Antibiotics
Protocols
Ceftriaxone
Brand: Ceftron(square),Oricef(Healthcare),Traxon(opsonin)
Arixon(Beximco),Ceftrizone(Renata)
Preparation; 250 mg /500mg/1gm/2 gm injection(IM OR IV)
Susceptible infections IV/IM 1-2 g/day, up to 4 g/day for severe infections.
Intra-abdominal Infections
Complicated, mild-to-moderate, community acquired: 1-2 g/day IV
Intra-abdominal Infections
Complicated, mild-to-moderate, community acquired: 1-2 g/day IV
in single daily dose or divided q12hr for 4-7 days, in
combination with metronidazole
Meningitis
2 g IV q12hr for 7-14 days
Acute Uncomplicated Pyelonephritis
1-2 g IV qDay
Typhoid fever
2 g IV once daily for 14 days.
Surgical Prophylaxis
Prophylaxis of surgical infection
1 g IV 0.5-2 hours before procedure
Uncomplicated Gonococcal Infections
Uncomplicated gonococcal infection of pharynx, cervix, urethra, or
Meningitis
2 g IV q12hr for 7-14 days
Acute Uncomplicated Pyelonephritis
1-2 g IV qDay
Typhoid fever
2 g IV once daily for 14 days.
Surgical Prophylaxis
Prophylaxis of surgical infection
1 g IV 0.5-2 hours before procedure
Uncomplicated Gonococcal Infections
Uncomplicated gonococcal infection of pharynx, cervix, urethra, or
rectum: ceftriaxone 250 mg IM once plus azithromycin 1 g PO once
(preferred) or alternatively, doxycycline 100 mg PO q12hr for 7 days
Pelvic Inflammatory Disease
250 mg IM as single dose with doxycycline, with or without metonidazole for 14 days
Pelvic Inflammatory Disease
250 mg IM as single dose with doxycycline, with or without metonidazole for 14 days
Children: IV, IM: 50–75 mg/kg/day, max 2 g/day q24h
50 mg/kg, max 1 g, 1–3 doses IM for AOM q24h
100 mg/kg/day for meningitis, max 4 g/day q12h
50 mg/kg, max 1 g, 1–3 doses IM for AOM q24h
100 mg/kg/day for meningitis, max 4 g/day q12h
Renal impairment:
CrCl (ml/min)
<10 Max: 2 g daily.
CrCl (ml/min)
<10 Max: 2 g daily.
IV/IM Administration
IV: Infuse intermittently over 30 minutes
IM: Inject deep into large muscle mass
IV: Infuse intermittently over 30 minutes
IM: Inject deep into large muscle mass
Pneumonia, Meningitis, Acute otitis media, Lyme disease, Typhoid fever,
Otitis media, Pelvic inflammatory disease, Septicemia, Skin and
Skin-Structure Infections, Gonorrhea, Respiratory tract infections,
Urinary tract infections, Bone and Joint Infections, Chlamydia infection,
Surgical Prophylaxis
Hypersensitivity to cephalosporins; hyperbilirubinaemic neonates. Do not use
calcium or calcium-containing solutions or products with or within 48 hr of
ceftriaxone administration due to risk of calcium-ceftriaxone precipitate formation.
>10%
Induration after IM injection (5-17%)
1-10%
Eosinophilia (6%),Thrombocytosis (5%),Diarrhea (3%),Elevated hepatic
Induration after IM injection (5-17%)
1-10%
Eosinophilia (6%),Thrombocytosis (5%),Diarrhea (3%),Elevated hepatic
transaminases (3%),Leukopenia (2%),Rash (2%),Increased blood urea
nitrogen (BUN) (1%),Induration at IV site (1%),Pain (1%)
<1%
Agranulocytosis,Anaphylaxis,Anemia,Basophilia,Bronchospasm,Candidiasis,
<1%
Agranulocytosis,Anaphylaxis,Anemia,Basophilia,Bronchospasm,Candidiasis,
Chills,Diaphoresis,Dizziness,Dysgeusia,Flushing,Gallstones,Glycosuria,Headache,
Hematuria,Hemolytic anemia,Increased alkaline phosphatase or bilirubin,Increased creatinine,Jaundice,Leukocytosis,Lymphocytosis,Lymphopenia,Monocytosis,Nausea,
Neutropenia,Phlebitis,Prolonged or decreased prothrombin time (PT),Pruritus,Renal
stones,Serum sickness,Thrombocytopenia,Urinary casts,Vaginitis,Vomiting
Third generation Cephalosporins
Category: B
pregnancy_description
pregnancy_description
Ceftriaxone binds to one or more of the penicillin-binding proteins (PBPs) which
inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell
wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in
bacterial cell death.
May increase nephrotoxicity of aminoglycosides. May diminish therapeutic
effect of BCG, typhoid vaccine, Na picosulfate. May increase anticoagulant
effect of vit K antagonists (e.g. warfarin). May increase serum level w/
probenecid. Potentially Fatal: Admin w/ Ca-containing IV soln may cause
precipitation of a crystalline material in the lungs and kidneys.
Per Unit Price: Tk. 250 mg(120tk),250mg(190tk),1gm(300tk)
2gm(350/490tk)
Package:
Cefixime:
Brand name: Cef-3(square),orcef(renata),Denvar(Healthcare),
Fix-A(ACME),
Preparation: 200mg( Cap/Tablet),400mg (Table/Cap),100mg/5ml or
200mg/5ml (suspention),100mg/1ml or 25mg/1ml(paediatric drop)
Adult Dose
Acute Bronchitis & Acute Exacerbations of Chronic Bronchitis,
Otitis Media, Pharyngitis/Tonsillitis, Uncomplicated Urinary Tract Infections
Adult: 200 or 400 mg daily as a single dose or in two divided doses
Gonorrhea: 400 mg as a single dose.
Typhoid fever: 20 mg/kg body weight daily in two divided dose.
The usual treatment of is 7 days.
This may be continued for up to 14 days according to the severity of infection.
Adult: 200 or 400 mg daily as a single dose or in two divided doses
Gonorrhea: 400 mg as a single dose.
Typhoid fever: 20 mg/kg body weight daily in two divided dose.
The usual treatment of is 7 days.
This may be continued for up to 14 days according to the severity of infection.
Child: PO 8 mg/kg/day if <50 kg q12–24h
For convalescent oral therapy of serious infections, up to 20 mg/kg/day
Child over 12 years:
Capsule: 200 or 400 mg daily as a single dose or in two divided doses
Powder for Suspension & DS Powder for Suspension & Paediatric Drops:
Children above 6 months: 8 mg/kg daily in 1-2 divided doses or
6 months-1year: 75 mg daily
1-4 years: 100 mg daily
5-10 years: 200 mg daily
Typhoid Fever
15-20 mg/kg/day PO divided q12hr for 7-14 days; not to exceed 400 mg/day
<6 months: Safety and efficacy not established
For convalescent oral therapy of serious infections, up to 20 mg/kg/day
Child over 12 years:
Capsule: 200 or 400 mg daily as a single dose or in two divided doses
Powder for Suspension & DS Powder for Suspension & Paediatric Drops:
Children above 6 months: 8 mg/kg daily in 1-2 divided doses or
6 months-1year: 75 mg daily
1-4 years: 100 mg daily
5-10 years: 200 mg daily
Typhoid Fever
15-20 mg/kg/day PO divided q12hr for 7-14 days; not to exceed 400 mg/day
<6 months: Safety and efficacy not established
Renal impairment: Dose reduction is necessary.
CrCl (ml/min)
<20 Max: 200 mg daily.
CrCl (ml/min)
<20 Max: 200 mg daily.
May be taken with or without food. May be taken w/ food or milk
to reduce GI discomfort.
Pneumonia, Pharyngitis, Typhoid fever, Susceptible infections , Sinusitis,
Otitis media, Tonsillitis, Soft tissue infections, Respiratory tract infections,
Acute Exacerbations of Chronic bronchitis, Gonococcal urethritis, Acute bronchitis
Hypersensitivity to cephalosporin.
>10%
Diarrhea (16%)
Frequency Not Defined
Abdominal pain,Candidiasis,Dizziness,Dyspepsia,Elevated transaminases,
Diarrhea (16%)
Frequency Not Defined
Abdominal pain,Candidiasis,Dizziness,Dyspepsia,Elevated transaminases,
Eosinophilia,Erythema multiforme,Fever,Flatulence,Headache,Increased
blood urea nitrogen (BUN),Increased creatinine,Leukopenia,Nausea,
Prolonged prothrombin time (PT),Pruritus,Pseudomembranous colitis,
Rash,Serum sickness-like reaction,Stevens-Johnson syndrome,
Thrombocytopenia,Urticaria,Vaginitis,Vomiting
Potentially Fatal: Pseudomembranous colitis.
Potentially Fatal: Pseudomembranous colitis.
Third generation Cephalosporins
Category: Not Classified
pregnancy_description
pregnancy_description
Cefixime binds to one or more of the penicillin-binding proteins (PBPs)
which inhibits the final transpeptidation step of peptidoglycan synthesis
in bacterial cell wall, thus inhibiting biosynthesis and arresting cell
wall assembly resulting in bacterial cell death.
Increased concentrations with probenecid. Potentially Fatal:
May increase prothrombin time with anticoagulants.
Per Unit Price:
suspension price
37.5 ml bottle: ৳ 130.00
50 ml bottle: ৳ 230.00
75 ml bottle: ৳ 250.00
200mg(30tk),400mg(55tk)
Paediatric drop:
21 ml bottle: ৳ 100.30 (25mg/1ml)
20 ml bottle: ৳ 250.00(100mg/1ml)
Package: 6's pack,12's pack
Brand Name: Furotil(healthcare),Cefotil(square)
Pharyngitis/Tonsillitis
250 mg PO q12hr for 10 days
Acute Bacterial Maxillary Sinusitis
250 mg PO q12hr for 10 days
Acute Bacterial Exacerbations of Chronic Bronchitis
250-500 mg PO q12hr for 10 days
500-750 mg IV q8hr; switch to oral therapy as soon as
250 mg PO q12hr for 10 days
Acute Bacterial Maxillary Sinusitis
250 mg PO q12hr for 10 days
Acute Bacterial Exacerbations of Chronic Bronchitis
250-500 mg PO q12hr for 10 days
500-750 mg IV q8hr; switch to oral therapy as soon as
clinically possible
Secondary Bacterial Infections of Acute Bronchitis
250-500 mg PO q12hr for 5-10 days
Uncomplicated Pneumonia
750 mg IV/IM q8hr
Uncomplicated Skin/Skin Structure Infections
250-500 mg PO q12hr for 10 days
750 mg IV/IM q8hr; switch to oral therapy as soon as
Secondary Bacterial Infections of Acute Bronchitis
250-500 mg PO q12hr for 5-10 days
Uncomplicated Pneumonia
750 mg IV/IM q8hr
Uncomplicated Skin/Skin Structure Infections
250-500 mg PO q12hr for 10 days
750 mg IV/IM q8hr; switch to oral therapy as soon as
clinically possible
Uncomplicated Urinary Tract Infections
125-250 mg PO q12hr for 7-10 days
750 mg IV/IM q8hr; switch to oral therapy as soon as
Uncomplicated Urinary Tract Infections
125-250 mg PO q12hr for 7-10 days
750 mg IV/IM q8hr; switch to oral therapy as soon as
clinically possible
Gonorrhea
Uncomplicated: 1 g PO once or 1.5 g IM once at 2 different
Gonorrhea
Uncomplicated: 1 g PO once or 1.5 g IM once at 2 different
sites with 1 g probenecid PO
Disseminated: 750 mg IV/IM q8hr
Early Lyme Disease
500 mg PO q12hr for 20 days
Severe or Complicated Infections
1.5 g IV/IM q8hr; may be administered q6hr in life-threatening
Disseminated: 750 mg IV/IM q8hr
Early Lyme Disease
500 mg PO q12hr for 20 days
Severe or Complicated Infections
1.5 g IV/IM q8hr; may be administered q6hr in life-threatening
situations
Oral
Susceptible infections
Adult: 250 mg bid.
Parenteral
Susceptible infections
Adult: 0.75 g 8 hrly, by deep IM or slow IV inj over 3-5 min or IV
Oral
Susceptible infections
Adult: 250 mg bid.
Parenteral
Susceptible infections
Adult: 0.75 g 8 hrly, by deep IM or slow IV inj over 3-5 min or IV
infusion, may increase up to 1.5 g 6-8 hrly in more severe infections.
Children: PO 20–30 mg/kg/day q12h
For bone and joint infections, up to 100 mg/kg/day
IV, IM 100–150 mg/kg/day q8h
For bone and joint infections, up to 100 mg/kg/day
IV, IM 100–150 mg/kg/day q8h
Renal impairment: Patients undergoing haemodialysis should receive an
additional 750-mg dose after each dialysis; those undergoing continuous
peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)
10-20 750 mg bid.
<10 750 mg once daily.
CrCl (ml/min)
10-20 750 mg bid.
<10 750 mg once daily.
Tab: May be taken with or without food.
Oral susp: Should be taken with food.
IV Preparation
Direct injection: reconstitute in 8 mL (for 750-mg vial) or 16 mL
Oral susp: Should be taken with food.
IV Preparation
Direct injection: reconstitute in 8 mL (for 750-mg vial) or 16 mL
(for 1.5-g vial) to obtain ~90 mg/mL solution
Infusion: Reconstitute in 100 mL SWI, D5W or NS to obtain
Infusion: Reconstitute in 100 mL SWI, D5W or NS to obtain
7.5 mg/mL (750-mg vial) or 15 mg/mL (1.5-g vial) solution
7.5 g bulk package not to be used for direct injection
IM Preparation
Reconstitute 750 mg in 3 mL SWI to obtain ~220 mg/mL solution
IV Administration
Direct injection: Inject directly into vein over 3-5 minutes or slowly
7.5 g bulk package not to be used for direct injection
IM Preparation
Reconstitute 750 mg in 3 mL SWI to obtain ~220 mg/mL solution
IV Administration
Direct injection: Inject directly into vein over 3-5 minutes or slowly
into tubing of free-flowing compatible IV solution
Infusion: Infuse intermittently over 15-60 minutes
Infusion: Infuse intermittently over 15-60 minutes
Pharyngitis, Acute otitis media, Lyme disease, Susceptible infections,
Sinusitis, Otitis media, Skin and skin structure infections,Tonsillitis,
Respiratory tract infections, Acute Maxillary Sinusitis, Urinary tract
infections, Acute bacterial exacerbation of chronic bronchitis,
Surgical Prophylaxis
Hypersensitivity to cephalosporins.
>10%
Diarrhea (4-11%; depends on duration)
1-10%
Decreased hemoglobin or hematocrit (10%),Eosinophilia (7%),
Diarrhea (4-11%; depends on duration)
1-10%
Decreased hemoglobin or hematocrit (10%),Eosinophilia (7%),
Nausea or vomiting (3-7%),Vaginitis (<5%),Transient rise in
hepatic transaminases (2-4%),Diaper rash (3%),Increase in
alkaline phosphatase (2%),Thrombophlebitis (2%),Increase in
lactate dehydrogenase (1%)
<1%
Anemia,Cholestasis,Colitis,Dyspnea,Epidermal necrolysis,Increase in
<1%
Anemia,Cholestasis,Colitis,Dyspnea,Epidermal necrolysis,Increase in
blood urea nitrogen (BUN) and creatinine,Jaundice,Nephritis,
Prolonged prothrombin time (PT)/international normalized ratio (INR)
,Rash,Stevens-Johnson syndrome,Stomach cramps,Transient
neutropenia and leukopenia,Urticaria
Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.
Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.
Second generation Cephalosporins
Category: Not Classified
pregnancy_description
pregnancy_description
Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs)
which inhibits the final transpeptidation step of peptidoglycan synthesis
in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall
assembly resulting in bacterial cell death.
May enhance the nephrotoxic effect of strong-acting diuretics
(e.g. furosemide) and aminoglycosides. May enhance the
effect of oral anticoagulants. May reduce the efficacy of OCs.
Probenecid prolongs the excretion of cefuroxime and elevated
peak serum level.
Per Unit Price: Tk.
Package: 8's Pack
Package: 8's Pack
Adult: PO Resp tract infections; Skin and soft tissue infections
500 mg once daily for 3 days.
Chancroid; Non-gonococcal cervicitis/urethritis due to Chlamydia
500 mg once daily for 3 days.
Chancroid; Non-gonococcal cervicitis/urethritis due to Chlamydia
trachomatis; Uncomplicated genital infections due to Chlamydia
trachomatis
1 g as a single dose.
Prophylaxis of disseminated MAC infections 1.2 g once wkly.
Treatment or secondary propjhylaxis: 500 mg once daily w/
1 g as a single dose.
Prophylaxis of disseminated MAC infections 1.2 g once wkly.
Treatment or secondary propjhylaxis: 500 mg once daily w/
other antimycobacterials.
Uncomplicated gonorrhoea 2 g as a single dose. Granuloma
Uncomplicated gonorrhoea 2 g as a single dose. Granuloma
inguinale Initial: 1 g, then 500 mg/day until all lesions have
healed completely.
Active immunisation against typhoid fever caused by
Active immunisation against typhoid fever caused by
Salmonella typhi 1 g once daily for 5 days.
IV Community-acquired pneumonia 500 mg as a single IV
IV Community-acquired pneumonia 500 mg as a single IV
daily dose for 2 days, then 500 mg single oral dose daily to
complete 7-10 days of therapy.
Pelvic inflammatory disease 500 mg as a single IV daily
Pelvic inflammatory disease 500 mg as a single IV daily
dose for 1-2 days, then 250 mg single oral dose daily to
complete a 7-day therapy.
Elderly: No dosage adjustment needed.
Hepatic impairment: No dosage adjustment needed.
Elderly: No dosage adjustment needed.
Hepatic impairment: No dosage adjustment needed.
Child: PO: q24h
Otitis: 10 mg/kg/day for 1 day, then 5 mg/kg for 4 days; or
Otitis: 10 mg/kg/day for 1 day, then 5 mg/kg for 4 days; or
10 mg/kg/day for 3 days; or 30 mg/kg once.
Pharyngitis: 12 mg/kg/day for 5 days.
Sinusitis: 10 mg/kg/day for 3 days.
CABP: 10 mg/kg for 1 day, then 5 mg/kg/day for 4 days
Pharyngitis: 12 mg/kg/day for 5 days.
Sinusitis: 10 mg/kg/day for 3 days.
CABP: 10 mg/kg for 1 day, then 5 mg/kg/day for 4 days
or 60 mg/kg once of ER susp
MAC/PCP prophylaxis: 5 mg/kg/day
IV: 10 mg/kg q24h
>6 mth 10 mg/kg;
15-25 kg: 200 mg;
26-35 kg: 300 mg;
36-45 kg: 400 mg.
