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Phenergan 25mg (Promethazine) Phenergan general information What is Phenergan used for? Phenergan tablets 25mg are used to treat a variety of allergic conditions, including allergic contact dermatitis, allergic reactions to drugs, hives (urticaria), and bites and stings, to relieve symptoms of redness, swelling and itching of the skin; also to relieve upper respiratory tract symptoms of allergic rhinitis, including nasal congestion, runny itchy nose and sneezing, caused by seasonal allergies like hayfever. Phenergan tablets 25mg are also used as an antiemetic to reduce nausea and vomiting due to several conditions including postoperative vomiting, irradiation sickness, drug-induced nausea and motion sickness. Phenergan tablets 25mg have sedative properties, which can be used to help with management of the symptoms of measles and chicken pox; also for short-term sedation. How does Phenergan work? Phenergan tablets 25mg contain promethazine, an antihistamine belonging to phenothiazine group of drugs that also has antiemetic (prevents nausea) and sedative properties. Histamine is a chemical released from mast cells, (cells involved in allergies) as part of the body’s defence mechanism during an allergic reaction. Histamine and binds to H1 receptors in small blood vessels causing them to leak, allowing white blood cells and blood proteins into the tissues. These infiltrating cells produce inflammatory chemicals (prostaglandins and leukotrienes) that cause tissue swelling and irritation, which are symptoms of an allergic reaction. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors and blocking the action of histamine without blocking its secretion. This action blocks histamine-mediated allergic reactions, relieving symptoms in the upper respiratory tract like nasal congestion, runny itchy nose and sneezing, and in the skin like redness, swelling and itching. Promethazine in Phenergan tablets 25mg also acts on the central nervous system (CNS). Some brain neurones (nerve cells) produce histamine and the action of histamine in the brain is involved in stress and anxiety reactions. Blocking these brain histamine receptors is thought to be responsible for causing sedation. The same CNS mechanism is also responsible for the anti-emetic effect of Phenergan tablets 25mg. Motion sickness is caused by conflicting information being received by the brain from the eyes and the vestibular system in the inner ear; messages sent by the ear suggest motion, whereas the messages sent by the eye suggest that the body is still. The conflicting information received into the brain stimulates the vomiting centre of the brain to induce the vomiting reflex. Promethazine in Phenergan tablets 25mg binds to histamine receptors on cells of the vestibular apparatus of the inner ear and is also thought to bind to histamine receptors on nerve cells in the brain to block the transmission of nerve impulses from the inner ear to the vomiting center in the brain, which in turn prevents transmission of nerve signals from the brain to receptors in the stomach, so that the vomiting reflex is blocked. What does Phenergan contain? Phenergan tablets 25mg contain the active ingredient promethazine hydrochloride, an antihistamine belonging to phenothiazine group of drugs that also has antiemetic (prevents nausea) and sedative properties. They also contain lactose, starch maize, povidone, magnesium stearate, hypromellose, macrogol 200, blue opaspray. Treating allergy with Phenergan Phenergan tablets 25mg contain the antihistamine promethazine, which is used to relieve symptoms of allergy in several allergic conditions, including allergic contact dermatitis, allergic reactions to drugs, hives (urticaria), bites and stings; also allergic rhinitis caused by seasonal allergies like hayfever. Histamine is a chemical released from mast cells, (cells involved in allergies) as part of the body’s defence mechanism during an allergic reaction and binds to H1 receptors in small blood vessels causing them to leak, allowing white blood cells and blood proteins into the tissues. These infiltrating cells produce inflammatory chemicals (prostaglandins and leukotrienes) that cause tissue swelling and irritation, which are symptoms of an allergic reaction. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors and blocking the action of histamine without blocking its secretion. This action blocks histamine-mediated allergic reactions, relieving symptoms in the upper respiratory tract like nasal congestion, runny itchy nose and sneezing, and in the skin like redness, swelling and itching. Treating motion sickness with Phenergan Phenergan tablets 25mg contain promethazine, an antihistamine that is used to control the nausea and vomiting associated with motion sickness caused by all forms of travel including, air, sea train or car travel. The inner ear contains the vestibular apparatus, comprising the membranous labyrinth structures of the cochlea and semicircular canals, where motion or changes in the body’s position is detected and continual information about body position is transmitted to the brain. Motion causes the endolymph (fluid that fills the inner ear) to trigger electrical signals via special sensory cells sending nerve impulses via neurotransmitters (chemicals that allow nerve cells to communicate) along the auditory nerve to the brain to be interpreted. Motion sickness is caused by conflicting information being received by the brain from the eyes and the vestibular system; messages sent by the ear suggest motion, whereas the messages sent by the eye suggest that the body is still. The conflicting information received into the brain stimulates the area postrema or vomiting centre of the brain to induce the vomiting reflex. Promethazine in Phenergan tablets 25mg binds to histamine receptors on cells of the vestibular apparatus of the inner ear and is also thought to bind to histamine receptors on nerve cells in the brain and this blocks the transmission of nerve impulses from the inner ear to the vomiting center in the brain, which in turn prevents transmission of nerve signals from the brain to receptors in the stomach, so that the vomiting reflex is blocked. Phenergan tablets 25mg are also used to reduce nausea and vomiting due to several conditions including postoperative vomiting, irradiation sickness and drug-induced nausea. Phenergan for sedation Phenergan tablets 25mg contain promethazine, an antihistamine that has sedating properties. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors in various parts of the body including the brain. Some brain neurones (nerve cells) produce histamine and the action of histamine in the brain is involved in stress and anxiety reactions. Blocking these brain histamine receptors is thought to be responsible for causing sedation. What are the side effects of Phenergan? The most commonly reported side effects when taking Phenergan tablets 25mg include: dry mouth, gastro-intestinal disturbances (diarrhoea, constipation, nausea, vomiting or abdominal pain) loss of appetite, tiredness, sleepiness, restlessness, dizziness, blurred vision. When should Phenergan not be used? You should not use Phenergan tablets 25mg if you: are allergic to promethazine or any ingredients in Phenergan are allergic to sulphites, benzoates or phenothiazines are pregnant or are breastfeeding have had jaundice induced by other phenothiazine derivatives are taking medicines that interact with Phenergan, including: monoamine oxidase inhibitors (MAOIs) (up to 14 days previously), tricyclic antidepressants, sedatives and hypnotics, opioid analgesics, barbiturates Phenergan tablets 25mg should not be used for children under 2 years or for anyone in a coma. What medications interact with Phenergan? Several medications interact with Phenergan tablets 25mg to increase side effects and can cause a serious reaction and should either not be taken while you are taking Phenergan or only after discussion and instruction from your doctor: including: monoamine oxidase inhibitors (MAOIs) (up to 14 days previously, tricyclic antidepressants, sedatives and hypnotics, opioid analgesics, barbiturates. How should Phenergan be taken? You should take your Phenergan tablets 25mg swallowed whole with a glass of water. The dose you take and how often depends on what you are being treated for and your doctor’s recommendation. For allergy and sedation you should take your Phenergan tablets 25mg at night. For travel sickness you should take one tablet the night before travel and you can take another dose the next day, provided 6-8 hours has elapsed. For nausea and vomiting you should take your Phenergan tablets 25mg every 4 to 6 hours as recommended by your doctor. You should continue to take your Phenergan tablets 25mg for as long as your symptoms persist, or as recommended by your doctor but for no longer than 10 consecutive days. How long should you take Phenergan? You should continue to take your Phenergan tablets 25mg for as long as your symptoms persist, or as recommended by your doctor but for no longer than 10 consecutive days. Missed dose of Phenergan If you miss a dose of Phenergan tablets 25mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should Phenergan be stored? You should store your Phenergan below 25°C in a cool dry place.
