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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 encephalopathy^2-5. 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.
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.
Cipflox (Ciprofloxacin 250mg) Cipflox general information What is Cipflox used for? Cipflox tablets 250mg are an antibiotic medication used to treat uncomplicated and complicated bacterial infections in adults, caused by a wide range of susceptible bacteria in various parts of the body. Cipflox tablets 250mg are used to treat pneumonia (community acquired as outpatients), caused by various bacteria, but should not be the antibiotic of first choice for pneumonia caused by Pneumococcus. Cipflox tablets 250mg are also use to treat infections of the skin and soft tissue, such as impetigo and cellulitis; also of the bones and joints, which can be very painful; and infections of the abdominal cavity such as peritonitis. Cipflox tablets 250mg are also used to treat infections of the urogenital system, including adnexitis (infection and inflammation of the ovary and the fallopian tubes), prostatitis (infection and inflammation of the prostate), gonorrhoea, infections of the efferent urinary tract like cystitis and pyelonephritis (infection and inflammation of the kidney). Cipflox tablets 250mg are used to treat sepsis, which is a serious and life-threatening condition that occurs as a result of the body’s response to an infection. It is caused by chemicals released into the bloodstream to fight the infection, which can result in damage to tissues and organs. Cipflox tablets 250mg may also be used after inhalation of anthrax spores, as post exposure prophylaxis to reduce risk of pulmonary disease. Cipflox tablets 250mg are also used to treat acute pulmonary exacerbation of cystic fibrosis caused by the bacteria Pseudomonas aeruginosa; also complicated urinary tract infections or pyelonephritis due to E.coli in children over the age of 5 years. How does Cipflox work? Cipflox tablets 250mg contain the antibiotic ciprofloxacin that belongs to the fluoroquinolones group of antibiotics and is a synthetic broad spectrum antibiotic with antibacterial activity against a wide range of bacteria including, Klebsiella, Haemophilus, Enterobacter, E. coli, Pseudomonas, Legionella, Staphylococcus, Streptococcus, Listeria and Chlamydia. Ciprofloxacin in Cipflox tablets 250mg works by inhibiting several bacterial enzymes (bacterial topoisomerase IV and DNA gyrase) needed for the bacteria to replicate and repair its DNA. This action of ciprofloxacin in Cipflox tablets 250mg kills the bacteria by blocking its growth and preventing the spread of infection. Cipflox tablets 250mg do not work against viruses which use a different mechanism to grow and replicate. What does Cipflox contain? Cipflox tablets 250mg contain the active ingredient ciprofloxacin, a synthetic broad spectrum antibiotic used to treat a wide range of bacterial infections. They also contain microcrystalline cellulose, maize starch, pregelatinised maize starch, crospovidone, colloidal anhydrous silica, magnesium stearate, titanium dioxide, polydextrose, hypromellose, glycerol triacetate, macrogol. Treating bacterial infection with Cipflox Cipflox tablets 250mg contain ciprofloxacin a synthetic broad spectrum fluoroquinolone antibiotic that used to treat uncomplicated and complicated bacterial infections in adults, caused by a wide range of susceptible bacteria in various parts of the body. Infections that Cipflox tablets 250mg are suitable for include, pneumonia; infections of the skin, soft tissue bones and joints; infections of the urogenital system; infections of the abdominal cavity; sepsis and to reduce risk of pulmonary disease following inhalation of anthrax spores. Cipflox tablets 250mg are also used to treat acute pulmonary exacerbation of cystic fibrosis and complicated urinary tract infections in children over the age of 5 years. Ciprofloxacin in Cipflox tablets 250mg works by inhibiting several bacterial enzymes needed for the bacteria to replicate and repair its DNA. This action of ciprofloxacin in Cipflox tablets 250mg kills the bacteria by blocking its growth and preventing the spread of infection. What are the side effects of Cipflox? The most commonly reported side effects when taking Cipflox tablets 250mg include diarrhoea, nausea, vomiting, abdominal pain, rash, headache, altered taste, arthralgia (joint pain). Very rarely taking Cipflox tablets 250mg is associated with an increased risk of tendonitis and tendon rupture with increased risk if you are over the age of 60 years, taking systemic steroids or have received a kidney, heart or lung transplant. When should Cipflox not be used? You should not use Cipflox tablets 250mg if you: are allergic to ciprofloxacin or any ingredients in Cipflox are pregnant or are breastfeeding have kidney or liver disease history of tendon disease/disorder related to quinolone treatment have epilepsy or a history of convulsion have a history of stroke, heart attack or heart failure, without discussion with your doctor have myasthenia gravis are taking medicines that interact with Cipflox, including the muscle relaxant tizanidine for cystic fibrosis, anti-arrhythmics like amiodarone, tricyclic antidepressants like amitriptylene, macrolides antibiotics like azithromycin, clarithromycin, antipsychotics like olanzapine,, mineral supplements, sucralfate, omeprazole or antacids for ulcers and