All doses to be taken once daily for 3 days.
MAC/PCP prophylaxis: 5 mg/kg/day
IV: 10 mg/kg q24h
>6 mth 10 mg/kg;
15-25 kg: 200 mg;
26-35 kg: 300 mg;
36-45 kg: 400 mg.
All doses to be taken once daily for 3 days.
Renal impairment: No dosage adjustment needed.
Oral Administration
Tablet: Take tablets without regard to food; however,
Tablet: Take tablets without regard to food; however,
food may enhance tolerability
Oral suspension
Conventional oral suspension (100 mg/5 mL, 200 mg/5 mL)
Oral suspension
Conventional oral suspension (100 mg/5 mL, 200 mg/5 mL)
may be stored for 10 days after reconstitution and taken
without regard to food
Conventional 1 g package must be taken immediately
Conventional 1 g package must be taken immediately
after reconstitution
Extended-release oral suspension must be taken on
Extended-release oral suspension must be taken on
empty stomach within 12 hours of reconstitution; given
only in single dose; not interchangeable with immediate
release formulation
IV Preparation
Dilute 500-mg vial in 4.8 mL of SWI (100 mg/mL)
Dilute further in NS to 1 mg/mL (500 mL) or 2 mg/mL (250 mL)
IV Administration
1 mg/mL solution: Infuse over 3 hours
2 mg/mL solution: Infuse over 1 hour
IV Preparation
Dilute 500-mg vial in 4.8 mL of SWI (100 mg/mL)
Dilute further in NS to 1 mg/mL (500 mL) or 2 mg/mL (250 mL)
IV Administration
1 mg/mL solution: Infuse over 3 hours
2 mg/mL solution: Infuse over 1 hour
Bacterial infections, bacterial endocarditis, typhoid fever,
community-acquired pneumonia, uncomplicated gonorrhea,
streptococcal pharyngitis/tonsillitis, COPD, acute bacterial
sinusitis, acute otitis media, uncomplicated UTI, Uncomplicated
gonorrhea, PID, non-gonococcal urethritis, chancroid, acute
salmonellosis, cervicitis, babesiosis, chlamydial infections,
pelvic inflammatory disease, PID, traveler's diarrhea,
Known hypersensitivity to azithromycin, erythromycin, any
macrolide or ketolide antibiotic. Coadministration w/ pimozide.
History of cholestatic jaundice/hepatic dysfunction associated
w/ prior use of azithromycin.
>10%
High single dose therapy
Diarrhea (52.8%),Nausea (32.6%),Abdominal pain (27%),Loose
High single dose therapy
Diarrhea (52.8%),Nausea (32.6%),Abdominal pain (27%),Loose
stool (19.1%)
1-10%
Cramping (2-10%),Vaginitis (2-10%),Dyspepsia (9% with single high
1-10%
Cramping (2-10%),Vaginitis (2-10%),Dyspepsia (9% with single high
dose therapy),Flatulence (9% with single high dose therapy),
Vomiting (6.7% with single high dose therapy),Malaise (1.1%)
<1%
Agitation,Allergic reaction,Anemia,Anorexia,Candidiasis,Chest pain,
<1%
Agitation,Allergic reaction,Anemia,Anorexia,Candidiasis,Chest pain,
Conjunctivitis,Constipation,Dermatitis (fungal),Dizziness,Eczema,
Edema,Enteritis,Facial edema,Fatigue,Gastritis,Headache,
Hyperkinesia,Hypotension,Increased cough,Insomnia,Leukopenia,
Malaise,Melena,Mucositis,Nervousness,Oral candidiasis,Pain,
Palpitations,Pharyngitis,Pleural effusion,Pruritus,Pseudomembranous
colitis,Rash,Rhinitis,Seizures,Somnolence,Urticaria,Vertigo
Potentially Fatal: Angioedema and cholestatic jaundice.
Potentially Fatal: Angioedema and cholestatic jaundice.
Macrolides
Category: Not Classified
pregnancy_description
pregnancy_description
Azithromycin is a semisynthetic azalide antibiotic. It blocks transpeptidation
by binding to 50s ribosomal subunit of susceptible organisms and disrupting
RNA-dependent protein synthesis at the chain elongation step.
Increases serum concentrations of digoxin, ciclosporin, terfenadine,
hexobarbital and phenytoin. Decreased rate of absorption w/ antacids
containing aluminium and magnesium. Increased risk of ergot toxicity.
Potentially Fatal: Increased risk of cardiotoxicity w/ pimozide.
Per Unit Price: Tk. 85.58,130.88,186.26
Package: 15ml,30ml,50ml bot
Package: 15ml,30ml,50ml bot
Amoxicillin:
Adult: PO Susceptible infections 250-500 mg 8 hrly.
Uncomplicated gonorrhoea W/ probenecid: 3 g as a
single dose. Dental abscesses 3 g, repeat once 8 hr later.
Uncomplicated acute UTI 3 g, repeat once 10-12 hr later.
Uncomplicated acute UTI 3 g, repeat once 10-12 hr later.
Prophylaxis of endocarditis 2 or 3 g as a single dose, 1 hr
before dental procedure.
Severe or recurrent resp tract infections 3 g twice daily.
H.pylori infection W/ either metronidazole or clarithromycin
Severe or recurrent resp tract infections 3 g twice daily.
H.pylori infection W/ either metronidazole or clarithromycin
and a bismuth compound or an antisecretory drug: 500 mg
3 times/day.
IV/IM Susceptible infections 500 mg 8 hrly. Listerial meningitis
IV/IM Susceptible infections 500 mg 8 hrly. Listerial meningitis
W/ other antibiotics: 2 g 4 hrly for 10-14 days.
Child: PO Standard dose: 40–45 mg/kg/day q8-12h
High dose: 80–90 mg/kg/day, max 4 g/day q12h
150 mg/kg/day div q8h for penicillin-resistant S pneumoniae
High dose: 80–90 mg/kg/day, max 4 g/day q12h
150 mg/kg/day div q8h for penicillin-resistant S pneumoniae
otitis media
Renal impairment: Patients on haemodialysis should receive
250-500 mg every 24 hr and an additional dose during and
after each dialysis session.
CrCl (ml/min)
10-30 250-500 mg every 12 hr.
<10 250-500 mg every 24 hr.
CrCl (ml/min)
10-30 250-500 mg every 12 hr.
<10 250-500 mg every 24 hr.
May be taken with or without food. May be taken w/ meals for
better absorption & to reduce GI discomfort.
Bacterial infections, Pharyngitis, Acute otitis media, Acute bacterial
sinusitis, Endocarditis, Anthrax, Chlamydial cervicitis, Chlamydial
urethritis, Lyme disease, Dental abscess, Salmonellosis,Typhoid
fever, Acute Uncomplicated gonorrhea, Infections of the Lower
Respiratory Tract, Skin and Skin Structure, Genitourinary Tract,
Ear, Nose, Throat
Hypersensitivity
Hyperactivity, agitation, insomnia, dizziness; maculopapular rash,
exfoliative dermatitis, urticaria, hypersensitivity vasculitis; diarrhoea,
nausea, vomiting; anaemia, thrombocytopenia, leucopenia,
agranulocytosis.
Potentially Fatal: Neuromuscular hypersensitivity;
Potentially Fatal: Neuromuscular hypersensitivity;
pseudomembranous colitis.
Broad spectrum penicillins
Category: Not Classified
pregnancy_description
pregnancy_description
Amoxicillin inhibits the final transpeptidation step of peptidoglycan
synthesis in bacterial cell wall by binding to one or more of the
penicillin-binding proteins (PBPs), thus inhibiting cell wall
biosynthesis resulting in bacterial lysis.
May reduce the efficacy of OC. May increase the effect of
anticoagulants. Increased risk of allergic reactions w/ allopurinol.
Increased and prolonged blood levels w/ probenecid.
Chloramphenicol, macrolides, sulfonamides and tetracyclines
may interfere w/ the bactericidal effect of amoxicillin.
Per Unit Price: Tk. 25
Package: 1's pack
Package: 1's pack
Oral
Acute Exacerbation of Chronic Bronchitis
250-500 mg PO q12hr for 7-14 days
Extended release: 1000 mg PO once daily for 7 days
Mycobacterial Infection
Prophylaxis and treatment
500 mg PO q12hr for 7-14 days
Use with antimycobacterial drugs such as
Acute Exacerbation of Chronic Bronchitis
250-500 mg PO q12hr for 7-14 days
Extended release: 1000 mg PO once daily for 7 days
Mycobacterial Infection
Prophylaxis and treatment
500 mg PO q12hr for 7-14 days
Use with antimycobacterial drugs such as
rifampin and ethambutol
Peptic Ulcer Disease
500 mg PO q8-12hr for 10-14 days
Administer as part of 2- or 3-drug combination
Peptic Ulcer Disease
500 mg PO q8-12hr for 10-14 days
Administer as part of 2- or 3-drug combination
regimen with bismuth subsalicylate, amoxicillin,
H2 receptor antagonist, or proton pump inhibitor
Pharyngitis, Tonsillitis
250 mg PO q12hr for 10 days
Community-Acquired Pneumonia, Skin/Skin
Pharyngitis, Tonsillitis
250 mg PO q12hr for 10 days
Community-Acquired Pneumonia, Skin/Skin
Structure Infection
250 mg PO q12hr for 7-14 days
Extended release: 1000 mg PO once daily for 7 days
Endocarditis
Prophylaxis
500 mg PO 30-60 minutes before surgical procedure
Intravenous
Respiratory tract infections; Skin and soft tissue infections ;
250 mg PO q12hr for 7-14 days
Extended release: 1000 mg PO once daily for 7 days
Endocarditis
Prophylaxis
500 mg PO 30-60 minutes before surgical procedure
Intravenous
Respiratory tract infections; Skin and soft tissue infections ;
Susceptible infections
Adult: 500 mg bid for 2-5 days. Infuse over 60 min using a 0.2%
Adult: 500 mg bid for 2-5 days. Infuse over 60 min using a 0.2%
soln. Revert to oral therapy whenever possible.
Child: PO 15 mg/kg/day, max 1 g/day q12h
Renal impairment:
CrCl (ml/min)
<30 Half the dosage or double dosing interval.
CrCl (ml/min)
<30 Half the dosage or double dosing interval.
Standard release tab & oral susp: May be taken with or without food.
XL & MR tab: Should be taken with food. Swallow whole, do not chew/crush.
XL & MR tab: Should be taken with food. Swallow whole, do not chew/crush.
Respiratory tract infections, Skin and soft tissue infections, Leprosy, peptic
ulcer disease, pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial
exacerbation of chronic bronchitis, pneumonia, legionellosis, Helicobacter
pylori, lyme disease, Community-Acquired Pneumonia.
Hypersensitivity. Patients receiving terfenadine, astemizole, pimozide,
cisapride and ergot derivatives. Pregnancy; history of acute porphyria.
>10%
Gastrointestinal (GI) effects, general (13%)
1-10%
Abnormal taste (adults, 3-7%),Diarrhea (3-6%),Nausea (adults, 3-6%),
Gastrointestinal (GI) effects, general (13%)
1-10%
Abnormal taste (adults, 3-7%),Diarrhea (3-6%),Nausea (adults, 3-6%),
Vomiting (adults, 1%; children, 6%),Elevated blood urea nitrogen
(BUN; 4%),Abdominal pain (adults, 2%; children, 3%),Rash
(children, 3%),Dyspepsia (2%),Heartburn (adults, 2%),
Headache (2%),Elevated prothrombin time (PT; 1%)
<1%
Anaphylaxis,Anorexia,Anxiety,Clostridium difficile colitis,Dizziness,
<1%
Anaphylaxis,Anorexia,Anxiety,Clostridium difficile colitis,Dizziness,
Dyspnea,Elevated liver function tests,Glossitis,Hallucinations,Hepatic
dysfunction,Hepatitis,Hypoglycemia,Increased alkaline phosphatase,
Increased aspartate aminotransferase,Increased bilirubin,Increased
serum creatinine,Jaundice,Leukopenia,Manic behavior,Neuromuscular
blockade,Neutropenia,Pancreatitis,Psychosis,QT prolongation,Seizures,
Stevens-Johnson syndrome,Thrombocytopenia
Potentially Fatal: Pseudomembranous colitis, anaphylaxis,
Potentially Fatal: Pseudomembranous colitis, anaphylaxis,
Stevens-Johnson syndrome.
Macrolides
Category: C
pregnancy_description
pregnancy_description
Clarithromycin inhibits protein synthesis by binding to
50s ribosomal subunits of susceptible organisms.
It has activity against susceptible streptococci and
staphylococci as well as other species including
B. catarrhalis, L. spp, C. trachomatis and U. urealyticum.
Reduced efficacy w/ CYP3A inducers (e.g. phenytoin, carbamazepine).
Strong inducers of CYP450 system (e.g. efavirenz, rifampicin) may
accelerate metabolism, thus lower plasma levels of clarithromycin.
Inhibition of metabolism w/ ritonavir. Torsades de pointes may result
from concomitant quinidine or disopyramide. Increased phosphodiesterase
inhibitor exposure w/ sildenafil, tadalafil or vardenafil. Increased risk of digoxin
toxicity. Decreased concentration of zidovudine. Concomitant use w/ atazanavir,
itraconazole or saquinavir may result to bi-directional drug interactions.
Hypotension, bradyarrhythmias, and lactic acidosis may result when taken
w/ verapamil. Increased risk of myopathy, including rhabdomyolysis w/
HMG-CoA reductase inhibitors. Increased risk of hypoglycaemia w/ oral
hypoglycaemic drugs (e.g. pioglitazone) and insulin. Risk of serious haemorrhage
and elevation of INR and prothrombin time w/ oral anticoagulants. Increased
ototoxicity w/ aminoglycosides. Increased and prolonged sedation w/ triabenzodiazepines
(e.g. midazolam). Potentially Fatal: Concurrent use w/ ergot alkaloids (e.g. ergotamine
or dihydroergotamine) is associated w/ acute ergot toxicity characterised by vasospasm
and ischaemia of the extremities. Concomitant use w/ astemizole, cisapride, pimozide
and terfenadine may result in QT prolongation or ventricular cardiac arrhythmia.
Per Unit Price: Tk. 40.27
Package: 6's pack
Package: 6's pack
Cefuroxime + Clavulanic Acid;
Adolescents & adults:
Pharyngitis or Tonsillitis:
Pharyngitis or Tonsillitis:
250 mg twice daily 5-10 days
Acute bacterial maxillary sinusitis:
Acute bacterial maxillary sinusitis:
250 mg twice daily 10 days
Acute bacterial exacerbation of chronic bronchitis:
Acute bacterial exacerbation of chronic bronchitis:
250-500 mg twice daily 10 days
Secondary bacterial infections of acute bronchitis:
Secondary bacterial infections of acute bronchitis:
250-500 mg twice daily 5-10 days
Community acquired pneumonia:
Community acquired pneumonia:
250-500 mg twice daily 5-10 days
Uncomplicated skin & skin-structure infections:
Uncomplicated skin & skin-structure infections:
250-500 mg twice daily 10 days
MDR Typhoid fever: 500 mg twice daily 10-14 days
Uncomplicated urinary tract infection:
MDR Typhoid fever: 500 mg twice daily 10-14 days
Uncomplicated urinary tract infection:
250 mg twice daily 7-10 days
Uncomplicated gonorrhea: 1000 mg single dose
Lyme disease: 500 mg twice daily 20 days
Uncomplicated gonorrhea: 1000 mg single dose
Lyme disease: 500 mg twice daily 20 days
Paediatric patients (3 months to 12 years)
Pharyngitis or Tonsillitis: 20 mg/kg/day in two divided
Pharyngitis or Tonsillitis: 20 mg/kg/day in two divided
doses 5-10 days
Acute otitis media: 30 mg/kg/day in two divided doses
Acute otitis media: 30 mg/kg/day in two divided doses
10 days
Acute bacterial maxillary sinusitis: 30 mg/kg/day in
Acute bacterial maxillary sinusitis: 30 mg/kg/day in
two divided doses 10 days
Community acquired pneumonia: 30 mg/kg/day in two
Community acquired pneumonia: 30 mg/kg/day in two
divided doses 5-10 days
MDR Typhoid fever: 30 mg/kg/day in two divided
MDR Typhoid fever: 30 mg/kg/day in two divided
doses 10-14 days
Uncomplicated skin & skin-structure infections: 30 mg/kg/day
Uncomplicated skin & skin-structure infections: 30 mg/kg/day
in two divided doses 10 days
Uncomplicated urinary tract infection: 20 mg/kg/day in two
Uncomplicated urinary tract infection: 20 mg/kg/day in two
divided doses 7-10 days
Tab: May be taken with or without food.
Oral susp: Should be taken with food.
Oral susp: Should be taken with food.
Pharyngitis, Acute otitis media, Lyme disease, Susceptible infections,
Sinusitis,Otitis media, Skin and skin structure infections,Tonsillitis,
Respiratory tract infections, Acute Maxillary Sinusitis, MDR Typhoid fever,
Urinary tract infections, Acute bacterial exacerbation of chronic bronchitis,
Surgical Prophylaxis
Hypersensitivity to cephalosporins.
>10%
Diarrhea (4-11%; depends on duration)
1-10%
Decreased hemoglobin or hematocrit (10%),Eosinophilia (7%),Nausea
Diarrhea (4-11%; depends on duration)
1-10%
Decreased hemoglobin or hematocrit (10%),Eosinophilia (7%),Nausea
or vomiting (3-7%),Vaginitis (<5%),Transient rise in hepatic transaminases
(2-4%),Diaper rash (3%),Increase in alkaline phosphatase (2%),
Thrombophlebitis (2%),Increase in lactate dehydrogenase (1%)
<1%
Anemia,Cholestasis,Colitis,Dyspnea,Epidermal necrolysis,Increase in
<1%
Anemia,Cholestasis,Colitis,Dyspnea,Epidermal necrolysis,Increase in
blood urea nitrogen (BUN) and creatinine,Jaundice,Nephritis,Prolonged
prothrombin time (PT)/international normalized ratio (INR),Rash,Stevens-Johnson
syndrome,Stomach cramps,Transient neutropenia and leukopenia,Urticaria
Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.
Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.
Second generation Cephalosporins
Category: B
pregnancy_description
pregnancy_description
Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs)
which inhibits the final transpeptidation step of peptidoglycan synthesis in
bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly
resulting in bacterial cell death. Addition of clavulanate inhibits
beta-lactamase-producing bacteria; Clavulanic acid has a high affinity
for and binds to certain ?-lactamases that generally inactivate Cefuroxime by
hydrolyzing its ?-lactam ring. Combining clavulanate potassium with Cefuroxime
extends the antibacterial spectrum of Cefuroxime to include many bacteria normally
resistant to Cefuroxime and other penicillins and cephalosporins.