AR Estradiol Valerate 20mg/ml AR Estradiol Valerate general information What is AR Estradiol Valerate used for? Menopause is a natural part of a woman’s life and represents the end of her childbearing years and the beginning of her next phase of life. As menopause approaches, estrogen production starts to slow down, and eventually, no more is produced by the ovaries. Menstruation ceases, and this lack of estrogen can cause severe problems for some women. Hormone replacement therapy (HRT) can help relieve symptoms of menopause. AR Estradiol Valerate 20mg/mL is an injectable form of HRT. It is recommended for HRT in combination with progesterone, because of the health risk of estrogen-only HRT. You should only use AR Estradiol Valerate alone if you have had a hysterectomy; or are also taking progesterone. Estrogen is the female hormone produced by the ovaries that transforms the girl into the woman and plays a central role in all stages of female reproduction, along with other female hormones like progesterone. Estrogen stimulates the development of female sexual characteristics, including breast development and body shape. It regulates the menstrual cycle, triggers ovulation, and stimulates the thickening of the endometrium (lining of the uterus) and thickening of vaginal tissue and its secretions. It also plays other essential roles, including regulating lipid metabolism and supporting bone density throughout the fertile years of a woman’s life. As menopause approaches, estrogen production starts to slow down. Eventually, no more is produced by the ovaries, so that menstruation ceases. Symptoms of menopause Symptoms associated with low estrogen in menopause include hot flashes caused by sudden dilating of surface blood vessels; when this happens at night, they cause night sweats. Vaginal thinning and dryness, known as atrophic vaginitis, can cause discomfort or pain with sex and recurrent urine infections. Other signs of menopause are headaches, mood swings, lack of concentration, and loss of energy. Loss of bone density is another problem related to the loss of estrogen. It can lead to osteoporosis, which makes the bones brittle so that they fracture more easily. AR Estradiol Valerate relieves symptoms of menopause. It also helps prevent postmenopausal bone loss (osteoporosis), reducing the risk of fracture. Transgender hormone therapy Estrogen is an essential component in transgender hormone therapy for male to female gender reassignment. AR Estradiol Valerate helps stimulate the development of female sexual characteristics. This promotes the feminisation process, such as breast development, and inducing metabolic changes such as fat distribution to redefine the general body shape. How does AR Estradiol Valerate work? AR Estradiol Valerate contains estradiol valerate 20mg/mL. It is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women and relieve symptoms of menopause. Estradiol valerate is a synthetic form of naturally occurring estradiol, the primary and most active form of the female sex hormone estrogen. Estradiol is biologically similar to the natural hormone. Other types of estrogen that exist post-menopause include estrone. This form of estrogen is produced by conversion from androgens (predominantly a male hormone but found in small amounts in women) in other tissues like fat cells. Estone does not have much activity, which is why a lack of estradiol is responsible for most menopausal symptoms. Estradiol in AR Estradiol Valerate works by passing through the cell membrane and binding to specific receptors inside the cells of its target tissues, including the ovaries, uterus, bone, and breast tissue. Estrogen attaches to its receptor then interacts directly with the DNA to promote the expression (activation) of specific genes that make proteins needed for estrogen-dependent processes in those tissues. These include breast cell growth, improved lubrication of vaginal cells, and increased bone density. AR Estradiol Valerate is formulated for intramuscular injection in an oily solution that slows down absorption. A single injection of AR Estradiol Valerate is absorbed slowly over several weeks and works for longer, with a prolonged action time What does AR Estradiol Valerate contain? AR Estradiol Valerate contains the active ingredient estradiol valerate 20mg/mL that is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women. It also contains 224mg/mL benzyl benzoate, 20mg/mL benzyl alcohol, castor oil. What are the side effects of AR Estradiol Valerate? Most medications have some side effects, but they are not experienced by everyone. Some side effects are commonly experienced when taking AR Estradiol Valerate, but others are not so common, and you should discuss any problems or concerns with your primary care physician. Common side effects when taking AR Estradiol Valerate include breast tenderness, breast pain, abdominal pain, nausea, oedema, and headache, breakthrough bleeding, and spotting. When should AR Estradiol Valerate not be used? Have a talk with your primary healthcare physician before taking AR Estradiol Valerate 20mg/mLso that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for AR Estradiol Valerate you should consider the following before taking AR Estradiol Valerate : Have you ever had an unusual reaction or an allergy when taking AR Estradiol Valerate? Are you pregnant or breastfeeding? Do you have any problems with your liver or had a liver disease? Have you had an estrogen-dependent cancer, including cancer of the breast or endometrium? Have you had any condition caused by a blood clot such as deep vein thrombosis (blood clots in the leg), pulmonary embolism (blood clot in the lungs)? Do you have a heart condition like angina, and have you ever had cardiovascular disease, including a heart attack or stroke or uncontrolled high blood pressure? Have you had abnormal genital bleeding of unknown cause? What medications interact with AR Estradiol Valerate? Some medicines interact with AR Estradiol Valerate 20mg/mL and may affect the way it works, or are affected by AR Estradiol Valerate or increase side effects; you should discuss possible interactions with your primary care physician. These may include anticonvulsants like phenytoin and carbamazepine, barbiturates, anti-infectives like rifampicin, rifabutin, nevirapine, antibiotics like penicillin. If other medications may interact with AR Estradiol Valerate, your doctor will discuss these with you. How should AR Estradiol Valerate be taken and for how long? You should take your AR Estradiol Valerate using a clean, dry needle and syringe. Draw up 1mL Estradiol Valerate and inject deep into the upper, outer area of the gluteal muscle. The usual dose is one injection every four weeks, depending on your doctor’s recommendation. You should continue to take Estradiol Valerate Injection injections as long as recommended by your doctor, which may be for several months Missed dose of AR Estradiol Valerate If you miss a dose of AR Estradiol Valerate 20mg/mL, take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should AR Estradiol Valerate be stored? You should store your AR Estradiol Valerate 20mg/mL below 25°C in a cool dry place and protect from light.
Cardizem CD 180mg (Diltiazem) Cardizem general information What is Cardizem used for? Cardizem capsules 180mg are used to treat hypertension, which is high blood pressure when at rest. Although there are usually no other symptoms, high blood pressure increases risk of cardiovascular disease. Cardizem CD capsules reduce the risk of stroke and heart attack, by lowering blood pressure to normal resting levels. Cardizem CD can be used alone or in combination with other antihypertensive medications such as diuretics. Cardizem capsules 180mg are also used to treat chronic stable angina, to prevent symptoms like chest pain and to prevent heart attack; also to treat angina due to coronary artery spasm, which is an acute angina attack which can occur at rest. How does Cardizem work? Cardizem capsules 180mg contain diltiazem, which is a calcium channel blocker that inhibits the inflow of calcium ions across specific calcium channels in the cell membrane into smooth muscle cells of the heart (myocardium) and blood vessel walls (only arteries). Calcium is needed for smooth muscle cells to contract, so by blocking calcium channels, smooth muscle cells contraction is prevented. Diltiazem in Cardizem capsules 180mg blocks calcium channels in smooth muscle cells, allowing peripheral arteries to relax and widen (vasodilation) and this reduces the workload on the heart, the force needed for the heart to pump blood around the body (negative inotropic effect), increases oxygen supply to the heart, and decreases blood pressure. Cardizem capsules CD also causes widening of the main arteries of the heart, increasing the oxygen supply to the heart and, as the heart workload is reduced, the demand for oxygen is also reduced, which prevents chest pain symptoms of angina caused by lack of oxygen to the heart muscle. What does Cardizem contain? Cardizem capsules 180mg contain the active ingredient diltiazem hydrochloride, a calcium channel blocker used to treat hypertension and angina, formulated for slow release over a 24 hours period. They also contain fumaric acid, purified talc, non-pareil seeds (sucrose), colloidal silica, white beeswax, ethylcellulose, castor oil, stearic acid, methacrylic acid copolymers, tributyl acetylcitrate, simethicone, gelatin, Brilliant Blue FCF CI 42090 and titanium dioxide. What doses of Cardizem are available? Cardizem CD capsules are available online form Inhouse Pharmacy in 3 doses: 120mg CDcapsule 180mg CD capsules 240mg CD capsules Treating hypertension (high blood pressure) with Cardizem Cardizem capsules 180mg contain diltiazem, a calcium channel