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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.
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 inflammation^{1, 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
Spiractin 25 (Spironolactone) Spiractin general information What is Spiractin used for? Spiractin tablets 25mg are used to reduce fluid retention and swelling (oedema) which is caused by several conditions, including congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease. Spiractin 25 can be used alone to treat hypertension or in combination with other antihypertensive medications like beta blockers, to enhance their activity. Spiractin tablets 25mg is also used to increase blood potassium levels, which occurs in a condition called hypokalaemia (low blood potassium) and to treat hyperaldosteronism, which is caused by excess secretion by the adrenal gland of the hormone aldosterone (involved in regulating sodium and potassium levels), both of which can cause fluid retention. Spiractin 25 has anti-androgen activity which is used in the treatment of female hirsutism (androgen-related increase in facial and body hair) and can be used as an anti-androgen component of transgender hormone therapy, to help stimulate the development of female sexual characteristics for male to female transsexuals. How does Spiractin work? Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic (water pill) that acts as an antagonist of the hormone aldosterone, by binding to the aldosterone receptor blocking its action. This action of spironolactone in Spiractin tablets 25mg increases sodium excretion and reduces potassium loss at the distal renal tubule of the kidney. The overall effect of this action is to increase water excretion in the urine which reduces fluid build-up in the tissues, increase blood potassium levels and lower sblood pressure. Spironolactone in Spiractin tablets 25mg also has moderate anti-androgenic activity as it binds to the androgen receptor competing with dihydrotestosterone (DHT) an active metabolite of testosterone. Binding of DHT to the androgen receptor promotes male characteristics therefore, blocking the action of DHT helps reduce male characteristics. Another anti-androgenic action of Spiractin 25 is that it blocks the synthesis of a testosterone by the ovaries. What does Spiractin contain? Spiractin tablets 25mg contain the active ingredient spironolactone, a potassium-sparing diuretic used to treat oedema in various conditions. They also contain quinoline yellow, sunset yellow, erythrosine, polysorbate, peppermint oil, povidone, microcrystalline cellulose, maize starch, sodium starch glycollate, talc, magnesium stearate and lactose. Treating oedema with Spiractin Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic (water pill) that is used to treat fluid retention (oedema) caused by several conditions, including congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease. Spironolactone in Spiractin tablets 25mg works by blocking the action of the hormone aldosterone on the kidneys, which increases excretion of excess water and sodium from the body while at the same time maintaining blood potassium levels. Spiractin for hypertension Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic that is used to treat hypertension or high blood pressure, which increases risk of cardiovascular disease and if uncontrolled can cause kidney damage, stroke, heart attack and heart failure. Spironolactone in Spiractin tablets 25mg binds to the receptor for the hormone aldosterone on the kidneys, blocking the action of aldosterone, which increases sodium excretion and reduces potassium loss at the distal renal tubule of the kidney. This action of spironolactone in Spiractin tablets 25mg increases water excretion in the urine which reduces fluid build-up in the tissues, increase blood potassium levels and lowers blood pressure. Spiractin for transgender treatment Spiractin tablets 25mg contain spironolactone, which is primarily used as a diuretic, to reduce fluid retention in conditions such as congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease. Spironolactone in Spiractin tablets 25mg also acts as an anti-androgen by binding to the androgen receptor and competing with dihydrotestosterone (DHT), the active metabolite of testosterone, which promotes male characteristics, thereby blocking the action of DHT. Using an anti-androgen like spironolactone (usually in high doses of 200–400 mg per day) allows the amount of oestrogen administered for feminising hormone therapy to be reduced while optimising the hormone regime needed to stimulate breast development, feminisation of skin, and female fat distribution. What are the side effects of Spiractin? The most commonly reported side effects when taking Spiractin includes nausea, vomiting, headache, abdominal cramps and pain, diarrhoea, headache, drowsiness, lethargy, hair loss and excessive hair growth. Other side effects include skin rash, menstrual period changes in women, breast enlargement (gynaecomastia) and sexual problems (impotence) in men. When should Spiractin not be used? You should not use Spiractin tablets 25mg if you: are allergic to spironolactone or any ingredients in Spiractin are pregnant or are breastfeeding have kidney or liver disease have high potassium levels in your blood due to a potassium rich diet or if you are taking medications or supplements that increase blood potassium levels are not producing or passing urine are taking other medications that may interact with Spiractin, such as potassium supplements, non-steroidal anti-inflammatory drugs like indomethacin or mefenamic acid, aspirin, digoxin for heart failure, carbenoxolone for mouth ulcers, other diuretics, the ACE inhibitors antihypertensives, ammonium chloride in some cough medications, cholestyramine for lowering blood cholesterol What medications interact with Spiractin? Several medications interact with Spiractin tablets 25mg and should either not be taken while you are taking Spiractin or only after discussion and instruction from your doctor: Drugs that cause a serious reaction with Spiractin: potassium supplements, ammonium chloride in some cough medications, cholestyramine for lowering blood cholesterol, the ACE inhibitors antihypertensives Drugs that affect Spiractin: non-steroidal anti-inflammatory drugs