperchloremic acidosis. Cautions - Renal or hepatic impairment, corneal edema, contact lens wearers. Avoid - Use in patients with known sulfa allergy without close monitoring. Interactions - Additive effects with other carbonic anhydrase inhibitors (e.g., acetazolamide); caution with high-dose salicylates. Trade names - Trusopt Eye Drops:, Dorzox Eye Drops: Adult: Instill 1 drop into the affected eye(s) 2–3 times daily. Child: Safety and efficacy not established; use only if prescribed by ophthalmologist.
Bimatoprost (Prostaglandin Analog – Antiglaucoma) Indications - Raised intraocular pressure in open-angle glaucoma, ocular hypertension. Contraindications - Hypersensitivity to bimatoprost or any component of the formulation. Cautions - Macular edema, aphakia, pseudophakia with torn posterior lens capsule, history of intraocular inflammation or uveitis. Avoid - Avoid touching the dropper tip to avoid contamination; avoid in pregnancy unless absolutely necessary. Interactions - Additive IOP-lowering effect with other prostaglandin analogs; may reduce effectiveness if used with other PG analogs concurrently. Trade names - Lumigan Eye Drops:, Careprost Eye Drops: Adult: Instill 1 drop into the affected eye(s) once daily in the evening. Child: Not recommended in children under 16 years unless specifically prescribed.
Tafluprost (Prostaglandin Analog – Antiglaucoma) Indications - Raised intraocular pressure in open-angle glaucoma, ocular hypertension. Contraindications - Hypersensitivity to tafluprost or any component of the formulation. Cautions - History of intraocular inflammation, macular edema, aphakia, pseudophakia with torn posterior lens capsule. Avoid - Avoid contact of dropper tip with any surface; avoid in pregnancy unless clearly necessary. Interactions - May interact with other prostaglandin analogs, reducing intraocular pressure-lowering effect. Trade names - Saflutan Eye Drops: Adult: Instill 1 drop into the affected eye(s) once daily in the evening. Child: Safety and efficacy not established in pediatric patients.
Travoprost (Prostaglandin Analog – Antiglaucoma) Indications - Raised intraocular pressure in open-angle glaucoma, ocular hypertension. Contraindications - Hypersensitivity to Travoprost or any component of the formulation. Cautions - Use with caution in aphakia, pseudophakia with torn posterior lens capsule, or risk of macular edema. Avoid - Avoid in pregnancy unless clearly indicated; avoid contact of dropper with eye or surrounding areas. Interactions - Concurrent use with other prostaglandin analogs may decrease intraocular pressure-lowering effect. Trade names - Travatan Eye Drops: Adult: Instill 1 drop into the affected eye(s) once daily in the evening. Child: Safety and efficacy not established in pediatric patients.
Brimonidine tartrate(aaa)Indications - Raised intra-ocular pressure in open-angle glaucoma in patients for whom beta-blockers are inappropriate, Ocular hypertension in patients for whom beta-blockers are inappropriate, Adjunctive therapy when intra-ocular pressure is inadequately controlled by other antiglaucoma therapy, Facial erythema in rosacea. tab:®, Cap:® Adult : Child:
Ranibizumab (Anti-VEGF monoclonal antibody) Indications - Age-related macular degeneration, Diabetic macular oedema, Macular oedema secondary to retinal vein occlusion, Choroidal neovascularisation, Macular oedema secondary to branch retinal vein occlusion. Avoid - Ocular or periocular infection. Trade Names - Lucentis inj:®, Accentrix inj:® (Specialist use only) Adult: 0.5 mg by intravitreal injection once a month. Child: Not routinely recommended; specialist discretion advised.
Verteporfin (Photosensitising agent) Indications - Photodynamic treatment of age-related macular degeneration associated with predominantly classic subfoveal choroidal neovascularisation or with pathological myopia. Avoid - Acute porphyrias. Trade Names - Visudyne inj:® (Specialist use only) Adult: 6 mg/m² IV over 10 minutes; laser treatment 15 minutes after infusion start. Child: Not routinely recommended; use only under specialist supervision.
Idebenone (Synthetic Coenzyme Q10 Analog) Indications - Leber’s Hereditary Optic Neuropathy. Contraindications - Known hypersensitivity to Idebenone or any component of the formulation. Cautions - Use with caution in patients with hepatic impairment; monitor liver function. Avoid - Pregnancy, Breastfeeding. Interactions - Limited data available; theoretical interactions with other antioxidants. Trade names - Raxone tab:, Idebenone Cap: (Initiate by a specialist) Adult: 300 mg orally three times daily with food. Child: Not recommended unless prescribed by a specialist; safety and efficacy not established.
Ocriplasmin (Proteolytic enzyme) Indications - Treatment of vitreomacular traction, including when associated with a macular hole of diameter ≤ 400 microns. Trade Names - Jetrea inj:® (Specialist use only) Adult: Single intravitreal injection of 0.125 mg (0.1 mL) per affected eye. Child: Not routinely recommended; use only under specialist supervision.
Almond oil(aaa)Indications - Removal of earwax. tab:®, Cap:® Adult : Child:
Olive oil(aaa)Indications - Removal of earwax. Ear drops:®, Cap:® Adult : Child:
Urea hydrogen peroxide(aaa)Indications - Removal of earwax. Ear drops ®, Cap:® Adult : Child:
Hexetidine(aaa)Indications - Oral hygiene, Mouthwash. tab:®, Cap:® Adult : Child:
Sodium bicarbonate with sodium chloride(aaa)Indications - Oral hygiene. tab:®, Cap:® Adult : Child:
Sodium fluoride(aaa)Indications - Prophylaxis of dental caries. tab:®, Cap:® Adult : Child:
Benzydamine Hcl(aaa)Indications - Painful inflammatory conditions of oropharynx. tab:®, Cap:® Adult : Child:
Choline salicylate(aaa)Indications - Mild oral and perioral lesions. tab:®, Cap:® Adult : Child:
Salicylic acid with rhubarb extract(aaa)Indications - Mild oral and perioral lesions. tab:®, Cap:® Adult : Child:
Emollient creams(aaa)Indications - Dry and pruritic skin conditions including eczema and dermatitis, Dry, Scaling and itching skin. tab:®, Cap:® Adult : Child:
Silver sulfadiazine(aaa)Indications - Prophylaxis and treatment of infection in burn wounds, For conservative management of finger-tip injuries, Adjunct to short-term treatment of infection in pressure sores, As an adjunct to short-term treatment of infection in leg ulcers. Silverkant cream®, Cap:® Adult : Child:
Undecenoic acid with zinc undecenoate(aaa)Indications - Treatment and prevention of athletes foot. tab:®, Cap:® Adult : Child:
Chlorhexidine with nystatin(aaa)Indications - Skin infections due to Candida spp:, skin disinfection in acne, Pre-operative hand and skin disinfection. tab:®, Cap:® Adult : Child:
Benzoic acid with salicylic acid(aaa)Indications - Ringworm of skin(tinea. tab:®, Cap:® Adult : Child:
Benzyl benzoate(aaa)Indications - Scabies. Burscabe lotion:® Adult : Child:
Dimeticone (Anti-parasitic, Pediculicide) Indications - Treatment of head lice infestation. Contraindications - Hypersensitivity to dimeticone or formulation components. Cautions - Avoid contact with eyes; for external use only. Avoid - Use on broken or inflamed skin. Interactions - No significant drug interactions known. Trade names - Hedrin Lotion:, NYDA Solution: Adult: Apply sufficient quantity to cover dry hair and scalp; leave for at least 8 hours or overnight, then wash. Repeat after 7 days if necessary. Child: Same as adult dosage; suitable for use in children over 6 months of age under supervision.
Malathion(aaa)Indications - Head lice, Crab lice, Scabies. tab:®, Cap:® Adult : Child:
Permethrin (Topical Antiparasitic) Indications - Treatment of scabies, head lice, crab lice, and associated skin irritation and nodules. Contraindications - Hypersensitivity to permethrin or pyrethroids. Cautions - Avoid contact with eyes and mucous membranes; discontinue if irritation persists. Avoid - Use in infants under 2 months unless advised by a physician. Interactions - No significant drug interactions reported. Trade names - Lorax cream:®, PERMIN cream:®, Permezole cream:® Adult: Apply cream from neck down; leave on for 8–14 hours, then wash off. For lice: Apply to scalp and hair, leave for 10 minutes, then rinse. Child: Same as adults. For infants under 2 years, include scalp, face, and ears (avoiding eyes and mouth); under medical supervision.
Alclometasone dipropionate(aaa)Indications - Inflammatory skin disorders such as eczemas. tab:®, Cap:® Adult : Child:
Calcipotriol(aaa)Indications - Plaque psoriasis, Scalp psoriasis. Avoid - Pregnancy. tab:®, Cap:® Adult : Child:
Betamethasone with Calcipotriol (aaa)Indications - Scalp psoriasis, Mild to moderate plaque psoriasis, Stable plaque psoriasis. tab:®, Cap:® Adult : Child:
Clobetasol propionate(aaa)Indications - Chronic hyperkeratonic eczema, Chronic hyperkeratonic psoriasis, Recalcitrant eczema. Short-term treatment only of severe resistant inflammatory skin disorders such as recalcitrant eczemas unresponsive to less potent corticosteroids, Psoriasis, Moderate scalp psoriasis. Topical application Clobetamil G cream:®, Tenovate cream 30g:®, Dermi Fitz-5 cream® Adult : Child:
Clobetasone butyrate(aaa)Indications - Eczemas and dermatitis of all types. tab:®, Cap:® Adult : Child:
Diflucortolone valerate(aaa)Indications - Severe inflammatory skin disorders such as eczemas, Psoriasis. tab:®, Cap:® Adult : Child:
Fludroxycortide, Flurandrenolone(aaa)Indications - Inflammatory skin disorders such as eczemas. tab:®, Cap:® Adult : Child:
Fluocinonide(aaa)Indications - Severe inflammatory skin disorders such as eczemas unresponsive to less potent corticosteroids, Psoriasis. tab:®, Cap:® Adult : Child:
Hydrocortisone butyrate(aaa)Indications - Severe inflammatory skin disorders such as eczemas unresponsive to less potent corticosteroids, Psoriasis. tab:®, Cap:® Adult : Child:
Betamethasone with clioquinol(anti-inflammatory)Indications - Severe inflammatory skin disorders such as eczemas unresponsive to less potent corticosteroids, Psoriasis. QUADRAN cream:® Adult : Child:
Betamethasone with lotrimazole(aaa)Indications - Severe inflammatory skin disorders such as eczemas unresponsive to less potent corticosteroids, Psoriasis. tab:®, Cap:® Adult : Child:
Betamethasone with fusidic acid(aaa)Indications - Severe inflammatory skin disorders such as eczemas unresponsive to less potent corticosteroids, Psoriasis. tab:®, Cap:® Adult : Child:
Clobetasone butyrate with nystatin and oxytetracycline(aaa)Indications - Steroid-responsive dermatoses where candidal or bacterial infection is present. tab:®, Cap:® Adult : Child:
Ichthammol(aaa)Indications - Chronic lichenified eczema. tab:®, Cap:® Adult : Child:
Dithranol(aaa)Indications - Subacute and chronic psoriasis. tab:®, Cap:® Adult : Child:
Coal tar(aaa)Indications - Psoriasis, Chronic atopic eczema, Seborrhoeic ermatitis, Scaling, Itching, Dandruff. tab:®, Cap:® Adult : Child:
Pimecrolimus(aaa)Indications - Short-term treatment of facial, Flexural, Or genital psoriasis in patients unresponsive to, Or intolerant of other topical therapy, Short-term treatment of mild to moderate atopic eczema (including flares) when topical corticosteroids cannot be used . tab:®, Cap:® (Initiate by a specialist) Adult : Child:
Tacrolimus (Calcineurin inhibitor) Indications - Short-term treatment of moderate to severe atopic eczema (including flares) in patients unresponsive to or intolerant of conventional therapy; short-term treatment of facial, flexural, or genital psoriasis in patients unresponsive to or intolerant of other topical therapy. Trade Names - Protopic ointment:®, Tacroz ointment:®, Advagraf cap:®, Prograf cap:® (Initiate under specialist supervision) Adult: Apply thinly to affected areas twice daily (ointment); Oral immunosuppressive dose varies by indication (specialist-prescribed). Child: Protopic 0.03% ointment for ages ≥2 years: apply thinly twice daily for up to 3 weeks, then once daily if needed (under specialist advice).
Brodalumab, Interleukin inhibitor(aaa)Indications - Moderate-to-severe plaque psoriasis under expert supervision. tab:®, Cap:® Adult : Child:
Dupilumab (Monoclonal antibody, IL-4/IL-13 inhibitor)Indications - Moderate-to-severe atopic dermatitis (eczema), Severe asthma with type 2 inflammation, Chronic rhinosinusitis with nasal polyposis, Eosinophilic esophagitis. Contraindications - Hypersensitivity to dupilumab or any excipient. Cautions - Parasitic (helminth) infections, conjunctivitis, keratitis, herpes infection risk, immunocompromised states. Avoid - Use in pregnancy or breastfeeding unless clearly needed (limited human data). Drug interactions - No major interactions; may affect CYP450 expression indirectly via inflammation suppression. Trade names - Prefilled syringe or pen (SC): Dupixent® (Specialist use only) Adult: 600 mg SC once, then 300 mg SC every 2 weeks (adjust per indication). Child: Approved for children ≥6 months for atopic dermatitis (dose weight-based: e.g., 200–300 mg SC every 2–4 weeks).
Guselkumab (Monoclonal antibody, IL-23 inhibitor)Indications - Moderate-to-severe plaque psoriasis, Active psoriatic arthritis. Contraindications - Hypersensitivity to guselkumab or excipients. Cautions - Infections (especially tuberculosis), immunosuppression, vaccination status, hepatic impairment. Avoid - Live vaccines during treatment; limited data in pregnancy and breastfeeding. Drug interactions - May affect CYP450 metabolism due to cytokine modulation (monitor narrow therapeutic index drugs). Trade names - Prefilled syringe (SC): Tremfya® (Specialist use only) Adult: 100 mg SC initially, then at week 4, then every 8 weeks. Child: Safety and efficacy not established.
Ixekizumab (Interleukin-17A Inhibitor) Indications - Moderate-to-severe plaque psoriasis (under expert supervision), Psoriatic arthritis with concomitant moderate-to-severe plaque psoriasis (under expert supervision). Contraindications - Hypersensitivity to ixekizumab or any of its components. Cautions - History of chronic infections, active tuberculosis, inflammatory bowel disease. Avoid - Live vaccines during treatment. Interactions - No significant drug interactions reported, but monitor when used with immunosuppressants. Trade names - Taltz Inj: Adult: 160 mg subcutaneously initially, then 80 mg every 2 weeks for 12 weeks, followed by 80 mg every 4 weeks. Child: Not recommended below 18 years unless under specialist care.
Tildrakizumab(aaa)Indications - Moderate-to-severe plaque psoriasis (under expert supervision). tab:®, Cap:® Adult : Child:
Alitretinoin (Retinoid) Indications - Severe chronic hand eczema refractory to potent topical corticosteroids. Contraindications - Pregnancy, hepatic insufficiency, uncontrolled hyperlipidemia, thyroid dysfunction. Cautions - Monitor liver function, lipid levels, and thyroid function during therapy. Use effective contraception in women of childbearing potential. Avoid - Pregnancy, breastfeeding, vitamin A supplements, tetracyclines. Interactions - Vitamin A (risk of hypervitaminosis A), tetracyclines (risk of increased intracranial pressure), hormonal contraceptives may be affected. Trade names - Toctino Cap: Adult: 30 mg once daily with food for up to 24 weeks; 10 mg may be used in patients with intolerance. Child: Not recommended under 18 years of age.
Tazarotene (Topical Retinoid) Indications - Mild to moderate plaque psoriasis affecting up to 10% of body surface area, Acne vulgaris. Contraindications - Pregnancy, eczema, skin abrasions or sunburned skin. Cautions - Use sunscreen and avoid excessive sun exposure; may cause local irritation. Avoid - Pregnancy, use with photosensitizing agents. Interactions - Avoid concomitant use with other topical agents that may cause skin irritation. Trade names - Zorac Cream:, Tazret Gel: Adult: Apply a thin film once daily in the evening to affected area. Child: Not recommended under 12 years of age.
Tacalcitol(aaa)Indications - Plaque psoriasis. tab:®, Cap:® Adult : Child:
Aluminium chloride hexahydrate(aaa)Indications - Hyperhidrosis affecting axillae, Hands or feet, Hyperhidrosis, Bromidrosis, Intertrigo, Prevention of tinea pedis and related conditions. tab:®, Cap:® Adult : Child:
Levomenthol(aaa)Indications - Pruritus. tab:®, Cap:® Adult : Child:
Co-cyprindiol(aaa)Indications - Moderate to severe acne in females of child-bearing age refractory to topical therapy or oral antibacterials, Moderately severe hirsutism. tab:®, Cap:® Adult : Child:
Erythromycin with zinc acetate(aaa)Indications - Acne vulgaris. tab:®, Cap:® Adult : Child:
Benzoyl peroxide(aaa)Indications - Acne vulgaris. Apply 1–2 times a day tab:®, Cap:® Adult : Child:
Azelaic acid(aaa)Indications - Facial acne vulgaris, Papulopustular rosacea, Acne vulgaris in patients with sensitive skin. Avoid - contact with eyes, Mouth and mucous membranes. tab:®, Cap:® Adult : Child:
Tretinoin with clindamycin(aaa)Indications - Facial acne. tab:®, Cap:® Adult : Child:
Benzalkonium chloride(aaa)Indications - Seborrhoeic scalp conditions associated with dandruff and scaling. Apply as required. tab:®, Cap:® Adult : Child:
Eflornithine(aaa)Indications - Adjunct to laser therapy for facial hirsutism in women. Apply twice daily tab:®, Cap:® Adult : Child:
Potassium permanganate(aaa)Indications - Cleansing and deodorising suppurating eczematous reactions and wounds. Cautions - Irritant to mucous membranes. tab:®, Cap:® Adult : Child:
Proflavine(aaa)Indications - Infected wounds, Infected burns. tab:®, Cap:® Adult : Child:
Glycerol, Glycerin(Lexative, Purgative)Indications - Constipation. tab:®, Cap:® Adult : Child:
Glycerol with magnesium sulfate and phenol(aaa)Indications - Treat carbuncles and boils. tab:®, Cap:® Adult : Child:
Hepatitis B immunoglobulin(aaa)Indications - Prophylaxis against hepatitis B infection. tab:®, Cap:® Adult : Child:
Normal immunoglobulin(aaa)Indications - Hepatitis A prophylaxis in outbreaks, Rubella in pregnancy, Antibody deficiency syndromes. tab:®, Cap:® Adult : Child:
Rabies immunoglobulin(aaa)Indications - Post-exposure prophylaxis against rabies infection. tab:®, Cap:® Adult : Child:
Bezlotoxumab(aaa)Indications - Prevention of recurrence of Clostridium difficile infection. tab:®, Cap:® Adult : Child:
Botulism antitoxin(aaa)Indications - Post exposure prophylaxis of botulism. i.m injection:®, Cap:® Adult : Child:
Diphtheria antitoxin(aaa)Indications - Passive immunisation in suspected cases of diphtheria. tab:®, Cap:® Adult : Child:
Etomidate (Short-acting IV anesthetic)Indications - Induction of general anaesthesia, procedural sedation. Contraindications - Known hypersensitivity to etomidate, adrenal insufficiency. Cautions - Sepsis, elderly, hypotension, renal or hepatic impairment, history of epilepsy. Avoid - Long-term infusion (risk of adrenal suppression). Interactions - Additive CNS depression with other sedatives, opioids, or alcohol. Trade names - Hypnomidate Inj:, Etomidate-Lipuro Inj: Adult: 0.2–0.3 mg/kg IV over 30–60 seconds for induction. Child: 0.3 mg/kg IV (dose should be titrated and under specialist care).
Nitrous oxide(aaa)Indications - Maintenance of anaesthesia in conjunction with other anaesthetic agents, Analgesia. tab:®, Cap:® Adult : Child:
Co-amilofruse (Loop diuretic + Potassium-sparing diuretic)Indications - Oedema associated with congestive heart failure, hepatic cirrhosis, nephrotic syndrome. Contraindications - Anuria, Severe renal impairment, Hyperkalemia. Avoid - Use with potassium supplements, Addison’s disease. Cautions - Elderly, Diabetes, Gout, Hypotension, Electrolyte imbalance. Interactions - Increased risk of hyperkalemia with ACE inhibitors, ARBs; lithium toxicity; NSAIDs may reduce diuretic effect. Trade names - Frumil® tab:, Lasilactone® tab: Adult: 1 tab daily or on alternate days (e.g., 40 mg furosemide + 5 mg amiloride). Child: Not recommended.
Suxamethonium chloride, Succinylcholine chloride(aaa)Indications - Neuromuscular blockade (short duration) during surgery and intubation. i.v inj:®, Cap:® Adult : Child:
Mivacurium(aaa)Indications - Neuromuscular blockade (short duration) during surgery and intubation. tab:®, Cap:® Adult : Child:
Pancuronium bromide(aaa)Indications - Neuromuscular blockade (long duration) during surgery and intubation. tab:®, Cap:® Adult : Child:
Neostigmine with glycopyrronium bromide(aaa)Indications - Reversal of non-depolarising neuromuscular blockade. tab:®, Cap:® Adult : Child:
Esketamine(aaa)Indications - Induction and maintenance of anaesthesia, Analgesia in emergency medicine. tab:®, Cap:® (Specialist use only) Adult : Child:
Parecoxib(Cyclo-oxygenase-2 inhibitor)Indications - Short-term management of acute postoperative pain. Contraindications - Active GI bleeding, GI ulcer, Inflammatory bowel disease, Ischaemic heart disease, Heart failure, Cerebrovascular disease. Cautions - Allergic disorders, Dehydration, Elderly, Hypertension, Coagulation defects. Side effects - Nausea, Vomiting, Back pain, Constipation, Dizziness, GI discomfort, Peripheral oedema, Renal impairment, Increased risk of infection. Parecoxib inj:®(deep i.m) Adult : Child:
Papaveretum with hyoscine hydrobromide(aaa)Indications - Premedication. tab:®, Cap:® Adult : Child:
Bupivacaine with adrenaline(aaa)Indications - Acute pain management, Surgical anaesthesia. Bylumbar epidural, Or by local infiltration, Or by caudal epidural tab:®, Cap:® Adult : Child:
Levobupivacaine(aaa)Indications - Acute postoperative pain, Acute labour pain, Surgical anaesthesia, Peripheral nerve block, Peribulbular nerve block, Surgical anaesthesia for caesarean section. tab:®, Cap:® Adult : Child:
Mepivacaine Hcl(aaa)Indications - Infiltration anaesthesia and nerve block in dentistry. tab:®, Cap:® Adult : Child:
Prilocaine Hcl(aaa)Indications - Infiltration anaesthesia, Nerve block, Spinal anaesthesia. tab:®, Cap:® Adult : Child:
Ropivacaine Hcl(aaa)Indications - Acute pain, Peripheral nerve block, field block, lumbar epidural block, Acute labour pain, Acute postoperative pain, thoracic epidural block, Surgical anaesthesia, Thoracic epidural block. tab:®, Cap:® Adult : Child:
Methylthioninium chloride(Poisoning, Antidote)Indications - Aniline- or dapsone-induced methaemoglobinaemia. Slow i.v inj:®, Cap:® Adult : Child:
Viper snake venom antiserum(Poisoning, Antidote)Indications - viper snake bite. tab:®, Cap:® Adult : Child:
Sodium acid phosphate(Lexative, Purgative)Indications - Constipation, Bowel evacuation before abdominal radiological procedures, Endoscopy and surgery. tab:®, Cap:® Adult : Child:
Arachis oil(aaa)Indications - To soften impacted faeces. tab:®, Cap:® Adult : Child:
Liquid paraffin(Lexative, Purgative)Indications - Constipation. tab:®, Cap:® Adult : Child:
Co-danthramer(Lexative, Purgative)Indications - Constipation in palliative care. 1–2 capsules once daily tab:®, Cap:® Adult : Child:
Co-danthrusate(Lexative, Purgative)Indications - Constipation in palliative care. (1–2 capsules once daily). tab:®, Cap:® Adult : Child:
Senna(Lexative, Purgative)Indications - Constipation. tab:®, Cap:® Adult : Child:
Methylnaltrexone bromide(aaa)Indications - Opioid-induced constipation in patients with chronic pain, Adjunct to other laxatives in opioid-induced constipation in palliative care. Avoid - Acute surgical abdominal conditions . gastro-intestinal obstruction. tab:®, Cap:® Adult : Child:
Co-phenotrope(Antidiarrhoeal)Indications - Adjunct to rehydration in acute diarrhoea, Control of faecal consistency after colostomy or ileostomy. Avoid - Gastro-intestinal obstruction . intestinal atony . myasthenia gravis. tab:®, Cap:® Adult : Child:
Simeticone (Antidiarrhoeal)Indications - Acute diarrhoea with abdominal colic, Relief of flatulence, bloating, and abdominal discomfort due to gas. Contraindications - Hypersensitivity to simeticone or formulation components. Cautions - Persistent or severe abdominal pain, gastrointestinal bleeding, obstruction or perforation. Avoid - Use in infants under 6 months unless prescribed. Interactions - May interfere with the absorption of thyroid medications if taken simultaneously. Trade names - Colicare Oral Suspension:®, Simethicone Cap:®, Gasvil Drops:®, Infacol Drops:® Adult: 40–125 mg orally after meals and at bedtime as needed. Child: 20–40 mg orally after meals and at bedtime (dosage varies by age group and formulation).