blocker used to lower blood pressure in people with hypertension (high blood pressure at rest), who are at risk of cardiovascular disease due to high blood pressure, although there are usually no other symptoms. Cardizem capsules 180mg can either be used alone or in combination with other antihypertensive drugs such as diuretics. Diltiazem in Cardizem CD capsules 180mg blocks the inflow of calcium ions, needed for contraction, into smooth muscle cells of the heart and blood vessel walls (only arteries), which causes blood vessel walls to relax and peripheral arteries to widen. This action reduces the workload on the heart, which is the force needed for the heart to pump blood around the body, as measured by blood pressure. By lowering blood pressure Cardizem capsules 180mg help reduce risk of cardiovascular disease including stroke and heart attack. Treating angina with Cardizem Cardizem capsules 180mg contain diltiazem, a calcium channel blocker used to treat chronic stable angina and angina due to coronary artery spasm, which is an acute angina attack that can occur at rest. Diltiazem in Cardizem CD capsules 180mg blocks the inflow of calcium ions, needed for contraction, into smooth muscle cells of the heart and blood vessel walls (only arteries), which causes blood vessel walls to relax and peripheral arteries to widen. Cardizem capsules 180mg reduces the workload on the heart and its demand for oxygen, while at the same time increasing oxygen supply to the heart, which prevents chest pain symptoms of angina caused by lack of oxygen to the heart muscle. What are the side effects of Cardizem? The most commonly reported side effects when taking Cardizem capsules 180mg include: headache, dizziness, flushing, bradycardia (slow heart rate), gastrointestinal upset (nausea, vomiting, constipation, diarrhoea, indigestion, gastric pain) oedema (swelling of the ankles, feet, face or hands), flushing, palpitations, tiredness, weakness, drowsiness. When should Cardizem not be used? You should not use Cardizem capsules 180mg if you: are allergic to diltiazem, other calcium channel blockers or any ingredients in Cardizem capsules are pregnant or are breastfeeding have certain types of abnormal heart rhythm like sick sinus syndrome have heart problems including, congestive heart failure, left ventricular failure or myocardial infarction with pulmonary congestion have hypotension (low blood pressure) have kidney or liver disease are taking medicines that interact with Cardizem, including: the muscle relaxant dantrolene, the antivirals atazanavir and ritonavir, cimetidine and ranitidine for gastric ulcers or reflux, the immunosuppressant cyclosporine, benzodiazepines like diazepam, midazolam and triazolam for depression or anxiety, corticosteroids like methylprednisolone, beta-blockers like propranolol’ digoxin for heart failure, the antiepileptic carbamazepine, ithium for mood disorders, theophylline for asthma, rimonabant for obesity, alpha-blockers for prostate problems, the antiarrhythmic amiodarone, inhalation anaesthetics like halothane, nitrates for heart conditions, statins for high cholesterol like simvastatin What medications interact with Cardizem? Several medications interact with Cardizem capsules 180mg and should either not be taken while you are taking Cardizem 180 or only after discussion and instruction from your doctor: Drugs that cause a serious reaction with Cardizem: the muscle relaxant dantrolene; lithium for mood disorders; alpha-blockers for prostate problems; the antiarrhythmic amiodarone; nitrates for heart conditions Drugs that affect Cardizem: the antivirals atazanavir and ritonavir; cimetidine and ranitidine for gastric ulcers or reflux; benzodiazepines like diazepam Drugs that are affected by Cardizem: the immunosuppressant cyclosporine; benzodiazepines like midazolam and triazolam for depression or anxiety; corticosteroids like methylprednisolone; beta-blockers like propranolol, digoxin for heart failure, the antiepileptic carbamazepine; theophylline for asthma; rimonabant for obesity; inhalation anaesthetics like halothane; statins for high cholesterol like simvastatin How should Cardizem be taken? You should take your Cardizem capsules 180mg with a glass of water, swallowed whole, once daily, with or without food. The dose you take and for how long should be as recommended by your doctor. If required your doctor may increase your dose. How long should you take Cardizem? You should take your Cardizem capsules 180mg for as long as recommended by your doctor. Missed dose of Cardizem If you miss a dose of Cardizem capsules 180mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should Cardizem be stored? You should store your Cardizem capsules 180mg below 25°C in a cool dry place.
Hyphoral 200mg (Ketoconazole) Hyphoral general information What is Hyphoral used for? Hyphoral tablets 200mg are used to treat severe systemic fungal infections only in patients who cannot tolerate other treatments or where other treatments have failed and where the potential benefits are considered to outweigh the potential risks. Hyphoral tablets 200mg are used for systemic fungal infections caused by inhalation of the spores of a soil fungus that can affect internal organs and cause influenza-like illness with fever, cough, headaches, skin rash, and myalgia (muscle pain), such as coccidioidomycosis caused by Coccidioides immitis, Blastomycosis, caused by Blastomyces dermatitidis and histoplasmosis caused by Histoplasma capsulatum. Serious symptoms can develop including chronic lung infection and widespread infection reaching the bones, skin and urinogenital tract. Hyphoral 200 is also used to treat chromomycosis, caused by penetration of the skin by a thorn or splinter and infection by several different fungal species that spread slowly through the skin. Hyphoral tablets 200mg should not be used to treat fungal meningitis as the medication cannot penetrate into the nervous system. How does Hyphoral work? Hyphoral tablets 200mg contain ketoconazole, a synthetic broad-spectrum antifungal agent that specifically kills the fungus by inhibiting the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells. Ketoconazole in Hyphoral tablets 200mg weakens the fungal cell membrane, causing the cell contents to leak out which kills the fungus, preventing the infection from spreading and relieving symptoms caused by the fungal infection, including pain and inflammation. What does Hyphoral contain? Hyphoral tablets 200mg contain the active ingredient ketoconazole, a synthetic broad-spectrum antifungal used to treat severe systemic fungal infections. Treating systemic fungal infection with Hyphoral Hyphoral tablets 200mg contain ketoconazole, a synthetic broad-spectrum antifungal agent that is used to treat severe systemic fungal infections in patients who cannot tolerate other treatments or where other treatments have failed and where the potential benefits are considered to outweigh the potential risks. These infections include coccidioidomycosis, histoplasmosis and blastomycosis, which are all caused by inhalation of spores produced by soil fungi. Symptoms usually include influenza-like illness with fever, cough, headaches, skin rash, and myalgia (muscle pain), however, these infections can be difficult to treat and can affect internal organs causing serious symptoms including chronic lung infection and widespread infection reaching the bones, skin and urinogenital tract. Ketoconazole in Hyphoral tablets 200mg inhibits the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells, which weakens the fungal cell membrane, causing the cell contents to leak out which kills the fungus, preventing the infection from spreading. What are the side effects of Hyphoral? The most commonly reported side effects when taking Hyphoral include: upset stomach, stomach cramps, nausea and vomiting, diarrhoea or constipation, headache, rash, dizziness, tingling sensations, sensitivity to light, erectile dysfunction, swelling of the breast. What are the risks of using of Hyphoral? Ketoconazole in Hyphoral tablets 200mg can cause serious liver toxicity and can result in the need for liver transplant or be fatal. Liver function should therefore be checked before and during treatment with Hyphoral tablets 200mg. Symptoms of liver toxicity include: nausea, vomiting feel tired, stomach pain or tenderness, weight loss, or loss of appetite, dark urine or light coloured stools, yellowing of the skin or the whites of the eyes, fever or rash. Ketoconazole in Hyphoral tablets 200mg can also cause QT prolongation due to changes in the electrical activity of the heart, which can cause irregular heart beat and can be life threatening When should Hyphoral not be used? You should not use Hyphoral tablets 200mg if you: are allergic to ketoconazole or any ingredients in Hyphoral are pregnant or are breastfeeding have liver disease or are recovering from hepatitis as there is a risk of serious liver damage have adrenal insufficiency have had an abnormal heart rhythm tracing (ECG) or anyone in your family have or have had a heart problem called “congenital long QT syndrome drink alcohol, as this may make you feel sick or cause headache in combination with ketoconazole are taking medicines that interact with Hyphoral, including terfenadine, mizolastine or astemizole for allergy, halofantrine for treating malaria, cisapride for reflux, statins for cholesterol lowering (simvastatin, atrovastatin lovastatin) pimozide for mental disorders, calcium channel blockers (bepridil, epleronone, nisoldipine) for angina and high