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Rifakem-550 (Rifaximin 550mg)
Rifakem-550 general information
What is Rifakem-550 used for?
Rifakem 550 is an antibiotic used to treat hepatic encephalopathy (HE) to prevent its recurrence, where other treatments have failed or are contraindicated. HE is a neuropsychiatric condition in which there is a loss of brain function due to liver damage, such as cirrhosis. This results in a build-up of toxins like ammonia in the blood, which causes symptoms including confusion, difficulty thinking, loss of fine hand movements, behaviour changes and a musty or sweet smelling breath. It is thought that an imbalance of the intestinal microbiota (good versus bad bacteria) with a higher proportion of pathogenic bacteria, may contribute to the pathogenesis of several diseases including liver cirrhosis. Rifakem-550 is effective against a wide range of intestinal bacteria, including those like Streptococcus salivarius that produce ammonia. Ammonia is a toxin that a healthy liver would convert into urea which is then excreted in the urine, but in a damaged liver this process is impaired. Rifakem tablets 550mg help restore the balance in the composition of intestinal bacteria and reduce risk of HE and its recurrence1. Rifakem-550 cannot be used to treat other infections as it is not absorbed into the blood and therefore, only acts locally in the gastrointestinal tract to kill local bacteria.
How does Rifakem-550 work?
Rifakem tablets 550mg contain rifaximin, a locally acting antibiotic belonging to the rifamycin class of antibiotics. It is a non-systemic antibiotic, which means it acts locally in the intestines and is not absorbed into the circulation. Rifaximin in Rifakem 550 works by binding to the bacterial enzyme DNA-dependent RNA polymerase and this action inhibits bacterial RNA synthesis. This prevents RNA transcription and thereby the production of bacterial proteins, which inhibits growth of the bacteria. Rifaximin in Rifakem 550 is effective against bacteria that break down proteins in the intestines by the process of deamination resulting in ammonia production, reducing the high blood levels of ammonia that contribute to the pathogenesis of hepatic encephalopathy2-5.
What does Rifakem-550 contain?
Rifakem tablets contain the active ingredient rifaximin 550mg, a locally acting antibiotic used to prevent the recurrence of hepatic encephalopathy where other treatments have failed or are contraindicated.
Rifakem-550 for hepatic encephalopathy
Rifakem tablets 550mg contain rifaximin, a locally acting antibiotic that is used to treat hepatic encephalopathy to prevent its recurrence where other treatments have failed or are contraindicated. Hepatic encephalopathy is a neuropsychiatric condition in which there is a loss of brain function due to liver damage, such as cirrhosis. This results in a build-up of toxins in the blood, such as ammonia which causes symptoms including confusion, difficulty thinking, loss of fine hand movements, behaviour changes and a musty or sweet smelling breath. Rifaximin in Rifakem 550 is effective against bacteria that break down proteins in the intestines by deamination resulting in ammonia production. A healthy liver would normally convert ammonia into urea which is then excreted in the urine, but in a damaged liver this process is impaired. Rifaximin in Rifakem-550 inhibits growth of ammonia producing bacteria, reducing the high blood levels of ammonia that contribute to the pathogenesis of hepatic encephalopathy.
What are the side effects of Rifakem-550?
The most commonly reported side effects when taking Rifakem-550 include dizziness, headache, fever, fatigue, abdominal pain, constipation, defecation urgency, diarrhoea, flatulence, bloating and distension, nausea and vomiting, oedema, rash. Rifakem-550 can result in Clostridium difficile-associated diarrhoea (CDAD), which is a more serious form of diarrhoea ranging in severity from mild to life-threatening and is due to the changes in intestinal flora that happens when taking antibiotics.
When should Rifakem-550 not be used?
You should not use Rifakem-550 if you:
- are allergic to rifaximin or any ingredients in Rifakem-550
- are pregnant or are breastfeeding
- have severe liver disease, without discussion with your doctor
- have any form of intestinal obstruction
- are taking medicines that interact with Rifakem-550, including other rifamycin antibiotics and the immunosuppressant ciclosporin. Rifakem-550 reduces the effect of warfarin
How should Rifakem-550 be taken?