May enhance the nephrotoxic effect of strong-acting diuretics (e.g. furosemide) and
aminoglycosides. May enhance the effect of oral anticoagulants. May reduce the
efficacy of OCs. Probenecid prolongs the excretion of cefuroxime and elevated peak serum level.
Per Unit Price: Tk. 50.15
Package: 6's pack
Package: 6's pack
Flucloxacillin:
Adults (including elderly patients):
Oral:
250-500mg 3-4 times a day.
Intravenous
IV 0.25-1 g 4 times/day, may double in severe cases.
Oral:
250-500mg 3-4 times a day.
Intravenous
IV 0.25-1 g 4 times/day, may double in severe cases.
Up to 8 g/day in 3-4 divided doses may be given for
osteomyelitis.
Up to 8 g/day in 4 divided doses for endocarditis in patients
Up to 8 g/day in 4 divided doses for endocarditis in patients
weighing <85 kg and 12 g/day in 6 divided doses for patients
weighing >85 kg.
Children have been given doses of 12.5-25 mg/kg body
weight 4 times a day.
Intravenous
2-10 years: Half of adult dose
Under 2 years: One fourth of adult dose
Intravenous
2-10 years: Half of adult dose
Under 2 years: One fourth of adult dose
Renal impairment:
CrCl (ml/min)
<10 Dosage adjustment may be necessary.
CrCl (ml/min)
<10 Dosage adjustment may be necessary.
Should be taken on an empty stomach. Take on an empty
stomach ½-1 hr before meals.
Reconstitution: Dissolve 250-500 mg in 5-10 mL water for
Reconstitution: Dissolve 250-500 mg in 5-10 mL water for
inj or 1 g in 15-20 mL water for inj. For IV infusion, further dilute
in suitable IV fluids (e.g. water for inj, NaCl 0.9%, glucose 5%,
NaCl 0.18% w/ glucose 4%).
Pneumonia, Burns, Meningitis, Endocarditis, Sinusitis, Septicaemia,
Tonsillitis, Surgical Prophylaxis, Staphylococcal skin infections, Boils,
Osteomyelitis, Enteritis, Wounds, Abscesses, Infected eczema, Infected acne
Hypersensitivity to penicillins. Porphyria.
Hypersensitivity reactions including urticaria; fever; joint pains; rashes;
angioedema; serum sickness-like reactions; haemolytic anaemia;
interstitial nephritis; neutropenia; thrombocytopenia; CNS toxicity
including convulsions; diarrhoea; antibiotic-associated colitis; hepatitis,
cholestatic jaundice; agranulocytosis; phlebitis (IV infusion).
Potentially Fatal: Anaphylaxis. Stevens-Johnson syndrome
Potentially Fatal: Anaphylaxis. Stevens-Johnson syndrome
Penicillinase-resistant penicillins
Category: B
pregnancy_description
pregnancy_description
Flucloxacillin inhibits the 3rd and last step of bacterial cell wall synthesis by binding
to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall.
It is active against penicillinase-producing and non-penicillinase-producing
staphylococci.
May increase the risk of methotrexate toxicity. May decrease the efficacy of
oestrogen-containing OC. Enhanced plasma concentrations w/ probenecid.
Bacteriostatic drugs (e.g. chloramphenicol, tetracycline) may interfere w/ the
bactericidal effect of flucloxacillin. May prolong bleeding time in patients on
oral anticoagulants.
Per Unit Price: Tk. 61.23
Package: 100ml bot
Package: 100ml bot
Metronidazole:
Oral
Child: PO 30–50 mg/kg/day q8h
Amoebiasis
Adult: 800 mg tid for 5 days (intestinal infection);
Child: PO 30–50 mg/kg/day q8h
Amoebiasis
Adult: 800 mg tid for 5 days (intestinal infection);
5-10 days (extra-intestinal infection). Max: 2.4 g/day.
Trichomoniasis
Adult: 2 g as a single dose, 200 mg tid for 7 days or 400 mg
Trichomoniasis
Adult: 2 g as a single dose, 200 mg tid for 7 days or 400 mg
bid for 5-7 days. Sexual partners should also be treated.
Repeat treatment 4-6 wk between courses as necessary.
Giardiasis
Adult: 2 g once daily for 3 days, 400 mg tid for 5 days or 500 mg
Giardiasis
Adult: 2 g once daily for 3 days, 400 mg tid for 5 days or 500 mg
bid for 7-10 days.
Bacterial vaginosis
Adult: 2 g as a single dose or 400 mg bid for 5-7 days.
Acute necrotising ulcerative gingivitis
Adult: 200 mg tid for 3 days.
Anaerobic bacterial infections
Adult: Initially, 800 mg followed by 400 mg 8 hrly. Alternatively,
Bacterial vaginosis
Adult: 2 g as a single dose or 400 mg bid for 5-7 days.
Acute necrotising ulcerative gingivitis
Adult: 200 mg tid for 3 days.
Anaerobic bacterial infections
Adult: Initially, 800 mg followed by 400 mg 8 hrly. Alternatively,
7.5 mg/kg 6-8 hrly. Max: 4 g/day. Duration of treatment is usually
for 7 days depending on the severity of infection.
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 400 mg 8 hrly 24 hr prior to surgery followed by post-op IV or
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 400 mg 8 hrly 24 hr prior to surgery followed by post-op IV or
rectal admin until oral therapy is possible.
Eradication of H. pylori associated with peptic ulcer disease
Adult: 400 mg bid in combination w/ another antibacterial and a PPI
Eradication of H. pylori associated with peptic ulcer disease
Adult: 400 mg bid in combination w/ another antibacterial and a PPI
or 400 mg tid, if given w/ omeprazole and amoxicillin. Initial
treatment is given for 1 wk.
Leg ulcers and pressure sores
Adult: 400 mg tid for 7 days.
Acute dental infections
Adult: 200 mg tid for 3-7 days.
Intravenous
Children: IV 22.5–40 mg/kg/day q8h
Anaerobic bacterial infections
Adult: 500 mg infused as 100 mL of a 5 mg/mL soln at 5 mL/min
Leg ulcers and pressure sores
Adult: 400 mg tid for 7 days.
Acute dental infections
Adult: 200 mg tid for 3-7 days.
Intravenous
Children: IV 22.5–40 mg/kg/day q8h
Anaerobic bacterial infections
Adult: 500 mg infused as 100 mL of a 5 mg/mL soln at 5 mL/min
8 hrly. Alternatively, 15 mg/kg infused over 1 hr, followed by 7.5 mg/kg
infused over 1 hr 6 hrly. Max: 4 g/day. Substitute oral therapy as soo
as possible.
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 500 mg shortly before operation and repeated 8 hrly. Alternatively,
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 500 mg shortly before operation and repeated 8 hrly. Alternatively,
15 mg/kg infused over 30-60 min and completed approx 1 hr before surgery,
followed by 7.5 mg/kg infused over 30-60 min at 6 and 12 hr after the initial dose.
Hepatic impairment: Severe: 1/3 of usual dose once daily.
Hepatic impairment: Severe: 1/3 of usual dose once daily.
Oral
Amoebiasis
Child: 1-3 yr 100-200 mg tid;
>3-7 yr 100-200 mg 4 times daily;
>7-10 yr 200-400 mg tid. Doses are given for 5-10 days.
Trichomoniasis
Child: 1-10 yr 40 mg/kg as a single dose or 15-30 mg/kg
Amoebiasis
Child: 1-3 yr 100-200 mg tid;
>3-7 yr 100-200 mg 4 times daily;
>7-10 yr 200-400 mg tid. Doses are given for 5-10 days.
Trichomoniasis
Child: 1-10 yr 40 mg/kg as a single dose or 15-30 mg/kg
daily in 2-3 divided doses for 7 days. Max: 2 g/dose.
Giardiasis
Child: 1-3 yr 500 mg once daily;
>3-7 yr 600-800 mg once daily;
>7-10 yr 1 g once daily. Doses are given for 3 days.
Acute necrotising ulcerative gingivitis
Child: 1-3 yr 50 mg tid;
>3-7 yr 100 mg bid;
>7-10 yr 100 mg tid. Doses are given for 3 days.
Anaerobic bacterial infections
Child: <8 wk 7.5 mg/kg 12 hrly or 15 mg/kg once daily.
8 wk to 12 yr 7.5 mg/kg 8 hrly or 20-30 mg/kg once daily. Duration
Giardiasis
Child: 1-3 yr 500 mg once daily;
>3-7 yr 600-800 mg once daily;
>7-10 yr 1 g once daily. Doses are given for 3 days.
Acute necrotising ulcerative gingivitis
Child: 1-3 yr 50 mg tid;
>3-7 yr 100 mg bid;
>7-10 yr 100 mg tid. Doses are given for 3 days.
Anaerobic bacterial infections
Child: <8 wk 7.5 mg/kg 12 hrly or 15 mg/kg once daily.
8 wk to 12 yr 7.5 mg/kg 8 hrly or 20-30 mg/kg once daily. Duration
of treatment is usually for 7 days depending on the severity of infection.
Prophylaxis of postoperative anaerobic bacterial infections
Child: <40 wk 10 mg/kg as a single dose before surgery;
<12 yr 20-30 mg/kg as a single dose 1-2 hr before surgery.
Intravenous
Anaerobic bacterial infections
Child: 7.5 mg/kg 8 hrly.
Prophylaxis of postoperative anaerobic bacterial infections
Child: <40 wk 10 mg/kg as a single dose before surgery;
<12 yr 20-30 mg/kg as a single dose 1-2 hr before surgery.
Intravenous
Anaerobic bacterial infections
Child: 7.5 mg/kg 8 hrly.
Susp: Should be taken on an empty stomach. Take at least
1 hr before meals.
Tab: Should be taken with food.
Reconstitution: Add 4.4 mL of sterile or bacteriostatic water for inj,
Tab: Should be taken with food.
Reconstitution: Add 4.4 mL of sterile or bacteriostatic water for inj,
NaCl 0.9% inj, or bacteriostatic NaCl inj to a vial labeled as containing
metronidazole 500 mg. The resultant soln contains approx 100 mg/mL
and must be further diluted w/ NaCl 0.9% inj, dextrose 5% inj, or lactated
Ringer's inj to a concentration of 8 mg/mL or less. The reconstituted and
diluted soln must then be neutralised by adding approx 5 mEq of Na
bicarbonate inj for each 500 mg.
Pneumonia, Giardiasis, Peptic ulcer disease, Peritonitis, H. pylori infection,
Rosacea, Septicemia, Endometritis, Aspiration pneumonia, Lung abscess,
Empyema, Bone and Joint Infections, Surgical Prophylaxis, Amoebiasis,
Bacterial vaginosis, Balantidiasis, Blastocystis hominis infection,
Trichomoniasis, Acute dental infections, Acute necrotising ulcerative
gingivitis, Anaerobic bacterial infections, Antibiotic-associated colitis,
Fungating tumours, Leg ulcers and pressure sores, Diverticulitis,
Diabetic foot ulcer, Meningitis and brain abscesses, endocarditis
History of hypersensitivity to metronidazole or other nitroimidazole
derivatives. Pregnancy (1st trimester) and lactation.
GI disturbances e.g. nausea, unpleasant metallic taste, vomiting,
diarrhoea or constipation. Furred tongue, glossitis, and stomatitis due
to overgrowth of Candida. Rarely, antibiotic-associated colitis. Weakness,
dizziness, ataxia, headache, drowsiness, insomnia, changes in mood or
mental state. Numbness or tingling in the extremities, epileptiform
seizures (high doses or prolonged treatment). Transient leucopenia
and thrombocytopenia. Hypersensitivity reactions. Urethral discomfort
and darkening of urine. Raised liver enzyme values, cholestatic hepatitis,
jaundice. Thrombophlebitis (IV).
Potentially Fatal: Anaphylaxis.
Potentially Fatal: Anaphylaxis.
Anti-diarrhoeal Antiprotozoal
Category: A
pregnancy_description
pregnancy_description
Metronidazole is converted to reduction products that interact w/
DNA to cause destruction of helical DNA structure and strand leading to
a protein synthesis inhibition and cell death in susceptible organisms.
It is active against most anaerobic protozoa, some gm+ve, gm-ve and
facultative anaerobes.
Concurrent use w/ disulfiram may produce psychotic reactions. May
potentiate the effect of oral anticoagulants. May increase risk of lithium
toxicity. May reduce the renal clearance resulting to increased toxicity of
5-fluorouracil. May increase serum levels of ciclosporin. May increase
plasma levels of busulfan resulting to severe busulfan toxicity. Enhanced
metabolism w/ phenobarbital and phenytoin resulting to decreased serum
concentrations.
Per Unit Price: Tk. 29
Package: 60ml bot
Package: 60ml bot
Adult: PO Serious anaerobic infections 150-300 mg 6 hrly,
up to 450 mg 6 hrly for severe infections.
Max: 1.8 g/day.
Prophylaxis of endocarditis 600 mg 1 hr before dental procedure.
IV Serious anaerobic infections 0.6-2.7 g/day in divided does,
Max: 1.8 g/day.
Prophylaxis of endocarditis 600 mg 1 hr before dental procedure.
IV Serious anaerobic infections 0.6-2.7 g/day in divided does,
up to 4.8 g/day for severe infections.
Toxic shock syndrome W/ penicillin G or ceftriaxone: 900 mg 8 hrly.
Pelvic inflammatory disease W/ gentamicin: 900 mg 8 hrly.
Bacterial Vaginosis: 300 mg PO q12hr for 7 days
Toxic shock syndrome W/ penicillin G or ceftriaxone: 900 mg 8 hrly.
Pelvic inflammatory disease W/ gentamicin: 900 mg 8 hrly.
Bacterial Vaginosis: 300 mg PO q12hr for 7 days
Neonates (less than 1 month): 15 to 20 mg/kg/day in 3 to 4 equal doses.
The lower effective dosage may be adequate for small prematures.
Child: PO 10–25 mg/kg/day q8h
30–40 mg/kg/day for CA-MRSA, intra-abdominal infection, or AOM
Parenteral (IV/IM) administration: 20–40 mg/kg/day q8h. The higher
Child: PO 10–25 mg/kg/day q8h
30–40 mg/kg/day for CA-MRSA, intra-abdominal infection, or AOM
Parenteral (IV/IM) administration: 20–40 mg/kg/day q8h. The higher
doses would be used for more severe infections.
Cap: May be taken with or without food. Swallow whole w/ a
full glass of water & in an upright position.
Granules: Should be taken with food.
IV Preparation
Dilute 300 and 600 mg in 50 mL of D5W
Dilute 900 mg in 50-100 mL of D5W
Dilute 1200 mg in 100 mL of D5W
IV Administration
Intermittent IV infusion
Infuse over 10-60 min at a rate not exceeding 30 mg/min
300 mg doses infuse over 10 min
600 mg doses infuse over 20 min
900 mg doses infuse over 30 min
1200 mg doses infuse over 60 min; no more than 1200 mg
Granules: Should be taken with food.
IV Preparation
Dilute 300 and 600 mg in 50 mL of D5W
Dilute 900 mg in 50-100 mL of D5W
Dilute 1200 mg in 100 mL of D5W
IV Administration
Intermittent IV infusion
Infuse over 10-60 min at a rate not exceeding 30 mg/min
300 mg doses infuse over 10 min
600 mg doses infuse over 20 min
900 mg doses infuse over 30 min
1200 mg doses infuse over 60 min; no more than 1200 mg
of drug should be given by IV infusion in 1 hr
Continuous IV infusion
May give continuous IV infusion instead of intermittent after
Continuous IV infusion
May give continuous IV infusion instead of intermittent after
first dose has been given by rapid IV infusion
Dental infections, Respiratory tract infections, Skin and soft tissue infections,
peritonitis, acne, anaerobic infections, endocarditis, Toxic shock syndrome,
Bacterial vaginosis, Pelvic inflammatory disease
Hypersensitivity.
Diarrhoea, nausea, vomiting, abdominal pain; erythema multiforme,
contact dermatitis, exfoliative and vesiculous dermatitis, urticaria;
eosinophilia; local irritation, thrombophloebitis.
Potentially Fatal: Gasping syndrome (neonates); pseudomembranous colitis.
Potentially Fatal: Gasping syndrome (neonates); pseudomembranous colitis.
Category: B
pregnancy_description
pregnancy_description
Clindamycin inhibits protein synthesis by reversibly binding to the 50S subunit
of the ribosomal thus blocking the transpeptidation or translocation reactions of
susceptible organisms resulting to stunted cell growth.
May enhance the action of neuromuscular blocking agents (e.g. atracurium).
May antagonise the effects of parasympathomimetics. May competitively
inhibit the effects of macrolides, ketolides, streptogramins, linezolid and
chloramphenicol. Increased coagulation tests (prothrombin time/INR)
and/or bleeding w/ vit K antagonists (e.g. warfarin, acenocoumarol, fluindione).
Per Unit Price: Tk. 15.1
Package: 30's pack
Package: 30's pack
Ciprofloxacin:
Oral
Adult Dose: For oral dosage & suspension: Urinary
Adult Dose: For oral dosage & suspension: Urinary
Tract infection: Acute uncomplicated: 250 mg twice daily
for 3 days; Mild/Moderate: 250 mg twice daily for 7 to 14
days; Severe/Complicated: 500 mg twice daily for 7 to 14 days;
Chronic Bacterial Prostitis : 500 mg twice daily for 28 days;
Lower Respiratory Tract infection: Mild/Moderate: 500 mg
Chronic Bacterial Prostitis : 500 mg twice daily for 28 days;
Lower Respiratory Tract infection: Mild/Moderate: 500 mg
twice daily for 7 to 14 days, Severe/Complicated : 750 mg
twice daily for 7 to 14 days;
Acute Sinusitis : 500 mg twice daily for 10 days; Skin and Skin
Acute Sinusitis : 500 mg twice daily for 10 days; Skin and Skin
Structure infection: Mild/Moderate : 500 mg twice daily for 7 to
14 days, Severe/Complicated : 750 mg twice daily for 7 to 14 days,
Bone and joint infection: Mild/Moderate 500 mg twice daily for 4 to
Bone and joint infection: Mild/Moderate 500 mg twice daily for 4 to
6 weeks, Severe/Complicated : 750 mg twice daily for 4 to 6 weeks,
Intra Abdominal Infection: 500 mg twice daily for 7 to 14 days,
Intra Abdominal Infection: 500 mg twice daily for 7 to 14 days,
Infectious Diarrhea: Mild/Moderate/Severe: 500 mg twice
daily for 5 to 7 days, Typhoid Fever : 500 mg twice daily for 10 days,
Urethral & Cervical Gonococcal Infections:
Urethral & Cervical Gonococcal Infections:
Uncomplicated: 250 mg Single dose.
Ciprofloxacin extended release:
PO Adults 500–1,000 mg q24h.
