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Amaryl 2mg (Glimepiride) 30's Amaryl general information What is Amaryl used for? Amaryl tablets 2mg are an antidiabetic medication used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone. Amaryl tablets 2mg should be used in conjunction with diet, exercise and weight loss to lower blood sugar levels in type-2 diabetes mellitus and can be used alone as monotherapy, in conjunction with diet and exercise, or in combination with other antihyperglycaemic medication (lowers blood sugar), like metformin, when a single drug does not result in adequate glycaemic control. However, Amaryl tablets 2mg are not suitable for treatment of type-1 diabetes mellitus or insulin-dependent diabetes. Diabetes increases the risk of serious health complications, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage). Maintaining glycaemic control with Amaryl tablets 2mg reduces the risk of developing these vascular complications. How does Amaryl work? Amaryl tablets 2mg contain glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs. Glimepiride in Amaryl tablets 2mg controls blood glucose (sugar) primarily by acting directly on the beta cells, which are the insulin-producing cells of pancreatic islet tissue, to increase their sensitivity to glucose and to stimulate the cells to produce and release more insulin. Insulin is normally produced in response to food and increased blood glucose levels and it controls postprandial (after eating) blood glucose levels (glycaemic control). In diabetes, resistance to insulin results in loss of glycaemic control. Glimepiride in Amaryl tablets 2mg helps the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours. It is also thought that as well as acting as an insulin secretagogue (stimulates insulin secretion) glimepiride in Amaryl tablets 2mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and uptake of insulin into peripheral tissues for energy and storage, is more efficient. What does Amaryl contain? Amaryl tablets 2mg contains the active ingredient glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs, used to treat type-2 diabetes. They also contain, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, sodium starch glycollate, indigo carmine, iron oxide yellow. Treating type 2 diabetes with Amaryl Amaryl tablets 2mg contain glimepiride, an oral antihyperglycaemic medication, used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone. Glimepiride in Amaryl tablets 2mg controls blood glucose (sugar) primarily by acting directly on the insulin-producing beta cells of pancreatic islet tissue, to stimulate the cells to produce more insulin. Insulin is normally produced in response to food and increased blood glucose levels, and it controls postprandial (after eating) blood glucose levels (glycaemic control). In diabetes, resistance to insulin results in loss of glycaemic control. Amaryl tablets 2mg help the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours. It is also thought that as well as stimulating insulin secretion, glimepiride in Amaryl tablets 2mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and insulin uptake into peripheral tissues for energy and storage, is more efficient. Maintaining glycaemic control with Amaryl tablets 2mg reduces risk of serious health complications associated with diabetes, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage). What are the side effects of Amaryl? The most commonly reported side effects when taking Amaryl tablets 2mg include: gastrointestinal complaints like nausea, diarrhoea, constipation and stomach or abdominal pain; allergic skin reactions like, redness (erythema), itching (pruritus), hives (urticaria); dizziness, drowsiness, headache, visual disturbances, confusion, malaise and tremor, which are usually transient and may be signs of hypoglycaemia. A more serious side effect of taking Amaryl tablets 2mg is severe hypoglycaemia (very low blood glucose), as glimepiride continues to work between meals to reduce blood sugar levels, so it is important to eat regularly; also certain other conditions like liver or kidney problems, or taking other medications like beta blockers, can make you more susceptible to hypoglycaemia. Other symptoms of hypoglycaemia include headache, hunger, restlessness, loss of consciousness, which can result in coma. What is hypoglycaemia (hypo) Having a hypo is an unpleasant episode experienced by diabetics and refers to extreme hypoglycaemia or very low blood glucose. Glimepiride in Amaryl tablets 2mg continue to work between meals to reduce blood sugar levels and therefore if glucose levels fall too low, by missing a meal or waiting too long between eating, severe hypoglycaemia, which is very low blood glucose, can be the result. Symptoms of hypoglycaemia include headache, hunger, nausea, vomiting, restlessness, sensory disturbances, delirium, loss of consciousness, which can result in shallow respiration, bradycardia (slow heart beat) and coma. When should Amaryl not be used? You should not use Amaryl tablets 2mg if you: are allergic to glimepiride or any ingredients in Amaryl are pregnant or are breastfeeding have kidney or liver or thyroid disease have type 1 (insulin-dependent) diabetes or suffer from diabetic coma or diabetic ketoacidosis have G6PD deficiency as you may be at risk of haemolytic anaemia are malnourished or have adrenal or pituitary insufficiency, as this may increase risk of hypoglycaemia are taking medicines that interact with Amaryl, including: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesicis like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis What medications interact with Amaryl? Several medications interact with Amaryl tablets 2mg and should either not be taken while you are taking Amaryl or only after discussion and instruction from your doctor: Drugs that affect Amaryl tablets 2mg and cause hypoglaemia (low blood sugar) by increasing its glucose-lowering effect: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesics like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, bronchodilators like salbutamol Drugs that affect Amaryl tablets 2mg and cause hyperglycaemia (high blood sugar) by reducing its glucose-lowering effect: Danazol for hormone treatment, the antipsychotic chlorpromazine, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis How should Amaryl be taken? You should take your Amaryl tablets 2mg swallowed whole with a glass of water just before breakfast of if you only have a light breakfast, then take your Amaryl tablets just before your midday meal. It is important that you do not skip a meal while taking Amaryl tablets 2mg. The dose you take depends on how well you respond and your doctor may increase your dose until your blood glucose has reached normal levels and remains controlled. You should continue to take your Amaryl tablets 2mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes. How long should you take Amaryl? You should continue to take your Amaryl tablets 2mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes. Missed dose of Amaryl If you miss a dose of Amaryl tablets 2mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should Amaryl be stored? You should store your Amaryl below 25°C in a cool dry place.