blood pressure, medicines containing ergot alkaloids such as ergotamine, antiarrhythmic drugs for irregular heat beats (quinidine, disopyramide and dofetilide), irinotecan for cancer chemotherapy What medications interact with Hyphoral? Several medications interact with Hyphoral tablets 200mg and should either not be taken while you are taking Hyphoral or only after discussion and instruction from your doctor: Drugs that cause muscle problems with Hyphoral: the cholesterol lowering statins simvastatin, atrovastatin and lovastatin. Drugs that prolong the QT interval with with Hyphoral: pimozide for mental disorders, cisapride for reflux, methadone, the antiarrhythmics disopyramide, dofetilide, dronedarone, and ranolazine, medicines containing ergot alkaloids such as ergotamine Drugs that affect Hyphoral: ritonavir for HIV, anticonvulsants like phenytoin and carbamazepine, anti-infectives like rifampicin, nevirapine, isoniazid and rifabutin Drugs that are affected by Hyphoral: triazolam, midazolam, or alprazolam, halofantrine for treating malaria, terfenadine, mizolastine or astemizole for allergy, calcium channel blockers (bepridil, epleronone, nisoldipine) for angina and high blood pressure, irinotecan for cancer chemotherapy How should Hyphoral be taken? You should take your Hyphoral tablets 200mg swallowed whole with a glass of water and with food once a day. You should continue to take your Hyphoral tablets 200mg for 5-10 days or up to several months, depending on what you are being treated for and your doctor’s recommendations. Always finish your course of tablets even if you feel better, if not, the infection may not clear up completely. Do not take medicines that neutralise stomach acid within 2 hours of taking Hyphoral 200mg tablets, as sufficient stomach acid is required for ketoconazole to be absorbed and do not drink any alcohol while taking Hyphoral tablets 200mg. How long should you take Hyphoral? You should continue to take your Hyphoral tablets 200mg for 5-10 days or up to several months, depending on what you are being treated for and your doctor’s recommendations. Missed dose of Hyphoral If you miss a dose of Hyphoral tablets 200mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should Hyphoral be stored? You should store your Hyphoral tablets 200mg below 25°C in a cool dry place.
Wysolone 5 (Prednisolone 5mg) Wysolone general information What is Wysolone used for? Wysolone tablets 5mg are a steroid medication used in wide range of inflammatory, allergic and immune disorders to suppress clinical symptoms of the disease. Amongst their many applications, Wysolone tablets 5mg are used to reduce inflammation in conditions where the immune system is overactive, like anaphylaxis, severe asthma, acute outbreaks of eczema and severe allergies; to reduce inflammation and suppress the immune system in autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, ulcerative colitis or Crohn's disease, where the body’s immune system is directed against self, and to prevent rejection following organ transplant. Wysolone 5 is also used as an anti-cancer medication along with other drugs, to treat certain tumours like leukemia and lymphoma, and to replace a lack natural corticosteroid cortisol in conditions where there is not enough produced, such as underactive adrenal glands or congenital adrenal hyperplasia, which can affect the ability of the body to regulate blood pressure, blood sugar, energy levels, normal development and protect against stress. How does Wysolone work? Wysolone tablets 5mg contain prednisolone, which is corticosteroid hormone and is a synthetic derivative of the natural glucocorticoid cortisol. Prednisolone is the active metabolite of prednisone and can be converted from prednisone into prednisolone in the liver. Prednisolone in Wysolone 5 acts directly through the glucocorticoid receptor that is expressed inside most cells of the body and regulates transcription of specific genes that control many aspects of development, metabolism and the immune response. Prednisolone in Wysolone 5 has potent anti-inflammatory, anti-allergic, anti-rheumatic and immunosuppressant properties and has widespread effects acting on most tissues in the body to modify, glucose, fat, protein and calcium metabolism. The major therapeutic actions of prednisolone are to reduce the vascular (blood vessels) and cellular inflammatory response primarily by blocking the production of inflammatory chemicals, like prostaglandins and leukotrienes, from inflammatory cells to reduce the swelling, redness and pain associated with inflammation; to modify the actions of cells involved in the allergic response, and to suppress the immune system to prevent rejection following organ transplant. Prednisolone in Wysolone 5 also has anti-cancer properties and is used to prevent growth of certain tumours like leukemia and lymphoma. What does Wysolone contain? Wysolone tablets 5mg contain the active ingredient prednisolone a potent synthetic corticosteroid used to treat a wide range of inflammatory, allergic and immune disorders. What is the difference between prednisone and prednisolone? Prednisone is an inactive drug precursor that must be converted to prednisolone in the liver to become active. Prednisolone is particularly helpful for patients with liver problems who cannot metabolise prednisone into prednisolone in the liver. Treating inflammation with Wysolone Wysolone tablets 5mg contain prednisolone, which is a corticosteroid hormone and is a synthetic derivative of the natural glucocorticoid cortisol, with potent anti-inflammatory, anti-allergic, anti-rheumatic and immunosuppressant properties. Wysolone 5 is used in a wide range of inflammatory disorders, to suppress clinical symptoms of the disease where inflammation is caused by many different factors. For example, where the immune system is overactive, like severe asthma, acute outbreaks of eczema and severe allergies; autoimmune diseases, where the immune system is directed against self, like rheumatoid arthritis, systemic lupus erythematosus or Crohn's disease. The anti-inflammatory actions of prednisolone in Wysolone tablets 5mg are to block the production of inflammatory chemicals, like prostaglandins and leukotrienes, from inflammatory cells which reduces the swelling, redness and pain associated with inflammation. What are the side effects of Wysolone? The most commonly reported side effects when taking Wysolone 5 include: increased susceptibility to infection, muscle or bone aches and pains, weight gain, thinning of skin, bone demineralisation, slow wound healing, acne, redistribution of body fat creating the typical moon face, altered vision. Also behavioural and mood disturbances such as depression, irritability, anxiety, sleep disturbances. What are the health risks of taking Wysolone? Long term use of Wysolone 5 may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently. This may slow down the growth rate in children and will need regular monitoring. Wysolone 5 may also cause decreased bone mineral density, if used for long periods. Long term use of steroids may be associated with a range of side effects such as round face, altered body shape, altered hair growth, thinning of the bones, decreased resistance to infection, increased salt and water retention, increased blood pressure and diabetes. When should Wysolone not be used? You should not use Wysolone 5 if you: are allergic to prednisolone or any ingredients in Wysolone are pregnant or are breastfeeding have thyroid, stomach, heart, kidney or liver problems, high blood pressure, mood disorders, epilepsy, diabetes, glaucoma, osteoporosis have any infectious disease, acute infection, systemic fungal infection, tuberculosis, uncomplicated viral hepatitis are due to receive a vaccination with a live virus vaccine are taking medicines that interact with Wysolone like anti-inflammatories such as; diclofenac, ibuprofen, mefenamic acidor naproxen; barbiturates, phenylbutazone, phenytoin or rifampicin, anticoagulants, insulin for diabetes are taking diuretic medicines such as the thiazides or frusemide, these may cause increased loss of potassium when taken with Wysolone 5 What medications interact with Wysolone? Several medications interact with Wysolone and should either not be taken while you are taking Wysolone or only after discussion and instruction from your doctor: Drugs that cause a serious reaction with Wysolone: anti-inflammatories such as; diclofenac, ibuprofen, mefenamic acidor naproxen Drugs that affect Wysolone: rifampicin, barbiturates, phenylbutazone, phenytoin Drugs that are affected by Wysolone: live virus vaccine may be less effective, anticoagulants, insulin for diabetes How should Wysolone be taken? You should take your Wysolone tablets 5mg swallowed whole with a glass of water and with food. The dose of Wysolone 5 that you take, how often and for how long depends on what you are being treated for and as recommended by your doctor. You should continue to take your Wysolone 5 for as long as recommended by your doctor and should not stop taking them suddenly; withdrawal should be gradual to reduce risk of side effects. How long should you take Wysolone? You should continue to take your Wysolone 5 for as long as recommended by your doctor and should not stop taking them suddenly; withdrawal should be gradual to reduce risk of side effects. Missed dose of Wysolone If you miss a dose of Wysolone 5 take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should Wysolone be stored? You should store your Wysolone below 25°C in a cool dry place.

