Pharmacological Classification of Drugs with Doses and Preparations PDF

Pharmacological CLASSIFICATION OF DRUGS with Doses and Preparations Pharmacological CLASSIFICATION OF DRUGS with Doses and Preparations FIFTH EDITION KD Tripathi MD Ex-Director-Professor and Head of Pharmacology Maulana Azad Medical College and associated LN and GB Pant Hospitals, New Delhi ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi London Philadelphia Panama Jaypee Brothers Medical Publishers (P) Ltd Headquarters Website: www.jaypeebrothers.com Website: www.jaypeedigital.com Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj © 2014, KD Tripathi New Delhi 110 002, India The views and opinions expressed in this book are solely those of the original Phone: +91-11-43574357 contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book. Fax: +91-11-43574314 Email: [email protected] All rights reserved. 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Inquiries for bulk sales may be solicited at: [email protected] Pharmacological Classification of Drugs with Doses and Preparations First Edition: 1986, Second Edition: 1990, Third Edition: 2006, Fourth Edition: 2010, Fifth Edition: 2014 ISBN 978-93-5152-108-2 Printed at Preface A systematized listing of drugs according to their primary actions, mechanisms, chemical nature, clinical uses and/or other relevant characteristics is the first step to learn about them. The mental exercise to prescribe a drug for a patient starts with identifying the class of drugs to be prescribed and then selecting the specific member most appropriate for that patient according to its subclass/group/individual characteristic. For example, the first thing one decides is whether an analgesic or an antihypertensive or an antibiotic is to be prescribed; then proceeds to consider which type of analgesic (opioid/ nonopioid), or antihypertensive (β blocker/ACE inhibitor, etc.), or antibiotic (β-lactam/fluoroquinolone, etc.) is required and then which specific member is most suitable. On the other hand, every drug is known by its class and subclass, e.g. furosemide is a high-ceiling diuretic, glibenclamide is a sulfonylurea antidiabetic. As such, drug classifications are pivotal to pharmacology students and highly valuable to prescribing doctors. The phenomenal increase in the number of drugs in recent years has further underscored the need for drug classifications. Drug classifications have been criticised for being arbitrary and imperfect because of nonuniform criteria that have often to be adopted and frequent lack of watertight distinctions among drug groups/subgroups. Nevertheless, basing on pharmacological differences and applying practical criteria, meaningful drug classifications can be devised. Though, any drug has multiple actions/properties, it can be designated by the most outstanding one. For example, labelling atenolol as a cardioselective β blocker summarises its actions, uses, etc. This booklet has adopted such a pragmatic approach and presented classifications of drugs that have been well accepted. The outstanding feature of the present edition is reformating of the classifications in the form of eye-catching charts. These charts create pictorial images and help memorizing. All classifications have been updated, modified where necessary and newer drugs have been included, particularly those marketed recently. To be useful to medical/pharmacy students as well as to practitioners, the doses (including pediatric doses wherever relevant), frequency and route(s) of administration along with leading brand names of drugs and different types of dosage forms (oral, parenteral, topical, etc.) are listed distinctively after each class of drugs. Thus, essential prescribing vi Pharmacological Classification of Drugs with Doses and Preparations information is incorporated for drugs that are available. Single drug formulations are mainly mentioned. Combined drug formulations find a place wherever important or relevant. The listing of brand names is restricted to only 1–4 per drug, and is not exhaustive. Synonyms and alternative names of drugs and classes of drugs are also mentioned. Two separate indices, one of nonproprietary (generic) names and the other of proprietary (brand) names of drugs is provided for instantaneous location of the drug or the product one is looking for. It is hoped that the present user-friendly format of the booklet will make it a better aid to remembering drug names, identifying the class and subclass to which they belong, and provide easy access to core prescribing information. The credit for meticulous production of this booklet goes to the staff of M/s Jaypee Brothers. KD Tripathi Explanatory Notes 1. The information on dosage form(s) is printed in maroon colour, and the proprietary (brand) names of drugs/products appear in capital letters. 2. The doses and regimens are given in smaller type, while nonproprietary (generic) drug names appear in bigger type and different font. 3. If no brand name of a drug is listed, it is not currently marketed in India, or is marketed only in combinations. This can be found out from the composition of the combined formulations given. 4. If the route of administration is not specified, the drug is administered only orally, and the dose mentioned is the oral dose. 5. Drug doses mentioned without specifying frequency of administration indicate the quantity for a single dose. Abbreviations amp Ampoule i.m. Intramuscular AP Action potential inj Injection BD Twice daily IU International unit BHP Benign hypertrophy of prostate i.v. intravenous BSA Body surface area kg Kilogram cap Capsule L Litre Ch Child dose LES Lower esophageal sphincter cm Centimeter liq Liquid CR Continuous release m Meter Distab Dispersible tablet max Maximum DS Double strength mEq Milliequivalent DTPA Diethylene triamine pentaacetic acid mg Milligram e.c. Enteric coated min Minute ER Extended release ml Millilitre ERP Effective refractory period MR Modified release ext Extract MU Mega (million) unit g Gram MW Molecular weight GITS Gastrointestinal therapeutic system µg Microgram hr hour OD Once daily i.d. Intradermal oint Ointment x Pharmacological Classification of Drugs with Doses and Preparations Pot. Potassium tab Tablet QID Four times a day TCID50 Tissue culture infective dose 50% rDNA Recombinant deoxyribonucleic acid TDS Three times a day s.c. Subcutaneous THFA Tetrahydrofolic acid s.l. Sublingual TTS Transdermal therapeutic system Sod Sodium U Unit SR Sustained release UV Ultra violet susp Suspension yr Year (age) syr Syrup ZE Zollinger-Ellison Contents 1. Drugs Acting on Autonomic Nervous System.....................................................................................................................1 Cholinergic Drugs, Anticholinergic Drugs, Ganglionic Stimulants, Ganglionic Blocking Agents, Adrenergic Drugs, α-Adrenergic Blocking Drugs, β-Adrenergic Blocking Drugs, Topical Drugs for Glaucoma 2. Autacoids and Related Drugs.................................................................................................................................................16 Histaminergic Agonists, H1-Antagonists, 5-Hydroxytryptamine (5-HT) Antagonists, Drugs for Migraine, Prostaglandins (PGs), Nonsteroidal Antiinflammatory Drugs (NSAIDs)/Antipyretic Analgesics, Antirheumatoid Drugs, Drugs for Gout 3. Drugs for Respiratory Disorders............................................................................................................................................29 Drugs for Cough, Drugs for Bronchial Asthma 4. Hormones and Related Drugs................................................................................................................................................37 Anterior Pituitary Hormones, Drugs Altering Anterior Pituitary Hormone Secretion, Thyroid Hormone, Thyroid Inhibitors, Insulins, Oral Antidiabetic Drugs, Corticosteroids, Topical Steroids, Androgens and Related Drugs, Drugs for Erectile Dysfunction, Estrogens and Related Drugs, Progestins, Hormonal Contraceptives, Uterine Stimulants, Uterine Relaxants 5. Drugs Acting on Peripheral (somatic) Nervous System...................................................................................................60 Skeletal Muscle Relaxants, Local Anaesthetics 6. Drugs Acting on Central Nervous System..........................................................................................................................64 General Anaesthetics, Preanaesthetic Medication Drugs, Sedative-Hypnotic Drugs, Antiepileptic Drugs, Antiparkinsonian Drugs, Antipsychotic Drugs, Drugs for Mania and Bipolar Disorder, Hallucinogens, Antidepressants, Antianxiety Drugs, Opioid Analgesics and Antagonists, Central Nervous System (CNS) Stimulants, Cognition Enhancers 7. Cardiovascular Drugs...............................................................................................................................................................88 Antihypertensive Drugs, Antianginal Drugs, Drugs for Peripheral Vascular Diseases, Drugs for Congestive Heart Failure, Antiarrhythmic Drugs xii Pharmacological Classification of Drugs with Doses and Preparations 8. Drugs Acting on Kidney........................................................................................................................................................102 Diuretics, Antidiuretics 9. Drugs Affecting Blood...........................................................................................................................................................105 Haematinics, Coagulants, Anticoagulants, Fibrinolytics, Antifibrinolytics, Antiplatelet Drugs, Hypolipidaemic Drugs, Plasma Expanders 10. Gastrointestinal Drugs...........................................................................................................................................................118 Drugs for Peptic Ulcer, Antiemetics, Laxatives, Drugs for Diarrhoea 11. Antibacterial Drugs.................................................................................................................................................................130 Antibacterial Drugs, Sulfonamides, Quinolone Antimicrobials, Penicillins, Cephalosporins, Monobactams, Carbapenems, Aminoglycoside Antibiotics, Tetracyclines, Chloramphenicol, Macrolide Antibiotics, Lincosamide Antibiotics, Aminocyclitol Antibiotic, Glycopeptide Antibiotics, Oxazolidinone, Polypeptide Antibiotics, Urinary Antiseptics, Antitubercular Drugs, Antileprotic Drugs 12. Antifungal, Antiviral, Antiprotozoal and Anthelmintic Drugs....................................................................................150 Antifungal Drugs, Antiviral Drugs (Non-retroviral), Antiretrovirus Drugs, Antimalarial Drugs, Antiamoebic Drugs, Drugs for Giardiasis, Drugs for Trichomoniasis, Drugs for Leishmaniasis, Anthelmintic Drugs 13. Anticancer Drugs (Antineoplastic Drugs)..........................................................................................................................169 14. Miscellaneous Drugs..............................................................................................................................................................176 Immunosuppressant Drugs, Chelating Agents, Locally Acting Drugs on Skin and Mucous Membranes, Drugs for Acne vulgaris, Antiseptics and Disinfectants, Ectoparasiticides, Vaccines, Antisera and Immune Globulins Index of Nonproprietary Names of Drugs..................................................................................................................................195 Index of Proprietary (Brand) Names of Drugs..........................................................................................................................211 1 Drugs Acting on Autonomic Nervous System 2 Drugs Acting on Autonomic Nervous System Preparations 1. Bethanechol: 10–40 mg oral, 2.5–5 mg s.c. UROTONIN, BETHACOL 25 mg tab. 2. Pilocarpine: 0.5–4% topically in eye. PILOCAR 1%, 2%, 4% eye drops; CARPINE 0.5% eye drops; PILODROPS 2% eye drops. 