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Kenacort-A 40 (by Aspen)
Kenacort-A40 general information
What is Kenacort-A40 used for?
Kenacort-A40 is used to treat pain, swelling and stiffness in a range of inflammatory conditions of joints and tendons, by injecting directly into the painful area of the joint or tendon sheath. These conditions include osteoarthritis (wear and tear of the joints); rheumatoid arthritis (inflammation and swelling of joints) and acute gouty arthritis (a form of arthritis caused by deposits of uric acid in the joints). Other painful joint conditions that Kenacort-A40 is used to treat include synovitis and tenosynovitis (inflammation of the synovium or fluid filled sheath that line the ends of joints or that surrounds a tendon); bursitis (inflammation of the fluid-filled sac or bursa between tendon and skin or bone); epicondylitis (also known as tennis elbow due to overuse of the elbow tendon). Kenacort-A40 is also used to treat various conditions that require systemic treatment, by injecting directly into the muscle (intramuscular), particularly where oral treatment is not possible. These conditions include various allergic diseases, such as severe seasonal or perennial allergic rhinitis, allergic dermatitis and bronchial asthma. Intramuscular Kenacort 40 is also used to treat various dermatoses (skin diseases), including severe dermatitis, such as bullous dermatitis herpetiformis (a chronic blistering skin condition); pemphigus (an autoimmune blistering condition of the skin and mucous membranes) and Stevens Johnson Syndrome (a severe hypersensitivity reaction of the skin and mucous membranes). Intramuscular Kenacort 40 is also used to treat generalised rheumatoid arthritis and other connective tissue disorders, such as systemic lupus erythematosus.
How does Kenacort-A40 work?
Kenacort-A40 contains triamcinalone a synthetic glucocorticoid corticosteroid, similar to the naturally occurring cortisol and its metabolite hydrocortisone, with potent anti-inflammatory, anti-allergic, anti-rheumatic and immunosuppressant properties. Corticosteroids are hormones that are naturally produced by the adrenal glands and are involved in regulation of many functions including control of inflammatory and immune responses. Triamcinalone in Kenacort-A40 inhibits the production of inflammatory chemicals, like prostaglandins and leukotrienes, from inflammatory cells at specific sites such as within joint tissue or in skin. This reduces the swelling, redness and pain associated with inflammation and helps suppress clinical symptoms of a wide range of disorders, including inflammation in the joints caused by wear and tear in osteoarthritis or overuse as in tennis elbow; also autoimmune diseases, where the immune system is directed against self, as in rheumatoid arthritis. By injecting Kenacort-A40 locally directly into the site of inflammation it can start to work immediately to provide symptom relief within a few hours and provide greater freedom of movement of the affected joint. When injected directly into the muscle, Kenacort-A40 is slowly absorbed into the blood so that its effect is systemic and is effective for a prolonged period. This is particularly useful for conditions that occur systemically such as skin conditions and connective tissue diseases.
What does Kenacort-A40 contain?
Kenacort-A40 aqueous suspension contains the active ingredient triamcinolone acetonide (40mg in a glass vial containing 1mL), a synthetic corticosteroid used to treat various inflammatory, allergic and autoimmune diseases. It also contains sodium chloride, benzyl alcohol, carmellose sodium, polysorbate and water.
Treating joint inflammation with Kenacort-A40
Kenacort-A40 contains triamcinalone a synthetic corticosteroid that is used to treat joint pain, swelling and stiffness in a range of inflammatory joint conditions, by injecting directly into the painful area of the joint or tendon sheath. These conditions include osteoarthritis (wear and tear of the joints); rheumatoid arthritis (inflammation and swelling of joints) and acute gouty arthritis (a form of arthritis caused by deposits of uric acid in the joints). Other painful joint conditions that Kenacort-A10 is used to treat include synovitis and tenosynovitis (inflammation of the synovium or fluid filled sheath that line the ends of joints or that surrounds a tendon); bursitis (inflammation of the fluid-filled sac or bursa between tendon and skin or bone); epicondylitis (also known as tennis elbow due to overuse of the elbow tendon). Triamcinalone in Kenacort-A40 inhibits the production of inflammatory chemicals, like prostaglandins and leukotrienes, from inflammatory cells at specific sites such as within joint tissue to reduce the swelling and pain associated with inflammation. By injecting Kenacort-A40 locally directly into the site of inflammation it can act on a specific tissue and start work immediately to provide freedom of movement and symptom relief within a few hours.