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Phenergan general information

What is Phenergan used for?

Phenergan tablets 25mg are used to treat a variety of allergic conditions, including allergic contact dermatitis, allergic reactions to drugs, hives (urticaria), and bites and stings, to relieve symptoms of redness, swelling and itching of the skin; also to relieve upper respiratory tract symptoms of allergic rhinitis, including nasal congestion, runny itchy nose and sneezing, caused by seasonal allergies like hayfever. Phenergan tablets 25mg are also used as an antiemetic to reduce nausea and vomiting due to several conditions including postoperative vomiting, irradiation sickness, drug-induced nausea and motion sickness. Phenergan tablets 25mg have sedative properties, which can be used to help with management of the symptoms of measles and chicken pox; also for short-term sedation.

How does Phenergan work?

Phenergan tablets 25mg contain promethazine, an antihistamine belonging to phenothiazine group of drugs that also has antiemetic (prevents nausea) and sedative properties. Histamine is a chemical released from mast cells, (cells involved in allergies) as part of the body’s defence mechanism during an allergic reaction. Histamine and binds to H1 receptors in small blood vessels causing them to leak, allowing white blood cells and blood proteins into the tissues. These infiltrating cells produce inflammatory chemicals (prostaglandins and leukotrienes) that cause tissue swelling and irritation, which are symptoms of an allergic reaction. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors and blocking the action of histamine without blocking its secretion. This action blocks histamine-mediated allergic reactions, relieving symptoms in the upper respiratory tract like nasal congestion, runny itchy nose and sneezing, and in the skin like redness, swelling and itching. Promethazine in Phenergan tablets 25mg also acts on the central nervous system (CNS). Some brain neurones (nerve cells) produce histamine and the action of histamine in the brain is involved in stress and anxiety reactions. Blocking these brain histamine receptors is thought to be responsible for causing sedation. The same CNS mechanism is also responsible for the anti-emetic effect of Phenergan tablets 25mg. Motion sickness is caused by conflicting information being received by the brain from the eyes and the vestibular system in the inner ear; messages sent by the ear suggest motion, whereas the messages sent by the eye suggest that the body is still. The conflicting information received into the brain stimulates the vomiting centre of the brain to induce the vomiting reflex. Promethazine in Phenergan tablets 25mg binds to histamine receptors on cells of the vestibular apparatus of the inner ear and is also thought to bind to histamine receptors on nerve cells in the brain to block the transmission of nerve impulses from the inner ear to the vomiting center in the brain, which in turn prevents transmission of nerve signals from the brain to receptors in the stomach, so that the vomiting reflex is blocked.

What does Phenergan contain?

Phenergan tablets 25mg contain the active ingredient promethazine hydrochloride, an antihistamine belonging to phenothiazine group of drugs that also has antiemetic (prevents nausea) and sedative properties. They also contain lactose, starch maize, povidone, magnesium stearate, hypromellose, macrogol 200, blue opaspray.

Treating allergy with Phenergan

Phenergan tablets 25mg contain the antihistamine promethazine, which is used to relieve symptoms of allergy in several allergic conditions, including allergic contact dermatitis, allergic reactions to drugs, hives (urticaria), bites and stings; also allergic rhinitis caused by seasonal allergies like hayfever. Histamine is a chemical released from mast cells, (cells involved in allergies) as part of the body’s defence mechanism during an allergic reaction and binds to H1 receptors in small blood vessels causing them to leak, allowing white blood cells and blood proteins into the tissues. These infiltrating cells produce inflammatory chemicals (prostaglandins and leukotrienes) that cause tissue swelling and irritation, which are symptoms of an allergic reaction. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors and blocking the action of histamine without blocking its secretion. This action blocks histamine-mediated allergic reactions, relieving symptoms in the upper respiratory tract like nasal congestion, runny itchy nose and sneezing, and in the skin like redness, swelling and itching.

Treating motion sickness with Phenergan

Phenergan tablets 25mg contain promethazine, an antihistamine that is used to control the nausea and vomiting associated with motion sickness caused by all forms of travel including, air, sea train or car travel. The inner ear contains the vestibular apparatus, comprising the membranous labyrinth structures of the cochlea and semicircular canals, where motion or changes in the body’s position is detected and continual information about body position is transmitted to the brain. Motion causes the endolymph (fluid that fills the inner ear) to trigger electrical signals via special sensory cells sending nerve impulses via neurotransmitters (chemicals that allow nerve cells to communicate) along the auditory nerve to the brain to be interpreted. Motion sickness is caused by conflicting information being received by the brain from the eyes and the vestibular system; messages sent by the ear suggest motion, whereas the messages sent by the eye suggest that the body is still. The conflicting information received into the brain stimulates the area postrema or vomiting centre of the brain to induce the vomiting reflex. Promethazine in Phenergan tablets 25mg binds to histamine receptors on cells of the vestibular apparatus of the inner ear and is also thought to bind to histamine receptors on nerve cells in the brain and this blocks the transmission of nerve impulses from the inner ear to the vomiting center in the brain, which in turn prevents transmission of nerve signals from the brain to receptors in the stomach, so that the vomiting reflex is blocked. Phenergan tablets 25mg are also used to reduce nausea and vomiting due to several conditions including postoperative vomiting, irradiation sickness and drug-induced nausea.

Phenergan for sedation

Phenergan tablets 25mg contain promethazine, an antihistamine that has sedating properties. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors in various parts of the body including the brain. Some brain neurones (nerve cells) produce histamine and the action of histamine in the brain is involved in stress and anxiety reactions. Blocking these brain histamine receptors is thought to be responsible for causing sedation.

What are the side effects of Phenergan?

The most commonly reported side effects when taking Phenergan tablets 25mg include: dry mouth, gastro-intestinal disturbances (diarrhoea, constipation, nausea, vomiting or abdominal pain) loss of appetite, tiredness, sleepiness, restlessness, dizziness, blurred vision.

When should Phenergan not be used?

You should not use Phenergan tablets 25mg if you:

are allergic to promethazine or any ingredients in Phenergan
are allergic to sulphites, benzoates or phenothiazines
are pregnant or are breastfeeding
have had jaundice induced by other phenothiazine derivatives
are taking medicines that interact with Phenergan, including: monoamine oxidase inhibitors (MAOIs) (up to 14 days previously), tricyclic antidepressants, sedatives and hypnotics, opioid analgesics, barbiturates

Phenergan tablets 25mg should not be used for children under 2 years or for anyone in a coma.

What medications interact with Phenergan?

Several medications interact with Phenergan tablets 25mg to increase side effects and can cause a serious reaction and should either not be taken while you are taking Phenergan or only after discussion and instruction from your doctor: including: monoamine oxidase inhibitors (MAOIs) (up to 14 days previously, tricyclic antidepressants, sedatives and hypnotics, opioid analgesics, barbiturates.

How should Phenergan be taken?

You should take your Phenergan tablets 25mg swallowed whole with a glass of water. The dose you take and how often depends on what you are being treated for and your doctor’s recommendation. For allergy and sedation you should take your Phenergan tablets 25mg at night. For travel sickness you should take one tablet the night before travel and you can take another dose the next day, provided 6-8 hours has elapsed. For nausea and vomiting you should take your Phenergan tablets 25mg every 4 to 6 hours as recommended by your doctor. You should continue to take your Phenergan tablets 25mg for as long as your symptoms persist, or as recommended by your doctor but for no longer than 10 consecutive days.

How long should you take Phenergan?

You should continue to take your Phenergan tablets 25mg for as long as your symptoms persist, or as recommended by your doctor but for no longer than 10 consecutive days.

Missed dose of Phenergan

If you miss a dose of Phenergan tablets 25mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Phenergan be stored?

You should store your Phenergan below 25°C in a cool dry place.

AR Estradiol Valerate 20mg/ml

AR Estradiol Valerate general information

What is AR Estradiol Valerate used for?

Menopause is a natural part of a woman’s life and represents the end of her childbearing years and the beginning of her next phase of life. As menopause approaches, estrogen production starts to slow down, and eventually, no more is produced by the ovaries. Menstruation ceases, and this lack of estrogen can cause severe problems for some women. Hormone replacement therapy (HRT) can help relieve symptoms of menopause. AR Estradiol Valerate 20mg/mL is an injectable form of HRT. It is recommended for HRT in combination with progesterone, because of the health risk of estrogen-only HRT. You should only use AR Estradiol Valerate alone if you have had a hysterectomy; or are also taking progesterone.