For IV infusion :
Urinary Tract Infection: Mild to Moderate: 200 mg 12 hourly
Ciprofloxacin extended release:
PO Adults 500–1,000 mg q24h.
For IV infusion :
Urinary Tract Infection: Mild to Moderate: 200 mg 12 hourly
for 7-14 days;Severe or Complicated: 400 mg 12 hourly for 7-14 days;
Lower Respiratory Tract infection: Mild to Moderate: 400 mg 12 hourly
Lower Respiratory Tract infection: Mild to Moderate: 400 mg 12 hourly
for 7-14 days; Severe or Complicated: 400 mg 8 hourly for 7-14 days;
Nosocomial Pneumonia: Mild/Moderate/Severe: 400 mg 8 hourly for 10-14 days;
Skin and Skin Structure: Mild to Moderate: 400 mg 12 hourly for 7-14 days;
Skin and Skin Structure: Mild to Moderate: 400 mg 12 hourly for 7-14 days;
Severe or Complicated: 400 mg 8 hourly for 7-14 days; Bone and
Joint Infection: Mild to Moderate: 400 mg 12 hourly for more than 4-6 weeks;
Severe/Comlicated: 400 mg 8 hourly for more than 4-6weeks;
Intra abdominal (Acute abdomen): Complicated: 400 mg 12 hourly for 7-14 days;
Intra abdominal (Acute abdomen): Complicated: 400 mg 12 hourly for 7-14 days;
Acute Sinusitis: Mild/Moderate: 400 mg 12 hourly for10 days:
Chronic Bacterial Prostatitis: Mild/Moderate: 400 mg 12 hourly for 28 Days.
Chronic Bacterial Prostatitis: Mild/Moderate: 400 mg 12 hourly for 28 Days.
Child Dose: PO 20–40 mg/kg/day, max 1.5 g/day q12h.
IV 20–30 mg/kg/day, max 1.2 g/day q12h.
Children and adolescents: RTI & GI infections: Neonate-15mg/kg twice daily,
IV 20–30 mg/kg/day, max 1.2 g/day q12h.
Children and adolescents: RTI & GI infections: Neonate-15mg/kg twice daily,
Child (1 month -18 years)-20mg/kg (max 750 mg) twice daily;
UTI: Neonate-10 mg/kg twice daily, Child (1 month -18 years)-10mg/kg
UTI: Neonate-10 mg/kg twice daily, Child (1 month -18 years)-10mg/kg
(max 750 mg) twice daily;
Pseudomonal lower respiratory tract infection in cystic fibrosis: Child
Pseudomonal lower respiratory tract infection in cystic fibrosis: Child
(1 month -18 years) - 20mg/kg (max 750 mg) twice daily; Anthrax
(treatment & post exposure prophylaxis): Child (1 month -18 years)
- 20mg/kg (max 750 mg) twice daily.
Renal impairment
CrCl >50 mL/min: Dose adjustment not necessary
CrCl 30-50 mL/min: 250-500 mg PO q12hr
CrCl <30 mL/min: Extended-release, 500 mg PO q24hr
CrCl 5-29 mL/min: 250-500 mg PO q18hr or 200-400 mg IV q18-24hr
Some clinicians suggest decreasing dose but not frequency of administration
Hemodialysis: 0.25-0.5 g PO q12hr or 0.2-0.4 g IV q24hr
Peritoneal dialysis: 0.25-0.5 g PO q8hr or 0.2-0.4 g IV q24hr
CrCl >50 mL/min: Dose adjustment not necessary
CrCl 30-50 mL/min: 250-500 mg PO q12hr
CrCl <30 mL/min: Extended-release, 500 mg PO q24hr
CrCl 5-29 mL/min: 250-500 mg PO q18hr or 200-400 mg IV q18-24hr
Some clinicians suggest decreasing dose but not frequency of administration
Hemodialysis: 0.25-0.5 g PO q12hr or 0.2-0.4 g IV q24hr
Peritoneal dialysis: 0.25-0.5 g PO q8hr or 0.2-0.4 g IV q24hr
May be taken with or without food. May be taken w/ meals to minimise
GI discomfort. Do not take w/ antacids, Fe or dairy products.
IV Administration
Infuse 1-2 mg/mL (diluted in D5W or NS) into large vein over 60 minutes
IV Administration
Infuse 1-2 mg/mL (diluted in D5W or NS) into large vein over 60 minutes
Cystic fibrosis, Intra-abdominal infections, Meningitis, Peritonitis,
Endocarditis, Anthrax, Otitis media, Septicaemia, Lower Respiratory
Tract Infections, Cystitis, Gonorrhoea, Skin and skin structure infections,
Nosocomial pneumonia, Urinary tract infections, Enteric fever, Bone and
Joint Infections, Biliary tract infections, Surgical Prophylaxis, Gastroenteritis,
Q fever, Acute Sinusitis, Cat scratch disease, Spotted fever, Typhus,
Chanroid, Brucellosis, Typhoid and paratyphoid fever, Superficial
ophthalmic infections, Otitis externa
Hypersensitivity. Not to be used concurrently with tizanidine.
Avoid exposure to strong sunlight or sun lamps during treatment.
1-10%
Nausea (3%),Abdominal pain (2%),Diarrhea (2% adults; 5% children),
Nausea (3%),Abdominal pain (2%),Diarrhea (2% adults; 5% children),
Increased aminotransferase levels (2%),Vomiting (1% adults; 5% children),
Headache (1%),Increased serum creatinine (1%),Rash (2%),Restlessness (1%)
<1%
Acidosis,Allergic reaction,Angina pectoris,Anorexia,Arthralgia,
<1%
Acidosis,Allergic reaction,Angina pectoris,Anorexia,Arthralgia,
Ataxia,Back pain,Bad taste,Blurred vision,Breast pain,Bronchospasm,
Diplopia,Dizziness,Drowsiness,Dysphagia,Dyspnea,Flushing,Foot pain,
Hallucinations,Hiccups,Hypertension,Hypotension,Insomnia,Irritability,
Joint stiffness,Lethargy,Migraine,Nephritis,Nightmares,Oral candidiasis
,Palpitation,Photosensitivity,Polyuria,Syncope,Tachycardia,Tinnitus,
Tremor,Urinary retention,Vaginitis
Potentially Fatal: Anaphylactoid reaction; cardiopulmonary arrest.
Potentially Fatal: Anaphylactoid reaction; cardiopulmonary arrest.
Anti-diarrhoeal Antimicrobial drugs
Category: C
pregnancy_description
pregnancy_description
Ciprofloxacin promotes breakage of double-stranded DNA in
susceptible organisms and inhibits DNA gyrase, which is
essential in reproduction of bacterial DNA.
May increase plasma concentrations of CYP1A2 substrates
(e.g. clozapine, ropinirole, theophylline). Enhances effect of
oral anticoagulants (e.g. warfarin) and glibenclamide. Increased
toxicity of methotrexate. Plasma concentrations may be increased
by probenecid. Reduced absorption w/ oral multivitamins and
mineral supplements containing divalent or trivalent cations
(e.g. Fe, Zn, Ca) and antacids containing Al, Ca or Mg. Concomitant
use w/ class IA antiarrhythmics (e.g. quinidine, procainamide), class
III antiarrhythmics (e.g. amiodarone, sotalol), TCAs, macrolides and
antipsychotics may result in additive effects on QT interval prolongation.
Concurrent use w/ corticosteroids may increase risk of severe tendon
disorders. Increased risk of CNS stimulation w/ NSAIDs. Altered serum
concentrations of phenytoin. Potentially Fatal: Marked elevation in serum
levels of tizanidine which is associated w/ potentiated hypotensive
and sedative effect.
Per Unit Price: Tk. 8.56
Package: 50's pack
Package: 50's pack
Meropenem:
Brand name: Neopanan(Healthcare),Meropen(Renata)
Spacebac(Square),
Intravenous
Intra-abdominal infections
Adult: 1 g 8 hrly via IV inj over approx 3-5 min
Intra-abdominal infections
Adult: 1 g 8 hrly via IV inj over approx 3-5 min
or infused over approx 15-30 min.
Skin and skin structure infections
Adult: 500 mg 8 hrly via IV inj over approx 3-5 min
Skin and skin structure infections
Adult: 500 mg 8 hrly via IV inj over approx 3-5 min
or infused over approx 15-30 min.
Cystic fibrosis, Meningitis
Adult: 2 g 8 hrly infused over approx 15-30 min.
Susceptible infections
Adult: 0.5-1 g 8 hrly via IV inj over approx 3-5 min or
Cystic fibrosis, Meningitis
Adult: 2 g 8 hrly infused over approx 15-30 min.
Susceptible infections
Adult: 0.5-1 g 8 hrly via IV inj over approx 3-5 min or
infused over approx 15-30 min.
Hepatic impairment: No dosage adjustment needed.
Hepatic impairment: No dosage adjustment needed.
Children:
IV 60 mg/kg/day, max 3 g/day q8h
120 mg/kg/day meningitis, max 6 g/day q8h
Intravenous
Intra-abdominal infections
Child: >3mth ?50 kg: 20 mg/kg 8 hrly via IV inj over
IV 60 mg/kg/day, max 3 g/day q8h
120 mg/kg/day meningitis, max 6 g/day q8h
Intravenous
Intra-abdominal infections
Child: >3mth ?50 kg: 20 mg/kg 8 hrly via IV inj over
approx 3-5 min or infused over approx 15-30 min.
Max: 1000 mg.
Skin and skin structure infections
Child: >3 mth ?50 kg: 10 mg/kg 8 hrly via IV inj over
Skin and skin structure infections
Child: >3 mth ?50 kg: 10 mg/kg 8 hrly via IV inj over
approx 3-5 min or infused over approx 15-30 min.
Max: 500 mg.
Cystic fibrosis, Meningitis
Child: >3 mth ?50 kg: 40 mg/kg 8 hrly via IV inj over
Cystic fibrosis, Meningitis
Child: >3 mth ?50 kg: 40 mg/kg 8 hrly via IV inj over
approx 3-5 min or infused over approx 15-30 min. Max: 2 g.
Susceptible infections
Child: >3 mth ?50 kg: 10 or 20 mg/kg 8 hrly via IV
Susceptible infections
Child: >3 mth ?50 kg: 10 or 20 mg/kg 8 hrly via IV
inj over approx 3-5 min or infused over approx 15-30 min.
Renal impairment:
CrCl (ml/min)
26-50 Usual dose 12 hrly.
10-25 Half the usual dose 12 hrly.
<10 Half the usual dose 24 hrly.
CrCl (ml/min)
26-50 Usual dose 12 hrly.
10-25 Half the usual dose 12 hrly.
<10 Half the usual dose 24 hrly.
IV Administration
Administer IV infusion over 15-30 minutes;
Administer IV infusion over 15-30 minutes;
administer IV bolus over 3-5 minutes
Cystic fibrosis, Intra-abdominal infections, Meningitis,
Skin and skin structure infections, Diabetic foot infection
Hypersensitivity to meropenem, other carbapenems.
History of anaphylactic reaction to β-lactams
(e.g. penicillins, cephalosporins).
1-10%
Constipation (1-7%),Diarrhea (4-5%),Nausea or vomiting
Constipation (1-7%),Diarrhea (4-5%),Nausea or vomiting
(1-4%),Rash (2-3%; includes diaper-area moniliasis in
pediatric patients),Headache (2%),Inflammation at injection
site (2%),Sepsis (2%),Oral moniliasis (≤2% in pediatric patients),
Bleeding (1.2%),Apnea (1%),Constipation (1%),Glossitis (1%),
Injection-site reaction (1%),Phlebitis or thrombophlebitis (1%),
Pruritus (1%),Septic shock (1%)
<1%
Agranulocytosis,Angioedema,Erythema multiforme,Hypersensitivity
<1%
Agranulocytosis,Angioedema,Erythema multiforme,Hypersensitivity
reaction,Hypokalemia,Leukopenia,Neutropenia,Pleural effusion,
Stevens-Johnson syndrome,Toxic epidermal necrolysis disorders
or renal impairment.
Potentially Fatal: Anaphylaxis; pseudomembranous colitis;
Potentially Fatal: Anaphylaxis; pseudomembranous colitis;
Stevens-Johnsons sydrome.
Other beta-lactam Antibiotics
Category: Not Classified
pregnancy_description
pregnancy_description
Meropenem is a synthetic carbapenem beta-lactam antibiotic that
exerts its bactericidal activity by inhibiting bacterial cell wall synthesis
in gm+ve and gm-ve bacteria through binding to several penicillin-
binding proteins (PBPs).
Increased plasma concentration w/ probenecid. May decrease plasma
levels of valproic acid thus, increasing the risk of seizures.
Per Unit Price: Tk. 1300
Package: 1's pack
Package: 1's pack
Ceftazidime:
Bone & Joint Infections
2 g IV q12hr
Gynecologic & Intra-abdominal Infections,
2 g IV q12hr
Gynecologic & Intra-abdominal Infections,
Meningitis, Complicated Pneumonia,
Life-Threatening Infections
2 g IV q8hr
Pulmonary Infections
Infections caused by Pseudomonas spp in
2 g IV q8hr
Pulmonary Infections
Infections caused by Pseudomonas spp in
patients with cystic fibrosis who have healthy
renal function
30-50 mg/kg IV q8hr; not to exceed 6 g/day
Uncomplicated Pneumonia
0.5-1 g IV q8hr
Mild Skin/Skin Structure Infections
0.5-1 g IV or IM q8hr
Urinary Tract Infections
Complicated: 500 mg IV or IM q8-12hr
Uncomplicated: 250 mg IV or IM q12hr
Elderly: >80 yr Max: 3 g daily.
30-50 mg/kg IV q8hr; not to exceed 6 g/day
Uncomplicated Pneumonia
0.5-1 g IV q8hr
Mild Skin/Skin Structure Infections
0.5-1 g IV or IM q8hr
Urinary Tract Infections
Complicated: 500 mg IV or IM q8-12hr
Uncomplicated: 250 mg IV or IM q12hr
Elderly: >80 yr Max: 3 g daily.
Child: IV, IM 90–150 mg/kg/day q8h
IV 200–300 mg/kg/day for serious Pseudomonas
IV 200–300 mg/kg/day for serious Pseudomonas
infection (max 8–12 g/day) q8h
Renal impairment: Loading dose: 1 g; maintenance
doses based on CrCl. May need to increase doses by
50% in severe infections. Peritoneal dialysis: Loading
dose is followed by 500 mg every 24 hr; may add
ceftazidime to the dialysis fluid (usually 125-250 mg
for 2 litres of dialysis fluid). Haemodialysis: Admin
loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)
31-50 1 g every 12 hr.
16-30 1 g every 24 hr.
6-15 500 mg every 24 hr.
<5 500 mg every 48 hr.
CrCl (ml/min)
31-50 1 g every 12 hr.
16-30 1 g every 24 hr.
6-15 500 mg every 24 hr.
<5 500 mg every 48 hr.
IV/IM Administration
IV
Direct injection: Inject over 3-5 minutes directly into vein
IV
Direct injection: Inject over 3-5 minutes directly into vein
or through tubing of running compatible infusion solution
Infusion: Infuse intermittently over 15-30 minutes
IM
Inject deeply
Infusion: Infuse intermittently over 15-30 minutes
IM
Inject deeply
Pneumonia, Cystic fibrosis, Bacterial septicemia, Meningitis,
Peritonitis, Skin and Skin-Structure Infections, Endometritis,
Pelvic cellulitis, Respiratory tract infections, Urinary tract infections,
Febrile neutropenia, Melioidosis, Bone and Joint Infections,
G ynecologic Infections, Biliary tract infections, Endophthalmitis
Hypersensitivity to cephalosporins.
1-10%
Transient increases in transaminases (3-9%),Eosinophilia (<7%),Diarrhea
Transient increases in transaminases (3-9%),Eosinophilia (<7%),Diarrhea
(<2%),Immune hypersensitivity reaction (2%),Phlebitis (<2%),Rash
(maculopapular or erythematous) (2%),Thrombocytosis (2%),
Injection site pain (1%)
<1%
Abdominal pain,Agranulocytosis,Angioedema,Asterixis,Coma,Dizziness,
<1%
Abdominal pain,Agranulocytosis,Angioedema,Asterixis,Coma,Dizziness,
Encephalopathy,Fever,Hallucinations,Increased serum concentrations of
bilirubin,Leukopenia,Lymphocytosis,Metallic taste,Myoclonia,Nausea or
vomiting,Neuromuscular excitability,Neutropenia,Paresthesia,
Photosensitivity,Pruritus,Seizures,Thrombocytopenia,Transient
increases in blood urea nitrogen (BUN) or serum creatinine,Urticaria
Potentially Fatal: Anaphylactic reactions, nephrotoxicity,
Potentially Fatal: Anaphylactic reactions, nephrotoxicity,
pseudomembranous colitis.
Third generation Cephalosporins
Category: B
pregnancy_description
pregnancy_description
Ceftazidime binds to one or more of the penicillin-binding proteins (PBPs)
which inhibits the final transpeptidation step of peptidoglycan synthesis in
bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall
assembly resulting in bacterial cell death.
May increase nephrotoxicity of aminoglycosides. May diminish therapeutic
effect of BCG, typhoid vaccine, Na picosulfate. May increase anticoagulant
effect of vit K antagonists (e.g. warfarin). May increase serum
level w/ probenecid.
Per Unit Price: Tk. 240.72
Package: 1's Pack
Package: 1's Pack
Amikacin:
Brand Name; INJ.Kacin(ACL)
Parenteral
Uncomplicated urinary tract infections
Adult: 250 mg bid, given via IM, IV
Uncomplicated urinary tract infections
Adult: 250 mg bid, given via IM, IV
inj over 2-3 minutes or as IV infusion.
Severe Gram-negative infections resistant
Severe Gram-negative infections resistant
to gentamicin and tobramycin
Adult: 15 mg/kg daily in equally divided doses
Adult: 15 mg/kg daily in equally divided doses
injected every 8 or 12 hr for 7-10 days. Max: Up to 500 mg
every 8 hr in life-threatening infections.
Max cumulative dose: 15 g. Doses may be given via IM,
Max cumulative dose: 15 g. Doses may be given via IM,
slow IV inj over 2-3 minutes or IV infusion.