For hepatic encephalopathy you should take your Rifakem-550 swallowed whole with a glass of water with or without food twice daily for 6 months. The dose you take should be as recommended by your doctor. You should only continue to take your Rifakem-550 beyond 6 months based on your doctor’s recommendation, after evaluation by your doctor of how well you are responding and any side effects you are experiencing.
How long should you take Rifakem-550?
You should only continue to take your Rifakem-550 beyond 6 months based on your doctor’s recommendation, after evaluation by your doctor of how well you re responding and any side effects you are experiencing.
Missed dose of Rifakem-550
If you miss a dose of Rifakem-550 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 Rifakem-550 be stored?
You should store your Rifakem-550 below 25°C in a cool dry place.
References
- Ponziani FR, Gerardi V, Pecere S, D'Aversa F, Lopetuso L, Zocco MA, Pompili M, Gasbarrini A. Effect of rifaximin on gut microbiota composition in advanced liver disease and its complications. World J Gastroenterol. 2015 Nov 21;21(43):12322-33.
- Zeng X, Tang XJ, Sheng X, Ni W, Xin HG, et al. Does low-dose rifaximin ameliorate endotoxemia in patients with liver cirrhosis: a prospective study. J Dig Dis 2015 Nov;16(11):665-74.
- Shayto RH, Abou Mrad R, Sharara AI. Use of rifaximin in gastrointestinal and liver diseases. World J Gastroenterol. 2016 Aug 7;22(29):6638-51.
- Peleman C, Camilleri M. Rifaximin, Microbiota Biology, and Hepatic Encephalopathy. Clin Transl Gastroenterol 2016 Oct 6;7(10):
- Iadevaia MD, Del Prete A, Cesaro C, Gaeta L, Zulli C, Loguercio C. Rifaximin in the treatment of hepatic encephalopathy. Hepat Med 2011; 3: 109–117.
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Esomac 40 (Esomeprazole 40mg)
Esomac general information
What is Esomac used for?
Esomac tablets 40mg are used to treat conditions caused by gastric reflux, which is when the acidic contents of the stomach flow back into the oesophagus because the sphincter (muscle at the junction of the oesophagus and stomach) that normally acts as a one-way valve and prevents backflow of stomach contents, does not function properly or is damaged. Gastroesophageal reflux disease (GORD), as this condition is known, causes symptoms like heartburn and dyspepsia (indigestion and abdominal pain), and can damage the oesophagus causing inflammation (oesophagitis). Esomac 40 is also used to treat and prevent peptic ulcers in the stomach (gastric ulcers or damage to the stomach lining) and duodenum (duodenal ulcers or damage to the lining of the upper intestine); and gastric ulcers caused by use of nonsteroidal anti-inflammatory drugs (NSAID); also as combination therapy to treat gastric ulcers that are caused by infection of the stomach with the bacterium Helicobacter pylori, in conjunction with using antibiotics. Esomac 40 is also used to treat symptoms of acid-related dyspepsia that can be caused by eating high fat or acidic foods, or Zollinger-Ellison syndrome in which increased levels of the hormone gastrin causes an excessive production of gastric acid.
How does Esomac work?
Esomac tablets 40mg contain esomeprazole, a proton pump inhibitor that is used to treat conditions caused by excess gastric acid, by reducing the amount of gastric acid released into the stomach. Stomach acid is needed for digestion of proteins in your diet and is made by the parietal cells of the stomach wall. Gastric acid production is dependent on the action of the enzyme H+/K+-ATPase, which is the proton pump responsible for pumping positive hydrogen ions out of the cells into the stomach, which increases the acidity of the stomach contents. Esomeprazole in Esomac 40 inhibits the functioning of the H+/K+-ATPase, which prevents acid secretion by blocking the source of acid production. This action of esomeprazole reduces the acidity of the stomach contents, which reduces the acid damage that can be caused by gastroesophageal reflux disease (GORD) and oesophagitis and relieves symptoms caused by excess gastric acid like heartburn and dyspepsia. By inhibiting gastric acid secretion Esomac 40 also help prevent the formation of gastric (stomach) and duodenal (upper intestine) peptic ulcers and also helps ulcers and damage caused by gastric reflux to heal.