3. Physostigmine: 0.5–1.0 mg oral/i.m., 0.25–0.5% topically in eye. BI-MIOTIC 0.25% eye drops with 2% pilocarpine nitrate. 4. Neostigmine: 15–30 mg oral, 0.5–2.5 mg s.c./i.m. PROSTIGMIN, MYOSTIGMIN, TILSTIGMIN 15 mg tab, 0.5 mg/ml in 1 ml and 5 ml inj. 5. Pyridostigmine: 60–180 mg oral. DISTINON, MYESTIN 60 mg tab. 6. Rivastigmine: Initially 1.5 mg BD, increase every 2 weeks by 1.5 mg/day upto 6 mg BD. EXELON, RIVAMER 1.5, 3, 4.5, 6.0 mg caps. 7. Donepezil: 5 mg at bed time once daily (max 10 mg/day). DONECEPT, DOPEZIL, DORENT 5, 10 mg tabs. 8. Galantamine: 4 mg BD (max 12 mg BD). GALAMER 4, 8, 12 mg tabs. Anticholinergic Drugs 3 4 Drugs Acting on Autonomic Nervous System Preparations 1. Atropine: 0.6–2.0 mg i.m./i.v. (Child 10 µg/kg), 1–2% topically in eye. ATROPINE SULPHATE 0.6 mg/ml inj, 1% eye drop/oint, ATROSULPH 1% eye drop, 5% eye oint. 2. Hyoscine hydrobromide: 0.3–0.5 mg oral/i.m. (Child 10 µg/kg). 3. Hyoscine butyl bromide: 20–40 mg oral/i.m./s.c./i.v. BUSCOPAN 10 mg tab, 20 mg/ml amp. 4. Atropine methonitrate: 2.5–10 mg oral/i.m. MYDRINDON 1 mg (adult), 0.1 mg (child) tab; in SPASMOLYSIN 0.32 mg tab. 5. Propantheline: 15–30 mg oral. PROBANTHINE 15 mg tab. 6. Oxyphenonium: 5–10 mg (Child 3–5 mg) oral. ANTRENYL 5, 10 mg tab. 7. Clidinium: 2.5–5 mg oral. In SPASRIL, ARWIN 2.5 mg tab with chlordiazepoxide 5 mg. NORMAXIN, CIBIS 2.5 mg with dicyclomine 10 mg and chlordiazepoxide 5 mg tab. 8. Pipenzolate methyl bromide: 5–10 mg (Child 2–3 mg) oral. In PIPEN 5 mg tab. 4 mg/ml drops with dimethyl polysiloxane. 9. Isopropamide: 5 mg oral. In STELABID, GASTABID 5 mg tab. with trifluoperazine. 10. Dicyclomine: 20 mg oral. CYCLOSPAS-D 20 mg with dimethicone 40 mg tab; CYCLOPAM INJ. 10 mg/ml in 2 ml, 10 ml, 30 ml amp/vial, also 20 mg tab with paracetamol 500 mg; in COLIMEX, COLIRID 20 mg with paracetamol 500 mg tab, 10 mg/ ml drops with dimethicone. 11. Valethamate: 8 mg i.m., 10 mg oral, repeated as required. VALAMATE 8 mg in 1 ml inj, EPIDOSIN 10 mg tab, 8 mg inj. Anticholinergic Drugs 5 12. Glycopyrrolate: 0.1–0.3 mg i.m./i.v., 1–2 mg oral. GLYCO-P 0.2 mg/ml amp., 1 mg in 5 ml vial, PYROLATE 0.2 mg/ml, 1 ml amp, 10 ml vial. 13. Ipratropium bromide: 40–80 µg by inhalation/nasal spray. IPRAVENT 20 µg/puff metered dose inhaler, 2 puffs 3–4 times daily; 250 µg/ml respirator soln., 0.4–2 ml nebulized in conjunction with a β2 agonist 2–4 times daily. Also used to control rhinorrhoea in perennial rhinitis and common cold; IPRANASE–AQ 0.084% nasal spray (42 µg per actuation), 1–2 sprays in each nostril 3–4 times a day. 14. Tiotropium bromide: 18 µg by inhalation. TIOVA 18 µg rotacaps, 1 rotacap by inhalation OD. 15. Oxybutynin: 5 mg BD/TDS oral; children above 5 yr 2.5 mg BD. OXYBUTIN, CYSTRAN, OXYSPAS 2.5 mg and 5 mg tabs. 16. Flavoxate: 200 mg TDS. URISPAS, FLAVATE, FLAVOSPAS 200 mg tab. 17. Tolterodine: 1–2 mg BD or 2–4 mg OD of sustained release tab. oral; ROLITEN, TOLTER 1, 2 mg tabs, TORQ 2, 4 mg SR tab. 18. Homatropine: 1–2% topically in eye. HOMATROPINE EYE, HOMIDE 1%, 2% eye drops. 19. Cyclopentolate: 0.5–1.0% topically in eye. CYCLOMID EYE, 0.5%, 1.0%, CYCLOGYL, CYCLOPENT 1% eye drops. 20. Tropicamide: 0.5–1.0% topically in eye. OPTIMIDE, TROPICAMET, TROMIDE 1% eye drops; TROPAC-P, TROPICAMET PLUS 0.8% + phenylephrine 5% eye drops. 21. Trihexyphenidyl (benzhexol): 2–10 mg/day; PACITANE, PARBENZ 2 mg tab. 22. Procyclidine: 5–20 mg/day; KEMADRIN 2.5, 5 mg tab. 23. Biperiden: 2–10 mg/day oral, i.m. or i.v.: DYSKINON 2 mg tab., 5 mg/ml inj. 6 Drugs Acting on Autonomic Nervous System Preparations 1. Nicotine transdermal: NICOTINELL-TTS 10, 20, 30 cm2 patches releasing 7, 14, 21 mg nicotine per 24 hr respectively. In those smoking > 20 cigarettes every day—start with 30 cm2 patch, shift to smaller patches every 3–5 days, treat for 3–4 weeks. 2. Nicotine chewing gum: NULIFE 1, 2, 4 mg chewing gum; In those smoking > 20 cigarettes/day—start with 4 mg gum chewed slowly for 30 min when urge to smoke occurs—gradually reduce to 2 mg gum and then 1 mg gum. In less heavy smokers—start at lower doses. Adrenergic Drugs 7 8 Drugs Acting on Autonomic Nervous System Preparations 1. Adrenaline (Epinephrine): 0.2–0.5 mg s.c./i.m.; ADRENALINE 1 mg/ml inj; ADRENA 4 mg (of adrenaline bitartrate=2 mg adrenaline base) per ml inj. 2. Noradrenaline (Norepinephrine, Levarterenol): 2–4 µg/min i.v. infusion; ADRENOR, NORAD, NORDRIN 2 mg (base)/2 ml amp. 3. Isoprenaline (Isoproterenol): 20 mg s.l., 1–2 mg i.m., 5–10 µg/min i.v. infusion; NEOEPININE 20 mg sublingual tab, ISOPRIN, ISOSOL 4 mg/2 ml inj. 4. Dopamine: 0.2–1.0 mg/min i.v. infusion; DOPAMINE, INTROPIN, DOPACARD 200 mg/5 ml amp. 5. Dobutamine: 2.5–10 µg/kg/min i.v. infusion; CARDIJECT 50 mg/4 ml and 250 mg/20 ml inj, DOBUTREX, DOBUSTAT 250 mg inj. 6. Ephedrine: 15–60 mg oral, 15–30 mg i.m./i.v.; 0.5–0.75% topically in nose. EPHEDRINE HCL 15, 30 mg tabs, SUFIDRIN 50 mg in 1 ml inj, ENDRINE 0.75% nasal drops. 7. Phenylephrine: 5–10 mg oral, 2–5 mg i.m., 0.1–0.5 mg slow i.v. inj, 30–60 µg/min i.v. infusion, 0.25% topically in nose, 5–10% topically in eye; in DECOLD PLUS 5 mg with paracetamol 400 mg + chlorpheniramine 2 mg + caffeine 15 mg tab; SINAREST 10 mg with chlorpheniramine 2 mg, paracetamol 500 mg, caffeine 30 mg tab; FRENIN 10 mg in 1 ml inj, in FENOX 0.25% with naphazoline 0.025% nasal drops, DROSYN 10% eye drops, in DROSYN-T, TROPAC-P 5% with tropicamide 0.8% eye drops. 8. Methoxamine: 10–20 mg i.m., 3–5 mg slow i.v. inj; VASOXINE 20 mg/ml inj. 9. Mephentermine: 10–20 mg oral/i.m., also by i.v. infusion. MEPHENTINE 10 mg tab, 15 mg in 1 ml amp, 30 mg/ml in 10 ml vial. 10. Amphetamine: 5–15 mg oral. 11. Dexamphetamine: 5–10 mg (children 2.5–5 mg) oral. 12. Methamphetamine: 5–10 mg oral. Adrenergic Drugs 9 13. Sibutramine: Start with 10 mg OD, increase to 15 mg OD if needed. 14. Xylometazoline: 0.05%–0.1% topically in nose; OTRIVIN 0.05% (pediatric), 0.1% (adult) nasal drops and nasal spray. 15. Oxymetazoline: 0.025–0.05% topically in nose; NASIVION, SINAREST 0.025% (pediatric), 0.05% (adult) nasal drops. 16. Naphazoline: 0.1% topically in nose; PRIVINE 0.1% nasal drops. 17. Pseudoephedrine: 30–60 mg oral TDS; SUDAFED 60 mg tab, 30 mg/5 ml syrup; in SINAR- EST 60 mg with chlorpheniramine 2 mg + caffeine 30 mg + paracetamol 500 mg tab; in CHESTON 30 mg with chlorpheniramine 2 mg + bromhexine 4 mg per tab and per 5 ml syr; in ACTICOLD 60 mg with chlorpheniramine 4 mg + paracetamol 500 mg tab; in CODYLEX 60 mg with chlorpheniramine 4 mg + ibuprofen 400 mg tab. 18. Phenylpropanolamine: 25–50 mg TDS; In ACTIFED 25 mg with triprolidine 2.5 mg tab; in ESKOLD 50 mg with diphenylpyraline 5 mg spansule; in FLUCOLD 25 mg with chlorpheniramine 2 mg + paracetamol 500 mg tab. 19. Ritodrine: 50–200 µg/min i.v. infusion, 10 mg i.m./oral 4–6 hourly; YUTOPAR, RITROD 10 mg/ml inj (5 ml amp), 10 mg tab. RITODINE 10 mg tab, 10 mg in 1 ml inj. 20. Isoxsuprine: 5–10 mg oral, i.m. 4–6 hourly, DUVADILAN 10 mg tab, 40 mg SR cap, 10 mg/2 ml inj. Note: For doses and preparations of β2 agonist bronchodilators (salbutamol, etc.) See p. 34. 10 Drugs Acting on Autonomic Nervous System a Adrenergic Blocking Drugs 11 Preparations 1. Phenoxybenzamine: 20–60 mg/day oral, 1 mg/kg slow i.v. infusion over 1 hour; FENOXENE 10 mg cap, 50 mg/ml inj, BIOPHENOX 50 mg/ml inj. 2. Ergotamine: For migraine 1–3 mg oral/sublingual, repeat as required (max 6 mg in a day); rarely 0.25–0.5 mg i.m. or s.c.; ERGOTAMINE, GYNERGEN, INGAGEN 1 mg tab, 0.5 mg/ml and 1 mg/ml inj. 3. Dihydroergotamine: For migraine 2–6 mg oral (max 10 mg/day), 0.5–1 mg i.m., s.c. repeat hourly (max 3 mg); DIHYDERGOT, DHE 1 mg tab, MIGRANIL 1 mg/ml inj. 4. Dihydroergotoxine (codergocrine): For dementia 1–1.5 mg oral or sublingual, 0.15–0.6 mg i.m., HYDERGINE 1.5 mg tab, CERELOID 1 mg tab. 5. Phentolamine: 5 mg i.v. repeated as required; REGITINE, FENTANOR 10 mg/ml inj. 6. Prazosin: Start with 0.5–1 mg at bedtime; usual dose 1–4 mg BD or TDS; PRAZOPRES 0.5, 1.0 and 2.0 mg tabs. MINIPRESS XL: PRAZOSIN GITS 2.5 mg and 5 mg tablets; 1 tab OD. 7. Terazosin: Usual maintenance dose 2–10 mg OD; HYTRIN, TERALFA, OLYSTER 1, 2, 5 mg tab. 8. Doxazosin: 1 mg OD initially, increase upto 8 mg BD; DOXACARD, DURACARD, DOXAPRESS 1, 2, 4 mg tabs. 9. Alfuzosin: 2.5 BD-QID or 10 mg OD as modified release tab. ALFUSIN, ALFOO 10 mg ER tab. 10. Tamsulosin: URIMAX, DYNAPRES 0.2, 0.4 mg MR cap; CONTIFLO-OD 0.4 mg cap; 1 cap (max 2) in the morning with meals. 11. Yohimbine: 2 mg oral; YOHIMBINE 2 mg tab. 12 Drugs Acting on Autonomic Nervous System b Adrenergic Blocking Drugs 13 Preparations 1. Propranolol: Oral—10 mg BD to 160 mg QID (average 40–160 mg/day). Start with a low dose and gradually increase according to need; i.v.—2 to 5 mg injected over 10 min with constant monitoring. It is not injected s.c. or i.m. because of irritant property. INDERAL, CIPLAR 10, 40, 80 mg tab, 1 mg/ml inj., BETABLOC 10, 40 mg tab. 2. Sotalol: 80 mg BD–160 mg TDS oral; SOTAGARD 40, 80 mg tabs. 3. Pindolol: 5–15 mg BD; PINADOL 5 mg tab, VISKEN 10, 15 mg tab. 4. Metoprolol: 25 mg BD–100 mg QID oral, 5–15 mg slow i.v. inj; BETALOC 25, 50, 100 mg tab, 5 mg/ml inj., LOPRESOR, METOLAR 50, 100 mg tab. 5. S(–) Metoprolol: 12.5 mg BD–50 mg QID; METPURE–XL 12.5, 25, 50 mg ER tabs. 6. Atenolol: 25 mg OD–50 mg BD; BETACARD, ATEN, TENORMIN 25, 50, 100 mg tabs. 7. S(–) Atenolol: 12.5–50 mg OD; ATPURE, ADBETA 12.5, 25, 50 mg tabs. 8. Acebutolol: 200 mg BD–400 mg TDS oral; 20–40 mg slow i.v. injection; SECTRAL 200, 400 mg tabs, 10 mg/2 ml amp. 9. Bisoprolol: 2.5–10 mg OD; CONCOR, CORBIS 5 mg tab. 10. Esmolol: 0.5 mg/kg i.v. injection followed by 0.05–0.2 mg/kg/min i.v. infusion; MINIBLOCK 100 mg/10 ml, 250 mg/10 ml inj. 11. Celiprolol: 100 mg OD–300 mg BD; CELIPRES 100, 200 mg tab. 12. Nebivolol: 5 mg OD (start with 2.5 mg OD in elderly); NODON 5 mg tab, NEBICARD 2.5, 5 mg tabs. 13. Labetalol: Start with 50 mg BD, increase to 100–200 mg TDS oral. In hypertensive emergencies 20–40 mg slow i.v. injection every 10 min till desired response is obtained. NORMADATE 50, 100, 200 mg tab; LABESOL, LABETA 50 mg tab, 20 mg/4 ml inj. 14. Carvedilol: for CHF: Start with 3.125 mg BD for 2 weeks, if well tolerated, gradually increase to max. of 25 mg BD. for hypertension/angina: 6.25 mg BD initially, titrate to max. of 25 mg BD. CARVIL, CARLOC, CARVAS 3.125, 6.25, 12.5, 25 mg tabs; ORICAR 12.5, 25 mg tabs. 14 Drugs Acting on Autonomic Nervous System Preparations 1. Timolol: Start with 0.25% eye drops BD, change to 0.5% drops in case of inadequate response. 