Kenacort-A40 for allergies
Kenacort-A40 contains triamcinalone a synthetic corticosteroid that is used to treat severe allergies requiring systemic treatment, such as such as severe seasonal or perennial allergic rhinitis. Kenacort-A40 is injected directly into the muscle (intramuscular) and is absorbed slowly into the blood so that it is effective for a prolonged period. This is particularly helpful where oral treatment is not possible. Triamcinalone in Kenacort-A40 is a synthetic corticosteroid, similar to the naturally occurring cortisol and its metabolite hydrocortisone that are involved in regulation of many functions including control of inflammatory and immune responses. The potent anti-allergic and immunosuppressant properties of triamcinalone in Kenacort-A40 helps dampen down the allergic response that causes symptoms like breathing difficulties in asthma and continual runny itchy nose associated with allergic rhinitis.
Kenacort-A40 for skin diseases
Kenacort-A40 contains triamcinalone a synthetic corticosteroid that is used to treat various skin diseases (dermatoses) such as bullous dermatitis herpetiformis (a chronic blistering skin condition); pemphigus (an autoimmune blistering condition of the skin and mucous membranes) and Stevens Johnson Syndrome (a severe hypersensitivity reaction of the skin and mucous membranes, usually in response to a medicine). Kenacort-A40 is injected directly into the muscle (intramuscular) and is absorbed slowly into the blood so that it is effective for a prolonged period. This is particularly helpful where oral treatment is not possible. Triamcinalone in Kenacort-A40 is a synthetic corticosteroid, similar to the naturally occurring cortisol and its metabolite hydrocortisone that are involved in regulation of many functions including control of inflammatory and immune responses. Some skin diseases such as pemphigus are caused by autoimmune reactions (where the immune system is directed against self); others like Stevens Johnson Syndrome are caused by a severe allergic reaction. The potent anti-allergic and immunosuppressant properties of triamcinalone in Kenacort-A40 help dampen down the autoimmune or allergic responses that cause severe symptoms in these dermatoses.
What are the side effects of Kenacort-A40?
The most commonly reported side effects when taking Kenacort-A40 include: increased risk and severity of infection, impaired wound healing, high blood pressure, fluid retention, muscle weakness, thinning of the skin, thinning of the bones with increased risk of fracture, peptic ulcer, convulsions, numbness and tingling, irregular menstrual periods, sore eyes, pain at the injection site.
When should Kenacort-A40 not be used?
You should not use Kenacort-A40 if you:
- are allergic to triamcinalone or any ingredients in Kenacort-A40
- are pregnant or are breastfeeding
- have any infectious disease, including infection in the joint and surrounding tissues and tuberculosis
- have idiopathic thrombocytopenic purpura (tendency to bleed easily)
- have no immunity to chicken pox or measles and are at risk of exposure
- are due to receive a vaccination with a live virus vaccine as Kenacort-A10 can affect the immune system’s ability to react to the virus
- have thyroid, stomach, heart, kidney or liver problems, high blood pressure, mood disorders, epilepsy, glaucoma, osteoporosis, without discussion with your doctor
- are diabetic without discussion with your doctor as Kenacort-A10 can increase blood sugar levels
- are taking medicines that interact with Kenacort-A40, including: including: non-steroidal anti-inflammatories such as; diclofenac and ibuprofen, aspirin, the antifungal amphotericin B, anticholinesterases for myethenia gravis and dementia, Isoniazid for tuberculosis, the immunosuppressant cyclosporine, digoxin for heart failure, oestrogen contraceptives, barbiturate sedatives, the anticonvulsants phenytoin, carbamazepine and primidone, the antibacterial rifampicin, aminoglutethimide for Cushing’s syndrome and adrenal gland disorder, human growth hormone, the antifungal ketoconazole
What medications interact with Kenacort-A40?