Sodium alginate with potassium bicarbonate(aaa)Indications - Management of mild sympto. tab:®, Cap:® Adult : Child:
Co-magaldrox(aaa)Indications - Dyspepsia. tab:®, Cap:® Adult : Child:
Co-simalcite(aaa)Indications - Dyspepsia. tab:®, Cap:® Adult : Child:
Naltrexone with bupropion(aaa)Indications - Adjunct in obesity (in conjunction with dietary measures and increased physical activity in individuals with a body mass index (BMI) of 30 kg/m2 or more or in individuals with a BMI of 27 kg/m2 or more in the presence of one or more weight related co-morbidity. Avoid - Uncontrolled hypertension. tab:®, Cap:® Adult : Child:
Phenol(aaa)Indications - Haemorrhoids (particularly when unprolapsed. tab:®, Cap:® Adult : Child:
Dried prothrombin complex(aaa)Indications - Treatment and peri-operative prophylaxis of haemorrhage in patients with congenital deficiency of factors II, VII, IX, Or X if purified specific coagulation factors not available, Treatment and peri-operative prophylaxis of haemorrhage in patients with acquired deficiency of factors II, VII, IX, Or X (e.g. during warfarin treatment, Major bleeding in patients on warfarin following phytomenadione. tab:®, Cap:® (Initiate under specialist supervision) Adult : Child:
Factor VIIa, Eptacog alfa(aaa)Indications - Treatment and prophylaxis of haemorrhage in patients with haemophilia A or B with inhibitors to factors VIII or IX, Acquired haemophilia, Factor VII deficiency, Or Glanzmann’s thrombasthenia. tab:®, Cap:® Adult : Child:
(Human coagulation factor VIII,Indications - Treatment and prophylaxis of haemorrhage in congenital factor VIII deficiency (haemophilia A), Acquired factor VIII deficiency, Von Willebrand’s disease. tab:®, Cap:® Adult : Child:
Factor IX fraction(aaa)Indications - Treatment and prophylaxis of haemorrhage in congenital factor IX deficiency (haemophilia B). tab:®, Cap:® Adult : Child:
Dipyridamole with aspirin(aaa)Indications - Secondary prevention of ischaemic stroke and transient ischaemic attacks. tab:®, Cap:® Adult : Child:
Danaparoid sodium(aaa)Indications - Prevention of deep-vein thrombosis in general surgery. Initially 1250 units(IV. Avoid - Active peptic ulcer, Acute bacterial endocarditis, Diabetic retinopathy, Haemorrhagic disorders, Recent cerebral haemorrhage, Severe hypertension) Cautions - Body-weight over 90 kg, Recent bleeding, Risk of bleeding) . tab:®, Cap:® Adult : Child:
Dalteparin sodium (Low Molecular Weight Heparin - LMWH)Indications - Prophylaxis and treatment of deep-vein thrombosis (DVT), Pulmonary embolism (PE), Unstable coronary artery disease, Prevention of thromboembolic events in cancer patients. Contraindications - Active major bleeding, Heparin-induced thrombocytopenia (HIT), Severe coagulation disorders, Recent hemorrhagic stroke. Avoid - Spinal or epidural anesthesia during treatment, Uncontrolled hypertension, Severe renal impairment. Cautions - Hepatic impairment, Renal impairment, Elderly, Low body weight, Recent surgery, Diabetic retinopathy. Interactions - Anticoagulants, Antiplatelets, NSAIDs, SSRIs/SNRIs, Thrombolytics (increased bleeding risk). Trade names - Fragmin inj:, Dalteparin inj:, Daltina inj:, Dalciparin inj:, Parinex inj: Adult - Prophylaxis: 2500–5000 IU SC once daily; Treatment: 100 IU/kg SC every 12 hours or 200 IU/kg once daily. Child - Use only under specialist supervision; dose based on weight and indication.
Tinzaparin sodium (Low Molecular Weight Heparin - LMWH)Indications - Prophylaxis and treatment of deep-vein thrombosis (DVT), Pulmonary embolism (PE), Extended treatment of venous thromboembolism in cancer patients. Contraindications - Active major bleeding, Heparin-induced thrombocytopenia (HIT), Severe coagulation disorders, Recent hemorrhagic stroke. Avoid - Intramuscular injection, Spinal or epidural anesthesia during treatment, Uncontrolled hypertension. Cautions - Renal or hepatic impairment, Elderly, Recent surgery, Diabetic retinopathy, Low body weight. Interactions - Antiplatelets, NSAIDs, SSRIs/SNRIs, Thrombolytics, Other anticoagulants (↑ risk of bleeding). Trade names - Innohep inj:, Tinzaparin inj:, Tinzaparin Leo inj:, Inhep inj: Adult - Prophylaxis: 3500 IU SC once daily; Treatment: 175 IU/kg SC once daily. Child - Use only under specialist supervision; dose adjusted per weight and condition.
Argatroban monohydrate (Direct Thrombin Inhibitor) Indications - Anticoagulation in patients with heparin-induced thrombocytopenia (HIT), Percutaneous coronary intervention (PCI) in patients with or at risk for HIT. Contraindications - Active major bleeding, Severe hepatic impairment. Avoid - Concomitant use with other anticoagulants, Severe bleeding disorders. Cautions - Hepatic dysfunction, Recent surgery or trauma, Bleeding risk conditions. Interactions - Increased bleeding risk with antiplatelet agents, NSAIDs, thrombolytics. Trade names - Argatra inj:, Novastan inj:, Argatoban Leo inj: Adult - Initial IV infusion: 2 mcg/kg/min, adjust to maintain aPTT 1.5–3x baseline. Child - Use with caution; dosing not well established—specialist consultation required.
Dabigatran etexilate(aaa)Indications - Prophylaxis of venous thromboembolism after replacement surgery, Deep-vein thrombosis, Pulmonary embolism. tab:®, Cap:® Adult : Child:
Acenocoumarol, Nicoumalone(aaa)Indications - Prophylaxis of embolisation in rheumatic heart disease and atrial fibrillation, Prophylaxis and treatment of venous thrombosis and pulmonary embolism, Transient ischaemic attacks. tab:®, Cap:® Adult : Child:
Warfarin sodium(aaa)Indications - Prophylaxis and treatment of venous thrombosis and pulmonary embolism, Transient ischaemic attacks, Prophylaxis of embolisation in rheumatic heart disease. tab:®, Cap:® Adult : Child:
Clonidine HCl (Centrally Acting Antihypertensive) Indications - Hypertension, prevention of recurrent migraine and vascular headache, menopausal symptoms (especially flushing and vasomotor disturbances). Contraindications - Severe bradyarrhythmia due to AV block or sick sinus syndrome. Cautions - Cerebrovascular disease, constipation, heart failure, history of depression, bradyarrhythmia, peripheral vascular disease. Avoid - Abrupt withdrawal (risk of rebound hypertension). Side effects - Constipation, depression, dizziness, dry mouth, headache, salivary gland pain, sexual dysfunction, sleep disorders. Interactions - May enhance CNS depression with alcohol, sedatives; interacts with beta-blockers and tricyclic antidepressants. Trade names - tab:®, Cap:® Adult: 50–100 mcg orally three times daily. Child: Dose must be individualized; used with caution and under specialist supervision.
Labetalol HCl (Alpha and Beta-Adrenergic Blocker) Indications - Hypertension, hypertensive emergencies, hypertension following myocardial infarction, hypertension in pregnancy, controlled hypotension during anesthesia. Contraindications - Bronchial asthma, overt cardiac failure, greater-than-first-degree heart block, bradycardia, cardiogenic shock. Cautions - Diabetes mellitus, hepatic or renal impairment, peripheral vascular disease, elderly patients. Avoid - Abrupt withdrawal (risk of rebound hypertension), breastfeeding unless clearly necessary. Interactions - May enhance hypotensive effect of other antihypertensives; interacts with calcium channel blockers, general anesthetics, and digoxin. Trade names - Trandate tab:®, Normodyne tab:® Adult: 100–400 mg twice daily orally; IV: 20–80 mg by slow injection at 10-minute intervals or infusion. Child: 0.25–1 mg/kg/dose IV over 2 minutes; maintenance: 0.4–1 mg/kg/hr IV infusion (specialist use).
Atenolol (Beta-blocker) Indications - Angina pectoris, Cardiac arrhythmia, Hypertension, Myocardial infarction, Migraine prophylaxis. Contraindications - Sinus bradycardia, second- or third-degree AV block, cardiogenic shock, overt cardiac failure, untreated pheochromocytoma. Cautions - Renal impairment, bronchospasm, diabetes mellitus, peripheral arterial disease, myasthenia gravis, elderly. Avoid - Abrupt withdrawal (may precipitate angina or MI), breastfeeding unless clearly necessary. Interactions - May interact with calcium channel blockers (e.g., verapamil), digoxin, clonidine, NSAIDs, and insulin or oral hypoglycemics. Trade names - Tenoren 50 tab:®, Atenolol tab:® Adult: 25–100 mg once daily or in divided doses. Child: 0.5–1 mg/kg/day orally, adjusted based on response; maximum 2 mg/kg/day.
Nifedipine (Calcium Channel Blocker) Indications - Angina pectoris (including Prinzmetal’s angina), Hypertension, Raynaud’s phenomenon. Contraindications - Cardiogenic shock, significant aortic stenosis, unstable angina, during or within 1 month of MI (immediate-release form). Cautions - Hepatic impairment, heart failure, hypotension, elderly, diabetic patients. Avoid - Grapefruit juice (increases drug level), abrupt withdrawal. Interactions - May interact with beta-blockers, CYP3A4 inhibitors (e.g., erythromycin), rifampicin, and digoxin. Trade names - Adalat® tab, Adipine® cap, Nifecard® tab Adult: 10–20 mg 3 times daily (immediate release); 30–60 mg once daily (extended-release). Child: 0.25–0.5 mg/kg/dose orally every 8–12 hours; max 3 mg/kg/day (specialist supervision required).
Bisoprolol fumarate (Beta-1 selective blocker) Indications - Hypertension, Angina pectoris, Adjunct treatment in chronic stable heart failure. Contraindications - Severe bradycardia, 2nd or 3rd degree AV block, cardiogenic shock, decompensated heart failure, sick sinus syndrome (without pacemaker). Cautions - Diabetes mellitus, bronchospasm, renal or hepatic impairment, elderly, history of psoriasis, myasthenia gravis. Avoid - Abrupt discontinuation, pregnancy unless essential. Interactions - May interact with verapamil, diltiazem, insulin, antidiabetics, clonidine. Trade names - Concor® tab, Bisotab® tab, Bisoprolol® tab Adult: 5–10 mg once daily (maximum 20 mg/day); start with 1.25 mg in heart failure, titrate gradually. Child: Not routinely recommended; use only under specialist supervision.
Celiprolol HCl (Beta-1 selective blocker with partial beta-2 agonist activity)Indications - Mild to moderate hypertension. Contraindications - Asthma, severe bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure. Caution - Renal impairment, hepatic impairment, diabetes mellitus, peripheral vascular disease, thyrotoxicosis. Avoid - Abrupt withdrawal, pregnancy unless essential. Interactions - May enhance hypotensive effect with other antihypertensives; risk of bradycardia with digoxin, verapamil, diltiazem; NSAIDs may reduce antihypertensive effect. Trade names - Selectol tab:®, Celipres tab:® Adult: 200–400 mg once daily; may be increased to 400 mg twice daily based on response. Child: Not recommended due to lack of clinical data.
Co-tenidone(aaa)Indications - Hypertension. Oral 50/12.5 mg daily tab:®, Cap:® Adult : Child:
Esmolol HCl (Ultra-short-acting beta-blocker)Indications - Supraventricular arrhythmias (including atrial fibrillation, atrial flutter, sinus tachycardia), tachycardia and hypertension in peri-operative period. Contraindications - Severe bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure, hypersensitivity to beta-blockers. Cautions - Diabetes, bronchospastic disease, renal impairment, elderly. Interactions - Additive effect with other antihypertensives or AV-node blockers, may mask hypoglycemia with insulin/sulfonylureas. Trade names - Brevibloc Inj:®, Esocard Inj:®, Esmolol Hydrochloride Inj:® Adult: Loading dose 500 mcg/kg IV over 1 min, then infusion 50–200 mcg/kg/min titrated to response. Child: Not routinely recommended; consult specialist if use is necessary.
Felodipine(Calcium channel blocker)Indications - Hypertension, Prophylaxis of angina. Oral 5–10 mg once daily tab:®, Cap:® Adult : Child:
Lacidipine(aaa)Indications - Hypertension. Oral 4 mg daily tab:®, Cap:® Adult : Child:
Hydrochlorothiazide(aaa)Indications - Hypertension. tab:®, Cap:® Adult : Child:
Guanethidine monosulfate(aaa)Indications - Hypertension. tab:®, Cap:® Adult : Child:
Selexipag(aaa)Indications - Pulmonary arterial hypertension. tab:®, Cap:® (Initiate under specialist supervision) Adult : Child:
Riociguat(aaa)Indications - Pulmonary arterial hypertension, Chronic thromboembolic pulmonary hypertension. Oral 1 mg 3 times a day for 2 weeks Cautions - Elderly, risk of hypotension, Hypotension. tab:®, Cap:® Adult : Child:
Tezacaftor(aaa)Indications - Cystic fibrosis. Oral 100/150 mg, To be taken in the morning tab:®, Cap:® (Specialist use only) Adult : Child:
Ivacaftor(aaa)Indications - Cystic fibrosis. Oral 150 mg to be taken in the evening tab:®, Cap:® (Specialist use only) Adult : Child:
Olmesartan Medoxomil(aaa)Indications - Hypertension. Olesta 20mg tab:, Olmesar A tab: Avoid - Biliary obstruction. Cautions - Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Triglycerides(aaa)Indications - Calories, Energy supply. Omnilipid Emulsion Inj: Adult : Child:
Lohexol(aaa)Indications - Used before X-ray imaging tests such as CT scans. Omnipaque Solution for Inj:. Adult : Child:
Nabumetone(aaa)Indications - Pain and inflammation in osteoarthritis and rheumatoid arthritis, Pain and inflammation in osteoarthritis and rheumatoid arthritis (severe and persistent symptoms. Nabumetone tab:, Opebutal 750 Caplet Avoid - Active gastro-intestinal ulcer and bleeding, Heart failure, Pregnancy, Renal impairment. Cautions - Allergic disorders, Elderly, Heart disease, Ulcerative colitis, Hypertension, Breast feeding, Hepatic impairment. tab:®, Cap:® Adult : Child:
Octreotide(aaa)Indications - Symptoms associated carcinoid tumours, Acromegaly, Neuroendocrine tumour, Advanced neuroendocrine tumours of the midgut, Or Tumours of unknown primary origin where non-midgut sites of origin have been excluded, Reduce intestinal secretions in palliative care, Reduce vomiting due to bowel obstruction in palliative care. Octride 100 inj, Otide 100 Inj: Adult : Child:
Oxytocin (Uterotonic hormone)Indications - Induction of labour for medical reasons, stimulation of labour in hypotonic uterine inertia, Caesarean section, prevention of postpartum haemorrhage after delivery of placenta, treatment of postpartum haemorrhage, incomplete, inevitable, or missed miscarriage. Avoid - Cardiovascular disease, women over 35 years. Caution - Monitor uterine activity and fetal heart rate; use with caution in multiple pregnancies, grand multipara, or previous uterine surgery. Interactions - Increased risk of hypertension with vasoconstrictors; enhanced uterine contractility with prostaglandins. Trade names - Oxyson Inj:®, Oxytroy Inj:® (IM/IV/Infusion) Adult: For induction/stimulation: IV infusion 1–2 milliunits/min, increased gradually to 20 milliunits/min max. For PPH prevention/treatment: IM 5–10 units after placenta delivery or IV infusion 20–40 units in 1L fluid. Child: Not applicable.
Carboprost(aaa)Indications - Postpartum haemorrhage due to uterine atony in patients unresponsive to ergometrine and oxytocin. Avoid - Cardiac disease, Pulmonary disease. Cautions - Excessive dosage may cause utrine rupture, History of Asthma, Diabetes, Epilepsy, Hypertension, Hypotension, Jaundice. Endoprost 125mcg/ 0.5ml Inj:, Endoprost 250mcg/1ml Inj:. Adult : Child:
GemeprostIndications - Cervix softening and dilation before surgical abortion (in Oxytocin unresponsive), Termination of pregnancy of(50-63)days, Termination of pregnancy of(13-24)weeks(with prostaglandin. Insert into posterior fornix Use when unresponsive to Ergometrine and Oxytocin Avoid - Unexplained vaginal bleeding, Placenta praevia, Renal impairment. Cautions - Cardiovascular insufficiency, Cervicitis, Obstructive airways disease, Vaginitis. tab:®, Cap:® Adult : Child:
Levonorgestrel(aaa)Indications - Emergency contraception, Menorrhagia, Prevention of endometrial hyperplasia during oestrogen replacement therapy. Monodiol tab:, Paclevo tab:. tab:®, Cap:® Adult : Child:
Pemetrexed, Antineoplastic(aaa)Indications - Non-small cell lung cancer. Pexitaz 100 Powder for Inj: Adult : Child:
Repaglinide (Blood glucose lowering drug) Indications - Type 2 diabetes mellitus (as monotherapy or in combination with metformin or thiazolidinediones). Contraindications - Type 1 diabetes mellitus, Diabetic ketoacidosis, Severe hepatic impairment. Avoid - Concomitant use with gemfibrozil, Pregnancy, Breastfeeding. Cautions - Hepatic impairment, Elderly, Malnourished patients, Adrenal or pituitary insufficiency. Interactions - Gemfibrozil (increased repaglinide levels), Beta-blockers (may mask hypoglycemia), Rifampicin (reduced effect). Trade names - Novonorm 0.5 mg tab:, Novonorm 1 mg tab:, Novonorm 2 mg tab:, GlucoNorm tab: Adult - Initially 0.5 mg before each main meal, adjusted based on response. Usual range: 0.5–4 mg before meals; max 16 mg/day. Child - Not recommended (safety and efficacy not established).
Dinoprost Tromethamine (Prostaglandin analogue)Indications - Abortion, Labor induction, Postpartum hemorrhage, Uterine atony. Trade Names - Primigyn 0.5mg Endocervical Gel: Adult: Endocervical: 0.5 mg once; may repeat every 6 hours if needed, up to a max dose of 1.5 mg in 24 hrs. Child: Not recommended for pediatric use.
Drotaverine HCl (Antispasmodic)Indications - Relief of smooth muscle spasms in gastrointestinal, biliary, and urinary tracts including biliary colic, cholecystitis, nephrolithiasis, ureterolithiasis, and dysmenorrhea. Contraindications - Severe hepatic, renal, or cardiac insufficiency; known hypersensitivity to drotaverine or similar compounds. Cautions - Use with caution in elderly, patients with hypotension, or those with impaired liver or kidney function. Avoid - Use in patients with porphyria; avoid in pregnancy and lactation unless necessary. Interactions - May reduce the efficacy of levodopa; additive effect with other antispasmodics. Trade names - Relispa Inj:, Pymenospain Tab:, Droverin-40 Tablet:, DOVASPIN Inj: Adult - Oral: 40–80 mg 2–3 times daily; IM/IV: 40–80 mg up to 3 times daily. Child - 1–2 mg/kg/day in 2–3 divided doses; use under close medical supervision.
Progesterone (Progestin hormone)Indications - Infertility due to inadequate luteal phase, premenstrual syndrome, post-natal depression, dysfunctional uterine bleeding, recurrent miscarriage due to inadequate luteal phase, supplementation of luteal phase during assisted reproductive technology treatment in women for whom vaginal preparations are inappropriate. Contraindications - Severe hepatic dysfunction, active thromboembolic disorders, undiagnosed vaginal bleeding, known or suspected breast/genital malignancy. Caution - Hypertension, diabetes, epilepsy, migraine, asthma, renal or cardiac impairment, history of depression. Avoid - During pregnancy unless indicated, breastfeeding (with caution). Interactions - Barbiturates, phenytoin, rifampin may reduce efficacy. Trade names - Progestromark 100 Cap:®, Progestromark 200 Cap:®, Crinone 8% Gel:® (vaginal) Adult: 100–200 mg daily by vaginal or oral route in divided doses; dosage may vary based on indication and formulation (e.g., 90 mg vaginal gel once daily for luteal support). Child: Not recommended.
Rabeprazole Sodium (Proton pump inhibitor - PPI)Indications - Gastro-esophageal reflux disease (GERD), Benign gastric ulcer, Duodenal ulcer, severe oesophagitis, Zollinger-Ellison syndrome. Avoid - Use during pregnancy and breastfeeding unless clearly needed. Cautions - Use with caution in hepatic impairment; monitor for long-term effects such as vitamin B12 deficiency and hypomagnesemia. Side Effects - Headache, diarrhea, nausea, abdominal pain, rash, dizziness. Trade Names - Amirab Cap:, Amirab-D Cap:, Rabidus 20 tab:, Rabipam Powder for Inj: Adult: Oral: 10–20 mg once daily for 4–8 weeks depending on condition; may increase for hypersecretory conditions. Child: Not routinely recommended; off-label use in children above 1 year at 5–10 mg daily under specialist supervision.
Bupivacaine Hcl(aaa) (Surgical anaesthesia, Lumbar epidural nerve block, thoracic epidural block, Caudal epidural block, Major nerve block, Acute pain, Intra-articular block, Acute pain, Thoracic epidural block, Intrathecal anaesthesia for surgery. tab:®, Cap:® Adult : Child:
Buprenorphine (Opioid analgesic)Indications - Management of moderate to severe pain, including perioperative pain, and opioid dependence (in combination with naloxone). Contraindications - Respiratory depression, acute alcoholism, paralytic ileus, severe hepatic impairment. Cautions - Use with caution in elderly, those with head injury, hypotension, or respiratory conditions; taper dose gradually to avoid withdrawal symptoms. Side Effects - Constipation, nausea, dizziness, sedation, respiratory depression, dependence. Trade Names - Buprigesic Patch®, Suboxone® (with Naloxone), Temgesic® Sublingual Tab: Adult: Sublingual: 200–400 mcg every 6–8 hours; Transdermal: 5–20 mcg/hour patch changed every 7 days. Child: Not recommended for use in children under 16 years (safety and efficacy not established).
Buserelin, Gonadotropin-releasing hormone(aaa)Indications - Enometriosis, Advanced prostate cancer, Pituitary desensitisation before induction of ovulation by gonadotrophins for in vitro fertilisation. under expert supervision. tab:®, Cap:® Adult : Child:
Phthalaldehyde(aaa)Indications - Disinfectant for medical equipment which is sensitive to normal heat or steam sterilization processes, Including endoscope, Cystoscopes and certain instruments. Sanidex OPA Solution tab:®, Cap:® Adult : Child:
Cefotaxime (Third-generation cephalosporin)Indications - Broad-spectrum antibiotic; indicated in uncomplicated gonorrhoea, gynecological infections, surgical prophylaxis, Haemophilus influenzae epiglottitis, meningitis, and infections in patients allergic to benzylpenicillin. Contraindications - Hypersensitivity to cephalosporins or beta-lactam antibiotics. Cautions - Use with caution in patients with renal impairment; dose adjustment may be required. Side Effects - Diarrhea, rash, injection site reactions, eosinophilia, transient hepatic enzyme elevations, allergic reactions. Trade Names - Necaxime-Taxim Inj:, Gcet-S 1.5g Powder for Inj:, Letax-SB 750 Powder for Inj: Adult: 1–2 g every 8–12 hours IV/IM; dose may be increased in severe infections. Child: 50–100 mg/kg/day in divided doses every 6–8 hours IV/IM (up to 180–200 mg/kg/day in severe cases like meningitis).
Ambroxol HCl (Mucolytic, Expectorant) Indications - Bronchitis, Cystic fibrosis, Chronic obstructive pulmonary disease (COPD), Acute respiratory tract infections. Contraindications - Known hypersensitivity to ambroxol or similar compounds. Cautions - Peptic ulcer disease, severe hepatic or renal impairment. Avoid - Use with caution during pregnancy, especially in the first trimester. Interactions - May enhance the penetration of some antibiotics into bronchial secretions (e.g. amoxicillin, cefuroxime). Trade names - Mucodyle®, Ambrodil 30®, Mubroxol 30 mg®, Respo®, Lytex Drops®, Mucorol Syrup® Adult: 30 mg orally 2–3 times daily. Child: Under 2 years: 7.5 mg twice daily; 2–5 years: 7.5 mg three times daily; 6–12 years: 15 mg 2–3 times daily.
Cetirizine(Antihistamine) Indications - Allergic rhinitis (sneezing, runny nose, itchy nose, watery eyes), urticaria, hay fever, and other allergic conditions. Contraindications - Severe renal impairment, hypersensitivity to cetirizine or hydroxyzine. Cautions - Renal or hepatic impairment, elderly, risk of drowsiness. Avoid - Alcohol (increases sedation), pregnancy unless clearly needed. Interactions - CNS depressants (additive sedative effects), theophylline may reduce clearance. Trade names - Mucodyle®, Zyrtec®, Aller-Tec®, Reactine®, Cetzine® Adult: 10 mg once daily orally. Child: 6–12 years: 5 mg twice daily or 10 mg once daily; 2–6 years: 2.5 mg twice daily or 5 mg once daily.
Cefoperazone (Third-generation cephalosporin antibiotic) Indications - Bone infections, Joint infections, Peritonitis, Respiratory tract infections, Urinary tract infections, Skin infections, Pelvic inflammatory diseases, Septicemia, Intra-abdominal infections. Contraindications - Hypersensitivity to cephalosporins or penicillins. Cautions - History of beta-lactam allergy, impaired renal or hepatic function. Avoid - Caution in neonates with hyperbilirubinemia. Interactions - Alcohol (disulfiram-like reaction), increased bleeding risk with anticoagulants or antiplatelet drugs. Trade names - Salbec 2g Powder for Inj:® Adult: 2–4 g per day in divided doses every 12 hours by IM or IV injection; up to 8 g/day in severe infections. Child: 50–200 mg/kg/day in 2–4 divided doses by IM or IV injection depending on severity.
Polyethylene Glycol (Osmotic laxative) Indications - Occasional constipation, Induction of bowel movements, Dry eye syndrome (topical formulation only). Contraindications - Gastrointestinal obstruction, Bowel perforation, Toxic colitis or megacolon. Cautions - Renal impairment, Dehydration, Electrolyte imbalance. Avoid - Use with caution during pregnancy and breastfeeding (only if clearly needed). Interactions - May alter absorption of concomitant oral medications if taken together. Trade names - Safelax Powder for Oral Solution (17.1g), Polyethylene Glycol Powder for Solution® Adult: 17 g powder dissolved in 120–240 mL water once daily (may be adjusted based on response). Child: For ages 6 months–17 years: Dose varies by age and weight, typically 0.4–1.5 g/kg/day in divided doses (under medical supervision).
Hydroxyurea(Antimetabolite, Antineoplastic) Indications - Acute leukemia, Brain tumors, Solid tumors, Chronic myeloid leukemia (CML), Head and neck cancers, Psoriasis, Sickle cell disease. Contraindications - Severe bone marrow depression, Pregnancy, Hypersensitivity to hydroxyurea. Cautions - Renal or hepatic impairment, Elderly patients, History of leg ulcers, Long-term use increases risk of secondary malignancies. Avoid - Live vaccines during treatment. Interactions - Increased myelosuppression with antiretrovirals (especially didanosine and stavudine), Enhanced effect with other cytotoxic agents. Trade names - Riborea Cap® Adult: Oral 15–30 mg/kg once daily (dose individualized based on condition and response). Child: Oral 15–20 mg/kg/day for sickle cell anemia or malignancies (under specialist supervision).
Hydroxycarbamide (Hydroxyurea) (Antineoplastic, Antisickling agent)Indications - Polycythaemia vera, Essential thrombocythaemia, Chronic myeloid leukaemia (CML), Sickle-cell disease (to reduce frequency of painful crises and transfusion requirements). Contraindications - Hypersensitivity to hydroxyurea, Severe bone-marrow depression, Pregnancy or breastfeeding (unless specialist deems benefit outweighs risk). Cautions - Renal or hepatic impairment, Elderly, Prior or concurrent radiotherapy, Risk of secondary malignancy (especially cutaneous), Regular full-blood-count monitoring essential. Avoid - Live vaccines, Unprotected sun exposure (photosensitivity/skin-ulcer risk), Concomitant use with other myelosuppressive drugs without close monitoring. Interactions - Enhanced myelosuppression with antiretrovirals (e.g. didanosine, stavudine) and other cytotoxics; additive toxicity with radiotherapy; increased pancreatitis/hepatotoxicity risk with some HIV regimens. Trade names - Tab: Siklos® Cap: Hydrea®, Droxia® (Specialist use only) Adult: CML / Polycythaemia / Thrombocythaemia: 15–30 mg/kg/day orally in single or divided doses and titrate to response; Sickle-cell disease: start 15 mg/kg/day, increase by 5 mg/kg every 8 weeks to a max 35 mg/kg/day as tolerated. Child: Sickle-cell disease: 15–20 mg/kg/day orally; increase cautiously (≤5 mg/kg every 8 weeks) under specialist supervision, usual max 35 mg/kg/day.
