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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.
Nilstat Oral Drops (Nystatin) Nilstat Oral Drops general information What is Nilstat Oral Drops used for? Nilstat Oral Drops are used to treat infections of the mouth and oral cavity caused by the yeast-like fungus Candida albicans. Infection with Candida (candidiasis) is also known as oral thrush and appears as patches of creamy/white spots in the mouth, usually the tongue or cheeks, but can spread to the gums and back of the throat. The infection can cause discomfort and bleed if disturbed such as when brushing your teeth. Candida is normally present in the mouth in small amounts and is kept from spreading by other microorganisms. However, if Candida grows unchecked and increases in numbers sufficient to tip the healthy balance between yeast and bacteria, this can cause infection. Some conditions like diabetes, impaired immune system, such as those imunocompromised by HIV infection can disturb this balance; also some medications like antibiotics and corticosteroids. Wearing ill-fitting dentures can also increase the risk of Candida infection. Nilstat Oral Drops are used as a topical treatment to kill the Candida yeast that causes infection in the mouth, relieving symptoms and preventing spread of infection. How does Nilstat Oral Drops work? Nilstat Oral Drops contain nystatin, an antifungal that works by binding to ergosterol, an important component of fungal cell membrane that is not found in animal cells. This weakens the fungal cell membrane, causing a change in permeability and allowing the cell contents to leak out, which kills the fungus, preventing the infection from spreading and relieving symptoms caused by the infection. Nilstat Oral Drops do not absorb into the blood in sufficient amounts to be effective anywhere else in the body. What does Nilstat Oral Drops contain? Nilstat Oral Drops contain the active ingredient nystatin (100,000 units/mL), which is an antifungal used to treat Intestinal candidiasis. They also contain propyl hydroxybenzoate, sucrose, polysorbate 80, sodium calciumedetate, methyl hydroxybenzoate, purified water, bentonite, quinoline yellow CI 47005, cherry flavour F-1242. Treating oral thrush with Nilstat Oral Drops Nilstat Oral Drops contain nystatin, an antifungal used to treat infections of the mouth and oral cavity caused by the yeast-like fungus Candida albicans, also known as oral thrush. Candida is normally present in the mouth in small amounts and is kept from spreading by a healthy balance between yeast and bacteria. However, some conditions like diabetes and impaired immune system, such as those imunocompromised by HIV infection can disturb this balance; also some medications like antibiotics and corticosteroids. This allows Candida to grow unchecked and result in an infection, which appears as patches of creamy/white spots in the mouth, usually the tongue or cheeks, but can spread to the gums and back of the throat. Wearing ill-fitting dentures can also increase the risk of Candida infection. Nilstat Oral Drops work by binding to ergosterol, an important component of fungal cell membrane that is not found in animal cells. This weakens the fungal cell membrane, causing a change in permeability and allowing the cell contents to leak out, which kills the fungus, preventing the infection from spreading and relieving symptoms caused by the infection, including discomfort and bleeding. What are the side effects of Nilstat Oral Drops? The most commonly reported side effects when taking Nilstat Oral Drops are gastrointestinal distress including diarrhoea, nausea and vomiting. When should Nilstat Oral Drops not be used? You should not use Nilstat Oral Drops if you: are allergic to nystatin or any ingredients in Nilstat Oral Drops are pregnant or are breastfeeding, without discussion with your doctor How should Nilstat Oral Drops be taken? You should take your Nilstat Oral Drops using the syringe provided four times daily. Shake the bottle and then fill the 1mL syringe with Nilstat Oral Drops. Drop the full amount in the syringe into your mouth or under your tongue. Leave in the mouth for as long as possible before swallowing and ensure all areas of the infection are covered. Wash the syringe and repeat after 3 hours. You should continue taking your Nilstat Oral Drops daily until the contents of the bottle have been used up otherwise the infection may not be fully cleared up and may return. How long should you take Nilstat Oral Drops? You should continue taking your Nilstat Oral Drops daily until the contents of the bottle have been used up otherwise the infection may not be fully cleared up and may return. Missed dose of Nilstat Oral Drops If you miss a dose of Nilstat Oral Drops 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 Nilstat Oral Drops be stored? You should store your Nilstat Oral Drops below 25°C in a cool dry place.
Oruvail SR (Ketoprofen 200mg) Oruvail general information What is Oruvail used for? Oruvail SR capsules 200mg are used to help manage symptoms caused by various chronic inflammatory diseases. These include rheumatoid arthritis, osteoarthritis (wear and tear) and ankylosing spondylitis, (an autoimmune inflammatory disease that affects the joints in the spine and pelvis and can cause fusion of the spine) to reduce pain, inflammation, tenderness, stiffness and swelling in the affected joints. Oruvail SR capsules 200mg do not cure the underlying disease but can relieve symptoms of pain and inflammation and improve the functional use of affected joints. Oruvail SR capsules 200mg are also used for acute articular and periarticular disorders, such as bursitis (inflammation of the fluid filled sac in the joints), capsulitis (inflammation of tendons in joints), synovitis (inflammation of the membrane surrounding joints), tendonitis (inflammation of tendons), fibrositis (inflammation of connective tissues in muscles and joints), cervical spondylitis (wear and tear in the neck spinal disks); also for musculoskeletal disorders, such as sprains, strains, lower back pain (lumbago, sciatica) and for gout (uric acid crystals in the joints) to relieve chronic pain and inflammation. Oruvail SR capsules 200mg are also used for relief dysmenorrhoea (menstrual pain) and in the treatment of post-operative pain. How does Oruvail work? Oruvail SR capsules 200mg contain ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) that has anti-inflammatory, analgesic (pain relieving) and anti-pyretic properties (reduces fever). Ketoprofen in Oruvail SR capsules 200mg blocks the production of specific chemicals called prostaglandins (PG) that mediate inflammation, particularly PGE2, and works by inhibiting the enzyme cyclooxygenase (COX) including cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2) that is induced during the inflammation process and is responsible for the synthesis of inflammatory