Several medications interact with Kenacort-A40 and should either not be taken while you are taking Kenacort-A40 or only after discussion and instruction from your doctor:
- Drugs that cause a serious reaction with Kenacort-A40: non-steroidal anti-inflammatories such as; diclofenac and ibuprofen, aspirin, amphotericin B, the immunosuppressant cyclosporine, digoxin for heart failure
- Drugs that affect Kenacort-A40: the anticonvulsants phenytoin, carbamazepine and primidone, the antibacterial rifampicin, aminoglutethimide for Cushing’s syndrome and adrenal gland disorder
- Drugs that are affected by Kenacort-A40: non-steroidal anti-inflammatories such as; diclofenac and ibuprofen, anticholinesterases for myethenia gravis and dementia, Isoniazid for tuberculosis, the immunosuppressant cyclosporine, digoxin for heart failure, oestrogen contraceptives, human growth hormone, the antifungal ketoconazole
How should Kenacort-A40 be given?
For intra-articular injection (into the joint), you will be given an injection of Kenacort-A40 directly into the affected joint or tendon sheath, depending on what you are being treated for. The dose you receive and how many injections you will be given, depends on your response and should be as recommended by your doctor. For intramuscular injection (intramuscular) you will be given an injection of Kenacort-A40 deep into the gluteal muscle and at different sites of the same muscle for subsequent injections. You will usually be given several injections over a period of time but for the shortest time possible to relieve your symptoms, to reduce the risk of side effects from long-term treatment. Your injections will be stopped gradually by reducing the dose.
How long should you take Kenacort-A40?
You will usually be given several injections over a period of time but for the shortest time possible to relieve your symptoms, to reduce the risk of side effects from long-term treatment. Your injections will be stopped gradually by reducing the dose.
How should Kenacort-A40 be stored?
You should store your Kenacort-A40 below 30°C in a dark place and it must be kept upright and must not be frozen.
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Restasis Eye Drops 0.05%
Restasis general information
What is Restasis used for?
Restasis Eye Drops 0.05% are used to increase natural tear production by the eye. Tear production is reduced due to inflammation associated with a chronic eye disease called keratoconjunctivitis sicca, more commonly known as dry eye disease, in which the eye does not produce sufficient tears to cover the cornea and protect the surface of the eye. This condition can be caused as a side effect of certain drugs, such as isotretinoin; as a symptom of certain diseases, such as rheumatoid arthritis; abnormal composition of tears causing them to evaporate rapidly; the aging process. Often there is no known cause (idiopathic). Chronic dry eyes results in inflammation and damage to the structures of the eye surface. Restasis Eye Drops 0.05% help prevent inflammation on the surface of the eye and this in turn helps increase natural tear production. Restasis Eye Drops 0.05% can also be used in conjunction with artificial tears.
How does Restasis work?
Restasis Eye Drops 0.05% contain cyclosporine, which is an immunosuppressive drug usually taken orally for suppressing the immune system and preventing rejection of organ transplants or for treatment of certain autoimmune diseases. When used for treating dry eye disease caused by reduced normal tear production, cyclosporine in Restasis Eye Drops 0.05% is thought to act as an immunomodulator by inhibiting the production of certain inflammatory chemicals called cytokines produced by lymphocytes at sites of inflammation. By damping down the effect of inflammatory cytokines in the eye, cyclosporine in Restasis Eye Drops 0.05% reduces local inflammation and helps the eyes resume normal tear production, which is important to protect and lubricate the eyes.
What does Restasis contain?
Restasis Eye Drops 0.05% are an ophthalmic emulsion containing the active ingredient cyclosporine, an immunosuppressant and immunomodulator, used to increase tear production in dry eye disease. They also contain: glycerine, castor oil, polysorbate 80, carbomer copolymer type A, purified water; and sodium hydroxide to adjust pH.