Regorafenib (Antineoplastic)Indications - Metastatic colorectal cancer, unresectable or metastatic gastrointestinal stromal tumours, hepatocellular carcinoma. Contraindications - Hypersensitivity to regorafenib or any component of the formulation. Cautions - Hepatic impairment, hypertension, cardiac disorders, bleeding risks, wound healing complications. Avoid - Use in severe hepatic impairment, concomitant strong CYP3A4 inducers. Interactions - CYP3A4 inhibitors/inducers, warfarin, other antineoplastic agents. Trade names - Stivarga 40mg Film Coated tab:® (Specialist use only) Adult: 160 mg once daily for 21 days of a 28-day cycle (with food). Child: Safety and efficacy not established.
Finasteride (5-alpha-reductase inhibitor)Indications - Androgenetic alopecia (male pattern hair loss), Benign prostatic hyperplasia (BPH). Contraindications - Pregnancy (Category X — can cause abnormalities in a male fetus), hypersensitivity to finasteride. Cautions - Risk of high-grade prostate cancer, liver impairment; may affect PSA levels (prostate cancer screening). Side Effects - Decreased libido, erectile dysfunction, ejaculation disorders, breast tenderness or enlargement, depression (rare). Trade Names - Stercar tab:, Pronor tab: Adult: For BPH: 5 mg orally once daily; For alopecia: 1 mg orally once daily. Continued use is necessary to maintain benefits. Child: Not recommended for use in children.
Mesalamine (Aminosalicylate)Indications - Ulcerative colitis (induction and maintenance of remission). Contraindications - Hypersensitivity to salicylates or Mesalamine. Cautions - Renal impairment, hepatic impairment, elderly patients, history of myocarditis or pericarditis. Avoid - Use in patients with severe renal or hepatic dysfunction. Interactions - Azathioprine, mercaptopurine, NSAIDs, other nephrotoxic agents. Trade names - Spagone 800 Delayed Release tab:, tab:®, Cap:® Adult: 2.4–4.8 g/day in divided doses, adjusted based on response. Child: Varies by age/weight; typically 30–50 mg/kg/day in divided doses (under specialist guidance).
Tenofovir Alafenamide Indications - Chronic hepatitis B, HIV (AIDS) infection. Contraindications - Hypersensitivity to tenofovir alafenamide or any component of the formulation. Cautions - Decompensated liver disease, Renal impairment, Osteopenia or risk of bone loss. Avoid - Concurrent use with certain nephrotoxic drugs unless benefits outweigh risks. Interactions - May interact with rifampicin, carbamazepine, phenytoin, St John’s wort (decreased effectiveness); caution with boosted protease inhibitors. Trade names - Tenohep-AF®, HepBest® tab: Adult: 25 mg once daily with food. Child: 15–25 mg once daily based on body weight and age (specialist advice required).
Olanzapine (Second-generation antipsychotic)Indications - Schizophrenia, Combination therapy for mania, Preventing recurrence in bipolar disorder, Monotherapy for mania, Control of agitation and disturbed behaviour in schizophrenia or mania. Contraindications - Hypersensitivity to Olanzapine. Cautions - Diabetes, Parkinson’s disease, prostatic hypertrophy, epilepsy, cardiovascular disease, hepatic or renal impairment. Avoid - Breastfeeding, narrow-angle glaucoma. Interactions - CNS depressants, carbamazepine, fluvoxamine, antihypertensives, alcohol. Trade names - Oleanz tab:® Adult: Initially 5–10 mg once daily; usual dose 10–20 mg/day depending on condition and response. Child: Not generally recommended (off-label use under specialist supervision).
Donepezil HCl (Parasympathomimetic, Anticholinesterase, Acetylcholinesterase inhibitor)Indications - Mild to moderate dementia in Alzheimer’s disease. Contraindications - Hypersensitivity to donepezil or piperidine derivatives. Cautions - Asthma, Chronic obstructive pulmonary disease, Peptic ulcer, Hepatic impairment, Sick sinus syndrome, Seizure disorders. Avoid - Breastfeeding, Severe hepatic impairment. Interactions - May interact with NSAIDs (↑ risk of GI bleeding), anticholinergics (↓ efficacy), CYP3A4 inhibitors (↑ donepezil levels). Trade names - Aricept®, Aricept Evess®, Servonex® Adult: Initially 5 mg once daily at bedtime; may increase to 10 mg daily after 4–6 weeks if needed. Child: Not recommended in pediatric population.
Amisulpride (Antipsychotic - selective D2/D3 antagonist)Indications - Acute psychotic episodes in schizophrenia, Schizophrenia with predominantly negative symptoms. Contraindications - Pheochromocytoma, prolactin-dependent tumors (e.g., pituitary prolactinoma, breast cancer), lactation, children under 15 years. Avoid - Alcohol, abrupt withdrawal, combination with levodopa or QT-prolonging drugs. Cautions - Cardiovascular disease, renal impairment, epilepsy, risk of QT prolongation, elderly (especially with dementia), diabetes. Drug interactions - Increased risk of QT prolongation with other antipsychotics, antiarrhythmics, some antibiotics; avoid with dopaminergic agents like levodopa. Trade names - Tab: Sizopride-50®, Solian® Adult: Negative symptoms: 50–300 mg/day; positive symptoms: up to 400–800 mg twice daily depending on severity. Child: Not recommended in children under 15 years; use only under specialist supervision.
L-Cystine (Amino acid supplement)Indications - Arthritis, Atherosclerosis (hard arteries), Bronchitis, Emphysema, Tuberculosis, Slow growth rate of hair. Contraindications - Hypersensitivity to L-Cystine or any component of the formulation. Cautions - Renal impairment, hepatic impairment, pregnancy and lactation (safety not well established). Avoid - Use in children unless prescribed by a physician. Interactions - May interact with amino acid-modifying medications or protein supplements. Trade names - Silgoma Soft Cap® Adult: Typically 50–100 mg orally once or twice daily, or as directed by physician. Child: Dosage not established; use only under medical supervision.
Choline (Nutritional supplement)Indications - Hepatitis, Hepatic cirrhosis, Depression, Memory loss, Alzheimer's disease, Dementia, Huntington's chorea, Tourette's disease, Cerebellar ataxia, Certain types of seizures, Schizophrenia. Contraindications - Hypersensitivity to choline or any excipient. Cautions - Use with caution in patients with bipolar disorder or depression; high doses may worsen mood symptoms. Avoid - Excessive intake above recommended daily levels. Interactions - May interact with anticholinergic drugs and methotrexate. Trade names - Silgoma Soft Cap® Adult: Typical dose: 250–500 mg daily or as directed by physician. Child: Dosage depends on age and body weight; use only under medical supervision.
Quetiapine(Second-generation antipsychotics)Indications - Schizophrenia, Treatment of mania in bipolar disorder, Treatment of depression in bipolar disorder, Prevention of mania and depression in bipolar disorder, Adjunctive treatment of major depression. Qutipin 25 tab. tab:®, Cap:® Adult : Child:
Phospholipids Intratracheal(aaa)Indications - Hyperipidaemia. Survanta Intratracheal Suspension tab:®, Cap:® Adult : Child:
Glutathione Sodium (Antioxidant, Mucolytic)Indications - Chronic airway inflammation, Lung infection, Adjunct in chemotherapy-induced toxicity, Liver detoxification. Contraindications - Hypersensitivity to glutathione or formulation components. Cautions - Asthma, Sulfite sensitivity. Avoid - Concomitant use with other inhaled irritants without supervision. Interactions - May interact with some chemotherapeutic agents (consult specialist). Trade names - STS Lyophilized Powder for Inj: Adult: 600–1200 mg/day IV or as prescribed depending on indication. Child: Dose individualized based on weight and clinical condition under specialist care.
Flurbiprofen(aaa)Indications - Pain and inflammation in rheumatic disease and other musculoskeletal disorders, Migraine, Postoperative analgesia, Mild to moderate pain, Dysmenorrhoea, Relief of sore throat. Amedolfen 100 Caplet, Strepsils MaxPro Lozenges Avoid - Intestinal bleeding, Heart failure, Peregnancy, Renal impairment. Cautions - Allergic disorders, Hepatic impairment, Breast feeding, Elderly, Heart failure, Hypertyension, Ulcerative colitis. tab:®, Cap:® Adult : Child:
Regorafenib (Antineoplastic agent) Indications - Metastatic colorectal cancer, Unresectable or metastatic gastrointestinal stromal tumors, Hepatocellular carcinoma. Contraindications - Hypersensitivity to regorafenib or any component of the formulation. Caution - Liver impairment, Hypertension, Bleeding disorders, Recent surgery, Cardiac disease. Avoid - Pregnancy, Breastfeeding, Severe hepatic impairment. Interactions - CYP3A4 inhibitors or inducers (e.g., rifampicin, ketoconazole), Warfarin, Statins. Trade names - Stivarga 40mg film-coated tab: (Specialist use only) Adult - 160 mg once daily for 21 days of each 28-day cycle, orally after a light meal. Child - Not recommended in children and adolescents under 18 years.
Torasemide (Loop diuretic) Indications - Oedema associated with heart failure, renal or hepatic disease; Hypertension. Contraindications - Anuria, Hepatic coma, Severe electrolyte depletion, Hypersensitivity to sulfonamides or torasemide. Caution - Diabetes mellitus, Gout, Hypotension, Renal impairment, Elderly patients. Avoid - Pregnancy, Breastfeeding, Severe liver disease without monitoring. Interactions - Lithium, Aminoglycosides, NSAIDs, Antihypertensives, Digoxin. Trade names - Sutrilneo 10mg Prolonged Release tab:, Toras-Denk 10 tab:, Diuver 5 tab:, Torem 10 tab: Adult - Oedema: 5–20 mg once daily. Hypertension: 2.5–5 mg once daily. Child - Safety and efficacy not established.
Topiramate (Antiepileptic, Migraine prophylactic) Indications - Generalised tonic-clonic seizures, Focal seizures (partial onset seizures), Lennox–Gastaut syndrome, Migraine prophylaxis. Contraindications - Hypersensitivity to topiramate or excipients. Avoid - Acute porphyrias, Pregnancy (especially for migraine prophylaxis), Breastfeeding. Caution - Renal impairment, Hepatic impairment, History of nephrolithiasis, Dehydration, Use with oral contraceptives (may reduce efficacy). Interactions - Oral contraceptives, CNS depressants, Carbonic anhydrase inhibitors, Phenytoin, Carbamazepine, Valproate. Trade names - Sutrilneo 5mg Prolonged Release tab:, Topaz 100 tab:, Topvex tab:, Topamac tab:, Toplep tab: Adult - Epilepsy: Initial 25–50 mg daily, titrated up to 200–400 mg/day. Migraine prophylaxis: 25 mg daily, increased to 100 mg/day. Child - Epilepsy: Dose based on weight, usually starting at 0.5–1 mg/kg/day and titrated up. Not recommended for migraine in children under 12 years.
Tolperisone (Centrally acting muscle relaxant)Indications - Muscular hypertension (spasticity) associated with neurological disorders such as stroke, multiple sclerosis, or spinal cord diseases; obliterative vascular disease. Contraindications - Myasthenia gravis, known hypersensitivity to tolperisone or any excipients, lactation. Caution - Renal or hepatic impairment, elderly, dizziness or hypotension may occur. Avoid - During pregnancy and breastfeeding. Interactions - CNS depressants (e.g., benzodiazepines, alcohol) may enhance sedative effect; caution with other muscle relaxants. Trade names - Tolmax tab:®, Mydocalm tab:® Adult: 150–450 mg/day in divided doses after meals (typically 50 mg 3 times daily, can be increased based on response). Child: Not recommended for children under 3 years; for 3–14 years: 5 mg/kg/day in 3 divided doses under medical supervision.
Antithymocyte immunoglobulin(aaa)Indications - Prophylaxis of organ rejection in heart allograft recipients, Treatment of corticosteroid-resistant allograft rejection in renal transplantation. Thymogam Inj: Adult : Child:
Telmisartan (Angiotensin II Receptor Blocker - ARB) Indications - Hypertension, Prevention of cardiovascular events in patients with type 2 diabetes mellitus and cardiovascular risk. Contraindications - Hypersensitivity to Telmisartan, Second and third trimesters of pregnancy, Severe hepatic impairment, Cholestasis and biliary obstructive disorders. Avoid - Biliary obstructive disorders, Pregnancy, Breastfeeding. Cautions - Hepatic and renal impairment, Volume depletion, Aortic or mitral stenosis, Hyperkalaemia, Severe congestive heart failure. Interactions - ACE inhibitors, Potassium-sparing diuretics, NSAIDs, Lithium, Diuretics, Aliskiren. Trade names - Tazloc 40 mg tab:, Terazar 40 tab:, Terazar H 80/12.5 tab:, Telma 40 tab:, Micardis 40 tab: Adult - Initial dose 40 mg once daily, may be increased to 80 mg once daily. For cardiovascular risk reduction: 80 mg once daily. Child - Not recommended in children under 18 years due to insufficient data on safety and efficacy.
Oseltamivir (Neuraminidase inhibitor)Indications - Prevention and treatment of Influenza A and B. Contraindications - Hypersensitivity to oseltamivir or any component of the formulation. Cautions - Renal impairment, Immunocompromised patients, History of psychiatric disorders. Avoid - Use in children under 1 year without medical supervision, Severe renal failure unless dose-adjusted. Interactions - Live attenuated influenza vaccine (avoid use within 2 weeks before or 48 hours after vaccine). Trade names - Tamiflu® (Powder for Oral Suspension, Oral Capsules 75 mg) Adult: 75 mg orally twice daily for 5 days (treatment); 75 mg once daily for 10 days (prophylaxis). Child: Based on weight: <15 kg: 30 mg; 15–23 kg: 45 mg; 23–40 kg: 60 mg; >40 kg: adult dose – all twice daily for 5 days (treatment).
BenznidazoleIndications - Common cold, Influenza, Trypanosomiasis in child. Secnidazole, Dysen/Dysen Forte, Tagera Forte, Zifam 3VC Kit® Adult : Child:
Urapidil(aaa)Indications - Hypertension. Tachyben 25mg/5ml50mg/10ml100mg/20ml Solution for Inj:®, Adult : Child:
Sodium iodide(aaa)Indications - Cataract, Thyroid diseases, Diabetes mellitus, Hypertension, Myopia, Periphlebitis. Pima. tab:®, Cap:® Adult : Child:
Tranexamic Acid(aaa)Indications - Antiofibrinolytic, Hereditary angioedema, Prevention of bleeding, Menorrhagia. Cautions - Irregular menstrual bleeding, Massive haematuria, Patient receiving oral contraceptives. Azeptil 500 Cap:, Tramense tab:, Hemsamic 250mg Cap:, Tranexamin Inj:, Hemsamic 250mg Inj: Adult : Child:
Atosiban(aaa)Indications - Uncomplicated premature labour between 24 and 33 weeks of gestation. Tractocile 6.75mg/0.9ml for Infusion, Tractocile 7.5mg/ml for Infusion Avoid - Intra-uterine fetal death, Intra-uterine infection, Eclampsia. Cautions - Intra-uterine growth restriction, Abnormal placental site, Hepatic impairment. tab:®, Cap:® Adult : Child:
Dapoxetine (Selective Serotonin Reuptake Inhibitor)Indications - Premature ejaculation in men with poor ejaculatory control, persistent issue for at least 6 months, significant distress, and intravaginal ejaculatory latency time < 2 minutes. Contraindications - Bipolar disorder, Mania, Severe depression, Significant cardiac disease, Uncontrolled epilepsy, Hepatic impairment. Avoid - Use with MAOIs, thioridazine, SSRIs, and other serotonergic drugs. Cautions - Bleeding disorders, Angle-closure glaucoma, Renal impairment. Interactions - Increased risk of serotonin syndrome with other serotonergic drugs, CYP3A4 inhibitors increase levels. Trade names - DURAJECT-60 tab:, Kepiton tab:, Wonder tab: 60 mg Adult: 30 mg taken 1–3 hours before sexual activity; may increase to 60 mg based on efficacy and tolerability. Child: Not recommended.
Cefepime HCl (Fourth-generation cephalosporin)Indications - Neutropenia, Pneumonia, Pyelonephritis, Skin infections, Urinary tract infections. Contraindications - Hypersensitivity to cephalosporins. Cautions - Renal impairment, history of GI disease (especially colitis), CNS disorders (risk of seizures). Interactions - Increased nephrotoxicity with aminoglycosides, loop diuretics. Trade names - Ceftipime 1g IV/IM Powder for Inj:, Ceftipime 2g IV Powder for Inj:, Pimesan-1g IV/IM Powder for Inj:, Vaxcel Cefepime 1g Powder for Inj:® Adult: 1–2 g IV every 8–12 hours depending on severity. Child: 50 mg/kg IV every 8–12 hours (max 2 g/dose).
Valsartan(aaa)Indications - Hypertension, Heart failure, Myocardial infarction. Vasartim 40 Film Coated tab:, Vasartim 80 Film Coated tab: Avoid - Biliary cirrhosis, Cholestasis. Cautions - Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Trisodium EdetateIndications - Hypercalcaemia. tab:®, Cap:® Adult : Child:
BisphosphonateaIndications - Hypercalcaemia, Osteoporosis) tab:®, Cap:® Adult : Child:
BendroflumethiazideIndications - Hypertension, Oedema. Cautions - report if thigh, hip or groin pain occure during treatment. tab:®, Cap:® Adult : Child:
Sodium valproate(Antiepileptic)Indications - Epilepsy, Migraine prophylaxis, Mania. Avoid - Acute porphyrias, Liver dysfunction, Hepatic impairment. Pregnancy. Cautions - Systemic lupus erythematosus, Severe seizure, Renal impairment, Contraception needed. Side effects - Abdominal pain, Alopecia, Anaemia, behavior abnormal, concentration impaired, confusion, deafness, diarrhea, haemorrhage. ENCORATE-200 tab:®, Valporate Chrono-200 tab:, Depakine 200 mg/ml Oral Solution 60ml. Adult : Child:
Enoxaparin sodium (Low Molecular Weight Heparin - LMWH)Indications - Prevention and treatment of deep-vein thrombosis (DVT), Pulmonary embolism (PE), Venous thromboembolism in pregnancy, Unstable angina, Non-Q wave myocardial infarction, ST-elevation myocardial infarction (STEMI), During hemodialysis. Contraindications - Active major bleeding, History of heparin-induced thrombocytopenia, Severe bleeding disorders, Acute bacterial endocarditis. Avoid - Recent hemorrhagic stroke, Uncontrolled hypertension, Low body weight (increased bleeding risk), Pregnancy (unless indicated), Breastfeeding. Cautions - Renal impairment, Hepatic impairment, Elderly, Recent surgery, Epidural or spinal anesthesia, Diabetic retinopathy. Interactions - Other anticoagulants, Antiplatelet drugs (aspirin, clopidogrel), NSAIDs, SSRIs/SNRIs (increased bleeding risk), Thrombolytics. Trade names - Clexane inj:, Clonox inj:, Kalparin inj:, Lomoh-40 inj:, Lomoh-60 inj:, Parin-E inj:, Clonox-20 inj:, Intravas inj: Adult - Prophylaxis: 20–40 mg SC once daily; Treatment: 1 mg/kg SC every 12 hours or 1.5 mg/kg once daily. Child - Safety and efficacy not well established; use only under specialist supervision.
Pentoxyverine citrate (Antitussive)Indications - Cough. Contraindications - Hypersensitivity to pentoxyverine or related compounds, respiratory insufficiency. Cautions - Use with caution in patients with chronic respiratory diseases such as asthma or COPD. Avoid - Use in children under 2 years of age unless prescribed. Interactions - May interact with CNS depressants (e.g., alcohol, sedatives). Trade names - Pentoxyverine tab:®, Cap:® Adult: 25 mg up to 3–4 times daily, or as prescribed. Child: Not recommended below 2 years; 1–2.5 mg/kg/day in divided doses under supervision.
Vinorelbine, Antineoplastic(aaa)Indications - Advanced breast cancer, Advanced non-small cell lung cancer. Vinelbine 10mg Inj:, Vinelbine 50mg Inj:®, Cap:® Adult : Child:
Adapalen(aaa)Indications - Mild to moderate acne vulgaris. Zylene Nano Gel:®, Cap:® Adult : Child:
TorsemideIndications - diuretic, Edema, Fluid retention, Heart failure, Liver disease and kidney disease. Sutrilneo tab:, Ztor tab:, Ztor 5 tab: tab:®, Cap:® Adult : Child:
Zoledronic Acid(Bisphosphonate)Indications - Prevention of skeletal related events in advanced malignancies involving bone, Tumour-induced hypercalcaemia, Osteoporosis, Tumour-induced hypercalcaemia. Zoldro Inj:, Zoledro-Denk 4mg/5ml Inj:®, Cap:® Adult : Child:
Cefprozil(Second-generation cephalosporins)Indications - Upper respiratory tract infection, Skin infection, Soft tissue infection. Zilt 250 tab:, Zilt 500 tab:, Refprozil- 250 Hard Gelatin Cap: Adult : Child:
Rivaroxaban(aaa)Indications - Prophylaxis of venous thrombolism, pulmonary embolism, Prophylaxis of systemic embolism in patients of aged over 75 years and Diabetes mellitus. Avoid - Active bleeding, Malignant neoplasms, Oesophageal varices, Recent brain surgery, Recent gastro-intestinal ulcer, Recent intracranial haemorrhage, Recent ophthalmic surgery, Recent spine surgery . Significant risk of major bleeding, Vascular aneurysm) Cautions - Bronchiectasis, Elderly, Severe hypertension. Xarelto 10mg tab:, Xarelto 20mg tab:, Xarelto15mg Film Coated tab: Adult : Child:
Cefuroxime(Second-generation cephalosporins)Indications - broad-spectrum antibiotis, Lyme disease, Lower urinary-tract infection, Prophylaxis of endophthalmitis after cataract surgery, Pyelonephritis, Surgicalprophylaxia. Xzim-250 tab:, Xzim-500 tab:, Sanfur -250 tab: Renal impairment. tab:®, Cap:® Adult : Child:
Crotamiton(aaa)Indications - Pruritus (including pruritus after scabies. Scabion Cream:®, Cap:® Adult : Child:
Aripiprazole(Second-generation antipsychotics)Indications - It is used to treat various mental health conditions, including schizophrenia, Bipolar disorder, major depressive disorder (as an adjunct treatment) and irritability associated with autism spectrum disorder. Aripiprazole works by affecting the activity of certain neurotransmitters in the brain, particularly dopamine and serotonin, which play key roles in regulating mood, Behavior and cognition. Arpizol 5 Uncoated tab:, Arpizol 10 tab: Adult : Child:
Captopril(Angiotensin-converting enzyme (ACE) inhibitor)Indications - Hypertension, Heart failure, Short-term treatment in myocardial infarction, Diabetic nephropathy in type 1 Diabetic mellius. Apuzin tab: Cautions - in children tab:®, Cap:® Adult : Child:
CeftizoximeIndications - Genito-urinary tract infection, Lower respiratory tract infection, Skin infection, Soft tissue infection, Bone infection, Joint infection, Gynacological infection. tab:®, Cap:® Adult : Child:
Ceftazidime(Third-generation cephalosporins)Indications - Broad-spectrum antiboitic, Complicated urinary tract infection, Prophylaxis for transurethral resection of prostate, Pseudomonal lung infection, Meningitis, Hospital-acquired pneumonia. Cautions - Hepatic impairment, Renal impairment . Paczidime inj(vial), Tazicef Inj:, Zibec 1g IV/IM Powder:®, Cap:® Adult : Child:
Triprolidine HCl(aaa)Indications - Allergic conjunctivitis, Allergic rhinitis, Angioedema, Urticaria, Commom cold. Axcel Tridine Syrup. tab:®, Cap:® Adult : Child:
Bromhexine(mucolytic, expectorant)Indications - Dry cough, Respiratory tract infections. Solvin tab: 8 mg, Asovon tab:, Asovon Syrup, Ascoril Expectorant, Cosome Expectorant 100ml. Adult : Child:
Prasugrel, Antithrombotic(aaa)Indications - Prevention of atherothrombotic events(In combination with aspirin. Prasulet 5 tab:®, Prasulet 10 tab:®, Cap:® Adult : Child:
AmpicillinIndications - Otitis media, Chronic bronchitis, Lower Urinary-tract infection, Sinusitis, Uncomplicated comunity-acquired pneumonia, Salmonellosis, Endocarditis, Listerial meningitis. Acute lymphocytic leukaemia, Renal failure. Ampik Oral Suspension, Ampiclox 500mg Powder for Inj:, Ampicillin Sodium Powder for Inj: Adult : Child:
Cloxacillin(aaa)Indications - Bone infection, Joint infection, Cystitis, Endocarditis, Enterocolitis, Meningitis, Respiratory tract infection, Skin infections. Bluclox-P tab:, Cloxispa-500 Cap:, Opticlox, Ampiclox 500mg Powder for Inj:, Cloxacillin Eye drop. Adult : Child:
DicloxacillinIndications - Bone infection, Joint infection, Cellulitis, Bronchitis, Lower respitatory tract infection, Pharyngitis, Pneumonia, Skin infections, Urinary tract infection) tab:®, Cap:® Adult : Child:
Povidone iodineIndications - Antiseptic solution, Vaginal, Mouthwash. LeoPovidone antiseptic solution, Betadine Ointment, Saniquad PVP S Surgical Scrub, Betadine Vaginal Gel, Betadine Vaginal Douche 10%. tab:®, Cap:® Adult : Child:
Albendazole(Anthelmintic)Indications - Chronic Strongyloid infectionHydative disease(in conjunction with surgery), Hookworm infections. tab:® BENDOZ-400 tab:®, Zoleworm-A Oral Suspension, Corzole 400 tab:®, Pentinox tab:®, Bendoz-400 tab:® Adult : Child:
Irinotecan Hcl, Antineoplastic(aaa)Indications - Metastatic colorectal cancer, Metastatic adenocarcinoma of the pancreas, Pancreas cancer. Campto 40mg/2ml Inj:®, Campto 100mg/5ml Inj:® (Specialist use only) Adult : Child:
EXPECTORANTS(aaa) Ammonium Chloride, Ipecacuanha, Squill.