prostaglandins. Inhibition of COX-2 helps relieve the symptoms of inflammation, including pain, swelling, and joint stiffness. Inhibition of COX-1 is responsible for the gastrointestinal side effects that are due to inhibition of protective prostaglandins in the gut and disruption of regulation of acid content. Oruvail SR capsules 200mg contain multiple microbeads which are formulated for sustained controlled release. This provides a constant concentration of ketoprofen over a period of time, for maximum effectiveness and minimum side effects. What does Oruvail contain? Oruvail SR capsules 200mg contains the active ingredient ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation of chronic inflammatory bone and joint diseases, and other conditions. They also contain erythrosine, ethylcellulose, gelatin, non-pareil beads (PI 1014), shellac, colloidal anhydrous silica, sodium lauryl sulfate, purified talc and titanium dioxide. The 200mg capsules also contain Opacode Blue (PI 12300). Treating arthritis with Oruvail Oruvail SR capsules 200mg contain ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain and inflammation in joints affected with arthritis. Osteoarthritis a degenerative disease (also known as wear and tear), and rheumatoid arthritis (an autoimmune disease where the immune system turns on self) are chronic inflammatory diseases in which the joints become inflamed, swollen and painful. Ketoprofen in Oruvail SR capsules 200mg blocks the production of specific chemicals called prostaglandins (PG) that mediate inflammation, particularly PGE2, and works by inhibiting the enzyme cyclooxygenase (COX) that is responsible for the synthesis of inflammatory prostaglandins. Inhibition of PG production by ketoprofen in Oruvail SR capsules 200mg helps relieve the symptoms of inflammation, including pain, swelling, and joint stiffness, to improve the functional use of affected joints., but does not cure the underlying disease. Oruvail for pain and inflammation Oruvail SR capsules 200mg contain ketoprofen a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat several chronic inflammatory joint diseases to relieve pain and inflammation. These include rheumatoid arthritis, osteoarthritis (wear and tear), ankylosing spondylitis (an autoimmune inflammatory disease that affects the joints in the spine and pelvis and can cause fusion of the spine). Oruvail SR capsules 200mg are also used for musculoskeletal disorders, such as sprains, strains, lower back pain (lumbago) to relieve chronic pain and inflammation; also to treat rheumatic conditions of the connective tissue surrounding joints (non-articular), including bursitis, tendonitis, synovitis and fibrositis. Oruvail SR capsules 200mg are also used for acute pain and inflammation are also associated with dysmenorrhea (menstrual pain) and post-operative pain (following surgery). Ketoprofen in Oruvail SR capsules 200mg blocks the production of specific chemicals called prostaglandins (PG) that mediate inflammation, particularly PGE2, and works by inhibiting the enzyme cyclooxygenase (COX) including cyclooxygenase 2 (COX-2) that is induced during the inflammation process and is responsible for the synthesis of inflammatory prostaglandins. Inhibition of COX-2 helps relieve the symptoms of inflammation, including pain, swelling, and joint stiffness. Oruvail SR capsules 200mg also inhibit cyclooxygenase 1 (COX-1), which is thought to be responsible for the gastrointestinal side effects associated with the non-selective NSAIDs. What are the side effects of Oruvail? The most commonly reported side effects when taking Oruvail SR capsules 200mg are gastrointestinal and include: upset stomach or stomach pain, diarrhoea, indigestion, bloating wind, heartburn, indigestion, constipation. Other side effects include dizziness, headache, visual disturbance, tinnitus (buzzing or ringing in the ears), skin rash, oedema and fluid retention. When should Oruvail not be used? You should not use Oruvail SR capsules 200mg if you: are allergic to ketoprofen or any other NSAID including aspirin or any ingredients in Oruvail are pregnant or are breastfeeding, without discussion with your have kidney or liver disease have asthma as ketoprofen may cause bronchospasm have uncontrolled hypertension, severe heart failure or cardiovascular disease, without discussion with your doctor have active or a history of gastrointestinal bleeding or perforation due to an ulcer have a tendency to bleed easily are taking medicines that interact with Oruvail, aspirin or other NSAIDs, anticoagulants like warfarin, cholestyramine for high cholesterol, probenecid for gout, the anti-cancer drug methotrexate, lithium for mood disorders, diuretics like frusemide, beta blockers and ACE inhibitors for high blood pressure, digitalis for heart failure, sulphonamide antibiotics, sulphonylureas for diabetes, SSRI antidepressants, corticosteroids What medications interact with Oruvail? Several medications interact with Oruvail SR capsules 200mg and should either not be taken while you are taking Oruvail or only after discussion and instruction from your doctor: Drugs that cause a serious reaction with Oruvail: aspirin or other NSAIDs, SSRI antidepressants, anticoagulants like warfarin, and ACE inhibitors Drugs that affect Oruvail: cholestyramine for high cholesterol, probenecid for gout Drugs that are affected by Oruvail: anticoagulants like warfarin, the anti-cancer drug methotrexate, lithium for mood disorders, diuretics like frusemide, beta blockers and ACE inhibitors for high blood pressure, sulphonamide antibiotics, sulphonylureas for diabetes How should Oruvail be taken? You should take your Oruvail SR capsules 200mg swallowed whole with a glass of water once daily at the same time each day and with food to reduce risk of gastrointestinal side effects. The dose you take depends on your condition and your doctor’s recommendation. You should continue to take your Oruvail SR capsules 200mg for as long as recommended by your doctor, which may be for a few days, several weeks or longer, depending on what you are being treated for. How long should you take Oruvail? You should continue to take your Oruvail SR capsules 200mg for as long as recommended by your doctor, which may be for a few days, several weeks or longer, depending on what you are being treated for. Missed dose of Oruvail If you miss a dose of Oruvail SR capsules 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 Oruvail be stored? You should store your Oruvail SR capsules 200mg below 25°C in a cool dry place.