Treating dry eyes with Restasis
Restasis Eye Drops 0.05% contain cyclosporine, an immunomodulator that is used to increase natural tear production in dry eye disease. Dry eye disease is a chronic eye disease called keratoconjunctivitis sicca, in which the eye does not produce sufficient tears to cover the cornea and protect the surface of the eye. This condition can be caused as a side effect of certain drugs, such as isotretinoin; as a symptom of certain diseases, such as rheumatoid arthritis conditions; abnormal composition of teats causing them to evaporate rapidly; the aging process. Often there is no known cause (idiopathic). Chronic dry eyes results in inflammation which blocks normal tear production and causes damage to the structures of the eye surface. Cyclosporine in Restasis Eye Drops 0.05% is thought to work by inhibiting the production of certain inflammatory chemicals called cytokines produced by lymphocytes at sites of inflammation. Reducing inflammation locally helps the increase normal tear production, which is important to protect and lubricate the eyes.
What are the side effects of Restasis?
The most commonly reported side effects when taking Restasis include: burning sensation in the eye, eye redness and discharge, watery eyes, eye pain, foreign body sensation, itching, stinging, and blurred vision.
When should Restasis not be used?
You should not use Restasis Eye Drops 0.05% if you:
- are allergic to cyclosporine or any ingredients in Restasis eye drops
- have an active eye infection
- are pregnant or are breastfeeding, without discussion with your doctor
How should Restasis be used?
Before using your Restasis Eye Drops 0.05%, gently invert the vial a few times to ensure it is well mixed and the white emulsion is uniform and opaque. Add one drop into each eye twice daily, 12 hours apart. If you are also using artificial tears, you should wait for 15 minutes after applying your Restasis Eye Drops 0.05%. You should continue to use your Restasis Eye Drops 0.05% continually for as long as recommended by your doctor, usually for at least 30 days.
How long should you take Restasis?
You should continue to use your Restasis Eye Drops 0.05% continually for as long as recommended by your doctor, usually for at least 30 days.
Missed dose of Restasis
If you miss a dose of Restasis 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 Restasis be stored?
You should store your Restasis below 15-25°C in a cool dry place.
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Acnewar (Dapsone 5%) Gel
Acnewar general information
What is Acnewar used for?
Acnewar gel 5% is a topical treatment for of mild inflammatory acne vulgaris of the face, chest or back in patients over 12 years of age. Acne can range from mild non-inflammatory to severe inflammatory and can become infected. Acnewar gel 5% is suitable to treat acne that has not been responsive to non-antibiotic treatments and is used to help clear up the lesions, including pimples (papules), whiteheads (pustules) and blackheads (comedones), and to clear up and prevent spread of infection.
How does Acnewar work?
Acnewar gel 5% contains dapsone, an antibiotic that is used as a topical treatment for acne vulgaris but is also used to treat serious infections like leprosy and dermatitis herpetiformis (a chronic blistering skin condition) when taken orally. Acne forms as a result of over stimulation of the sebaceous glands (oil producing glands in hair follicles). This often happens in response to a surge of androgen hormones at puberty and causes pores to become clogged with dead skin, leading to the formation of new pimples, whitehead and blackheads (comedones), which can become infected and inflamed. Clogged pores attract bacteria which then overgrow and cause infection. Propionibacterium acnes are bacteria that normally exist on the skin without causing any problems, living on fatty acids in the sebum (oil) secreted by the sebaceous glands (oil producing glands in hair follicles of the skin). Dapsone in Acnewar gel 5% is a sulfone antibacterial with anti-inflammatory actions and is thought to work by blocking the formation of dihydrofolic acid bacterial cells, a precursor for folic acid, which is needed for nucleic acid synthesis. This does not affect the host cells as only preformed folic acid is used in mammalian cells. This action of dapsone in Acnewar gel 5% kills the bacteria and prevents spread of bacteria. Acnewar gel 5% is an effective and well tolerated option for the topical treatment of acne vulgaris.
What does Acnewar contain?
Acnewar gel 5% contains the active ingredient dapsone, a sulfone antibiotic that is used as a topical treatment for acne vulgaris to clear and prevent the spread of infection.