Ammonium ChlorideIndications - Cough, Metabolic alkalosis, Urinary retention. Axcel Flemin Expectorant. tab:®, Cap:® Adult : Child:
Sulfadiazine(aaa)Indications - Prevention of recurrence of Rheumatic fever . Burnaway Ointment Avoid - Acute pophyrias. Cautions - Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Terbutaline sulfate(aaa)Indications - Asthma, Reversible airways obstruction, Exercise-induced bronchospasm, Reversible airway obstruction, Uncomplicated premature labour(between 22 and 37 weeks of gestation. Bucanil Syrup, Cosome A Oral Solution Avoid - Intra-uterine infection, History of cardiac disease. Cautions - Eclampsia, Suspected cardiovascular disease. tab:®, Cap:® Adult : Child:
Chitosan(aaa)Indications - renal disease. Ipakitine. tab:®, Cap:® Adult : Child:
Chlorhexidine, Antiseptic(aaa)Indications - Skin infection. Shampoo 2-3 time weekly tab:®, Cap:® Adult : Child:
Chlorhexidine(aaa)Indications - Mouthwash. Saniquad M 25 Solution, Sanidyl Mouthwash, Sildaz Cream®. tab:®, Cap:® Adult : Child:
Chorionic Gonadotropin -HCG(aaa)Indications - Ovulation failure-induce lactation-mating failure. Chorulon tab:®, Cap:® Adult : Child:
Ciclosporin, Cyclosporin.(Immunosuppressant)Indications - Nephrotic syndrome, Severe acute ulcerative colitis refractory to corticosteroid treatment, Severe active rheumatoid arthritis (administered on expert advice), Short-term treatment of severe atopic dermatitis where conventional therapy ineffective or inappropriate (administered on expert advice), Severe psoriasis where conventional therapy ineffective or inappropriate (administered on expert advice), Severe keratitis in dry eye disease. Atopica, Optimmune, Neoral, Sandimmun, Nephrotoxic. Panimun Bioral-50 mg Cap:, Cipol.N Oral Solution, Cipol-N 25mg Cap:, Cipol-N 100mg Cap: Adult : Child:
Cimetidine(aaa)Indications - Benign duodenal ulceration, Benign gastric ulceration, NSAID-associated ulceration, Reflux oesophagitis, Prophylaxis of stress ulceration, Gastric acid reduction in obstetrics, Short-bowel syndrome, To reduce degradation of pancreatic enzyme supplements. Zitac, Cimetidine, Dyspamet tab: Avoid - Pregnancy and Breast feeding. Cautions - Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Cinchophen(aaa)Indications - Osteoarthritis. PLT tab:s. tab:®, Cap:® Adult : Child:
Cisatracurium(aaa)Indications - Neuromuscular blockade during intensive care, Muscle relaxation block during anaesthesia. Nimbex:®, Cap:® Adult : Child:
Atracurium besilate, Atracurium besylate(aaa)Indications - Neuromuscular blockade during intensive care. Artacil Inj:®, Cap:® Adult : Child:
Clazuril(aaa)Indications - Coccidiosis. Appertex Only use for Birds. tab:®, Cap:® Adult : Child:
Clemastine(Sedating antihistamine)Indications - Symptomatic relief of allergy such as hay fever, urticaria. Oral 1 mg twice daily Avoid - Acute porphyrias, Pregnancy, Breast feeding. Cautions - Elderly, Epilepsy, Prostatic hypertrophy, Urinary retension, Angle-closure glaucoma, Pyloroduodenal obstruction, Stenosing peptic ulcer. tab:®, Cap:® Adult : Child:
Sodium Clodronate(aaa)Indications - Hypercalcaemia, Bone pain associated with skeletal metastases in patients with breast cancer or multiple myeloma, Osteolytic lesions. Bonefos, Loron tab:®, Cap:® Adult : Child:
Clofazimine(aaa)Indications - Multibacillary leprosy(with rifampicin+dapsone)-Feline leprosy. Clofazimine Avoid - persistent abdominal pain and diarrhoea. Cautions - pregnancy, Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Clomipramine Hcl(aaa)Indications - Depressive illness, Phobic and obsessional states, Cataplexy associated with narcolepsy. Clomicalm, Oral 10 mg daily Avoid - Acute porphyrias, Arrhythmias, During the manic phase of bipolar disorder, Heart block, Immediate recovery period after myocardial infarction. tab:®, Cap:® Adult : Child:
Clonazepam, Hypnotic, Seative, Anxiolytic(aaa)Indications - Epilepcy, seizures, Myoconus, Infantile spasm, Panic disorders. Clonopin, Rivotril Avoid - Coma, Current alcohol abuse, Current drug abuse, Respiratory depression, Breast feeding. Cautions - Acute porphyrias, Airway obstructions, Brain damage, Depression, Cerebellar ataxia, Renal impairment. tab:®, Cap:® Adult : Child:
Amoxicillin, Amoxycillin(aaa)Indications - Urinary tract infection, Sinusitis, Uncomplicated community-acquired pneumonia, Salmonellosis, Oral infections, Bronchiectasis, Chronic obstructive pulmonary disease, Acute otitis media, lyme disease, lyme arthritis, Anthrax, Dental abscess, Listerial meningitis, Endocarditis, Helicobacter pylori eradication(with metronidazole and omeprazole). Cautions - Acute lymphocytic leukaemia, Renal impairment, Endocardidis cause by Enterococci(Use Vancomycin if Penicillin allergic), Meningitis cause by Listeria can be treat Amoxicillin+Gentamicin 14-days. Flumox Cap:®, Amoxicap 250 Cap:, Dumoclav 625 tab: Adult : Child:
Ticarcillin(Extended-spectrum penicillin)Indications - Serious infections including septicaemia, lower respiratory tract infections, urinary tract infections, bone and joint infections, and intra-abdominal infections caused by susceptible Gram-negative organisms. Avoid - Penicillin allergy. Cautions - Renal impairment, Sodium overload (contains significant sodium), Monitor renal function during prolonged therapy. inj:® Adult : 3–5 g every 6–8 hours IV (max 30 g/day) Child: Not routinely used alone; specialist advice required
Ticarcillin + Clavulanic acid(Extended-spectrum penicillin + β-lactamase inhibitor)Indications - Severe infections due to β-lactamase–producing organisms, including lower respiratory tract infections, urinary tract infections, intra-abdominal infections, skin and soft tissue infections, septicaemia. Avoid - Penicillin allergy. Cautions - Renal impairment, Hepatic impairment, Monitor liver and renal function during prolonged use. inj: Timentin® Adult : 3.1 g (ticarcillin 3 g + clavulanic acid 100 mg) every 8 hours IV Child: Not routinely used; specialist advice required
Oxacillin Sodium(aaa)Indications - Staphyloco-al infections.) tab:®, Cap:® Adult : Child:
Bisoprolol(Beta-blocker)Indications - Hypertension, Angina, Heart failure. Concor 5 Film Coated tab: Acue hert failure requaire intravenous inotropes, Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Potassium Chloride(aaa)Indications - Prevention of hypokalaemia (patients with normal diet), Electrolyte imbalance. Compound Sodium Chloride Inj: USP, Ringer's Inj:-500ml:®, Cap:® Adult : Child:
Potassium CitrateIndications - Disconfort in mild urinary tract infection, Alakalinisation of urine . Cautions - Cardiac disease, Renal impairment, Elderly. tab:®, Cap:® Adult : Child:
Sodium BicarbonateIndications - Alkalinisation of urine, Relief of discomfort in mild urinary-tract infections, Maintenance of alkaline urine, Chronic acidotic states such as uraemic acidosis or renal tubular acidosis, Severe metabolic acidosis, Removal of earwax. Cautions - in Cardiac disease, In renal impairment, Elderly
Sertraline(Antidepressant)Indications - Depressive illness, Obsessive-compulsive disorder, Post-traumatic stress, Panic disorder, Social anxiety disorder. Avoid - Hepatic impairment. Cautions - Renal impairment. Zosert 25 tab:, Zoloft tab:, Setralin-50 tab:, Zert OD 50 tab:, Zert OD 100 tab: Adult : Child:
Hypericum perforatum, HyperforinIndications - Depression, Anxiety, Nervous system related disorders. Zifam St John's Wort 1800 tab: tab:®, Cap:® Adult : Child:
Paroxetine, Antidepressant,Indications - Major depresson, Social anxiety disorder, Post-traumatic stress disorder, Obsessive-compulsive disorder, Panic disorder, Menopausal symptoms, Woman with breast cancer. Xalexa 20 tab: Avoid - Pregnancy. Cautions - Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Ezetimibe(aaa)Indications - Primary hypercholesterolaemia. Eze-10 Film Coated tab: Adult : Child:
Tioconazole (Antifungal)Indications - Fungal nail infections (onychomycosis), Cutaneous and vaginal candidiasis. Contraindications - Hypersensitivity to tioconazole or any imidazole antifungal component. Cautions - Avoid contact with eyes; use with caution in patients with known hypersensitivity to similar azole antifungals; prolonged use may cause local irritation. Avoid - Avoid use in broken or inflamed skin; avoid occlusive dressings unless directed by a physician. Interactions - Minimal with topical use; systemic absorption is negligible but avoid concurrent use with other topical antifungals on the same site. Trade names - Trosyd®, Fungoid Tincture®, Gyno-Tioconazole® Adult: Apply to affected area once or twice daily for 2–4 weeks depending on the type and location of infection. For vaginal use, apply one applicatorful intravaginally at bedtime for 1–3 days as prescribed. Child: Not routinely recommended; if necessary, use only under medical supervision with limited duration.
Amorolfine (Antifungal)Indications - Fungal nail infections (onychomycosis). Contraindications - Hypersensitivity to amorolfine or any component of the formulation. Cautions - Avoid contact with eyes and mucous membranes; use with caution in immunocompromised individuals or those with peripheral circulatory disorders. Avoid - Use under occlusive dressings; avoid using nail polish or cosmetic nail products during treatment. Interactions - No significant drug interactions reported with topical use. Trade names - Loceryl®, Amorolfine Nail Lacquer® Adult: Apply once or twice weekly to affected nails for up to 6–12 months depending on severity and nail regrowth. Child: Safety and efficacy not established; use only under medical advice.
Econazole Nitrate (Antifungal)Indications - Vaginal and vulval candidiasis, Fungal skin infections (e.g., athlete’s foot, ringworm), Fungal nail infections. Contraindications - Hypersensitivity to econazole or any component of the formulation. Cautions - Use with caution in pregnancy (especially during the first trimester); avoid contact with eyes and mucous membranes. Avoid - Occlusive dressings unless advised by a physician; vaginal use during menstruation. Interactions - May reduce the effectiveness of latex contraceptives; use alternative contraception during and shortly after treatment. Trade names - Intra-vaginal Econazine Cream® (10g, 20g) (Longer duration may be needed in pregnant women), Cap:® Adult: Topical: Apply to affected skin twice daily for 2–4 weeks.
DoxofyllineIndications - Bronchial asthma, Bronchospasm, Chronic asthmatic bronchitis. tab:®, Cap:® Adult : Child:
Docetaxel Trihydrate(aaa)Indications - Gastric cancer, Breast cancer, Ovarian cancer. Doxoril 400 Uncoated tab:, Doxol 20mg/ 0.5ml Concentrate for Solution for Infusion, Docetel-20 Inj:, Docetec 80 Inj: Adult : Child:
Diltiazem Hcl(Calcium channel blocker)Indications - Prophylaxis and treatment of angina, Chronic anal fissure, Mild to moderate hypertension. Cardizam tab:, Diltizem tab: Left ventricular failure with pulmonary congestion, AV block, Bradycardia, Sick sinus syndrome. tab:®, Cap:® Adult : Child:
Mebendazole(aaa)Indications - Roundworm, Threadworm, Whipworm. Avoid - Pregnancy, Breast feeding Mebendazole tab:, Vermox 100mg tab:, Ermox 500 tab:, Ermox Suspension 30 ml Adult : Child:
PiparazineIndications - Roundworm Infection, Threadworm Infection. Avoid - in Renal impairment, Liver disease, Pregnancy tab:®, Cap:® Adult : Child:
Niclosamide(Anthelmintic)Indications - Tapeworm Infection. tab:®, Cap:® Adult : Child:
DiethylcarbamazineIndications - Microfilaria, Wuchereria and Brugia malayi infectionsLea loa infectiona. tab:®, Cap:® Adult : Child:
Allopurinol(xanthine oxidase inhibitor)Allopurinol decrease uric acid in blood. Indications - Prophylaxis of gout and of uric acid and calcium oxalate renal stones, Prophylaxis of hyperuricaemia associated with cancer chemotherapy. Contraindications - Not a treatment for acute gout but continue if attack develops when already receiving allopurinol, and treat attack separately. Cautions - Ensure adequate fluid intake (2-3 litters/day), For hyperuricaemia associated with cancer therapy. Allopurinol treatment should be started before cancer therapy. Adminster prophylactic NSAID(not aspirin or salicylates)or colchicine until at least one month after hyperuricaemia is corrected (usually for first three months)to avoid precipitating an acute attack. Congestive Side effects - Rash(discontinue therapy if rash mild, reintroduce cautiously but discontinue immediately if recurrence. Avoid - Renal impairment (adjust dose), Hepatic Impairment (monitor liver function periodically during early stage of treatment) Allopurinol tab:®, Erloric tab:®, Esloric tab:®, Zyloric tab:® Adult : Child:
Acetylsalicylic Acid, Aspirin( Analgesic, Nonsteroidal anti-inflammatory drug (NSAID)Indications - Cardiovascular disease, Unstable angina, Myocardial infarction, Transient ischaemic heart attack, Mild to moderate pain, to prevent blood clot formation Contraindications - Active peptic ulcer, Bleeding disorders, Children under 16 years, Severe cardiac failure, Anaemia, Allergic disease, Asthma, Dehydration, Elderly, During fever, Uncontroled hypertension Aspilet tab:®, Aspirex tab:®, Aspirin tab:®, Ecosprin 75 tab: Adult : Child:
Baclofen(aaa)Indications - Pain of muscle spasm in palliative care, Hiccup due to gastric distension in palliative care, Chronic severe spasticity resulting from disorders such as multiple sclerosis or traumatic partial section of spinal cord, Severe chronic spasticity unresponsive to oral antispastic drugs (or where side-effects of oral therapy unacceptable) or as alternative to ablative neurosurgical procedures. Flexbac-10 tab:®, Flexilax 5 tab:® (Specialist use only) Adult : Child:
Vitamins(Products)(aaa). Neuromax-Fort tab:, Richvit Sugar Coated tab:, Pregnacare Cap:, Little Toys tab:, Appeton Multivitamin Plus Infant Drops, Multilives Cap:, Trivitamins B Inj: Adult : Child:
Selenium with vitaminIndications - Dendruf, Pityriasis versicolor, Seborrhoea of scalp. Basic Nutrition tab:, SC Livopac soft gel. tab:®, Cap:® Adult : Child:
Vitamin A (Retinol) (Fat-soluble vitamin) Indications - Bronchitis, Pneumonia, Skin diseases, Biliary cirrhosis, Cholestasis, Measles, Conjunctivitis, Corneal ulcers. Contraindications - Hypervitaminosis A, Hypersensitivity to retinoids or formulation components. Cautions - Chronic renal or hepatic impairment, alcoholism, elderly patients. Avoid - Pregnancy (high doses teratogenic), breastfeeding unless prescribed. Interactions - Concomitant use with retinoid-containing products, oral contraceptives (may increase vitamin A levels), cholestyramine (may reduce absorption). Trade names - Vicvit A 25000 IU Cap:, Vitamin A & D Cap:, Fish Liver Oil Cap:, M Hovid Cod Liver Oil Cap: Adult: 10,000–25,000 IU daily depending on condition and deficiency severity. Child: Infants: 2,000–5,000 IU/day; older children: 5,000–10,000 IU/day, under medical supervision.
Vitamin B1 (Thiamine) Indications - Treatment and prevention of thiamine deficiency, beriberi, Wernicke's encephalopathy, neuritis, and as a general nerve tonic. Contraindications - Hypersensitivity to thiamine or any component of the formulation. Cautions - Parenteral administration may cause hypersensitivity reactions; use cautiously in allergic individuals. Avoid - Avoid high doses without medical supervision, especially in pregnancy and lactation. Interactions - Reduced absorption with alcohol, fluorouracil, and certain diuretics (e.g., furosemide). Trade names - Neurobion Tab:, Betex Tab:, Rejubion Tab:, Neurofort Tab:, Vitamin B1 Tab:, Vitamin B1 Inj: Adult: Oral: 50–100 mg once daily; IM/IV: 100 mg once daily or as prescribed. Child: Oral: 10–50 mg once daily depending on age and condition; IM/IV: only under medical supervision.
Provitamin B5(Dexpanthenol)(Skin Protectant)Indications - Prevention and treatment of dry, irritated or damaged skin; minor burns, abrasions, diaper rash, pressure sores, and nipple soreness in breastfeeding. Contraindications - Known hypersensitivity to dexpanthenol or any component of the formulation. Cautions - For external use only; avoid contact with eyes; discontinue if irritation develops. Side Effects - Rarely skin irritation or allergic reaction. Trade Names - Bepanthen First Aid Cream®, Bepanthen Ointment®, Panthenol Cream®, Dexpanthenol Gel® Adult: Apply 1–3 times daily to the affected area. Child: Safe for infants and children; apply thinly to affected area 1–3 times daily as needed.
Vitamin B6 (Pyridoxine) Indications - Peripheral neuritis, Premenstrual syndrome, Anaemia, Isoniazid-induced neuropathy, Edema and ascites in liver cirrhosis. Contraindications - Hypersensitivity to pyridoxine or any component of the formulation. Cautions - Use cautiously in patients with Parkinson’s disease on levodopa therapy without decarboxylase inhibitor. Avoid - High doses for prolonged periods unless prescribed. Interactions - Reduced effectiveness of levodopa when given without a decarboxylase inhibitor; may interfere with phenobarbital and phenytoin. Trade names - Vitamin B6 Tab:, Vitamin B6 Inj:, Rejubion Tab:, Neurofort Tab:, Pacvit B6 Inj: Adult: Oral: 10–200 mg/day depending on condition; IM/IV: 50–100 mg/day. Child: Oral: 2–5 mg/day for deficiency; up to 20 mg/day under supervision in specific conditions.
Vitamin B12 (Cyanocobalamin) Indications - Vitamin B12 deficiency due to dietary insufficiency, pernicious anemia, megaloblastic anemia, neuropathy. Contraindications - Hypersensitivity to cobalamins or cobalt. Cautions - Leber's disease (hereditary optic nerve atrophy), folate deficiency should be corrected concomitantly. Avoid - Unnecessary long-term use without diagnosis; caution in polycythemia vera. Interactions - Decreased absorption with chloramphenicol, colchicine, neomycin, metformin, alcohol. Trade names - Pai B12 Inj:®, Neurofort Tab:®, Neuro-B Inj:® Adult: IM/SC: 100–1000 mcg daily for 1–2 weeks, then weekly until improvement, followed by monthly maintenance. Child: IM/SC: 30–50 mcg/day for 2 weeks, then maintenance dose depending on condition and age.
Vitamin B Complex (Multivitamin – B group) Indications - Treatment and prevention of B-vitamin deficiencies, anemia, peripheral neuropathy, malnutrition, convalescence, and during increased physiological needs (e.g. pregnancy, illness). Contraindications - Hypersensitivity to any component of the formulation. Cautions - Patients with renal impairment, history of hypersensitivity reactions. Avoid - Excessive dosing beyond recommended levels. Interactions - Reduced absorption with alcohol, antacids; may interfere with levodopa efficacy when combined with pyridoxine. Trade names - Neuromax-Forte Tab:, Becosules Cap:, Neurobion Tab:, B-Complex Cap: Adult: 1 tablet or capsule daily, or as directed by physician. Child: Half to 1 tablet daily depending on age and physician recommendation.
Vitamin C (Ascorbic Acid) Indications - Prevention and treatment of scurvy, adjunct in wound healing, iron absorption enhancement, antioxidant support. Contraindications - Hypersensitivity to ascorbic acid. Cautions - Patients with a history of kidney stones, renal impairment, G6PD deficiency. Avoid - High doses in renal impairment or oxalate nephropathy. Interactions - May affect absorption of vitamin B12, interfere with lab tests (glucose, occult blood), reduce efficacy of anticoagulants. Trade names - C-Vion 500mg Tab:, Hicee Sweetlets Tab:, Vitacee Tab:, Limcee Film Coated Tab: Adult: 250–1000 mg daily in divided doses. Child: 100–300 mg daily depending on age and condition.
Vitamin D (Calciferol) (Fat-soluble Vitamin) Indications - Prevention and treatment of Vitamin D deficiency, hypoparathyroidism, rickets, osteomalacia, severe renal impairment, chronic liver disease. Contraindications - Hypercalcemia, hypervitaminosis D, malabsorption syndrome, severe renal impairment with hyperphosphatemia. Cautions - Use with caution in patients with renal impairment, cardiovascular disease, or sarcoidosis. Avoid - Excessive dosage due to risk of toxicity (hypercalcemia, renal damage). Interactions - May interact with digoxin, thiazide diuretics, anticonvulsants (phenytoin, phenobarbital), corticosteroids. Trade names - D3 Tab:, Calciferol Tab:, Calcirol Sachet: Adult: 400–1000 IU daily for prevention; up to 50,000 IU weekly for deficiency (under medical supervision). Child: 400 IU daily; 1000–5000 IU in deficiency states based on age and severity.
Vitamin D2(Ergocalciferol, Calciferol) (Vitamin D analogue) Indications - Vitamin D deficiency due to malabsorption or chronic liver disease, hypocalcaemia of hypoparathyroidism, prevention and treatment of rickets and osteomalacia, prevention and treatment of vitamin D deficiency. Contraindications - Hypercalcaemia, hypervitaminosis D, metastatic calcification, known hypersensitivity to vitamin D analogues. Cautions - Use with caution in infants—ensure accurate dosing; monitor calcium levels in renal impairment, sarcoidosis, and elderly. Avoid - Excessive doses; avoid concomitant use with high-calcium products without supervision. Trade Names - Drisdol tab:®, Calciferol cap:®, Ostelin D2 tab:® Drug Interactions - Thiazide diuretics (increased risk of hypercalcaemia), digoxin (toxicity with hypercalcaemia), anticonvulsants (may reduce vitamin D effect), corticosteroids (decreased vitamin D efficacy). Adult: 400–1250 mcg (16,000–50,000 IU) once weekly or monthly depending on severity and regimen. Child: 400–800 IU/day for prevention; higher doses under medical supervision for deficiency.
Vitamin E (Tocopherol) (Fat-soluble antioxidant vitamin) Indications - Cholestasis, Congenital cholestasis, Vitamin E deficiency, Neuromuscular disorders, Cystic fibrosis, Fat malabsorption syndromes. Contraindications - Hypersensitivity to vitamin E or any component of the formulation. Cautions - Use with caution in patients with bleeding disorders or those on anticoagulants. Avoid - High doses in pregnancy unless prescribed, severe renal impairment without supervision. Interactions - May potentiate effects of anticoagulants (e.g., warfarin), reduce vitamin K action, interfere with chemotherapy agents. Trade names - EPOSOFT Cap:, Etovit 200 Cap:, Evion 400 Cap: Adult: 100–400 IU daily, dose depending on deficiency severity or therapeutic need. Child: 10–30 IU daily depending on age and clinical condition, under medical supervision.
Alpha Tocopherol (Vitamin E – Fat-soluble antioxidant) Indications - Vitamin E deficiency due to fat malabsorption, congenital or hereditary chronic cholestasis. Contraindications - Hypersensitivity to alpha tocopherol or formulation components. Cautions - Predisposition to thrombosis, concurrent use with anticoagulants, renal or hepatic impairment. Avoid - High doses during pregnancy and in bleeding disorders unless prescribed. Interactions - May enhance the effects of anticoagulants (e.g., warfarin), reduce absorption of vitamin K, and interact with chemotherapy drugs. Trade names - EPOSOFT Gelatin Cap:, Etovit-400 Cap: Adult: 100–400 IU per day depending on clinical requirement. Child: 10–30 IU per day adjusted per age and condition under supervision.
Vitamin K (Fat-soluble vitamin) Indications - Prevention and treatment of Vitamin K deficiency, bleeding disorders due to anticoagulants, obstructive jaundice, liver disease, and prophylaxis in newborns. Contraindications - Hypersensitivity to Vitamin K or its derivatives (e.g., phytonadione). Cautions - Use cautiously in patients with hepatic impairment or glucose-6-phosphate dehydrogenase deficiency. Avoid - Large IV doses due to risk of anaphylaxis. Interactions - Reduced effectiveness of warfarin; may interact with broad-spectrum antibiotics that reduce gut flora producing Vitamin K. Trade names - Konakion Inj:, Mephyton Tab: Adult: 2.5–10 mg orally or IV depending on indication and severity. Child: Neonates: 0.5–1 mg IM after birth; Children: dosage varies by age and condition, usually 1–5 mg/day.
Vitamin K (Menadiol Sodium Phosphate) (Fat-soluble vitamin) Indications - Prevention and treatment of Vitamin K deficiency, especially in malabsorption syndromes, biliary obstruction, hepatic disease, and anticoagulant overdose. Contraindications - Hypersensitivity to vitamin K or its derivatives. Cautions - Impaired liver function, G6PD deficiency, and use in patients on anticoagulant therapy. Avoid - Use in neonates and infants unless prescribed under medical supervision. Interactions - May reduce the effects of oral anticoagulants (e.g., warfarin); interactions possible with broad-spectrum antibiotics that reduce vitamin K synthesis. Trade names - Vitak tab:, Konakion Inj:, Mephyton tab: Adult: 2.5–10 mg orally or by injection depending on severity; up to 40 mg/day in divided doses. Child: Not routinely recommended; dose individualized based on condition and medical advice.
Vitamin K₁ (Phytonadione) (Fat-soluble vitamin / Antidote)Indications - Reversal of coagulopathy due to anticoagulant rodenticide (super-warfarin) poisoning, warfarin overdose, vitamin K deficiency–related bleeding. Contraindications - Hypersensitivity to phytonadione or formulation components. Cautions - Severe hepatic insufficiency (delayed response), impaired biliary secretion, G6PD deficiency (rare hemolysis), neonates with hyperbilirubinemia (parenteral forms). Avoid - Large rapid IV bolus (risk of anaphylactoid reaction); avoid use without INR monitoring. Interactions - Antagonises anticoagulant effect of warfarin and other coumarins; broad-spectrum antibiotics may reduce endogenous vitamin K production; large doses may blunt response to antiplatelet drugs. Trade names - Konakion Inj:, Mephyton Tab:, Vitak Tab: Adult: Rodenticide poisoning: 30–50 mg oral or IV initially, titrate to normalise INR; maintenance 10–40 mg/day for several days to weeks as guided by INR. Child: Rodenticide poisoning: 0.5–1 mg/kg (max 50 mg) oral/IV; repeat and adjust per INR; neonatal prophylaxis and routine doses per specialist advice.
Benzoic acid (Topical antifungal and antibacterial) Indications - Topical treatment of fungal skin infections such as ringworm, athlete's foot, and tinea infections. Contraindications - Hypersensitivity to benzoic acid or formulation components. Cautions - Avoid contact with eyes, mucous membranes, and broken skin. Avoid - Use on large areas of damaged skin or in occlusive dressings unless advised. Interactions - No significant drug interactions reported with topical use. Trade names - Whitfield’s Ointment Adult: Apply topically 1–2 times daily to affected area for 2–4 weeks. Child: Use under medical supervision; not recommended for children under 2 years.
NicotinamideIndications - Inflammatory acne vulgaris. tab:®, Cap:® Adult : Child:
Glucarpidase(aaa)Indications - pesticide (insect spray) or a chemical that interferes with the central nervous system, Such as nerve gas. Voraxaze (Pro)®, Cap:® Adult : Child:
Nalmefene (Opioid receptor antagonist) Indications - Reduction of alcohol consumption in patients with alcohol dependence, opioid overdose reversal. Contraindications - Hypersensitivity to nalmefene or any component of the formulation. Cautions - Hepatic or renal impairment, history of seizures, psychiatric comorbidities. Avoid - Use in pregnancy and lactation unless clearly necessary. Interactions - May interact with opioids, reducing their efficacy and increasing withdrawal symptoms. Trade names - Selincro Tab: Adult: 18 mg orally once daily, as needed, 1–2 hours before anticipated alcohol consumption. Child: Not recommended due to lack of safety and efficacy data.