Symmetrel 100mg (Amantadine) Symmetrel general information What is Symmetrel used for? Symmetrel capsules 100mg are used to treat Parkinson's disease, a neurological disorder that is either idiopathic, which means that its cause is unknown or secondary to a known cause such as stroke, head trauma or as a side effect of medication, particularly neuroleptic antipsychotics. Symmetrel 100 may be used alone as monotherapy, or in combination with other medications, like anticholinergic drugs or levodopa and helps relieve symptoms of Parkinsonism and Parkinson's disease, including tremor, bradykinesia (slowness of movement) and loss of balance. Symmetrel capsules 100mg are also used as prophylaxis to prevent signs and symptoms of infection caused by influenza A virus, particularly for those at high risk of infection, if vaccination is unavailable or contraindicated, and for those at risk of serious illness if they were to become infected, such as being immunocompromised or having lung problems; also to treat flu-like symptoms if administered within 48 hours. How does Symmetrel work? Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug with virostatic properties. The abnormal movements associated with Parkinsonism and Parkinson's disease are caused by low levels of dopamine, a neurotransmitter (chemical that allows communication between nerve cells) produced by certain neurons (nerve cells) in the brain and plays an important role in controlling muscle function and movement; it is important to have the correct levels of dopamine. The loss of dopamine seen in Parkinson's disease is due to slow and progressive destruction of the neurons that produce the dopamine in a certain area of the brain called the substantia nigra. Amantadine in Symmetrel 100 is thought to increase the amount of dopamine in the brain by enhancing the release of dopamine from central neurons and by delaying its re-uptake from the synapse, the gap between nerve cells across which chemical messages are sent from one nerve cell to another. The increase in dopamine levels helps the brain control muscle function and restore normal movement. Amantadine in Symmetrel 100 is also thought to exert some anticholinergic activity, which means that it blocks the binding of the neurotransmitter acetylcholine to its receptor in nerve cells and this action helps prevent the involuntary movements associated with Parkinsonism. The mechanism of action by which Symmetrel 100 prevents the growth of influenza A virus is not known but it is thought to be due to interference with a viral protein needed for the virus to infect the host cell and this inhibits the early stage of replication of the influenza A virus and checks the growth of virus. What does Symmetrel contain? Symmetrel capsules 100mg contain the active ingredient amantadine hydrochloride, used to treat Parkinson's disease and to treat and prevent symptoms of influenza A virus. They also contain: rape seed oil, lecithin, a wax blend composed of white beeswax and hydrogenated soya and vegetable oils, sodium ethyl hydroxybenzoate, gelatin, glycerol, iron oxide red CI 77491, sorbitol, sodium propyl hydroxybenzoate, titanium dioxide. Treating Parkinson's disease with Symmetrel Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug used to treat neurological symptoms that cause the abnormal movements associated Parkinsonism and Parkinson's disease. Parkinson's disease is a neurological disorder that is either idiopathic, which means that its cause is unknown, or secondary to a known cause such as stroke, head trauma or as a side effect of medication, particularly neuroleptic antipsychotics. Parkinsonism is caused by low levels of dopamine, a neurotransmitter (chemical that allows communication between nerve cells) produced by certain neurons (nerve cells) in the brain that plays an important role in controlling muscle function and movement. This loss of dopamine is due to slow and progressive destruction of the dopamine-producing neurons in the substantia nigra area of the brain. Amantadine in Symmetrel 100 is thought to increase the amount of dopamine in the brain by enhancing the release of dopamine from central neurons and by delaying its re-uptake from the synapse, the gap between nerve cells across which chemical messages are sent from one nerve cell to another. The increase in dopamine levels helps the brain control muscle function and restore normal movement. Amantadine in Symmetrel 100 is also thought to exert some anticholinergic activity, which means that it blocks the binding of the neurotransmitter acetylcholine to its receptor in nerve cells and this action helps prevent the involuntary movements associated with Parkinsonism. Symmetrel 100 may be used alone (monotherapy), or in combination with other medications, like anticholinergic drugs or levodopa and helps relieve symptoms of Parkinsonism and Parkinson's disease, including tremor, bradykinesia (slowness of movement) and loss of balance. Treating symptoms of influenza A infection with Symmetrel Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug with influenzal virostatic properties, which means that it specifically blocks the growth of the Influenza A virus. Although the mechanism of action by which Symmetrel 100 prevents the growth of influenza A virus is not known it is thought to be due to interference with a viral protein needed for the virus to infect the host cell and this inhibits the early stage of replication of the influenza A virus. Symmetrel capsules 100mg are used as prophylaxis to prevent signs and symptoms of infection caused by influenza A virus, particularly for those at high risk of infection, if vaccination is unavailable or contraindicated, and for those at risk of serious illness if they were to become infected, such as being immunocompromised or having lung problems; also to treat flu-like symptoms if administered within 48 hours. What are the side effects of Symmetrel? The most commonly reported side effects when taking Symmetrel capsules 100mg include: depression, anxiety, elevation of mood, agitation, nervousness, difficulty in concentrating, dizziness, light-headedness, headache, insomnia, lethargy, hallucinations, nightmares, ataxia, slurred speech, blurred vision, oedema of ankles, livedo reticularis (purplish-red blotchy spots on the skin), dry mouth, anorexia, nausea, vomiting, constipation, palpitations, orthostatic hypotension, excessive sweating. When should Symmetrel not be used? You should not use Symmetrel capsules 100mg if you: are allergic to amantadine or any ingredients in Symmetrel are pregnant or are breastfeeding have kidney or liver disease have or have had recurrent eczema, stomach ulcers, or cardiovascular disorders suffer from convulsions or psychiatric disorders are taking medicines that interact with Symmetrel, including: other antiparkinsonian drugs, like anticholinergics or levodopa (without discussion with your doctor), other medicines that act on the central nervous system, like sedatives, analgesics and alcohol, combination diuretics, like hydrochlorothiazide + potassium-sparing diuretics What medications interact with Symmetrel? Several medications interact with Symmetrel capsules 100mg and should either not be taken while you are taking Symmetrel or only after discussion and instruction from your doctor: Drugs that increase