Treating acne with Acnewar
Acnewar gel 5% contains dapsone, an antibiotic with anti-inflammatory actions that is used as a topical treatment for acne vulgaris in people over 12 years of age. Acne is characterised by the formation of pimples (papules), whiteheads (pustules) and blackheads (comedones), which form as a result of over stimulation of the sebaceous glands (oil producing glands in hair follicles) and often relates to the androgen surge at puberty. Pores become clogged with dead skin, leading to the formation of new pimples, whitehead and blackheads (comedones), which can become infected and inflamed. Clogged pores attract bacteria which then overgrow and cause infection. Propionibacterium acnes are bacteria that normally exist on the skin without causing any problems, living on fatty acids in the sebum (oil) secreted by the sebaceous glands (oil producing glands in hair follicles of the skin). Dapsone in Acnewar gel 5% is and is thought to work by blocking folic acid in susceptible bacteria, which is needed for bacterial nucleic acid synthesis. This does not affect the host cells as only preformed folic acid is used. This action of dapsone in Acnewar gel 5% kills the bacteria and prevents spread of bacteria. Acnewar gel 5% is an effective and well tolerated option for the topical treatment of acne vulgaris1, 2.
What are the side effects of Acnewar?
The most commonly reported side effects when using Acnewar include dryness, itching and redness of the skin at the site of application. Other rare side effects include Methemoglobinemia (a blood disorder where abnormal amounts of the blood pigment methemoglobin is produced.
When should Acnewar not be used?
You should not use Acnewar gel 5% if you:
- are allergic to dapsone or any ingredients in Acnewar
- are pregnant or are breastfeeding, without discussion with your doctor
- have a glucose-6- phosphate dehydrogenase (G6PD) deficiency as this may increase risk of hemolytic anemia when using Acnewar
- are using benzoyl peroxide containing medication for acne followed by dapsone as this may cause a temporary local yellow or orange discoloration of the skin and facial hair
- are taking medicines that induce methemoglobinemia when using Acnewar, such as sulfonamides, acetaminophen, acetanilide, aniline dyes, benzocaine, chloroquine, dapsone, naphthalene, nitrates and nitrites, nitrofurantoin, nitroglycerin, nitroprusside, pamaquine, para‐aminosalicylic acid, phenacetin, phenobarbital, phenytoin, primaquine, and quinine
How should Acnewar be used?
You should apply your Acnewar gel 5% to the affected area of the skin once daily preferably in the evening before going to bed. Clean the skin with a mild soap or soap-free cleanser, rinse with water and pat dry. Apply a small amount of Acnewar gel 5% with clean fingers and rub gently into the skin. Wash your hand after applying your Acnewar gel 5% and ensure that you do not get any in your mouth, eyes, or vagina. Continue to use your Acnewar gel 5% daily for as long as recommended by your doctor, which is usually 12 weeks.
How long should you use Acnewar?
Continue to use your Acnewar gel 5% daily for as long as recommended by your doctor, which is usually 12 weeks.
Missed dose of Acnewar
If you miss a dose of Acnewar gel 5% apply it as soon as you remember, unless it is time to apply the next dose, then skip the missed dose. Do not take a double dose.
How should Acnewar be stored?
You should store your Acnewar gel 5% below 25°C in a cool dry place.
References
- Pickert A, Raimer S. An evaluation of dapsone gel 5% in the treatment of acne vulgaris. Expert Opin Pharmacother. 2009 Jun;10(9):1515-21.
- Al-Salama ZT, Deeks ED. Dapsone 7.5% Gel: A Review in Acne Vulgaris. Am J Clin Dermatol. 2017 Feb;18(1):139-145
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Daivobet 50/500 Ointment
Daivobet general information
What is Daivobet used for?
Daivobet ointment 50/500 is used to treat mild to moderate plaque psoriasis or psoriasis vulgaris of the body, in adults only. Psoriasis is a common non-allergic, chronic skin condition that causes the appearance of red raised patches of thickened skin covered in a dry silvery scaly rash usually on the skin of the elbows, knees and lower back. Psoriasis is thought to be an autoimmune disorder (when the immune system attacks self), which affects people of any age, usually who have a genetic predisposition. Daivobet ointment 50/500 is a topical treatment that helps reduce the redness and scaly appearance of the affected skin and relieve the symptoms of psoriasis, which are mainly pain and itching.
How does Daivobet work?