Levoleucovorin(aaa)Indications - itching related to kidney dialysis treatment and to treat poisoning or drug overdose, Stomach pain caused by excess gas, Diarrhea, Or indigestion. Fusilev (Pro), Lucal 50 tab:®, Cap:® Adult : Child:
Calcium trisodium Pentetate(aaa)Indications - stomach pain caused by excess gas, Diarrhea, Or indigestion. AN-DTPA (Pro) tab:®, Cap:® Adult : Child:
Dextromethorphan(Cough suppressant)Indications - Dry cough. Contraindications - children of under 12 years. DE-TUSSIN 15 mg tab:®, ROMIVON tab:®, TUSSOLO tab:®, RODILAR tab:®, CHERICOF 100ml syrup, Romilar 15mg tab:®, Konidin tab:®, BRONCHEST tab:®, Presco tab:®, Atussin tab:® Adult : Child:
Methoxsalen (Psoralens)Indications - Methoxsalen is primarily used in combination with ultraviolet light therapy to treat certain skin conditions like psoriasis, eczema, vitiligo and some cutaneous lymphomas. MELANOCYL 10 mg tab:® Adult : Child:
Fluocinolone Acetonide(aaa)Indications - Treatment of visual impairment associated with chronic diabetic macular oedema which is insufficiently responsive to available therapies, Severe inflammatory skin disorders such as eczemas, Psoriasis. Avoid - Active or suspected ocular infection, Active or suspected peri-ocular infection. Fluosyn Cream®, Cap:® (Specialist use only) Adult : Child:
Ticlopidine HCl (Antiplatelet agent – ADP receptor antagonist) Indications - Prevention of thrombotic stroke in patients who have experienced a previous stroke or a precursor event (e.g. TIA), Prevention of stent thrombosis after coronary stent placement (in combination with Aspirin). Contraindications - Active pathological bleeding (e.g. peptic ulcer, intracranial hemorrhage), Hematopoietic disorders (e.g. neutropenia, thrombocytopenia, aplastic anemia), Severe liver impairment, Known hypersensitivity to Ticlopidine. Cautions - Increased bleeding risk (surgery, trauma), Renal impairment, Hepatic impairment, Elderly patients, History of hematologic abnormalities. Trade Names - Ticlid® (Tablet: Ticlopidine HCl 250 mg) Adult: 250 mg orally twice daily with food. Child: Not recommended (Safety and efficacy not established).
Pioglitazone(Blood glucose lowering drug)Indications - Type 2 diabetes mellitus. Glit-15 tab:®, Glit-30 tab:® Adult : Child:
Crisantaspase, Antineoplastic(aaa)Indications - Acute lymphoblastic leukaemia. Asparaginase, Elspar, Erwinase Avoid - History of pancreatitis related to asparaginase therapy, History of serious haemorrhage related to asparaginase therapy, History of serious thrombosis related to asparaginase therapy, Pancreatitis. tab:®, Cap:® Adult : Child:
Colchicine (Antifibrotic, Anti-gout agent) Indications - Acute gout flares, Familial Mediterranean fever, Prevention of gout flares. Avoid - Severe renal or hepatic impairment, Hypersensitivity to colchicine. Cautions - Renal impairment, Hepatic impairment, Blood dyscrasias, Elderly patients, Concomitant use of CYP3A4 inhibitors. Drug interactions - CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole), P-glycoprotein inhibitors (e.g., verapamil), grapefruit juice (increases risk of toxicity). tab: Colcrys® Adult : 1 mg initially, followed by 0.5 mg every 1–2 hours until pain relief or maximum dose (usually 1–1.5 mg/day). Child: Not recommended without specialist advice.
Cholestyramine, ColestyramineIndications - Hyperlipidaemias, Primary prevention of coronary heart disease, Elimination of teriflunomide and leflunomide, Pruritus associated with partial biliary obstruction. Questran powder sachet®, Cap:® Adult : Child:
CyclopentolateIndications - Preoperative use intraocular surgery. Mydrilate, Cyclopentolate Hcl tab:®, Cap:® Adult : Child:
Cyclophosphamide, Antineoplastic(aaa)Indications - Rheumatoid arthritis with severe systemic manifestations, Severe systemic rheumatoid arthritis, Other connective tissue diseases (especially with active vasculitis), Used mainly in combination with other agents for treating a wide range of malignancies, including some leukaemias, Lymphomas and solid tumours. Endoxana, Cyclophosphamide. tab:®, Cap:® Adult : Child:
Indomethacin (Nonsteroidal anti-inflammatory drug - NSAID)Indications - Pain and moderate to severe inflammation in rheumatic disease and other musculoskeletal disorders, Acute gout, Dysmenorrhoea. Contraindications - Active peptic ulcer, severe heart failure, hypersensitivity to NSAIDs. Cautions - Elderly, history of GI bleeding, cardiovascular disease, hepatic/renal impairment. Avoid - Use in pregnancy (especially 3rd trimester), breastfeeding. Interactions - Anticoagulants, corticosteroids, SSRIs, ACE inhibitors, diuretics. Trade names - Indocid Cap:®, Indorem 25 Cap:® Adult: Initially 25–50 mg two to three times daily after food; max 200 mg/day. Child: 1–2 mg/kg/day in divided doses (specialist advice recommended).
Etonogestrel (Progestin contraceptive)Indications - Contraception, Contraception following abortion or miscarriage in the second trimester. Contraindications - Active thromboembolic disorders, liver tumors, hormone-sensitive cancers. Avoid - Gastro-intestinal ulcers and bleeding, Heart failure, Pregnancy, Breast feeding, Renal impairment. Cautions - Allergic disorders, Elderly, Epilepsy, Ischaemic heart disease, Parkinsonism, Ulcerative colitis, Hepatic impairment. Interactions - CYP3A4 inducers (e.g., rifampin, phenytoin), certain antivirals, St. John’s wort. Trade names - Implanon NXT Implant Adult: One implant (68 mg) subdermally; effective for 3 years. Child: Not recommended under 18 years without specialist advice.
Indoramin (Alpha-adrenergic blocker)Indications - Hypertension, Benign prostatic hyperplasia. Contraindications - Severe hepatic impairment, Hypotension. Avoid - Alcohol, Hepatic impairment, Renal impairment, Heart failure, Elderly, Parkinson’s disease. Cautions - Monitor blood pressure during initiation, Caution in patients with orthostatic hypotension. Interactions - May enhance the hypotensive effects of antihypertensives, alcohol, and CNS depressants. Trade names - tab:®, Cap:® Adult: 20–40 mg two to three times daily; max 150 mg daily in divided doses. Child: Not recommended.
Hyoscine Butylbromide (Anticholinergic, Antispasmodic)Indications - Symptomatic relief of GI and GU tract disorders, including acute spasm, irritable bowel syndrome, excessive respiratory secretions, and bowel colic. Contraindications - Myasthenia gravis, megacolon, glaucoma, prostatic hypertrophy, mechanical GI obstruction. Cautions - Elderly, patients with cardiovascular conditions, impaired renal/hepatic function. Avoid - Use in pregnancy unless clearly necessary; caution in tachycardia and lactation. Interactions - May enhance effects of other anticholinergics; reduced GI absorption of concurrent oral medications. Trade names - Spasmin-10 Tab:, Spasmocibalgin Tab: Adult - Oral: 10–20 mg 3–5 times daily; IM/IV: 20 mg, may repeat after 30 minutes if needed. Child - 6–12 years: Oral 10 mg 3× daily; IM/IV: 0.3–0.6 mg/kg up to 3× daily.
Trastuzumab emtansine, Antineoplastic(aaa)Indications - Early breast cancer. Herceptin 440mg powder for Infusion:® Adult : Child:
Bromelain(aaa)Indications - Digestive problems, Edema, Soft tissue inflammation, Trauma. KOTASE 40mg tab:® Adult : Child:
Trypsin(aaa)Indications - Wounds, Ulcers, Indigestion. KOTASE tab:®, Kimose tab:, Bromotase tab: Adult : Child:
Ethinylestradiol, Ethinyloestradiol(aaa)Indications - Short-term treatment of symptoms of oestrogen deficiency, Female hypogonadism, Menstrual disorders, Palliative treatment of prostate cancer. Marvelon-28 tab:®, Sophie 28 Sugar Coated tab:® Adult : Child:
Magnesium SulphateIndications - Constipation, Seriuos arrhythmias, Myocardial infarction, Eclampsia . Cautions - in Hepatic impairment, Renal impairment. tab:®, Cap:® Adult : Child:
Magnesium Hydroxide(Lexative, Purgative)Indications - Constipation. Avoid - Hepatic impairment, Renal impairment . Cautions - Elderly, Deblitated patients. CREAM OF MAGNESUM chewable tab:, B-Cal tab:, Trisil Plus Chewable tab:, Simecon Suspension 120ml, Digeva-F Gel, Centacid Suspension Adult : Child:
Magnesium Citrate(Laxative)Indications - Bowel evacuation before radiolological examination. Acute severe collitis, Ascites, Congestive heart failure, Intestinal obstruction Magnesium citrate tab:, Picoprep Powder for Oral Solution Adult : Child:
Rifampicin with Isoniazid(Antimycobacterial combination)Indications - Tuberculosis (continuation phase). Avoid - Hypersensitivity, Severe hepatic impairment. Cautions - Monitor liver function, Drug interactions, Administer on empty stomach. tab: Rifinah® 150/100, 300/150 Adult : 450/300 mg once daily (≤50 kg), 600/300 mg once daily (≥50 kg) Child: Refer to individual drug components
Penicillin VIndications - Respiratory tract infections, Scarlet fever, Ear infections, Skin infections, Gum infections, Mouth infections, Throat infections. Pen-V tab:. tab:®, Cap:® Adult : Child:
Olopatadine(aaa)Indications - Seasonal allergic conjunctivitis. Pataday Ophthalmic Solution:®, Patanol Eye Drops:® Adult : Child:
ChlorzoxazoneIndications - analgesic, Muscular spasm. Parazox uncoated tab: tab:®, Cap:® Adult : Child:
CilastatinIndications - Small cell carcinoma, Small cell cancer. Pantin 250mg Inj:, Pantin 500mg Inj:, Milanem Inj. Powder for Inj:®, Cap:® Adult : Child:
Imipenem + cilastatin(aaa)Indications - Abdominal sepsis, Advanced prostate cancer, Biliary tract infection, Bone infections, Joint infection, Brain abscess, Pseudomonas and other less sensitive organism, Life-threatening infection. Cautions - CNS disorders, Epilepsy. Pantin 250mg Inj:, Pantin 500mg Inj:, Milanem Powder for Inj:® Adult : Child:
Nikethamide(aaa)Indications - CNS depression, Respiratory depression, Asphyxia. Pai Nike Inj tab:®, Cap:® Adult : Child:
Clopidogrel(aaa)Indications - Anticoagulant, Ischaemic hart attack(in Aspirin hypersensitive patient), Acute myocardial infarction. Active bleeding, Surgery, Pregnancy, Breast feeding, Hepatic impairment, Renal impairment . Clopid, Clovix, Clopilet, Plagril 75 tab:, Res-Q tab: 75mg, Plagerine Film Coated tab: Adult : Child:
ORAL ANTICOAGULANTS Warfarin Sodium, Acenocoumarol, Phenindione, Protamine Sulphate, Pratamine Sulphate.
Heparin(aaa)Indications - Analgesia, Deep vein thrombosis, Unstable angina, Thrombosis in pregnancy, Prophylaxis of thrombosis, Pulmonary embolism. Vaxcel Heparin Sodium tab:®, Cap:® Adult : Child:
CertoparinIndications - Prophylaxis of deep vein thrombosis, Unstable angina, Thrombosis in pregnancy, Pulmonary embolism. Vaxcel Heparin Sodium tab:®, Cap:® Adult : Child:
VogliboseIndications - diabetes mellitus. Voglibose delays the absorption of glucose. Voglibose 0.3mg tab:. tab:®, Cap:® Adult : Child:
Riluzole(Neuroprotective drug)Indications - To extend life in patients with amyotrophic lateral sclerosis. tab:®, Cap:® (Initiate by specialist experienced in the management of motor neurone disease) Adult : Child:
Piracetam, CNS stimulant(aaa)Indications - Adjunctive treatment of cortical myoclonus. P-cetam tab:®, Piracetam 400mg tab:®, Nootropil 3g/15ml Inj:®, Lilonton Inj:® Adult : Child:
Primidone, Antiepileptic(aaa)Indications - Epilepsy, Essential tremor. Avoid - Acute porphyrias. Cautions - Children, Debilitated, Elderly, History of alkohol abuse, Respiratory depression, Hepatic impairment, Renal impairment , Pregnancy tab:®, Cap:® Adult : Child:
Propranolol Hcl(Beta-blocker)Indications - Thyrotoxicosis(adjunct), Thyrotoxic crisis, Hypertension, Angina, Prophylaxis of variceal bleeding in portal hypertension, Hypertropic cardiomyopathy, Migraine prophylaxis, Hypertension, Thyrotoxicosis, Anxiety, tachycardia, Anxiety with sweating and tremor, Arrhythmia. Cautions - in Hepatic impairment, Renal impairment . CARDENOL tab:®, Polar 10 tab:®, Polar 40 tab:®, Cap:® Adult : Child:
Haloperidol(First-generation antipsychotics)Indications - Prophylaxis of post-operative nausea and vomiting, Acute delirium, Moderate to severe manic episodes associated with bipolar I disorder, Persistent aggression, Restlessness and confusion in palliative care. tab:®, Cap:® Adult : Child:
Tetrabenazine, Monoamine depleting drug(aaa)Indications - Movement disorders due to Huntington’s chorea, Hemiballismus, Senile chorea and related neurological conditions. tab:®, Cap:® Adult : Child:
Timolol Maleate(aaa)Indications - Reduction of intra-ocular pressure in primary open-angle glaucoma. Breast feeding, Renal impairment. Timolol Maleate USP 0.5% Eye Drops:®, Timolol Eye Drops:® Adult : Child:
Sodium Citrate(aaa)Indications - Bladder washouts, Constipation, Discomfort in mild urinary tract infections, Constipation. Cautions - in renal impairment, Cardiac diseases, Pregnancy, Elderly KATARIA powder pack Adult : Child:
Sodium picosulfate, Sodium picosulphate(Lexative, Purgative)Indications - Constipation Intestinal obstruction, Undiagnosed abdomina pain tab:®, Cap:® Adult : Child:
Lansoprazole( Proton pump inhibitor (PPI))Indications - Helicobacter pylori eradication(with amoxicillin, Clarithromycin or amoxicillin metronidazole), Duodenal ulcer, Gastric ulcer, NSAID-associated ulver, Gastro-oesophageal reflux disease Avoid - Pregnancy, Breast feeding. Cautions - Hepatic impairment. tab:®, Cap:® Adult : Child:
Prostaglandin(aaa)Indications - lnduce abortion, lnduce labor, lnduce uterine contraction. Misoprostol tab:®, Cap:® Adult : Child:
Pantoprazole(Proton pump inhibitors (PPIs)Indications - Helicobacter pylori eradication(with amoxicillin, Clarithromycin or amoxicillin metronidazole), Duodenal ulcer, Gastric ulcer, NSAID-associated ulcer, Acid reflux diseas. Avoid - Pregnancy, Breast feeding. Cautions - Only 20mg/daily in Hepatic impairment, Renal impairment . Pantozan-20 tab:, PanPure tab:, Pantora-40 tab:, Panzo tab Adult : Child:
Ranitidine(aaa)Indications - Benign gastric and duodenal uleration, Chronic dyspepsia, NSAID-associated ulceration, Gastro-oesophageal reflux, Prophylaxis of stress ulceration. Avoid - Pregnancy, Half dose in adult. GASOUT 150 tab:®, Rantac 150 tab:, Xantid Inj: Adult : Child:
MOTILITY STIMULANTS Metoclopramide, Domperidone.
Dicyclomine(Anticholinergics drugs, Muscarinic Antagonist)Indications - Infantile colic, Irritable bowl syndrome, Urinary incontinence, Symptomatic relief of GI-disorders, Abdominal pain. Kremil-S tab:, Kremil-S tab:, Berclomin tab:. Adult : Child:
ANTACIDS Aluminium Hydroxide, Magnisium Carbonate, Magnisium Trisilicate, Omeprazole, Pantoprazole, Ranitidine, Simethicone Adult : Child:
Aluminium Hydroxide(Antacid)Indications - Chronic diarrhoea, Hyperparathyroidism, Hyperphosphataemia in renal failure, Peptic ulcer. Avoid - Hypophosphataemia. Fourrts 250mg tab:®, Siloxogene 250mg tab:®, Kremil-S tab:, Magnomint tab:, Trisil Plus Chewable tab:, Simecon Suspension. Adult : Child:
Aluminium acetate(aaa)Indications - Inflammation in otitis externa. Ear-drop:® Adult : Child:
Domperidone maleate(Antiemetic, Antinauseant, Dopamine receptor antagonist)Indications - Acute nausea, Acute vomiting, Gastric distension pain, Heart burn, Lactation. Mirax-M tab:®, Gasidone tab:®, Vertidom tab:, Cosy suspension. Adult : Child:
CetrizineIndications - fever, Conjunctivitis and some skin reactions and reactions to bites and stings. It relieves watery eyes, Runny nose, Sneezing and itching. Hicet-AX tab:, TriZin tab: Adult : Child:
Cyproheptadine HCl(Antihistamine)Indications - Symptomatic relief of allergy such as hay fever, urtiarias, Pruritus. Avoid - Acute porphyrias, Pregnancy, Breast feeding, Cautions - Epilepsy, Prostatic hypertrophy Pyloroduodenal obstruction, Urinary retension. Cyproheptadine tab:®, Becoactin syrup(100 ml.) Adult : Child:
Loratadine(Antihistamine)Indications - Symptomatic relief of allergy such as chronic idiopathic urticaria, Hay fever. Avoid - Pregnancy, Breast feedingCautions - Hepatic impairment. Side effects - drowsiness, nervousness in children. Lorascot 10 mg tab:®, Loratimed 10 mg tab:®, Lorinol-10 tab:®, Loritab tab:® Adult : 10mg once daily. Child: 5-10mg once daily.
Desloratadine, (Antihistamine)Indications - Symptomatic relief of allergy such as allergic rhinitis, Urticaria, Chronic idiopathic urticaria. Aviod(Pregnancy, Breast feeding)Cautions - Renal impairment. DAZIT tab:, D-LOR tab:, Neo Loridin tab: Adult : Child:
Fexofenadine Hcl, (Antihistamine)Indications - Symptomatic relief of Chronic idiopathic urticaria, Seasonal allergic rhinitis. Avoid - Pregnancy, Breast feeding. Maxallergy 120 tab:, Fexodin 120 tab: Adult : Child:
Levocetirizine DiHcl(aaa)Indications - Symptomatic relief of allergy such as Hay fever, urticaria, Rhinitis. Avoid - Acute porphyrias, Pregnancy, Breast feeding Cautions - Renal impairment) Levorex tab:, Lecet-5 tab:, Welbeen-L tab:, LCZINE (2.5 mg) 5-ml Syrup:, Lazine-zicet 5 tab: Adult : Child:
Bambuterol Hcl, Adrenoceptor agonist(aaa)Indications - Asthma, Reversible airway obstruction, Oral drug. Avoid - Hepatic impairmentPregnancy, Breast feeding, Half dose in Renal impairment. tab:®, Cap:® Adult : Child:
Salmeterol( Long-term regular bronchodilator)Indications - Reversible airways obstruction i, Nocturnal asthma, Prevention of exercise-induced bronchospasm, Chronic obstructive pulmonary diseases. Avoid - in sever liver cirrhosis. SEROFLO-250 tab:®, Aroflo-125 tab:, Combiwave SF, Inhalation powder. Adult : Child:
Formoterol Fumarate, Eformoterol fumarate(Long-term bronchodilator)Indications - Chronic asthma, Chronic obstructive pulmonary disease, Brochospasm. Budesonide + Formoterol, Inhalation powder:®, Cap:® Adult : Child:
Aminophylline (Bronchodilator, Methylxanthine derivative)Indications - Severe acute asthma, Chronic obstructive pulmonary disease (COPD), Reversible airway obstruction, Apnea of prematurity. Contraindications - Hypersensitivity to theophylline or ethylenediamine, Porphyria. Cautions - Cardiac arrhythmias, Epilepsy, Hyperthyroidism, Peptic ulcers, Hepatic impairment, Elderly. Trade names - Tab: Amino®, Phyllocontin® Inj: Nuelin®, Minophylline® Adult: 225–450 mg orally twice daily, or IV infusion adjusted based on serum theophylline levels. Child: Loading IV 5–6 mg/kg, then maintenance 0.5–1 mg/kg/hr IV infusion (adjust per serum levels).
Metadoxine(Antioxidant)Metadoxine is a pyridoxine-pyrrolidone carboxylate compound, it is a hepatoprotective agent.Indications - alcohol-related liver diseases. ALCOLIV 500mg tab:® Adult : Child:
Teprenone(Gastroprotective agents)Indications - gastric ulcers. Gastric mucosal damage caused by stress, alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs). Selbex 50mg tab:® Adult : Child:
Salbutamol(BETA2- Adrenoceptor agonist)Indications - Acute bronchospasm, Acute asthma, Reversible obstructive airway disease, Prophylaxis of allergen- or exercise-induced bronchospasm, Uncomplicated premature labour (between 22 and 37 weeks of gestation). Avoid - Cardiac disease, Eclampsia, Intra-uterine infection. Cautions - Arrhythmia, Elderly, Epilepsy, Fever, Hypertension, Hyperthyroidism, Peptic ulcer, Hepatic impairment, Breast feeding, Pregnancy. Ventolin inhaler, Sulflo Inhaler, Salbuvent-2 tab:, Salbutamol Syrup 60ml. (Under specialist supervision in hospital) Adult : Child:
Albuterol SulfateIndications - Bronchitis, Asthma, Emphysema, Bronchospasm, Premature Labour) tab:®, Cap:® Adult : Child:
Levosalbutamol(aaa)Indications - Bronchospasm, Obstructive airway disease, Asthma. Brodil Levo Tab: tab:®, Cap:® Adult : Child:
Dicycloverine HCl (Antispasmodic)Indications - Symptomatic relief of GI disorders with smooth muscle spasm, irritable bowel syndrome. Contraindications - Obstructive uropathy, paralytic ileus, severe ulcerative colitis, reflux esophagitis, myasthenia gravis, glaucoma. Cautions - Elderly patients, renal or hepatic impairment. Avoid - Use in breastfeeding, infants under 6 months. Interactions - Potentiates anticholinergic effects with antihistamines, tricyclic antidepressants, and MAO inhibitors. Trade names - Coligon-O tab:, Dicyclomine Cap: Adult - 10–20 mg orally 3–4 times daily before meals. Child - 6 months–2 years: 5–10 mg up to 4× daily; 2–12 years: 10 mg up to 4× daily.
MagaldrateIndications - Heartburn, Indigestion, Hyperphosphatemia, Magnesium deficiency, Gastric ulcers, Duodenal ulcers, Gastroesophageal reflux disease. Coligon-O tab:®, Cap:® Adult : Child:
Phytonadione(aaa)Indications - Anticoagulant rodenticide poisoning) tab:®, Cap:® Adult : Child:
Succimer(aaa)Indications - Arsenic poisoning, Mercury poisoning, Lead poisoning. tab:®, Cap:® Adult : Child:
Dimercaprol(aaa)Indications - Ethylene glycol poisoning, Methanol poisoning, Arsenic poisoning, Bismuth poisoning, Gold poisoning, Mercury poisoning, Thallium poisoning, Lead poisoning. BAL In Oil (Pro. Use adjunct with Sodium Calcium Edetate in Lead poisoning. tab:®, Cap:® Adult : Child:
Activated charcoal, Poisoning(aaa)Indications - Reduction of absorption of poisons in the gastro-intestinal system, Active elimination of poisons, Accelerated elimination of teriflunomide and leflunomide. Charcdote, Liqui-Char Cap:®, Actidose-Aqua Cap:® Adult : Child:
N-Acetylcysteine, Occular lubricant(aaa)Indications - Tear deficiency, Impaired or abnormal mucus production, Acetaminophen poisoning. tab:®, Cap:® Adult : Child:
Ammonium molybdate and tetrathiomolybdate(aaa)Indications - Copper poisoning. Dilute in 100-250 ml saline slow IV Dilute in 100-250 ml saline slow IV. tab:®, Cap:® Adult : Child:
Ertugliflozin (SGLT2 Inhibitor / Blood Glucose Lowering Drug)Indications - Type 2 diabetes mellitus as monotherapy or in combination with other antidiabetic agents to improve glycemic control in adults; also reduces the risk of cardiovascular events in patients with type 2 diabetes and established cardiovascular disease. Contraindications - Avoid - Use in pregnancy and breastfeeding, in patients with a history of recurrent urinary or genital tract infections, or during volume depletion. Cautions - Elderly, renal impairment, hypotension, cardiovascular disease, dehydration, increased risk of genital infections, risk of diabetic ketoacidosis even with normal blood glucose. Drug interactions - Diuretics (hypotension), insulin or insulin secretagogues (hypoglycemia), UGT inducers like rifampicin (reduced efficacy), digoxin (monitor levels). Trade Names - Tab: Steglujan® (ertugliflozin + sitagliptin), Segluromet® (ertugliflozin + metformin), Steglatro® 5 mg, 15 mg Adult: Starting dose 5 mg once daily; may increase to 15 mg once daily based on response and renal function. Child: Not recommended in individuals under 18 years (safety and efficacy not established).