Hospital Acquired Pneumonia
20 mg/kg/day IV; may administer with antipseudomonal
Hospital Acquired Pneumonia
20 mg/kg/day IV; may administer with antipseudomonal
beta-lactam or carbapenem
Parenteral
Child: IV, IM 15–22.5 mg/kg/day q8h
Neonates
Aged <7 days
<29 weeks gestational age: 18 mg/kg IV/IM q48hr
30-33 weeks gestational age: 18 mg/kg IV/IM q36hr
>34 weeks gestational age: 15 mg/kg IV/IM q24hr
Aged >7 days
30-33 weeks gestational age: 15 mg/kg IV/IM q24hr
>34 weeks gestational age: 15 mg/kg IV/IM q12-18hr
Aged 8-28 days old & <29 weeks gestational age
15 mg/kg IV/IM q36hr
Neonates Aged >28 days old & <29 weeks gestational age
15 mg/kg IV/IM q24hr
Also use this dose for the following: significant asphyxia,
Child: IV, IM 15–22.5 mg/kg/day q8h
Neonates
Aged <7 days
<29 weeks gestational age: 18 mg/kg IV/IM q48hr
30-33 weeks gestational age: 18 mg/kg IV/IM q36hr
>34 weeks gestational age: 15 mg/kg IV/IM q24hr
Aged >7 days
30-33 weeks gestational age: 15 mg/kg IV/IM q24hr
>34 weeks gestational age: 15 mg/kg IV/IM q12-18hr
Aged 8-28 days old & <29 weeks gestational age
15 mg/kg IV/IM q36hr
Neonates Aged >28 days old & <29 weeks gestational age
15 mg/kg IV/IM q24hr
Also use this dose for the following: significant asphyxia,
indomethacin for PDA, poor cardiac output, or renal impairment
Renal impairment: Doses should be adjusted either by administering
normal doses at prolonged intervals or by administering reduced
doses at fixed intervals based on the patient's CrCl or serum
creatinine values.
Simple doses schedule for renal impairment is given below:
Renal function Dosage schedule
Mild impairment 500 mg every 18 hours
Moderate impairment 500 mg every 24 hours
Severe impairment 250 mg every 24 hours.
or
CrCl >90 mL/min and aged <60 yr: q8hr
CrCl 60-90 mL/min OR aged ?60 yr: q12hr
CrCl 25-60 mL/min: q24hr
CrCl 10-25 mL/min: q48hr
CrCl <10 mL/min: q72hr
Administer after dialysis in ESRD
Simple doses schedule for renal impairment is given below:
Renal function Dosage schedule
Mild impairment 500 mg every 18 hours
Moderate impairment 500 mg every 24 hours
Severe impairment 250 mg every 24 hours.
or
CrCl >90 mL/min and aged <60 yr: q8hr
CrCl 60-90 mL/min OR aged ?60 yr: q12hr
CrCl 25-60 mL/min: q24hr
CrCl 10-25 mL/min: q48hr
CrCl <10 mL/min: q72hr
Administer after dialysis in ESRD
IV/IM Administration
IM: Administer undiluted to upper outer quadrant of buttocks
IV: Infuse over 30-60 min in adults and children; infuse
IM: Administer undiluted to upper outer quadrant of buttocks
IV: Infuse over 30-60 min in adults and children; infuse
over 1-2 hr in infants
Reconstitution: IV infusion: For adults, add 500 mg of amikacin to
Reconstitution: IV infusion: For adults, add 500 mg of amikacin to
100-200 mL of compatible IV fluid (e.g. NaCl 0.9%, dextrose 5%).
For pediatric patients, the vol of diluent depends on the prescribed
dosage.
Tuberculosis, Complicated and recurrent urinary tract infections,
Severe Gram-negative infections, Non-tubercular mycobacterial
infections, Bacterial septicemia, Infections of the respiratory tract,
Bones and joints, Central nervous system and skin and soft tissue,
Intra-abdominal infections, Burns, Postoperative infections,
Meningitis, Peritonitis, Neonatal sepsis
Pregnancy, perforated ear drum, myasthenia gravis, hypersensitivity.
1-10%
Neurotoxicity,Nephrotoxicity (if trough >10 mg/L),Ototoxicity
<1%
Hypotension,Headache,Drug fever,Rash,Nausea,Vomiting,Eosinophilia,
Neurotoxicity,Nephrotoxicity (if trough >10 mg/L),Ototoxicity
<1%
Hypotension,Headache,Drug fever,Rash,Nausea,Vomiting,Eosinophilia,
Paresthesia,Tremor,Arthralgia,Weakness,Allergic reaction
Potentially Fatal: Ototoxicity, nephrotoxicity, neuromuscular blockade.
Potentially Fatal: Ototoxicity, nephrotoxicity, neuromuscular blockade.
Aminoglycosides
Category: D
pregnancy_description
pregnancy_description
Amikacin binds to 30S ribosomal subunits of susceptible bacteria, thus
inhibiting its protein synthesis.
Amphotericin B may lead to increased nephrotoxicity and reduced clearance
of amikacin when used together. Potentially Fatal: Increased ototoxic or
nephrotoxic effects with other nephrotoxic or ototoxic drugs. Enhanced
neuromuscular blockade with neuromuscular blocking drugs. Increased
risk of ototoxicity with potent diuretics.
Per Unit Price: Tk. 16.06
Package: 10 amps pack
Package: 10 amps pack
Ampicillin:
Brand Name: Ampexin(Opsonin),Acmecilin(Acme)
Adult: PO Susceptible infections
0.25-0.5 g 6 hrly.
Typhoid and paratyphoid fever 1-2 g 6 hrly.
Typhoid and paratyphoid fever 1-2 g 6 hrly.
Duration: 2 wk (acute infections); 4-12 wk (carriers).
Uncomplicated gonorrhoea W/ probenecid:
Uncomplicated gonorrhoea W/ probenecid:
2 g as single dose.
IV/IM:
IV Intrapartum prophylaxis against group B streptococcal
IV/IM:
IV Intrapartum prophylaxis against group B streptococcal
infections Initial, 2 g, then 1 g 4 hrly until delivery.
Septicaemia 150-200 mg/kg/day. Start with IV admin for 3 days,
Septicaemia 150-200 mg/kg/day. Start with IV admin for 3 days,
then IM inj 3-4 hrly. Continue treatment for at least 48-72 hr
after patient has become asymptomatic or when there is
evidence of bacterial eradication.
IV/IM Susceptible infections 250-500 mg 6 hrly.
Meningitis 2-3 g 4-6 hrly, may start w/ IV admin, then
IV/IM Susceptible infections 250-500 mg 6 hrly.
Meningitis 2-3 g 4-6 hrly, may start w/ IV admin, then
continue w/ IM inj.
Inj Supplement to systemic therapy For intrapleural/
Inj Supplement to systemic therapy For intrapleural/
intraperitoneal/intra-articular admin: 500 mg/day.
Susceptible infections
Child:
PO: 50–100 mg/kg/day divided q6hr if <20
>20 kg 1–2 g/day divided q6hr
IV/IM:
Child: 50–200 mg/kg/day q6h
300–400 mg/kg/day endocarditis/meningitis q4–6h
Child:
PO: 50–100 mg/kg/day divided q6hr if <20
>20 kg 1–2 g/day divided q6hr
IV/IM:
Child: 50–200 mg/kg/day q6h
300–400 mg/kg/day endocarditis/meningitis q4–6h
Renal impairment: Patients undergoing haemodialysis
should receive an additional dose after the session.
CrCl (ml/min)
<10 Dose reduction or increase in dose interval.
CrCl (ml/min)
<10 Dose reduction or increase in dose interval.
Should be taken on an empty stomach. Take on an empty
stomach 1 hr before or 2 hr after meals.
Reconstitution: IM: Add 1.5 mL water for inj to 500 mg vial
Reconstitution: IM: Add 1.5 mL water for inj to 500 mg vial
contents. IV: Dissolve 500 mg in 10 mL water for inj.
Bacterial infections, Endocarditis, Typhoid fever,
Community-acquired pneumonia, Uncomplicated gonorrhea,
Susceptible infections, Bacterial meningitis, Paratyphoid fever,
Septicaemia, Intrapartum prophylaxis against group
B streptococcal infections
Hypersensitivity; infectious mononucleosis.
GI upset, nausea, vomiting, diarrhoea; blood dyscrasias;
urticaria, exfoliative dermatitis, rash; fever, seizures;
interstitial nephritis.
Potentially Fatal: Anaphylactic shock; pseudomembranous
Potentially Fatal: Anaphylactic shock; pseudomembranous
colitis; neuromuscular hypersensitivity; electrolyte imbalance.
Broad spectrum penicillins
Category: B
pregnancy_description
pregnancy_description
Ampicillin exerts bactericidal action on both gm+ve and
gm-ve organisms. Its spectrum includes gm+ve organisms
eg, S pneumoniae and other Streptococci, L monocytogenes
and gm-ve bacteria eg, M catarrhalis, N gonorrhoea, N meningitidis,
E coli, P mirabilis, Salmonella, Shigella, and H influenzae. Ampicillin
exerts its action by inhibiting the synthesis of bacterial cell wall.
May reduce the efficacy of OC. May alter INR while on warfarin and
phenindione. May reduce the efficacy of oral typhoid vaccines. May
reduce the excretion of methotrexate. Reduced excretion w/
probenecid and sulfinpyrazone, resulting to increased risk of toxicity.
Allopurinol increases ampicillin-induced skin reactions. Reduced
absorption w/ chloroquine. Bacteriostatic antibacterials (e.g. erythromycin,
chloramphenicol, tetracycline) may interfere w/ the bactericidal action of ampicillin.
Per Unit Price: Tk. 26.5
Package: 15ml bottle
Package: 15ml bottle
Levofloxacin:
Brand Name: EVO(Beximco),Leo(ACME)
Levoxin(INCEPTA)
Community-Acquired Pneumonia
500 mg PO/IV once daily for 7-14 days
500 mg PO/IV once daily for 7-14 days
or 750 mg PO/IV once daily for 5 days
Nosocomial Pneumonia
750 mg PO/IV once daily for 7-14 days
Acute Bacterial Sinusitis
500 mg PO/IV once daily for 10-14 days or
Nosocomial Pneumonia
750 mg PO/IV once daily for 7-14 days
Acute Bacterial Sinusitis
500 mg PO/IV once daily for 10-14 days or
750 mg PO/IV once daily for 5 days
Limitations-of-use: Reserve fluoroquinolones for
Limitations-of-use: Reserve fluoroquinolones for
patients who do not have other available treatment
options for acute sinusitis
Acute Bacterial Exacerbation of Chronic Bronchitis
500 mg PO/IV once daily for 7 days
Limitations-of-use: Reserve fluoroquinolones for patients
Acute Bacterial Exacerbation of Chronic Bronchitis
500 mg PO/IV once daily for 7 days
Limitations-of-use: Reserve fluoroquinolones for patients
who do not have other available treatment options for
acute bacterial exacerbation of chronic bronchitis
Inhalational Anthrax
Postexposure therapy
500 mg PO once daily for 60 days, beginning as soon
Inhalational Anthrax
Postexposure therapy
500 mg PO once daily for 60 days, beginning as soon
as possible after exposure
Skin/Skin Structure Infections
Uncomplicated: 500 mg PO/IV once daily for 7-10 days
Complicated: 750 mg PO/IV once daily for 7-14 days
Chronic Bacterial Prostatitis
500 mg PO/IV once daily for 28 days
Complicated Urinary Tract Infections & Acute Pyelonephritis
250 mg PO/IV once daily for 10 days or 750 mg PO/IV
Skin/Skin Structure Infections
Uncomplicated: 500 mg PO/IV once daily for 7-10 days
Complicated: 750 mg PO/IV once daily for 7-14 days
Chronic Bacterial Prostatitis
500 mg PO/IV once daily for 28 days
Complicated Urinary Tract Infections & Acute Pyelonephritis
250 mg PO/IV once daily for 10 days or 750 mg PO/IV
once daily for 5 days
Uncomplicated Urinary Tract Infections
250 mg PO/IV once daily for 3 days
Limitations-of-use: Reserve fluoroquinolones for patients who do
Uncomplicated Urinary Tract Infections
250 mg PO/IV once daily for 3 days
Limitations-of-use: Reserve fluoroquinolones for patients who do
not have other available treatment options for uncomplicated
urinary tract infections
Plague
Indicated for treatment and prophylaxis of plague, including
Plague
Indicated for treatment and prophylaxis of plague, including
pneumonic and septicemic plague, caused by Yersinia pestis
in adults and pediatric patients, aged 6 months or older
500 mg PO/IV once daily for 10-14 days
500 mg PO/IV once daily for 10-14 days
Children
PO, IV 16 mg/kg/day div q12h up to 50 kg body weight, then
500 mg qd for postexposure anthrax prophylaxis q12h
For respiratory infections:
<5 y: 20 mg/kg/day q12h
>5 y: 10 mg/kg/day q24h
PO, IV 16 mg/kg/day div q12h up to 50 kg body weight, then
500 mg qd for postexposure anthrax prophylaxis q12h
For respiratory infections:
<5 y: 20 mg/kg/day q12h
>5 y: 10 mg/kg/day q24h
Renal impairment: Haemodialysis/CAPD: Initially, 500 mg daily,
then 250 mg every 48 hr. Alternatively: Initially, 750 mg daily,
then 500 mg every 48 hr.
CrCl (ml/min)
20-49 Initially, 500 mg daily, then 250 mg every 24 hr.
CrCl (ml/min)
20-49 Initially, 500 mg daily, then 250 mg every 24 hr.
Alternatively: Initially, 750 mg daily, then 750 mg every 48 hr.
10-19 Initially, 500 mg daily, then 250 mg every 48 hr.
10-19 Initially, 500 mg daily, then 250 mg every 48 hr.
Alternatively: Initially, 750 mg daily, then 500 mg every 48 hr.
Oral soln: Should be taken on an empty stomach. Take on an
empty stomach 1 hr before or 2 hr after meals.
Ensure adequate fluid intake.
Tab: May be taken with or without food. Ensure
Tab: May be taken with or without food. Ensure
adequate fluid intake.
IV Preparation
Single-use vials: Dilute in 50-100 mL D5W or NS or
IV Preparation
Single-use vials: Dilute in 50-100 mL D5W or NS or
D5/NS solution for injection to 5 mg/mL; alternative
solutions include sodium lactate, Plasma-Lyte,
D5/lactated Ringer, D5/NS and potassium chloride
IV Administration
Give by IV infusion only, not bolus; rapid or bolus administration
IV Administration
Give by IV infusion only, not bolus; rapid or bolus administration
has been associated with hypotension and must be avoided
Infuse 250-500 mg over 60 minutes or 750 mg over 90 minutes
Infuse 250-500 mg over 60 minutes or 750 mg over 90 minutes
Chronic bronchitis, Acute bacterial sinusitis, Anthrax,
Community-acquired pneumonia, Skin and skin structure infections,
Nosocomial pneumonia, Urinary tract infections, Complicated skin
and skin structure infections, Acute pyelonephritis, Chronic bacterial
prostatitis
Hypersensitivity to levofloxacin or other quinolones. Child <18 yr.
1-10%
Nausea (7%),Headache (6%),Diarrhea (5%),Insomnia (4%),
Nausea (7%),Headache (6%),Diarrhea (5%),Insomnia (4%),
Constipation (3%),Dizziness (3%),Dyspepsia (2%),Rash (2%),
Vomiting (2%),Chest pain (1%),Dyspnea (1%),Edema (1%),
Fatigue (1%),Injection-site reaction (1%),Moniliasis (1%),
Pain (1%),Pruritus (1%),Vaginitis (1%)
<1%
Cardiac: Cardiac arrest, palpitation, ventricular tachycardia,
<1%
Cardiac: Cardiac arrest, palpitation, ventricular tachycardia,
arrhythmia
Nervous system: Tremor, convulsions, paresthesia, vertigo,
Nervous system: Tremor, convulsions, paresthesia, vertigo,
hypertonia, hyperkinesias, abnormal gait, somnolence, syncope
Metabolic: Hypoglycemia, hyperglycemia, hyperkalemia
Blood/lymphatic system: Anemia, thrombocytopenia,
Metabolic: Hypoglycemia, hyperglycemia, hyperkalemia
Blood/lymphatic system: Anemia, thrombocytopenia,
granulocytopenia
Musculoskeletal/connective tissue: Arthralgia, tendonitis,
Musculoskeletal/connective tissue: Arthralgia, tendonitis,
myalgia, skeletal pain
Gastrointestinal (GI): Gastritis, stomatitis, pancreatitis,
Gastrointestinal (GI): Gastritis, stomatitis, pancreatitis,
esophagitis, gastroenteritis, glossitis, pseudomembranous/C
difficile colitis
Hepatobiliary: Abnormal hepatic function, increased hepatic
Hepatobiliary: Abnormal hepatic function, increased hepatic
enzymes, increased alkaline phosphatase
Psychiatric: Anxiety, agitation, confusion, depression, hallucinations,
Psychiatric: Anxiety, agitation, confusion, depression, hallucinations,
nightmares, sleep disorder, anorexia, abnormal dreaming
Other: Immune hypersensitivity reaction, acute renal failure,
Other: Immune hypersensitivity reaction, acute renal failure,
urticaria, phlebitis, epistaxis
Potentially Fatal: Anaphylaxis.
Potentially Fatal: Anaphylaxis.
4-Quinolone preparations
Category: Not Classified
pregnancy_description
pregnancy_description
Levofloxacin exerts antibacterial action by inhibiting bacterial
topoisomerase IV and DNA gyrase, the enzymes required for
DNA replication, transcription repair and recombination. It has
in vitro activity against a wide range of gram-negative and
gram-positive microorganisms.
Additive effects on QT interval prolongation w/ class IA
(e.g. quinidine, procainamide) or class III (amiodarone, sotalol)
antiarrhythmics, fluoxetine or imipramine. Reduced absorption w/
sucralfate, didanosine, antacids containing Mg or Al, dietary
supplements containing Zn, Ca, Mg or Fe. Altered glucose levels
w/ antidiabetic agents (e.g. insulin, glibenclamide). Increased risk
of severe tendon disorders w/ corticosteroids. Increased risk of CNS
stimulation and seizures w/ NSAIDs. Increased prothrombin time w/ warfarin.
Per Unit Price: Tk. 75.28
Package: 100ml bot
Package: 100ml bot
Ofloxacin:
Brand name: Oflacin(Drug),Rutix(Square)
Oral
Bronchitis Exacerbation, Community
Bronchitis Exacerbation, Community
Acquired Pneumonia, Skin & Skin
Structure Infections
Adult: 400 mg bid for 10 days.
Uncomplicated gonorrhoea
Adult: 400 mg as a single dose.
Nongonococcal Cervicitis/Urethritis
Adult: 400 mg daily in single or divided
Adult: 400 mg bid for 10 days.
Uncomplicated gonorrhoea
Adult: 400 mg as a single dose.
Nongonococcal Cervicitis/Urethritis
Adult: 400 mg daily in single or divided
doses for 7 days.
Uncomplicated Cystitis
Adult: 200 mg bid for 3-7 days.
Complicated UTIs
Adult: 200 mg bid for 10 days.
Pelvic inflammatory disease
Adult: 400 mg bid for 10-14 days.
Prostatitis
Adult: Acute or chronic: 200 mg bid for 28 days.
Intravenous
Complicated urinary tract infections
Adult: 200 mg daily by infusion over at least 30 min.