Estrogen is the female hormone produced by the ovaries that transforms the girl into the woman and plays a central role in all stages of female reproduction, along with other female hormones like progesterone. Estrogen stimulates the development of female sexual characteristics, including breast development and body shape. It regulates the menstrual cycle, triggers ovulation, and stimulates the thickening of the endometrium (lining of the uterus) and thickening of vaginal tissue and its secretions. It also plays other essential roles, including regulating lipid metabolism and supporting bone density throughout the fertile years of a woman’s life. As menopause approaches, estrogen production starts to slow down. Eventually, no more is produced by the ovaries, so that menstruation ceases.

Symptoms of menopause

Symptoms associated with low estrogen in menopause include hot flashes caused by sudden dilating of surface blood vessels; when this happens at night, they cause night sweats. Vaginal thinning and dryness, known as atrophic vaginitis, can cause discomfort or pain with sex and recurrent urine infections. Other signs of menopause are headaches, mood swings, lack of concentration, and loss of energy.

Loss of bone density is another problem related to the loss of estrogen. It can lead to osteoporosis, which makes the bones brittle so that they fracture more easily. AR Estradiol Valerate relieves symptoms of menopause. It also helps prevent postmenopausal bone loss (osteoporosis), reducing the risk of fracture.

Transgender hormone therapy

Estrogen is an essential component in transgender hormone therapy for male to female gender reassignment. AR Estradiol Valerate helps stimulate the development of female sexual characteristics. This promotes the feminisation process, such as breast development, and inducing metabolic changes such as fat distribution to redefine the general body shape.

How does AR Estradiol Valerate work?

AR Estradiol Valerate contains estradiol valerate 20mg/mL. It is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women and relieve symptoms of menopause.

Estradiol valerate is a synthetic form of naturally occurring estradiol, the primary and most active form of the female sex hormone estrogen. Estradiol is biologically similar to the natural hormone. Other types of estrogen that exist post-menopause include estrone. This form of estrogen is produced by conversion from androgens (predominantly a male hormone but found in small amounts in women) in other tissues like fat cells. Estone does not have much activity, which is why a lack of estradiol is responsible for most menopausal symptoms.

Estradiol in AR Estradiol Valerate works by passing through the cell membrane and binding to specific receptors inside the cells of its target tissues, including the ovaries, uterus, bone, and breast tissue. Estrogen attaches to its receptor then interacts directly with the DNA to promote the expression (activation) of specific genes that make proteins needed for estrogen-dependent processes in those tissues. These include breast cell growth, improved lubrication of vaginal cells, and increased bone density.

AR Estradiol Valerate is formulated for intramuscular injection in an oily solution that slows down absorption. A single injection of AR Estradiol Valerate is absorbed slowly over several weeks and works for longer, with a prolonged action time

What does AR Estradiol Valerate contain?

AR Estradiol Valerate contains the active ingredient estradiol valerate 20mg/mL that is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women. It also contains 224mg/mL benzyl benzoate, 20mg/mL benzyl alcohol, castor oil.

What are the side effects of AR Estradiol Valerate?

Most medications have some side effects, but they are not experienced by everyone. Some side effects are commonly experienced when taking AR Estradiol Valerate, but others are not so common, and you should discuss any problems or concerns with your primary care physician.

Common side effects when taking AR Estradiol Valerate include breast tenderness, breast pain, abdominal pain, nausea, oedema, and headache, breakthrough bleeding, and spotting.

When should AR Estradiol Valerate not be used?

Have a talk with your primary healthcare physician before taking AR Estradiol Valerate 20mg/mLso that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for AR Estradiol Valerate you should consider the following before taking AR Estradiol Valerate :

Have you ever had an unusual reaction or an allergy when taking AR Estradiol Valerate?
Are you pregnant or breastfeeding?
Do you have any problems with your liver or had a liver disease?
Have you had an estrogen-dependent cancer, including cancer of the breast or endometrium?
Have you had any condition caused by a blood clot such as deep vein thrombosis (blood clots in the leg), pulmonary embolism (blood clot in the lungs)?
Do you have a heart condition like angina, and have you ever had cardiovascular disease, including a heart attack or stroke or uncontrolled high blood pressure?
Have you had abnormal genital bleeding of unknown cause?

What medications interact with AR Estradiol Valerate?

Some medicines interact with AR Estradiol Valerate 20mg/mL and may affect the way it works, or are affected by AR Estradiol Valerate or increase side effects; you should discuss possible interactions with your primary care physician. These may include anticonvulsants like phenytoin and carbamazepine, barbiturates, anti-infectives like rifampicin, rifabutin, nevirapine, antibiotics like penicillin.

If other medications may interact with AR Estradiol Valerate, your doctor will discuss these with you.

How should AR Estradiol Valerate be taken and for how long?

You should take your AR Estradiol Valerate using a clean, dry needle and syringe. Draw up 1mL Estradiol Valerate and inject deep into the upper, outer area of the gluteal muscle. The usual dose is one injection every four weeks, depending on your doctor’s recommendation. You should continue to take Estradiol Valerate Injection injections as long as recommended by your doctor, which may be for several months

Missed dose of AR Estradiol Valerate

If you miss a dose of AR Estradiol Valerate 20mg/mL, take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should AR Estradiol Valerate be stored?

You should store your AR Estradiol Valerate 20mg/mL below 25°C in a cool dry place and protect from light.

Cardizem CD 180mg (Diltiazem)

Cardizem general information

What is Cardizem used for?

Cardizem capsules 180mg are used to treat hypertension, which is high blood pressure when at rest. Although there are usually no other symptoms, high blood pressure increases risk of cardiovascular disease. Cardizem CD capsules reduce the risk of stroke and heart attack, by lowering blood pressure to normal resting levels. Cardizem CD can be used alone or in combination with other antihypertensive medications such as diuretics. Cardizem capsules 180mg are also used to treat chronic stable angina, to prevent symptoms like chest pain and to prevent heart attack; also to treat angina due to coronary artery spasm, which is an acute angina attack which can occur at rest.

How does Cardizem work?

Cardizem capsules 180mg contain diltiazem, which is a calcium channel blocker that inhibits the inflow of calcium ions across specific calcium channels in the cell membrane into smooth muscle cells of the heart (myocardium) and blood vessel walls (only arteries). Calcium is needed for smooth muscle cells to contract, so by blocking calcium channels, smooth muscle cells contraction is prevented. Diltiazem in Cardizem capsules 180mg blocks calcium channels in smooth muscle cells, allowing peripheral arteries to relax and widen (vasodilation) and this reduces the workload on the heart, the force needed for the heart to pump blood around the body (negative inotropic effect), increases oxygen supply to the heart, and decreases blood pressure. Cardizem capsules CD also causes widening of the main arteries of the heart, increasing the oxygen supply to the heart and, as the heart workload is reduced, the demand for oxygen is also reduced, which prevents chest pain symptoms of angina caused by lack of oxygen to the heart muscle.

What does Cardizem contain?

Cardizem capsules 180mg contain the active ingredient diltiazem hydrochloride, a calcium channel blocker used to treat hypertension and angina, formulated for slow release over a 24 hours period. They also contain fumaric acid, purified talc, non-pareil seeds (sucrose), colloidal silica, white beeswax, ethylcellulose, castor oil, stearic acid, methacrylic acid copolymers, tributyl acetylcitrate, simethicone, gelatin, Brilliant Blue FCF CI 42090 and titanium dioxide.

What doses of Cardizem are available?

Cardizem CD capsules are available online form Inhouse Pharmacy in 3 doses:

120mg CDcapsule
180mg CD capsules
240mg CD capsules

Treating hypertension (high blood pressure) with Cardizem

Cardizem capsules 180mg contain diltiazem, a calcium channel blocker used to lower blood pressure in people with hypertension (high blood pressure at rest), who are at risk of cardiovascular disease due to high blood pressure, although there are usually no other symptoms. Cardizem capsules 180mg can either be used alone or in combination with other antihypertensive drugs such as diuretics. Diltiazem in Cardizem CD capsules 180mg blocks the inflow of calcium ions, needed for contraction, into smooth muscle cells of the heart and blood vessel walls (only arteries), which causes blood vessel walls to relax and peripheral arteries to widen. This action reduces the workload on the heart, which is the force needed for the heart to pump blood around the body, as measured by blood pressure. By lowering blood pressure Cardizem capsules 180mg help reduce risk of cardiovascular disease including stroke and heart attack.