What does Esomac contain?
Esomac tablets 40mg contain the active ingredient esomeprazole, which is a proton pump inhibitor that is used to treat conditions caused by excess gastric acid secretion.
Treating gastric reflux with Esomac
Esomac tablets 40mg contain esomeprazole, which is used to treat conditions caused by gastroesophageal reflux disease (GORD). Gastric reflux is when the acidic contents of the stomach flow back into the oesophagus because the sphincter (muscle at the junction of the oesophagus and stomach) that normally acts as a one-way valve and prevents backflow of stomach contents, does not function properly or is damaged. Symptoms caused by gastric reflux include heartburn and dyspepsia (indigestion and abdominal pain), and damage to the oesophagus causing inflammation (oesophagitis). Esomeprazole in Esomac tablets 40mg reduces acid secretion by parietal cells of the stomach wall, by blocking the action of the enzyme H+/K+-ATPase, which is responsible for acid production. This action of esomeprazole reduces the acidity of the stomach contents, which reduces the acid damage that can be caused by gastroesophageal reflux disease (GORD) and oesophagitis, relieves symptoms caused by excess gastric acid like heartburn and dyspepsia; as well as helping damaged tissues caused by excess acid to heal.
Esomac for peptic ulcers
Esomac tablets 40mg contain the active ingredient esomeprazole, which is used to treat and prevent prevent peptic ulcers in the stomach (gastric ulcers or damage to the stomach lining) and duodenum (duodenal ulcers or damage to the lining of the upper intestine), caused by excess secretion of gastric acid; and gastric ulcers caused by use of nonsteroidal anti-inflammatory drugs (NSAID). Esomac tablets 40mg are also used as combination therapy to treat and prevent gastric ulcers that are caused by infection of the stomach with the bacterium Helicobacter pylori, in conjunction with using antibiotics. Esomeprazole in Esomac tablets 40mg reduces acid secretion by parietal cells of the stomach wall, by blocking the action of the enzyme H+/K+-ATPase, which responsible for acid production. This action of esomeprazole reduces the acidity of the stomach contents, which reduces the acid damage to the stomach wall and allows ulcers that have already developed to heal.
What are the side effects of Esomac?
The most commonly reported side effects when taking Esomac include, include: constipation, nausea, vomiting, diarrhoea, wind (flatulence), headache, dry mouth, skin rash, dizziness, sensation of tingling in the skin (paraesthesia), insomnia.
When should Esomac not be used?
You should not use Esomac 40 if you:
- are allergic to esomeprazole or any ingredients in Esomac
- are taking medicines that interact with Esomac including: the antifungals ketoconazole and itraconazole, the anticoagulant warfarin, phenytoin for epilepsy, the antiretroviral atazanavir, the antibiotic clarithromycin, the immunosuppressive tacrolimus, the sedative diazepam
How should Esomac be taken?
You should take your Esomac tablets 40mg with a glass of water at least one hour before a meal. You should continue to take your Esomac tablets 40mg for as long as recommended by your doctor, usually for a few weeks to 6 months, depending on the condition you are being treated for.
How long should you take Esomac?
You should continue to take your Esomac tablets 40mg for as long as recommended by your doctor, usually for a few weeks to 6 months, depending on the condition you are being treated for.
Missed dose of Esomac
If you miss a dose of Esomac 40 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 Esomac be stored?
You should store your Esomac 40 below 25°C in a cool dry place.