Atret 0.05% (Tretinoin) Cream Atret Cream general information What is Atret Cream used for? Atret Cream 0.05% is used to treat acne vulgaris of the face, chest or back, including pimples (papules), whiteheads (pustules) and blackheads (comedones) and can also be used to treat acne cysts, which can be deep, painful and inflamed. Atret Cream 0.05% may also be used to help reduce visible signs of ageing on the face by fading age spots, reducing fine wrinkles and reducing the roughness of dry skin, caused by sun damage and aging, as it promotes skin turnover to replace old damaged skin with new skin. How does Atret Cream work? Atret Cream 0.05% contains tretinoin, which is an active metabolite of Vitamin A and is a keratolytic medication. Tretinoin in Atret Cream 0.05% works by binding to specific retinoic acid receptors in the nucleus of skin cells that affects the way skin cells behave and this regulates cell growth and differentiation. Tretinoin is thought to act by enhancing skin epithelial cell proliferation and accelerating epithelial differentiation; it also has anti-inflammatory properties. Acne is often associated with puberty when a surge of androgen hormones can over stimulate the sebaceous glands (oil producing glands in hair follicles). Skin cells that are shed from the lining of the hair follicle become trapped in sebum forming a plug below the surface of the skin, clogging the pores, which then attracts bacteria, so that the clogged pores become infected and inflamed, causing an acne outbreak. Atret Cream 0.05% prevents formation of new pimples and blackheads (comedones) by blocking the hardening processes of the outer skin layer (keratinisation and cornification) and increasing the shedding of old hardened skin cells, while at the same time promoting growth of new skin cells. The combined effect of these actions is to speed up skin cell turnover, clear up pimples and blackheads and reduce the spread of acne. This also works for aging or damaged skin by promoting skin turnover, where damaged skin is replaced by new skin cells giving the effect of lightening and smoothing the skin. Atret Cream 0.05% promotes healing of acne lesions and prevents formation of new acne lesions, as well as reducing the appearance of age spots and fine wrinkles caused by sun damage and aging. What does Atret Cream contain? Atret Cream contains the active ingredient tretinoin 0.05%, a keratolytic that is used to treat acne and reduce wrinkles and age spots. It also contains Butytlated Hydroxy Toluene, Propylen Glycol, Macrogol Cetostearyl Ether, Glyceryl Mono Stearate, Sodium Citrate, Polyethylne Glcol 400, Citric Acid Monohydrate, Sodium Metabisulphite, Methyl Paraben, Propyl Paraben, Light Liquid Paraffin, Ceto Stearyl Alcohol, Paraffin wax and Micro Wax. Treating acne with Atret Cream Atret Cream 0.05% contains tretinoin, a keratolytic that regulates growth and differentiation of skin cells. Acne is often associated with puberty when a surge of androgen hormones can over stimulate the sebaceous glands (oil producing glands in hair follicles). Skin cells that are shed from the lining of the hair follicle become trapped in sebum forming a plug below the surface of the skin, clogging the pores, which then attracts bacteria, so that the clogged pores become infected and inflamed, causing an acne outbreak. Tretinoin in Atret Cream 0.05% prevents formation of new pimples and blackheads (comedones) by blocking the hardening processes of the outer skin layer (keratinisation and cornification) and increasing the shedding of old hardened skin cells, while at the same time promoting growth of new skin cells. The combined effect of these actions is to speed up skin cell turnover, clear up pimples and blackheads and reduce the spread of acne. Atret Cream 0.05% also has anti-inflammatory properties, promotes healing of acne lesions and prevents formation of new acne lesions. Atret Cream for aging skin Atret Cream 0.05% contains tretinoin, a keratolytic that regulates growth and differentiation of skin cells. The visible signs of aging of the skin include age spots, which are pigmented patches of skin, and fine wrinkles, both caused by sun damage and general aging of the skin. Tretinoin in Atret Cream 0.05% helps speeds up skin turnover by promoting the shedding of old damaged skin and growth of new skin cells giving the effect of lightening and smoothing the skin. It also promotes skin cells to produce collagen, which keeps skin flexible. What are the side effects of Atret Cream? The most commonly reported side effects when using Atret Cream 0.05% include increased sensitivity to sunlight, irritation, burning or stinging where applied to the skin, redness, peeling blistering or dryness of the skin, discolouration. When should Atret Cream not be used? You should not use Atret Cream 0.05% if you: are allergic to tretinoin or any ingredients in Atret Cream are pregnant or are breastfeeding, as tretinoin may cause birth defects have acute eczema, as tretinoin can cause severe irritation on eczematous skin have a skin condition such as rosacea or perioral dermatitis have a personal or familial history of cutaneous epithelioma are using any topical skin peeling medication containing sulphur, resorcinal or salicylic acid are exposed to sunlight for prolonged periods. If unavoidable use a sunscreen and protective clothing over treated areas to protect the skin. How should Atret Cream be used? You should apply your Atret Cream 0.05% to the affected area of the skin once daily in the evening before going to bed. Clean the skin with a mild soap or soap-free cleanser, rinse with water then apply a small amount with clean fingers and rub gently into the skin. Do not use large amounts or apply more often than directed, as your skin will not clear up faster, instead you may increase the chance for side effects like skin irritation. Avoid contact with the eyes, eyelids, inside of the nose and mouth, which are easily irritated areas, or other areas where treatment is not intended. Do not apply to severely inflamed skin or to open lesions. Avoid excess sun exposure and use of oil-based makeups and creams or abrasive cosmetic products. You should use Atret Cream 0.05% for as long as is recommended, it usually takes 4-8 weeks for acne to clear up, with more improvement after further use. How long should you take Atret Cream? You should use Atret Cream 0.05% for as long as is recommended, it usually takes 4-8 weeks for acne to clear up, with more improvement after further use. Missed dose of Atret Cream If you miss a dose of Atret Cream apply 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 Atret Cream be stored? You should store your Atret Cream below 25°C in a cool dry place.