reflux, probenecid for gout, theophylline for asthma, caffeine and methylxanthines (found in some medicines and in drinks such as coffee, tea, cola), phenytoin for seizures, some NSAIDs (non-steroidal anti-inflammatory drugs), the immunosuppressant cyclosporine, anticoagulants like warfarin, oral antidiabetic medications like glibenclamide, methotrexate for cancer treatment, the antiemetic metoclopramide, the antidepressant duloxetine, ropinirole for Parkinson’s disease, clozapine for schizophrenia, sildenafil for erectile dysfunction What medications interact with Cipflox? Several medications interact with Cipflox tablets 250mg and should either not be taken while you are taking Cipflox or only after discussion and instruction from your doctor: Drugs that cause a serious reaction or increase side effects with Cipflox: the muscle relaxant tizanidine for cystic fibrosis, anti-arrhythmics like amiodarone, tricyclic antidepressants like amitriptylene, macrolides antibiotics like azithromycin, clarithromycin, antipsychotics like olanzapine, theophylline for asthma, some NSAIDs (non-steroidal anti-inflammatory drugs), the immunosuppressant cyclosporine, Drugs that affect Cipflox: mineral supplements, sucralfate, omeprazole or antacids for ulcers and reflux, probenecid for gout, the antiemetic metoclopramide Drugs that are affected by Cipflox: the muscle relaxant tizanidine for cystic fibrosis, theophylline for asthma, caffeine and methylxanthines (found in some medicines and in drinks such as coffee, tea, cola), phenytoin for seizures, anticoagulants like warfarin, oral antidiabetic medications like glibenclamide, methotrexate for cancer treatment, the antidepressant duloxetine, ropinirole for Parkinson’s disease, clozapine for schizophrenia, sildenafil for erectile dysfunction How should Cipflox be taken? You should take your Cipflox tablets 250mg swallowed whole with a glass of water, with or without food. The dose you take and how often, depends on what you are being treated for and your doctor’s recommendations, which for most infections is usually one tablet twice daily for 7 to 14 days, but the dose or length of time you need to take your Cipflox tablets 250mg for may be increased depending on the severity of your infection and your response to treatment. You should not consume dairy products that are high in calcium (milk and yoghurt) or calcium-fortified orange juice, unless they are part of a meal as this may affect the absorption of ciprofloxacin. Avoid direct exposure to excessive sunlight or UV-light as this can cause photosensitisation (sunburn-like skin reactions). You should continue to take your Cipflox tablets 250mg for as long as recommended by your doctor. How long should you take Cipflox? You should continue to take your Cipflox tablets 250mg for as long as recommended by your doctor. Missed dose of Cipflox If you miss a dose of Cipflox tablets 250mg 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 Cipflox be stored? You should store your Cipflox tablets 250mg below 25°C in a cool dry place.
Cardinol 160 LA (Propranolol) Cardinol general information What is Cardinol used for? Cardinol 160mg capsules are used to treat a variety of conditions including, control of hypertension (high blood pressure); management of angina (chest pain) and long-term prevention of myocardial infarction (heart attack). Cardinol capsules 160 LA work through a common mechanism in several different body systems to manage the condition and relieve symptoms by reducing heart rate (pulse), workload (force needed to pump) and oxygen demand, increasing blood flow and lowering blood pressure. How does Cardinol work? Cardinol capsules 160mg contain propanolol, which is a beta-blocker or selective beta-receptor antagonist and acts by blocking the action of chemicals called catecholamines, such as adrenaline (epinephrine), which are released by the adrenal glands in response to nerve stimulation during physical and mental stress. Adrenaline works via beta-receptors in the heart to stimulate increased heart rate and constriction (narrowing) of blood vessels. These actions of adrenaline are blocked by propanolol in Cardinol capsules 160mg, to slow heart rate, dilate (widen) blood vessels, lower blood pressure, and increase blood flow and oxygen to the heart. Since beta-receptors are found in many tissues, particularly the heart, kidneys, vascular smooth muscle in blood vessel walls, lung, skeletal muscle and liver, all short-term and long-term symptom relief due to taking Cardinol capsules 160 LA, is based on blocking beta-receptors in the target tissue. Cardinol capsules 160mg are formulated for long acting slow release of propanolol over a 24 hour period so that you need only take one capsule a day. What Cardinol doses are available? Cardinol is available to order and buy online from Inhouse Pharmacy in the following doses: Cardinol 10mg tablets Cardinol 40mg tablets Cardinol 160mg capsules (long-acting slow release) What does Cardinol contain? Cardinol 160mg capsules contain spheroids of the active ingredient propanolol hydrochloride, a beta-blocker and beta-receptor agonist that blocks the action of adrenaline to slow heart rate and relax blood vessels, amongst other actions. These spheroids have a sustained release coating to provide long action. Propanolol Cardinol 160mg capsules also contain sucrose, maize starch, shellac, talc and the gelatin capsule. What is the difference between Cardinol long acting capsules and