Uncomplicated Cystitis
Adult: 200 mg bid for 3-7 days.
Complicated UTIs
Adult: 200 mg bid for 10 days.
Pelvic inflammatory disease
Adult: 400 mg bid for 10-14 days.
Prostatitis
Adult: Acute or chronic: 200 mg bid for 28 days.
Intravenous
Complicated urinary tract infections
Adult: 200 mg daily by infusion over at least 30 min.
Max: 400 mg bid infused over at least 1 hr.
Lower respiratory tract infections; Septicaemia
Adult: 200 mg bid by infusion over at least 30 min.
Lower respiratory tract infections; Septicaemia
Adult: 200 mg bid by infusion over at least 30 min.
Max: 400 mg bid infused over at least 1 hr.
Skin and soft tissue infections
Adult: 400 mg bid infused over at least 1 hr.
Hepatic impairment: Severe: Reduce dose.
Skin and soft tissue infections
Adult: 400 mg bid infused over at least 1 hr.
Hepatic impairment: Severe: Reduce dose.
Max: 400 mg daily.
Not indicated
Renal impairment:
CrCl (ml/min) Dosage Recommendation
20-50 Reduce dose by half 24 hrly following
CrCl (ml/min) Dosage Recommendation
20-50 Reduce dose by half 24 hrly following
usual initial dose.
<20 and patients on haemodialysis or peritoneal
<20 and patients on haemodialysis or peritoneal
dialysis 100 mg 24 hrly following usual initial dose..
May be taken with or without food. Avoid antacids or
supplements containing Fe or Znor or dairy products
w/in 2 hr before or after ofloxacin.
Ensure adequate hydration.
Ensure adequate hydration.
Leprosy, chronic bronchitis, Community-acquired pneumonia,
Uncomplicated skin infections, anthrax, Legionnaire's disease,
Nongonococcal cervicitis, Urethritis, Uncomplicated cystitis,
Complicated UTI, Traveller's diarrhea, bacterial prostatis,
Typhoid fever, Skin and soft tissue infections, Uncomplicated
gonorrhea, Pelvic inflammatory disease, Lower respiratory
tract infections, Septicaemia
Hypersensitivity to quinolones; pregnancy and lactation;
prolongation of the QT interval; uncorrected hypokalaemia.
1-10%
Nausea (3-10%),Headache (1-9%),Insomnia (3-7%),
Nausea (3-10%),Headache (1-9%),Insomnia (3-7%),
Dizziness (1-5%),Vaginitis (1-5%),Diarrhea (1-4%),
Vomiting (1-4%),Appetite decreased (1-3%),Abdominal
cramps (1-3%),Abnormal taste (1-3%),Chest pain (1-3%),
External genital pruritis in women (1-3%),Fatigue (1-3%),
Flatulence (1-3%),GI distress (1-3%),Nervousness (1-3%),
Pharyngitis (1-3%),Pyrexia (1-3%),Rash/pruritis (1-3%),
Sleep disorders (1-3%),Visual disturbances (1-3%),
Xerostomia (1-3%)
<1%
Prolonged QT interval,Torsades de pointes,Syncope,
<1%
Prolonged QT interval,Torsades de pointes,Syncope,
Vasculitis,Edema,HTN,Palpitations,Vasodilation,
Stevens-Johnson syndrome,Toxic epidermal necrolysis,
Agranulocytosis,Aplastic anemia,Pancytopenia,
Thrombocytopenia,Thrombocytopenic purpura,
Acute hepatitis,Hepatic failure,Hepatic necrosiImmune
hypersensitivity reaction,Rupture of tendon, Tendinitis,
Peripheral neuropathy,Seizure,Acute renal failure,
Interstitial nephritis,Renal impairment,Tourette's
syndrome,Decrease hearing acuity,Tinnitus
Potentially Fatal: Anaphylaxis; rarely seizures.
Potentially Fatal: Anaphylaxis; rarely seizures.
4-Quinolone preparations
Category: C
pregnancy_description
pregnancy_description
Ofloxacin is a fluoroquinolone which inhibits bacterial
topoisomerase IV and DNA gyrase enzymes required
for DNA replication, transcription, repair and recombination.
It has activity against a wide range of gram-negative and
gram-positive microorganisms.
Concomitant use of class IA (e.g. quinidine, procainamide) or
class III (e.g. amiodarone, sotalol) antiarrhythmic agents may
increase risk of QT interval prolongation. Decreased serum and
urine concentrations w/ antacids containing Mg, Al or Ca. Additive
antibacterial activity w/ aminoglycosides (e.g. amikacin, tobramycin).
Corticosteroids may increase risk of severe tendon disorders.
Increased risk of CNS stimulation (e.g. seizures) w/ NSAIDs.
Higher and prolonged serum theophylline concentrations and
increased risk of theophylline-related adverse effects.
Per Unit Price: Tk. 12
Package: 20's pack
Package: 20's pack
Moxifloxacin:
Brand name: Moxibac(popular),Iventi(square)
Oral
The dose of Moxifloxacin is 400 mg once every 24 hours.
The dose of Moxifloxacin is 400 mg once every 24 hours.
The duration of therapy depends on the type of
infection as described bellow
Acute Bacterial Sinusitis
400 mg is given once daily for 10 days.
Acute Bacterial Exacerbation of Chronic Bronchitis
400 mg is given once daily for 5 days.
Community Acquired Pneumonia
400 mg is given once daily for 7-14 days.
Uncomplicated Skin & Skin Structure infections
400 mg is given once daily for 7 days.
Complicated Skin & Skin Structure infections
400 mg is given once daily for 7-21 days.
Complicated Intra-Abdominal infections
400 mg is given once daily for 5-14 days.
Typhoid Fever
400 mg is given once daily for 10-14 days.
Acute Bacterial Sinusitis
400 mg is given once daily for 10 days.
Acute Bacterial Exacerbation of Chronic Bronchitis
400 mg is given once daily for 5 days.
Community Acquired Pneumonia
400 mg is given once daily for 7-14 days.
Uncomplicated Skin & Skin Structure infections
400 mg is given once daily for 7 days.
Complicated Skin & Skin Structure infections
400 mg is given once daily for 7-21 days.
Complicated Intra-Abdominal infections
400 mg is given once daily for 5-14 days.
Typhoid Fever
400 mg is given once daily for 10-14 days.
<18 years: Safety and efficacy not established
May be taken with or without food.
Community Acquired Pneumonia, Acute Bacterial
Exacerbation of Chronic Bronchitis, Acute Bacterial
Sinusitis, Complicated Intra-Abdominal Infection,
Uncomplicated Skin and Skin Structure Infections,
Complicated Skin and Skin Structure Infections,
Typhoid Fever.
Known hypersensitivity to moxifloxacin, other quinolones.
Patients w/ known prolongation of QT interval, uncorrected
hypokalaemia, myasthenia gravis. Concurrent use of class
Ia (e.g.quinidine, procainamide, class III (e.g. amiodarone,
sotalol) antiarrhythmic drugs or w/ other drugs that prolong
QT interval (e.g. erythromycin, TCAs, antipsychotic agents).
1-10%
Nausea (7%),Diarrhea (6%),Dizziness (3%),Decreased amylase (2%),
Nausea (7%),Diarrhea (6%),Dizziness (3%),Decreased amylase (2%),
Decreased basophils, eosinophils, hemoglobin, prothrombin time,
red blood cells, neutrophils (2%),Decreased serum glucose (2%),
Increased serum chloride (2%),Increased serum ionized calcium
(2%),Immune hypersensitivity reaction (0.1-2%),Prolonged QT
interval (0.1-2%)
<1%
Acute renal failure,Agranulocytosis,Anaphylactoid reaction,Aplastic
<1%
Acute renal failure,Agranulocytosis,Anaphylactoid reaction,Aplastic
anemia,Extrinsic allergic alveolitis,Hemolytic anemia,Hepatic failure
,Hepatic necrosis,Hepatitis,Pancytopenia,Seizure,Serum sickness
due to drug,Stevens-Johnson syndrome,Tendon rupture, tendinitis,
Thrombocytopenia,Torsades de pointes,Toxic epidermal necrolysis
4-Quinolone preparations
Category: Not Classified
pregnancy_description
pregnancy_description
Moxifloxacin inhibits the topoisomerase II (DNA gyrase) and
topoisomerase
IV required for bacterial DNA replication, transcription, repair
and recombination.
Additive effect on QT interval prolongation w/ other drugs that
prolong QT interval (e.g. erythromycin, TCAs, antipsychotic agents).
Decreased absorption and bioavailability w/ Al- or Mg-containing antacids,
or Fe or Zn preparations. Concomitant use of corticosteroids increases the
risk of severe tendon disorders esp in elderly (>60 yr). Decreased
absorption w/ sucralfate or didanosine. Potentially Fatal: Concurrent
use of class Ia (e.g. quinidine, procainamide) or III (e.g. amiodarone,
sotalol) antiarrhythmic drugs or w/ other drugs that prolong QT interval
(e.g. erythromycin, TCAs, antipsychotic agents) may cause additive
effect on QT interval prolongation.
Per Unit Price: Tk. 70
Package: 10's Pack
Package: 10's Pack
Gentamicin:
Brand name: Gentin, Gentabac(popular)(20mg/2ml)
(80mg/2ml)
Ophthalmic
Superficial ophthalmic infections
Adult: As eye drops: Instill 1-2 drops into
Superficial ophthalmic infections
Adult: As eye drops: Instill 1-2 drops into
affected eye up to 6 times daily.
For severe infections, initially, 1-2 drops
For severe infections, initially, 1-2 drops
every 15 min, reducing the frequency gradually
as the infection is controlled.
As eye oint: Place a small amount into the
As eye oint: Place a small amount into the
conjunctival sac 2-3 times daily.
Otic/Aural
Otitis externa
Adult: As ear drops: Instill 2-3 drops in the affected
Otic/Aural
Otitis externa
Adult: As ear drops: Instill 2-3 drops in the affected
ear 3-4 times a day and at night.
Ophthalmic
Superficial ophthalmic infections
Child: As eye drops: Instill 1-2 drops into affected eye
Superficial ophthalmic infections
Child: As eye drops: Instill 1-2 drops into affected eye
up to 6 times daily.
For severe infections, initially, 1-2 drops every 15 min,
For severe infections, initially, 1-2 drops every 15 min,
reducing the frequency gradually as the infection is controlled.
As eye oint: Place a small amount into the conjunctival
As eye oint: Place a small amount into the conjunctival
sac 2-3 times daily.
Otic/Aural
Otitis externa
Child: As ear drops: Instill 2-3 drops in the affected
Otic/Aural
Otitis externa
Child: As ear drops: Instill 2-3 drops in the affected
ear 3-4 times a day and at night.
Superficial ophthalmic infections, Otitis externa,
History of hypersensitivity to aminoglycoside; pregnancy;
hepatic impairment, perforated ear drum.
Allergic contact dermatitis, Transient irritation, burning,
stinging, Increased redness, lacrimation
Aural Anti-bacterial preparations
Category: C
pregnancy_description
pregnancy_description
Gentamicin is an aminoglycoside that binds to 30s and 50s
ribosomal
subunits of susceptible bacteria disrupting protein synthesis,
thus rendering the bacterial cell membrane defective.
Additive effect w/ other neurotoxic and/or nephrotoxic drugs
including cephalosporins, methicillin, amphotericin B, ciclosporin,
cisplatin, potent diuretics (e.g. ethacrynic acid, furosemide) and
neuromuscular blocking agents (e.g. succinylcholine, tubocurarine).
May potentiate the effect of anticoagulants (e.g. warfarin, phenindione).
May antagonise the effect of neostigmine and pyridostigmine. Increased
risk of hypocalcaemia w/ bisphosphonates. Increased risk of neuromuscular
blockade w/ botulinum toxin. Indometacin may increase the plasma
concentration of gentamicin in neonates.
Per Unit Price: Tk. 31.37
Package: 10 ml bot
Package: 10 ml bot
Rifampicin:
Brand name: Rifatan(100mg/5ml),Rifcin(Pharmadesh)
Oral
Tuberculosis
Adult: 10 mg/kg/day or 2-3 times/wk.
Tuberculosis
Adult: 10 mg/kg/day or 2-3 times/wk.
Max: 600 mg/day.
<50 kg: 450 mg daily;
>50 kg: 600 mg daily.
Leprosy
600 mg once mthly.
Prophylaxis against meningococcal meningitis
600 mg twice daily for 2 days.
Prophylaxis against meningitis due to Haemophilus influenzae
600 mg/day for 4 days.
Hepatic impairment: Max: 8 mg/kg/day.
<50 kg: 450 mg daily;
>50 kg: 600 mg daily.
Leprosy
600 mg once mthly.
Prophylaxis against meningococcal meningitis
600 mg twice daily for 2 days.
Prophylaxis against meningitis due to Haemophilus influenzae
600 mg/day for 4 days.
Hepatic impairment: Max: 8 mg/kg/day.
Oral
Tuberculosis
10–20 mg/kg, max 600 mg for TB q24h
With directly observed biweekly therapy, dosage is still 10–20 mg/kg/dose
Tuberculosis
10–20 mg/kg, max 600 mg for TB q24h
With directly observed biweekly therapy, dosage is still 10–20 mg/kg/dose
(max 600 mg) twice weekly
20 mg/kg/day for 2 days for meningococcus prophylaxis, q12h
20 mg/kg/day for 2 days for meningococcus prophylaxis, q12h
Should be taken on an empty stomach. Best taken on an empty stomach
1 hr before or 2 hr after meals.
Tuberculosis, Leprosy, Brucellosis, Meningitis , Legionnaire's disease;
Staphylococcal infections
Hypersensitivity to rifampicin or other rifamycins. Patient w/ jaundice.
Concurrent use w/ saquinavir/ritonavir therapy.
Facial flushing and itching, w/ or w/o a rash, flu-like syndrome characterised
by episodes of fever, chills, headache, dizziness, bone pain, shortness
of breath, and malaise; GI adverse effects (e.g. nausea, vomiting, anorexia,
diarrhoea, epigastric distress), pseudomembranous colitis, eosinophilia,
leucopenia, haemolytic anaemia; alterations in kidney function and renal
failure, menstrual disturbances, oedema, myopathy, muscular weakness;
orange-red discolouration of the urine, faeces, sweat, saliva, sputum, tears,
and other body fluids; Rarely, eye irritation and visual disturbances,
anaphylaxis or shock.
Potentially Fatal: Hepatotoxicity, hypotension, sinus tachycardia,
Potentially Fatal: Hepatotoxicity, hypotension, sinus tachycardia,
ventricular arrhythmias, seizures and cardiac arrest,
thrombocytopenia and purpura.
Anti-Tubercular Antibiotics
Category: C
pregnancy_description
pregnancy_description
Rifampicin suppresses initiation of chain formation for RNA synthesis
in susceptible bacteria by binding to the beta subunit of DNA-dependent
RNA polymerase, thus blocking RNA transcription.
May accelerate the metabolism and reduce the effect of drugs that are
metabolised by CYP450 enzymes (e.g. quinidine, phenytoin, theophylline).
Decreased concentrations of atovaquone and increased concentrations of
rifampicin when taken concomitantly. Concurrent use of ketoconazole and
rifampicin may result in decreased serum concentrations of both drugs.
May decrease serum concentrations of enalaprilat. Reduced absorption
by antacids. Increased risk of hepatotoxicity w/ halothane or isoniazid.
Potentially Fatal: Increased potential for hepatotoxicity when taken
concomitantly w/ saquinavir/ritonavir combination.
Per Unit Price: Tk. 6
Package: 50's pack
Package: 50's pack
Streptomycin:
Intramuscular
Tuberculosis
Adult: 15 mg/kg as a single dose daily. Max: 1 g daily.
Tuberculosis
Adult: 15 mg/kg as a single dose daily. Max: 1 g daily.
As part of intermittent regimen: 25-30 mg/kg 2-3 times
wkly. Max: 1.5 g/dose.
Bacterial endocarditis
Adult: Streptococcal endocarditis: 1 g bid for 1 wk, then
Bacterial endocarditis
Adult: Streptococcal endocarditis: 1 g bid for 1 wk, then
500 mg bid for the 2nd wk. Enterococcal endocarditis:
1 g bid for 2 wk then 500 mg bid for 4 wk. Doses are
given in combination w/ penicillin.
Bacteraemia; Meningitis; Pneumonia ; Brucellosis;
Bacteraemia; Meningitis; Pneumonia ; Brucellosis;
Urinary tract infections
Adult: For concomitant use w/ other agents and as 2nd
Adult: For concomitant use w/ other agents and as 2nd
line agent: 1-2 g daily in divided doses 6-12 hrly. Max: 2 daily.
Plague
Adult: 2 g daily in 2 divided doses for a minimum of 10 days.
Tularaemia
Adult: 1-2 g daily in divided doses for 7-14 days until the patient
Plague
Adult: 2 g daily in 2 divided doses for a minimum of 10 days.
Tularaemia
Adult: 1-2 g daily in divided doses for 7-14 days until the patient
is afebrile for 5-7 days.
Child:
Moderate to Severe Infections: IM usually 20–30 mg/kg/day,
Moderate to Severe Infections: IM usually 20–30 mg/kg/day,
max 1 g/day q12h
Intramuscular
Tuberculosis
Child: 20-40 mg/kg as a single dose daily. Max: 1 g daily. As part
Intramuscular
Tuberculosis
Child: 20-40 mg/kg as a single dose daily. Max: 1 g daily. As part
of intermittent regimen: 25-30 mg/kg 2-3 times wkly. Max: 1.5 g/dose.
Bacterial endocarditis
Child: Enterococcal endocarditis: 20-30 mg/kg daily in 2 divided doses,
Bacterial endocarditis
Child: Enterococcal endocarditis: 20-30 mg/kg daily in 2 divided doses,
in combination w/ penicillin.
Bacteraemia; Meningitis; Pneumonia ; Brucellosis; Urinary tract infections
Child: 20-40 mg/kg daily in divided doses 6-12 hrly.
Plague
Child: 30 mg/kg daily in 2-3 divided doses. Max: 2 g daily.
Tularaemia
Child: 15 mg/kg bid for at least 10-14 days. Max: 2 g daily.
Bacteraemia; Meningitis; Pneumonia ; Brucellosis; Urinary tract infections
Child: 20-40 mg/kg daily in divided doses 6-12 hrly.
Plague
Child: 30 mg/kg daily in 2-3 divided doses. Max: 2 g daily.
Tularaemia
Child: 15 mg/kg bid for at least 10-14 days. Max: 2 g daily.