Phenergan 25mg (Promethazine) Phenergan general information What is Phenergan used for? Phenergan tablets 25mg are used to treat a variety of allergic conditions, including allergic contact dermatitis, allergic reactions to drugs, hives (urticaria), and bites and stings, to relieve symptoms of redness, swelling and itching of the skin; also to relieve upper respiratory tract symptoms of allergic rhinitis, including nasal congestion, runny itchy nose and sneezing, caused by seasonal allergies like hayfever. Phenergan tablets 25mg are also used as an antiemetic to reduce nausea and vomiting due to several conditions including postoperative vomiting, irradiation sickness, drug-induced nausea and motion sickness. Phenergan tablets 25mg have sedative properties, which can be used to help with management of the symptoms of measles and chicken pox; also for short-term sedation. How does Phenergan work? Phenergan tablets 25mg contain promethazine, an antihistamine belonging to phenothiazine group of drugs that also has antiemetic (prevents nausea) and sedative properties. Histamine is a chemical released from mast cells, (cells involved in allergies) as part of the body’s defence mechanism during an allergic reaction. Histamine and binds to H1 receptors in small blood vessels causing them to leak, allowing white blood cells and blood proteins into the tissues. These infiltrating cells produce inflammatory chemicals (prostaglandins and leukotrienes) that cause tissue swelling and irritation, which are symptoms of an allergic reaction. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors and blocking the action of histamine without blocking its secretion. This action blocks histamine-mediated allergic reactions, relieving symptoms in the upper respiratory tract like nasal congestion, runny itchy nose and sneezing, and in the skin like redness, swelling and itching. Promethazine in Phenergan tablets 25mg also acts on the central nervous system (CNS). Some brain neurones (nerve cells) produce histamine and the action of histamine in the brain is involved in stress and anxiety reactions. Blocking these brain histamine receptors is thought to be responsible for causing sedation. The same CNS mechanism is also responsible for the anti-emetic effect of Phenergan tablets 25mg. Motion sickness is caused by conflicting information being received by the brain from the eyes and the vestibular system in the inner ear; messages sent by the ear suggest motion, whereas the messages sent by the eye suggest that the body is still. The conflicting information received into the brain stimulates the vomiting centre of the brain to induce the vomiting reflex. Promethazine in Phenergan tablets 25mg binds to histamine receptors on cells of the vestibular apparatus of the inner ear and is also thought to bind to histamine receptors on nerve cells in the brain to block the transmission of nerve impulses from the inner ear to the vomiting center in the brain, which in turn prevents transmission of nerve signals from the brain to receptors in the stomach, so that the vomiting reflex is blocked. What does Phenergan contain? Phenergan tablets 25mg contain the active ingredient promethazine hydrochloride, an antihistamine belonging to phenothiazine group of drugs that also has antiemetic (prevents nausea) and sedative properties. They also contain lactose, starch maize, povidone, magnesium stearate, hypromellose, macrogol 200, blue opaspray. Treating allergy with Phenergan Phenergan tablets 25mg contain the antihistamine promethazine, which is used to relieve symptoms of allergy in several allergic conditions, including allergic contact dermatitis, allergic reactions to drugs, hives (urticaria), bites and stings; also allergic rhinitis caused by seasonal allergies like hayfever. Histamine is a chemical released from mast cells, (cells involved in allergies) as part of the body’s defence mechanism during an allergic reaction and binds to H1 receptors in small blood vessels causing them to leak, allowing white blood cells and blood proteins into the tissues. These infiltrating cells produce inflammatory chemicals (prostaglandins and leukotrienes) that cause tissue swelling and irritation, which are symptoms of an allergic reaction. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors and blocking the action of histamine without blocking its secretion. This action blocks histamine-mediated allergic reactions, relieving symptoms in the upper respiratory tract like nasal congestion, runny itchy nose and sneezing, and in the skin like redness, swelling and itching. Treating motion sickness with Phenergan Phenergan tablets 25mg contain promethazine, an antihistamine that is used to control the nausea and vomiting associated with motion sickness caused by all forms of travel including, air, sea train or car travel. The inner ear contains the vestibular apparatus, comprising the membranous labyrinth structures of the cochlea and semicircular canals, where motion or changes in the body’s position is detected and continual information about body position is transmitted to the brain. Motion causes the endolymph (fluid that fills the inner ear) to trigger electrical signals via special sensory cells sending nerve impulses via neurotransmitters (chemicals that allow nerve cells to communicate) along the auditory nerve to the brain to be interpreted. Motion sickness is caused by conflicting information being received by the brain from the eyes and the vestibular system; messages sent by the ear suggest motion, whereas the messages sent by the eye suggest that the body is still. The conflicting information received into the brain stimulates the area postrema or vomiting centre of the brain to induce the vomiting reflex. Promethazine in Phenergan tablets 25mg binds to histamine receptors on cells of the vestibular apparatus of the inner ear and is also thought to bind to histamine receptors on nerve cells in the brain and this blocks the transmission of nerve impulses from the inner ear to the vomiting center in the brain, which in turn prevents transmission of nerve signals from the brain to receptors in the stomach, so that the vomiting reflex is blocked. Phenergan tablets 25mg are also used to reduce nausea and vomiting due to several conditions including postoperative vomiting, irradiation sickness and drug-induced nausea. Phenergan for sedation Phenergan tablets 25mg contain promethazine, an antihistamine that has sedating properties. Promethazine in Phenergan tablets 25mg is an H1 receptor antagonist and works by binding to histamine receptors in various parts of the body including the brain. Some brain neurones (nerve cells) produce histamine and the action of histamine in the brain is involved in stress and anxiety reactions. Blocking these brain histamine receptors is thought to be responsible for causing sedation. What are the side effects of Phenergan? The most commonly reported side effects when taking Phenergan tablets 25mg include: dry mouth, gastro-intestinal