Cardinol tablets? Cardinol tablets are formulated for rapid release and absorption and contain lower concentrations of active ingredient than capsules. Cardinol capsules contain slow release spheroids which release the active ingredient over a longer time period for slower but sustained drug absorption, which means that you need only take one capsule a day to get the same dose of drug as several tablets taken each day. Treating high blood pressure (hypertension) with Cardinol Cardinol capsules 160mg contain propanolol, a beta-blocker that blocks the action of adrenaline in stimulating beta-receptors in blood vessel walls, causing blood vessels to constrict (narrow) which reduces blood flow and raises blood pressure. Cardinol capsules 160 LA are used to treat high blood pressure (hypertension) by widening blood vessels, reducing heart rate (number of heart beats) and reducing the force of the heart contraction. These actions lower blood pressure and help the heart to cope better, Reducing heart rate with Cardinol Cardinol 160mg capsules contain propanolol, a beta-blocker that blocks the action of adrenaline in stimulating beta-receptors in the heart muscle. Adrenaline increases heart rate and the strength of muscular contraction in response to excitement/physical exertion. Cardinol capsules 160 LA are used for management of angina (chest pain) and long-term prevention of myocardial infarction (heart attack) by widening blood vessels, reducing heart rate and the force of contraction of the heart. When the heart does not have to work as hard, it requires less oxygen and relieves symptoms of angina including chest pain and breathlessness on exertion. What are the side effects of Cardinol? The mot common side effects reported while taking Cardinol capsules 160mg include: tiredness, dizziness, sleep disturbances or nightmares, hair loss, mood changes or confusion, dry eyes, nausea, vomiting, diarrhoea, stomach pain. When should Cardinol not be used? You should not use Cardinol capsules 160mg if you: are allergic to propranolol hydrochloride or any other ingredients in Cardinol 160 LA have a history of bronchial asthma or bronchospasm are diabetic and taking hypoglycaemic therapy as propranolol may prolong the hypoglycaemic response to insulin have, poor peripheral blood circulation, uncontrolled heart failure, low blood pressure (hypotension), metabolic acidosis (too much acid in your blood) or a certain type of angina called Prinzmetal's angina have a phaeochromocytoma (a rare tumour of the adrenal gland) which is not already being treated with other medicines have certain other heart problems are taking medication that may interact with Cardinol 160mg capsules, including: other medicines for high blood pressure; angina or an irregular heart beat such as calcium channel blockers (disopyramide) digoxin, clonidine, hydralazine, diltiazem, verapamil, and nifedipine; adrenaline for emergencies like anaphylaxis; ergotamine and derivatives for migraine; antiinflammatories like ibuprofen or indomethacin; cimetidine for reflux and ulcers; chlorpromazine for psychiatric disorders How should Cardinol be taken? You should take your Cardinol capsules 160mg with a glass of water, swallowed whole with or without food, usually once daily either morning or evening, but at the same time each day. You should take Cardinol capsules 160 LA according to your doctor’s recommendations and the number of capsules you take each day, how often you take them and for how long depends on the condition you are being treated for. The dose you are taking may be increased by your doctor. You must take your capsules every day, as instructed and if you are advised to stop taking them, withdrawal should be gradual and treatment should not be discontinued abruptly. How long should you take Cardinol? You should take your Cardinol capsules 160mg for as long as your doctor recommendations, which may be for a few days or weeks, depending on the condition you are being treated for. Missed dose of Cardinol If you miss a dose of Cardinol capsules 160mg, 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 Cardinol name be stored? You should store your Cardinol capsules 160mg below 25°C, protected from light and moisture.
Cipramil 20mg 28 Tablets/Pack Cipramil general information What is Cipramil used for? Cipramil tablets 20mg (also known as Celexa) are used to treat major depression in the initial phase to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. Cipramil tablets 20mg are also used as maintenance against relapse or recurrence of depressive episodes. How does Cipramil work? Cipramil tablets 20mg (also known as Celexa) contain citalopram which is an antidepressant belonging to the class of drugs known as selective serotonin reuptake inhibitors (SSRI). Citalopram is one of the most selective SSRIs yet described, which means that it does not affect noradrenaline, dopamine or gamma aminobutyric acid (GABA) uptake. Cipramil tablets 20mg act in the brain to correct the chemical imbalance that is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin (a neurotransmitter or brain chemical that allows nerve cells to communicate), which controls many body activities, including regulating mood. Citalopram in Cipramil tablets blocks the reuptake of serotonin from the synapse, which is the gap between nerve cells across which chemical messages are sent from one nerve cell to another. If the re-uptake of serotonin by the first nerve cell (pre-synaptic) is