0.5% OD as gel forming solution. GLUCOMOL, OCUPRES, IOTIM, LOPRES 0.25% and 0.5% eye drops. TIMOLAST 0.5% gel forming eye drops (long acting). Timolol 0.5% + Latanoprost 0.005%: LAPROST PLUS, LATOCHEK-T eye drops. 2. Betaxolol: 0.5% topically in eye BD; OPTIPRES, IOBET, OCUBETA 0.5% eye drops. 3. Levobunolol: 0.5% topically in eye OD; BETAGAN 0.5% ophthalmic solution. 4. Dipivefrine: 0.1% topically in eye BD; PROPINE 0.1% eye drops. 5. Apraclonidine: 0.5–1.0% topically in eye; ALFADROPS-DS 1% eye drops. 6. Brimonidine: 0.2% topically in eye TDS; ALPHAGAN-P, BRIMODIN-P 0.15% eye drops, IOBRIM 0.2% eye drops. Topical Drugs for Glaucoma 15 7. Latanoprost: 0.005% topically in eye OD in evening; LACOMA, XALATAN, LATOPROST, 9 PM 50 µg/ml eye drops; LACOMA-T, LAPROST-PLUS, LATOCHEK-T with timolol 0.5% eye drops (store in cold place). 8. Travoprost: 0.004% topically in eye OD in evening; TRAVATAN 0.004% eye drops (refrigeration of the eye drops not required); TRAVACOM 0.004% with timolol 0.5% eye drops. 9. Bimatoprost: 0.03% as eye drops OD in evening; LUMIGAN, CAREPROST 0.03% eye drops; the eye drop need not be stored in refrigerator; CAREPROST-PLUS, GANFORT with timolol 0.5% eye drop. 10. Pilocarpine: 0.5%–4% topically in eye; CARPINE, PILOCAR 0.5%, 1%, 2%, 4% eye drops. 11. Dorzolamide: 2% topically in eye BD–TDS; DORTAS, DORZOX 2% eye drops. 2 Autacoids and Related Drugs Histaminergic Agonists/H1 Antagonists 17 Preparations Betahistine (Histaminergic agonist): 4–8 mg 6–8 hourly; VERTIN 8 mg tab. 1. Diphenhydramine: 25–50 mg oral; BENADRYL 25 mg cap, 12.5 mg/5 ml syr. 2. Dimenhydrinate: 25–50 mg oral, i.m.; DRAMAMINE 16 mg/5 ml syr, 50 mg tab, GRAVOL 50 mg tab. 3. Promethazine: 25–50 mg oral, i.m. (1 mg/kg); PHENERGAN 10, 25 mg tab., 5 mg/ml elixer, 25 mg/ml inj. 4. Hydroxyzine: 25–50 mg oral, i.m.; ATARAX 10, 25 mg tab., 10 mg/5 ml syr, 6 mg/ml drops, 25 mg/ml inj. 5. Pheniramine: 20–50 mg oral, i.m.; AVIL 25 mg, 50 mg tab, 15 mg/5 ml syr, 22.5 mg/ml inj. 6. Cyproheptadine: 4 mg oral; PRACTIN, CIPLACTIN 4 mg tab., 2 mg/5 ml syrup. 7. Meclozine (Meclizine): 25–50 mg oral; In DILIGAN 12.5 mg + niacin 50 mg tab., In PREGNIDOXIN 25 mg + Caffeine 20 mg tab. 8. Cinnarizine: 25–50 mg oral; STUGERON, VERTIGON 25 and 75 mg tab. 9. Chlorpheniramine: 2–4 mg (0.1 mg/kg) oral, i.m.; PIRITON, CADISTIN 4 mg tab. 10. Dexchlorpheniramine: 2 mg oral; POLARAMINE 2 mg tab., 0.5 mg/5 ml syrup. 11. Triprolidine: 2.5–5 mg oral; ACTIDIL 2.5 mg tab, ACTIFED 2.5 mg with pseudoephedrine 60 mg. 12. Clemastine: 1–2 mg oral; TAVEGYL 1 mg tab., 0.5 mg/5 ml syr. 13. Fexofenadine: 120–180 mg oral; ALLEGRA, ALTIVA, FEXO 120, 180 mg tab. 14. Loratadine: 10 mg oral; LORFAST, LORIDIN, LORMEG, 10 mg tab, 1 mg/ml susp. 15. Desloratadine: 5 mg oral; DESLOR, LORDAY, NEOLORIDIN 5 mg tab. 16. Cetirizine: 10 mg oral; ALERID, CETZINE, ZIRTIN, SIZON 10 mg tab, 5 mg/5 ml syr. 17. Levocetirizine: 5 mg oral; LEVORID, LEVOSIZ 5 mg, 10 mg tab, TECZINE, LEVOCET 5 mg tab, 2.5 mg/5 ml syr. 18. Azelastine: 4 mg oral, 0.28 mg intranasal; AZEP NASAL SPRAY 0.14 mg per puff nasal spray. 18 Autacoids and Related Drugs 19. Mizolastine: 10 mg oral; ELINA 10 mg tab. 20. Ebastine: 10 mg oral; EBAST 10 mg tab. 21. Rupatadine: 10 mg oral; RUPAHIST 10 mg tab. Note: For H2-Antagonists (H2-Antihistaminics) See p. 118, 119. Drugs for Migraine 19 20 Autacoids and Related Drugs Preparations 1. Ergotamine: 1 mg oral/sublingual, repeat as required (max. 6 mg), 0.25–0.5 mg s.c./i.m.; ERGOTAMINE 1 mg tab, 0.5 mg/ml inj. MIGRIL: Ergotamine 2 mg, caffeine 100 mg, cyclizine 50 mg tab. VASOGRAIN: Ergotamine 1 mg, caffeine 100 mg, paracetamol 250 mg, prochlorperazine 2.5 mg tab. 2. Dihydroergotamine (DHE): 2–6 mg oral (max. 10 mg/day), 0.5–1.0 mg i.m., s.c.; DHE 1 mg tab, MIGRANIL 1 mg/ml inj. 3. Sumatriptan: 6 mg s.c., 50–100 mg oral at the onset of migraine attack, may be repeated once within 24 hours if required. Those not responding to the first dose should not be given the second dose; 25 mg nasal spray, may be repeated once after 2 hours; SUMINAT, SUMITREX 25, 50, 100 mg tabs, MIGRATAN 50, 100 mg tabs, SUMITREX-INJ KIT 6 mg in 0.5 ml inj.; also SUMINAT 25 mg per actuation nasal spray. 4. Rizatriptan: 5-10 mg at the onset of migraine attack, may be repeated after 2 hours if required.Those not responding to the first dose should not be given the second dose; RIZACT, RIZATAN 5 mg, 10 mg tabs. 5. Flunarizine: 10–20 mg OD, children 5 mg OD; NOMIGRAIN, FLUNARIN 5 mg, 10 mg caps/tab. Note: For preparations of other drugs, see Index. Prostaglandins (PGs) 21 22 Autacoids and Related Drugs Prostaglandins (PGs) 1. PGE2 (Dinoprostone): PROSTIN-E2 for induction/augmentation of labour, midterm abortion. Vaginal gel (1 mg or 2 mg in 2.5 ml) 1 mg inserted into posterior fornix, followed by 1–2 mg after 6 hour if required. Vaginal tab (3 mg) 3 mg inserted into posterior fornix, followed by another 3 mg if labour does not start within 6 hour. Extraamniotic solution (10 mg/ml in 0.5 ml amp.) infrequently used. Intravenous solution (1 mg/ml in 0.75 ml amp., 10 mg/ml in 0.5 ml amp) i.v. route rarely used, more side effects. Oral tablet PRIMIPROST 0.5 mg tab, one tab. hourly till induction, max 1.5 mg per hr; rarely used. Cervical gel CERVIPRIME (0.5 mg in 2.5 ml prefilled syringe) 0.5 mg inserted into cervical canal for preinduc- tion cervical softening and dilatation in patients with poor Bishop’s score. 2. Gemeprost: CERVAGEM 1 mg vaginal pessary: for softening of cervix in first trimester–1 mg 3 hr before attempting dilatation; for 2nd trimester abortion/molar gestation—1 mg every 3 hours, max. 5 doses. 3. PGF2α (Dinoprost): PROSTIN F2 ALPHA intraamniotic injection, 5 mg/ml in 4 ml amp. for midterm abortion/ induction of labour (rarely used). 4. 15-methyl PGF2α (Carboprost): PROSTODIN 0.25 mg in 1 ml amp; 0.25 mg i.m. every 30–120 min for PPH, midterm abortion, missed abortion. 5. Misoprostol (methyl–PGE1 ester): 200 µg oral 6 hourly; CYTOLOG 200 µg tab, MISOPROST 100, 200 µg tab. T-PILL + MISO Mifepristone 200 mg tab (3 tabs) + misoprostol 200 µg (2 tabs); mifepristone 3 tab orally followed 2 days later by misoprostol 2 tab orally for termination of pregnancy of upto 49 days. 6. PGE1 (Alprostadil): 0.5 mg by slow i.v. infusion; PROSTIN–VR, BIOGLANDIN 0.5 mg in 1 ml inj. 7. PGI2 (Prostacyclin, Epoprostenol): 0.5 mg by i.v. infusion or injection in extracorporeal circulation; |FLOLAN 0.5 mg per vial for reconstitution. Note: For preparations of other analogues, see Index. Nonsteroidal Antiinflammatory Drugs/ Antipyretic-Analgesics 23 24 Autacoids and Related Drugs Preparations 1. Aspirin: Antiinflammatory dose 3–5 g/day (75–100 mg/kg/day); analgesic-antipyretic dose 0.3–0.6 g 6–8 hourly; antiplatelet dose 75–150 mg/day. ASPIRIN 350 mg tab, COLSPRIN 100, 325 mg tabs, ECOSPRIN 75, 150, 325 mg tabs, DISPRIN 325 mg (with calcium carbonate 105 mg + citric acid 35 mg) tab, LOPRIN 75, 162.5 mg tabs. BIOSPIRIN: Lysine acetylsalicylate 900 mg + glycine 100 mg/vial for dissolving in 5 ml water and i.v. injection. 2. Indomethacin: 25–50 mg BD–QID. Those not tolerating the drug orally may be given nightly suppository. IDICIN, INDOCAP 25 mg cap, 75 mg SR cap, ARTICID 25, 50 mg cap, INDOFLAM 25, 75 mg caps, 1% eye drop. RECTICIN 50 mg suppository. 3. Ibuprofen: 400–800 mg TDS; BRUFEN, EMFLAM, IBUSYNTH 200, 400, 600 mg tab, IBUGESIC also 100 mg/5 ml susp. 4. Naproxen: 250 mg BD–TDS; NAPROSYN, NAXID, ARTAGEN, XENOBID 250 mg tab, NAPROSYN also 500 mg tab. 5. Ketoprofen: 50–100 mg BD–TDS; KETOFEN 50, 100 mg tab; OSTOFEN 50 mg cap. RHOFENID 100 mg tab, 200 mg SR tab; 100 mg/2 ml amp. 6. Flurbiprofen: 50 mg BD–QID; ARFLUR 50, 100 mg tab, 200 mg SR tab, FLUROFEN 100 mg tab, OCUFLUR 0.03% eye drops. 7. Mephenamic acid: 250–500 mg TDS; MEDOL 250, 500 mg cap; MEFTAL 250, 500 mg tab, 100 mg/5 ml susp. PONSTAN 125, 250, 500 mg tab, 50 mg/ml syrup. 8. Diclofenac: 50 mg TDS, then BD oral, 75 mg deep i.m.; VOVERAN, DICLONAC, MOVONAC 50 mg enteric coated tab, 100 mg S.R. tab, 25 mg/ml in 3 ml amp. for i.m. inj. DICLOMAX 25, 50 mg tab, 75 mg/3 ml inj. Diclofenac potassium: VOLTAFLAM 25, 50 mg tab, ULTRA‑K 50 mg tab; VOVERAN 1% topical gel. 9. Aceclofenac: 100 mg BD; ACECLO, DOLOKIND 100 mg tab, 200 mg SR tab. Nonsteroidal Antiinflammatory Drugs/ Antipyretic-Analgesics 25 10. Piroxicam: 20 mg BD for two days followed by 20 mg OD; DOLONEX, PIROX 10, 20 mg cap, 20 mg dispersible tab, 20 mg/ml inj in 1 and 2 ml amps; PIRICAM 10, 20 mg cap. 11. Tenoxicam: 20 mg OD; TOBITIL 20 mg tab. 12. Ketorolac: 10–20 mg oral 6 hourly, 15–30 mg i.m./i.v. 6 hourly (max 90 mg/day); KETOROL, ZOROVON, KETANOV, TOROLAC 10 mg tab, 30 mg in 1 ml amp., KETLUR, ACULAR 0.5% eye drops. 