disturbances (diarrhoea, constipation, nausea, vomiting or abdominal pain) loss of appetite, tiredness, sleepiness, restlessness, dizziness, blurred vision. When should Phenergan not be used? You should not use Phenergan tablets 25mg if you: are allergic to promethazine or any ingredients in Phenergan are allergic to sulphites, benzoates or phenothiazines are pregnant or are breastfeeding have had jaundice induced by other phenothiazine derivatives are taking medicines that interact with Phenergan, including: monoamine oxidase inhibitors (MAOIs) (up to 14 days previously), tricyclic antidepressants, sedatives and hypnotics, opioid analgesics, barbiturates Phenergan tablets 25mg should not be used for children under 2 years or for anyone in a coma. What medications interact with Phenergan? Several medications interact with Phenergan tablets 25mg to increase side effects and can cause a serious reaction and should either not be taken while you are taking Phenergan or only after discussion and instruction from your doctor: including: monoamine oxidase inhibitors (MAOIs) (up to 14 days previously, tricyclic antidepressants, sedatives and hypnotics, opioid analgesics, barbiturates. How should Phenergan be taken? You should take your Phenergan tablets 25mg swallowed whole with a glass of water. The dose you take and how often depends on what you are being treated for and your doctor’s recommendation. For allergy and sedation you should take your Phenergan tablets 25mg at night. For travel sickness you should take one tablet the night before travel and you can take another dose the next day, provided 6-8 hours has elapsed. For nausea and vomiting you should take your Phenergan tablets 25mg every 4 to 6 hours as recommended by your doctor. You should continue to take your Phenergan tablets 25mg for as long as your symptoms persist, or as recommended by your doctor but for no longer than 10 consecutive days. How long should you take Phenergan? You should continue to take your Phenergan tablets 25mg for as long as your symptoms persist, or as recommended by your doctor but for no longer than 10 consecutive days. Missed dose of Phenergan If you miss a dose of Phenergan tablets 25mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should Phenergan be stored? You should store your Phenergan below 25°C in a cool dry place.
AR Estradiol Valerate 40mg/ml AR Estradiol Valerate general information What is AR Estradiol Valerate used for? Menopause is a natural part of a woman’s life and represents the end of her childbearing years and the beginning of her next phase of life. As menopause approaches, estrogen production starts to slow down, and eventually, no more is produced by the ovaries. Menstruation ceases, and this lack of estrogen can cause severe problems for some women. Hormone replacement therapy (HRT) can help relieve symptoms of menopause. AR Estradiol Valerate 40mg/mL is an injectable form of HRT. It is recommended for HRT in combination with progesterone, because of the health risk of estrogen-only HRT. You should only use AR Estradiol Valerate alone if you have had a hysterectomy; or are also taking progesterone. Estrogen is the female hormone produced by the ovaries that transforms the girl into the woman and plays a central role in all stages of female reproduction, along with other female hormones like progesterone. Estrogen stimulates the development of female sexual characteristics, including breast development and body shape. It regulates the menstrual cycle, triggers ovulation, and stimulates the thickening of the endometrium (lining of the uterus) and thickening of vaginal tissue and its secretions. It also plays other essential roles, including regulating lipid metabolism and supporting bone density throughout the fertile years of a woman’s life. As menopause approaches, estrogen production starts to slow down. Eventually, no more is produced by the ovaries, so that menstruation ceases. Symptoms of menopause Symptoms associated with low estrogen in menopause include hot flashes caused by sudden dilating of surface blood vessels; when this happens at night, they cause night sweats. Vaginal thinning and dryness, known as atrophic vaginitis, can cause discomfort or pain with sex and recurrent urine infections. Other signs of menopause are headaches, mood swings, lack of concentration, and loss of energy. Loss of bone density is another problem related to the loss of estrogen. It can lead to osteoporosis, which makes the bones brittle so that they fracture more easily. AR Estradiol Valerate relieves symptoms of menopause. It also helps prevent postmenopausal bone loss (osteoporosis), reducing the risk of fracture. Transgender hormone therapy Estrogen is an essential component in transgender hormone therapy for male to female gender reassignment. AR Estradiol Valerate helps stimulate the development of female sexual characteristics. This promotes the feminisation process, such as breast development, and inducing metabolic changes such as fat distribution to redefine the general body shape. How does AR Estradiol Valerate work? AR Estradiol Valerate contains estradiol valerate 40mg/mL. It is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women and relieve symptoms of menopause. Estradiol valerate is a synthetic form of naturally occurring estradiol, the primary and most active form of the female sex hormone estrogen. Estradiol is biologically similar to the natural hormone. Other types of estrogen that exist post-menopause include estrone. This form of estrogen is produced by conversion from androgens (predominantly a male hormone but found in small amounts in women) in other tissues like fat cells. Estone does not have much activity, which is why a lack of estradiol is responsible for most menopausal symptoms. Estradiol in AR Estradiol Valerate works by passing through the cell membrane and binding to specific receptors inside the cells of its target tissues, including the ovaries, uterus, bone, and breast tissue. Estrogen attaches to its receptor then interacts directly with the DNA to promote the expression (activation) of specific genes that make proteins needed for estrogen-dependent processes in those tissues. These include breast cell growth, improved lubrication of vaginal cells, and increased bone density. AR Estradiol Valerate is formulated for intramuscular injection in an oily solution that slows down absorption. A single injection of AR Estradiol Valerate is absorbed slowly over several weeks and works for longer, with a prolonged action time What does AR Estradiol Valerate contain? AR Estradiol Valerate contains the active ingredient estradiol valerate 40mg/mL that is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women. It also contains 224mg/mL benzyl benzoate, 40mg/mL benzyl alcohol, castor oil. What are the side effects of AR Estradiol Valerate? Most medications have some side effects, but they are not experienced by everyone. Some side effects are commonly experienced when taking AR