side effects with Symmetrel: other antiparkinsonian drugs, like anticholinergics or levodopa, Drugs that cause dangerous reactions with Symmetrel: other medicines that act on the central nervous system, like sedatives, analgesics and alcohol Drugs that affect Symmetrel: combination diuretics, like hydrochlorothiazide + potassium-sparing diuretics How should Symmetrel be taken for Parkinson's disease? You should take your Symmetrel capsules 100mg with a glass of water once daily and preferably with food to prevent stomach problems. Your doctor may increase the dose to one capsule twice daily, depending on your condition. You should see some benefit within a few days and should continue to take your Symmetrel 100 for as long as recommended by your doctor, which may be for a long time depending on your condition. For some people the effectiveness of Symmetrel 100 wears off after a few months of continuous treatment, if this is the case your doctor may recommend that you gradually reduce the dose and stop it for a few weeks, then start again. How should Symmetrel be taken for influenza A? You should take your Symmetrel capsules 100mg with a glass of water twice daily and preferably with food to prevent stomach problems, or once daily for children or adults over 65. For prophylaxis you should start taking Symmetrel as soon as possible after you have been exposed to the flu and keep taking it through outbreak for at least 10 days or until the outbreak of influenza A is over. For treatment you should start taking Symmetrel 100 within 48 hours of the first symptoms onset and then for 4-5 days. How long should you take Symmetrel? For Parkinson's disease you should continue to take your Symmetrel capsules 100mg for as long as recommended by your doctor, which may be for a long time depending on your condition. For prophylaxis against influenza A, you should start taking Symmetrel capsules 100mg as soon as possible after you have been exposed to the flu and keep taking it through outbreak for at least 10 days or until the outbreak of influenza is over. For treatment you should start taking Symmetrel 100 within 48 hours of the first symptoms onset and then for 4-5 days. Missed dose of Symmetrel If you miss a dose of Symmetrel capsules 100mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose. How should Symmetrel be stored? You should store your Symmetrel below 25°C in a cool dry place. Protect from moisture and heat.
Carodyl 75mg (Carprofen 75mg) Carodyl general information What is Carodyl used for? Carodyl chewable tablets 75mg are a medication used for dogs to treat and manage the pain and inflammation that can be caused by osteoarthritis. Many dogs suffer from osteoarthritis, particularly as they age. Osteoarthritis is caused by wear and tear of the joints and can cause pain, swelling and stiffness, particularly in the legs, hips and backbone, which can restrict your dog’s activity and cause lameness. Carodyl 75 can help relieve symptoms of osteoarthritis and improve your dog’s mobility. Carodyl 75 is also used to reduce pain following orthopaedic and soft tissue surgery in dogs. Carodyl 75 is intended for use for dogs only and should not be given to cats or other pets. How does Carodyl work? Carodyl chewable tablets 75mg contain carprofen a non-steroidal anti-inflammatory drug (NSAID) belonging to the propionic acid class that has anti-inflammatory, analgesic (pain relief) and antipyretic (reduces fever) properties. NSAIDs inhibit the cyclooxygenase (COX) enzyme responsible for the production of chemicals called prostaglandins, which are mediators of a variety of cellular processes as well as inflammation. There are two COX enzymes, COX1 which is needed for normal cell functions and COX-2 which is involved in the inflammatory process. Carprofen in Carodyl 75 acts specifically on the inhibition of COX-2 resulting in anti-inflammatory activity which relieves the pain, swelling and stiffness in the joints caused by osteoarthritis. Carodyl tablets 75mg are available as meaty flavoured chewable tablets that are more palatable and easier for dogs to swallow. What does Carodyl contain? Carodyl chewable tablets 75mg contains the active ingredient carprofen a non-steroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation due to osteoarthritis and surgery in dogs. Treating osteoarthritis with Carodyl Carodyl 75 contains carprofen a non-steroidal anti-inflammatory drug (NSAID) used to treat dogs to help manage the pain and inflammation caused by osteoarthritis. Many dogs suffer from osteoarthritis, particularly as they age. Osteoarthritis is caused by wear and tear of the joints causing pain, swelling and stiffness, particularly in the legs, hips and backbone, which can restrict your dog’s activity and cause lameness. Carprofen in Carodyl 75 specifically inhibits the COX-2 enzyme responsible for the production of chemicals called prostaglandins, which are mediators of inflammation. The anti-inflammatory activity of carprofen in Carodyl 75 relieves the pain, swelling and stiffness in the joints caused by osteoarthritis. What are the side effects of Carodyl? The most commonly reported side effects when taking Carodyl 75 include; vomiting, diarrhoea, loss of appetite, lethargy and behavioural changes. When should Carodyl not be used? You should not use Carodyl 75 if your dog: has a sensitivity reaction to carprofen or any other NSAID or any ingredients in Carodyl is younger than 6 months is pregnant or lactating has a heart condition, liver or kidney disease or bleeding disorders has been given other NSAID medication, corticosteroids, some heart drugs (ACE inhibitors), some drugs for seizure control How should Carodyl be given? You should give your dog Carodyl 75 chewable tablets by mouth and with food. The recommended dose is 2-4mg per kg body weight (2.2lb) per day given in two equally divided doses. The same dose may be reduced to once daily after 7 days, depending on your dog’s response and your veterinarian’s recommendation. You should see signs of improvement within a few days. You should continue to give Carodyl 75 to your dog for as long as recommended by your veterinarian, which may be long term, as Carodyl 75 will help relieve symptoms of osteoarthritis in your dog but will not cure your dog’s condition. Dosage: 7-10kg (15.4–22lb) 37.5mg in half tablet 14-18kg (30-39.6lb) 75mg in one tablet How long should you give Carodyl? You should continue to give Carodyl 75 to your dog for as long as recommended by your veterinarian, which may be long term, as. Carodyl 75 will help relieve symptoms of osteoarthritis in your dog but will not cure your dog’s condition. Missed dose of Carodyl If you miss a dose of Carodyl 75 give it as soon as you remember, unless it is time to give the next dose, then skip the missed dose. Do not give a double dose. How should Carodyl be stored? You should store your Carodyl 75 below 25°C in a cool dry place and protect from light.