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Ivrea 1 (Ivermectin 1%) Cream
Ivrea 1 general information
What is Ivrea 1 used for?
Ivrea 1 cream 1% is a topical treatment for the inflammatory lesions caused by Rosacea, which is a chronic skin condition characterised by a red rash mainly on the face including the cheeks, nose, chin and forehead. Symptoms of rosacea include flushing, red spider veins (telangiectasia), papules (hard pimples), pustules (pus-filled pimples), dry flaky skin, swelling of the face and eyes, burning skin, sore eyes and thickening of the skin. Rosacea differs from acne by not producing blackheads or cysts. There is an inherited disposition for rosacea but also several factors exacerbate the condition by increasing blood flow to the skin and causing inflammation. These include sun exposure, cold temperatures, strong winds, some medications like steroids, certain foods like spicy foods, cheese and chocolate, hot drinks, wine, some facial creams and cosmetics, and stress. The Dermadex mite that inhabits the facial hair follicles are a normal inhabitant of the skin and usually causes no problems. However, they are found in greater numbers in the skin of those suffering from rosacea and are thought to be a trigger for inflammation. Rosacea can also affect emotional well-being and mental health which may result in social phobias, anxiety, and depression. Ivrea 1 cream 1% helps relieve symptoms of rosacea and reduce the inflammatory lesions.
How does Ivrea 1 work?
Ivrea 1 cream 1% is contains ivermectin that is used to treat inflammatory lesions of rosacea. Although the mechanism of action of ivermectin in the treatment of rosacea is not fully known, it is known to have anti-parasitic and anti-inflammatory properties. Ivermectin in Ivrea 1 cream 1% inhibits the production of inflammatory cytokines like interleukin-1 (IL-1) and increases the production of anti-inflammatory cytokines like Interleukin-10 (IL-10) by macrophages at the site of inflammation1, 2. Ivermectin in Ivrea 1 cream 1% may reduce inflammation by interacting directly with the nervous system of the Dermadex mite that is thought to be a trigger for inflammation in rosacea. Ivermectin stimulates overproduction of neurotransmitters in the mite, without effect on skin cells, causing paralysis and killing the mite. Reducing inflammation helps reduce the lesions and blemishes caused by rosacea, and the mild moisturising base of Ivrea 1 cream helps soothe symptoms of rosacea.
What does Ivrea 1 contain?
Ivrea 1 cream 1% may contains the active ingredient ivermectin (10mg/gm) in a cream base that is used to treat inflammatory lesions of rosacea.
Treating rosacea with Ivrea 1
Ivrea 1 cream 1% is contains ivermectin, and anti-parasitic and anti-inflammatory that is used to treat inflammatory lesions of rosacea, a chronic skin condition with an inherited disposition characterised by a red rash mainly on the face including the cheeks, nose, chin and forehead. Symptoms of rosacea include flushing, red spider veins (telangiectasia), papules (hard pimples), pustules (pus-filled pimples), dry flaky skin, swelling of the face and eyes, burning skin, sore eyes and thickening of the skin, but differs from acne by not producing blackheads or cysts. Symptoms of rosacea can be triggered by sun exposure, cold temperatures, strong winds, some medications like steroids, certain foods like spicy foods, cheese and chocolate, hot drinks, wine, some facial creams and cosmetics, and stress. The Dermadex mite that inhabits the facial hair follicles are a normal inhabitant of the skin and usually causes no problems. However, they are found in greater numbers in the skin those suffering from rosacea and are thought to be a trigger for inflammation. Rosacea can also affect emotional well-being and mental health which may result in social phobias, anxiety, and depression. Ivermectin in Ivrea 1 cream 1% is thought to work by inhibiting the production of inflammatory cytokines and also by interacting directly with the nervous system of the Dermadex mite and killing the mite. Ivrea 1 cream 1% helps reduce inflammation and relieves symptoms of rosacea.
What are the side effects of Ivrea 1?
The most commonly reported side effects when taking Ivrea 1 cream 1% include burning sensation and irritation at the site of application.