13. Nimesulide: 100 mg BD; NIMULID, NIMEGESIC, NIMODOL 100 mg tab, 50 mg/5 ml susp. 14. Meloxicam: 7.5–15 mg OD; MELFLAM, MEL–OD, MUVIK, M–CAM 7.5 mg, 15 mg tabs. 15. Nabumetone: 500 mg OD; NABUFLAM 500 mg tab. 16. Etodolac: 200-400 mg BD-TDS; ETOVA 200, 300, 400 mg tabs. 17. Celecoxib: 100–200 mg BD; CELACT, CELCOX, COLCIBRA, COBIX 100, 200 mg tabs. 18. Etoricoxib: 60–120 mg OD; TOROCOXIA, ETOXIB, ETOSHINE, NUCOXIA 60, 90, 120 mg tabs. 19. Parecoxib: 40 mg oral/i.m./i.v. repeated after 6–12 hours (max. 80 mg/day); PAROXIB 40 mg tab, REVALDO, VALTO-P 40 mg/vial inj. 20. Paracetamol: 325–650 mg (children 10–15 mg/kg) 3-5 times a day (max. 2600 mg/day); also 80–250 mg as suppository in infants and children; CROCIN 0.5 g tab, 125 mg/5 ml and 250 mg/5 ml syr, 100 mg/ml pediatric drops, CROCIN PAIN RELIEF 650 mg with caffeine 50 mg tab; METACIN, PARACIN 500 mg tab, 125 mg/5 ml syrup, 150 mg/ml ped. drops, ULTRAGIN, PYRIGESIC, CALPOL 500 mg tab, 125 mg/5 ml syrup, NEOMOL, FEVASTIN, FEBRINIL 300 mg/2 ml inj. JUNIMOL-RDS 80, 170, 250 mg suppository, PARACETAMOL RECTAL SUPPOSITORY 80, 170 mg. 21. Metamizol: 0.5–1.5 g oral/i.m./i.v.; ANALGIN 0.5 g tab; NOVALGIN, BARALGAN 0.5 g tab, 0.5 g/ml in 2 ml and 5 ml amps; ULTRAGIN 0.5 g/ml inj in 2 ml amp and 30 ml vial. 26 Autacoids and Related Drugs 22. Propiphenazone: 300–600 mg TDS; marketed only in combination in several ‘over the counter’ preparations–in SARIDON, ANAFEBRIN: propiphenazone 150 mg + paracetamol 250 mg tab, DART: propiphenazone 150 mg + paracetamol 300 mg + caffeine 50 mg tab. 23. Nefopam: 30–60 mg TDS oral, 20 mg i.m. 6 hourly; NEFOMAX 30 mg tab, 20 mg in 1 ml amp. Topical NSAIDs 1. Diclofenac 1% gel: VOLINI GEL, RELAXYL GEL, DICLONAC GEL 2. Ibuprofen 10% gel: RIBUFEN GEL 3. Naproxen 10% gel: NAPROSYN GEL 4. Ketoprofen 2.5% gel: RHOFENID GEL 5. Flurbiprofen 5% gel: FROBEN GEL 6. Nimesulide 1% gel: NIMULID TRANS GEL, ZOLANDIN GEL, NIMEGESIC-T-GEL 7. Piroxicam 0.5% gel: DOLONEX GEL, MOVON GEL, PIROX GEL, MINICAM GEL Antirheumatoid Drugs/Drugs for Gout 27 28 Autacoids and Related Drugs Preparations Antirheumatoid drugs 1. Chloroquine: 150 mg (base) per day; LARIAGO, RESOCHIN, NIVAQUIN-P 250 mg as phosphate (150 mg base) tab. 2. Hydroxychloroquine: initially 200 mg BD followed by 200 mg OD for maintenance; ZHQUINE, ZYQ 200 mg tab. 3. Sulfasalazine: 1–3 g/day in 2–3 divided doses; SALAZOPYRIN, SAZO-EN 0.5 g tab. 4. Leflunomide: 100 mg/day for 3 days loading dose followed by 20 mg OD; LEFRA 10 mg, 20 mg tabs. 5. Methotrexate: 7.5–15 mg weekly oral; NEOTREXATE, BIOTREXATE 2.5 mg tab. 6. Azathioprine: 50–150 mg/day; IMURAN 50 mg tab. 7. Etanercept: 25–50 mg s.c. once or twice weekly; ENBREL, ENBROL 25 mg/0.5 ml and 50 mg/1 ml inj. Note: For preparations of corticosteroids, see Index. Drugs for gout 1. Colchicine: For control of acute attack – 0.5 mg 1–3 hourly to a total of 3 doses; maintenance dose 0.5–1 mg/ day; for prophylaxis 0.5–1.5 mg/day; ZYCOLCHIN, GOUTNIL 0.5 mg tab. 2. Probenecid: 0.25–1.0 g BD; BENEMID, BENCID 0.5 g tab. 3. Allopurinol: Start with 100 mg OD, gradually increase to maintenance dose of 300 mg/day; maximum 600 mg/ day. ZYLORIC 100, 300 mg tabs., ZYLOPRIM, CIPLORIC 100 mg cap. 4. Febuxostat: 40–80 mg OD; FABULAS, FABUSTAT, ZURIG, 40, 80, 120 mg tabs. 3 Drugs for Respiratory Disorders 30 Drugs for Respiratory Disorders Preparations 1. Sod./Pot. citrate/acetate: 0.3–1.0 g TDS. 2. Guaiphenesin: 100–200 mg TDS. 3. Tolu balsam: 0.3–0.6 g TDS. 4. Vasaka syrup: 2–4 ml TDS. 5. Ammonium chloride: 50–200 mg TDS. 6. Bromhexine: 8 mg TDS, child 1–5 yr 4 mg BD, 5–10 yr 4 mg TDS; BROMHEXINE 8 mg tab, 4 mg/5 ml elixer. 7. Ambroxol: 15–30 mg TDS; AMBRIL, AMBROLITE, AMBRODIL, MUCOLITE 30 mg tab, 30 mg/5 ml liq, 7.5 mg/ml drops. 8. Carbocisteine: 250–750 mg TDS; MUCODYNE 375 mg cap, 250 mg/5 ml syr. 9. Acetylcysteine: 200 mg/ml solution by nebulization or instillation through tracheostomy tube; MUCOMIX 200 mg/ml inj in 1, 2, 5 ml amps. 10. Codeine: 15–30 mg TDS; children 2–6 years 7.5 mg, 6–12 years 15 mg; CODINE 15 mg tab, 15 mg/5 ml linctus. 11. Ethylmorphine: 10-30 mg TDS; DIONINDON 16 mg tab. 12. Pholcodine: 10–15 mg BD–TDS. 13. Noscapine: 15–30 mg, children 2–6 years 7.5 mg, 6–12 years 15 mg; COSCOPIN 7 mg/5 ml syrup, COSCOTABS 25 mg tab. 14. Dextromethorphan: 10–20 mg TDS, child 2–6 yr 2.5–5 mg, 6–10 yrs 5–10 mg. 15. Chlophedianol: 20–40 mg BD–TDS; DETIGON, TUSSIGON 20 mg/5 ml linctus with Ammon. chloride 50 mg and menthol 0.25 mg. 16. Prenoxdiazine: 100–200 mg TDS. PRENOXID 100, 200 mg tab. Drugs for Cough 31 Some combined antitussive-expectorant formulations ASTHALIN EXPECTORANT: Salbutamol 2 mg, guaiphenesin 100 mg per 10 ml syr; dose 10–20 ml. ASCORIL-C: Codeine 10 mg, chlorpheniramine 4 mg per 5 ml syr. AXALIN: Ambroxol 15 mg, guaiphenesin 50 mg, salbutamol 1 mg, menthol 1 mg per 5 ml syr. BRONCHOSOLVIN: Guaiphenesin 100 mg, terbutaline 2.5 mg, bromhexine 8 mg per 10 ml susp. CADICOFF, GRILINCTUS: Dextromethorphan 5 mg, chlorpheniramine 2.5 mg, guaiphenesin 50 mg, amm. chloride 60 mg per 5 ml syr. BENADRYL COUGH FORMULA: Diphenhydramine 14 mg, amm. chlor. 138 mg, sod. citrate 57 mg, menthol 1.1 mg per 5 ml syrup; dose 5–10 ml, children 2.5–5 ml. BRO-ZEDEX: Bromhexine 8 mg, guaiphenesin 100 mg, terbutaline 2.5 mg, menthol 5 mg per 10 ml syrup; dose 10 ml. CADISTIN EXPECTORANT: Chlorpheniramine 2 mg, glyceryl guaiacolate 80 mg, amm. chlor. 100 mg, sod. citrate 44 mg, menthol 0.8 mg, terpin hydrate 4 mg, tolu balsam 6 mg, vasaka syrup 0.13 ml per 5 ml syrup; dose 10 ml. CHERICOF: Dextromethorphan 10 mg, chlorpheniramine 2 mg, phenylpropanolamine 12.5 mg per 5 ml liq. CLISTIN: Dextromethorphan 10 mg, Carbinoxamine 4 mg, amm. chlor. 240 mg, sod. citrate 240 mg per 10 ml syrup. COREX: Chlorpheniramine 4 mg, codeine phos. 10 mg, menthol 0.1 mg per 5 ml syrup; dose 5 ml, children 1.25–2.5 ml. COSCOPIN LINCTUS: Noscapine 7 mg, chlorpheniramine 2 mg, citric acid 29 mg, sod. citrate 3 mg, amm. chlor. 28 mg per 5 ml syrup; dose 10–20 ml. 32 Drugs for Respiratory Disorders COSOME: Bromhexine 8 mg, phenylephrine 10 mg, chlorpheniramine 4 mg per 10 ml syr; dose 10 ml. SOLVIN EXPECTORANT: Bromhexine 4 mg, pseudoephedrine 30 mg tablet and in 10 ml liquid; dose 1 tablet or 5 ml liquid. TOSSEX: Codeine phos 10 mg, chlorpheniramine 4 mg, menthol 1.5 mg, sod. citrate 75 mg per 5 ml liquid; dose 5 ml. VENTORLIN EXPECTORANT: Salbutamol 2 mg, guaiphenesin 100 mg per 10 ml syrup; dose 10 ml, children 2.5–7.5 ml. ZEET EXPECTORANT: Diphenhydramine 8 mg, amm. chlor. 100 mg, guaiphenesin 50 mg, bromhexine 4 mg, menthol 1 mg per 5 ml syr. ZEET LINCTUS: Dextromethorphan 10 mg, guaiphenesin 50 mg, phenylpropanolamine 25 mg per 5 ml syr; dose 5 ml. Drugs for Bronchial Asthma 33 34 Drugs for Respiratory Disorders Preparations 1. Salbutamol (Albuterol): 2–4 mg oral, 0.25–0.5 mg i.m./s.c., 100–200 µg by inhalation; ASTHALIN 2, 4 mg tab., 8 mg SR tab., 2 mg/5 ml syrup, 100 µg metered dose inhaler; 5 mg/ml respirator soln., 200 µg rota caps; CROYSAL 0.5 mg/ml inj, SALOL 2.5 mg/3 ml inj; VENTORLIN 2 mg/5 ml syr, 4 mg, 8 mg CR caps., DERIHALER 100 µg metered dose inhaler. 2. Terbutaline: 5 mg oral, 0.25 mg s.c., 250 µg by inhalation; TERBUTALINE, BRICAREX 2.5, 5 mg tab., 3 mg/ 5 ml syrup, 0.5 mg/ml inj; MISTHALER 250 µg/metered dose, 10 mg/ml nebulizing soln.; BRICANYL 0.5 mg/ ml inj, 2.5 mg, 5 mg tabs, 1.5 mg/5 ml syr. 3. Bambuterol: 10–20 mg OD in the evening; BAMBUDIL 10 mg, 20 mg tabs, 5 mg/5 ml oral soln; BETADAY 10, 20 mg tabs. 4. Salmeterol: 50–100 µg by inhalation; SALMETER, SEROBID 25 µg per metered dose inhaler; 2 puffs BD; severe cases 4 puffs BD; also SEROBID ROTACAPS 50 µg; 1–2 caps BD by inhalation. SEROFLO—100/250/500 ROTACAPS: Salmeterol 50 µg + fluticasone 100 µg/250 µg/500 µg per rotacap SEROFLO—125/250, COMBITIDE—125/250, INHALERS: Salmeterol 25 µg + fluticasone 125 µg or 250 µg per puff. 5. Formoterol: 12–24 µg by inhalation twice daily; FORATEC 12 µg rotacaps. 6. Theophylline (anhydrous): 100–300 mg TDS (15 mg/kg/day), THEOLONG 100, 200 mg SR cap., DURALYN- CR 400 mg continuous release cap, UNICONTIN 400 mg, 600 mg CR tabs, THEOBID 200, 300 mg tabs. 7. Aminophylline (Theophylline-ethylenediamine; 85% theophylline): water soluble, can be injected i.v. but not i.m. or s.c., 250–500 mg oral or slow i.v. injection; children 7.5 mg/kg i.v.; AMINOPHYLLINE 100 mg tab, 250 mg/10 ml inj. 8. Hydroxyethyl theophylline (Etophylline, 80% theophylline): water soluble; can be injected i.v. and i.m. (but not s.c.), 250 mg oral/i.m./i.v.; DERIPHYLLIN 100 mg tab., 300 mg SR tab., 220 mg/2 ml inj. Drugs for Bronchial Asthma 35 9. Choline theophyllinate (Oxtriphylline; 64% theophylline): 250–500 mg oral; CHOLIPHYLLINE 125 mg cap., 125 mg/5 ml elixir. 10. Theophylline ethanolate of piperazine: 250–500 mg oral or i.v.; CADIPHYLLATE, 80 mg/5 ml elixir; ETOPHYLATE 125 mg/5 ml syrup. 11. Doxophylline: 400 mg OD-BD, Children 12 mg/kg/day; DOXORIL 400 mg tab, 100 mg/5 ml syr. 12. Ipratropium bromide: 40–80 µg by inhalation; IPRAVENT 20 µg/puff metered dose inhaler, 2 puffs 3–4 times daily; 250 µg/ml respirator soln., 0.4–2 ml nebulized in conjunction with a β2 agonist 2–4 times daily. 13. Tiotropium bromide: 18 µg by inhalation; TIOVA 18 µg rotacaps; 1 rotacap by inhalation OD. 14. Montelukast: 10 mg OD; children 2–5 yr 4 mg OD, 6–14 yr 5 mg OD in the evening; EMLUKAST, MONTAIR, VENTAIR 4 mg, 5 mg, 10 mg tabs. 15. Zafirlukast: 20 mg BD; children 5–11 yr 10 mg BD; ZUVAIR 10 mg, 20 mg tabs. 16. Sodium cromoglycate: 2–10 mg by inhalation 3–4 times a day; FINTAL inhaler: 1 mg metered dose aerosol; 2 puffs 4 times daily. CROMAL-5 INHALER: 5 mg metered dose aerosol, 2 puffs 4 times daily. 17. Ketotifen: 1–2 mg BD; children 0.5 mg BD; ASTHAFEN 1 mg tab, 1 mg/5 ml syrup; KETOVENT 1 mg tab. 18. Beclomethasone dipropionate: Initially 100–200 µg BD by inhalation, increase as needed upto 400 µg QID; BECLATE INHALER 50 µg, 100 µg, 200 µg per metered dose, 200 doses inhaler, BECORIDE 50, 100, 250 µg per puff inhaler. BECLATE ROTACAPS (with rotahaler) 100, 200, 400 µg powder per cap. AEROCORT INHALER 50 µg/metered aerosol dose with salbutamol 100 µg. AEROCORT ROTACAPS 100 µg with salbutamol 200 µg rotacaps (with rotahaler). 19. Budesonide: 200–400 µg BD–QID by inhalation in asthma; 200–400 µg/day by intranasal spray for allergic rhinitis. 36 Drugs for Respiratory Disorders PULMICORT 100, 200, 400 µg/metered dose inhaler, BUDECORT 100 µg/metered dose inhaler. FORACORT: Formoterol 6 µg + Budesonide 100 µg/200 µg rotacaps. RHINOCORT 50 µg per metered dose nasal spray; BUDENASE AQ 100 µg/metered dose aqueous nasal spray; for prophylaxis and treatment of seasonal and perennial allergic or vasomotor rhinitis, nasal polyposis; initially 2 puffs in each nostril every morning, maintenance 1 puff in each nostril in the morning. 20. Fluticasone propionate: 100–250 µg BD (max 1000 µg/day) by inhalation; FLOHALE INHALER 25 µg, 50 µg, 125 µg per actuation, FLOHALE ROTACAPS 50 µg, 100 µg, 250 µg rotacaps. FLOMIST 50 µg per actuation nasal spray. 21. Flunisolide: 25 µg by local spray in each nostril BD-TDS; SYNTARIS 25 µg per actuation nasal spray (for allergic rhinitis). 22. Ciclesonide: 80–160 µg by inhalation OD in the evening; CICLEZ 80 µg and 160 µg per metered dose inhaler. Note: For preparations of systemic corticosteroids, see Index. Some combined antiasthma formulations BRONKOPLUS: Salbutamol 2 mg, anhydrous theophylline 100 mg tab., also per 5 ml syrup. BRONKOTUS: Bromhexine 8 mg, salbutamol 2 mg tab., also syrup—bromhexine 4 mg, salbutamol 2 mg per 5 ml. DUOLIN INHALER, COMBIMIST INHALER Salbutamol 100 µg + ipratropium 20 µg per metered dose inhaler. DUOLIN ROTACAP salbutamol 200 µg + ipratropium 40 µg per rotacap. DUOLIN RESPULES, COMBIMIST RESPULES salbutamol 2.5 mg + ipratropium 500 µg in 2.5 ml respirator solution. TERPHYLIN: Terbutaline 2.5 mg, etophylline 100 mg tab. THEO ASTHALIN: Salbutamol 2 mg, theophylline anhydrous 100 mg tab. THEO ASTHALIN-SR: Salbutamol 4 mg, theophylline 300 mg SR tab, also syrup—Salbutamol 2 mg, theophylline 100 mg per 10 ml. THEOBRIC: Terbutaline 2.5 mg, theophylline 100 mg tab. THEOBRIC SR: Terbutaline 5 mg, theophylline 300 mg SR tab. 4 Hormones and Related Drugs 38 Hormones and Related Drugs Preparations 1. Growth hormone (Somatropin: recombinant human GH): For pituitary dwarfism: 0.03–0.06 mg/kg s.c./i.m. in the evening daily or on alternate days. For adult GH deficiency 150–300 μg/day s.c., later adjusted according to response; NORDITROPIN 5,10,15 mg inj., HUMATROPE 6 mg, 12 mg cartridges, 1.33 and 5.33 mg vials. 