Viper Antivenon(aaa)Indications - Snake viper bites. slow IV. tab:®, Cap:® Adult : Child:
Calcitonin, Salcatonin, Calcium regulating drug(aaa)Indications - Hypercalcaemia of malignancy, Paget’s disease of bone, Prevention of acute bone loss due to sudden immobility. Forcaltonin inj:® Adult : Child:
Naloxone Hcl(Poisoning, Antidote)Indications - Narcotic Opioid toxicity, postoperative respiratory depression. Evzio inj:®, Narcan inj:®, Cap:® Adult : Child:
Tolazoline(aaa)Indications - Reversal of xylaxine) tab:®, Cap:® Adult : Child:
Yohimbine(aaa)Indications - Reversal of potentially amitraz, Reversal of xylazine) tab:®, Cap:® Adult : Child:
Atipamezole HClIndications - Anaesthesia quick recovery, Reversal of medetomidine, Reversal of amitraz, Reversal of xylazine. Antisedan®- IM tab:®, Cap:® Adult : Child:
Fomepizole(aaa)Indications - Ethylene glycol poisoning) tab:®, Cap:® Adult : Child:
Desferrioxamine mesilate(aaa)Indications - Iron salt poisoning, Aluminium overload in dialysis patients, Chronic iron overload. Desferal Inj: -I.V. Cautions - Pregnancy, Breast feeding, Renal impairment. tab:®, Cap:® Adult : Child:
Dicobalt edetate(Poisoning, Antidote)Indications - Cyanide poisoning. Slow I.V and follow by Glucose infusion tab:®, Cap:® Adult : Child:
Sodium Nitrite(Poisoning, Antidote)Indications - Cyanide poisoning. Nithiodote (Pro. Use in conjunction with Sodium Thiosulphate. tab:®, Cap:® Adult : Child:
Sodium Thiosulfate(Poisoning, Antidote)Indications - Cyanide poisoning, Skin diseases, Arsenic poisoning. Nithiodote (Pro. Use in conjunction with Sodium Nitrite. tab:®, Cap:® Adult : Child:
Sodium Calcium Edetate, Sodium CalciumedetateIndications - Lead poisoning. Cautions - in Renal impairment. tab:®, Cap:® Adult : Child:
Calcium-EDTAIndications - Zinc poisoning, Lead poisoning) tab:®, Cap:® Adult : Child:
Epinephrine-Adrenalin(aaa)Indications - Anaphylaxis Reactions. tab:®, Cap:® Adult : Child:
Vitamin K1(aaa)Indications - Anticoagulant rodenticides Poisoning) tab:®, Cap:® Adult : Child:
Copper glycinateIndications - Molybdenum poisoning) tab:®, Cap:® Adult : Child:
Ethanol(aaa)Indications - Ethylene Glycol poisoning. tab:®, Cap:® Adult : Child:
Fomepizole(aaa)Indications - Ethylene Glycol poisoning. tab:®, Cap:® Adult : Child:
Methylene blueIndications - Phenol poisoning, Iron poisoning, Chlorate poisoning, Nitrate poisoning. Provayblue (Pro ) tab:®, Cap:® Adult : Child:
Pralidoxime Chloride(Poisoning, Antidote)Indications - Organophosphorus and nerve agent poisoning. Protopam Chloride, ATNAA (Pro), Pralidoxime mesilate inj: Use adjunct with Atropine Cautions - in Renal impairment and Myasthenia Gravis. tab:®, Cap:® Adult : Child:
Dexamfetamine sulfate(CNS Stimulant)Indications - Narcolepsy, DEficit hyperactivity disorder. Avoid - Cardiovascular disease, Pregnancy, Breast feeding, Hyperthyroidism, Hypertension. Cautions - Bipolar disorder, Anorexia, Renal impairment. tab:®, Cap:® Adult : Child:
Lisdexamfetamine mesilate, CNS Stimulant(aaa)Indications - Hyperactivity disorder. Avoid - Hyperthyroidism, Hypertension, Cardiovascular disease, Breast feeding. Cautions - Bipolar disorder, History of cardiovascular disease. tab:®, Cap:® Adult : Child:
Guanfacine, Sympathomimetic(aaa)Indications - Hyperactivity disorder in children. Cautions - Hypokalaemia, Bradycardia, History of cardiovascular disease. tab:®, Cap:® Adult : Child:
Sacubitril+Valsartan(aaa)Indications - Chronic heartfailure. tab:®, Cap:® Adult : Child:
Milrinone(aaa)Indications - Severe congestive heart failure, Acute heart failure. tab:®, Cap:® Adult : Child:
Colesevelam Hcl(aaa)Indications - Primary hypercholesterolaemia. Avoid - Biliary obstruction, Bowel obstruction. tab:®, Cap:® Adult : Child:
Colestipol Hcl(aaa)Indications - Hyperlipidaemia. tab:®, Cap:® Adult : Child:
Bezafibrate(aaa)Indications - Hyperlipidaemia, Hypertriglyceridaemia. Avoid - Gall bladder disease . hypoalbuminaemia . nephrotic syndrome . photosensitivity to fibrates. tab:®, Cap:® Adult : Child:
Ciprofibrate(aaa)Indications - Hyperlipidaemia(Adjunct to diet. Cautions - Correct hypothyroidism before initiating treatment. tab:®, Cap:® Adult : Child:
Fenofibrate(serum triglyceride reducer)Indications - Hyperlipidaemia(Adjunct to diet) in severe hypertriglyridaemia if station contraindicated or not tolerated. Adjunct to station in mixed hyperlipidemia. Contraindications - Gall bladder disease, pancreatitis, photosensitivity to ketoprofen. Cautions - Correct hypothyroidism before initiating treatment. Side effects - Abdominal pain, diarrhea, flatulence, nausea, vomiting. tab:® cap:® Adult : if capsule form, 200mg daily, then increased if necessary to 267mg daily. if tablet form, 160mg daily.
Acipimox(Lipid modifying drug)Indications - Hyperlipidaemia of type 2b and type 4 who have not respond adequately to other lipid-regulating drugs such as a statin or fibrate, and lifestyle changes (including diet, exercise and weight reduction) Contraindications - Peptic ulcers. Avoid - pregnancy, breastfeeding, renal impairment. Side effects - Asthenia, gastrointestinal disconfort, headache, skin reactions, vasodilation. Olbetam Cap:® Adult : Adjunct to diet. Child:
Nicotinic acid(aaa)Indications - Adjunct to statin in dyslipidaemia. tab:®, Cap:® Adult : Child:
Atorvastatin (HMG-CoA Reductase Inhibitor)Indications - Primary hypercholesterolaemia, mixed dyslipidaemia, homozygous familial hypercholesterolaemia, prevention of cardiovascular events in high-risk patients. Contraindications - Active liver disease, persistent serum-transaminase elevation, pregnancy, breastfeeding. Cautions - Haemorrhagic stroke history, renal impairment, hypothyroidism, heavy alcohol use, elderly, myopathy risk factors. Avoid - Use during breastfeeding; avoid excessive grapefruit-juice intake (increased drug levels). Interactions - Potent CYP3A4 inhibitors (cyclosporine, clarithromycin, itraconazole, protease inhibitors) increased atorvastatin levels; gemfibrozil increased myopathy risk; warfarin (monitor INR). Trade names - Lipitor Tab:, Atorlip Tab:, Sortis Tab:, Torvast Cap: Adult: 10–80 mg once daily, dose adjusted to lipid targets. Child: 10–17 yrs: 10 mg once daily (max 20 mg/day) under specialist supervision.
Fluvastatin(aaa)Indications - Adjunct to diet in primary hypercholesterolaemia, Hyperlipidaemia, Prevention of coronary events. tab:®, Cap:® Adult : Child:
Pravastatin sodium(aaa)Indications - Adjunct to diet in primary hypercholesterolaemia, Hyperlipidaemia, Prevention of cardiovascular events after myocardial infarction. tab:®, Cap:® Adult : Child:
Rosuvastatin (HMG-CoA Reductase Inhibitor)Indications - Primary hypercholesterolaemia, familial hypercholesterolaemia (heterozygous and homozygous), mixed dyslipidaemia, prevention of cardiovascular events in high-risk patients. Contraindications - Active liver disease, unexplained persistent elevations in serum transaminases, pregnancy, breastfeeding. Caution - Hepatic impairment, renal impairment, hypothyroidism, elderly, history of muscle disorders. Avoid - During pregnancy and lactation. Interactions - Cyclosporine, gemfibrozil, protease inhibitors, warfarin, antacids. Trade names - ROSWI 10 tab®, Rozatin-10 tab®, Rosave 10 tab®, Rosave 20 tab® Adult: Start with 5–10 mg once daily, max 40 mg daily based on response and tolerability. Child: ≥10 years: Initially 5 mg once daily, may titrate up to 20 mg daily under supervision.
Simvastatin(aaa)Indications - Primary hypercholesterolaemia, Hyperlipidaemia in patients who have not respond to diet, Familial hypercholesterolaemia in patients who have not respond to diet, Prevention of cardiovascular events in patients with atherosclerotic cardiovascular disease or Diabetes mellitus. tab:®, Cap:® Adult : Child:
Alirocumab(PCSK9 inhibitor)Indications - Primary hypercholesterolaemia, Hyperlipidaemia in patients who have not responded to diet, Familial hypercholesterolaemia. Contraindications - Hypersensitivity to alirocumab or any excipients. Cautions - Liver impairment, Recent stroke or cardiovascular events, Elderly. Avoid - Use in pregnancy and lactation unless clearly needed. Interactions - May enhance effects of other lipid-lowering agents; monitor statin use. Trade names - Praluent Pre-filled Pen for SC injection Adult: 75 mg subcutaneously once every 2 weeks; may be increased to 150 mg based on LDL response. Child: Safety and efficacy not established.
Inclisiran(siRNA PCSK9 inhibitor)Indications - Primary hypercholesterolaemia, Hyperlipidaemia in patients who have not responded to diet, Familial hypercholesterolaemia. Contraindications - Hypersensitivity to Inclisiran or any excipients. Cautions - Severe hepatic impairment, Immunocompromised patients, Recent cardiovascular events. Avoid - Use during pregnancy and breastfeeding unless clearly necessary. Interactions - No known significant interactions; monitor when used with statins. Trade names - Leqvio Prefilled Syringe for SC injection Adult: 284 mg SC initially, then at 3 months, then every 6 months. Child: Safety and efficacy not established.
Evolocumab (PCSK9 Inhibitor)Indications - Primary hypercholesterolaemia (heterozygous familial and non-familial), mixed dyslipidaemia, homozygous familial hypercholesterolaemia as an adjunct to diet and maximally tolerated statin therapy. Contraindications - Hypersensitivity to Evolocumab or any component of the formulation. Caution - Patients with severe renal or hepatic impairment, monitor lipid levels regularly. Avoid - Use in pregnancy and breastfeeding unless clearly necessary. Interactions - No significant drug interactions reported; can be used with statins. Trade names - Repatha Prefilled Syringe® (Subcutaneous injection) Adult: 140 mg subcutaneously every 2 weeks or 420 mg once monthly. Child: ≥10 years (with familial hypercholesterolaemia): Dose based on weight; consult specialist.
Lomitapide(aaa)Indications - Adjunct to diet in familial hypercholesterolaemia(By expert supervision. under expart supervision tab:®, Cap:® Adult : Child:
Cangrelor(aaa)Indications - Thrombotic cardiovascular events in patients with coronary artery disease(with aspirin). tab:®, Cap:® Adult : Child:
Eptifibatide (Antiplatelet agent – Glycoprotein IIb/IIIa receptor antagonist) Indications - Prevention of early myocardial infarction in patients with unstable angina or non–Q-wave myocardial infarction undergoing percutaneous coronary intervention (PCI). Contraindications - Active internal bleeding, History of stroke within 30 days or any history of hemorrhagic stroke, Severe hypertension, Thrombocytopenia, Major surgery or trauma within past 6 weeks, Severe renal impairment. Cautions - Recent bleeding disorders, Use with anticoagulants or other antiplatelets, Advanced age, Low body weight. Trade Names - Integrilin® (Injection: Eptifibatide 0.75 mg/mL, 2 mg/mL) (Specialist use only) Adult: Intravenous bolus of 180 mcg/kg followed by continuous infusion of 2 mcg/kg/min for up to 72 hours. Child: Not recommended (Safety and efficacy not established).
Tirofiban (Antiplatelet agent – Glycoprotein IIb/IIIa receptor antagonist) Indications - In combination with Aspirin, Heparin, and Clopidogrel for the prevention of early myocardial infarction in patients with unstable angina or non–Q-wave myocardial infarction, including those undergoing percutaneous coronary intervention (PCI). Contraindications - Active internal bleeding, History of hemorrhagic stroke or stroke within 30 days, Severe hypertension, Thrombocytopenia, Major trauma or surgery within previous 6 weeks, Severe renal failure not undergoing dialysis. Cautions - Risk of bleeding, Recent bleeding disorders, Use with anticoagulants or thrombolytics, Hepatic impairment, Low body weight, Elderly patients. Trade Names - Aggrastat® (Injection: Tirofiban 0.05 mg/mL, 0.25 mg/mL) (Specialist use only) Adult: Initial IV bolus of 25 mcg/kg over 3 minutes, followed by continuous infusion of 0.15 mcg/kg/min for up to 18–24 hours. Child: Not recommended (Safety and efficacy not established).
Ranolazine (Antianginal agent)Indications - Adjunctive therapy in the treatment of chronic stable angina in patients inadequately controlled with other antianginal drugs. Contraindications - Hepatic impairment, QT prolongation, concurrent use with potent CYP3A inhibitors (e.g., ketoconazole, clarithromycin). Caution - Elderly, renal impairment, low body weight, history of QT interval prolongation. Avoid - Pregnancy and breastfeeding. Interactions - CYP3A inhibitors (increased ranolazine levels), CYP3A inducers (decreased efficacy), digoxin, simvastatin (increasedtoxicity). Trade names - Ranozex tab:®, Ranexa tab:®, Rancad tab:® Adult: Initially 500 mg twice daily; may be increased to 1000 mg twice daily based on clinical response and tolerance. Child: Safety and efficacy not established; not recommended.
Ivabradine(aaa)Indications - Angina(If normal sinus rhythm), Chronic heart failure. tab:®, Cap:® Adult : Child:
Ticagrelor, Antithrombotic(aaa)Indications - Antithrombotic, Prevention of atherothrombotic events, Acute coronary syndrome(in combination with aspirin. tab:®, Cap:® Adult : Child:
Alteplase, Fibrinolytic(aaa)Indications - Antithrombotic, Acute myocardial infarction, Pulmonary embolism. tab:®, Cap:® Adult : Child:
Tenecteplase, Fibrinolytic(aaa)Indications - Acute myocardial infarction. tab:®, Cap:® Adult : Child:
Isosorbide Mononitrate (Nitrate vasodilator)Indications - Prophylaxis of angina pectoris, Adjunct in congestive heart failure. Contraindications - Acute myocardial infarction with low filling pressures, Severe hypotension, Constrictive pericarditis. Avoid - Concomitant use with PDE5 inhibitors (e.g., sildenafil), Severe anemia. Cautions - Hypotension, Aortic or mitral valve stenosis, Glaucoma, Head trauma. Interactions - Enhanced hypotensive effect with antihypertensives, alcohol, and phosphodiesterase inhibitors. Trade names - Monotrate® tab:, Ismo® tab:, Isordil® Cap: Adult: 20–40 mg once or twice daily (modified-release may be used). Child: Not recommended.
Triamterene(aaa)Indications - Oedema. Avoid - Breast feeding, Renal impairment, Anuria, Hyperkalaemia. tab:®, Cap:® Adult : Child:
Chlortalidone, Chlorthalidone, Diuretic(aaa)Indications - Thiazide diuretic, Ascites due to cirrhosis(under close supervision), Oedema due to nephrotic syndrome, Hypertension, Mild to moderate chronic heart failure, Nephrogenic diabetes insipidus, Partial pituitary diabetes insipidus. tab:®, Cap:® Adult : Child:
Co-triamterzide(aaa)Indications - Hypertension, Oedema. tab:®, Cap:® Adult : Child:
Xipamide(aaa)Indications - Oedema, Hypertension. Oral 40 mg daily Cautions - Acute porphyrias. tab:®, Cap:® Adult : Child:
Dasabuvir(antiviral)Indications - Chronic hepatitis C infection of genotype (1), with other antiviral drugs. tab:®, Cap:® Adult : Child:
Cidofovir(aaa)Indications - Cytomegalovirus retinitis in AIDs patients Cautions - Diabetes melliyus. tab:®, Cap:® (Specialist use ony) Adult : Child:
Ganciclvir(aaa)Indications - Prevention and treatment of Cytomegalovirus disease. tab:®, Cap:® Adult : Child:
Valganciclovir(aaa)Indications - Prevention of Cytomegalovirus disease, Prevention of Cytomegalovirus retinitis in AIDS patients. Oral 900 mg tab: daily for 100 days. Adult : Child:
Foscarnet sodium(aaa)Indications - Cytomegalovirus disease, Mucocutaneous herpes simplex virus infections unresponsive to aciclovir. 40 mg/kg every 8 hours(IV) tab:®, Cap:® Adult : Child:
Letermovir(aaa)Indications - Prevention of Cytomegalovirus. Oral 480 mg once daily for 100 days Avoid - Pregnancy, Breast feeding. Cautions - Hepatic impairment) tab:®, Cap:® (Initiatd by a specialist) Adult : Child:
Enfuvirtide(Antiviral)Indications - HIV infection resistant to other inhibitors, Use in combination with other antiretroviral drugs) Fuzeon inj:® Adult : Child:
Dolutegravir(Antiviral)Indications - HIV infection in combination with other antivirals. Oral 50 mg twice daily. tab:®, Cap:® Adult : Child:
Elvitegravir(Antiviral)Indications - HIV-1 infection. Cautions - Elderly tab:®, Cap:®(150 mg PO once daily) (Specialist use only) Adult : Child:
Raltegravir(Antiviral)Indications - HIV infection Oral 400 mg twice daily. (Initiate by a specialist) Adult : Child:
Doravirine(Antiviral)Indications - HIV infection in combination with other antivirals. Oral 100 mg once daily, Cap:® (Initiate by a specialist) Adult : Child:
Efavirenz(Antiviral)Indications - HIV infection stabillised on antirtetroviral therapy for more than 3month. Oral 600 mg once daily Avoid - Renal impairment. Cautions - Hepaticimpairment, Eldly. tab:®, Cap:® Adult : Child:
Etravirine(Antiviral)Indications - HIV infection resistant to other inhibitors. Oral 200 mg twice daily Avoid - Acute porphyrias. tab:®, Cap:® Adult : Child:
Rilpivirine(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs. Oral 25 mg once daily Avoid - Acute porphyrias. tab:®, Cap:® Adult : Child:
Abacavir(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs. Oral 600 mg daily in 1–2 divided doses. tab:®, Cap:® Adult : Child:
Bictegravir(Antiretroviral, Integrase inhibitor) Indications - HIV-1 infection, in combination with other antiretroviral agents. Contraindications - Hypersensitivity to bictegravir or any component of the formulation, Severe hepatic impairment. Cautions - Hepatitis B or C coinfection, Renal impairment, Depression history. Avoid - Use with strong enzyme inducers like rifampicin, carbamazepine, or St. John’s wort. Interactions - May interact with antacids (decreased absorption), rifampicin, anticonvulsants, metformin (increased levels). Trade names - Biktarvy® (with emtricitabine and tenofovir alafenamide) Adult: 50 mg once daily (typically given as fixed-dose combination). Child: Weighing ≥25 kg: same as adult dose (fixed-dose combination);
Emtricitabine(Antiretroviral, NRTI) Indications - HIV-1 infection (in combination with other antiretroviral agents), Hepatitis B virus infection (off-label). Contraindications - Hypersensitivity to emtricitabine or any component of the formulation. Cautions - Renal impairment, Hepatitis B coinfection (risk of severe exacerbation upon discontinuation), Elderly. Avoid - Monotherapy in HIV treatment. Interactions - Caution with other nephrotoxic agents (e.g., aminoglycosides), Co-administration with lamivudine not recommended due to similar resistance profile. Trade names - Emtriva®, part of combinations like Truvada®, Descovy®, Biktarvy® Adult: 200 mg orally once daily. Child: 3 months to 17 years: 6 mg/kg (max 240 mg) once daily; Fixed-dose combination dosing varies by weight.
Didanosine(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs. Oral 250 mg daily in 1–2 divided doses. tab:®, Cap:® Adult : Child:
Stavudine(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs when no sutabl alternative available. Oral 40 mg every 12 hours Cautions - Excessive alcohol intake, History of pancreatitis, History of peripheral neuropathy. Zerit cap:®, Stavir cap:® Adult : Child:
Tenofovir disoproxil (Antiviral)Indications - HIV infection in combination with other antiretroviral drugs, Chronic hepatitis-B infection. Contraindications - Hypersensitivity to tenofovir or any component of the formulation. Cautions - Hepatic disease, Renal impairment, Osteoporosis risk, Co-infection with hepatitis C or D. Avoid - Concomitant use with nephrotoxic drugs without close monitoring. Interactions - Increased risk of nephrotoxicity with aminoglycosides, NSAIDs; may interact with didanosine, atazanavir. Trade names - Tenofovir (TAF) tab:®, Viread®, Tenvir® Adult: 300 mg once daily. Child: 8–12 mg/kg (based on body weight and formulation) once daily, adjusted for age and renal function.
Atazanavir(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs. tab:®, Cap:® Adult : Child:
Darunavir(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs in patients prevously treated with antiretroviral therapy. Oral 600 mg twice daily. tab:®, Cap:® Adult : Child:
Fosamprenavir (Protease Inhibitor / Antiviral)Indications - Treatment of HIV-1 infection in combination with other antiretroviral agents. Contraindications - Severe hepatic impairment, hypersensitivity to fosamprenavir or amprenavir, concurrent use with drugs highly dependent on CYP3A4 (e.g., midazolam, triazolam). Avoid - Monotherapy, use in pregnancy unless no alternatives, use with statins metabolized by CYP3A4 (e.g., simvastatin, lovastatin). Cautions - Hepatic disease, diabetes, hemophilia, lipid disorders, sulfonamide allergy, risk of Stevens-Johnson syndrome. Drug interactions - Significant interactions via CYP3A4 (e.g., ritonavir used as booster), avoid with rifampicin, ergot derivatives, and certain anticonvulsants. Trade names - Tab: Lexiva®, Oral suspension: Telzir® Adult: 1400 mg once daily with ritonavir 100–200 mg, or 700 mg twice daily with ritonavir 100 mg twice daily. Child: Dose based on body weight and age; used under specialist supervision.
Saquinavir(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs in patients prevously treated with antiretroviral therapy. Oral 500 mg every 12 hours for 7 days Avoid - Bradycardia, Heart failure, History of symptomatic arrhythmias. tab:®, Cap:® Adult : Child:
Tipranavir(Antiviral)Indications - HIV infection in combination with other antiretroviral drugs in patients prevously treated with antiretroviral therapy. Oral 500 mg twice daily. tab:®, Cap:® Adult : Child:
Maraviroc(Antiviral)Indications - CCR5-tropic HIV infection in combination with other antiretroviral drugs in patients prevously treated with antiretroviral therapy. Oral 300 mg twice daily. tab:®, Cap:® Adult : Child:
Cobicistat, Pharmacokinetic enhancer(aaa)Indications - Used to increast the effect of atazanavir or darunavir. Oral 150 mg once daily, tab:®, Cap:® Adult : Child:
Zanamivir(Antiviral)Indications - Prevention and treatment of Influenza, Post-exposure prophylaxis of influenza. Inhalation powder:®, Cap:® Adult : Child:
Palivizumab(aaa)Indications - Prevention of lower respiratory-tract disease caused by Syncytial virus in children. 15 mg/kg(IV. Use under expert supervision. Synagis inj:® Adult : Child:
Vasopressin(aaa)Indications - Pituitary diabetes insipidus, Initial control of oesophageal variceal bleeding. 5–20 units every 4 hours (IM, IV. Avoid - Chronic nephritis, Vascular disease . Cautions - Asthma, Epilepsy, Heart failure, Hypertension, Migraine. tab:®, Cap:® Adult : Child:
Tolvaptan, Diuretic(aaa)Indications - Autosomal dominant polycystic kidney disease in adults, Hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion. 15 mg once daily(PO. Avoid - Anuria, Hypernatraemia. tab:®, Cap:® Adult : Child:
Deflazacort, Corticosteroid(aaa)Indications - Inflammatory and allergic disorders. Oral 120 mg daily. tab:®, Cap:® Adult : Child:
Metyrapone, Enzyme cortisol inhibitor(aaa)Indications - Management of Cushing's syndrome, Differential diagnosis of ACTH-dependent Cushing's syndrome, Resistant oedema due to increased aldosterone secretion in cirrhosis, nephrotic syndrome and congestive heart failure. Oral 3 g daily in divided doses Avoid - Adrenocortical insufficiency. tab:®, Cap:® Adult : Child:
Quinagolide, Dopamine D2 agonist, Dopaminergic drug,Indications - Hyperprolactinaemia. tab:®, Cap:® Adult : Child:
Goserelin(aaa)Indications - advanced prostate cancer as an alternative to surgical castration, Endometriosis, Endometrial thinning before intra-uterine surgery, Before surgery in women who have anaemia due to uterine fibroids, Pituitary desensitisation before induction of ovulation by gonadotrophins for in vitro fertilisation. tab:®, Cap:® Adult : Child:
Nafarelin(aaa)Indications - Endometriosis, Pituitary desensitisation before induction of ovulation by gonadtrophins for in vitro fertilisation. tab:®, Cap:® Adult : Child:
Triptorelin(aaa)Indications - advanced non-metastatic prostate cancer as an alternative to surgical castration, Endometriosis, Male hypersexuality with severe sexual deviation, Reduction in size of uterine fibroids. tab:®, Cap:® Adult : Child:
DanazolAnti-gonadotropin-releasing hormone(aaa)Indications - Endometriosis, Benign fibrocystic breast disease not responding to other treatment, Hereditary angioedema. tab:®, Cap:® Adult : Child:
Tetracosactide, Tetracosactrin, Corticotropin(aaa)Indications - Crohn's disease, Diagnosis of adrenocortical insufficiency. tab:®, Cap:® Adult : Child:
Choriogonadotropin alfa, Human chorionic gonadotropin,Indications - Treatment of infertility in women with proven hypopituitarism or who have not responded to clomifene, Superovulation treatment for assisted conception (such as in vitro fertilisation. tab:®, Cap:® Adult : Child:
Follitropin alfa, Recominant human follicle stimulating hormone(aaa)Indications - Treatment of Infertility in women with poven hypopituitarism or who have not responded to clomifene(superovulation treatment, Hypogonadotrophic hypogonadism. tab:®, Cap:® Adult : Child:
Follitropin delta(aaa)Indications - Superovulation treatment for assisted concepton(such as in vitro fertilisation. tab:®, Cap:® (Initiate under specialist supervision) Adult : Child:
Lutropin alfa(aaa)Indications - Treatment of Infertility in women with poven hypopituitarism or who have not responded to clomifene, superovulation treatment. tab:®, Cap:® Adult : Child:
Menotrophin(aaa)Indications - Treatment of Infertility in women with poven hypopituitarism or who have not responded to clomifene, Superovulation treatment, Hypogonadotrophic hypogonadism. tab:®, Cap:® Adult : Child:
Urofollitropin(aaa)Indications - Treatment of Infertility in women with poven hypopituitarism or who have not responded to clomifene, Ssuperovulation treatment. tab:®, Cap:® Adult : Child:
Pegvisomant(Growth hormone receptor antagonist)Indications - Treatment of acromegaly in patients with inadequate respond to surgery, radiation. tab:®, Cap:® (Initiate by a specialist) Adult : Child:
Somatropin, Human growth hormone(aaa)Indications - Gonadal dysgenesis, Deficiency of growth hormoe. tab:®, Cap:® Adult : Child:
Raloxifene Hcl, Bone resorption inhibitor,Indications - Treatment and prevention of postmenopausal osteoporosis, Breast cancer(chemoprevention in postmenopausal women at moderate to high risk. tab:®, Cap:® (Initiate under specialist supervision) Adult : Child:
Tibolone(aaa)Indications - Short-term treatment of symptoms of oestrogen deficiency, Prophalyxis of osteoporosis if other prophylaxis is not tolerated. tab:®, Cap:® Adult : Child:
Norethisterone(aaa)Indications - Endometriosis, Dysfunctimnal uterine bleeding, Menorrhagia, Dysmenorrhoea, Premenstrual syndrome, Postponement of menstruation, Breast cancer, Short-term contraception, Short-term contraception. Norelut tab:, Norethisterone tab:, Primolut N tab: Adult : Child:
Thyrotropin alfa(aaa)Indications - Detection of thyroid remnants and thyroid cancer in post thyroidectomy patients, Together with serum thyroglobulin testing (with or without radioiodine imaging), To increase radio-iodine uptake for the ablation of thyroid remnant tissue in suitable post thyroidectomy patients. tab:®, Cap:® Adult : Child:
Propylthiouracil, Antithyroid drug(aaa)Indications - Hyperthyroidism. tab:®, Cap:® Adult : Child:
Iodide with iodine(aaa)Indications - Thyrotoxicosis(pre-operative. tab:®, Cap:® Adult : Child:
Terazosin(Alpha-1 blocker, Alpha-1 adrenergic antagonist)Indications - Mild to moderate hypertension, Benign prostatic hyperplasia. tab:®, Cap:® Adult : Child:
Dutasteride(aaa)Indications - Benign prostatic hyperplasia. Dudat Cap: Adult : Child:
Citric acid, Cough suppressant(aaa)Indications - Cough. Oral 5 mL 3–4 times a day Avoid - Cardiac disease, Elderly. tab:®, Cap:® Adult : Child:
Citric acid with magnesium carbonate(Laxative)Indications - Bowel evacuation for surgery, Colonoscopy or radiological examination. tab:®, Cap:® Adult : Child:
Magnesium citrate with sodium picosulfate(Laxative)Indications - Bowel evacuation for surgery, Colonoscopy or radiological examination. tab:®, Cap:® Adult : Child:
Pentosan polysulfate sodium(aaa)Indications - Bladder pain syndrome. tab:®, Cap:® Adult : Child:
Anethol with borneol, Camphene, Cineole, FenchonePinene(aaa)Indications - Urolithiasis for the expulsion of urinary calculi. tab:®, Cap:® Adult : Child:
Estradiol with dydrogesterone(aaa)Indications - Menopausal symptoms in women with a uterus, prophylaxis of Osteoporosis in women with a uterus, Contraception. tab:®, Cap:® Adult : Child:
Estradiol with levonorgestrel(aaa)Indications - Menopausal symptoms in women with a uterus whose last menstrual period occurred over 12 months previously. tab:®, Cap:® Adult : Child:
Norethisterone with mestranol(aaa)Indications - Contraception, Menstrual symptoms) tab:®, Cap:® Adult : Child:
Ulipristal acetate(aaa)Indications - Pre-operative treatment of moderate to severe symptoms of uterine fibroids, Emergency contraception, Uterine fibrosis. tab:®, Cap:® Adult : Child:
Desogestrel(aaa)Indications - Contraception. tab:®, Cap:® Adult : Child:
Nonoxinol(aaa)Indications - Spermicidal contraceptive in conjunction with barrier methods. tab:®, Cap:® Adult : Child:
Avanafil(aaa)Indications - Erectile dysfunction, Erectile dysfunction in patients on alpha-blocker therapy. Stendra tab:® Adult : Child:
Aviptadil with phentolamine mesilate, Vasodilator(aaa)Indications - Erectile dysfunction. Avoid - Anatomical deformtion of the penis. tab:®, Cap:® Adult : Child:
Belimumab(Immunosuppressant)Indications - Adjunctive therapy in patients with active, Autoantibody positive systemic lupus erythematosus with a high degree of disease activity despite standard therapy. tab:®, Cap:® Adult : Child:
Kidney damage(aaa) Blood creatinine male(0.6-1.2 mg/dl)-female(0.5-1.1 mg/dl) tab:®, Cap:® Adult : Child:
Kidney damage(aaa) Urine albumin male(more than 200mcg/minute)-female. tab:®, Cap:® Adult : Child:
Urokinase(aaa)Indications - Deep-vein thrombosis, Pulmonary embolism, Occlusive peripheral arterial disease. Urokinase-Green Cross inj:®, 60, 000IU inj:®, Cap:® Adult : Child:
Metoprolol tartrate(Beta-blocker)Indications - Hypertension, Angina, Arrhythmias, Prophylaxis of migraine, Adjunct treatment in Hyperthyroidism. Revelol XL 25 tab:®, Cap:® Adult : Child:
Besifloxacin Hcl(aaa)Indications - . Besiflox Sterile Ophthalmic Suspension. tab:®, Cap:® Adult : Child:
Chondroitin sulfate(Dietary supplement)Chondroitin reduce pain and inflammation, improve joint function and slow down the progression of osteoarthritis. Indications - joint injury, Osteoarthritis, Rheumatoid arthritis. Ostonil tab:®, Glucosamine Chondroitin tab:. Adult : Child:
Methyloestrenolone(aaa)Indications - . Gynelone tab: tab:®, Cap:® Adult : Child:
Iron Hydroxide Polymaltose Complex(aaa)Indications - . Hezoy Chewable tab:. tab:®, Cap:® Adult : Child:
Lignocaine Hcl(aaa)Indications - Local anaesthetic, Pain reduce. Hicaine 2% Inj:, Lignocain Hcl Gelatin tube. tab:®, Cap:® Adult : Child:
Camphor Inhaler(aaa)Indications - . Lang Inhaler. tab:®, Cap:® Adult : Child:
Menthol Inhaler(aaa)Indications - . Lang Inhaler. tab:®, Cap:® Adult : Child:
Lactobacillus sporogens(aaa)Indications - . Lactocid tab:. tab:®, Cap:® Adult : Child:
Lactobacillus reuteriIndications - . BIOGAIA Chewable tab:. tab:®, Cap:® Adult : Child:
Zinc Sulphate monohydrate(aaa)Indications - . Medizinc Chewable tab:, Medizinc Oral Solution Adult : Child:
Ceftriaxone Sodium (Third-generation cephalosporin)Indications - Lower respiratory tract infections, Otitis media, Skin and soft tissue infections, Urinary tract infections, Pelvic inflammatory disease, Bacterial septicemia, Bone and joint infections, Intra-abdominal infections, Meningitis, Surgical prophylaxis. Contraindications - Hypersensitivity to cephalosporins or penicillins, Neonates with hyperbilirubinemia. Cautions - History of GI disease (especially colitis), Renal or hepatic impairment, Premature neonates. Avoid - Concurrent use with calcium-containing IV solutions in neonates. Interactions - Calcium-containing IV solutions, Aminoglycosides (increased nephrotoxicity), Warfarin (enhanced anticoagulant effect). Trade names - Medocephine-S Powder for Inj:® Adult: 1–2 g once daily or in 2 divided doses; up to 4 g daily in severe infections. Child: 50–75 mg/kg once daily (maximum 2 g/day); meningitis: up to 100 mg/kg/day (maximum 4 g/day).