When should Ivrea 1 not be used?
You should not use Ivrea 1 cream 1% if you:
- are allergic to ivermectin or any ingredients in Ivrea 1
- are pregnant or are breastfeeding, without discussion with your doctor
How should Ivrea 1 be used?
You should apply your Ivrea 1 cream 1% once daily by adding small amount of cream to your fingertip and spread as a thin layer by rubbing gently into the affected areas. Avoid contact with the eyes and lips. You should continue to apply your Ivrea 1 cream 1% for as long as recommended by your doctor, which may be for up to 12 weeks.
How long should you take Ivrea 1?
You should continue to apply your Ivrea 1 cream 1% for as long as recommended by your doctor, which may be for up to 12 weeks.
Missed dose of Ivrea 1
If you miss a dose of Ivrea 1 cream 1% 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 Ivrea 1 be stored?
You should store your Ivrea 1 cream 1% below 25°C in a cool dry place.
References
- Raedler LA. Soolantra (Ivermectin) 1% Cream: A Novel, Antibiotic-Free Agent Approved for the Treatment of Patients with Rosacea. Am Health Drug Benefits 2015 Mar; 8(Spec Feature): 122–125.
- Ci X, Li H, Yu Q, et al. Ivermectin exerts anti-inflammatory effect by downregulating the nuclear transcription factor kappa-B and mitogen-activated protein kinase activation pathway. Fundam Clin Pharmacol. 2009;23:449-455
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Amaryl 2mg (Glimepiride) 30's
Amaryl general information
What is Amaryl used for?
Amaryl tablets 2mg are an antidiabetic medication used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone. Amaryl tablets 2mg should be used in conjunction with diet, exercise and weight loss to lower blood sugar levels in type-2 diabetes mellitus and can be used alone as monotherapy, in conjunction with diet and exercise, or in combination with other antihyperglycaemic medication (lowers blood sugar), like metformin, when a single drug does not result in adequate glycaemic control. However, Amaryl tablets 2mg are not suitable for treatment of type-1 diabetes mellitus or insulin-dependent diabetes. Diabetes increases the risk of serious health complications, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage). Maintaining glycaemic control with Amaryl tablets 2mg reduces the risk of developing these vascular complications.
How does Amaryl work?
Amaryl tablets 2mg contain glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs. Glimepiride in Amaryl tablets 2mg controls blood glucose (sugar) primarily by acting directly on the beta cells, which are the insulin-producing cells of pancreatic islet tissue, to increase their sensitivity to glucose and to stimulate the cells to produce and release more insulin. Insulin is normally produced in response to food and increased blood glucose levels and it controls postprandial (after eating) blood glucose levels (glycaemic control). In diabetes, resistance to insulin results in loss of glycaemic control. Glimepiride in Amaryl tablets 2mg helps the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours. It is also thought that as well as acting as an insulin secretagogue (stimulates insulin secretion) glimepiride in Amaryl tablets 2mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and uptake of insulin into peripheral tissues for energy and storage, is more efficient.
What does Amaryl contain?
Amaryl tablets 2mg contains the active ingredient glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs, used to treat type-2 diabetes. They also contain, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, sodium starch glycollate, indigo carmine, iron oxide yellow.
Treating type 2 diabetes with Amaryl
Amaryl tablets 2mg contain glimepiride, an oral antihyperglycaemic medication, used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone. Glimepiride in Amaryl tablets 2mg controls blood glucose (sugar) primarily by acting directly on the insulin-producing beta cells of pancreatic islet tissue, to stimulate the cells to produce more insulin. Insulin is normally produced in response to food and increased blood glucose levels, and it controls postprandial (after eating) blood glucose levels (glycaemic control). In diabetes, resistance to insulin results in loss of glycaemic control. Amaryl tablets 2mg help the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours. It is also thought that as well as stimulating insulin secretion, glimepiride in Amaryl tablets 2mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and insulin uptake into peripheral tissues for energy and storage, is more efficient. Maintaining glycaemic control with Amaryl tablets 2mg reduces risk of serious health complications associated with diabetes, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage).