like indomethacin or mefenamic acid and aspirin, carbenoxolone for mouth ulcers Drugs that are affected by Spiractin: digoxin for heart failure How should Spiractin be taken? You should take your Spiractin tablets 25mg with a glass of water with or without food, once or twice daily. The dose you take depends on your condition and what you are being treated for and should be as recommended by your doctor. You should continue taking your Spiractin tablets 25mg even if you are feeling well, which may be for a few days or several weeks and your doctor may increase your dose during treatment. How long should you take Spiractin? You should continue taking your Spiractin tablets 25mg even if you are feeling well, which may be for a few days or several weeks and your doctor may increase your dose during treatment. Missed dose of Spiractin If you miss a dose of Spiractin 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 Spiractin be stored? You should store your Spiractin tablets 25mg below 30°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.
Isentress 400mg (Raltegravir) Isentress general information What is Isentress used for? Isentress tablets 400mg are used to treat Human Immunodeficiency Virus (HIV) infection, in combination with other HIV medications. This combination therapy is known as highly active antiretroviral therapy (HAART). HIV impairs the immune system by attacking specific immune cells called CD4⁺ cells that are involved in fighting infection, which can lead to opportunistic life-threatening infection (infections that would not normally be harmful). If too many CD4⁺ cells are destroyed this can result in acquired immune deficiency syndrome (AIDS). Isentress tablets 400mg help prevent or slow down the ability of HIV to replicate, which reduces the viral load by keeping the amount virus down to a low level and this results in an increase in CD4 cell numbers, so that the immune system can recover reducing the risk of disease progression. How does Isentress work? Isentress tablets 400mg contains the antiretroviral raltegravir, an integrase strand transfer inhibitor. Raltegravir in Isentress tablets 400mg inhibits the catalytic activity of HIV integrase, an HIV-encoded enzyme that is required for viral replication. HIV is a retrovirus, which is an RNA virus that produces an enzyme called reverse transcriptase to transcribe its RNA into DNA. Another viral enzyme, integrase, is used to insert or integrate viral DNA into the host cell genome during the early phase of infection. By blocking the action of viral integrase, raltegravir in Isentress tablets 400mg prevents replication of the virus and thereby inhibits production of new infectious viral particles. Isentress tablets 400mg slow down the replication of HIV within your body but does not kill the virus already incorporated in the CD4⁺ cells or prevent the spread of the infection to others. What does Isentress contain? Isentress tablets 400mg contain the active ingredient raltegravir, an antiretroviral used in the treatment of Human Immunodeficiency Virus (HIV) infection. They also contain microcrystalline cellulose, lactose monohydrate, calcium phosphate dibasic anhydrous, hypromellose 2208, poloxamer 407, sodium stearyl fumarate, magnesium stearate. Treating HIV infection with Isentress Isentress tablets 400mg contain the antiretroviral drug raltegravir, an inhibitor of the viral integrase enzyme. HIV impairs the immune system by attacking specific immune cells called CD4⁺ cells that are involved in fighting infection, and this can lead to opportunistic life-threatening infection (infections that would not normally be harmful), including pneumonia, herpes virus infections, and Mycobacterium avium complex (MAC) infection. If too many CD4⁺ cells are destroyed this can result in acquired immune deficiency syndrome (AIDS). HIV is a retrovirus, which is an RNA virus that produces an enzyme called reverse transcriptase to transcribe its RNA into DNA. Another viral enzyme, integrase, is used to insert or integrate viral DNA into the host cell genome during the early phase of infection. Raltegravir in Isentress tablets 400mg works by blocking the action of the viral integrase and this inhibits viral replication and thereby inhibits production of new infectious viral particles. Isentress tablets 400mg are used in combination with other HIV medications to slow down the replication of HIV within your body but they do not kill the virus already incorporated in the CD4⁺ cells or prevent the spread of the infection to others. What are the side effects of Isentress? The most commonly reported side effects when taking Isentress tablets 400mg include: nausea, vomiting, headaches, tiredness, inflammation of the nasal passages and throat, trouble sleeping, upper respiratory tract infection, cough, fever, bronchitis, back pain and depression. A more serious but less common side effect is a condition is a severe skin reaction including Stevens-Johnson syndrome and toxic epidermal necrolysis. When should Isentress not be used? You should not use Isentress tablets 400mg if you: are allergic to raltegravir or any ingredients in Isentress are pregnant or are breastfeeding are taking medicines that interact with Isentress, including antacids containing aluminium and/or magnesium, the anti-infective rifampicin How should Isentress be taken? You should take your Isentress tablets 400mg with a glass of water twice daily, with or without food and in combination with other antiretroviral drugs that have been prescribed. You should continue to take your Isentress tablets 400mg for as long as recommended by your doctor, and you will be monitored carefully to ensure that you do not develop any serious side effects, in which case your doctor will probably recommend that you stop taking your Isentress tablets 400mg. How long should you take Isentress? You should continue to take your Isentress tablets 400mg for as long as recommended by your doctor, and you will be monitored carefully to ensure that you do not develop any serious side effects, in which case your doctor will probably recommend that you stop taking your Isentress tablets 400mg. Missed dose of Isentress If you miss a dose of Isentress tablets 400mg 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 Isentress be stored? You should store your Isentress below 25°C in a cool dry place.