Daivobet ointment 50/500 contains a combination of two anti-psoriatic medications for treating psoriasis, calcipotriol, a derivative of calcitriol or Vitamin D (also known as 1,25 dihydroxycholecalciferol or 1,25(OH)2D3) and betamethasone, a synthetic topical corticosteroid. Vitamin D is primarily involved in regulating calcium metabolism but has other actions including inhibition of cell proliferation, stimulation of cell differentiation and immunomodulation. There are Vitamin D receptors in many cells of the body including keratinocytes (skin cells) and T-cells of the immune system, which are thought to play a role in the development of psoriasis. Calcipotriol binds to the Vitamin D receptor with similar affinity and although it has minimal activity in regulating calcium metabolism it is thought to behave in a similar way to Vitamin D in terms of inducing cell proliferation and suppressing differentiation. Psoriasis is characterised by raised scaly plaques due to excess proliferation and abnormal differentiation of the keratinocytes of the epidermis (upper skin layer); also by infiltration of immune cells, which produce chemicals called cytokines that are thought to be responsible for this abnormal behaviour as well as causing inflammation. Betamethasone has potent anti-inflammatory properties as well as immunosuppressive properties and is more potent than hydrocortisone. Betamethasone in Daivobet ointment 50/500 works by blocking production and action of phospholipase A2, the first enzyme involved in the synthesis of prostaglandins and leukotrienes, which are hormone-like substances involved in the process of inflammation; also cyclooxygenase (COX 1 and COX 2), the enzymes specifically involved in prostaglandin production. The combined action of calcipotriol and betamethasone ointment in Daivobet 50/500 reverses the abnormal changes in keratinocyte behaviour and reduces inflammation that occurs in psoriasis due to the infiltrated immune cells, restoring normal cell growth and behaviour to the epidermal skin cells. This reduces the scaling and thickening of the psoriatic plaques and relieves symptoms of psoriasis.
What does Daivobet contain?
Daivobet 50/500 reverses contains a combination of two active ingredients, calcipotriol (50mcg/gm), a derivative of calcitriol or Vitamin D and betamethasone dipropionate (500mcg/gm), a synthetic topical corticosteroid that are used to treat psoriasis. It also contains liquid paraffin, PPG-15-stearyl-ether, all-rac-alpha-tocopherol, castor oil, hydrogenated, butylhydroxytoluene (E321).
Treating psoriasis with Daivobet
Daivobet ointment 50/500 contains calcipotriol, a derivative of calcitriol or Vitamin D (also known as 1,25 dihydroxycholecalciferol or 1,25(OH)2D3) and betamethasone, a synthetic topical corticosteroid that are used in combination to treat mild to moderate plaque psoriasis or psoriasis vulgaris of the body. Psoriasis is a common non-allergic, chronic skin condition that causes the appearance of red raised patches of thickened skin covered in a dry silvery scaly rash usually on the skin of the elbows, knees and lower back. Psoriasis is thought to be an autoimmune disorder (when the immune system attacks self), which affects people of any age, usually who have a genetic predisposition. Vitamin D is primarily involved in regulating calcium metabolism but has other actions including inhibition of cell proliferation, stimulation of cell differentiation and immunomodulation. Calcipotriol in Daivobet ointment 50/500 works by binding to the Vitamin D receptor on many cells of the body including keratinocytes (skin cells) and T-cells of the immune system, which are thought to play a role in the development of psoriasis and is thought to behave in a similar way to Vitamin D in terms of inducing cell proliferation and suppressing differentiation. Psoriasis is characterised by raised scaly plaques due to excess proliferation and abnormal differentiation of the keratinocytes of the epidermis (upper skin layer); also by infiltration of immune cells, which produce chemicals called cytokines that are thought to be responsible for this abnormal behaviour as well as causing inflammation. Betamethasone in Daivobet ointment 50/500 has potent anti-inflammatory properties as well as immunosuppressive properties and works by blocking production and action of the enzymes specifically involved in production of the inflammatory chemicals prostaglandins. The combined action of calcipotriol and betamethasone ointment in Daivobet 50/500 reverses the abnormal changes in keratinocyte behaviour and reduces inflammation that occurs in psoriasis due to the infiltrated immune cells, restoring normal cell growth and behaviour to the epidermal skin cells. This reduces the scaling and thickening of the psoriatic plaques and relieves symptoms of psoriasis.