Estradiol Valerate, but others are not so common, and you should discuss any problems or concerns with your primary care physician. Common side effects when taking AR Estradiol Valerate include breast tenderness, breast pain, abdominal pain, nausea, oedema, and headache, breakthrough bleeding, and spotting. When should AR Estradiol Valerate not be used? Have a talk with your primary healthcare physician before taking AR Estradiol Valerate 40mg/mLso that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for AR Estradiol Valerate you should consider the following before taking AR Estradiol Valerate : Have you ever had an unusual reaction or an allergy when taking AR Estradiol Valerate? Are you pregnant or breastfeeding? Do you have any problems with your liver or had a liver disease? Have you had an estrogen-dependent cancer, including cancer of the breast or endometrium? Have you had any condition caused by a blood clot such as deep vein thrombosis (blood clots in the leg), pulmonary embolism (blood clot in the lungs)? Do you have a heart condition like angina, and have you ever had cardiovascular disease, including a heart attack or stroke or uncontrolled high blood pressure? Have you had abnormal genital bleeding of unknown cause? What medications interact with AR Estradiol Valerate? Some medicines interact with AR Estradiol Valerate 40mg/mL and may affect the way it works, or are affected by AR Estradiol Valerate or increase side effects; you should discuss possible interactions with your primary care physician. These may include anticonvulsants like phenytoin and carbamazepine, barbiturates, anti-infectives like rifampicin, rifabutin, nevirapine, antibiotics like penicillin. If other medications may interact with AR Estradiol Valerate, your doctor will discuss these with you. How should AR Estradiol Valerate be taken and for how long? You should take your AR Estradiol Valerate using a clean, dry needle and syringe. Draw up 1mL Estradiol Valerate and inject deep into the upper, outer area of the gluteal muscle. The usual dose is one injection every four weeks, depending on your doctor’s recommendation. You should continue to take Estradiol Valerate Injection injections as long as recommended by your doctor, which may be for several months Missed dose of AR Estradiol Valerate If you miss a dose of AR Estradiol Valerate 40mg/mL, take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should AR Estradiol Valerate be stored? You should store your AR Estradiol Valerate 40mg/mL below 25°C in a cool dry place and protect from light.
Kenozole Cream (Ketoconazole) Kenozole general information What is Kenozole used for? Kenozole Cream 2% is used as a topical treatment for fungal infections of the skin and scalp, due to the Tinea fungus. Tinea is a dermatophyte fungus also known as ringworm. Tinea causes fungal infection in different parts of the body including ringworm of the foot, also known as Athlete's foot (tinea pedis), of the body (tinea corporis), of the groin (tinea cruris or jock itch), and of the scalp (tinea capitis). Kenozole Cream 2% is also used to treat infection by the yeast fungus Malassezia, which causes Pityriasis versicolor, characterised by flaky discoloured patches that appear on the chest and back and seborrhoeic dermatitis, a form of dermatitis or inflammation of the skin that affects mainly the scalp and face. Kenozole Cream 2% is also effective against infection with the yeast fungus Candida, which causes cutaneous candidiasis, characterised by itchy red rash on various parts of the body, usually in warm, moist creased areas of skin, like under the arms and in the groin. How does Kenozole work? Kenozole Cream 2% contains ketoconazole, a synthetic broad-spectrum antifungal that is used to treat a variety of fungal infections of the skin. Ketoconazole in Kenozole Cream 2% prevents growth of dermatophyte and yeast fungi by inhibiting the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells. This results in altering the permeability of the fungal cell membrane causing it to become weakened, so that 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. When used as a topical antifungal, no detectable ketoconazole enters the blood, reducing risk of systemic side effects. What does Kenozole contain? Kenozole Cream contains the active ingredient ketoconazole 2% (w/w), a synthetic broad-spectrum antifungal that is used to treat a variety of fungal infections. Treating fungal infections with Kenozole Kenozole Cream 2% contains ketoconazole, a synthetic broad-spectrum antifungal that is used to treat a variety of fungal infections due to dermatophyte fungus Tinea, known as ringworm and the yeast Candida. These infections include, ringworm of the foot, also known as Athlete's foot (tinea pedis), of the body (tinea corporis), of the groin (tinea cruris or jock itch), and of the scalp (tinea capitis). Malassezia is a yeast-like fungus that causes Pityriasis versicolor, characterised by flaky discoloured patches that appear on the chest and back and seborrhoeic dermatitis, a form of dermatitis or inflammation of the skin that affects mainly the scalp and face. Candida causes cutaneous candidiasis, characterised by itchy red rash on various parts of the body, usually in warm, moist creased areas of skin, like under the arms and in the groin. Ketoconazole in Kenozole Cream 2% prevents growth of dermatophyte and yeast fungi by inhibiting the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells. This results in altering the permeability of the fungal cell membrane causing it to become weakened, so that 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 are the side effects of Kenozole? The most commonly reported side effects when using Kenozole Cream 2% include, burning sensation or irritation at the site of application, such as redness, pain and swelling; oily or dry scalp, mild hair loss. When should Kenozole not be used? You should not use Kenozole Cream 2% if you: are allergic to ketoconazole or any ingredients in Kenozole are pregnant or are breastfeeding, without discussion with your doctor How should Kenozole be used? You should apply your Kenozole Cream 2% to the affected area and rub gently into the skin once or twice daily depending on what you are being treated for and the severity of the infection. You should continue your course of treatment with Kenozole Cream for 2-6 weeks, depending on what you are being treated for and your doctor’s recommendation, until signs and symptoms of the infection has disappeared. Wash your hands to prevent spreading the infection and do not get the cream into your eyes. How long should you take Kenozole? You should continue your course of treatment with Kenozole Cream for 2-6 weeks, depending on what you are being treated for and your doctor’s recommendation. Missed dose of Kenozole If you miss a dose of Kenozole apply 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 Kenozole be stored? You should store your Kenozole below 25°C in a cool dry place.