blocked, this means that there is more serotonin remaining for the receiving nerve cell (post-synaptic), which allows nerve cells to communicate with each other for longer. The action of Cipramil tablets 20mg helps relieve symptoms of depression and other mood disorders by increasing the amount of serotonin in the brain, which in turn increases stimulation of nerve pathways that control mood. What does Cipramil contain? Cipramil tablets contain citalopram an antidepressant belonging to the class of drugs known as selective serotonin reuptake inhibitors (SSRI), used to treat major depression. They also contain: maize starch, lactose, cellulose - microcrystalline, PVP/VA copolymer, glycerol, croscarmellose sodium, magnesium stearate, hypromellose, macrogol 400 and titanium dioxide. Treating depression with Cipramil Cipramil tablets 20mg contain citalopram, an antidepressant belonging to the class of drugs known as selective serotonin reuptake inhibitors (SSRI), used to treat major depression in the initial phase, to relieve symptoms of depression, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating and recurrent thoughts of suicide. Cipramil tablets 20mg are also used as maintenance against relapse or recurrence of depressive episodes. One of the major causes of depression is thought to be a lack of serotonin a neurotransmitter (brain chemical that allows nerve cells to communicate) that regulates mood. Citalopram in Cipramil tablets 20mg blocks the reuptake of serotonin from the synapse, which is the gap between nerve cells across which chemical messages are sent from one nerve cell to another. This means that there is more serotonin to allow nerve cells to communicate with each other for longer, and increasing the amount of serotonin in the brain in turn increases stimulation of nerve pathways that control mood. The action of Cipramil tablets 20mg helps relieve symptoms of depression as well as preventing relapse or recurrence of depressive episodes. What are the side effects of Cipramil? The most commonly reported side effects when taking Cipramil tablets 20mg are generally mild and transient and usually disappear with continued treatment. They include: nausea, diarrhoea, drowsiness, dry mouth, increased sweating, tremor, sexual problems Why you should not suddenly stop taking Cipramil If you stop taking your Cipramil tablets 20mg suddenly you may experience withdrawal symptoms, including: dizziness, tingling or pricking sensations (paraesthesia), headache, anxiety and nausea. If your doctor has suggested reducing your dose of Cipramil tablets 20mg, this should be done gradually over a period of at least 1 to 2 weeks. When should Cipramil not be used? You should not use Cipramil if you: are allergic to citalopram or any of the ingredients in Cipramil tablets 20mg are pregnant or breastfeeding, without discussion with your doctor have liver or kidney disease are taking any monoamine oxidase inhibitor medications as these can cause serious reactions if taken with Cipramil or within 14 days are taking other medication that interacts with Cipramil, including, monoamine oxidase inhibitors (MAOIs) for depression, the analgesic tramadol, tryptophan, or phentermine (weight-reducing medicines), migraine medicines like sumatriptan, the antipsychotic pimozide, herbal remedies containing St. John´s Wort, bupropion, for nicotine dependence are taking medication that affects blood clotting as these may increase risk of bleeding if taken with Cipramil What medications interact with Cipramil? Several medications interact with Cipramil and should either not be taken while you are taking Cipramil or only after discussion and instruction from your doctor: Drugs that cause a serious reaction with Cipramil: monoamine oxidase inhibitors (MAOIs) for depression; medication that affects blood clotting like warfarin, as these may increase risk of bleeding if taken with Cipramil Drugs that affect Cipramil: tramadol (analgesic), tryptophan or lithium (mood alteration), phentermine (weight-reducing medicines), medicines used to treat migraine, eg sumatriptan, St John's Wort, a herbal remedy used to treat mood disorders, cimetidine for reflux and ulcers Drugs that are affected by Cipramil: the antipsychotic pimozide, clozapine for schizophrenia, the anticoagulant warfarin, phenytoin for epilepsy, the sedative diazepam, tolbutamide for diabetes methadone for drug addiction, bupropion for nicotine dependence How should Cipramil be taken? You should take your Cipramil tablets 10mg with a glass of water with or without food usually once a day, at the same time each day, for several weeks or months, depending on your condition and your doctor’s recommendations. Your doctor may increase your dose, depending on the severity of your depression how you are responding to treatment. You should take your Cipramil tablets 20mg regularly for as long as recommended by your doctor, usually at least 6 months even if you feel better, to ensure that you are free of symptoms. How long should you take Cipramil? You should take your Cipramil tablets 20mg regularly for as long as recommended by your doctor, usually at least 6 months even if you feel better, to ensure that you are free of symptoms. Missed dose of Cipramil If you miss a dose of Cipramil tablets 20mg 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 Cipramil be stored? You should keep your Cipramil tablets 20mg in their blister packs until use and store below 25°C in a cool dry place.