What are the side effects of Amaryl?
The most commonly reported side effects when taking Amaryl tablets 2mg include: gastrointestinal complaints like nausea, diarrhoea, constipation and stomach or abdominal pain; allergic skin reactions like, redness (erythema), itching (pruritus), hives (urticaria); dizziness, drowsiness, headache, visual disturbances, confusion, malaise and tremor, which are usually transient and may be signs of hypoglycaemia. A more serious side effect of taking Amaryl tablets 2mg is severe hypoglycaemia (very low blood glucose), as glimepiride continues to work between meals to reduce blood sugar levels, so it is important to eat regularly; also certain other conditions like liver or kidney problems, or taking other medications like beta blockers, can make you more susceptible to hypoglycaemia. Other symptoms of hypoglycaemia include headache, hunger, restlessness, loss of consciousness, which can result in coma.
What is hypoglycaemia (hypo)
Having a hypo is an unpleasant episode experienced by diabetics and refers to extreme hypoglycaemia or very low blood glucose. Glimepiride in Amaryl tablets 2mg continue to work between meals to reduce blood sugar levels and therefore if glucose levels fall too low, by missing a meal or waiting too long between eating, severe hypoglycaemia, which is very low blood glucose, can be the result. Symptoms of hypoglycaemia include headache, hunger, nausea, vomiting, restlessness, sensory disturbances, delirium, loss of consciousness, which can result in shallow respiration, bradycardia (slow heart beat) and coma.
When should Amaryl not be used?
You should not use Amaryl tablets 2mg if you:
- are allergic to glimepiride or any ingredients in Amaryl
- are pregnant or are breastfeeding
- have kidney or liver or thyroid disease
- have type 1 (insulin-dependent) diabetes or suffer from diabetic coma or diabetic ketoacidosis
- have G6PD deficiency as you may be at risk of haemolytic anaemia
- are malnourished or have adrenal or pituitary insufficiency, as this may increase risk of hypoglycaemia
- are taking medicines that interact with Amaryl, including: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesicis like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis
What medications interact with Amaryl?
Several medications interact with Amaryl tablets 2mg and should either not be taken while you are taking Amaryl or only after discussion and instruction from your doctor:
- Drugs that affect Amaryl tablets 2mg and cause hypoglaemia (low blood sugar) by increasing its glucose-lowering effect: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesics like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, bronchodilators like salbutamol
- Drugs that affect Amaryl tablets 2mg and cause hyperglycaemia (high blood sugar) by reducing its glucose-lowering effect: Danazol for hormone treatment, the antipsychotic chlorpromazine, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis
How should Amaryl be taken?
You should take your Amaryl tablets 2mg swallowed whole with a glass of water just before breakfast of if you only have a light breakfast, then take your Amaryl tablets just before your midday meal. It is important that you do not skip a meal while taking Amaryl tablets 2mg. The dose you take depends on how well you respond and your doctor may increase your dose until your blood glucose has reached normal levels and remains controlled. You should continue to take your Amaryl tablets 2mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes.
How long should you take Amaryl?
You should continue to take your Amaryl tablets 2mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes.
Missed dose of Amaryl
If you miss a dose of Amaryl tablets 2mg 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 Amaryl be stored?
You should store your Amaryl below 25°C in a cool dry place.
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Symmetrel 100mg (Amantadine)
Symmetrel general information
What is Symmetrel used for?