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Amaryl 2mg (Glimepiride) 30's

Amaryl general information

What is Amaryl used for?

Amaryl tablets 2mg are an antidiabetic medication used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone. Amaryl tablets 2mg should be used in conjunction with diet, exercise and weight loss to lower blood sugar levels in type-2 diabetes mellitus and can be used alone as monotherapy, in conjunction with diet and exercise, or in combination with other antihyperglycaemic medication (lowers blood sugar), like metformin, when a single drug does not result in adequate glycaemic control. However, Amaryl tablets 2mg are not suitable for treatment of type-1 diabetes mellitus or insulin-dependent diabetes. Diabetes increases the risk of serious health complications, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage). Maintaining glycaemic control with Amaryl tablets 2mg reduces the risk of developing these vascular complications.

How does Amaryl work?

Amaryl tablets 2mg contain glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs. Glimepiride in Amaryl tablets 2mg controls blood glucose (sugar) primarily by acting directly on the beta cells, which are the insulin-producing cells of pancreatic islet tissue, to increase their sensitivity to glucose and to stimulate the cells to produce and release more insulin. Insulin is normally produced in response to food and increased blood glucose levels and it controls postprandial (after eating) blood glucose levels (glycaemic control). In diabetes, resistance to insulin results in loss of glycaemic control. Glimepiride in Amaryl tablets 2mg helps the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours. It is also thought that as well as acting as an insulin secretagogue (stimulates insulin secretion) glimepiride in Amaryl tablets 2mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and uptake of insulin into peripheral tissues for energy and storage, is more efficient.

What does Amaryl contain?

Amaryl tablets 2mg contains the active ingredient glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs, used to treat type-2 diabetes. They also contain, lactose monohydrate, magnesium stearate, microcrystalline cellulose, povidone, sodium starch glycollate, indigo carmine, iron oxide yellow.

Treating type 2 diabetes with Amaryl

Amaryl tablets 2mg contain glimepiride, an oral antihyperglycaemic medication, used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone. Glimepiride in Amaryl tablets 2mg controls blood glucose (sugar) primarily by acting directly on the insulin-producing beta cells of pancreatic islet tissue, to stimulate the cells to produce more insulin. Insulin is normally produced in response to food and increased blood glucose levels, and it controls postprandial (after eating) blood glucose levels (glycaemic control). In diabetes, resistance to insulin results in loss of glycaemic control. Amaryl tablets 2mg help the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours. It is also thought that as well as stimulating insulin secretion, glimepiride in Amaryl tablets 2mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and insulin uptake into peripheral tissues for energy and storage, is more efficient. Maintaining glycaemic control with Amaryl tablets 2mg reduces risk of serious health complications associated with diabetes, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage).

What are the side effects of Amaryl?

The most commonly reported side effects when taking Amaryl tablets 2mg include: gastrointestinal complaints like nausea, diarrhoea, constipation and stomach or abdominal pain; allergic skin reactions like, redness (erythema), itching (pruritus), hives (urticaria); dizziness, drowsiness, headache, visual disturbances, confusion, malaise and tremor, which are usually transient and may be signs of hypoglycaemia. A more serious side effect of taking Amaryl tablets 2mg is severe hypoglycaemia (very low blood glucose), as glimepiride continues to work between meals to reduce blood sugar levels, so it is important to eat regularly; also certain other conditions like liver or kidney problems, or taking other medications like beta blockers, can make you more susceptible to hypoglycaemia. Other symptoms of hypoglycaemia include headache, hunger, restlessness, loss of consciousness, which can result in coma.

What is hypoglycaemia (hypo)

Having a hypo is an unpleasant episode experienced by diabetics and refers to extreme hypoglycaemia or very low blood glucose. Glimepiride in Amaryl tablets 2mg continue to work between meals to reduce blood sugar levels and therefore if glucose levels fall too low, by missing a meal or waiting too long between eating, severe hypoglycaemia, which is very low blood glucose, can be the result. Symptoms of hypoglycaemia include headache, hunger, nausea, vomiting, restlessness, sensory disturbances, delirium, loss of consciousness, which can result in shallow respiration, bradycardia (slow heart beat) and coma.

When should Amaryl not be used?

You should not use Amaryl tablets 2mg if you:

are allergic to glimepiride or any ingredients in Amaryl
are pregnant or are breastfeeding
have kidney or liver or thyroid disease
have type 1 (insulin-dependent) diabetes or suffer from diabetic coma or diabetic ketoacidosis
have G6PD deficiency as you may be at risk of haemolytic anaemia
are malnourished or have adrenal or pituitary insufficiency, as this may increase risk of hypoglycaemia
are taking medicines that interact with Amaryl, including: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesicis like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis

What medications interact with Amaryl?

Several medications interact with Amaryl tablets 2mg and should either not be taken while you are taking Amaryl or only after discussion and instruction from your doctor:

Drugs that affect Amaryl tablets 2mg and cause hypoglaemia (low blood sugar) by increasing its glucose-lowering effect: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesics like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, bronchodilators like salbutamol
Drugs that affect Amaryl tablets 2mg and cause hyperglycaemia (high blood sugar) by reducing its glucose-lowering effect: Danazol for hormone treatment, the antipsychotic chlorpromazine, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis

How should Amaryl be taken?

You should take your Amaryl tablets 2mg swallowed whole with a glass of water just before breakfast of if you only have a light breakfast, then take your Amaryl tablets just before your midday meal. It is important that you do not skip a meal while taking Amaryl tablets 2mg. The dose you take depends on how well you respond and your doctor may increase your dose until your blood glucose has reached normal levels and remains controlled. You should continue to take your Amaryl tablets 2mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes.

How long should you take Amaryl?

You should continue to take your Amaryl tablets 2mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes.

Missed dose of Amaryl

If you miss a dose of Amaryl tablets 2mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Amaryl be stored?

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

Atret 0.05% (Tretinoin) Cream

Atret Cream general information

What is Atret Cream used for?

Atret Cream 0.05% is used to treat acne vulgaris of the face, chest or back, including pimples (papules), whiteheads (pustules) and blackheads (comedones) and can also be used to treat acne cysts, which can be deep, painful and inflamed. Atret Cream 0.05% may also be used to help reduce visible signs of ageing on the face by fading age spots, reducing fine wrinkles and reducing the roughness of dry skin, caused by sun damage and aging, as it promotes skin turnover to replace old damaged skin with new skin.

How does Atret Cream work?