Treating angina with Cardizem

Cardizem capsules 180mg contain diltiazem, a calcium channel blocker used to treat chronic stable angina and angina due to coronary artery spasm, which is an acute angina attack that can occur at rest. Diltiazem in Cardizem CD capsules 180mg blocks the inflow of calcium ions, needed for contraction, into smooth muscle cells of the heart and blood vessel walls (only arteries), which causes blood vessel walls to relax and peripheral arteries to widen. Cardizem capsules 180mg reduces the workload on the heart and its demand for oxygen, while at the same time increasing oxygen supply to the heart, which prevents chest pain symptoms of angina caused by lack of oxygen to the heart muscle.

What are the side effects of Cardizem?

The most commonly reported side effects when taking Cardizem capsules 180mg include: headache, dizziness, flushing, bradycardia (slow heart rate), gastrointestinal upset (nausea, vomiting, constipation, diarrhoea, indigestion, gastric pain) oedema (swelling of the ankles, feet, face or hands), flushing, palpitations, tiredness, weakness, drowsiness.

When should Cardizem not be used?

You should not use Cardizem capsules 180mg if you:

are allergic to diltiazem, other calcium channel blockers or any ingredients in Cardizem capsules
are pregnant or are breastfeeding
have certain types of abnormal heart rhythm like sick sinus syndrome
have heart problems including, congestive heart failure, left ventricular failure or myocardial infarction with pulmonary congestion
have hypotension (low blood pressure)
have kidney or liver disease
are taking medicines that interact with Cardizem, including: the muscle relaxant dantrolene, the antivirals atazanavir and ritonavir, cimetidine and ranitidine for gastric ulcers or reflux, the immunosuppressant cyclosporine, benzodiazepines like diazepam, midazolam and triazolam for depression or anxiety, corticosteroids like methylprednisolone, beta-blockers like propranolol’ digoxin for heart failure, the antiepileptic carbamazepine, ithium for mood disorders, theophylline for asthma, rimonabant for obesity, alpha-blockers for prostate problems, the antiarrhythmic amiodarone, inhalation anaesthetics like halothane, nitrates for heart conditions, statins for high cholesterol like simvastatin

What medications interact with Cardizem?

Several medications interact with Cardizem capsules 180mg and should either not be taken while you are taking Cardizem 180 or only after discussion and instruction from your doctor:

Drugs that cause a serious reaction with Cardizem: the muscle relaxant dantrolene; lithium for mood disorders; alpha-blockers for prostate problems; the antiarrhythmic amiodarone; nitrates for heart conditions
Drugs that affect Cardizem: the antivirals atazanavir and ritonavir; cimetidine and ranitidine for gastric ulcers or reflux; benzodiazepines like diazepam
Drugs that are affected by Cardizem: the immunosuppressant cyclosporine; benzodiazepines like midazolam and triazolam for depression or anxiety; corticosteroids like methylprednisolone; beta-blockers like propranolol, digoxin for heart failure, the antiepileptic carbamazepine; theophylline for asthma; rimonabant for obesity; inhalation anaesthetics like halothane; statins for high cholesterol like simvastatin

How should Cardizem be taken?

You should take your Cardizem capsules 180mg with a glass of water, swallowed whole, once daily, with or without food. The dose you take and for how long should be as recommended by your doctor. If required your doctor may increase your dose.

How long should you take Cardizem?

You should take your Cardizem capsules 180mg for as long as recommended by your doctor.

Missed dose of Cardizem

If you miss a dose of Cardizem capsules 180mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Cardizem be stored?

You should store your Cardizem capsules 180mg below 25°C in a cool dry place.

Hyphoral 200mg (Ketoconazole)

Hyphoral general information

What is Hyphoral used for?

Hyphoral tablets 200mg are used to treat severe systemic fungal infections only in patients who cannot tolerate other treatments or where other treatments have failed and where the potential benefits are considered to outweigh the potential risks. Hyphoral tablets 200mg are used for systemic fungal infections caused by inhalation of the spores of a soil fungus that can affect internal organs and cause influenza-like illness with fever, cough, headaches, skin rash, and myalgia (muscle pain), such as coccidioidomycosis caused by Coccidioides immitis, Blastomycosis, caused by Blastomyces dermatitidis and histoplasmosis caused by Histoplasma capsulatum. Serious symptoms can develop including chronic lung infection and widespread infection reaching the bones, skin and urinogenital tract. Hyphoral 200 is also used to treat chromomycosis, caused by penetration of the skin by a thorn or splinter and infection by several different fungal species that spread slowly through the skin. Hyphoral tablets 200mg should not be used to treat fungal meningitis as the medication cannot penetrate into the nervous system.

How does Hyphoral work?

Hyphoral tablets 200mg contain ketoconazole, a synthetic broad-spectrum antifungal agent that specifically kills the fungus by inhibiting the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells. Ketoconazole in Hyphoral tablets 200mg weakens the fungal cell membrane, causing the cell contents to leak out which kills the fungus, preventing the infection from spreading and relieving symptoms caused by the fungal infection, including pain and inflammation.

What does Hyphoral contain?

Hyphoral tablets 200mg contain the active ingredient ketoconazole, a synthetic broad-spectrum antifungal used to treat severe systemic fungal infections.

Treating systemic fungal infection with Hyphoral

Hyphoral tablets 200mg contain ketoconazole, a synthetic broad-spectrum antifungal agent that is used to treat severe systemic fungal infections in patients who cannot tolerate other treatments or where other treatments have failed and where the potential benefits are considered to outweigh the potential risks. These infections include coccidioidomycosis, histoplasmosis and blastomycosis, which are all caused by inhalation of spores produced by soil fungi. Symptoms usually include influenza-like illness with fever, cough, headaches, skin rash, and myalgia (muscle pain), however, these infections can be difficult to treat and can affect internal organs causing serious symptoms including chronic lung infection and widespread infection reaching the bones, skin and urinogenital tract. Ketoconazole in Hyphoral tablets 200mg inhibits the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells, which weakens the fungal cell membrane, causing the cell contents to leak out which kills the fungus, preventing the infection from spreading.

What are the side effects of Hyphoral?

The most commonly reported side effects when taking Hyphoral include: upset stomach, stomach cramps, nausea and vomiting, diarrhoea or constipation, headache, rash, dizziness, tingling sensations, sensitivity to light, erectile dysfunction, swelling of the breast.

What are the risks of using of Hyphoral?

Ketoconazole in Hyphoral tablets 200mg can cause serious liver toxicity and can result in the need for liver transplant or be fatal. Liver function should therefore be checked before and during treatment with Hyphoral tablets 200mg. Symptoms of liver toxicity include: nausea, vomiting feel tired, stomach pain or tenderness, weight loss, or loss of appetite, dark urine or light coloured stools, yellowing of the skin or the whites of the eyes, fever or rash. Ketoconazole in Hyphoral tablets 200mg can also cause QT prolongation due to changes in the electrical activity of the heart, which can cause irregular heart beat and can be life threatening

When should Hyphoral not be used?

You should not use Hyphoral tablets 200mg if you:

are allergic to ketoconazole or any ingredients in Hyphoral
are pregnant or are breastfeeding
have liver disease or are recovering from hepatitis as there is a risk of serious liver damage
have adrenal insufficiency
have had an abnormal heart rhythm tracing (ECG) or anyone in your family have or have had a heart problem called “congenital long QT syndrome
drink alcohol, as this may make you feel sick or cause headache in combination with ketoconazole
are taking medicines that interact with Hyphoral, including terfenadine, mizolastine or astemizole for allergy, halofantrine for treating malaria, cisapride for reflux, statins for cholesterol lowering (simvastatin, atrovastatin lovastatin) pimozide for mental disorders, calcium channel blockers (bepridil, epleronone, nisoldipine) for angina and high blood pressure, medicines containing ergot alkaloids such as ergotamine, antiarrhythmic drugs for irregular heat beats (quinidine, disopyramide and dofetilide), irinotecan for cancer chemotherapy

What medications interact with Hyphoral?