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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 encephalopathy^2-5.

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.

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.

Cipflox (Ciprofloxacin 250mg)

Cipflox general information

What is Cipflox used for?

Cipflox tablets 250mg are an antibiotic medication used to treat uncomplicated and complicated bacterial infections in adults, caused by a wide range of susceptible bacteria in various parts of the body. Cipflox tablets 250mg are used to treat pneumonia (community acquired as outpatients), caused by various bacteria, but should not be the antibiotic of first choice for pneumonia caused by Pneumococcus. Cipflox tablets 250mg are also use to treat infections of the skin and soft tissue, such as impetigo and cellulitis; also of the bones and joints, which can be very painful; and infections of the abdominal cavity such as peritonitis. Cipflox tablets 250mg are also used to treat infections of the urogenital system, including adnexitis (infection and inflammation of the ovary and the fallopian tubes), prostatitis (infection and inflammation of the prostate), gonorrhoea, infections of the efferent urinary tract like cystitis and pyelonephritis (infection and inflammation of the kidney). Cipflox tablets 250mg are used to treat sepsis, which is a serious and life-threatening condition that occurs as a result of the body’s response to an infection. It is caused by chemicals released into the bloodstream to fight the infection, which can result in damage to tissues and organs. Cipflox tablets 250mg may also be used after inhalation of anthrax spores, as post exposure prophylaxis to reduce risk of pulmonary disease. Cipflox tablets 250mg are also used to treat acute pulmonary exacerbation of cystic fibrosis caused by the bacteria Pseudomonas aeruginosa; also complicated urinary tract infections or pyelonephritis due to E.coli in children over the age of 5 years.

How does Cipflox work?

Cipflox tablets 250mg contain the antibiotic ciprofloxacin that belongs to the fluoroquinolones group of antibiotics and is a synthetic broad spectrum antibiotic with antibacterial activity against a wide range of bacteria including, Klebsiella, Haemophilus, Enterobacter, E. coli, Pseudomonas, Legionella, Staphylococcus, Streptococcus, Listeria and Chlamydia. Ciprofloxacin in Cipflox tablets 250mg works by inhibiting several bacterial enzymes (bacterial topoisomerase IV and DNA gyrase) needed for the bacteria to replicate and repair its DNA. This action of ciprofloxacin in Cipflox tablets 250mg kills the bacteria by blocking its growth and preventing the spread of infection. Cipflox tablets 250mg do not work against viruses which use a different mechanism to grow and replicate.

What does Cipflox contain?

Cipflox tablets 250mg contain the active ingredient ciprofloxacin, a synthetic broad spectrum antibiotic used to treat a wide range of bacterial infections. They also contain microcrystalline cellulose, maize starch, pregelatinised maize starch, crospovidone, colloidal anhydrous silica, magnesium stearate, titanium dioxide, polydextrose, hypromellose, glycerol triacetate, macrogol.

Treating bacterial infection with Cipflox

Cipflox tablets 250mg contain ciprofloxacin a synthetic broad spectrum fluoroquinolone antibiotic that used to treat uncomplicated and complicated bacterial infections in adults, caused by a wide range of susceptible bacteria in various parts of the body. Infections that Cipflox tablets 250mg are suitable for include, pneumonia; infections of the skin, soft tissue bones and joints; infections of the urogenital system; infections of the abdominal cavity; sepsis and to reduce risk of pulmonary disease following inhalation of anthrax spores. Cipflox tablets 250mg are also used to treat acute pulmonary exacerbation of cystic fibrosis and complicated urinary tract infections in children over the age of 5 years. Ciprofloxacin in Cipflox tablets 250mg works by inhibiting several bacterial enzymes needed for the bacteria to replicate and repair its DNA. This action of ciprofloxacin in Cipflox tablets 250mg kills the bacteria by blocking its growth and preventing the spread of infection.

What are the side effects of Cipflox?

The most commonly reported side effects when taking Cipflox tablets 250mg include diarrhoea, nausea, vomiting, abdominal pain, rash, headache, altered taste, arthralgia (joint pain). Very rarely taking Cipflox tablets 250mg is associated with an increased risk of tendonitis and tendon rupture with increased risk if you are over the age of 60 years, taking systemic steroids or have received a kidney, heart or lung transplant.

When should Cipflox not be used?

You should not use Cipflox tablets 250mg if you:

are allergic to ciprofloxacin or any ingredients in Cipflox
are pregnant or are breastfeeding
have kidney or liver disease
history of tendon disease/disorder related to quinolone treatment
have epilepsy or a history of convulsion
have a history of stroke, heart attack or heart failure, without discussion with your doctor
have myasthenia gravis
are taking medicines that interact with Cipflox, including the muscle relaxant tizanidine for cystic fibrosis, anti-arrhythmics like amiodarone, tricyclic antidepressants like amitriptylene, macrolides antibiotics like azithromycin, clarithromycin, antipsychotics like olanzapine,, mineral supplements, sucralfate, omeprazole or antacids for ulcers and reflux, probenecid for gout, theophylline for asthma, caffeine and methylxanthines (found in some medicines and in drinks such as coffee, tea, cola), phenytoin for seizures, some NSAIDs (non-steroidal anti-inflammatory drugs), the immunosuppressant cyclosporine, anticoagulants like warfarin, oral antidiabetic medications like glibenclamide, methotrexate for cancer treatment, the antiemetic metoclopramide, the antidepressant duloxetine, ropinirole for Parkinson’s disease, clozapine for schizophrenia, sildenafil for erectile dysfunction

What medications interact with Cipflox?