Monoclonal antibody(aaa)Indications - . CIMAher Solution for Inj:. tab:®, Cap:® Adult : Child:
Sodium Biphosphate EnemaIndications - Relief of occasional constipation, Bowel cleansing before diagnostic procedures (e.g. colonoscopy). Contraindications - Bowel obstruction, Congestive heart failure, Severe dehydration, Hypocalcemia, Hyperphosphatemia. Cautions - Renal impairment, Elderly, Inflammatory bowel disease, Recent gastrointestinal surgery. Avoid - Prolonged or frequent use, Use in children without medical advice. Interactions - Diuretics, ACE inhibitors, NSAIDs, Antacids (may alter electrolyte balance). Trade names - UNI-ma Enema Solution Adult: One enema (118 mL) rectally as a single dose. Do not exceed recommended dose. Child: 2–5 years: 33 mL; 5–12 years: 66 mL rectally as a single dose (use pediatric formulations).
Melitracen, Anxiety, Depression, GI disorder(aaa)Indications - U4 tab:®, Cap:® Adult : Child:
Sulfamethoxazole (Sulfonamide antibacterial)Indications - Urinary tract infections, Respiratory tract infections, Gastrointestinal infections, Nocardiosis, Pneumocystis jirovecii pneumonia (PCP), Toxoplasmosis (with pyrimethamine). Contraindications - Cautions - G6PD deficiency, Elderly, Asthma or allergy, Renal impairment, Hepatic impairment, Folate deficiency. Avoid - During late pregnancy and breastfeeding (risk of kernicterus in neonates). Interactions - Warfarin, Methotrexate, Phenytoin, Sulfonylureas, Cyclosporine (may increase nephrotoxicity). Trade names - Cotrim tab:, Cotrimstada tab:, Septrin tab:, Mediseptol 480 tab:, Metxaprim Syrup:, Septotrim 24% (100ml inj) Adult: 800 mg sulfamethoxazole + 160 mg trimethoprim every 12 hours (standard dose). Child: Based on trimethoprim component: 6–12 mg/kg/day in 2 divided doses (with 30–60 mg/kg/day of sulfamethoxazole).
Gadoxetic Acid(aaa)Indications - . Primovist-Solution for Inj: tab:®, Cap:® Adult : Child:
Iopamidol-IodineIndications - . Scanlux 300mg I/ml Solution for Inj: tab:®, Cap:® Adult : Child:
Tiemonium Methylsulphate(aaa)Indications - . Viset Inj: tab:®, Cap:® Adult : Child:
Dienogest (Progestogen, Hormonal therapy)Indications - Treatment of endometriosis. Contraindications - Active thromboembolic disorders, Severe hepatic disease, Known or suspected hormone-dependent malignancies, Undiagnosed vaginal bleeding, Pregnancy. Cautions - History of depression, Diabetes mellitus, Cardiovascular disorders, Migraine, Hepatic impairment. Avoid - Use in pregnancy and lactation unless specifically advised. Interactions - Barbiturates, phenytoin, carbamazepine, rifampicin, and St. John’s Wort may reduce effectiveness. Trade names - Visanne 2mg tab: Adult: 2 mg once daily, continuously without interruption. Child: Not recommended; safety and efficacy not established in pediatric patients.
Diosmin (Venoactive agent, Phlebotropic drug)Indications - Chronic venous insufficiency, Hemorrhoids, Lymphedema, Varicose veins. Contraindications - Hypersensitivity to diosmin or related compounds. Cautions - Use with caution in patients with chronic gastrointestinal disorders or hepatic impairment. Avoid - Avoid prolonged use without medical advice; avoid in pregnancy unless prescribed. Interactions - No significant known drug interactions. Trade names - Ven-Q tab:, Veriun 50 Powder for Oral Suspension. Adult: 500–1000 mg daily in divided doses, depending on condition (e.g., 500 mg twice daily for hemorrhoids). Child: Safety and efficacy not established in children.
Cefoperazone(aaa)Indications - . Vaxcel Cefobactam 1g Powder for Inj:®, Cap:® Adult : Child:
Silodosin(Alpha-1 blocker, Alpha-1 adrenergic antagonist) It helps to relieve symptoms associated with BPH, such as difficulty urinating, weak urine flow and the frequent need to urinate, By relaxing the smooth muscles in the prostate gland and the bladder neck. Indications - management of ureteral stones, Benign prostatic hyperplasia (BPH). Urief 4mg tab:®, Adult : Child:
Iopromide(aaa)Indications - . Ultravist -300 Solution for Inj: tab:®, Cap:® Adult : Child:
Leucovorin(aaa)Indications - . Leucovorin Calcium Inj: tab:®, Cap:® Adult : Child:
Almagate(aaa)Indications - . Yumangel F Suspension, Yumangel Suspension tab:®, Cap:® Adult : Child:
Xylometazoline HCl (Nasal Decongestant)Indications - Nasal congestion due to colds, sinusitis, hay fever, or other allergies; relief of nasal obstruction. Contraindications - Hypersensitivity to xylometazoline or other adrenergic agents, narrow-angle glaucoma. Cautions - Use with caution in patients with hypertension, hyperthyroidism, diabetes mellitus, prostatic hypertrophy, cardiovascular disease; prolonged use may lead to rebound congestion (rhinitis medicamentosa). Side Effects - Local irritation, dryness of nasal mucosa, headache, nausea, insomnia, palpitations (rare). Trade Names - Xylomark 0.05% Nasal Drops, Xylonap ND 0.1% Nasal Drops Adult: 0.1% nasal drops or spray: 2–3 drops/sprays into each nostril up to 3 times daily as needed. Do not use for more than 7 consecutive days. Child: 0.05% nasal drops: 1–2 drops into each nostril 1–2 times daily for children aged 2–12 years. Use for a maximum of 5–7 days.
Sulbactam (β-lactamase Inhibitor)Indications - Used in combination with β-lactam antibiotics (e.g., ampicillin, cefoperazone) to treat infections caused by β-lactamase-producing bacteria including respiratory tract infections, urinary tract infections, intra-abdominal infections, skin and soft tissue infections, and gynecological infections. Contraindications - Hypersensitivity to sulbactam, penicillins, or cephalosporins. Cautions - Renal impairment, history of allergic reactions to β-lactams, monitor liver function during prolonged therapy. Side Effects - Diarrhea, rash, urticaria, nausea, vomiting, eosinophilia, transient liver enzyme elevations, injection site reactions. Drug Interactions - May interact with methotrexate (increased toxicity), oral contraceptives (reduced efficacy), and anticoagulants (altered coagulation profile). Trade Names - Bactapezone Inj: (Cefoperazone + Sulbactam combination), Sulperazone Inj: Adult: Sulbactam (in combination) 0.5–1 g IV/IM every 6–8 hours with a suitable β-lactam antibiotic (e.g., cefoperazone). Child: Usually 25–50 mg/kg/day (as part of the combination), divided into 2–4 doses. Adjust based on infection severity and age.
Cefoperazone (Third-generation Cephalosporin Antibiotic)Indications - Treatment of serious infections including lower respiratory tract infections, urinary tract infections, biliary tract infections, peritonitis, sepsis, meningitis, skin and soft tissue infections, and infections caused by susceptible organisms. Contraindications - Hypersensitivity to cephalosporins or penicillins (cross-sensitivity may occur). Cautions - Renal impairment, history of penicillin allergy, prolonged use may lead to superinfection; monitor coagulation parameters during long-term therapy. Side Effects - Diarrhea, nausea, vomiting, allergic reactions (rash, anaphylaxis), hematologic changes (thrombocytopenia, eosinophilia), transient liver enzyme elevation. Drug Interactions - Increased bleeding risk with anticoagulants; alcohol may cause disulfiram-like reaction. Trade Names - Bactapezone Inj:, Cerazone Plus Inj:, Cepefoz Powder for Inj: Adult: 2–4 g/day IV or IM in 2 divided doses; may increase up to 6–12 g/day depending on severity. Child: 50–100 mg/kg/day in 2–4 divided doses; up to 200 mg/kg/day for severe infections.
Bacitracin (Topical Antibiotic)Indications - Topical treatment of superficial skin infections such as impetigo, minor cuts, burns, and abrasions. Contraindications - Hypersensitivity to bacitracin or any component of the formulation. Cautions - Prolonged use may lead to overgrowth of non-susceptible organisms; avoid use on large or deep wounds without medical supervision. Side Effects - Local irritation, allergic contact dermatitis, rash, itching. Trade Names - B.N.P Ointment®, Baciguent®, Polysporin® (combined with polymyxin B) Adult: Apply thin layer to affected area 1–3 times daily. Child: Same as adult dose; under supervision, especially in infants.
Menthol Inhaler(aaa)Indications - . Axe Brand Inhaler. tab:®, Cap:® Adult : Child:
Sodium Lactate Infusion(aaa)Indications - . Compound Sodium Lactate Intravenous Infusion Adult : Child:
Tonic (aaa)Indications - . Astymin Forte Cap:, Astymin Liquid, Celemin Nephro 5% Inj:. Adult : Child:
HBsAg (Hepatitis B Surface Antigen Vaccine)Indications - Active immunization against hepatitis B virus infection, especially in individuals at increased risk (e.g., healthcare workers, infants born to HBsAg-positive mothers, people with multiple sexual partners, injection drug users). Contraindications - Hypersensitivity to any component of the vaccine, including yeast. Severe allergic reaction to a previous dose. Cautions - Moderate or severe acute illness (defer vaccination), immunocompromised patients may have a reduced immune response. Side Effects - Pain and redness at injection site, low-grade fever, fatigue, headache, allergic reactions (rare). Trade Names - Engerix-B®, Recombivax HB®, Heplisav-B® Adult: 20 µg IM at 0, 1, and 6 months (deltoid muscle). Accelerated schedules may be used in specific cases. Child: 10 µg IM at 0, 1, and 6 months. Birth dose recommended within 24 hours in newborns, especially if mother is HBsAg-positive.
Arteether (Antimalarial – Artemisinin derivative)Indications - Treatment of severe Plasmodium falciparum malaria, especially when oral therapy is not feasible. Contraindications - Hypersensitivity to artemisinin or its derivatives, severe hepatic impairment (use with caution). Cautions - Use with caution in patients with a history of cardiac disease, liver dysfunction, or neurological conditions. Not recommended for prophylactic use. Avoid - Use in the first trimester of pregnancy unless no safer alternative is available; avoid concurrent use with other QT-prolonging agents. Side Effects - Dizziness, fever, injection site pain, nausea, QT prolongation (rare), transient neurological symptoms (e.g., ataxia, tremors). Drug Interactions - May interact with drugs that prolong QT interval (e.g., quinolones, macrolides), CYP450 enzyme inducers/inhibitors. Trade Names - EMAL Inj®, Falcigo Inj®, Artefan Inj® Adult: 150 mg IM once daily for 3 consecutive days. Child: 3 mg/kg IM once daily for 3 consecutive days (use under medical supervision).
Vitamins and Minerals (Nutritional Supplement)Indications - Nutritional deficiencies, support in chronic illnesses, pregnancy and lactation, postoperative recovery, anemia, general weakness, immune support, and metabolic disorders. Contraindications - Hypersensitivity to any vitamin or mineral in the preparation, hypervitaminosis (especially A or D), severe renal or hepatic impairment (depends on formulation). Cautions - Monitor for iron overload, fat-soluble vitamin toxicity with long-term use. Adjust dose in renal impairment. Some formulations may interact with medications like levodopa or tetracyclines. Avoid - High doses without medical supervision. Avoid in patients on certain medications unless advised by a doctor. Side Effects - Nausea, constipation or diarrhea, metallic taste, allergic reactions (rare), hypervitaminosis with excessive intake. Drug Interactions - Can interact with anticonvulsants, antibiotics, anticoagulants, and certain diuretics. Calcium and iron may affect absorption of some drugs. Trade Names - Renovit®, Nucleo CMP Forte Cap®, Theradyne-M Tab®, Orioplex-M F.C. Tab®, Diabetone Cap®, Cleavit Cap® Adult: Usually 1 tablet or capsule daily with food, or as prescribed depending on deficiency or clinical condition. Child: Pediatric formulations or doses should be used; typically half to one pediatric tablet/capsule per day under medical advice.
Concentrate Synthetic RetinolIndications - . Minigadine –MV Eye Drops. Adult : Child:
Phospholipids(aaa)Indications - . Cholezz Cap: Adult : Child:
Carboxymethylcellulose Sodium (Artificial Tear, Lubricant Eye Drop)Indications - Management of dry eye syndrome, eye irritation due to wind or sun, and relief from discomfort due to minor eye irritations or exposure. Contraindications - Hypersensitivity to carboxymethylcellulose or any component of the formulation. Cautions - Do not touch dropper tip to any surface; avoid contamination. Use with caution in patients with eye infections. Discontinue if eye pain, vision changes, or worsening irritation occurs. Side Effects - Temporary blurred vision, eye irritation or discomfort, foreign body sensation. Drug Interactions - May dilute or affect absorption of other topical ophthalmic agents; if using multiple eye products, space applications by at least 5–10 minutes. Trade Names - Digeva-F Gel®, Refresh Tears®, Cellufresh®, Tearose® Adult: 1–2 drops in the affected eye(s) as needed, up to 4–6 times daily or as prescribed. Child: 1 drop in affected eye(s) as needed under adult supervision; safe in children but use under medical advice.
Alanine (Non-essential Amino Acid, Nutritional Supplement)Indications - Used as part of amino acid supplementation in parenteral nutrition, supportive therapy in hepatic encephalopathy, and to promote recovery in catabolic states. Contraindications - Known hypersensitivity to alanine or any component of the formulation. Cautions - Use with caution in patients with renal impairment or disorders of amino acid metabolism; monitor nitrogen balance and liver function in long-term use. Avoid - Excessive use in patients with severe hepatic failure without monitoring. Side Effects - Nausea, vomiting, metabolic imbalances, local irritation at injection site (if IV). Drug Interactions - No major interactions noted; monitor when combined with other amino acids or protein supplements. Trade Names - Elemune Inj® Adult: Dose depends on clinical condition and total daily nitrogen requirement; commonly used in combination with other amino acids in IV nutrition. Child: Dose individualized by weight and metabolic needs under specialist supervision; often part of pediatric parenteral nutrition regimens.
Entecavir Monohydrate (Antiviral, Nucleoside Reverse Transcriptase Inhibitor)Indications - Treatment of chronic hepatitis B virus (HBV) infection in adults and children ≥2 years with evidence of active viral replication and either evidence of persistent elevations in serum aminotransferases (ALT/AST) or histologically active disease. Contraindications - Hypersensitivity to entecavir or any component of the formulation. Cautions - Monitor hepatic function closely during treatment and after discontinuation; use with caution in patients with renal impairment (dose adjustment required), risk of lactic acidosis and hepatomegaly with steatosis. Avoid - Discontinuation without proper medical supervision, as HBV reactivation may occur. Side Effects - Headache, fatigue, dizziness, nausea, lactic acidosis (rare), elevated ALT on discontinuation. Drug Interactions - Caution with other nephrotoxic agents; minimal CYP450 involvement, so lower risk of metabolic drug interactions. Trade Names - Barcavir tab®, Envir F.C. tab®, Entavir® Adult: 0.5 mg once daily for nucleoside treatment-naïve patients; 1 mg once daily in lamivudine-refractory or resistant patients. Child: ≥2 years: 0.015 mg/kg once daily (up to max 0.5 mg/day); dose adjustment based on weight and renal function.
Cinoxacin (Fluoroquinolone Antibiotic)Indications - Uncomplicated urinary tract infections (UTIs) caused by susceptible gram-negative organisms. Contraindications - Hypersensitivity to cinoxacin or other quinolones, history of tendon disorders related to quinolone use. Cautions - Seizure disorders, CNS disorders, renal impairment (dose adjustment needed), elderly (risk of tendon rupture), photosensitivity. Avoid - Concomitant use with antacids containing magnesium or aluminum, or with iron supplements (reduced absorption). Side Effects - Nausea, vomiting, rash, headache, dizziness, photosensitivity, hypersensitivity reactions. Drug Interactions - Reduced absorption with antacids, sucralfate, or zinc/iron-containing products; potential interaction with theophylline and anticoagulants. Trade Names - Cinobac® Adult: 250–500 mg orally every 12 hours for 7–14 days, depending on infection severity and renal function. Child: Not recommended due to risks of cartilage damage and lack of established safety.
Delafloxacin (Fluoroquinolone Antibiotic)Indications - Acute bacterial skin and skin structure infections (ABSSSI), Community-acquired bacterial pneumonia (CABP). Contraindications - Hypersensitivity to delafloxacin or other fluoroquinolones. Cautions - Tendon disorders, CNS disorders (risk of seizures), renal impairment (dose adjustment needed), risk of C. difficile–associated diarrhea, QT prolongation. Avoid - Concomitant use with other QT-prolonging drugs unless necessary, exposure to sunlight or UV light (photosensitivity). Side Effects - Nausea, diarrhea, headache, transaminase elevation, potential tendon rupture, hypersensitivity reactions. Drug Interactions - Chelation with antacids, iron, or multivitamins reduces absorption; caution with NSAIDs (risk of CNS stimulation); QT-prolonging agents. Trade Names - Baxdela® Adult: 300 mg IV every 12 hours or 450 mg orally every 12 hours for 5–14 days depending on infection severity. Child: Safety and efficacy not established in pediatric patients.
Gemifloxacin (Fluoroquinolone Antibiotic)Indications - Acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia (including infections due to multi-drug resistant Streptococcus pneumoniae). Contraindications - Hypersensitivity to gemifloxacin or other fluoroquinolones, history of tendon disorders related to quinolone use. Cautions - Elderly, patients with a history of seizures or QT prolongation, those with electrolyte disturbances, or on QT-prolonging agents. Avoid - Avoid in pregnancy, lactation, and in patients under 18 years due to risk of musculoskeletal adverse effects. Side Effects - Drug Interactions - Avoid concurrent use with antacids, sucralfate, iron or zinc (may reduce absorption); increased QT risk with other QT-prolonging drugs. Trade Names - Factive® (tablet 320 mg) Adult: 320 mg orally once daily for 5–7 days depending on indication. Child: Not recommended due to risk of cartilage damage.
Gatifloxacin (Fluoroquinolone Antibiotic)Indications - Bacterial conjunctivitis (ophthalmic form), acute exacerbations of chronic bronchitis, community-acquired pneumonia, urinary tract infections. Contraindications - Known hypersensitivity to gatifloxacin or other quinolones, diabetes mellitus (oral form - due to risk of dysglycemia). Cautions - Use with caution in elderly patients, those with renal impairment, and patients on other QT-prolonging drugs; monitor blood glucose in diabetic patients. Avoid - Avoid sun exposure (risk of photosensitivity), avoid use in children and pregnant women unless absolutely necessary. Side Effects - Nausea, headache, dizziness, dysglycemia (especially in elderly), QT interval prolongation, rash, diarrhea. Drug Interactions - Enhanced QT prolongation risk with antiarrhythmics; reduced absorption with antacids, iron, or zinc supplements. Trade Names - Zymaxid® (ophthalmic sol.), Gatiflo® (tab), Tequin® (tab - discontinued in some countries) Adult: Oral: 400 mg once daily for 5–10 days depending on infection type; Ophthalmic: 1 drop every 2 hours while awake (Days 1–2), then 4 times daily (Days 3–7). Child: Ophthalmic solution: Safety and efficacy established in children ≥1 year old (1 drop q2h for 2 days, then QID for 5 days); systemic use not recommended in children due to joint toxicity risk.
Sparfloxacin (Fluoroquinolone Antibiotic)Indications - Community-acquired pneumonia, acute bacterial exacerbations of chronic bronchitis, other lower respiratory tract infections caused by susceptible bacteria. Contraindications - QT interval prolongation, known hypersensitivity to fluoroquinolones, history of tendon disorders related to quinolones. Cautions - Use with caution in patients with CNS disorders (risk of seizures), arrhythmias, renal impairment, or electrolyte imbalances; avoid sun exposure due to risk of phototoxicity. Avoid - Concomitant use with Class IA/III antiarrhythmics, exposure to sunlight or UV light, antacids containing magnesium/aluminum within 2 hours of dosing. Side Effects - Headache, nausea, dizziness, rash, phototoxicity, QT prolongation, tendinitis. Drug Interactions - Increased risk of QT prolongation with certain antiarrhythmics; reduced absorption with iron, zinc, antacids. Trade Names - Zagam® (tab) Adult: Oral 400 mg as a single loading dose on Day 1, then 200 mg once daily for 5–10 days. Child: Not recommended due to risk of cartilage toxicity and QT prolongation.
Trovafloxacin (Fluoroquinolone Antibiotic)Indications - Serious bacterial infections including intra-abdominal infections, community-acquired pneumonia, and gynecological infections (use is restricted due to safety concerns). Contraindications - Hepatic impairment, known hypersensitivity to fluoroquinolones, history of tendon disorders related to quinolone use. Cautions - Monitor liver function closely; use only when other antibiotics are not appropriate due to risk of severe hepatotoxicity; caution in CNS disorders (risk of seizures); avoid in patients with myasthenia gravis. Side Effects - Hepatotoxicity (including hepatic failure), nausea, headache, dizziness, rash, photosensitivity, tendinitis. Drug Interactions - Increased risk of QT prolongation with antiarrhythmics; absorption reduced with antacids, sucralfate, iron, or zinc supplements. Trade Names - Trovan® (Withdrawn or restricted in many countries due to liver toxicity). Adult: 200–300 mg orally or IV once daily (restricted use; consult official guidelines). Child: Not recommended due to risk of severe liver toxicity and lack of safety data.
Zinc (Trace Element / Nutritional Supplement)Indications - Zinc deficiency, Diarrhea in children, Wound healing, Acrodermatitis enteropathica, Supportive treatment in respiratory infections. Contraindications - Hypersensitivity to zinc or any excipient. Cautions - Renal insufficiency; long-term use may cause copper deficiency; use with caution in patients with gastrointestinal disorders. Side Effects - Nausea, vomiting, abdominal cramps, metallic taste, headache. Drug Interactions - Decreased absorption of tetracyclines, quinolones, and penicillamine; avoid concurrent administration. Trade Names - Square Zinc-20®, Orazinc-20®, Zinconia®, Z&D Drops®, Zincofer® Adult: 20–40 mg elemental zinc daily depending on indication. Child: 10–20 mg elemental zinc daily; for diarrhea: 20 mg/day for 10–14 days in children over 6 months, 10 mg/day in infants under 6 months.