2. Menotropins (FSH + LH): obtained from urine of menopausal women: PREGNORM, PERGONAL, GYNOGEN 75/150; 75 IU FSH + 75 IU LH activity per amp, also 150 IU FSH + 150 IU LH per amp. 3. Urofollitropin or Menotropin (pure FSH): METRODIN, FOLIGEST, FOLICULIN, PUREGON 75 IU and 150 IU per amp. 4. Human chorionic gonadotropin (HCG) derived from urine of pregnant women. CORION, PROFASI, PUBERGEN 1000 IU, 2000 IU, 5000 IU, 10,000 IU, all as dry powder with separate solvent for injection. 5. Somatostatin: For upper g.i.bleeding 250 µg slow i.v. injection over 3 min followed by 3 mg i.v. infusion over 12 hours. STILMEN, SOMATOSAN, SOMASTAT 250 µg and 3 mg amps. 6. Octreotide: 100 µg i.v. followed by 25 µg/hour; SANDOSTATIN, OCTRIDE 50 µg, 100 µg in 1 ml amp, SANDOSTATIN LAR (microsphere formulation) 20 mg/5 ml inj. 7. Bromocriptine: Start with 1.25 mg BD, titrate upward upto 10 mg BD; PROCTINAL, PARLODEL, SICRIPTIN, BROMOGEN 1.25 mg, 2.5 mg tabs. 8. Cabergoline: Start with 0.25 mg twice weekly, increase upto 1 mg twice weekly as needed; CABERLIN 0.5 mg tab, CAMFORTE 0.5, 1 mg tabs. 9. Nafarelin: For endometriosis 200 µg intranasal spray BD; For precocious puberty 800 µg intranasal spray BD; NASAREL 2 mg/ml solution for nasal spray, 200 µg per actuation. Thyroid Hormone and Thyroid Inhibitors 39 10. Triptorelin: For endometriosis and carcinoma prostate: 3.75–7.5 mg of depot injection i.m. every 4 weeks; For female infertility: 0.1 mg s.c. daily for 10 days starting on 2nd day of menstruation; For precocious puberty: 50 µg/kg i.m. of depot injection every 4 weeks. DECAPEPTYL DAILY 0.1 mg inj, DECAPEPTYL DEPOT 3.75 mg inj. 11. Leuprolide: For palliative treatment of advanced carcinoma prostate—1 mg s.c. OD or 3.75 mg i.m./s.c. once a month of depot preparation; LUPRIDE 1 mg inj, 3.75 mg depot inj, PROGTASE 1 mg/ml inj. 40 Hormones and Related Drugs Preparations L-Thyroxine sod: Adult hypothyroidism—start with 50 µg/day, increase every 2–3 weeks by 25–50 µg to the optimum dose of 100–200 µg/day adjusted by the clinical response and serum TSH level. Cretinism—6–8 µg/kg/day; ELTROXIN, 25, 50, 100 μg tabs, ROXIN 100 μg tab, THYRONORM, 12.5, 25, 50, 62.5, 75, 88, 100, 112, 125, 137, 150 μg tabs, THYROX 25, 50, 75, 100 μg tabs. 1. Propylthiouracil: 50–150 mg TDS followed by 25–50 mg BD–TDS for maintenance. PTU 50 mg tab. 2. Methimazole: 5–10 mg TDS initially, maintenance dose 5–15 mg daily in 1–2 divided doses. 3. Carbimazole: 5–15 mg TDS initially, maintenance dose 2.5–10 mg daily in 1–2 divided doses; NEO MERCAZOLE, THYROZOLE, ANTITHYROX 5 mg tab. 4. Lugol’s solution (5% iodine in 10% Pot. iodide solution): LUGOL’S SOLUTION, COLLOID IODINE 10%: 5–10 drops/day. COLLOSOL 8 mg iodine/5 ml liq. 5. Iodide (Sod./Pot.): 5–10 mg/day prophylactic for endemic goiter; 100–300 mg/day before partial thyroidectomy in Graves' disease. Insulins 41 Preparations (Dose to be individualized according to requirement) 1. ACTRAPID, RAPIDICA: Highly purified pork regular insulin; 40 U/ml. 2. LENTARD, ZINULIN: Highly purified pork lente insulin; 40 U/ml. 3. ACTRAPHANE, RAPIMIX, MIXTARD: Highly purified pork regular insulin (30%) and isophane insulin (70%) 40 U/ml. 4. ACTRAPID MC: Monocomponent pork regular insulin; 40 U/ml, 100 U/ml. 5. MONOTRAD MC: Monocomponent pork lente insulin; 40 U/ml. 6. HUMAN ACTRAPID: Human regular insulin; 40 U/ml, 100 U/ml, ACTRAPID HM PENFIL 100 U/ml pen inj., WOSULIN-R 40 U/ml inj and 100 U/ml pen injector cartridges. 7. HUMAN MONOTRAD, HUMINSULIN-L: Human lente insulin; 40 U/ml, 100 U/ml. 8. HUMAN INSULATARD, HUMINSULIN-N: Human isophane insulin 40 U/ml, WOSULIN-N 40 U/ml inj and 100 U/ml cartridges for pen injector. 9. HUMAN ACTRAPHANE, HUMINSULIN 30/70, HUMAN MIXTARD: Human soluble insulin (30%) and isophane insulin (70%), 40 U/ml, and 100 U/ml vial. WOSULIN-30/70 40 U/ml inj and 100 U/ml cartridges. 10. ACTRAPHANE HM PENFIL: Human soluble insulin 30% + isophane insulin 70% 100 U/ml pen injector. 11. INSUMAN 50/50: Human soluble insulin 50% + isophane insulin 50% 40 U/ml inj; HUMINSULIN 50:50, HUMAN MIXTARD 50; WOSULIN 50/50 40 U/ml inj. and 100 U/ml cartridges. 12. Insulin Lispro (rDNA origin): HUMALOG 100 U/ml, 3 ml cartridge and 10 ml vial; to be injected s.c. within 15 min before or immediately after a meal. 13. Insulin Aspart: NOVOLOG, NOVORAPID 100 U/ml inj; NOVOMIX 30 FLEXPEN inj (biphasic insulin aspart). 14. Insulin Glargine: LANTUS OPTISET 100 U/ml prefilled pen injector 3 ml and vial 5 ml. 42 Hormones and Related Drugs Oral Antidiabetic Drugs 43 Preparations 1. Tolbutamide: 0.5–3 g/day in 2–3 divided doses; RASTINON 0.5 g tab. 2. Glibenclamide (Glyburide): 2.5–15 mg/day in 1–2 doses; DAONIL, EUGLUCON, BETANASE 2.5, 5 mg tab. 3. Glipizide: 5–20 mg/day in 1–2 doses; GLYNASE, GLIDE, MINIDIAB 5 mg tab. 4. Gliclazide: 40–240 mg/day in 1–2 doses; DIAMICRON 80 mg tab, DIAZIDE 20, 80 mg tab, GLIZID 30, 40, 80 mg tab. 5. Glimepiride: 1–6 mg per day in 1-2 doses; AMARYL, GLYPRIDE, GLIMER 1, 2 mg tab. 6. Metformin: 0.5–2.5 g/day in 1–2 doses; GLYCIPHAGE, GLYCOMET 0.5, 0.85 g tab. 7. Repaglinide: 1–8 mg/day in 3–4 doses; EUREPA, REGAN, RAPLIN 0.5, 1, 2 mg tab. 8. Nateglinide: 180–480 mg/day in 3–4 doses; GLINATE, NATELIDE 60, 120 mg tab. 9. Pioglitazone: 15–45 mg OD; PIONORM, PIOREST, PIOZONE 15, 30 mg tab. 10. Acarbose: 50–100 mg TDS taken just before each major meal; GLUCOBAY 50, 100 mg tabs, ASUCROSE, GLUCAR 50 mg tab. 11. Miglitol: 25-100 mg TDS at beginning of each meal; MIGTOR, DIAMIG, ELITOX 25, 50 mg tab. 12. Voglibose: 0.2-0.3 mg TDS just before meals; VOGLITOR, VOLIX, VOLIBO 0.2 and 0.3 mg tabs. 13. Sitagliptin: 100 mg OD-BD before meals; JANUVIA 100 mg tab. 14. Vildagliptin: 50–100 OD or BD before meals; GALVUS, JALRA, ZOMELIS 50 mg tab. 15. Saxagliptin: 5 mg OD; half dose in renal failure; ONGLYZA 2.5, 5 mg tabs. 44 Hormones and Related Drugs Corticosteroids/Topical Steroids 45 Preparations 1. Hydrocortisone: 20–30 mg/day oral for replacement therapy; 100 mg i.v. 8 hourly (as hemisuccinate); 100–200 mg i.m./intraarticular (as acetate), 2.0 g as retention enema; LYCORTIN-S, EFCORLIN SOLUBLE 100 mg/2 ml vial (as hemisuccinate for i.v. inj.) WYCORT, EFCORLIN 25 mg/ml vial (as acetate for i.m./intraarticualr inj.). PRIMACORT 100, 200, 400 mg/vial inj; ENTOFOAM 2 g in 20 g foam cream (10%) for retention enema. 2. Prednisolone: 5–60 mg/day oral, 10–40 mg i.m./intraarticular; DELTACORTRIL, HOSTACORTIN-H, 5, 10 mg tab, 20 mg/ml (as acetate) for i.m., intraarticular inj., WYSOLONE, NUCORT, 5, 10, 20, 40 mg tab. 3. Methyl prednisolone: 4–32 mg/day oral, 0.5–1.0 g slow i.v. injection for pulse therapy; SOLU-MEDROL methylprednisolone (as sod. succinate) 4 mg tab; 40 mg, 125 mg, 0.5 g (8 ml) and 1.0 g (16 ml) vial, for i.m. or slow i.v. inj., DEESOLONE 4 mg, 16 mg tab, 0.5 g, 1.0 g inj. 4. Triamcinolone: 4–32 mg/day oral, 5–40 mg i.m./intraarticular; KENACORT, TRICORT 1, 4, 8 mg tab., 10 mg/ml, 40 mg/ml (as acetonide) for i.m., intraarticular inj., LEDERCORT 4 mg tab., KENALOG-S EYE 0.1% with neomycin 0.25% and gramicidin 0.025% eye oint. 5. Dexamethasone: 0.5–5 mg/day oral, 4–20 mg i.v. or i.m.; DECADRON, DEXONA 0.5 mg tab, 4 mg/ml (as sod. phosphate) for i.v., i.m. inj, 0.5 mg/ml oral drops; WYMESONE, DECDAN 0.5 mg tab, 4 mg/ml inj, OCUDEX, MINIDEX, DEXONA 0.1% eye drops. 6. Betamethasone: 0.5–5 mg/day oral, 4–20 mg i.v./i.m. inj; BETNESOL, BETACORTRIL, CELESTONE 0.5 mg, 1 mg tab, 4 mg/ml (as sod. phosphate) for i.v., i.m. inj., 0.5 mg/ml oral drops. BETNELAN 0.5 mg, 1 mg tabs, BETNESOL EYE/EAR 0.1% drops and oint. 7. Deflazacort: Initially 60–120 mg/day, maintenance 6–18 mg/day, children 0.25–1.5 mg/kg on alternate days. DEFLAR, DEFZA, DFZ 1, 6, 30 mg tabs, DEFGLU 6, 30 mg tabs. 8. Desoxycorticosterone acetate (DOCA): 2–5 mg sublingual, 10–20 mg i.m. once or twice weekly; in DOCABOLIN 10 mg/ml inj. (along with nandrolone). 46 Hormones and Related Drugs 9. Fludrocortisone: Replacement therapy in Addison’s disease 50–200 µg daily. Congenital adrenal hyperplasia in patients with salt wasting 50–200 µg/day. Idiopathic postural hypotension 100–200 µg/day. FLORICORT 100 µg tab. Topical Steroids 1. Beclomethasone dipropionate 0.025% BECLATE cream 2. Betamethasone benzoate 0.025% TOPICASONE cream, oint. 3. Betamethasone valerate 0.12% BETNOVATE cream, oint., BETASONE cream 4. Halcinonide 0.1% CORTILATE, HALOG cream 5. Clobetasol propionate 0.05% LOBATE, TENOVATE, DERMOTYL cream 6. Dexamethasone sod. phosphate 0.1% DECADRON cream (with Neomycin 0.35%) 7. Dexamethasone trimethyl-acetate 0.1% MILLICORTENOL cream 8. Fluocinolone acetonide 0.025% FLUCORT oint., LUCI oint. 9. Fluocortolone 0.5% ULTRALAN oint. 10. Triamcinolone acetonide 0.1% LEDERCORT oint. 11. Fluocinolone acetonide 0.01% FLUCORT-H oint. and skin lotion 12. Clobetasol butyrate 0.05% EUMOSONE cream 13. Fluocortolone 0.25% COLSIPAN oint. 14. Mometasone 0.1% MOMATE, CUTIZONE oint, cream 15. Fluticasone propionate 0.05% FLUTIVATE, MOLIDERM cream 16. Hydrocortisone + (urea 12%) 1% COTARYL-H cream. 17. Hydrocortisone acetate 2.5% WYCORT oint. Androgens and Related Drugs 47 18. Hydrocortisone acetate 0.1–1.0% LYCORTIN 1% oint., in CORTOQUINOL 1% with quiniodochlor, 4% cream, GENTACYN-HC TOPICAL 1% with gentamicin 0.1%, CORTISON-KEMICETINE 0.5% with chloramphenicol 0.5%. 19. Hydrocortisone butyrate 0.001%LOCOID cream 48 Hormones and Related Drugs Preparations Androgens 1. Testosterone (free): 25 mg i.m. daily to twice weekly; AQUAVIRON 25 mg in 1 ml inj. 2. Testosterone propionate: 25–50 mg i.m. daily to twice weekly; TESTOVIRON, PARENDREN, TESTANON 25, 50 mg/ml inj. 3. TESTOVIRON DEPOT 100: testo. propionate 25 mg + testo. enanthate 100 mg in 1 ml amp; 1 ml i.m. weekly. 4. TESTOVIRON DEPOT 250: testo. propionate 250 mg + testo. enanthate 250 mg in 1 ml amp; 1 ml i.m. every 2–4 weeks. 5. SUSTANON ‘100’: testo. propionate 20 mg + testo. phenyl propionate 40 mg + testo. isocaproate 40 mg in 1 ml amp; 1 ml i.m. every 2–3 weeks. 6. SUSTANON ‘250’: testo. propionate 30 mg + testo. phenylpropionate 60 mg + testo. isocaproate 60 mg + testo. decanoate 100 mg in 1 ml amp; 1 ml i.m. every 3–4 weeks. 7. Testosterone undecanoate: NUVIR, ANDRIOL; 40 mg cap, 1–3 cap daily for male hypogonadism, osteo- porosis. 