Several medications interact with Cipflox tablets 250mg and should either not be taken while you are taking Cipflox or only after discussion and instruction from your doctor:

Drugs that cause a serious reaction or increase side effects with Cipflox: the muscle relaxant tizanidine for cystic fibrosis, anti-arrhythmics like amiodarone, tricyclic antidepressants like amitriptylene, macrolides antibiotics like azithromycin, clarithromycin, antipsychotics like olanzapine, theophylline for asthma, some NSAIDs (non-steroidal anti-inflammatory drugs), the immunosuppressant cyclosporine,
Drugs that affect Cipflox: mineral supplements, sucralfate, omeprazole or antacids for ulcers and reflux, probenecid for gout, the antiemetic metoclopramide
Drugs that are affected by Cipflox: the muscle relaxant tizanidine for cystic fibrosis, theophylline for asthma, caffeine and methylxanthines (found in some medicines and in drinks such as coffee, tea, cola), phenytoin for seizures, anticoagulants like warfarin, oral antidiabetic medications like glibenclamide, methotrexate for cancer treatment, the antidepressant duloxetine, ropinirole for Parkinson’s disease, clozapine for schizophrenia, sildenafil for erectile dysfunction

How should Cipflox be taken?

You should take your Cipflox tablets 250mg swallowed whole with a glass of water, with or without food. The dose you take and how often, depends on what you are being treated for and your doctor’s recommendations, which for most infections is usually one tablet twice daily for 7 to 14 days, but the dose or length of time you need to take your Cipflox tablets 250mg for may be increased depending on the severity of your infection and your response to treatment. You should not consume dairy products that are high in calcium (milk and yoghurt) or calcium-fortified orange juice, unless they are part of a meal as this may affect the absorption of ciprofloxacin. Avoid direct exposure to excessive sunlight or UV-light as this can cause photosensitisation (sunburn-like skin reactions). You should continue to take your Cipflox tablets 250mg for as long as recommended by your doctor.

How long should you take Cipflox?

You should continue to take your Cipflox tablets 250mg for as long as recommended by your doctor.

Missed dose of Cipflox

If you miss a dose of Cipflox tablets 250mg 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 Cipflox be stored?

You should store your Cipflox tablets 250mg below 25°C in a cool dry place.

Cardinol 160 LA (Propranolol)

Cardinol general information

What is Cardinol used for?

Cardinol 160mg capsules are used to treat a variety of conditions including, control of hypertension (high blood pressure); management of angina (chest pain) and long-term prevention of myocardial infarction (heart attack). Cardinol capsules 160 LA work through a common mechanism in several different body systems to manage the condition and relieve symptoms by reducing heart rate (pulse), workload (force needed to pump) and oxygen demand, increasing blood flow and lowering blood pressure.

How does Cardinol work?

Cardinol capsules 160mg contain propanolol, which is a beta-blocker or selective beta-receptor antagonist and acts by blocking the action of chemicals called catecholamines, such as adrenaline (epinephrine), which are released by the adrenal glands in response to nerve stimulation during physical and mental stress. Adrenaline works via beta-receptors in the heart to stimulate increased heart rate and constriction (narrowing) of blood vessels. These actions of adrenaline are blocked by propanolol in Cardinol capsules 160mg, to slow heart rate, dilate (widen) blood vessels, lower blood pressure, and increase blood flow and oxygen to the heart. Since beta-receptors are found in many tissues, particularly the heart, kidneys, vascular smooth muscle in blood vessel walls, lung, skeletal muscle and liver, all short-term and long-term symptom relief due to taking Cardinol capsules 160 LA, is based on blocking beta-receptors in the target tissue. Cardinol capsules 160mg are formulated for long acting slow release of propanolol over a 24 hour period so that you need only take one capsule a day.

What Cardinol doses are available?

Cardinol is available to order and buy online from Inhouse Pharmacy in the following doses:

Cardinol 10mg tablets
Cardinol 40mg tablets
Cardinol 160mg capsules (long-acting slow release)

What does Cardinol contain?

Cardinol 160mg capsules contain spheroids of the active ingredient propanolol hydrochloride, a beta-blocker and beta-receptor agonist that blocks the action of adrenaline to slow heart rate and relax blood vessels, amongst other actions. These spheroids have a sustained release coating to provide long action. Propanolol Cardinol 160mg capsules also contain sucrose, maize starch, shellac, talc and the gelatin capsule.