What are the side effects of Daivobet?
The most commonly reported side effects when using Daivobet ointment due to calcipotriol include: exacerbation of symptoms of psoriasis and local skin irritation, including itching, burning and rash, sensitivity of the skin to light (photosensitivity), skin discolouration and dermatitis. The most commonly reported side effects when using Daivobet ointment due to betamethasone include: stretch marks (striae), changes in skin colour, thinning and dilatation of the superficial blood vessels making them visible through the skin, increased hair growth. Long-term use of topical steroid creams may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently and this may slow down the growth rate in children
When should Daivobet not be used?
You should not use Daivobet ointment 50/500 if you:
- are allergic to calcipotriol, betamethasone or any ingredients in Daivobet
- are pregnant or are breastfeeding
- have kidney or liver disease
- have a known disorder of calcium metabolism
- other forms of psoriasis including guttate, erythrodermic, exfoliative and pustular psoriasis
- have a viral infection of the skin, tuberculosis, acne rosacea (a chronic skin condition), perioral dermatitis (facial rash around the mouth), fungal skin infections and ulcerative conditions
- have damaged skin
- are taking medicines that enhance the systemic availability of calcium, including calcium or vitamin D supplements
How should Daivobet be used?
You should apply your Daivobet ointment by applying to the affected area once daily. You should apply your Daivobet ointment to affected areas of your body, rub in gently and leave uncovered. Leave on the skin during the day or night before washing off. You should not use Daivobet ointment for more than 30% of body surface area. Do not use in skin folds such as groin or underarm, avoid the face, eyes, scalp and genitalia and protect against excessive UV radiation from the sun by covering the affected area with loose clothing. You should continue to use your Daivobet ointment for up to eight weeks and your doctor may recommend repeat treatments depending on how well you responded to the first treatment.
How long should you use Daivobet?
You should continue to use your Daivobet ointment for up to eight weeks and your doctor may recommend repeat treatments depending on how well you responded to the first treatment.
Missed dose of Daivobet
If you miss a dose of Daivobet ointment apply it as soon as you remember, unless it is time to apply the next dose, then skip the missed dose. Do not apply a double dose.
How should Daivobet be stored?
You should store your Daivobet ointment below 25°C in a cool dry place and do not refrigerate.
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Mirtazapine Tablets 45mg
MIRTAZAPINE general information
What is Mirtazapine used for?
Mirtazapine tablets 45mg are used to treat episodes of major depression to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. Mirtazapine tablets 45mg are also used to prevent relapse of depression. Mirtazapine tablets 45mg also have sedative properties.
How does Mirtazapine work?
Mirtazapine tablets 45mg contain mirtazapine, which is an antidepressant belonging to the class of drugs known as tetracyclic antidepressant. It is also classified as a Noradrenergic and Specific Serotonergic Antidepressant (NaSSA) because it acts as an antagonist of alpha adrenergic receptors in the central nervous system, which in turn increases the amount of noradrenaline and serotonin neurotransmitters (brain chemical that allows nerve cells to communicate). Mirtazapine in Mirtazapine tablets 45mg has several pharmacological properties, due to its interaction with several chemicals and numerous neurotransmitter systems that are thought to be involved in depression. These include blocking the effect of histamine, which explains its sedative properties. Also, Mirtazapine in Mirtazapine tablets 45mg blocks certain serotonin receptors, which prevents some of the side effects seen with antidepressants of the Selective Serotonin Reuptake Inhibitors (SSRI) and it does not have any effect as a reuptake inhibitor, which is how most SSRIs and SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors) work. The action of Mirtazapine in Mirtazapine tablets 45mg helps correct the chemical imbalance caused by a lack of certain neurotransmitters that is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin, which controls many body activities, including regulating mood.
What does Mirtazapine contain?
Mirtazapine tablets 45mg contain the active ingredient mirtazapine, a tetracyclic antidepressant classified as a Noradrenergic and Specific Serotonergic Antidepressant (NaSSA), used to treat, and relieve symptoms of major depression.