Cefoperazone Sodium (Third-generation Cephalosporin Antibiotic)Indications - Respiratory tract infections, urinary tract infections, peritonitis, septicemia, skin and soft tissue infections, pelvic inflammatory disease, and bone and joint infections. Contraindications - Hypersensitivity to cephalosporins or beta-lactam antibiotics. Cautions - Renal or hepatic impairment (monitor levels), history of gastrointestinal disease (especially colitis), monitor for bleeding risk due to hypoprothrombinemia (vitamin K deficiency). Avoid - Alcohol (risk of disulfiram-like reaction), avoid co-administration with calcium-containing IV solutions in neonates. Side Effects - Diarrhea, nausea, rash, eosinophilia, thrombocytopenia, elevated liver enzymes, bleeding tendencies. Drug Interactions - Increased bleeding risk with anticoagulants; avoid alcohol use (may cause flushing, headache, hypotension). Trade Names - Cerazone Plus-500 Powder for Inj:, Cepefoz Powder for Inj: Adult: 1–2 g IV/IM every 12 hours; may increase up to 4 g every 12 hours in severe infections. Child: 50–100 mg/kg/day in 2–4 divided doses IV/IM; up to 200 mg/kg/day in severe infections.
Minerals(aaa)Indications - . Osam tab:, B-29 Liquid 60ml, Canogrow Syrup. Adult : Child:
Benzoyl Peroxide (Topical Antibacterial/Keratolytic)Indications - Treatment of mild to moderate acne vulgaris, adjunctive therapy in inflammatory acne, keratolytic use in seborrheic dermatitis and folliculitis. Contraindications - Hypersensitivity to benzoyl peroxide or any formulation components. Cautions - Avoid contact with eyes, mouth, mucous membranes; may cause bleaching of hair/fabrics; use with caution in sensitive skin; initial irritation common. Side Effects - Skin dryness, peeling, redness, burning sensation, contact dermatitis (rare). Trade Names - Brevoxyl® gel, Benzac® AC gel, Persol® AC gel, PanOxyl® wash (2.5%, 5%, 10%) Adult: Apply a thin layer once or twice daily to affected area; keratolytic shampoos may be used 2–3 times weekly. Child: Safe for use in children over 12 years for acne; apply as in adults with medical guidance.
Yeast(aaa)Indications - . Aquarest Oral Powder, Chromwel Soft Cap: Adult : Child:
Lysine HCl(aaa)Indications - . Heptopep Syrup. Adult : Child:
Eperisone HCl (Muscle Relaxant)Indications - Relief of muscle stiffness and spasticity in conditions like cervical spondylosis, lumbar spondylosis, cerebrovascular disorders, and musculoskeletal pain. Contraindications - Hypersensitivity to Eperisone or any excipients, Myasthenia gravis. Cautions - Hepatic dysfunction, Renal impairment, Dizziness or hypotension may occur, Caution when operating machinery or driving. Side Effects - Nausea, Vomiting, Dizziness, Hypotension, Rash, Allergic reactions, Liver enzyme abnormalities (rare). Trade Names - Esrisone® tab, Myosone® tab, Eprisan® tab Adult: Usual dose is 50–150 mg daily in divided doses after meals (e.g., 50 mg three times daily). Child: Safety and efficacy not well established; use only if prescribed under specialist supervision.
Liver extract(aaa)Indications - . Hepavit (Liver extract) Inj: Adult : Child:
Hepatitis A Antigen(aaa)Indications - . Havrix 1440 Inj: Adult : Child:
Tetanus Toxoid (Vaccine)Indications - Active immunization against tetanus; post-exposure prophylaxis following injury in individuals with uncertain or incomplete vaccination history. Contraindications - Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to any component of the vaccine. Cautions - Moderate or severe acute illness (vaccination should be deferred), History of Guillain–Barré syndrome. Avoid - Avoid unnecessary repeated doses in adults already immune (may cause local adverse reactions). Side Effects - Local pain, redness, swelling at injection site, Fever, Malaise, Rare allergic reactions. Trade Names - Infanrix-Hexa® (DTaP-HepB-IPV-Hib), Tetavax®, Boostrix®, Tetanol®, TT Vaccine IP® Adult: Primary immunization: 0.5 mL IM in 3 doses (at 0, 4, and 6–12 months); Booster: 0.5 mL every 10 years. Child: DTaP: 0.5 mL IM at 2, 4, 6, and 15–18 months, with a booster at 4–6 years.
Tetanus Immunoglobulin (Passive Immunization)Indications - Post-exposure prophylaxis of tetanus in individuals with incomplete or uncertain immunization history or contaminated wounds; Treatment of clinical tetanus. Contraindications - Known hypersensitivity to human immunoglobulins or excipients. Cautions - Use with caution in individuals with IgA deficiency (risk of hypersensitivity), Monitor for allergic reactions. Avoid - Avoid use with live vaccines (e.g., MMR) within 3 months due to possible interference with immune response. Side Effects - Local pain or swelling at injection site, Fever, Chills, Allergic reactions (rare). Trade Names - Tetglob® Inj, Tetabulin® Inj, HyperTET®, TIG® Adult: Prophylaxis: 250 IU IM (500 IU if wound >24 hrs old or high risk); Treatment: 3,000–6,000 IU IM in divided doses. Child: Prophylaxis: 4 IU/kg IM; max 250 IU. Treatment: As per specialist advice (commonly 75 IU/kg up to 4,500–6,000 IU).
Diphtheria Toxoid (Vaccine)Indications - Active immunization against diphtheria, usually in combination with tetanus and pertussis vaccines (e.g., DTaP, Td, Tdap). Contraindications - Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to any vaccine component. Cautions - Moderate or severe acute illness (vaccination should be deferred), History of Guillain–Barré syndrome, Progressive neurological disorder (delay immunization until condition is stable). Avoid - Do not administer during high fever or acute infection; avoid multiple live vaccines unless clinically indicated. Side Effects - Local reactions (pain, redness, swelling), Fever, Irritability, Fatigue, Rarely, anaphylaxis or extensive limb swelling with repeated doses. Trade Names - Infanrix-Hexa® (DTaP-HepB-IPV-Hib), Daptacel®, Boostrix®, Pediarix® Adult: Tdap (tetanus, diphtheria, acellular pertussis): 0.5 mL IM once, then Td booster every 10 years. Child: DTaP: 0.5 mL IM at 2, 4, 6, and 15–18 months, with a booster at 4–6 years.
marine triglycerides, Omega-3(aaa)Indications - . Avoid - Unstable angina, Severe arrhythmia, Breast feeding. Cautions - Hypotension, Hepatic impairment. MEGA GOLD Cap:, Hovid Omega-3 Cap:® Adult : Child:
Magnesium Oxide (Antacid, Laxative, Electrolyte supplement)Indications - Treatment and prevention of magnesium deficiency, Relief of acid indigestion and heartburn, Used as a laxative for short-term constipation, Bowel preparation before procedures (often in combination). Contraindications - Severe renal impairment, Hypermagnesemia, Bowel obstruction, Hypersensitivity to magnesium salts. Cautions - Use with caution in renal impairment, Myasthenia gravis, Pregnancy and breastfeeding (use only if clearly needed), Electrolyte disturbances such as hyponatraemia or hypothyroidism. Avoid - Concurrent use with other magnesium-containing products; avoid in compensatory hypertension and severe vitamin B12 deficiency without correction. Side Effects - Diarrhea, Abdominal cramping, Electrolyte imbalance, Hypermagnesemia (especially in renal impairment), Nausea. Trade Names - Mag-Ox®, Uro-Mag®, Phillips' Laxative Capsules®, Picoprep® Powder for Oral Solution Adult: Antacid: 400–800 mg orally up to 4 times daily. Laxative: 2.4–4.8 g orally once daily with water. Electrolyte supplement: 250–500 mg daily or as prescribed. Child: Dose individualized by weight and indication; typically 5–10 mg/kg/day in divided doses; use under medical supervision.
Artesunate (Antimalarial)Indications - Severe malaria (including cerebral malaria), especially due to Plasmodium falciparum; used when oral therapy is not possible. Contraindications - Known hypersensitivity to artesunate or artemisinin derivatives. Avoid - Complete biliary obstruction, Use in early pregnancy (1st trimester) unless benefits outweigh risks, Breastfeeding (caution advised). Cautions - Hepatic impairment, Renal impairment, Monitor for delayed hemolysis after treatment. Side Effects - Transient elevation in liver enzymes, Bradycardia, Hemolysis (delayed), Injection site reactions, Dizziness. Trade Names - Pharba-Arte Powder for Inj®, Malinate® Inj, Artesun® Inj Adult: 2.4 mg/kg IV at 0, 12, and 24 hours, then once daily until oral therapy is possible (usually total 6 doses). Child: Same as adult dosing (2.4 mg/kg IV), adjusted by weight; switch to oral ACT (e.g., artemether-lumefantrine) when stable.
Rabies vaccine(aaa)Indications - . Avoid - Pregnancy, Breast feeding. Cautions - Arrhythmia, Elderly, Heart disease, Respiratory disease, Hypertension, Electrolyte disturbance. Rabipur Inj: Adult : Child:
Varicella Virus vaccine(aaa)Indications - . Varilrix Inj: Adult : Child:
Hepatitis-B vaccineIndications - . Engerix-B 10 Avoid - Bradycardia, Pregnancy, Breast feeding, Hepatic impairment, Renal impairment . tab:®, Cap:® Adult : Child:
Potassium iodide Indications - Thyroid protection in nuclear emergencies, Thyroid storm, Pre-operative preparation of thyrotoxic patients, Sporotrichosis. Contraindications - Hypersensitivity to iodides, Dermatitis herpetiformis, Hypocomplementemic vasculitis. Cautions - Need contraception during and 6 months after treatment, Renal impairment, Goiter, Elderly, Tuberculosis. Avoid - Breastfeeding, Prolonged use in pregnancy unless clearly indicated. Interactions - May interact with lithium, ACE inhibitors, and potassium-sparing diuretics. Trade names - Aristovit-M®, Biovit-M®, TS-ONE Cap 20®, Pima eyedrop®, Obimin®, Obimin-AF®, Riconia®, TS-ONE Cap 25®, Cliden eyedrop® Adult: Typical: 300–1000 mg/day orally in divided doses depending on indication. Child: Dose adjusted based on age and indication (e.g., 16 mg/kg for radiation exposure, max 1000 mg/day).
EucalyptusIndications - Nasal congestion. Aromatic inhalation powder(In very hot water), Cap:® Adult : Child:
Benzoin Tincture (Topical protectant, Inhalation decongestant)Indications - Relief of nasal congestion due to cold or sinusitis, Soothing agent for sore throat and irritated mucous membranes, Used topically for minor cuts and abrasions. Contraindications - Known hypersensitivity to benzoin or any component of the preparation. Cautions - Avoid prolonged use; use caution in individuals with respiratory conditions like asthma; not for use in children under 2 years without medical advice. Avoid - Contact with eyes or broken skin; do not ingest; avoid direct inhalation of concentrated vapors. Side Effects - Irritation of nasal mucosa, Allergic reactions (rash, swelling), Headache or dizziness from strong vapors. Trade names - Aromatic Inhalation Benzoin® Solution, Friar’s Balsam®, Tincture Benzoin Co.®, Compound Benzoin Inhalant® Adult: Add 5–10 drops to a bowl of very hot water; inhale vapors deeply for 5–10 minutes 2–3 times daily. Child: Use with caution in children over 2 years; add 2–5 drops in hot water and supervise closely while inhaling vapor; avoid direct contact with skin and eyes.
Ethosuximide (Antiepileptic, Succinimide derivative)Indications - Primarily absence seizures (petit mal), May be used in combination therapy for myoclonic seizures or other generalized seizure types. Contraindications - Known hypersensitivity to succinimides. Cautions - Hepatic or renal impairment, History of psychiatric disorders, Monitor for behavioral changes, blood counts, and liver function during prolonged therapy. Avoid - Use in patients with acute intermittent porphyria. Side Effects - Nausea, Vomiting, Headache, Drowsiness, Aggression or irritability, Stevens-Johnson syndrome (rare), Blood dyscrasias. Trade names - Caps: Zarontin®, Emeside®, Succinyl®, Epilantin® Adult: Initial: 250 mg twice daily orally; maintenance: 500 mg to 1.5 g daily in divided doses; max: 2 g/day. Child: Initial: 10 mg/kg/day in 1–2 divided doses; titrate to 20 mg/kg/day (max 1.5 g/day) based on response and tolerance.
Pumpkin seed extract.(aaa) Root extract for prostate and urogenital system. Prostamin tab: Adult : Child:
Grape seed extract.(aaa)Indications - Circulatory support, Antioxidant support. SG Megatec soft gel. tab:®, Cap:® Adult : Child:
Pyrimethamine (Antiparasitic, Antiprotozoal)Indications - Toxoplasmosis (especially in pregnancy, with sulfadiazine and folinic acid), Cerebral toxoplasmosis in immunocompromised patients, Acute malaria (in combination therapy). Contraindications - Megaloblastic anemia due to folate deficiency, Hypersensitivity to pyrimethamine. Cautions - History of seizures, Renal or hepatic impairment, Elderly patients, Monitor blood counts regularly during prolonged use, Supplement with folinic acid to reduce risk of bone marrow suppression. Avoid - Use without folinic acid in toxoplasmosis treatment (risk of hematologic toxicity). Side Effects - Nausea, Vomiting, Glossitis, Rash, Bone marrow suppression (e.g., leukopenia, thrombocytopenia), Seizures (rare). Trade names - Tab: Daraprim® 25 mg, Malocide®, Fansidar® (with sulfadoxine), Pyrimac®, Primacip® Adult: Toxoplasmosis: 50–75 mg orally once daily (with sulfadiazine and folinic acid). Malaria: 25 mg as part of combination therapy. Child: Toxoplasmosis: 1 mg/kg/day orally (max 25 mg/day) with sulfadiazine and folinic acid; adjust based on age/weight. Malaria: Dose based on body weight; use only under medical supervision.
Entecavir< Chronic hepatitis B with liverdisease. Oral 1 mg once daily Cautions - HIV infection. tab:®, Cap:® Adult : Child:
Telbivudine (Antiviral)Indications - Chronic hepatitis B infection in adults with evidence of viral replication and active liver inflammation. Contraindications - Hypersensitivity to telbivudine or any formulation component. Cautions - Renal impairment (dose adjustment needed), risk of lactic acidosis and severe hepatomegaly with steatosis, monitor for myopathy and peripheral neuropathy especially when used with interferon alfa. Avoid - Concurrent use with peginterferon alfa (increased risk of neuropathy); abrupt discontinuation due to potential flare of hepatitis B. Interactions - Increased risk of myopathy with statins or other agents causing muscle toxicity; caution with nephrotoxic drugs. Trade names - Tab: Sebivo® 600 mg, Tyzeka® 600 mg Adult: 600 mg orally once daily, with or without food. Child: Not routinely recommended; safety and efficacy not established in patients under 16 years of age.
Adefovir dipivoxil (Antiviral)Indications - Chronic hepatitis B infection in adults with compensated liver disease and active viral replication. Contraindications - Hypersensitivity to adefovir or any formulation component. Cautions - Renal impairment (dose adjustment/close monitoring), nephrotoxicity risk, HIV/HBV co-infection (may induce HIV resistance if HIV therapy inadequate), monitor for lactic acidosis and hepatomegaly with steatosis. Avoid - Concurrent nephrotoxic drugs unless essential and closely monitored; abrupt discontinuation (risk of severe HBV flare). Interactions - Additive nephrotoxicity with aminoglycosides, NSAIDs, tacrolimus, cyclosporine; use caution with other antivirals affecting renal clearance. Trade names - Tab: Hepsera® 10 mg, Adhep® 10 mg, Adevo® 10 mg, Adesera® 10 mg Adult: 10 mg orally once daily. Child: Not routinely recommended; may be used in adolescents ≥ 12 y under specialist guidance (10 mg once daily with renal monitoring).
Elbasvir Indications - Chronic hepatitis C infection (primarily genotype 1 and 4), in combination with grazoprevir. Contraindications - Severe hepatic impairment (Child-Pugh class B or C), concurrent use with strong CYP3A inducers (e.g. rifampin, carbamazepine). Cautions - Hepatitis B co-infection, liver enzyme abnormalities, cardiac disease. Avoid - During pregnancy unless clearly necessary; monitor liver function. Interactions - CYP3A inducers (e.g. efavirenz, phenytoin), statins (increased risk of myopathy), cyclosporine. Trade names - Zepatier tab:® Adult: 50 mg elbasvir + 100 mg grazoprevir orally once daily for 12 weeks (± ribavirin depending on genotype and viral load). Child: Safety and efficacy not established for patients under 18 years.
Grazoprevir Indications - Chronic hepatitis C virus (HCV) infection, particularly genotypes 1 and 4, in combination with elbasvir. Contraindications - Moderate to severe hepatic impairment (Child-Pugh B or C), concurrent use with strong CYP3A inducers (e.g. rifampin). Cautions - Liver enzyme elevations, co-infection with hepatitis B, use in decompensated cirrhosis. Avoid - Pregnancy unless clearly necessary; effective contraception required during treatment. Interactions - Strong CYP3A inducers (e.g. phenytoin, carbamazepine), efavirenz, HIV protease inhibitors. Trade names - Zepatier tab:® Adult: 100 mg grazoprevir + 50 mg elbasvir orally once daily for 12 weeks (± ribavirin depending on HCV genotype and resistance testing). Child: Not recommended; safety and efficacy not established in patients under 18 years.
Ledipasvir Indications - Chronic hepatitis C genotype 1, 4, 5, and 6 infections, used in combination with sofosbuvir (± ribavirin). Contraindications - Hypersensitivity to ledipasvir or any component of the formulation. Cautions - Severe renal impairment, decompensated liver disease, hepatitis B co-infection, prior treatment failure with NS5A inhibitors. Avoid - Co-administration with potent inducers of P-gp (e.g., rifampicin, carbamazepine). Interactions - Antacids (separate by 4 hours), H2 blockers, amiodarone (risk of bradycardia), tenofovir (monitor renal function). Trade names - Harvoni tab:® (with sofosbuvir) Adult: Ledipasvir 90 mg + Sofosbuvir 400 mg orally once daily for 12 weeks. Child: ≥3 years: Weight-based fixed-dose combination with sofosbuvir, once daily for 12 weeks.
Sofosbuvir Indications - Chronic hepatitis C infection in adults and children ≥3 years, used in combination with other antiviral agents such as ribavirin or ledipasvir. Contraindications - Known hypersensitivity to sofosbuvir or any component of the formulation. Cautions - Patients with severe renal impairment, co-infection with hepatitis B, risk of bradycardia when used with amiodarone. Avoid - Breastfeeding during treatment; pregnancy if used with ribavirin (teratogenic risk). Interactions - Avoid strong P-gp inducers (e.g., rifampicin, carbamazepine); interactions with amiodarone (risk of serious bradycardia). Trade names - Sovaldi tab:®, Hepcinat tab:® (Initiate by a specialist) Adult: 400 mg orally once daily in combination with other antiviral agents for 12–24 weeks depending on HCV genotype and clinical condition. Child: ≥3 years: 200–400 mg once daily (weight-based), used in combination with ribavirin or other antivirals.
Velpatasvir Indications - Chronic hepatitis C infection in adults and children ≥3 years, used in combination with sofosbuvir with or without ribavirin. Contraindications - Hypersensitivity to velpatasvir, sofosbuvir, or any component of the formulation. Cautions - Hepatitis B co-infection, severe hepatic impairment, renal impairment, prior use of direct-acting antivirals. Avoid - Use with potent inducers of P-gp and CYP enzymes (e.g. rifampicin, St. John's Wort). Avoid during pregnancy if ribavirin is co-administered. Interactions - Rifampicin, carbamazepine, phenytoin, and St. John's Wort significantly reduce plasma concentrations. Monitor with digoxin and amiodarone. Trade names - Epclusa tab:®, Velpanat tab:® (Initiate by a specialist) Adult: Sofosbuvir 400 mg + Velpatasvir 100 mg orally once daily for 12 weeks. Child: ≥3 years: Weight-based dosing with fixed-dose combination tablets once daily for 12 weeks.
Glecaprevir Indications - Chronic hepatitis C virus (HCV) infection in adults and children (≥3 years), in combination with pibrentasvir. Contraindications - Severe hepatic impairment (Child-Pugh C), coadministration with atazanavir or rifampicin. Cautions - Moderate hepatic impairment, patients with HCV/HIV co-infection, renal impairment, potential reactivation of hepatitis B. Avoid - Pregnancy unless clearly necessary; avoid breastfeeding during treatment. Interactions - May interact with statins, antiepileptics, oral contraceptives, and other antiviral drugs. Trade names - Mavyret tab:® (Specialist use only) Adult: Oral: Glecaprevir 300 mg + Pibrentasvir 120 mg once daily for 8–16 weeks depending on genotype and previous treatment. Child: Weight-based dosing in combination with pibrentasvir (≥3 years); consult specialist for exact dose.
Pibrentasvir Indications - Chronic hepatitis C virus (HCV) infection in adults and children (≥3 years), in combination with glecaprevir. Contraindications - Severe hepatic impairment (Child-Pugh C), use with atazanavir or rifampicin. Cautions - Patients with moderate hepatic impairment, HCV/HIV co-infection, history of hepatitis B infection (risk of reactivation), renal impairment. Avoid - Pregnancy unless clearly necessary; avoid breastfeeding during treatment. Interactions - May interact with antiepileptics, statins, oral contraceptives, and other antiviral agents. Trade names - Mavyret tab:® (Specialist use only) Adult: Oral: Pibrentasvir 120 mg + Glecaprevir 300 mg once daily for 8–16 weeks depending on genotype and treatment history. Child: Weight-based dosing in combination with glecaprevir (≥3 years); consult specialist for exact dose.
Calcium lactate Indications - Calcium deficiency, prevention and treatment of osteoporosis, hypocalcaemia. Contraindications - Hypercalcaemia, Severe renal impairment, Nephrolithiasis, Hypercalciuria. Cautions - Renal disease, Cardiac disease, Dehydration, History of kidney stones. Avoid - Use in hypercalcaemic disorders without monitoring. Interactions - May decrease absorption of tetracyclines, quinolones, iron, and thyroid hormones. Trade names - tab:®, Cap:® Adult: Oral: 1–3 g daily in divided doses depending on calcium requirement. Child: Oral: 45–65 mg/kg/day elemental calcium in divided doses.
Calcium phosphate Indications - Treatment and prevention of calcium deficiency, osteoporosis, and as a phosphate supplement in hypophosphatemia. Contraindications - Hypercalcaemia, Hyperphosphataemia, Severe renal impairment, Nephrolithiasis. Cautions - Renal impairment, Cardiac disease, Dehydration, History of kidney stones. Avoid - Use in patients with hypercalcaemia or chronic renal failure without specialist advice. Interactions - May reduce absorption of tetracyclines, quinolones, bisphosphonates, levothyroxine, and iron salts. Trade names - tab:®, Cap:® Adult: Oral: 500–1500 mg elemental calcium daily in divided doses. Child: Oral: 45–65 mg/kg/day elemental calcium in divided doses.
Dosulepin HCl Indications - Depressive illness, especially where sedation is required. Contraindications - Recent myocardial infarction, Arrhythmias, Heart block, Mania, Severe liver disease, Hypersensitivity to tricyclic antidepressants. Cautions - Epilepsy, Urinary retention, Prostatic hypertrophy, Glaucoma, Hyperthyroidism, Elderly, History of suicidal ideation. Avoid - Arrhythmias, During manic phase of bipolar disorder, Heart block. Interactions - May interact with MAO inhibitors, SSRIs, sympathomimetics, anticholinergics, and CNS depressants. Trade names - tab:®, Cap:® Adult: 75 mg orally daily in divided doses; may be increased to a maximum of 150 mg/day if needed. Child: Not recommended for use in children.
Mometasone furoate (Topical Corticosteroid)Indications - Severe inflammatory skin disorders such as eczema, atopic dermatitis, contact dermatitis, and psoriasis that are unresponsive to less potent corticosteroids; allergic rhinitis (nasal spray); asthma (inhalation); inflammatory dermatoses. Contraindications - Untreated bacterial, fungal, or viral skin infections; rosacea; perioral dermatitis; hypersensitivity to mometasone or any excipients. Avoid - Use on broken skin, long-term use on face or genitals, occlusion without medical supervision, use in children under 2 years without medical advice. Cautions - Use with caution in children (risk of adrenal suppression), prolonged use, application to large surface areas, or in pregnancy; avoid eye contact. Drug interactions - Minimal systemic absorption, but use with other corticosteroids may increase systemic effects; no major interactions at topical doses. Trade Names - Cream: Elocon® 0.1%, Ointment: Elocon®, Lotion: Mometasone Lotion®, Nasal Spray: Nasonex®, Inhaler: Asmanex® Adult: Apply a thin layer once daily to the affected area (cream/ointment/lotion); nasal spray 2 sprays in each nostril once daily; inhalation dose per asthma protocol. Child: >2 years: apply a thin layer once daily for up to 3 weeks under supervision; nasal spray from age 3; avoid long-term or high-dose use.
Hypoparathyroidism(aaa) Blood Parathyroid hormone(PTH), Blood cholesterol, Blood Creatinine, Blood Glucose Low blood PTH, Low blood calcium, Low blood magnesium, High blood phosphorus.
Hyperparathyroidism(aaa)Blood Parathyroid hormone(PTH), Blood calcium(++), Blood phosphorous(-. High PTH, High blood calcium.
Hyperthyroidism,Blood thyroxine hormone (T4), Blood thyroid-stimulating hormone (TSH. High blood thyroxine hormone (TH), Nonexistent of blood thyroid-stimulating hormone (TSH)
Morphine Sulfate (Opioid analgesic) Indications - Acute pain, Chronic pain, Myocardial infarction, Acute pulmonary oedema, Dyspnoea at rest in palliative care, Cough in palliative care, Premedication. Contraindications - Respiratory depression, Acute asthma, Paralytic ileus, Head injury, Raised intracranial pressure, Hypersensitivity to opioids. Cautions - Elderly, Hypotension, Hepatic or renal impairment, Hypothyroidism, Respiratory disease, CNS depression, Prostatic hypertrophy, Seizure disorders. Avoid - Alcohol, Concomitant CNS depressants, Breastfeeding (unless prescribed), Driving or operating machinery. Drug Interactions - Benzodiazepines, alcohol, MAOIs, tricyclic antidepressants, antipsychotics, muscle relaxants, sedatives. Side Effects - Respiratory depression, constipation, nausea, vomiting, sedation, hypotension, urinary retention, addiction, miosis. Trade Names - MS Contin® tab:, Oramorph® oral solution:, Avinza® cap:, Morphgesic® SR tab: Adult: Oral: 10–30 mg every 4 hours as needed (adjust based on pain control); IV: 2.5–10 mg every 2–4 hours as needed; SC/IM: 5–10 mg every 4 hours. Child: Oral/SC/IV: 0.1–0.2 mg/kg every 4 hours (under specialist supervision).
Hypothyroidism Blood thyroid-stimulating hormone (TSH), Thyroxine(T4. High level TSH and a low level T4 mean underactive thyroid.

General practice aid.

KBZ Pay