What is the difference between Cardinol long acting capsules and Cardinol tablets?

Cardinol tablets are formulated for rapid release and absorption and contain lower concentrations of active ingredient than capsules. Cardinol capsules contain slow release spheroids which release the active ingredient over a longer time period for slower but sustained drug absorption, which means that you need only take one capsule a day to get the same dose of drug as several tablets taken each day.

Treating high blood pressure (hypertension) with Cardinol

Cardinol capsules 160mg contain propanolol, a beta-blocker that blocks the action of adrenaline in stimulating beta-receptors in blood vessel walls, causing blood vessels to constrict (narrow) which reduces blood flow and raises blood pressure. Cardinol capsules 160 LA are used to treat high blood pressure (hypertension) by widening blood vessels, reducing heart rate (number of heart beats) and reducing the force of the heart contraction. These actions lower blood pressure and help the heart to cope better,
Reducing heart rate with Cardinol
Cardinol 160mg capsules contain propanolol, a beta-blocker that blocks the action of adrenaline in stimulating beta-receptors in the heart muscle. Adrenaline increases heart rate and the strength of muscular contraction in response to excitement/physical exertion. Cardinol capsules 160 LA are used for management of angina (chest pain) and long-term prevention of myocardial infarction (heart attack) by widening blood vessels, reducing heart rate and the force of contraction of the heart. When the heart does not have to work as hard, it requires less oxygen and relieves symptoms of angina including chest pain and breathlessness on exertion.

What are the side effects of Cardinol?

The mot common side effects reported while taking Cardinol capsules 160mg include: tiredness, dizziness, sleep disturbances or nightmares, hair loss, mood changes or confusion, dry eyes, nausea, vomiting, diarrhoea, stomach pain.

When should Cardinol not be used?

You should not use Cardinol capsules 160mg if you:

are allergic to propranolol hydrochloride or any other ingredients in Cardinol 160 LA
have a history of bronchial asthma or bronchospasm
are diabetic and taking hypoglycaemic therapy as propranolol may prolong the hypoglycaemic response to insulin
have, poor peripheral blood circulation, uncontrolled heart failure, low blood pressure (hypotension), metabolic acidosis (too much acid in your blood) or a certain type of angina called Prinzmetal's angina
have a phaeochromocytoma (a rare tumour of the adrenal gland) which is not already being treated with other medicines
have certain other heart problems
are taking medication that may interact with Cardinol 160mg capsules, including: other medicines for high blood pressure; angina or an irregular heart beat such as calcium channel blockers (disopyramide) digoxin, clonidine, hydralazine, diltiazem, verapamil, and nifedipine; adrenaline for emergencies like anaphylaxis; ergotamine and derivatives for migraine; antiinflammatories like ibuprofen or indomethacin; cimetidine for reflux and ulcers; chlorpromazine for psychiatric disorders

How should Cardinol be taken?

You should take your Cardinol capsules 160mg with a glass of water, swallowed whole with or without food, usually once daily either morning or evening, but at the same time each day. You should take Cardinol capsules 160 LA according to your doctor’s recommendations and the number of capsules you take each day, how often you take them and for how long depends on the condition you are being treated for. The dose you are taking may be increased by your doctor. You must take your capsules every day, as instructed and if you are advised to stop taking them, withdrawal should be gradual and treatment should not be discontinued abruptly.

How long should you take Cardinol?

You should take your Cardinol capsules 160mg for as long as your doctor recommendations, which may be for a few days or weeks, depending on the condition you are being treated for.

Missed dose of Cardinol

If you miss a dose of Cardinol capsules 160mg, 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 Cardinol name be stored?

You should store your Cardinol capsules 160mg below 25°C, protected from light and moisture.

Cipramil 20mg 28 Tablets/Pack

Cipramil general information

What is Cipramil used for?

Cipramil tablets 20mg (also known as Celexa) are used to treat major depression in the initial phase to relieve symptoms of depressive illness, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide. Cipramil tablets 20mg are also used as maintenance against relapse or recurrence of depressive episodes.

How does Cipramil work?

Cipramil tablets 20mg (also known as Celexa) contain citalopram which is an antidepressant belonging to the class of drugs known as selective serotonin reuptake inhibitors (SSRI). Citalopram is one of the most selective SSRIs yet described, which means that it does not affect noradrenaline, dopamine or gamma aminobutyric acid (GABA) uptake. Cipramil tablets 20mg act in the brain to correct the chemical imbalance that is thought to be one of the major causes of depression and other mood disorders, particularly a lack of serotonin (a neurotransmitter or brain chemical that allows nerve cells to communicate), which controls many body activities, including regulating mood. Citalopram in Cipramil tablets blocks the reuptake of serotonin from the synapse, which is the gap between nerve cells across which chemical messages are sent from one nerve cell to another. If the re-uptake of serotonin by the first nerve cell (pre-synaptic) is blocked, this means that there is more serotonin remaining for the receiving nerve cell (post-synaptic), which allows nerve cells to communicate with each other for longer. The action of Cipramil tablets 20mg helps relieve symptoms of depression and other mood disorders by increasing the amount of serotonin in the brain, which in turn increases stimulation of nerve pathways that control mood.