8. Mesterolone: 25 mg OD–TDS oral; PROVIRONUM, RESTORE, MESTILON 25 mg tab. 9. Dihydrotestosterone: 100–250 mg cutaneous application daily; ANDRACTIM 25 mg/g gel for application over nonscrotal skin once daily. Anabolic Steroids 10. Methandienone: 2–5 mg OD–BD oral; children 0.04 mg/kg/day, 25 mg i.m. weekly; ANABOLEX 2, 5 mg tab, 2 mg/ml drops, 25 mg/ml inj. 11. Nandrolone phenyl propionate: 10–50 mg; children 10 mg; i.m. once or twice weekly; DURABOLIN 10, 25 mg/ml inj. Androgens and Related Drugs 49 12. Nandrolone decanoate: 25–100 mg i.m. every 3 weeks, DECADURABOLIN 25, 100 mg/ml inj. 13. Oxymetholone: 5–10 mg, children 0.1 mg/kg, OD; ADROYD 5 mg tab. 14. Stanozolol: 2–6 mg/day; MENABOL, NEURABOL, TANZOL 2 mg tab. Impeded Androgen 15. Danazol: 200–600 mg/day; DANAZOL, LADOGAL, DANOGEN, GONABLOK 50, 100, 200 mg cap. Antiandrogens 16. Cyproterone acetate: 2 mg OD; GINETTE-35, DINAC-35 (cyproterone acetate 2 mg + ethinylestradiol 35 μg) tab. 17. Flutamide: 250 mg TDS; PROSTAMID, FLUTIDE, CYTOMID 250 mg tab. 18. Bicalutamide: 50 mg OD; BIPROSTA, CALUTIDE, TABI 50 mg tab. 5α-Reductase Inhibitor 19. Finasteride: For benign hypertrophy of prostate (BHP) 5 mg OD, review after 6 months; for male pattern bald- ness 1 mg/day. FINCAR, FINARA, FINAST 5 mg tab, FINPECIA, ASTIFINE 1 mg tab. 20. Dutasteride: For BHP 0.5 mg/day. DUPROST, DURIZE 0.5 mg tab. Drugs for Erectile Dysfunction 1. Sildenafil: 50 mg (max. 100 mg) 1 hour before intercourse; elderly 25 mg; PENEGRA, CAVERTA, EDEGRA 25, 50, 100 mg tabs. 2. Tadalafil: 10 mg (max. 20 mg) at least ½ hr before intercourse. MEGALIS, TADARICH, TADALIS 10, 20 mg tab, MANFORCE 10 mg tab. 50 Hormones and Related Drugs Estrogens and Related Drugs 51 Preparations Estrogens 1. Estradiol benzoate/cypionate/enanthate/valarate: 2.5–10 mg i.m.; OVOCYCLIN-P 5 mg inj, PROGYNON DEPOT 10 mg/ml inj. 2. Conjugated estrogens: 0.625–1.25 mg/day oral for hormone replacement therapy; PREMARIN 0.625 mg, 1.25 mg tab, 25 mg inj (for dysfunctional uterine bleeding). 3. Ethinylestradiol: for menopausal syndrome 0.02–0.2 mg/day oral; LYNORAL 0.01, 0.05, 1.0 mg tab, PROGYNON-C 0.02 mg tab. 4. Mestranol: 0.1–0.2 mg/day oral; in OVULEN 0.1 mg tab, with ethynodiol diacetate 1 mg. 5. Estriol succinate: 4–8 mg/day initially, maintenance dose in menopause 1–2 mg/day oral; EVALON 1, 2 mg tab, 1 mg/g cream for vaginal application in atrophic vaginitis 1–3 times daily. 6. Fosfestrol tetrasodium: initially 600–1200 mg slow i.v. inj for 5 days, maintenance dose 120–240 mg/day oral or 300 mg 1–3 times a week i.v.; HONVAN 120 mg tab, 60 mg/ml inj 5 ml amp. 7. Dienestrol: 0.01% topical; DIENESTROL 0.01% vaginal cream. 8. Estradiol transdermal: ESTRADERM-MX: Estradiol 25, 50 or 100 µg per 24 hr transdermal patches; apply to nonhairy skin below waist, replace every 3–4 days using a different site; add an oral progestin for last 10–12 days every month. 9. Estradiol dermal gel: 1–2.5 mg/day; OESTRAGEL, E2GEL 3 mg/5 g gel in 80 g tube, SANDRENA 1 mg/g gel; apply 1.5–4 g gel over arms & shoulder daily. 10. Tibolone: 2.5 mg/day without interruption in postmenopausal women; LIVIAL, TIBOFEM 2.5 mg tab. 52 Hormones and Related Drugs Antiestrogen Clomiphene citrate: for infertility in women—50 mg/day for 5 days starting from 5th day of cycle, increase to 100 mg/day after 2–3 unsuccessful cycles (max. 200 mg/day); for oligozoospermia in men—25 mg daily for 24 days in a month upto 6 months; CLOMID, FERTOMID, CLOFERT, CLOME 25, 50, 100 mg tabs. Selective Estrogen Receptor Down Regulator/Pure Estrogen Antagonist Fulvestrant: 250 mg i.m. (in gluteal region) monthly. Selective Estrogen Receptor Modulators (SERMs) 1. Tamoxifen citrate: 20 mg/day in 1–2 doses (max. 40 mg/day). TAMOXIFEN, MAMOFEN, TAMODEX 10, 20 mg tabs. 2. Toremifene: 60 mg OD. 3. Raloxifene: 60 mg/day; OSRAL, BONMAX, RALOTAB, ESSERM 60 mg tab. Aromatase Inhibitors 1. Letrozole: 2.5 mg/day oral; FEMARA, ONCOLET, LETOVAL, LETROZ 2.5 mg tab. 2. Anastrozole: 1 mg/day oral; ARMOTRAZ, ALTRAZ, ANABREZ 1 mg tab. 3. Exemestane: 25 mg/day oral. Progestins 53 54 Hormones and Related Drugs Preparations 1. Progesterone: 10–100 mg i.m. (as oily solution) OD; PROGEST, PROLUTON, GESTONE 50 mg/ml inj., 1 and 2 ml amp; 100–400 mg OD oral: NATUROGEST, OGEST, DUBAGEST 100, 200, 400 mg caps containing micro- nized oily suspension. 2. Hydroxyprogesterone caproate: 250–500 mg i.m. at 2–14 days intervals; PROLUTON DEPOT, MAINTANE INJ, PROCAPRIN 250 mg/ml in 1 and 2 ml amp. 3. Medroxyprogesterone acetate: 5–20 mg OD–BD oral, 50–150 mg i.m. at 1–3 month interval; FARLUTAL 2.5, 5, 10 mg tab., PROVERA, MEPRATE, MODUS 10 mg tab, DEPOT-PROVERA 150 mg in 1 ml inj. (as contraceptive). 4. Dydrogesterone: 5–10 mg OD/TDS oral; DUPHASTON 5 mg tab. 5. Norethindrone (Norethisterone): 5–10 mg OD–BD oral; PRIMOLUT-N, STYPTIN, REGESTRONE, NORGEST 5 mg tab; REGESTRONE HRT, NORETA HRT 1 mg tab (for HRT); NORISTERAT 200 mg/ml inj (as enanthate) for contraception 1 ml i.m every 2 months. 6. Lynestrenol (Ethinylestrenol): 5–10 mg OD oral; ORGAMETRIL 5 mg tab. 7. Allylestrenol: 10–40 mg/day; GESTANIN, FETUGARD, MAINTANE 5 mg tab, PROFAR 25 mg tab. 8. Levonorgestrel: 0.1–0.5 mg/day; DUOLUTON-L, OVRAL 0.25 mg + ethinylestradiol 0.05 mg tab. 9. Desogestrel: 150 µg + ethinylestradiol 30 µg (NOVELON) tab, 1 tab OD, 3 weeks on and 1 week off cyclic therapy. Antiprogestin Mifepristone: 200–600 mg single oral dose; MIFEGEST, MIFEPRIN 200 mg tab. Hormonal Contraceptives 55 56 Hormones and Related Drugs Combined Pills 1. Norgestrel 0.5 mg + Ethinylestradiol 50 µg; OVRAL-G, 20 tabs. 2. Levonorgestrel 0.25 mg + Ethinylestradiol 50 µg; OVRAL, DUOLUTON-L, 21 tabs. 3. Levonorgestrel 0.15 mg + Ethinylestradiol 30 µg; OVRAL-L, OVIPAUZ, 21 tabs. 4. Levonorgestrel 0.1 mg + Ethinylestradiol 20 µg; LOETTE, OVILOW, COMBEE 21 tabs. 5. Desogestrel 0.15 mg + Ethinylestradiol 30 µg; NOVELON. 6. Desogestrel 0.15 mg + Ethinylestradiol 20 µg; FEMILON. Phased Pills 1. Levonorgestrel 50–75–125 µg + Ethinylestradiol 30–40–30 µg; TRIQUILAR (6 + 5 + 10 tablets) 2. Norethindrone 0.5–0.75–1.0 mg + Ethinylestradiol 35–35–35 µg; ORTHONOVUM 7/7/7 tabs. Postcoital Pills 1. Levonorgestrel 0.25 mg + Ethinylestradiol 50 µg; OVRAL, DUOLUTON-L (2 + 2 tabs) 2. Levonorgestrel 0.75 mg; NORLEVO, ECEE2 (1 + 1 tab) 3. Levonorgestrel 1.5 mg iPILL, NOFEAR-72 (1 tab). 4. Mifepristone 600 mg; MIFEGEST, MIFEPRIN 200 mg (3 tabs) 5. Ulipristal (selective progesterone receptor modulator) 30 mg single dose as soon as possible, before 120 hours of intercourse. Mini Pills 1. Norethindrone 0.35 mg 2. Norgestrel 75 µg Hormonal Contraceptives 57 Anti implantation SERM Centchroman (Ormeloxifene): 30 mg twice weekly for 12 weeks and then 30 mg weekly; CENTRON, SAHELI 30 mg tab. Injectable Contraceptives 1. Depot medroxyprogesterone acetate (DMPA): 150 mg i.m. at 3 month intervals. DEPOT-PROVERA 150 mg in 1 ml vial for deep i.m. injection during first 5 days of menstrual cycle. Repeat every 3 months. 2. Norethindrone (Norethisterone) enanthate (NEE): 200 mg i.m. at 2 month intervals. NORISTERAT 200 mg in 1 ml vial for deep i.m. injection during first 5 days of menstrual cycle. Repeat every 2 months. 58 Hormones and Related Drugs Uterine Stimulants 59 Preparations Uterine Stimulants 1. Oxytocin: for induction/augmentation of labour 2–10 milli IU/min i.v. infusion (total 2–4 IU); for postpartum haemorrhage 5 IU i.m. or i.v. infusion; OXYTOCIN, SYNTOCINON 2 IU/2 ml and 5 IU/ml inj., PITOCIN 5 IU/0.5 ml inj. 2. Desamino-oxytocin: for induction 50 IU buccal every 30 min, for uterine inertia 25 IU buccal every 30 min; for breast engorgement 25–50 IU just before breast feeding; BUCTOCIN 50 IU buccal tab. 3. Ergometrine: 0.2–0.5 mg i.m./i.v., 0.25–0.5 mg TDS oral; ERGOMETRINE 0.25, 0.5 mg tab, 0.5 mg/ml inj. 4. Methylergometrine: 0.2–0.5 mg i.m./i.v., 0.125–0.25 mg TDS oral; METHERGIN, METHERONE, ERGOMET 0.125 mg tab, 0.2 mg/ml inj. 5. Ethacridine: 150 mg extra-amniotic infusion; EMCREDIL, VECREDIL 50 mg/50 ml inj. Note: For preparations of prostaglandins and uterine relaxants, see Index 5 Drugs Acting on Peripheral (somatic) Nervous System Skeletal Muscle Relaxants 61 Preparations (Note: Doses of neuromuscular blocking agents given below are initial paralysing doses for nitrous oxide-oxygen/opioid anaesthesia. These doses are to be reduced to 1/3–1/2 in patients anaesthetised with ether/halothane/isoflurane etc.) 1. Pancuronium: 0.04–0.1 mg/kg i.v.; PAVULON, PANURON, NEOCURON 2 mg/ml in 2 ml amp. 2. Doxacurium: 0.03–0.08 mg/kg i.v. 3. Pipecuronium: 0.05–0.08 mg/kg i.v.; ARDUAN 4 mg/2 ml inj. 4. Vecuronium: 0.08–0.1 mg/kg i.v.; NORCURON, NEOVEC 4 mg amp. and 10 mg vial; dissolve in 1–2.5 ml solvent supplied. 5. Atracurium: 0.3–0.6 mg/kg i.v.; TACRIUM 10 mg/ml in 2 ml vial. 6. Cisatracurium: 0.15–0.2 mg/kg i.v. 7. Rocuronium: 0.6–0.9 mg/kg i.v.; CUROMID, ROCUNIUM 50 mg/5 ml, 100 mg/10 ml vials. 8. Mivacurium: 0.07–0.15 mg/kg i.v. 9. Succinylcholine (Suxamethonium): 0.5–0.8 mg/kg i.v.; MIDARINE, SCOLINE, MYORELEX, ENTUBATE 50 mg/ml in 2 ml amp. 10. Dantrolene: 25–100 mg QID oral, 1 mg/kg i.v. repeated as required. 11. Carisoprodol: 350 mg TDS–QID oral; CARISOMA 350 mg tab; SOMAFLAM 175 mg + ibuprofen 400 mg tab. 12. Chlorzoxazone: 500 mg BD–TDS; ULTRAZOX 250 mg + diclofenac 50 mg + paracetamol 325 mg tab; MOBIZOX 500 mg + diclofenac 50 mg + paracetamol 500 mg tab; PARAFON 250 mg + paracetamol 300 mg tab; FLEXON- MR 250 mg + ibuprofen 400 mg + paracetamol 325 mg tab. 13. Chlormezanone: 100–200 mg TDS–QID; DOLOBAK 100 mg + paracetamol 450 mg tab. 14. Methocarbamol: 400–800 mg TDS oral, 100–200 mg i.m./i.v.; ROBINAX 0.5 g tab, 1 TDS: 100 mg/ml inj. for i.v. or i.m. use. ROBIFLAM 750 mg + ibuprofen 200 mg tab; NEUROMOL-MR 400 mg + paracetamol 500 mg tab. 62 Drugs Acting on Peripheral (somatic) Nervous System 15. Baclofen: 10 mg BD–25 mg TDS oral; LIORESAL, LIOFEN 10, 25 mg tabs. 16. Thiocolchicoside: 4 mg TDS-QID; NUCOXIA-MR: thiocolchicoside 4 mg + etoricoxib 60 mg tabs. 17. Tizanidine: 2 mg TDS; max 24 mg/day; SIRDALUD 2, 4, 6 mg tab; TIZAN 2, 4 mg tab; BRUFEN-MR, TIZAFEN 2 mg + ibuprofen 400 mg tab; TIZANAC 2 mg + diclofenac 50 mg tab., PROXYVON-MR 2 mg + nimesulide 100 mg cap. Local Anaesthetics 63 Preparations 1. Lidocaine (lignocaine): 0.5–2% for nerve block, 1–5% topically; XYLOCAINE, GESICAIN 4% topical solution, 2% jelly, 2% viscous, 5% ointment, 1% and 2% injection (with or without adrenaline), 5% heavy (for spinal anaesthesia); 100 mg/ml spray (10 mg per puff) 2. Bupivacaine: 0.25–0.5% for nerve block, 0.5–0.75% for spinal anaesthesia; MARCAIN 0.5%, 1% (hyperbaric for spinal anaesthesia). SENSORCAINE 0.25%, 0.5% inj, 0.5% heavy inj. 3. Tetracaine (Amethocaine): 0.25% for nerve block, 0.25–0.5% for spinal anaesthesia, 1% topically; ANETHANE powder for preparing solution, 1% oint. 4. Eutectic Lidocaine-prilocaine: 5% for cutaneous anaesthesia; PRILOX 5% cream 5. Dibucaine: 0.25–0.5% for nerve block and spinal anaesthesia, 1% for surface anaesthesia; NUPERCAINE 0.5% inj, NUPERCAINAL 1% oint, in OTOGESIC 1% ear drops. 6. Benzocaine: 5–20% topically; in PROCTOQUINOL 5% oint., ZOKEN 20% gel. 7. Butylaminobenzoate: 1–5% topically; in PROCTOSEDYL-M 1% oint with framycetin and hydrocortisone for anal application. 8. Benoxinate: 0.4% for corneal anaesthesia; BENDZON 0.4% eye drops. 9. Oxethazaine: 0.2% for gastric mucosal anaesthesia; MUCAINE 0.2% in alumina gel + magnesium hydroxide suspension; 5–10 ml orally. TRICAINE-MPS: Oxethazaine 10 mg with methyl polysiloxane 125 mg, alum. hydroxide gel 300 mg, mag. hydroxide 150 mg per 5 ml gel. 6 Drugs Acting on Central Nervous System General Anaesthetics 65 Preparations 1. Thiopentone sod.: 3–5 mg/kg i.v. for induction; PENTOTHAL, INTRAVAL SODIUM 0.5, 1.0 g for preparing injectable solution freshly. 