Several medications interact with Hyphoral tablets 200mg and should either not be taken while you are taking Hyphoral or only after discussion and instruction from your doctor:

Drugs that cause muscle problems with Hyphoral: the cholesterol lowering statins simvastatin, atrovastatin and lovastatin.
Drugs that prolong the QT interval with with Hyphoral: pimozide for mental disorders, cisapride for reflux, methadone, the antiarrhythmics disopyramide, dofetilide, dronedarone, and ranolazine, medicines containing ergot alkaloids such as ergotamine
Drugs that affect Hyphoral: ritonavir for HIV, anticonvulsants like phenytoin and carbamazepine, anti-infectives like rifampicin, nevirapine, isoniazid and rifabutin
Drugs that are affected by Hyphoral: triazolam, midazolam, or alprazolam, halofantrine for treating malaria, terfenadine, mizolastine or astemizole for allergy, calcium channel blockers (bepridil, epleronone, nisoldipine) for angina and high blood pressure, irinotecan for cancer chemotherapy

How should Hyphoral be taken?

You should take your Hyphoral tablets 200mg swallowed whole with a glass of water and with food once a day. You should continue to take your Hyphoral tablets 200mg for 5-10 days or up to several months, depending on what you are being treated for and your doctor’s recommendations. Always finish your course of tablets even if you feel better, if not, the infection may not clear up completely. Do not take medicines that neutralise stomach acid within 2 hours of taking Hyphoral 200mg tablets, as sufficient stomach acid is required for ketoconazole to be absorbed and do not drink any alcohol while taking Hyphoral tablets 200mg.

How long should you take Hyphoral?

You should continue to take your Hyphoral tablets 200mg for 5-10 days or up to several months, depending on what you are being treated for and your doctor’s recommendations.

Missed dose of Hyphoral

If you miss a dose of Hyphoral tablets 200mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Hyphoral be stored?

You should store your Hyphoral tablets 200mg below 25°C in a cool dry place.

Wysolone 5 (Prednisolone 5mg)

Wysolone general information

What is Wysolone used for?

Wysolone tablets 5mg are a steroid medication used in wide range of inflammatory, allergic and immune disorders to suppress clinical symptoms of the disease. Amongst their many applications, Wysolone tablets 5mg are used to reduce inflammation in conditions where the immune system is overactive, like anaphylaxis, severe asthma, acute outbreaks of eczema and severe allergies; to reduce inflammation and suppress the immune system in autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, ulcerative colitis or Crohn's disease, where the body’s immune system is directed against self, and to prevent rejection following organ transplant. Wysolone 5 is also used as an anti-cancer medication along with other drugs, to treat certain tumours like leukemia and lymphoma, and to replace a lack natural corticosteroid cortisol in conditions where there is not enough produced, such as underactive adrenal glands or congenital adrenal hyperplasia, which can affect the ability of the body to regulate blood pressure, blood sugar, energy levels, normal development and protect against stress.

How does Wysolone work?

Wysolone tablets 5mg contain prednisolone, which is corticosteroid hormone and is a synthetic derivative of the natural glucocorticoid cortisol. Prednisolone is the active metabolite of prednisone and can be converted from prednisone into prednisolone in the liver. Prednisolone in Wysolone 5 acts directly through the glucocorticoid receptor that is expressed inside most cells of the body and regulates transcription of specific genes that control many aspects of development, metabolism and the immune response. Prednisolone in Wysolone 5 has potent anti-inflammatory, anti-allergic, anti-rheumatic and immunosuppressant properties and has widespread effects acting on most tissues in the body to modify, glucose, fat, protein and calcium metabolism. The major therapeutic actions of prednisolone are to reduce the vascular (blood vessels) and cellular inflammatory response primarily by blocking the production of inflammatory chemicals, like prostaglandins and leukotrienes, from inflammatory cells to reduce the swelling, redness and pain associated with inflammation; to modify the actions of cells involved in the allergic response, and to suppress the immune system to prevent rejection following organ transplant. Prednisolone in Wysolone 5 also has anti-cancer properties and is used to prevent growth of certain tumours like leukemia and lymphoma.

What does Wysolone contain?

Wysolone tablets 5mg contain the active ingredient prednisolone a potent synthetic corticosteroid used to treat a wide range of inflammatory, allergic and immune disorders.

What is the difference between prednisone and prednisolone?

Prednisone is an inactive drug precursor that must be converted to prednisolone in the liver to become active. Prednisolone is particularly helpful for patients with liver problems who cannot metabolise prednisone into prednisolone in the liver.

Treating inflammation with Wysolone

Wysolone tablets 5mg contain prednisolone, which is a corticosteroid hormone and is a synthetic derivative of the natural glucocorticoid cortisol, with potent anti-inflammatory, anti-allergic, anti-rheumatic and immunosuppressant properties. Wysolone 5 is used in a wide range of inflammatory disorders, to suppress clinical symptoms of the disease where inflammation is caused by many different factors. For example, where the immune system is overactive, like severe asthma, acute outbreaks of eczema and severe allergies; autoimmune diseases, where the immune system is directed against self, like rheumatoid arthritis, systemic lupus erythematosus or Crohn's disease. The anti-inflammatory actions of prednisolone in Wysolone tablets 5mg are to block the production of inflammatory chemicals, like prostaglandins and leukotrienes, from inflammatory cells which reduces the swelling, redness and pain associated with inflammation.

What are the side effects of Wysolone?

The most commonly reported side effects when taking Wysolone 5 include: increased susceptibility to infection, muscle or bone aches and pains, weight gain, thinning of skin, bone demineralisation, slow wound healing, acne, redistribution of body fat creating the typical moon face, altered vision. Also behavioural and mood disturbances such as depression, irritability, anxiety, sleep disturbances.

What are the health risks of taking Wysolone?

Long term use of Wysolone 5 may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently. This may slow down the growth rate in children and will need regular monitoring. Wysolone 5 may also cause decreased bone mineral density, if used for long periods. Long term use of steroids may be associated with a range of side effects such as round face, altered body shape, altered hair growth, thinning of the bones, decreased resistance to infection, increased salt and water retention, increased blood pressure and diabetes.

When should Wysolone not be used?

You should not use Wysolone 5 if you:

are allergic to prednisolone or any ingredients in Wysolone
are pregnant or are breastfeeding
have thyroid, stomach, heart, kidney or liver problems, high blood pressure, mood disorders, epilepsy, diabetes, glaucoma, osteoporosis
have any infectious disease, acute infection, systemic fungal infection, tuberculosis, uncomplicated viral hepatitis
are due to receive a vaccination with a live virus vaccine
are taking medicines that interact with Wysolone like anti-inflammatories such as; diclofenac, ibuprofen, mefenamic acidor naproxen; barbiturates, phenylbutazone, phenytoin or rifampicin, anticoagulants, insulin for diabetes
are taking diuretic medicines such as the thiazides or frusemide, these may cause increased loss of potassium when taken with Wysolone 5

What medications interact with Wysolone?

Several medications interact with Wysolone and should either not be taken while you are taking Wysolone or only after discussion and instruction from your doctor:

Drugs that cause a serious reaction with Wysolone: anti-inflammatories such as; diclofenac, ibuprofen, mefenamic acidor naproxen
Drugs that affect Wysolone: rifampicin, barbiturates, phenylbutazone, phenytoin
Drugs that are affected by Wysolone: live virus vaccine may be less effective, anticoagulants, insulin for diabetes

How should Wysolone be taken?

You should take your Wysolone tablets 5mg swallowed whole with a glass of water and with food. The dose of Wysolone 5 that you take, how often and for how long depends on what you are being treated for and as recommended by your doctor. You should continue to take your Wysolone 5 for as long as recommended by your doctor and should not stop taking them suddenly; withdrawal should be gradual to reduce risk of side effects.

How long should you take Wysolone?

You should continue to take your Wysolone 5 for as long as recommended by your doctor and should not stop taking them suddenly; withdrawal should be gradual to reduce risk of side effects.

Missed dose of Wysolone

If you miss a dose of Wysolone 5 take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Wysolone be stored?

You should store your Wysolone below 25°C in a cool dry place.

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