Treating depression with Mirtazapine
Mirtazapine tablets 45mg contain mirtazapine, a tetracyclic antidepressant used to treat episodes of major depression to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. Mirtazapine tablets 45mg are also used to prevent relapse of depression. Mirtazapine in Mirtazapine tablets 45mg interacts with several chemicals and numerous neurotransmitter systems that are thought to be involved in depression. These include blocking alpha adrenergic receptors in the central nervous system, which in turn increases the amount of noradrenaline and serotonin neurotransmitters (brain chemical that allows nerve cells to communicate). This action of Mirtazapine in Mirtazapine tablets 45mg helps correct the chemical imbalance caused by a lack of these neurotransmitters, which is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin, which controls many body activities, including regulating mood. Mirtazapine in Mirtazapine tablets 45mg also blocks certain serotonin receptors, which prevents some of the side effects seen with antidepressants of the Selective Serotonin Reuptake Inhibitors (SSRI) and it does not have any effect as a reuptake inhibitor, which is how most SSRIs and SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors) work.
What are the side effects of Mirtazapine?
The most commonly reported side effects when taking Mirtazapine tablets 45mg include increase in appetite and weight gain, lethargy, drowsiness or sleepiness, headache, tiredness, dry mouth, nausea diarrhoea, vomiting, orthostatic hypotension or dizzy spell (low blood pressure when standing up), abnormal dreams, tremor, dizziness, painful joints, back pain, muscle aches and pains, oedema (swelling due to fluid accumulation), skin rash.
When should Mirtazapine not be used?
You should not use Mirtazapine tablets 45mg if you:
- are allergic to Mirtazapine or any ingredients in Mirtazapine
- are pregnant or are breastfeeding
- have kidney or liver disease
- have had a recent heart attack or have other heart problems like angina
- have certain conditions without discussion with your doctor, including low blood pressure, diabetes, glaucoma, problems in urinating due to an enlarged prostate,
- are taking any monoamine oxidase inhibitor medications (such as phenelzine, tranylcypromine and moclobemide) as these can cause serious reactions if taken with Mirtazapine
- are taking medicines that interact with Mirtazapine, including other antidepressants like the SNRI venlafaxine, the SSRI fluoxetine, lithium for bipolar, St John’s wort, benzodiazepines for anxiety, anticoagulants like warfarin, the antifungal ketoconazole, cimetidine for stomach ulcers, the antibiotic erythromycin, anticonvulsant carbamazepine, the antiepileptic phenytoin, alcohol
What medications interact with Mirtazapine?
Several medications interact with Mirtazapine tablets 45mg and should either not be taken while you are taking Mirtazapine or only after discussion and instruction from your doctor:
- Drugs that cause a serious reaction with Mirtazapine: monoamine oxidase inhibitor medications, like phenelzine, other antidepressants like the SNRI venlafaxine, the SSRI fluoxetine, lithium for bipolar, St John’s wort, alcohol
- Drugs that affect Mirtazapine: the antifungal ketoconazole, cimetidine for stomach ulcers, the antibiotic erythromycin, anticonvulsant carbamazepine, the antiepileptic phenytoin
- Drugs that are affected by Mirtazapine: benzodiazepines for anxiety, anticoagulants like warfarin
How should Mirtazapine be taken?
You should take your Mirtazapine tablets 45mg swallowed whole with a glass of water with or without food once daily, at the same times each day preferably at bedtime. The dose you take and for how long depends on your doctor’s recommendations how well you are responding to treatment. You should begin to feel an improvement within one to two weeks, with maximum effect within four weeks and you should continue to take your Mirtazapine tablets 45mg for at least a further four to six months after you feel well.
How long should you take Mirtazapine?
You should take your Mirtazapine tablets 45mg regularly for as long as recommended by your doctor and you should begin to feel an improvement within one to two weeks, with maximum effect within four weeks. You should continue to take your Mirtazapine tablets 45mg for at least a further four to six months after you feel well.
Missed dose of Mirtazapine?
If you miss a dose of Mirtazapine 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 Mirtazapine be stored?
You should store your Mirtazapine below 25°C in a cool dry place.
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