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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.

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 inflammation^{1, 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

Spiractin 25 (Spironolactone)

Spiractin general information

What is Spiractin used for?

Spiractin tablets 25mg are used to reduce fluid retention and swelling (oedema) which is caused by several conditions, including congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease. Spiractin 25 can be used alone to treat hypertension or in combination with other antihypertensive medications like beta blockers, to enhance their activity. Spiractin tablets 25mg is also used to increase blood potassium levels, which occurs in a condition called hypokalaemia (low blood potassium) and to treat hyperaldosteronism, which is caused by excess secretion by the adrenal gland of the hormone aldosterone (involved in regulating sodium and potassium levels), both of which can cause fluid retention. Spiractin 25 has anti-androgen activity which is used in the treatment of female hirsutism (androgen-related increase in facial and body hair) and can be used as an anti-androgen component of transgender hormone therapy, to help stimulate the development of female sexual characteristics for male to female transsexuals.

How does Spiractin work?

Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic (water pill) that acts as an antagonist of the hormone aldosterone, by binding to the aldosterone receptor blocking its action. This action of spironolactone in Spiractin tablets 25mg increases sodium excretion and reduces potassium loss at the distal renal tubule of the kidney. The overall effect of this action is to increase water excretion in the urine which reduces fluid build-up in the tissues, increase blood potassium levels and lower sblood pressure. Spironolactone in Spiractin tablets 25mg also has moderate anti-androgenic activity as it binds to the androgen receptor competing with dihydrotestosterone (DHT) an active metabolite of testosterone. Binding of DHT to the androgen receptor promotes male characteristics therefore, blocking the action of DHT helps reduce male characteristics. Another anti-androgenic action of Spiractin 25 is that it blocks the synthesis of a testosterone by the ovaries.

What does Spiractin contain?

Spiractin tablets 25mg contain the active ingredient spironolactone, a potassium-sparing diuretic used to treat oedema in various conditions. They also contain quinoline yellow, sunset yellow, erythrosine, polysorbate, peppermint oil, povidone, microcrystalline cellulose, maize starch, sodium starch glycollate, talc, magnesium stearate and lactose.