Symmetrel capsules 100mg are used to treat Parkinson's disease, a neurological disorder that is either idiopathic, which means that its cause is unknown or secondary to a known cause such as stroke, head trauma or as a side effect of medication, particularly neuroleptic antipsychotics. Symmetrel 100 may be used alone as monotherapy, or in combination with other medications, like anticholinergic drugs or levodopa and helps relieve symptoms of Parkinsonism and Parkinson's disease, including tremor, bradykinesia (slowness of movement) and loss of balance. Symmetrel capsules 100mg are also used as prophylaxis to prevent signs and symptoms of infection caused by influenza A virus, particularly for those at high risk of infection, if vaccination is unavailable or contraindicated, and for those at risk of serious illness if they were to become infected, such as being immunocompromised or having lung problems; also to treat flu-like symptoms if administered within 48 hours.
How does Symmetrel work?
Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug with virostatic properties. The abnormal movements associated with Parkinsonism and Parkinson's disease are caused by low levels of dopamine, a neurotransmitter (chemical that allows communication between nerve cells) produced by certain neurons (nerve cells) in the brain and plays an important role in controlling muscle function and movement; it is important to have the correct levels of dopamine. The loss of dopamine seen in Parkinson's disease is due to slow and progressive destruction of the neurons that produce the dopamine in a certain area of the brain called the substantia nigra. Amantadine in Symmetrel 100 is thought to increase the amount of dopamine in the brain by enhancing the release of dopamine from central neurons and by delaying its re-uptake from the synapse, the gap between nerve cells across which chemical messages are sent from one nerve cell to another. The increase in dopamine levels helps the brain control muscle function and restore normal movement. Amantadine in Symmetrel 100 is also thought to exert some anticholinergic activity, which means that it blocks the binding of the neurotransmitter acetylcholine to its receptor in nerve cells and this action helps prevent the involuntary movements associated with Parkinsonism. The mechanism of action by which Symmetrel 100 prevents the growth of influenza A virus is not known but it is thought to be due to interference with a viral protein needed for the virus to infect the host cell and this inhibits the early stage of replication of the influenza A virus and checks the growth of virus.
What does Symmetrel contain?
Symmetrel capsules 100mg contain the active ingredient amantadine hydrochloride, used to treat Parkinson's disease and to treat and prevent symptoms of influenza A virus. They also contain: rape seed oil, lecithin, a wax blend composed of white beeswax and hydrogenated soya and vegetable oils, sodium ethyl hydroxybenzoate, gelatin, glycerol, iron oxide red CI 77491, sorbitol, sodium propyl hydroxybenzoate, titanium dioxide.
Treating Parkinson's disease with Symmetrel
Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug used to treat neurological symptoms that cause the abnormal movements associated Parkinsonism and Parkinson's disease. Parkinson's disease is a neurological disorder that is either idiopathic, which means that its cause is unknown, or secondary to a known cause such as stroke, head trauma or as a side effect of medication, particularly neuroleptic antipsychotics. Parkinsonism is caused by low levels of dopamine, a neurotransmitter (chemical that allows communication between nerve cells) produced by certain neurons (nerve cells) in the brain that plays an important role in controlling muscle function and movement. This loss of dopamine is due to slow and progressive destruction of the dopamine-producing neurons in the substantia nigra area of the brain. Amantadine in Symmetrel 100 is thought to increase the amount of dopamine in the brain by enhancing the release of dopamine from central neurons and by delaying its re-uptake from the synapse, the gap between nerve cells across which chemical messages are sent from one nerve cell to another. The increase in dopamine levels helps the brain control muscle function and restore normal movement. Amantadine in Symmetrel 100 is also thought to exert some anticholinergic activity, which means that it blocks the binding of the neurotransmitter acetylcholine to its receptor in nerve cells and this action helps prevent the involuntary movements associated with Parkinsonism. Symmetrel 100 may be used alone (monotherapy), or in combination with other medications, like anticholinergic drugs or levodopa and helps relieve symptoms of Parkinsonism and Parkinson's disease, including tremor, bradykinesia (slowness of movement) and loss of balance.