Renal Impairment
Load: 1 g IM, THEN
CrCl: 50-80 mL/min: 7.5 mg/kg IM q24hr
CrCl: 10-50 mL/min: 7.5 mg/kg IM q24-72hr
CrCl <10 mL/min: 7.5 mg/kg IM q72-96hr
Hemodialysis: 50-75% of initial loading dose at end of dialysis period
Load: 1 g IM, THEN
CrCl: 50-80 mL/min: 7.5 mg/kg IM q24hr
CrCl: 10-50 mL/min: 7.5 mg/kg IM q24-72hr
CrCl <10 mL/min: 7.5 mg/kg IM q72-96hr
Hemodialysis: 50-75% of initial loading dose at end of dialysis period
Reconstitution: Add 4.2 mL, 3.2 mL, or 1.8 mL of sterile water for inj to
prepare a soln containing approx 200 mg, 250 mg, or 400 mg, respectively,
of streptomycin per mL.
Tuberculosis, Bacterial endocarditis, Plague, Tularaemia, Brucellosis
Hypersensitivity to streptomycin and other aminoglycosides.
Neurotoxic reactions (e.g. vestibular and cochlear function disturbance,
optic nerve dysfunction, peripheral neuritis, arachnoiditis, encephalopathy);
paraesthesia of face, rash, fever, angioneurotic oedema, eosinophilia;
exfoliative dermatitis, azotemia, leucopenia, thrombocytopenia,
pancytopenia, haemolytic anaemia, muscular weakness, amblyopia.
Potentially Fatal: Resp paralysis from neuromuscular blockade,
Potentially Fatal: Resp paralysis from neuromuscular blockade,
Clostridium difficile-associated diarrhoea, anaphylaxis; rarely, nephrotoxicity.
Anti-Tubercular Antibiotics
Category: D
pregnancy_description
pregnancy_description
Streptomycin is bactericidal which inhibits bacterial protein synthesis.
Susceptible organisms include Mycobacterium tuberculosis,
Pasteurella pestis, P.tularensis, Brucella, H.influenzae, H.ducreyi,
Klebsiella pneumonia, Escherichia coli, Proteus spp., Aerobacter
aerogenes, Streptococcus faecalis, and Streptococcus viridans.
H1-receptor blockers may mask early signs of ototoxicity. May reduce
excretion of zalcitabine. May inhibit ?-galactosidase activity. Potentially
Fatal: Potentiates nephrotoxicity produced by other aminoglycosides,
vancomycin and some cephalosporins. Potentiates ototoxicity produced
by other aminoglycosides, ethacrynic acid, mannitol, furosemide and
other diuretics.
Per Unit Price: Tk. 9.19
Package: 1gm vial
Package: 1gm vial
Ethambutol;
Brand name: Sural(Ambee pharma)
Oral
Primary treatment of pulmonary and
Primary treatment of pulmonary and
extrapulmonary tuberculosis
Adult: Initial 8 wk: 15 mg/kg/day or 30 mg/kg
Adult: Initial 8 wk: 15 mg/kg/day or 30 mg/kg
thrice wkly given with isoniazid, rifampicin and
pyrazinamide.
For patients with history of antimycobacterial
For patients with history of antimycobacterial
therapy: Initial doses: 25 mg/kg/day for 60 days,
thereafter reduce to 15 mg/kg/day.
Tuberculosis
Child: PO 15–25 mg/kg, max 2.5 g q24h
For treatment of drug-resistant tuberculosis: 15-25 mg/kg
Child: PO 15–25 mg/kg, max 2.5 g q24h
For treatment of drug-resistant tuberculosis: 15-25 mg/kg
daily or 50 mg/kg twice wkly.
For congenitally acquired tuberculosis:
Neonates: 15 mg/kg once daily and >1 mth: 15 mg/kg once
For congenitally acquired tuberculosis:
Neonates: 15 mg/kg once daily and >1 mth: 15 mg/kg once
daily or 30 mg/kg 3 times wkly for 2 mth initial treatment phase.
Renal impairment: Dose adjustment may be needed as
determined by blood levels of ethambutol.
Should be taken with food.
Tuberculosis
Hypersensitivity; optic neuritis. Lactation.
Acute gout or hyperuricemia,Abdominal pain,Anaphylaxis,Anorexia,
Confusion, disorientation,Fever,Headache,LFT abnormalities,
Malaise,Nausea
Optic neuritis; symptoms may include decreased acuity, color
Optic neuritis; symptoms may include decreased acuity, color
blindness or visual defects (usually revrsible with discontinuation,
though irreversible blindness has been reported)
Peripheral neuritis,Pruritis,Rash,Vomiting
Peripheral neuritis,Pruritis,Rash,Vomiting
Anti-Tubercular Chemotherapeutics
Category: B
pregnancy_description
pregnancy_description
Ethambutol interferes with RNA synthesis, causing suppression of
Mycobacteria multiplication. It also has bacteriostatic action against
M tuberculosis by acting on rapidly growing pathogens in cavity walls
and is also effective in slow-growing pathogens. Has some action against
atypical opportunistic Mycobacteria e.g. M kansasii, M avium complex (MAC).
Delayed or reduced absorption w/ Al hydroxide.
Per Unit Price: Tk. 1.66
Package: 100's pack
Package: 100's pack
Pyrazinamide:
Indications
Pyrazinamide is indicated for the initial treatment of active tuberculosis in adults and children when combined with other antituberculous agents.
Pyrazinamide should only be used in conjunction with other effective antituberculous agents.
- The current recommendation of the CDC for drug-susceptible disease is to use a six-month regimen for initial treatment of active tuberculosis, consisting of isoniazid, rifampin and Pyrazinamide given for 2 months, followed by isoniazid and rifampin for 4 months
- Patients with drug-resistant disease should be treated with regimens individualized to their situation. Pyrazinamide frequently will be an important component of such therapy.
- In patients with concomitant HIV infection, the physician should be aware of current recommendation of CDC. It is possible these patients may require a longer course of treatment
Pyrazinamide should only be used in conjunction with other effective antituberculous agents.
Pharmacology
Pyrazinamide may be bacteriostatic or bactericidal in action, depending on the concentration of the drug attained at the site of the infection and the susceptibility of the infecting organism. Its activity appears to partly depend on conversion of the drug to pyrazinoic acid (POA), which lowers the pH of the environment below that which is necessary for growth of Mycobacterium tuberculosis. Susceptible strains of M. tuberculosis produce pyrazinamidase, an enzyme that deaminates pyrazinamide to POA, and the in vitro susceptibility of a given strain of the organism appears to correspond to its pyrazinamidase activity.
Dosage & Administration
Usual Adult Dose for Tuberculosis: Active:
15 to 30 mg/kg (up to 2 g) orally once a day in combination with three other antituberculous drugs for the initial 2 months of a 6-month or 9-month treatment regimen, until drug susceptibility tests are known. An alternate dosing regimen of 50 to 75 mg/kg (up to 3 g) orally twice a week may be used after 2 weeks of daily therapy to increase patient compliance.Alternatively, the CDC, The American Thoracic Society, and the Infectious Diseases Society of America suggest the following dosing based on estimated lean body weight:
Daily dosing:
- 40 to 45 kg: 1000 mg
- 56 to 75 kg: 1500 mg
- 76 to 90 kg: 2000 mg
- 40 to 55 kg: 2000 mg
- 56 to 75 kg: 3000 mg
- 76 to 90 kg: 4000 mg
- 40 to 55 kg: 1500 mg
- 56 to 75 kg: 2500 mg
- 76 to 90 kg: 3000 mg
Usual Adult Dose for Tuberculosis: Latent:
A public health expert should be consulted prior to the use of the combination regimen with rifampin.15 to 20 mg/kg, based on actual body weight (lean), orally once daily (maximum 2 g) for 2 months. Alternatively, a dosage of 50 mg/kg may be administered orally twice-weekly (maximum 4 g).
Usual Pediatric Dose for Tuberculosis: Active:
(Used as part of a multidrug regimen. Treatment regimens consist of an initial 2-month phase, followed by a continuation phase of 4 or 7 additional months. Frequency of dosing may differ depending on phase of therapy)Infants, Children less than 40 kg and Adolescents 14 years and younger and less than 40 kg:
Non-HIV patients:
- Daily therapy: 15 to 30 mg/kg/dose (maximum: 2 g/dose) once daily
- Directly observed therapy (DOT): 50 mg/kg/dose (maximum: 2 g/dose) twice weekly
- Daily therapy: 20 to 40 mg/kg/dose once daily (maximum: 2 g/day)
Interaction
Antagonises the effect of uricosuric agents (e.g. probenecid, sulfinpyrazone). May reduce the contraceptive effect of oestrogens. May inactivate oral typhoid vaccine. May increase the serum concentration of ciclosporin. May enhance the hepatotoxic effect of rifampicin.
Contraindications
Pyrazinamide is contraindicated in persons:
- With severe hepatic damage.
- Who have shown hypersensitivity to it.
- With acute gout.
Side Effects
General: Fever, porphyria and dysuria have rarely been reported. Gout.
Gastrointestinal: The principal adverse effect is a hepatic reaction. Hepatotoxicity appears to be dose related, and may appear at any time during therapy. GI disturbances including nausea, vomiting and anorexia have also been reported.
Hematologic and Lymphatic: Thrombocytopenia and sideroblastic anemia with erythroid hyperplasia, vacuolation of erythrocytes and increased serum iron concentration have occurred rarely with this drug. Adverse effects on blood clotting mechanisms have also been rarely reported.
Other: Mild arthralgia and myalgia have been reported frequently. Hypersensitivity reactions including rashes, urticaria, and pruritis have been reported. Fever, acne, photosensitivity, porphyria, dysuria and interstitial nephritis have been reported rarely.
Gastrointestinal: The principal adverse effect is a hepatic reaction. Hepatotoxicity appears to be dose related, and may appear at any time during therapy. GI disturbances including nausea, vomiting and anorexia have also been reported.
Hematologic and Lymphatic: Thrombocytopenia and sideroblastic anemia with erythroid hyperplasia, vacuolation of erythrocytes and increased serum iron concentration have occurred rarely with this drug. Adverse effects on blood clotting mechanisms have also been rarely reported.
Other: Mild arthralgia and myalgia have been reported frequently. Hypersensitivity reactions including rashes, urticaria, and pruritis have been reported. Fever, acne, photosensitivity, porphyria, dysuria and interstitial nephritis have been reported rarely.
Pregnancy & Lactation
Pregnancy Category C. Animal reproduction studies have not been conducted with Pyrazinamide. It is also not known whether Pyrazinamide can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Pyrazinamide should be given to a pregnant woman only if clearly needed.
Nursing Mothers: Pyrazinamide has been found in small amounts in breast milk. Therefore, it is advised that Pyrazinamide be used with caution in nursing mothers taking into account the risk-benefit of this therapy.
Nursing Mothers: Pyrazinamide has been found in small amounts in breast milk. Therefore, it is advised that Pyrazinamide be used with caution in nursing mothers taking into account the risk-benefit of this therapy.
Precautions & Warnings
Pyrazinamide is contraindicated in patients with severe hepatic disease and with acute gout.
Patients started on pyrazinamide should have baseline serum uric acid and liver function test results. Liver function should be monitored closely during therapy. Patients with preexisting liver disease or those at increased risk of drug related hepatitis should be monitored closely.
Pyrazinamide should be discontinued and not restarted if signs of hepatocellular damage or hyperuricemia with an acute gouty arthritis appear.
Polyarthralgias have been reported in patients. The pain may respond to aspirin or other nonsteroidal anti-inflammatory agents.
Caution should be used in patients with a history of diabetes mellitus, as management of the disease may be more difficult.
Primary resistance of Mycobacterium tuberculosis to pyrazinamide is not common. In cases with known or suspected drug resistance, in vitro susceptibility tests with recent cultures of Mycobacterium tuberculosis against pyrazinamide and the usual primary drugs should be conducted. There are few reliable in vitro tests for pyrazinamide resistance. A reference laboratory capable of performing these tests must be utilized.
Clinical experience has not identified differences in responses between elderly and younger patients. In general, dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased renal or hepatic function, and of concomitant disease or other drug therapy.
Patients started on pyrazinamide should have baseline serum uric acid and liver function test results. Liver function should be monitored closely during therapy. Patients with preexisting liver disease or those at increased risk of drug related hepatitis should be monitored closely.
Pyrazinamide should be discontinued and not restarted if signs of hepatocellular damage or hyperuricemia with an acute gouty arthritis appear.
Polyarthralgias have been reported in patients. The pain may respond to aspirin or other nonsteroidal anti-inflammatory agents.
Caution should be used in patients with a history of diabetes mellitus, as management of the disease may be more difficult.
Primary resistance of Mycobacterium tuberculosis to pyrazinamide is not common. In cases with known or suspected drug resistance, in vitro susceptibility tests with recent cultures of Mycobacterium tuberculosis against pyrazinamide and the usual primary drugs should be conducted. There are few reliable in vitro tests for pyrazinamide resistance. A reference laboratory capable of performing these tests must be utilized.
Clinical experience has not identified differences in responses between elderly and younger patients. In general, dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased renal or hepatic function, and of concomitant disease or other drug therapy.
Use in Special Populations
Usage in Children: Pyrazinamide regimens employed in adults are probably equally effective in children. Pyrazinamide appears to be well tolerated in children.
Geriatric Use: Clinical studies of Pyrazinamide did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.
It does not appear that patients with impaired renal function require a reduction in dose. It may be prudent to select doses at the low end of the dosing range, however.
Renal Dose Adjustments: The manufacturer recommends to start therapy at low end of dosage range and monitor patient closely.
For the treatment of active tuberculosis, the CDC, ATS, and IDSA recommend against daily dosing. For patients with CrCl less than 30 mL/min or patients receiving hemodialysis the recommended dose is 25 to 35 mg/kg per dose three times per week.
Liver Dose Adjustments: Monitor patients closely.
Dose Adjustments: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.
If organism is susceptible to isoniazid and rifampin, pyrazinamide is continued for the first 2 months of a 6-month course of therapy (9-months if HIV positive). If primary drug resistance is shown, drug regimens should be adjusted as needed and continued for at least 6 months, or 3 months beyond culture conversion (9 months, or 6 months beyond culture conversion if HIV positive). If multiple-drug resistance is demonstrated, therapy should be continued for 12 to 24 months following culture conversion.
Geriatric Use: Clinical studies of Pyrazinamide did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.
It does not appear that patients with impaired renal function require a reduction in dose. It may be prudent to select doses at the low end of the dosing range, however.
Renal Dose Adjustments: The manufacturer recommends to start therapy at low end of dosage range and monitor patient closely.
For the treatment of active tuberculosis, the CDC, ATS, and IDSA recommend against daily dosing. For patients with CrCl less than 30 mL/min or patients receiving hemodialysis the recommended dose is 25 to 35 mg/kg per dose three times per week.
Liver Dose Adjustments: Monitor patients closely.
Dose Adjustments: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic or renal function, and of concomitant disease or other drug therapy.
If organism is susceptible to isoniazid and rifampin, pyrazinamide is continued for the first 2 months of a 6-month course of therapy (9-months if HIV positive). If primary drug resistance is shown, drug regimens should be adjusted as needed and continued for at least 6 months, or 3 months beyond culture conversion (9 months, or 6 months beyond culture conversion if HIV positive). If multiple-drug resistance is demonstrated, therapy should be continued for 12 to 24 months following culture conversion.
Overdose Effects
Overdosage experience is limited. In one case report of overdose, abnormal liver function tests developed. These spontaneously reverted to normal when the drug was stopped. Clinical monitoring and supportive therapy should be employed. Pyrazinamide is dialyzable.
Therapeutic Class
Anti-Tubercular Chemotherapeutics
Storage Conditions
Store between 15-30° C.
Isoniazid:
Indications
Isoniazid is indicated for the treatment of all forms of
tuberculosis in which organisms are susceptible.
Pharmacology
Isoniazid inhibits the synthesis of mycoloic acids in
susceptible bacteria which results in loss of acid-fastness
and disruption of bacterial cell wall. At therapeutic levels, it is
bacteriocidal against actively growing intracellular and extracellular
Mycobacterium tuberculosis organisms.
Dosage & Administration
Adult:
With directly observed biweekly therapy, dosage is 20-30 mg/kg, max 900 mg/dose twice weekly
- Active tuberculosis: 5 mg/kg/day. Max: 300 mg/day or 15 mg/kg up to 900 mg/day, 2 or 3 times wkly.
- Latent tuberculosis: 300 mg/day for 6 mth. Nontuberculous mycobacterial infections 5 mg/kg/day for at least 12 mth of culture-negative sputum. Max: 300 mg/day.
With directly observed biweekly therapy, dosage is 20-30 mg/kg, max 900 mg/dose twice weekly
Interaction
Inhibit the hepatic metabolism of antiepileptics (e.g. carbamazepine, ethosuximide, primidone, phenytoin), benzodiazepines (e.g. diazepam, triazolam), chlorzoxazone, theophylline, disulfiram, sometimes leading to increased toxicity. Increased metabolism of enflurane, resulting in potentially nephrotoxic levels of fluoride. Increased concentrations and enhanced effects or toxicity of clofazimine, cycloserine and warfarin. Reduced absorption with Al-containing antacids. Increased risk of peripheral neuropathy with zalcitabine and stavudine.
Contraindications
Acute liver disease or history of hepatic damage during INH therapy; hypersensitivity.
Side Effects
Peripheral neuropathy (dose-related incidence, 10-20% incidence with 10 mg/kg/d), Loss of appetite, Nausea, Vomiting, Stomach pain, Weakness 1-10%, Dizziness, Slurred speech, Lethargy, Progressive liver damage (increases with age; 2.3% in pts > 50 yo), Hyperreflexia, Agranulocytosis, Anemia, Megaloblastic anemia, Thrombocytopenia, Systemic lupus erythematosus, Seizure
Pregnancy & Lactation
Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Lactation: distributed into milk but safe for nursing infants
Lactation: distributed into milk but safe for nursing infants
Precautions & Warnings
Renal or hepatic impairment; convulsive disorders; history of psychosis; patients at risk of neuropathy or pyridoxine deficiency eg, diabetic, alcoholic, malnourished, uraemic, infected with HIV. Careful monitoring of hepatic function is necessary for black and hispanic women. Check hepatic function before and during treatment. Pregnancy and lactation.
Therapeutic Class
Anti-Tubercular Chemotherapeutics
Isoniazid + Pyrazinamide + Rifampicin:
Oral
Tuberculosis
Adult: Isoniazid + Pyrazinamide + Rifampicin
Initial Phase 2 months
30-37 kg: 2 tab daily;
38-54 kg: 3 tab daily;
55-70 kg: 4 tab daily;
>71 kg: 5 tab daily.
then
Continuation Phase 4 months
Isoniazid + Rifampicin
30-37 kg: 2 tab daily;
38-54 kg: 3 tab daily;
55-70 kg: 4 tab daily;
>71 kg: 5 tab daily.