Treating oedema with Spiractin

Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic (water pill) that is used to treat fluid retention (oedema) caused by several conditions, including congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease. Spironolactone in Spiractin tablets 25mg works by blocking the action of the hormone aldosterone on the kidneys, which increases excretion of excess water and sodium from the body while at the same time maintaining blood potassium levels.

Spiractin for hypertension

Spiractin tablets 25mg contain spironolactone, a potassium-sparing diuretic that is used to treat hypertension or high blood pressure, which increases risk of cardiovascular disease and if uncontrolled can cause kidney damage, stroke, heart attack and heart failure. Spironolactone in Spiractin tablets 25mg binds to the receptor for the hormone aldosterone on the kidneys, blocking the action of aldosterone, which increases sodium excretion and reduces potassium loss at the distal renal tubule of the kidney. This action of spironolactone in Spiractin tablets 25mg increases water excretion in the urine which reduces fluid build-up in the tissues, increase blood potassium levels and lowers blood pressure.

Spiractin for transgender treatment

Spiractin tablets 25mg contain spironolactone, which is primarily used as a diuretic, to reduce fluid retention in conditions such as congestive heart failure, hypertension (high blood pressure), liver cirrhosis and kidney disease. Spironolactone in Spiractin tablets 25mg also acts as an anti-androgen by binding to the androgen receptor and competing with dihydrotestosterone (DHT), the active metabolite of testosterone, which promotes male characteristics, thereby blocking the action of DHT. Using an anti-androgen like spironolactone (usually in high doses of 200–400 mg per day) allows the amount of oestrogen administered for feminising hormone therapy to be reduced while optimising the hormone regime needed to stimulate breast development, feminisation of skin, and female fat distribution.

What are the side effects of Spiractin?

The most commonly reported side effects when taking Spiractin includes nausea, vomiting, headache, abdominal cramps and pain, diarrhoea, headache, drowsiness, lethargy, hair loss and excessive hair growth. Other side effects include skin rash, menstrual period changes in women, breast enlargement (gynaecomastia) and sexual problems (impotence) in men.

When should Spiractin not be used?

You should not use Spiractin tablets 25mg if you:

are allergic to spironolactone or any ingredients in Spiractin
are pregnant or are breastfeeding
have kidney or liver disease
have high potassium levels in your blood due to a potassium rich diet or if you are taking medications or supplements that increase blood potassium levels
are not producing or passing urine
are taking other medications that may interact with Spiractin, such as potassium supplements, non-steroidal anti-inflammatory drugs like indomethacin or mefenamic acid, aspirin, digoxin for heart failure, carbenoxolone for mouth ulcers, other diuretics, the ACE inhibitors antihypertensives, ammonium chloride in some cough medications, cholestyramine for lowering blood cholesterol

What medications interact with Spiractin?

Several medications interact with Spiractin tablets 25mg and should either not be taken while you are taking Spiractin or only after discussion and instruction from your doctor:

Drugs that cause a serious reaction with Spiractin: potassium supplements, ammonium chloride in some cough medications, cholestyramine for lowering blood cholesterol, the ACE inhibitors antihypertensives
Drugs that affect Spiractin: non-steroidal anti-inflammatory drugs like indomethacin or mefenamic acid and aspirin, carbenoxolone for mouth ulcers
Drugs that are affected by Spiractin: digoxin for heart failure

How should Spiractin be taken?

You should take your Spiractin tablets 25mg with a glass of water with or without food, once or twice daily. The dose you take depends on your condition and what you are being treated for and should be as recommended by your doctor. You should continue taking your Spiractin tablets 25mg even if you are feeling well, which may be for a few days or several weeks and your doctor may increase your dose during treatment.

How long should you take Spiractin?

You should continue taking your Spiractin tablets 25mg even if you are feeling well, which may be for a few days or several weeks and your doctor may increase your dose during treatment.

Missed dose of Spiractin

If you miss a dose of Spiractin 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 Spiractin be stored?

You should store your Spiractin tablets 25mg below 30°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.

Isentress 400mg (Raltegravir)

Isentress general information

What is Isentress used for?