What does Cipramil contain?

Cipramil tablets contain citalopram an antidepressant belonging to the class of drugs known as selective serotonin reuptake inhibitors (SSRI), used to treat major depression. They also contain: maize starch, lactose, cellulose - microcrystalline, PVP/VA copolymer, glycerol, croscarmellose sodium, magnesium stearate, hypromellose, macrogol 400 and titanium dioxide.

Treating depression with Cipramil

Cipramil tablets 20mg contain citalopram, an antidepressant belonging to the class of drugs known as selective serotonin reuptake inhibitors (SSRI), used to treat major depression in the initial phase, to relieve symptoms of depression, including anxiety, loss of interest in usual activities, disturbed sleep, change in appetite, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating and recurrent thoughts of suicide. Cipramil tablets 20mg are also used as maintenance against relapse or recurrence of depressive episodes. One of the major causes of depression is thought to be a lack of serotonin a neurotransmitter (brain chemical that allows nerve cells to communicate) that regulates mood. Citalopram in Cipramil tablets 20mg blocks the reuptake of serotonin from the synapse, which is the gap between nerve cells across which chemical messages are sent from one nerve cell to another. This means that there is more serotonin to allow nerve cells to communicate with each other for longer, and increasing the amount of serotonin in the brain in turn increases stimulation of nerve pathways that control mood. The action of Cipramil tablets 20mg helps relieve symptoms of depression as well as preventing relapse or recurrence of depressive episodes.

What are the side effects of Cipramil?

The most commonly reported side effects when taking Cipramil tablets 20mg are generally mild and transient and usually disappear with continued treatment. They include: nausea, diarrhoea, drowsiness, dry mouth, increased sweating, tremor, sexual problems

Why you should not suddenly stop taking Cipramil

If you stop taking your Cipramil tablets 20mg suddenly you may experience withdrawal symptoms, including: dizziness, tingling or pricking sensations (paraesthesia), headache, anxiety and nausea. If your doctor has suggested reducing your dose of Cipramil tablets 20mg, this should be done gradually over a period of at least 1 to 2 weeks.

When should Cipramil not be used?

You should not use Cipramil if you:

are allergic to citalopram or any of the ingredients in Cipramil tablets 20mg
are pregnant or breastfeeding, without discussion with your doctor
have liver or kidney disease
are taking any monoamine oxidase inhibitor medications as these can cause serious reactions if taken with Cipramil or within 14 days
are taking other medication that interacts with Cipramil, including, monoamine oxidase inhibitors (MAOIs) for depression, the analgesic tramadol, tryptophan, or phentermine (weight-reducing medicines), migraine medicines like sumatriptan, the antipsychotic pimozide, herbal remedies containing St. John´s Wort, bupropion, for nicotine dependence
are taking medication that affects blood clotting as these may increase risk of bleeding if taken with Cipramil

What medications interact with Cipramil?

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

Drugs that cause a serious reaction with Cipramil: monoamine oxidase inhibitors (MAOIs) for depression; medication that affects blood clotting like warfarin, as these may increase risk of bleeding if taken with Cipramil
Drugs that affect Cipramil: tramadol (analgesic), tryptophan or lithium (mood alteration), phentermine (weight-reducing medicines), medicines used to treat migraine, eg sumatriptan, St John's Wort, a herbal remedy used to treat mood disorders, cimetidine for reflux and ulcers
Drugs that are affected by Cipramil: the antipsychotic pimozide, clozapine for schizophrenia, the anticoagulant warfarin, phenytoin for epilepsy, the sedative diazepam, tolbutamide for diabetes methadone for drug addiction, bupropion for nicotine dependence

How should Cipramil be taken?

You should take your Cipramil tablets 10mg with a glass of water with or without food usually once a day, at the same time each day, for several weeks or months, depending on your condition and your doctor’s recommendations. Your doctor may increase your dose, depending on the severity of your depression how you are responding to treatment. You should take your Cipramil tablets 20mg regularly for as long as recommended by your doctor, usually at least 6 months even if you feel better, to ensure that you are free of symptoms.

How long should you take Cipramil?

You should take your Cipramil tablets 20mg regularly for as long as recommended by your doctor, usually at least 6 months even if you feel better, to ensure that you are free of symptoms.

Missed dose of Cipramil

If you miss a dose of Cipramil tablets 20mg 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 Cipramil be stored?

You should keep your Cipramil tablets 20mg in their blister packs until use and store below 25°C in a cool dry place.

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