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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.

Nilstat Oral Drops (Nystatin)

Nilstat Oral Drops general information

What is Nilstat Oral Drops used for?

Nilstat Oral Drops are used to treat infections of the mouth and oral cavity caused by the yeast-like fungus Candida albicans. Infection with Candida (candidiasis) is also known as oral thrush and appears as patches of creamy/white spots in the mouth, usually the tongue or cheeks, but can spread to the gums and back of the throat. The infection can cause discomfort and bleed if disturbed such as when brushing your teeth. Candida is normally present in the mouth in small amounts and is kept from spreading by other microorganisms. However, if Candida grows unchecked and increases in numbers sufficient to tip the healthy balance between yeast and bacteria, this can cause infection. Some conditions like diabetes, impaired immune system, such as those imunocompromised by HIV infection can disturb this balance; also some medications like antibiotics and corticosteroids. Wearing ill-fitting dentures can also increase the risk of Candida infection. Nilstat Oral Drops are used as a topical treatment to kill the Candida yeast that causes infection in the mouth, relieving symptoms and preventing spread of infection.

How does Nilstat Oral Drops work?

Nilstat Oral Drops contain nystatin, an antifungal that works by binding to ergosterol, an important component of fungal cell membrane that is not found in animal cells. This weakens the fungal cell membrane, causing a change in permeability and allowing the cell contents to leak out, which kills the fungus, preventing the infection from spreading and relieving symptoms caused by the infection. Nilstat Oral Drops do not absorb into the blood in sufficient amounts to be effective anywhere else in the body.

What does Nilstat Oral Drops contain?

Nilstat Oral Drops contain the active ingredient nystatin (100,000 units/mL), which is an antifungal used to treat Intestinal candidiasis. They also contain propyl hydroxybenzoate, sucrose, polysorbate 80, sodium calciumedetate, methyl hydroxybenzoate, purified water, bentonite, quinoline yellow CI 47005, cherry flavour F-1242.

Treating oral thrush with Nilstat Oral Drops

Nilstat Oral Drops contain nystatin, an antifungal used to treat infections of the mouth and oral cavity caused by the yeast-like fungus Candida albicans, also known as oral thrush. Candida is normally present in the mouth in small amounts and is kept from spreading by a healthy balance between yeast and bacteria. However, some conditions like diabetes and impaired immune system, such as those imunocompromised by HIV infection can disturb this balance; also some medications like antibiotics and corticosteroids. This allows Candida to grow unchecked and result in an infection, which appears as patches of creamy/white spots in the mouth, usually the tongue or cheeks, but can spread to the gums and back of the throat. Wearing ill-fitting dentures can also increase the risk of Candida infection. Nilstat Oral Drops work by binding to ergosterol, an important component of fungal cell membrane that is not found in animal cells. This weakens the fungal cell membrane, causing a change in permeability and allowing the cell contents to leak out, which kills the fungus, preventing the infection from spreading and relieving symptoms caused by the infection, including discomfort and bleeding.

What are the side effects of Nilstat Oral Drops?

The most commonly reported side effects when taking Nilstat Oral Drops are gastrointestinal distress including diarrhoea, nausea and vomiting.

When should Nilstat Oral Drops not be used?

You should not use Nilstat Oral Drops if you:

are allergic to nystatin or any ingredients in Nilstat Oral Drops
are pregnant or are breastfeeding, without discussion with your doctor

How should Nilstat Oral Drops be taken?

You should take your Nilstat Oral Drops using the syringe provided four times daily. Shake the bottle and then fill the 1mL syringe with Nilstat Oral Drops. Drop the full amount in the syringe into your mouth or under your tongue. Leave in the mouth for as long as possible before swallowing and ensure all areas of the infection are covered. Wash the syringe and repeat after 3 hours. You should continue taking your Nilstat Oral Drops daily until the contents of the bottle have been used up otherwise the infection may not be fully cleared up and may return.

How long should you take Nilstat Oral Drops?

You should continue taking your Nilstat Oral Drops daily until the contents of the bottle have been used up otherwise the infection may not be fully cleared up and may return.

Missed dose of Nilstat Oral Drops

If you miss a dose of Nilstat Oral Drops 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 Nilstat Oral Drops be stored?

You should store your Nilstat Oral Drops below 25°C in a cool dry place.

Oruvail SR (Ketoprofen 200mg)

Oruvail general information

What is Oruvail used for?

Oruvail SR capsules 200mg are used to help manage symptoms caused by various chronic inflammatory diseases. These include rheumatoid arthritis, osteoarthritis (wear and tear) and ankylosing spondylitis, (an autoimmune inflammatory disease that affects the joints in the spine and pelvis and can cause fusion of the spine) to reduce pain, inflammation, tenderness, stiffness and swelling in the affected joints. Oruvail SR capsules 200mg do not cure the underlying disease but can relieve symptoms of pain and inflammation and improve the functional use of affected joints. Oruvail SR capsules 200mg are also used for acute articular and periarticular disorders, such as bursitis (inflammation of the fluid filled sac in the joints), capsulitis (inflammation of tendons in joints), synovitis (inflammation of the membrane surrounding joints), tendonitis (inflammation of tendons), fibrositis (inflammation of connective tissues in muscles and joints), cervical spondylitis (wear and tear in the neck spinal disks); also for musculoskeletal disorders, such as sprains, strains, lower back pain (lumbago, sciatica) and for gout (uric acid crystals in the joints) to relieve chronic pain and inflammation. Oruvail SR capsules 200mg are also used for relief dysmenorrhoea (menstrual pain) and in the treatment of post-operative pain.

How does Oruvail work?

Oruvail SR capsules 200mg contain ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) that has anti-inflammatory, analgesic (pain relieving) and anti-pyretic properties (reduces fever). Ketoprofen in Oruvail SR capsules 200mg blocks the production of specific chemicals called prostaglandins (PG) that mediate inflammation, particularly PGE2, and works by inhibiting the enzyme cyclooxygenase (COX) including cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2) that is induced during the inflammation process and is responsible for the synthesis of inflammatory prostaglandins. Inhibition of COX-2 helps relieve the symptoms of inflammation, including pain, swelling, and joint stiffness. Inhibition of COX-1 is responsible for the gastrointestinal side effects that are due to inhibition of protective prostaglandins in the gut and disruption of regulation of acid content. Oruvail SR capsules 200mg contain multiple microbeads which are formulated for sustained controlled release. This provides a constant concentration of ketoprofen over a period of time, for maximum effectiveness and minimum side effects.