2. Propofol: 2 mg/kg bolus i.v. injection for induction, 9 mg/kg/hr for maintenance; PROPOVAN 10 mg/ml and 20 mg/ml in 10, 20 ml vials. 3. Diazepam: 0.25–0.5 mg/kg by slow injection in a running i.v. drip; VALIUM, CALMPOSE 10 mg/2 ml inj. 4. Lorazepam: 0.04 mg/kg (2–4 mg total for adult) i.v.; CALMESE 4 mg/2 ml inj. 5. Midazolam: 1–2.5 mg i.v. bolus injection, 0.02–0.1 mg/kg/hour i.v. infusion for maintenance; MEZOLAM, FULSED, SHORTAL 1 mg/ml and 5 mg/ml inj. 6. Ketamine: 1–3 mg/kg i.v., 5 mg/kg i.m.; KETMIN, KETAMAX, ANEKET 50 mg/ml in 2 ml amp, 10 ml vial. 7. Fentanyl: 2–4 µg/kg i.v.; TROFENTYL, FENT, FENDOP 50 µg/ml in 2 ml amp, 10 ml vial. 66 Drugs Acting on Central Nervous System Preanaesthetic Medication Drugs Note: See Index for preparations Sedative-Hypnotic Drugs 67 68 Drugs Acting on Central Nervous System Preparations 1. Phenobarbitone: 30–60 mg OD–TDS (as antiepileptic) 100–200 mg i.m./i.v.; GARDENAL 30, 60 mg tab; LUMINAL 30 mg tab; PHENOBARBITONE SOD 200 mg/ml inj. 2. Diazepam: 2.5–10 mg (as hypnotic), 5–30 mg/day (as antianxiety); VALIUM 2, 5, 10 mg tab., 10 mg/2 ml inj., CALMPOSE 5, 10 mg tab, 2 mg/5 ml syr, 10 mg/2 ml inj. 3. Flurazepam: 15–30 mg (as hypnotic); NINDRAL, FLURAZ 15 mg cap. 4. Nitrazepam: 5–10 mg (as hypnotic); SEDAMON, HYPNOTEX, NITRAVET 5, 10 mg tab/cap. 5. Alprazolam: 0.25–1.0 mg (hypnotic dose), 0.25–1.0 mg TDS for anxiety; ALPRAX 0.25, 0.5, 1.0 mg tabs., 0.5, 1.0, 1.5 mg SR tabs; ALZOLAM 0.25, 0.5, 1.0 mg tabs; 1.5 mg SR tab, RESTYL 0.25, 0.5, 1.0 mg tab, RESTYL-SR 0.5, 1.0, 1.5 mg SR tab, ALPROCONTIN 0.5, 1.0, 1.5 mg CR tabs. 6. Temazepam: 10–20 mg (as hypnotic). 7. Triazolam: 0.125–0.25 mg (as hypnotic). 8. Zopiclone: 7.5 mg (hypnotic dose), elderly 3.75 mg; ZOPICON, ZOLIUM, ZOPITRAN 7.5 mg tab. 9. Zolpidem: 5–10 mg (max 20 mg) as hypnotic; elderly and liver disease patients 2.5–10 mg; NITREST, ZOLDEM, DEM 5, 10 mg tabs. 10. Zaleplon: 5–10 mg (max 20 mg) hypnotic dose; ZAPLON, ZASO, ZALEP 5, 10 mg tabs. Note: See Index for preparations of other drugs. Antiepileptic Drugs 69 70 Drugs Acting on Central Nervous System Preparations 1. Phenobarbitone: 60 mg OD–TDS (child 3–6 mg/kg/day), 100–200 mg i.m./i.v.; GARDENAL 30, 60 mg tab; LUMINAL 30 mg tab; PHENOBARBITONE SOD 200 mg/ml inj. 2. Primidone: 250–500 mg BD (child 10–20 mg/kg/day); MYSOLINE 250 mg tab. 3. Phenytoin: 100–200 mg BD (child 5–8 mg/kg/day) oral, 25 mg/min slow i.v. injection (max 1.0 g); DILANTIN 25 mg, 100 mg cap., 100 mg/4 ml oral suspension, 100 mg/2 ml inj.; EPTOIN 50, 100 mg tab, 25 mg/ ml syr; FENTOIN-ER 100 mg extended release cap. 4. Fosphenytoin: 25-100 mg (as phenytoin sod. equivalent)/min i.v. injection (max 1.0 g) for generalized convul- sive status epilepticus; FOSOLIN 50 mg/ml inj in 2 ml and 10 ml amp. 5. Carbamazepine: 200–400 mg TDS, children 15–30 mg/kg/day; TEGRETOL, MAZETOL 100, 200, 400 mg tab, 100 mg/5 ml syr; CARBATOL 100, 200, 400 mg tab; MAZETOL-SR, TEGRITAL-CR 200, 400 mg sustained release tabs. 6. Oxcarbazepine: 300–600 mg BD; OXCARB, OXEP, OXETOL 150, 300, 600 mg tabs. 7. Ethosuximide: 20–30 mg/kg/day; ZARONTIN 250 mg/5 ml syr. 8. Valproic acid (Sodium valproate): Adults—start with 200 mg TDS, maximum 800 mg TDS; children—15–30 mg/kg/day; VALPARIN CHRONO 200, 300, 500 mg tabs, 200 mg/5 ml syr, ENCORATE 200, 300, 500 mg regular tabs and controlled release tabs, 200 mg/5 ml syr, 100 mg/ml inj. 9. Divalproex: Epilepsy—initially 15 mg/kg/day, increase gradually as required (max 60 mg/kg/day); Bipolar disorder—250–500 mg TDS; Migraine 250–500 mg BD; DIPROEX, VALANCE, DEPAKOTE 125, 250, 500 mg tabs. 10. Clonazepam: Adults 0.5–5 mg TDS, children 0.02–0.2 mg/kg/day; status epilepticus 1–2 mg slow i.v. inj; LONAZEP, CLONAPAX, RIVOTRIL 0.5, 1.0, 2.0 mg tab. Antiepileptic Drugs 71 11. Diazepam: for status epilepticus—10 mg (0.2–0.3 mg/kg) slow i.v. injection (2 mg/min), repeat fractional doses as required (max 100 mg/day); for febrile convulsions 0.5 mg/kg rectal instillation, repeat 12 hourly for 48 hours; VALIUM, CALMPOSE, PLACIDOX 10 mg/2 ml inj. 12. Lorazepam: for status epilepticus—4 mg (0.1 mg/kg in children) slow i.v. injection (2 mg/min); CALMESE 4 mg/2 ml inj. 13. Clobazam: start with 10–20 mg at bed time, can be increased upto 60 mg/day; FRISIUM, LOBAZAM, CLOZAM 5, 10, 20 mg cap. 14. Lamotrigine: 50 mg/day initially, increase upto 300 mg/day as needed. LAMITOR, LAMETEC, LAMIDUS 25, 50, 100 mg tabs. 15. Gabapentin: start with 300 mg OD, increase to 300–600 mg TDS as required; NEURONTIN, GABANTIN 300 mg, 400 mg cap, GABAPIN 100, 300, 400 mg cap. 16. Pregabalin: 75–150 mg BD, max. 600/day (used primarily for neuropathic pain). PREEGA, NEUGABA, TRUGABA 75, 150 mg caps. 17. Vigabatrin: 2–4 g/day, child 40–100 mg/kg/day. 18. Topiramate: Initially 25 mg OD, increase weekly upto 100–200 mg BD as required, child 5–10 mg/kg/day. TOPEX, EPITOP, TOPAMATE, NEXTOP 25, 50, 100 mg tabs. 19. Zonisamide: 25–100 mg BD (not for children); ZONISEP, ZONICARE, ZONIT 50, 100 mg cap. 20. Levetiracetam: 0.5 g BD, increase upto 1.0 g BD; children 4–15 years 10–30 mg/kg/day. EPIFAST, TORLEVA, LEVROXA, LEVTAM 250, 500, 750 mg tabs. 72 Drugs Acting on Central Nervous System Antiparkinsonian Drugs 73 Preparations 1. Levodopa: Start with 0.25 g BD after meals, gradually increase till adequate response is obtained. Usual dose is 2–3 g/day. LEVOPA, BIDOPAL 0.5 g tab. 2. Carbidopa/Benserazide + Levodopa combination: Usual daily maintenance dose of levodopa is 0.4–0.8 g along with 75–100 mg carbidopa or 100–200 mg benserazide, given in 3–4 divided doses. Therapy is started at a low dose and suitable preparations are chosen according to the needs of individual patients, increas- ing the dose as required. Carbidopa Levodopa (per tab/cap) TIDOMET-LS, SYNDOPA-110, 10 mg + 100 mg SINEMET, DUODOPA-110 10 mg + 100 mg TIDOMET PLUS, SYNDOPA PLUS 25 mg + 100 mg TIDOMET FORTE, SYNDOPA-275 25 mg + 250 mg BENSPAR, MADOPAR: Benserazide 25 mg + levodopa 100 mg cap. 3. Bromocriptine: Start with 1.25 mg once at night, increase gradually as needed upto 5–10 mg TDS, as supple- ment to carbidopa-levodopa combination. PROCTINAL, PARLODEL, SICRIPTIN 1.25 mg, 2.5 mg tabs, ENCRIPT 2.5, 5 mg tabs. 4. Ropinirole: Starting dose is 0.25 mg TDS, titrated to a maximum of 4–8 mg TDS. Early cases generally require 1–2 mg TDS. ROPITOR, ROPARK, ROPEWAY 0.25, 0.5, 1.0, 2.0 mg tabs; also 1, 2, 4 and 8 mg ER tabs. 74 Drugs Acting on Central Nervous System 5. Pramipexole: Starting dose 0.125 mg TDS, titrate to 0.5–1.5 mg TDS; PRAMIPEX 0.5 mg tab., PARPEX 0.5, 1.0, 1.5 mg tabs, PRAMIROL 0.125, 0.25, 0.5, 1.0, 1.5 mg tabs. 6. Selegiline: 5 mg with breakfast and with lunch, either alone (in early cases) or with levodopa. Reduce by 1/4th levodopa dose after 2–3 days of adding selegiline. ELDEPRYL 5, 10 mg tab, SELERIN, SELGIN 5 mg tab. 7. Rasagiline: 1 mg OD in the morning; RELGIN, RASALECT 0.5, 1.0 mg tabs; RASIPAR 1.0 mg tab. 8. Entacapone: 200 mg with each dose of levodopa-carbidopa (max 1600 mg/day); ADCAPON 100 mg tab, COMTAN 200 mg tab. 9. Amantidine: 100 mg BD. AMANTREL, COMANTREL 200 mg tab. 10. Trihexyphenidyl (benzhexol): 2–10 mg/day. PACITANE, PARBENZ 2 mg tab. 11. Procyclidine: 5–20 mg/day; KEMADRIN 2.5, 5 mg tab. 12. Biperiden: 2–10 mg/day oral, i.m. or i.v.: DYSKINON 2 mg tab., 5 mg/ml inj. 13. Orphenadrine: 100–300 mg/day; DISIPAL, ORPHIPAL 50 mg tab. 14. Promethazine: 25–75 mg/day; PHENERGAN 10, 25 mg tab. Antipsychotic Drugs 75 76 Drugs Acting on Central Nervous System Preparations 1. Chlorpromazine: 100–800 mg/day; CHLORPROMAZINE, LARGACTIL 10, 25, 50, 100 mg tab. 5 mg/5 ml (pediatric) & 25 mg/5 ml (adult) syr., 50 mg/2 ml inj. 2. Triflupromazine: 50–200 mg/day; SIQUIL 10 mg tab; 10 mg/ml inj. 3. Thioridazine: 100–400 mg/day; MELLERIL 25, 100 mg tab, THIORIL 10, 25, 50 mg tab. 4. Trifluoperazine: 2–20 mg/day; TRINICALM 1, 5 mg tab, NEOCALM 5, 10 mg tab. 5. Fluphenazine: 1–10 mg/day; ANATENSOL 1 mg tab, 0.5 mg/ml elixir; ANATENSOL DECANOATE 25 mg/ml (as decanoate) for i.m. injection, 1–2 ml every 2–4 weeks. 6. Haloperidol: 2–20 mg/day; SERENACE 1.5, 5, 10, 20 mg tab; 2 mg/ml liq, 5 mg/ml inj., SENORM 1.5, 5, 10 mg tab, 5 mg/ml inj., HALOPIDOL 2, 20 mg tab, 2 mg/ml liq, 10 mg/ml drops. 7. Trifluperidol: 1–8 mg/day; TRIPERIDOL 0.5 mg tab, 2.5 mg/ml inj. 8. Penfluridol: 20–60 mg (max. 120 mg) once weekly; SEMAP, FLUMAP, PENFLUR 20 mg tab. 9. Flupenthixol: 3–15 mg/day; FLUANXOL 0.5, 1, 3 mg tab; FLUANXOL DEPOT 20 mg/ml in 1 and 2 ml amp. 10. Pimozide: 2–6 mg/day; ORAP, NEURAP, PIMODAC 2, 4 mg tab. 11. Loxapine: 20–50 mg/day; LOXAPAC 10, 25, 50 mg caps, 25 mg/ 5 ml liquid. 12. Clozapine: 100–300 mg/day; LOZAPIN, SIZOPIN, SKIZORIL 25, 100 mg tabs. 13. Risperidone: 2–8 mg/day; RESPIDON, SIZODON, RISPERDAL 1, 2, 3, 4 mg tabs. 14. Olanzapine: 2.5–20 mg/day; OLACE, OLANDUS 2.5, 5, 7.5, 10 mg tabs, OLZAP 5, 10 mg tab. 15. Quetiapine: 50–400 mg/day; QUEL, SOCALM, SEROQUIN 25, 100, 200 mg tabs. 16. Aripiprazole: 10–30 mg/day; ARIPRA, ARILAN, BILIEF 10, 15 mg tabs, ARIVE 10, 15, 20, 30 mg tabs. Drugs for Mania and Bipolar Disorder 77 78 Drugs Acting on Central Nervous System 17. Ziprasidone: 80–160 mg/day; AZONA, ZIPSYDON 20, 40, 80 mg tabs. 18. Amisulpiride: 50–300 mg/day in 2 doses; SULPITAC, AMIPRIDE, ZONAPRIDE 50, 100, 200 mg tabs. 19. Zotepine: 25 mg TDS initially, increase upto 100 mg TDS; ZOLEPTIL, NIPOLEPT 25, 50 mg tabs. Drugs for Mania and Bipolar Disorder 1. Lithium carbonate: Start at 600 mg/day, adjust dose to yield steady-state plasma level of 0.5–0.8 mEq/L (for bipolar disorder) or 0.8–1.1 mEq/L (for acute mania); LICAB, LITHOSUN 300 mg tab, 400 mg SR tab. Note: See Index for preparations of other drugs. Antidepressants 79 80 Drugs Acting on Central Nervous System Preparations 1. Moclobemide: 150 mg BD–TDS (max. 600 mg/day); RIMAREX, TRIMA 150, 300 mg tabs. 2. Imipramine: 50–200 mg/day; DEPSONIL, ANTIDEP 25 mg tab, 75 mg SR cap. 3. Amitriptyline: 50–200 mg/day; AMLINE, SAROTENA, TRYPTOMER, 10, 25, 75 mg tabs. 4. Trimipramine: 50–150 mg/day; SURMONTIL 10, 25 mg tab. 5. Doxepin: 50–150 mg/day; SPECTRA, DOXIN, DOXETAR 10, 25, 75 mg tab/cap; NOCTADERM 5% cream (to relieve itching). 