Atret Cream 0.05% contains tretinoin, which is an active metabolite of Vitamin A and is a keratolytic medication. Tretinoin in Atret Cream 0.05% works by binding to specific retinoic acid receptors in the nucleus of skin cells that affects the way skin cells behave and this regulates cell growth and differentiation. Tretinoin is thought to act by enhancing skin epithelial cell proliferation and accelerating epithelial differentiation; it also has anti-inflammatory properties. Acne is often associated with puberty when a surge of androgen hormones can over stimulate the sebaceous glands (oil producing glands in hair follicles). Skin cells that are shed from the lining of the hair follicle become trapped in sebum forming a plug below the surface of the skin, clogging the pores, which then attracts bacteria, so that the clogged pores become infected and inflamed, causing an acne outbreak. Atret Cream 0.05% prevents formation of new pimples and blackheads (comedones) by blocking the hardening processes of the outer skin layer (keratinisation and cornification) and increasing the shedding of old hardened skin cells, while at the same time promoting growth of new skin cells. The combined effect of these actions is to speed up skin cell turnover, clear up pimples and blackheads and reduce the spread of acne. This also works for aging or damaged skin by promoting skin turnover, where damaged skin is replaced by new skin cells giving the effect of lightening and smoothing the skin. Atret Cream 0.05% promotes healing of acne lesions and prevents formation of new acne lesions, as well as reducing the appearance of age spots and fine wrinkles caused by sun damage and aging.

What does Atret Cream contain?

Atret Cream contains the active ingredient tretinoin 0.05%, a keratolytic that is used to treat acne and reduce wrinkles and age spots. It also contains Butytlated Hydroxy Toluene, Propylen Glycol, Macrogol Cetostearyl Ether, Glyceryl Mono Stearate, Sodium Citrate, Polyethylne Glcol 400, Citric Acid Monohydrate, Sodium Metabisulphite, Methyl Paraben, Propyl Paraben, Light Liquid Paraffin, Ceto Stearyl Alcohol, Paraffin wax and Micro Wax.

Treating acne with Atret Cream

Atret Cream 0.05% contains tretinoin, a keratolytic that regulates growth and differentiation of skin cells. Acne is often associated with puberty when a surge of androgen hormones can over stimulate the sebaceous glands (oil producing glands in hair follicles). Skin cells that are shed from the lining of the hair follicle become trapped in sebum forming a plug below the surface of the skin, clogging the pores, which then attracts bacteria, so that the clogged pores become infected and inflamed, causing an acne outbreak. Tretinoin in Atret Cream 0.05% prevents formation of new pimples and blackheads (comedones) by blocking the hardening processes of the outer skin layer (keratinisation and cornification) and increasing the shedding of old hardened skin cells, while at the same time promoting growth of new skin cells. The combined effect of these actions is to speed up skin cell turnover, clear up pimples and blackheads and reduce the spread of acne. Atret Cream 0.05% also has anti-inflammatory properties, promotes healing of acne lesions and prevents formation of new acne lesions.

Atret Cream for aging skin

Atret Cream 0.05% contains tretinoin, a keratolytic that regulates growth and differentiation of skin cells. The visible signs of aging of the skin include age spots, which are pigmented patches of skin, and fine wrinkles, both caused by sun damage and general aging of the skin. Tretinoin in Atret Cream 0.05% helps speeds up skin turnover by promoting the shedding of old damaged skin and growth of new skin cells giving the effect of lightening and smoothing the skin. It also promotes skin cells to produce collagen, which keeps skin flexible.

What are the side effects of Atret Cream?

The most commonly reported side effects when using Atret Cream 0.05% include increased sensitivity to sunlight, irritation, burning or stinging where applied to the skin, redness, peeling blistering or dryness of the skin, discolouration.

When should Atret Cream not be used?

You should not use Atret Cream 0.05% if you:

are allergic to tretinoin or any ingredients in Atret Cream
are pregnant or are breastfeeding, as tretinoin may cause birth defects
have acute eczema, as tretinoin can cause severe irritation on eczematous skin
have a skin condition such as rosacea or perioral dermatitis
have a personal or familial history of cutaneous epithelioma
are using any topical skin peeling medication containing sulphur, resorcinal or salicylic acid
are exposed to sunlight for prolonged periods. If unavoidable use a sunscreen and protective clothing over treated areas to protect the skin.

How should Atret Cream be used?

You should apply your Atret Cream 0.05% to the affected area of the skin once daily in the evening before going to bed. Clean the skin with a mild soap or soap-free cleanser, rinse with water then apply a small amount with clean fingers and rub gently into the skin. Do not use large amounts or apply more often than directed, as your skin will not clear up faster, instead you may increase the chance for side effects like skin irritation. Avoid contact with the eyes, eyelids, inside of the nose and mouth, which are easily irritated areas, or other areas where treatment is not intended. Do not apply to severely inflamed skin or to open lesions. Avoid excess sun exposure and use of oil-based makeups and creams or abrasive cosmetic products. You should use Atret Cream 0.05% for as long as is recommended, it usually takes 4-8 weeks for acne to clear up, with more improvement after further use.

How long should you take Atret Cream?

You should use Atret Cream 0.05% for as long as is recommended, it usually takes 4-8 weeks for acne to clear up, with more improvement after further use.

Missed dose of Atret Cream

If you miss a dose of Atret Cream apply 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 Atret Cream be stored?

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

Phenergan 25mg (Promethazine)

Phenergan general information

What is Phenergan used for?

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

How does Phenergan work?

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

What does Phenergan contain?

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

Treating allergy with Phenergan

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

Treating motion sickness with Phenergan

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

Phenergan for sedation

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

What are the side effects of Phenergan?

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

When should Phenergan not be used?

You should not use Phenergan tablets 25mg if you:

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

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

What medications interact with Phenergan?

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

How should Phenergan be taken?

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

How long should you take Phenergan?

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

Missed dose of Phenergan

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

How should Phenergan be stored?

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

AR Estradiol Valerate 40mg/ml

AR Estradiol Valerate general information

What is AR Estradiol Valerate used for?