What does Oruvail contain?

Oruvail SR capsules 200mg contains the active ingredient ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation of chronic inflammatory bone and joint diseases, and other conditions. They also contain erythrosine, ethylcellulose, gelatin, non-pareil beads (PI 1014), shellac, colloidal anhydrous silica, sodium lauryl sulfate, purified talc and titanium dioxide. The 200mg capsules also contain Opacode Blue (PI 12300).

Treating arthritis with Oruvail

Oruvail SR capsules 200mg contain ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain and inflammation in joints affected with arthritis. Osteoarthritis a degenerative disease (also known as wear and tear), and rheumatoid arthritis (an autoimmune disease where the immune system turns on self) are chronic inflammatory diseases in which the joints become inflamed, swollen and painful. Ketoprofen in Oruvail SR capsules 200mg blocks the production of specific chemicals called prostaglandins (PG) that mediate inflammation, particularly PGE2, and works by inhibiting the enzyme cyclooxygenase (COX) that is responsible for the synthesis of inflammatory prostaglandins. Inhibition of PG production by ketoprofen in Oruvail SR capsules 200mg helps relieve the symptoms of inflammation, including pain, swelling, and joint stiffness, to improve the functional use of affected joints., but does not cure the underlying disease.

Oruvail for pain and inflammation

Oruvail SR capsules 200mg contain ketoprofen a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat several chronic inflammatory joint diseases to relieve pain and inflammation. These include rheumatoid arthritis, osteoarthritis (wear and tear), ankylosing spondylitis (an autoimmune inflammatory disease that affects the joints in the spine and pelvis and can cause fusion of the spine). Oruvail SR capsules 200mg are also used for musculoskeletal disorders, such as sprains, strains, lower back pain (lumbago) to relieve chronic pain and inflammation; also to treat rheumatic conditions of the connective tissue surrounding joints (non-articular), including bursitis, tendonitis, synovitis and fibrositis. Oruvail SR capsules 200mg are also used for acute pain and inflammation are also associated with dysmenorrhea (menstrual pain) and post-operative pain (following surgery). Ketoprofen in Oruvail SR capsules 200mg blocks the production of specific chemicals called prostaglandins (PG) that mediate inflammation, particularly PGE2, and works by inhibiting the enzyme cyclooxygenase (COX) including cyclooxygenase 2 (COX-2) that is induced during the inflammation process and is responsible for the synthesis of inflammatory prostaglandins. Inhibition of COX-2 helps relieve the symptoms of inflammation, including pain, swelling, and joint stiffness. Oruvail SR capsules 200mg also inhibit cyclooxygenase 1 (COX-1), which is thought to be responsible for the gastrointestinal side effects associated with the non-selective NSAIDs.

What are the side effects of Oruvail?

The most commonly reported side effects when taking Oruvail SR capsules 200mg are gastrointestinal and include: upset stomach or stomach pain, diarrhoea, indigestion, bloating wind, heartburn, indigestion, constipation. Other side effects include dizziness, headache, visual disturbance, tinnitus (buzzing or ringing in the ears), skin rash, oedema and fluid retention.

When should Oruvail not be used?

You should not use Oruvail SR capsules 200mg if you:

are allergic to ketoprofen or any other NSAID including aspirin or any ingredients in Oruvail
are pregnant or are breastfeeding, without discussion with your
have kidney or liver disease
have asthma as ketoprofen may cause bronchospasm
have uncontrolled hypertension, severe heart failure or cardiovascular disease, without discussion with your doctor
have active or a history of gastrointestinal bleeding or perforation due to an ulcer
have a tendency to bleed easily
are taking medicines that interact with Oruvail, aspirin or other NSAIDs, anticoagulants like warfarin, cholestyramine for high cholesterol, probenecid for gout, the anti-cancer drug methotrexate, lithium for mood disorders, diuretics like frusemide, beta blockers and ACE inhibitors for high blood pressure, digitalis for heart failure, sulphonamide antibiotics, sulphonylureas for diabetes, SSRI antidepressants, corticosteroids

What medications interact with Oruvail?

Several medications interact with Oruvail SR capsules 200mg and should either not be taken while you are taking Oruvail or only after discussion and instruction from your doctor:

Drugs that cause a serious reaction with Oruvail: aspirin or other NSAIDs, SSRI antidepressants, anticoagulants like warfarin, and ACE inhibitors
Drugs that affect Oruvail: cholestyramine for high cholesterol, probenecid for gout
Drugs that are affected by Oruvail: anticoagulants like warfarin, the anti-cancer drug methotrexate, lithium for mood disorders, diuretics like frusemide, beta blockers and ACE inhibitors for high blood pressure, sulphonamide antibiotics, sulphonylureas for diabetes

How should Oruvail be taken?

You should take your Oruvail SR capsules 200mg swallowed whole with a glass of water once daily at the same time each day and with food to reduce risk of gastrointestinal side effects. The dose you take depends on your condition and your doctor’s recommendation. You should continue to take your Oruvail SR capsules 200mg for as long as recommended by your doctor, which may be for a few days, several weeks or longer, depending on what you are being treated for.

How long should you take Oruvail?

You should continue to take your Oruvail SR capsules 200mg for as long as recommended by your doctor, which may be for a few days, several weeks or longer, depending on what you are being treated for.

Missed dose of Oruvail

If you miss a dose of Oruvail SR capsules 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 Oruvail be stored?

You should store your Oruvail SR capsules 200mg below 25°C in a cool dry place.

Symmetrel 100mg (Amantadine)

Symmetrel general information

What is Symmetrel used for?