Treating symptoms of influenza A infection with Symmetrel
Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug with influenzal virostatic properties, which means that it specifically blocks the growth of the Influenza A virus. Although the mechanism of action by which Symmetrel 100 prevents the growth of influenza A virus is not known it is thought to be due to interference with a viral protein needed for the virus to infect the host cell and this inhibits the early stage of replication of the influenza A virus. Symmetrel capsules 100mg are used as prophylaxis to prevent signs and symptoms of infection caused by influenza A virus, particularly for those at high risk of infection, if vaccination is unavailable or contraindicated, and for those at risk of serious illness if they were to become infected, such as being immunocompromised or having lung problems; also to treat flu-like symptoms if administered within 48 hours.
What are the side effects of Symmetrel?
The most commonly reported side effects when taking Symmetrel capsules 100mg include: depression, anxiety, elevation of mood, agitation, nervousness, difficulty in concentrating, dizziness, light-headedness, headache, insomnia, lethargy, hallucinations, nightmares, ataxia, slurred speech, blurred vision, oedema of ankles, livedo reticularis (purplish-red blotchy spots on the skin), dry mouth, anorexia, nausea, vomiting, constipation, palpitations, orthostatic hypotension, excessive sweating.
When should Symmetrel not be used?
You should not use Symmetrel capsules 100mg if you:
- are allergic to amantadine or any ingredients in Symmetrel
- are pregnant or are breastfeeding
- have kidney or liver disease
- have or have had recurrent eczema, stomach ulcers, or cardiovascular disorders
- suffer from convulsions or psychiatric disorders
- are taking medicines that interact with Symmetrel, including: other antiparkinsonian drugs, like anticholinergics or levodopa (without discussion with your doctor), other medicines that act on the central nervous system, like sedatives, analgesics and alcohol, combination diuretics, like hydrochlorothiazide + potassium-sparing diuretics
What medications interact with Symmetrel?
Several medications interact with Symmetrel capsules 100mg and should either not be taken while you are taking Symmetrel or only after discussion and instruction from your doctor:
- Drugs that increase side effects with Symmetrel: other antiparkinsonian drugs, like anticholinergics or levodopa,
- Drugs that cause dangerous reactions with Symmetrel: other medicines that act on the central nervous system, like sedatives, analgesics and alcohol
- Drugs that affect Symmetrel: combination diuretics, like hydrochlorothiazide + potassium-sparing diuretics
How should Symmetrel be taken for Parkinson's disease?
You should take your Symmetrel capsules 100mg with a glass of water once daily and preferably with food to prevent stomach problems. Your doctor may increase the dose to one capsule twice daily, depending on your condition. You should see some benefit within a few days and should continue to take your Symmetrel 100 for as long as recommended by your doctor, which may be for a long time depending on your condition. For some people the effectiveness of Symmetrel 100 wears off after a few months of continuous treatment, if this is the case your doctor may recommend that you gradually reduce the dose and stop it for a few weeks, then start again.
How should Symmetrel be taken for influenza A?
You should take your Symmetrel capsules 100mg with a glass of water twice daily and preferably with food to prevent stomach problems, or once daily for children or adults over 65. For prophylaxis you should start taking Symmetrel as soon as possible after you have been exposed to the flu and keep taking it through outbreak for at least 10 days or until the outbreak of influenza A is over. For treatment you should start taking Symmetrel 100 within 48 hours of the first symptoms onset and then for 4-5 days.
How long should you take Symmetrel?
For Parkinson's disease you should continue to take your Symmetrel capsules 100mg for as long as recommended by your doctor, which may be for a long time depending on your condition. For prophylaxis against influenza A, you should start taking Symmetrel capsules 100mg as soon as possible after you have been exposed to the flu and keep taking it through outbreak for at least 10 days or until the outbreak of influenza is over. For treatment you should start taking Symmetrel 100 within 48 hours of the first symptoms onset and then for 4-5 days.
Missed dose of Symmetrel
If you miss a dose of Symmetrel capsules 100mg 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 Symmetrel be stored?
You should store your Symmetrel below 25°C in a cool dry place. Protect from moisture and heat.
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