6. Clomipramine: 50–150 mg/day; CLOFRANIL 10, 25, 50 mg tab, 75 mg SR tab, CLONIL, ANAFRANIL 10, 25 mg tab; 7. Dothiepin (Dosulpin): 50–150 mg/day; PROTHIADEN, DOTHIN 25, 75 mg tab. 8. Nortriptyline: 50–150 mg/day; SENSIVAL, PRIMOX 25 mg tab. 9. Amoxapine: 100–300 mg/day; DEMOLOX 50, 100 mg tab. 10. Reboxetine: 4–8 mg/day; NAREBOX 4, 8 mg tabs. 11. Fluoxetine: 20–40 mg/day; FLUDAC 20 mg cap, 20 mg/5 ml susp; FLUNIL 10, 20 mg caps; FLUPAR, PRODAC 20 mg cap. 12. Fluvoxamine: 50–200 mg/day; FLUVOXIN 50, 100 mg tab. 13. Paroxetine: 20–50 mg/day; XET 10, 20, 30, 40 mg tabs. 14. Sertraline: 50–150 mg/day; SERENATA, SERLIN, SERTIL 50, 100 mg tabs. 15. Citalopram: 20–40 mg/day; CELICA 10, 20, 40 mg tabs. 16. Escitalopram: 10–20 mg OD; ESDEP, FELIZ-S 5, 10, 20 mg tabs. 17. Dapoxetine: 60 mg 1 hour before intercourse, elderly 30 mg; SUSTINEX, DURALAST, KUTUB 30, 60 mg tabs. Antianxiety Drugs 81 18. Trazodone: 50–200 mg/day; TRAZODAC 25, 50 mg tab, TRAZONIL, TRAZALON 25, 50, 100 mg tabs. 19. Mianserin: 30–100 mg/day; TETRADEP 10, 20, 30 mg tab, SERIDAC 10, 30 mg tab. 20. Bupropion: 150–300 mg/day; SMOQUIT–SR, BUPRON–SR 150 mg tab. 21. Mirtazapine: 15–45 mg/day; MIRT 15, 30, 45 mg tabs, MIRTAZ 15, 30 mg tab. 22. Venlafaxine: 75–150 mg/day; VENLOR 25, 37.5, 75 mg tabs, VENIZ-XR 37.5, 75, 150 mg ER caps. 23. Tianeptine: 12.5 mg BD–TDS; STABLON 12.5 mg tab. 24. Amineptine: 100 mg BD at breakfast and lunch; SURVECTOR 100 mg tab. 25. Duloxetine: 30–80 mg/day; DELOK, DULANE, DUZAC 20, 30, 40 mg caps. 82 Drugs Acting on Central Nervous System Preparations 1. Diazepam: 5–30 mg/day in 2–3 divided doses; VALIUM, PLACIDOX 2, 5, 10 mg tabs; CALMPOSE 5, 10 mg tab, 2 mg/5 ml syr. 2. Chlordiazepoxide: 20–100 mg/day in 2–3 divided doses, LIBRIUM 10, 25 mg tabs; EQUILIBRIUM 10 mg tab. 3. Oxazepam: 30–60 mg/day in 2–3 divided doses; SEREPAX 15, 30 mg tabs. 4. Lorazepam: 1–6 mg/day in 1–2 divided doses; LARPOSE, ATIVAN 1, 2 mg tab. CALMESE 1, 2 mg tabs, 4 mg/2 ml inj. 5. Alprazolam: 0.25–1.0 mg TDS; upto 6 mg/day in panic disorder; ALPRAX 0.25, 0.5, 1.0 mg tabs., 0.5, 1.0, 1.5 mg SR tabs; ALZOLAM 0.25, 0.5, 1.0 mg tabs; 1.5 mg SR tab, ALPROCONTIN 0.5, 1.0, 1.5 mg CR tabs. RESTYL-SR 0.5, 1.0, 1.5 mg SR tabs. 6. Buspirone: 5–15 mg 1–3 times daily; BUSCALM, ANXIPAR, BUSPIN 5, 10 mg tabs. 7. Hydroxyzine: 50–200 mg/day; ATARAX 10, 25 mg tabs, 10 mg/5 ml syr, 25 mg/2 ml inj. Opioid Analgesics and Antagonists 83 Preparations Opioid Analgesics 1. Morphine: 10–50 mg oral, 10–15 mg i.m. or s.c., 2–6 mg i.v.; 2–3 mg epidural/intrathecal; children 0.1–0.2 mg/ kg i.m. or s.c. MORPHINE SULPHATE 10 mg/ml inj; MORCONTIN 10, 30, 60, 100 mg continuous release tabs; 30–100 mg BD; RILIMORF 10, 20 mg tabs, 60 mg SR tab. 84 Drugs Acting on Central Nervous System 2. Codeine: 30–60 mg oral; CODEINE 15 mg tab, 15 mg/5 ml syr. 3. Pethidine: 50–100 mg oral/i.m./s.c., 10–15 mg i.v. (rarely); PETHIDINE 50, 100 mg tabs, 100 mg/2 ml inj. 4. Fentanyl: 2–4 µg/kg i.v.; 12.5–100 µg/hr transdermal; TROFENTYL, FENT 50 µg/ml in 2 ml amp and 10 ml vial, DUROGESIC transdermal patch delivering 12.5 µg/hr, 25 µg/hr, 50 µg/hr, 75 µg/hr and 100 µg per hour; the patch is changed every 3 days. 5. Methadone: As analgesic 2.5–10 mg oral/i.m. (not s.c.); for methadone maintenance therapy 5-40 mg per day; METHADONE 5 mg/ml and 10 mg/ml syr; 5, 10, 20, 40 mg tabs. 6. Dextropropoxyphene: 60–120 mg oral; PARVODEX 60 mg cap; PARVON, PROXYVON, WALAGESIC: dextropropoxyphene 65 mg + paracetamol 400 mg cap; WYGESIC, SUDHINOL 65 mg + paracetamol 650 mg cap. 7. Tramadol: 50–100 mg oral/i.m./slow i.v. infusion (children 1–2 mg/kg) 4–6 hourly. CONTRAMAL, DOMADOL, TRAMAZAC 50 mg cap, 100 mg SR tab; 50 mg/ml inj in 1 and 2 ml amps. Opioid Agonist-Antagonists and Pure Antagonists 1. Pentazocine: 50–100 mg, oral, 30–60 mg i.m., s.c., FORTWIN 25 mg tab., 30 mg/ml inj., FORTSTAR, SUSEVIN 30 mg/ml inj; FORTAGESIC pentazocine 15 mg + paracetamol 500 mg tab. 2. Butorphanol: 1–4 mg i.m./i.v.; BUTRUM 1 mg/ml and 2 mg/ml inj. 3. Buprenorphine: 0.3–0.6 mg i.m., s.c. or slow i.v., also sublingual 0.2–0.4 mg 6–8 hourly; NORPHIN, TIDIGESIC 0.3 mg/ml inj. 1 and 2 ml amps. 0.2 mg sublingual tab; BUPRIGESIC, PENTOREL 0.3 mg/ml inj in 1, 2 ml amp. 4. Naloxone: Adults 0.4–0.8 mg i.v. every 2–3 min (max 10 mg); neonates 10 µg/kg in the umbilical cord; NAR- COTAN 0.4 mg in 1 ml (adult) and 0.04 mg in 2 ml (infant) amps; NALOX, NEX 0.4 mg inj. 5. Naltrexone: 50 mg/day oral; NALTIMA, NALTROX 50 mg tab. CNS Stimulants and Cognition Enhancers 85 86 Drugs Acting on Central Nervous System Preparations CNS Stimulants 1. Doxapram: 40–80 mg i.m. or i.v.; 0.5–2 mg/kg/hr i.v. infusion. CAROPRAM 20 mg/ml in 5 ml amp. 2. Methylphenidate: Adults 5–10 mg BD, child 0.25 mg/kg/day (max 1 mg/kg/day); RETALIN 5, 10, 20, 30 mg tab. 3. Atomoxetine: 0.5 mg/kg OD in the morning (max 1.2 mg/kg/day) in children; adults 40 mg OD (max. 100 mg OD). ATTENTROL 10, 18, 25, 40 mg caps; AXEPTA 18, 25 mg cap. 4. Modafinil: 100-200 mg morning and afternoon (for day time sleepiness), 200 mg 1 hour before starting night shift. MODALERT, PROVAKE 100, 200 mg tabs. 5. Caffeine: 20–100 mg oral; in CAFERGOT: Caffeine 100 mg + ergotamine 1 mg tab. MICROPYRIN: Caffeine 20 mg + aspirin 350 mg tab. Cognition Enhancers 1. Rivastigmine: Start with 1.5 mg BD, increase every 2 weeks by 1.5 mg/day upto 6 mg/day; EXELON, RIVAMER 1.5, 3.0, 6.0 mg caps. 2. Donepezil: 5 mg once at bed time (max. 10 mg OD); DONECEPT, DOPEZIL, DORENT 5, 10 mg tabs. 3. Galantamine: 4 mg BD (max. 12 mg BD); GALAMER 4, 8, 12 mg tabs. 4. Memantine: 5 mg OD, increase up to 10 mg BD; ADMENTA, MENTADEM 5, 10 mg tabs, ALMANTIN 5 mg tab. 5. Piracetam: 0.8–1 g TDS; children 20 mg/kg BD–TDS; 1–3 g i.m. 6 hourly in stroke/head injury; NORMABRAIN, NEUROCETAM, NOOTROPIL 400, 800 mg cap, 500 mg/5 ml syr., 300 mg/ml inj. CNS Stimulants and Cognition Enhancers 87 6. Pyritinol (Pyrithioxine): 100–200 mg TDS, child 50–100 mg TDS oral, 200–400 mg 6 hourly (max. 1 g/day) i.v.; ENCEPHABOL 100, 200 mg tab, 100 mg/5 ml susp, 200 mg dry powder in vial with solvent for i.v. infusion. 7. Dihydroergotoxine (Codergocrine): 1–1.5 mg TDS oral/sublingual, 0.3 mg i.m. OD; HYDERGINE 1 mg tab, 0.3 mg/ml inj, CERELOID 1 mg tab. 8. Piribedil: 50 mg OD–BD; TRIVASTAL-LA 50 mg tab. 9. Ginkgo biloba: 40–80 mg TDS; GINKOCER, BILOVAS, GINKOBA 40 mg tab. 10. Citicoline: Oral 200–600 mg/day in divided doses; Parenteral 0.5–1.0 g/day i.m./i.v. STROLIN 500 mg tab, CITILIN, CITINOVA 500 mg tab, 500 mg/2 ml inj. 7 Cardiovascular Drugs Antihypertensive Drugs 89 90 Cardiovascular Drugs Preparations 1. Captopril: Initially 25 mg BD, increase upto 50 mg TDS as needed. To be taken 1 hr before or 2 hr after a meal; ANGIOPRIL 25 mg tab, ACETEN, CAPOTRIL 12.5, 25 mg tabs. 2. Enalapril: 2.5 mg OD–20 mg BD; ENAPRIL, ENVAS, ENAM 2.5, 5, 10, 20 mg tabs. 3. Lisinopril: 5 mg OD–20 mg BD; LINVAS, LISTRIL, LIPRIL 2.5, 5, 10 mg tabs, LISORIL 2.5, 5, 10, 20 mg tabs. 4. Perindopril: 2 mg OD–4 mg BD; COVERSYL 2, 4 mg tabs. 5. Ramipril: 1.25 mg OD–5 mg BD; CARDACE, RAMIRIL, CORPRIL, RPRIL 1.25, 2.5, 5 mg caps. 6. Benazepril: 10 mg OD–20 mg BD; BENACE 5, 10, 20 mg tabs. 7. Trandolapril: 2 mg OD–4 mg BD; ZETPRIL 1, 2 mg tabs. 8. Fosinopril: 10–40 mg OD; FOSINACE, FOVAS 10, 20 mg tabs. 9. Imidapril: Start with 5 mg (elderly 2.5 mg) OD, max. 10 mg BD; TANATRIL 5, 10 mg tabs. 10. Quinapril: 10–40 mg/day; ACCUPRIL-H Quinapril 20 mg + hydrochlorothiazide 12.5 mg tab. 11. Losartan: 50 mg OD (max. 50 mg BD), liver disease and volume depleted patients 25 mg OD; LOSAR, LOSACAR, TOZAR, ALSARTAN 25, 50 mg tabs. 12. Candesartan: 8 mg OD (max. 8 mg BD), liver/kidney disease patients 4 mg OD; CANDESAR 4, 8, 10 mg tabs, CANDILONG, CANDESTAN 4, 8 mg tabs. 13. Irbesartan: 150–300 mg OD; IROVEL, IRBEST 150, 300 mg tabs. 14. Valsartan: 80–160 mg OD; DIOVAN 40, 80, 160 mg tabs. STARVAL, VALZAAR 80, 160 mg tabs. 15. Telmisartan: 20–80 mg OD; TELMA, TELSAR, TELVAS 20, 40 mg tabs. 16. Olmesartan medoxomil: 20–40 mg OD; OLMAT 20, 40 mg tabs. 17. Aliskiren: 150–300 mg OD; RASILEZ 150 mg tab; RASILEZ-HC alongwith hydrochlorothiazide 12.5 mg. Antihypertensive Drugs 91 18. Verapamil: 40–160 mg TDS oral, 5 mg by slow i.v. inj; CALAPTIN 40, 80 mg tab, 120, 240 mg SR tab; VPL 5 mg/2 ml inj, VASOPTEN 40, 80, 120 mg tabs. 19. Diltiazem: 30–60 mg TDS–QID oral; DILZEM 30, 60 mg tabs, 90 mg SR tab; 25 mg/5 ml inj; ANGIZEM 30, 60, 90, 120, 180 mg tab, DILTIME 30, 60 mg tab; 90, 120 mg SR tab. 20. Nifedipine: 5–20 mg BD–TDS oral; CALCIGARD, DEPIN, NIFELAT 5, 10 mg cap, also 10 mg, 20 mg SR (RETARD) tab., ADALAT RETARD 10, 20 mg SR tab. 21. Felodipine: 5–10 mg OD (max. 10 mg BD); FELOGARD, PLENDIL, RENDIL 2.5, 5, 10 mg ER tab. 22. Amlodipine: 5–10 mg OD; AMLOPRES, AMCARD, AMLOPIN, MYODURA 2.5, 5, 10 mg tabs. 23. S(–) Amlodipine: 2.5–5 mg OD; S-NUMLO 1.25, 2.5, 5.0 mg tabs; ESAM, S-AMCARD, ASOMEX 2.5, 5.0 mg tabs. 24. Nitrendipine: 5–20 mg OD (max. 20 mg BD); CARDIF, NITREPIN 10, 20 mg tab. 25. Lacidipine: 4–6 mg OD; LACIVAS, SINOPIL 2, 4 mg tabs. 26. Benidipine: 4–8 mg OD; CARITEC 4, 8 mg tabs. 27. Lercanidipine: 10–20 mg OD; LERKA, LEREZ 10, 20 mg tabs. 28. Hydrochlorothiazide: 12.5–50 mg OD; AQUAZIDE. HYDRAZIDE, HYDRIDE 12.5, 25, 50 mg tabs. 29. Chlorthalidone: 25–100 mg OD; HYTHALTON 100 mg tab. 30. Indapamide: 2.5 mg OD; LORVAS, NATRILIX 2.5 mg tab, NATRILIX-SR, DIURIX-SR 1.5 mg tab. 31. Clonidine: Start with 100 µg OD or BD, max 300 µg TDS, orally or i.m.; CATAPRES 150 µg tab, ARKAMIN 100 µg tab. 32. Methyldopa: 0.25–0.5 g BD–QID; EMDOPA, ALPHADOPA 250 mg tab. 33. Hydralazine: 25–50 mg OD–TDS; NEPRESOL 25 mg tab. 34. Sodium nitroprusside: Initiate i.v. infusion with 0.02 mg/min, titrate with lowering of blood pressure upto 0.1–0.3 mg/min; SONIDE, PRUSIDE, NIPRESS 50 mg in 5 ml inj. Note: See Index for preparations of other drugs. 92 Cardiovascular Drugs Some combined antihypertensive formulations 1. Amlodipine 5 mg + Lisinopril 5 mg—AMLOPRES-L, LISTRIL-AM 2. Amlodipine 5 mg + Atenolol 50 mg—AMCARD-AT, AMLOPIN-AT, AMLOPRES-AT 3. Amlodipine 5 mg + Enalapril 5 mg—AMACE, AMTAS-E 4. Atenolol 25 mg or 50 mg + Chlorthalidone 12.5 mg—TENOCLOR, TENORIC 5. Enalapril 10 mg + Hydrochlorothiazide 25 mg–ENACE-D, VASONORM-H 6. Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg—CARDACE-H 7. Losartan 50 mg + Hydrochlorothiazide 12.5 mg—LOSAR-H, TOZAAR-H, LOSACAR-H 8. Lisinopril 5 mg + Hydrochlorothiazide 12.5 mg—LISTRIL PLUS, LISORIL-HT 9. Losartan 50 mg + Ramipril 2.5 mg or 5 mg—TOZAAR-R, LAPIDO-R 10. Losartan 50 mg + Amlodipine 5 mg—AMCARD-LP, AMLOPRES-Z, LOSACAR-A 11. Losartan 50 mg + Ramipril 2.5 mg + Hydrochlorothiazide 12.5 mg—LOSANORM-HR 12. Irbesartan 150 mg + Hydrochlorothiazide 12.5 mg—IROVEL-H, XARB-H. Antianginal Drugs 93 94 Cardiovascular Drugs Preparations 1. Glyceryl trinitrate (GTN), Nitroglycerine: 0.5 mg sublingual, 5–15 mg oral; ANGISED 0.5 mg tab, NITROLINGUAL spray, GTN spray 0.4 mg per spray; ANGISPAN-TR 2.5, 6.5 mg SR cap, NITROCONTIN, CORODIL 2.6, 6.4 mg CR tabs; One transdermal patch for 14–16 hr per day; NITRODERM-TTS 5 or 10 mg patch; 5–20 µg/min i.v.; MYOVIN, MILLISROL, NITROJECT 5 mg/ml inj. 2. Isosorbide dinitrate: 5–10 mg sublingual; SORBITRATE 5, 10 mg tab; 10–20 mg oral; ISORDIL 5 mg sublingual & 10 mg oral tab; 20–40 mg sustained release oral; DITRATE 5, 10 mg tab; 20, 40 mg SR tab. 3. Isosorbide-5-mononitrate: 20–40 mg oral; MONOTRATE 10, 20, 40 mg tab, 50 mg SR tab, 5-MONO, MONOSORBITRATE 10, 20, 40 mg tab. 4. Erythrityl tetranitrate: 15–60 mg oral; CARDILATE 5, 15 mg tab. 5. Pe

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