Symmetrel capsules 100mg are used to treat Parkinson's disease, a neurological disorder that is either idiopathic, which means that its cause is unknown or secondary to a known cause such as stroke, head trauma or as a side effect of medication, particularly neuroleptic antipsychotics. Symmetrel 100 may be used alone as monotherapy, or in combination with other medications, like anticholinergic drugs or levodopa and helps relieve symptoms of Parkinsonism and Parkinson's disease, including tremor, bradykinesia (slowness of movement) and loss of balance. Symmetrel capsules 100mg are also used as prophylaxis to prevent signs and symptoms of infection caused by influenza A virus, particularly for those at high risk of infection, if vaccination is unavailable or contraindicated, and for those at risk of serious illness if they were to become infected, such as being immunocompromised or having lung problems; also to treat flu-like symptoms if administered within 48 hours.

How does Symmetrel work?

Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug with virostatic properties. The abnormal movements associated with Parkinsonism and Parkinson's disease are caused by low levels of dopamine, a neurotransmitter (chemical that allows communication between nerve cells) produced by certain neurons (nerve cells) in the brain and plays an important role in controlling muscle function and movement; it is important to have the correct levels of dopamine. The loss of dopamine seen in Parkinson's disease is due to slow and progressive destruction of the neurons that produce the dopamine in a certain area of the brain called the substantia nigra. Amantadine in Symmetrel 100 is thought to increase the amount of dopamine in the brain by enhancing the release of dopamine from central neurons and by delaying its re-uptake from the synapse, the gap between nerve cells across which chemical messages are sent from one nerve cell to another. The increase in dopamine levels helps the brain control muscle function and restore normal movement. Amantadine in Symmetrel 100 is also thought to exert some anticholinergic activity, which means that it blocks the binding of the neurotransmitter acetylcholine to its receptor in nerve cells and this action helps prevent the involuntary movements associated with Parkinsonism. The mechanism of action by which Symmetrel 100 prevents the growth of influenza A virus is not known but it is thought to be due to interference with a viral protein needed for the virus to infect the host cell and this inhibits the early stage of replication of the influenza A virus and checks the growth of virus.

What does Symmetrel contain?

Symmetrel capsules 100mg contain the active ingredient amantadine hydrochloride, used to treat Parkinson's disease and to treat and prevent symptoms of influenza A virus. They also contain: rape seed oil, lecithin, a wax blend composed of white beeswax and hydrogenated soya and vegetable oils, sodium ethyl hydroxybenzoate, gelatin, glycerol, iron oxide red CI 77491, sorbitol, sodium propyl hydroxybenzoate, titanium dioxide.

Treating Parkinson's disease with Symmetrel

Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug used to treat neurological symptoms that cause the abnormal movements associated Parkinsonism and Parkinson's disease. Parkinson's disease is a neurological disorder that is either idiopathic, which means that its cause is unknown, or secondary to a known cause such as stroke, head trauma or as a side effect of medication, particularly neuroleptic antipsychotics. Parkinsonism is caused by low levels of dopamine, a neurotransmitter (chemical that allows communication between nerve cells) produced by certain neurons (nerve cells) in the brain that plays an important role in controlling muscle function and movement. This loss of dopamine is due to slow and progressive destruction of the dopamine-producing neurons in the substantia nigra area of the brain. Amantadine in Symmetrel 100 is thought to increase the amount of dopamine in the brain by enhancing the release of dopamine from central neurons and by delaying its re-uptake from the synapse, the gap between nerve cells across which chemical messages are sent from one nerve cell to another. The increase in dopamine levels helps the brain control muscle function and restore normal movement. Amantadine in Symmetrel 100 is also thought to exert some anticholinergic activity, which means that it blocks the binding of the neurotransmitter acetylcholine to its receptor in nerve cells and this action helps prevent the involuntary movements associated with Parkinsonism. Symmetrel 100 may be used alone (monotherapy), or in combination with other medications, like anticholinergic drugs or levodopa and helps relieve symptoms of Parkinsonism and Parkinson's disease, including tremor, bradykinesia (slowness of movement) and loss of balance.

Treating symptoms of influenza A infection with Symmetrel

Symmetrel capsules 100mg contain amantadine, which is an antiparkinsonian drug with influenzal virostatic properties, which means that it specifically blocks the growth of the Influenza A virus. Although the mechanism of action by which Symmetrel 100 prevents the growth of influenza A virus is not known it is thought to be due to interference with a viral protein needed for the virus to infect the host cell and this inhibits the early stage of replication of the influenza A virus. Symmetrel capsules 100mg are used as prophylaxis to prevent signs and symptoms of infection caused by influenza A virus, particularly for those at high risk of infection, if vaccination is unavailable or contraindicated, and for those at risk of serious illness if they were to become infected, such as being immunocompromised or having lung problems; also to treat flu-like symptoms if administered within 48 hours.

What are the side effects of Symmetrel?

The most commonly reported side effects when taking Symmetrel capsules 100mg include: depression, anxiety, elevation of mood, agitation, nervousness, difficulty in concentrating, dizziness, light-headedness, headache, insomnia, lethargy, hallucinations, nightmares, ataxia, slurred speech, blurred vision, oedema of ankles, livedo reticularis (purplish-red blotchy spots on the skin), dry mouth, anorexia, nausea, vomiting, constipation, palpitations, orthostatic hypotension, excessive sweating.

When should Symmetrel not be used?

You should not use Symmetrel capsules 100mg if you:

are allergic to amantadine or any ingredients in Symmetrel
are pregnant or are breastfeeding
have kidney or liver disease
have or have had recurrent eczema, stomach ulcers, or cardiovascular disorders
suffer from convulsions or psychiatric disorders
are taking medicines that interact with Symmetrel, including: other antiparkinsonian drugs, like anticholinergics or levodopa (without discussion with your doctor), other medicines that act on the central nervous system, like sedatives, analgesics and alcohol, combination diuretics, like hydrochlorothiazide + potassium-sparing diuretics

What medications interact with Symmetrel?

Several medications interact with Symmetrel capsules 100mg and should either not be taken while you are taking Symmetrel or only after discussion and instruction from your doctor:

Drugs that increase side effects with Symmetrel: other antiparkinsonian drugs, like anticholinergics or levodopa,
Drugs that cause dangerous reactions with Symmetrel: other medicines that act on the central nervous system, like sedatives, analgesics and alcohol
Drugs that affect Symmetrel: combination diuretics, like hydrochlorothiazide + potassium-sparing diuretics

How should Symmetrel be taken for Parkinson's disease?