Isentress tablets 400mg are used to treat Human Immunodeficiency Virus (HIV) infection, in combination with other HIV medications. This combination therapy is known as highly active antiretroviral therapy (HAART). HIV impairs the immune system by attacking specific immune cells called CD4⁺ cells that are involved in fighting infection, which can lead to opportunistic life-threatening infection (infections that would not normally be harmful). If too many CD4⁺ cells are destroyed this can result in acquired immune deficiency syndrome (AIDS). Isentress tablets 400mg help prevent or slow down the ability of HIV to replicate, which reduces the viral load by keeping the amount virus down to a low level and this results in an increase in CD4 cell numbers, so that the immune system can recover reducing the risk of disease progression.

How does Isentress work?

Isentress tablets 400mg contains the antiretroviral raltegravir, an integrase strand transfer inhibitor. Raltegravir in Isentress tablets 400mg inhibits the catalytic activity of HIV integrase, an HIV-encoded enzyme that is required for viral replication. HIV is a retrovirus, which is an RNA virus that produces an enzyme called reverse transcriptase to transcribe its RNA into DNA. Another viral enzyme, integrase, is used to insert or integrate viral DNA into the host cell genome during the early phase of infection. By blocking the action of viral integrase, raltegravir in Isentress tablets 400mg prevents replication of the virus and thereby inhibits production of new infectious viral particles. Isentress tablets 400mg slow down the replication of HIV within your body but does not kill the virus already incorporated in the CD4⁺ cells or prevent the spread of the infection to others.

What does Isentress contain?

Isentress tablets 400mg contain the active ingredient raltegravir, an antiretroviral used in the treatment of Human Immunodeficiency Virus (HIV) infection. They also contain microcrystalline cellulose, lactose monohydrate, calcium phosphate dibasic anhydrous, hypromellose 2208, poloxamer 407, sodium stearyl fumarate, magnesium stearate.

Treating HIV infection with Isentress

Isentress tablets 400mg contain the antiretroviral drug raltegravir, an inhibitor of the viral integrase enzyme. HIV impairs the immune system by attacking specific immune cells called CD4⁺ cells that are involved in fighting infection, and this can lead to opportunistic life-threatening infection (infections that would not normally be harmful), including pneumonia, herpes virus infections, and Mycobacterium avium complex (MAC) infection. If too many CD4⁺ cells are destroyed this can result in acquired immune deficiency syndrome (AIDS). HIV is a retrovirus, which is an RNA virus that produces an enzyme called reverse transcriptase to transcribe its RNA into DNA. Another viral enzyme, integrase, is used to insert or integrate viral DNA into the host cell genome during the early phase of infection. Raltegravir in Isentress tablets 400mg works by blocking the action of the viral integrase and this inhibits viral replication and thereby inhibits production of new infectious viral particles. Isentress tablets 400mg are used in combination with other HIV medications to slow down the replication of HIV within your body but they do not kill the virus already incorporated in the CD4⁺ cells or prevent the spread of the infection to others.

What are the side effects of Isentress?

The most commonly reported side effects when taking Isentress tablets 400mg include: nausea, vomiting, headaches, tiredness, inflammation of the nasal passages and throat, trouble sleeping, upper respiratory tract infection, cough, fever, bronchitis, back pain and depression. A more serious but less common side effect is a condition is a severe skin reaction including Stevens-Johnson syndrome and toxic epidermal necrolysis.

When should Isentress not be used?

You should not use Isentress tablets 400mg if you:

are allergic to raltegravir or any ingredients in Isentress
are pregnant or are breastfeeding
are taking medicines that interact with Isentress, including antacids containing aluminium and/or magnesium, the anti-infective rifampicin

How should Isentress be taken?

You should take your Isentress tablets 400mg with a glass of water twice daily, with or without food and in combination with other antiretroviral drugs that have been prescribed. You should continue to take your Isentress tablets 400mg for as long as recommended by your doctor, and you will be monitored carefully to ensure that you do not develop any serious side effects, in which case your doctor will probably recommend that you stop taking your Isentress tablets 400mg.

How long should you take Isentress?

You should continue to take your Isentress tablets 400mg for as long as recommended by your doctor, and you will be monitored carefully to ensure that you do not develop any serious side effects, in which case your doctor will probably recommend that you stop taking your Isentress tablets 400mg.

Missed dose of Isentress

If you miss a dose of Isentress tablets 400mg 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 Isentress be stored?

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

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