Menopause is a natural part of a woman’s life and represents the end of her childbearing years and the beginning of her next phase of life. As menopause approaches, estrogen production starts to slow down, and eventually, no more is produced by the ovaries. Menstruation ceases, and this lack of estrogen can cause severe problems for some women. Hormone replacement therapy (HRT) can help relieve symptoms of menopause. AR Estradiol Valerate 40mg/mL is an injectable form of HRT. It is recommended for HRT in combination with progesterone, because of the health risk of estrogen-only HRT. You should only use AR Estradiol Valerate alone if you have had a hysterectomy; or are also taking progesterone.

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

Symptoms of menopause

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

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

Transgender hormone therapy

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

How does AR Estradiol Valerate work?

AR Estradiol Valerate contains estradiol valerate 40mg/mL. It is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women and relieve symptoms of menopause.

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

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

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

What does AR Estradiol Valerate contain?

AR Estradiol Valerate contains the active ingredient estradiol valerate 40mg/mL that is used for hormone replacement therapy to substitute for lack of estrogen in postmenopausal women. It also contains 224mg/mL benzyl benzoate, 40mg/mL benzyl alcohol, castor oil.

What are the side effects of AR Estradiol Valerate?

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

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

When should AR Estradiol Valerate not be used?

Have a talk with your primary healthcare physician before taking AR Estradiol Valerate 40mg/mLso that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for AR Estradiol Valerate you should consider the following before taking AR Estradiol Valerate :

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

What medications interact with AR Estradiol Valerate?

Some medicines interact with AR Estradiol Valerate 40mg/mL and may affect the way it works, or are affected by AR Estradiol Valerate or increase side effects; you should discuss possible interactions with your primary care physician. These may include anticonvulsants like phenytoin and carbamazepine, barbiturates, anti-infectives like rifampicin, rifabutin, nevirapine, antibiotics like penicillin.

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

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

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

Missed dose of AR Estradiol Valerate

If you miss a dose of AR Estradiol Valerate 40mg/mL, take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should AR Estradiol Valerate be stored?

You should store your AR Estradiol Valerate 40mg/mL below 25°C in a cool dry place and protect from light.

Kenozole Cream (Ketoconazole)

Kenozole general information

What is Kenozole used for?

Kenozole Cream 2% is used as a topical treatment for fungal infections of the skin and scalp, due to the Tinea fungus. Tinea is a dermatophyte fungus also known as ringworm. Tinea causes fungal infection in different parts of the body including ringworm of the foot, also known as Athlete's foot (tinea pedis), of the body (tinea corporis), of the groin (tinea cruris or jock itch), and of the scalp (tinea capitis). Kenozole Cream 2% is also used to treat infection by the yeast fungus Malassezia, which causes Pityriasis versicolor, characterised by flaky discoloured patches that appear on the chest and back and seborrhoeic dermatitis, a form of dermatitis or inflammation of the skin that affects mainly the scalp and face. Kenozole Cream 2% is also effective against infection with the yeast fungus Candida, which causes cutaneous candidiasis, characterised by itchy red rash on various parts of the body, usually in warm, moist creased areas of skin, like under the arms and in the groin.

How does Kenozole work?

Kenozole Cream 2% contains ketoconazole, a synthetic broad-spectrum antifungal that is used to treat a variety of fungal infections of the skin. Ketoconazole in Kenozole Cream 2% prevents growth of dermatophyte and yeast fungi by inhibiting the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells. This results in altering the permeability of the fungal cell membrane causing it to become weakened, so that 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. When used as a topical antifungal, no detectable ketoconazole enters the blood, reducing risk of systemic side effects.

What does Kenozole contain?

Kenozole Cream contains the active ingredient ketoconazole 2% (w/w), a synthetic broad-spectrum antifungal that is used to treat a variety of fungal infections.

Treating fungal infections with Kenozole

Kenozole Cream 2% contains ketoconazole, a synthetic broad-spectrum antifungal that is used to treat a variety of fungal infections due to dermatophyte fungus Tinea, known as ringworm and the yeast Candida. These infections include, ringworm of the foot, also known as Athlete's foot (tinea pedis), of the body (tinea corporis), of the groin (tinea cruris or jock itch), and of the scalp (tinea capitis). Malassezia is a yeast-like fungus that causes Pityriasis versicolor, characterised by flaky discoloured patches that appear on the chest and back and seborrhoeic dermatitis, a form of dermatitis or inflammation of the skin that affects mainly the scalp and face. Candida causes cutaneous candidiasis, characterised by itchy red rash on various parts of the body, usually in warm, moist creased areas of skin, like under the arms and in the groin. Ketoconazole in Kenozole Cream 2% prevents growth of dermatophyte and yeast fungi by inhibiting the synthesis of ergosterol, an important component of fungal cell membrane that is not found in animal cells. This results in altering the permeability of the fungal cell membrane causing it to become weakened, so that 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 are the side effects of Kenozole?

The most commonly reported side effects when using Kenozole Cream 2% include, burning sensation or irritation at the site of application, such as redness, pain and swelling; oily or dry scalp, mild hair loss.

When should Kenozole not be used?

You should not use Kenozole Cream 2% if you:

are allergic to ketoconazole or any ingredients in Kenozole
are pregnant or are breastfeeding, without discussion with your doctor

How should Kenozole be used?

You should apply your Kenozole Cream 2% to the affected area and rub gently into the skin once or twice daily depending on what you are being treated for and the severity of the infection. You should continue your course of treatment with Kenozole Cream for 2-6 weeks, depending on what you are being treated for and your doctor’s recommendation, until signs and symptoms of the infection has disappeared. Wash your hands to prevent spreading the infection and do not get the cream into your eyes.

How long should you take Kenozole?

You should continue your course of treatment with Kenozole Cream for 2-6 weeks, depending on what you are being treated for and your doctor’s recommendation.

Missed dose of Kenozole

If you miss a dose of Kenozole apply 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 Kenozole be stored?

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

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