You should take your Symmetrel capsules 100mg with a glass of water once daily and preferably with food to prevent stomach problems. Your doctor may increase the dose to one capsule twice daily, depending on your condition. You should see some benefit within a few days and should continue to take your Symmetrel 100 for as long as recommended by your doctor, which may be for a long time depending on your condition. For some people the effectiveness of Symmetrel 100 wears off after a few months of continuous treatment, if this is the case your doctor may recommend that you gradually reduce the dose and stop it for a few weeks, then start again.

How should Symmetrel be taken for influenza A?

You should take your Symmetrel capsules 100mg with a glass of water twice daily and preferably with food to prevent stomach problems, or once daily for children or adults over 65. For prophylaxis you should start taking Symmetrel as soon as possible after you have been exposed to the flu and keep taking it through outbreak for at least 10 days or until the outbreak of influenza A is over. For treatment you should start taking Symmetrel 100 within 48 hours of the first symptoms onset and then for 4-5 days.

How long should you take Symmetrel?

For Parkinson's disease you should continue to take your Symmetrel capsules 100mg for as long as recommended by your doctor, which may be for a long time depending on your condition. For prophylaxis against influenza A, you should start taking Symmetrel capsules 100mg as soon as possible after you have been exposed to the flu and keep taking it through outbreak for at least 10 days or until the outbreak of influenza is over. For treatment you should start taking Symmetrel 100 within 48 hours of the first symptoms onset and then for 4-5 days.

Missed dose of Symmetrel

If you miss a dose of Symmetrel capsules 100mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Symmetrel be stored?

You should store your Symmetrel below 25°C in a cool dry place. Protect from moisture and heat.

Carodyl 75mg (Carprofen 75mg)

Carodyl general information

What is Carodyl used for?

Carodyl chewable tablets 75mg are a medication used for dogs to treat and manage the pain and inflammation that can be caused by osteoarthritis. Many dogs suffer from osteoarthritis, particularly as they age. Osteoarthritis is caused by wear and tear of the joints and can cause pain, swelling and stiffness, particularly in the legs, hips and backbone, which can restrict your dog’s activity and cause lameness. Carodyl 75 can help relieve symptoms of osteoarthritis and improve your dog’s mobility. Carodyl 75 is also used to reduce pain following orthopaedic and soft tissue surgery in dogs. Carodyl 75 is intended for use for dogs only and should not be given to cats or other pets.

How does Carodyl work?

Carodyl chewable tablets 75mg contain carprofen a non-steroidal anti-inflammatory drug (NSAID) belonging to the propionic acid class that has anti-inflammatory, analgesic (pain relief) and antipyretic (reduces fever) properties. NSAIDs inhibit the cyclooxygenase (COX) enzyme responsible for the production of chemicals called prostaglandins, which are mediators of a variety of cellular processes as well as inflammation. There are two COX enzymes, COX1 which is needed for normal cell functions and COX-2 which is involved in the inflammatory process. Carprofen in Carodyl 75 acts specifically on the inhibition of COX-2 resulting in anti-inflammatory activity which relieves the pain, swelling and stiffness in the joints caused by osteoarthritis. Carodyl tablets 75mg are available as meaty flavoured chewable tablets that are more palatable and easier for dogs to swallow.

What does Carodyl contain?

Carodyl chewable tablets 75mg contains the active ingredient carprofen a non-steroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation due to osteoarthritis and surgery in dogs.

Treating osteoarthritis with Carodyl

Carodyl 75 contains carprofen a non-steroidal anti-inflammatory drug (NSAID) used to treat dogs to help manage the pain and inflammation caused by osteoarthritis. Many dogs suffer from osteoarthritis, particularly as they age. Osteoarthritis is caused by wear and tear of the joints causing pain, swelling and stiffness, particularly in the legs, hips and backbone, which can restrict your dog’s activity and cause lameness. Carprofen in Carodyl 75 specifically inhibits the COX-2 enzyme responsible for the production of chemicals called prostaglandins, which are mediators of inflammation. The anti-inflammatory activity of carprofen in Carodyl 75 relieves the pain, swelling and stiffness in the joints caused by osteoarthritis.

What are the side effects of Carodyl?

The most commonly reported side effects when taking Carodyl 75 include; vomiting, diarrhoea, loss of appetite, lethargy and behavioural changes.

When should Carodyl not be used?

You should not use Carodyl 75 if your dog:

has a sensitivity reaction to carprofen or any other NSAID or any ingredients in Carodyl
is younger than 6 months
is pregnant or lactating
has a heart condition, liver or kidney disease or bleeding disorders
has been given other NSAID medication, corticosteroids, some heart drugs (ACE inhibitors), some drugs for seizure control

How should Carodyl be given?

You should give your dog Carodyl 75 chewable tablets by mouth and with food. The recommended dose is 2-4mg per kg body weight (2.2lb) per day given in two equally divided doses. The same dose may be reduced to once daily after 7 days, depending on your dog’s response and your veterinarian’s recommendation. You should see signs of improvement within a few days. You should continue to give Carodyl 75 to your dog for as long as recommended by your veterinarian, which may be long term, as Carodyl 75 will help relieve symptoms of osteoarthritis in your dog but will not cure your dog’s condition.

Dosage:

7-10kg (15.4–22lb) 37.5mg in half tablet

14-18kg (30-39.6lb) 75mg in one tablet

How long should you give Carodyl?

You should continue to give Carodyl 75 to your dog for as long as recommended by your veterinarian, which may be long term, as. Carodyl 75 will help relieve symptoms of osteoarthritis in your dog but will not cure your dog’s condition.

Missed dose of Carodyl

If you miss a dose of Carodyl 75 give it as soon as you remember, unless it is time to give the next dose, then skip the missed dose. Do not give a double dose.

How should Carodyl be stored?

You should store your Carodyl 75 below 25°C in a cool dry place and protect from light.

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