Total Dosage Requirement: Rifampicin: 10 (8-12)
Tuberculosis
Adult: Isoniazid + Pyrazinamide + Rifampicin
Initial Phase 2 months
30-37 kg: 2 tab daily;
38-54 kg: 3 tab daily;
55-70 kg: 4 tab daily;
>71 kg: 5 tab daily.
then
Continuation Phase 4 months
Isoniazid + Rifampicin
30-37 kg: 2 tab daily;
38-54 kg: 3 tab daily;
55-70 kg: 4 tab daily;
>71 kg: 5 tab daily.
Total Dosage Requirement: Rifampicin: 10 (8-12)
mg/kg body mass/day.
Isoniazid: 5 (4-6) mg/kg body mass/day.
Pyrazinamide: 25 (20-30) mg/kg body mass/day.
Isoniazid: 5 (4-6) mg/kg body mass/day.
Pyrazinamide: 25 (20-30) mg/kg body mass/day.
Oral
Tuberculosis
Adult: Isoniazid + Pyrazinamide + Rifampicin
Initial Phase 2 months
upto 7 kg: 1 tab daily;
8-9 kg: 1.5 tab daily;
10-14 kg: 2 tab daily;
15-19 kg: 3 tab daily.
20-24 kg: 4 tab daily.
25-29 kg: 5 tab daily.
then
Continuation Phase 4 months
Isoniazid + Rifampicin
upto 7 kg: 1 tab daily;
8-9 kg: 1.5 tab daily;
10-14 kg: 2 tab daily;
15-19 kg: 3 tab daily.
20-24 kg: 4 tab daily.
25-29 kg: 5 tab daily.
Tuberculosis
Adult: Isoniazid + Pyrazinamide + Rifampicin
Initial Phase 2 months
upto 7 kg: 1 tab daily;
8-9 kg: 1.5 tab daily;
10-14 kg: 2 tab daily;
15-19 kg: 3 tab daily.
20-24 kg: 4 tab daily.
25-29 kg: 5 tab daily.
then
Continuation Phase 4 months
Isoniazid + Rifampicin
upto 7 kg: 1 tab daily;
8-9 kg: 1.5 tab daily;
10-14 kg: 2 tab daily;
15-19 kg: 3 tab daily.
20-24 kg: 4 tab daily.
25-29 kg: 5 tab daily.
Should be taken on an empty stomach. Take on an empty
stomach 1 hr before or 2 hr after meals. Avoid antacids
w/in 1 hr of intake.
Tuberculosis
Known or suspected hypersensitivity to rifamycins and/or to
isoniazid and to pyrazinamide and/or to any of the excipients
including a history of drug-induced hepatitis, acute liver
diseases regardless of their origin, and peripheral neuritis.
Unwanted effects which may occur during continuous daily or
intermittent therapy: Rifampicin: Rifampicin may cause reddish
discolouration of body fluids and occasionally other body secretions
eg, urine, sputum, lacrimal fluid, faeces, saliva and sweat. It may
permanently discolour soft contact lenses.
Hepatic Effects: Very common (>10%) is an asymptomatic increase in
Hepatic Effects: Very common (>10%) is an asymptomatic increase in
liver enzymes; severe life-threatening hepatic reactions eg, hepatic
failure and acute fulminant hepatitis are uncommon (>0.1% and <1%).
In isolated cases (<0.01%), a fatal outcome was observed.
Renal Effects: Elevations of BUN and serum uric acid, haemolysis,
Renal Effects: Elevations of BUN and serum uric acid, haemolysis,
haematuria, interstitial nephritis, renal insufficiency.
Gastrointestinal Effects: Nausea, abdominal pains, vomiting or
Gastrointestinal Effects: Nausea, abdominal pains, vomiting or
diarrhoea, pseudomembranous colitis.
Central and Peripheral Nervous System Effects: Tiredness, drowsiness,
Central and Peripheral Nervous System Effects: Tiredness, drowsiness,
headache, dizziness, ataxia, mental confusion, muscular weakness,
visual disturbances.
Haematological Changes: Leucopenia, eosinophilia, thrombocytopenia
Haematological Changes: Leucopenia, eosinophilia, thrombocytopenia
and thrombocytopenic purpura.
Effects on Skin and Appendages: Flushing, itching with or without skin rash,
Effects on Skin and Appendages: Flushing, itching with or without skin rash,
urticaria, reddening of the eyes, exudative conjunctivitis or generalised
hypersensitivity reactions involving the skin eg, exfoliative dermatitis,
Lyell's syndrome and pemphigoid reactions.
Endocrine Effects: Disturbances in the menstrual cycle, induction of
Endocrine Effects: Disturbances in the menstrual cycle, induction of
crisis in Addison patients.
Unwanted effects chiefly occurring during intermittent therapy or upon
Unwanted effects chiefly occurring during intermittent therapy or upon
resumption of treatment after temporary interruption:
Combined anti- Tubercular Preparations
Category: Not Classified
pregnancy_description
pregnancy_description
Rifampicin, isoniazid and pyrazinamide are all active bactericidal
antituberculosis drugs. Rifampicin and isoniazid are particularly
active against the rapidly growing extracellular organisms and
have an intracellular bactericidal activity. Rifampicin also inhibits
DNA-dependent RNA polymerase activity in susceptible cells and
it has activity against slow and intermittently-growing M tuberculosis.
Pyrazinamide, particularly in the acid pH environment of macrophages
is active against intracellular organisms. Combination of these agents
covers activity against the 3 different bacterial populations.
Rifampicin may reduce effectivity of hormonal contraceptives, ACE
inhibitors (e.g. enalapril, imidapril), antiemetics (e.g. aprepitant),
antineoplastics (e.g. imatinib), diuretics (e.g. eplerenone), drugs
for erectile dysfunction (e.g. tadalafil), oral hypoglycaemics
(e.g. nateglinide, repaglinide), NSAIDs (e.g. etoricoxib).
Rifampicin may reduce serum levels of atovaquone, ketoconazole.
Antacids may reduce absorption of rifampicin. Anaesthetics and halothane
may increase risk for hepatotoxicity w/ rifampicin and isoniazid. Isoniazid
may increase serum levels of phenytoin and theophylline; and may decrease
carbamazepine metabolism. Stavudine may increase risk of distal sensory
neuropathy w/ isoniazid. Antacids may reduce isoniazid absorption. May
increase plasma levels of isoniazid w/ para-aminosalicylic acid. Increased
risk of CNS toxicity when isoniazid is used concomitantly w/ cycloserine.
Pyrazinamide antagonizes the effects of probenecid and sulfinpyrazone.
Potentially Fatal: Concominant use w/ saquinavir/ritonavir may increase
risk of severe hepatotoxicity. May reduce antiviral efficacy of atazanavir,
darunavir, fosamprenavir, saquinavir, or tipranavir
Per Unit Price: Tk. 12.1
Package: 100's pack
Package: 100's pack
Ethambutol + Isoniazid + Pyrazinamide + Rifampicin:
Fixed-dose combinations (FDCs) Tablets
Rifampicin 150mg + Isoniazid 75mg + Pyrazinamide
Rifampicin 150mg + Isoniazid 75mg + Pyrazinamide
400mg + Ethambutol 275mg (4FDC)
New patients:
Body weight
30-37kg: Initial 2 months- 4-FDC 2 tablets at a time daily;
New patients:
Body weight
30-37kg: Initial 2 months- 4-FDC 2 tablets at a time daily;
next 4 months- continuation dose 2-FDC
(Rifampicin 600mg + Isoniazid 300mg) 2 tablets at a time daily.
38-54kg: Initial 2 months- 4-FDC 3 tablets at a time daily; next
38-54kg: Initial 2 months- 4-FDC 3 tablets at a time daily; next
4 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg)
3 tablets at a time daily.
55-70kg: Initial 2 months- 4-FDC 4 tablets at a time daily;
55-70kg: Initial 2 months- 4-FDC 4 tablets at a time daily;
next 4 months- continuation dose 2-FDC
(Rifampicin 600mg + Isoniazid 300mg) 4 tablets at
a time daily.
>70kg: Initial 2 months- 4-FDC 5 tablets at a time daily;
>70kg: Initial 2 months- 4-FDC 5 tablets at a time daily;
next 4 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg)
5 tablets at a time daily.
Re-treatment patients:
Body weight
30-37kg: Initial 3 months- 4-FDC 2 tablets at a time daily; & Streptomycin 500mg
Re-treatment patients:
Body weight
30-37kg: Initial 3 months- 4-FDC 2 tablets at a time daily; & Streptomycin 500mg
daily, next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg)
2 tablets at a time daily, & Ethambutol 400mg 2 tablets at a time daily.
38-54kg: Initial 3 months- 4-FDC 3 tablets at a time daily; & Streptomycin 750mg daily,
38-54kg: Initial 3 months- 4-FDC 3 tablets at a time daily; & Streptomycin 750mg daily,
next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg)
3 tablets at a time daily, & Ethambutol 400mg 3 tablets at a time daily.
55-70kg: Initial 3 months- 4-FDC 4 tablets at a time daily; & Streptomycin 1g daily,
55-70kg: Initial 3 months- 4-FDC 4 tablets at a time daily; & Streptomycin 1g daily,
next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg)
4 tablets at a time daily, & Ethambutol 400mg 3 tablets at a time daily.
>70kg: Initial 3 months- 4-FDC 5 tablets at a time daily; & Streptomycin 1g daily,
>70kg: Initial 3 months- 4-FDC 5 tablets at a time daily; & Streptomycin 1g daily,
next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg)
5 tablets at a time daily, & Ethambutol 400mg 4 tablets at a time daily.
The dose of streptomycin should not exceed 750mg daily after the age of 50 years.
The dose of streptomycin should not exceed 750mg daily after the age of 50 years.
Should be taken on an empty stomach: Take at least1 hour before or 2 hours after
a meal with a full glass of water.
Swallow whole.
Swallow whole.
Tuberculosis
Hypersensitivity, history of drug-induced hepatitis, acute liver disease, peripheral or optic
neuritis, renal dysfunction, epilepsy, chronic alcoholism.
Rifampicin: Reddish discolouration of body fluids, asymptomatic increase in liver enzymes,
elevations of BUN & uric acid, hemolysis, hematuria, intestinal nephritis, renal insufficiency,
GI discomfort, CNS effects, hematological changes, skin rash, endocrine effects.
INH: Disturbances of liver function, hepatitis, GI disturbances, peripheral neuropathy,
INH: Disturbances of liver function, hepatitis, GI disturbances, peripheral neuropathy,
dizziness, lightheadedness, hematological changes, allergic reactions.
Pyrazinamide: Transient rise in serum transaminases, hepatotoxicity, hepatomegaly,
Pyrazinamide: Transient rise in serum transaminases, hepatotoxicity, hepatomegaly,
jaundice, hyperuricemia, intestinal nephritis, dysuria, GI disturbances, hematological
changes, allergic reactions.
Ethambutol: Confusion, disorientation, headache, visual disturbances, jaundice,
Ethambutol: Confusion, disorientation, headache, visual disturbances, jaundice,
transient liver dysfunction, GI disturbances, hematological changes, allergic effects,
acute gout (rare).
Combined anti- Tubercular Preparations
Category: Not Classified
pregnancy_description
pregnancy_description
Rifampicin, isoniazid and pyrazinamide are all active bactericidal antituberculosis drugs.
Rifampicin and isoniazid are particularly active against the rapidly growing extracellular
organisms and have an intracellular bactericidal activity. Rifampicin also inhibits
DNA-dependent RNA polymerase activity in susceptible cells and it has activity
against slow and intermittently-growing M tuberculosis. Pyrazinamide, particularly
in the acid pH environment of macrophages is active against intracellular organisms.
Combination of these agents covers activity against the 3 different bacterial populations.
Ethambutol interferes with RNA synthesis, causing suppression of Mycobacteria
multiplication. It also has bacteriostatic action against M tuberculosis by acting on
rapidly growing pathogens in cavity walls and is also effective in slow-growing
pathogens. Has some action against atypical opportunistic Mycobacteria
e.g. M kansasii, M avium complex (MAC).
Rifampicin: Induces microsomal enzymes (accelerates clearance of methadone,
oral anticoagulants, glucocorticoids, oestrogen, oral hypoglycaemic agents, digitoxin,
antiarrhythmics, theophylline, anticonvulsants, ?-blockers, azole antifungal, cyclosporin).
INH: Inhibits metabolism of antiepileptics, benzodiazepines, warfarin, theophylline.
Increases metabolism of enflurane. Alcohol, ASA, Al-containing antacids,
corticosteroids, ketoconazole, propranolol. PZA: Decreases efficacy of
gout therapy agents. Ethambutol: Neurotoxic agents.
Per Unit Price: Tk. 500
Package: 50's pack
Package: 50's pack
Phenoxymethyl Penicillin:
Brand name; Penvik(square)
Oral
Adult:
Usually 250-500 mg 6 hourly
Prophylaxis of recurrent rheumatic fever
250 mg twice daily.
Streptococcal infections of the upper respiratory tract,
Adult:
Usually 250-500 mg 6 hourly
Prophylaxis of recurrent rheumatic fever
250 mg twice daily.
Streptococcal infections of the upper respiratory tract,
including scarlet fever and erysipelas
125-250 mg 6-8 hrly for 10 days.
Pneumococcal infections of the respiratory tract, including
125-250 mg 6-8 hrly for 10 days.
Pneumococcal infections of the respiratory tract, including
otitis media
250-500 mg 6 hrly until patient is afebrile for at least 2 days.
Fusospirochetosis (Vincent's infection) of the oropharynx;
250-500 mg 6 hrly until patient is afebrile for at least 2 days.
Fusospirochetosis (Vincent's infection) of the oropharynx;
Staphylococcal infections of the skin and soft tissue
250-500 mg 6-8 hrly.
250-500 mg 6-8 hrly.
Oral
Tablet
Children: PO 25–50 mg/kg/day q6h
Syrup
Dry Syrup: 1-2 tea-spoonful (5-10ml) 6 hourly
Forte Syrup: ½-1 tea-spoonful (2.5-5ml) 6 hourly
Infants: 62.5-125 mg 6 hourly
Tablet
Children: PO 25–50 mg/kg/day q6h
Syrup
Dry Syrup: 1-2 tea-spoonful (5-10ml) 6 hourly
Forte Syrup: ½-1 tea-spoonful (2.5-5ml) 6 hourly
Infants: 62.5-125 mg 6 hourly
Tonsillitis, Pharyngitis, Skin & soft tissue infections, Anthrax,
Lyme disease, Rheumatic fever, Spleen disorders, Dental
Abscesses, gingivitis, upper respiratory tract, scarlet fever,
erysipelas, otitis media, Vincent's infection
Hypersensitivity to penicillins.
Nausea, vomiting, epigastric distress, diarrhoea, black
hairy tongue; skin eruptions (maculopapular to exfoliative
dermatitis), urticaria and other serum-sickness like reactions,
laryngeal oedema; fever, eosinophilia.
Potentially Fatal: Anaphylaxis.
Potentially Fatal: Anaphylaxis.
Benzylpenicillin & Phenoxymethyl penicillin
Category: B
pregnancy_description
pregnancy_description
Inhibits the biosynthesis of cell wall mucopeptide; bactericidal
against sensitive organisms when adequate concentrations
are reached, and most effective during the stage of active
multiplication; inadequate concentrations may produce only
bacteriostatic effects.
Per Unit Price: Tk. 1.52
Package: 100's pack
Package: 100's pack
Amoxicillin + Clavulanic Acid (Clavulanate):
Brand name:Moxaclav(square),Augment(skf)
Clacido(healthcare)Fimoxyclav(synovia)
Adults: PO: One 375 mg tablet 3 times a day.
In severe infection one 625mg tablet 3 times a
day or one 1gm tablet two times a day.
IV Injection: 1.2 g every 6-8 hours
Hepatic impairment: Dose with caution; monitor
IV Injection: 1.2 g every 6-8 hours
Hepatic impairment: Dose with caution; monitor
hepatic function regularly
Children: 125/31.25-, 250/62.5-mg/5-mL susp: 20–40 mg
amoxicillin component/kg/day (max 1,500 mg/day) q8h
200/28.5-, 400/57-mg/5-mL susp: 25-45 mg amoxicillin
200/28.5-, 400/57-mg/5-mL susp: 25-45 mg amoxicillin
component/kg/day (max 1,750 mg/day) q12h
Children of 6-12 years: 2 teaspoonful Powder for
Children of 6-12 years: 2 teaspoonful Powder for
Suspension every 8 hours.
Children of 1-6 years: 1 teaspoonful Powder for
Children of 1-6 years: 1 teaspoonful Powder for
Suspension every 8 hours.
Children below 1 year: 25 mg/kg/day in divided
Children below 1 year: 25 mg/kg/day in divided
doses every 8 hours.
Children over 12 years: IV Injection: 1.2 g every 6-8 hours,
Children up to 3 months: 30 mg/kg every 8 hours
Children over 12 years: IV Injection: 1.2 g every 6-8 hours,
Children up to 3 months: 30 mg/kg every 8 hours
(every 12 hours in the perinatal period and in premature infants);
Child 3 months-12 years, 30 mg/kg every 6-8 hours.
Child 3 months-12 years, 30 mg/kg every 6-8 hours.
Renal impairment
CrCl <30 mL/min: Do not use 875/125 mg tablet or
CrCl <30 mL/min: Do not use 875/125 mg tablet or
extended-release tablets
CrCl 10-30 mL/min: 250-500/125 mg PO q12hr
CrCl <10 mL/min: 250-500/125 mg PO q24hr
Hemodialysis: 250-500/125 mg PO q24hr; administer
CrCl 10-30 mL/min: 250-500/125 mg PO q12hr
CrCl <10 mL/min: 250-500/125 mg PO q24hr
Hemodialysis: 250-500/125 mg PO q24hr; administer
additional dose both during and at end of dialysis
Take with meals to avoid GI upset
Take suspension at start of meal to enhance absorption
Reconstitution: Powd for inj: Dissolve amoxicillin/clavulanic
Take suspension at start of meal to enhance absorption
Reconstitution: Powd for inj: Dissolve amoxicillin/clavulanic
acid 500/100 mg in 10 mL solvent and 1,000/200 mg in 20 mL
solvent. May further dilute to infusion soln containing either
water for inj or NaCl 0.9%.
Bacterial infections, Acute otitis media, Acute bacterial sinusitis,
Endocarditis, Dental abscess, Community-acquired pneumonia,
Acute uncomplicated UTI, Uncomplicated gonorrhea, Severe or
recurrent resp tract infections
Penicillin allergy.
>10%
Diarrhea (3-34%; varies upon dose and regimen)
1-10%
Diaper rash (3.5%),Mycosis (3.3%),Nausea (2-3%),Rash (1-3%),
Diarrhea (3-34%; varies upon dose and regimen)
1-10%
Diaper rash (3.5%),Mycosis (3.3%),Nausea (2-3%),Rash (1-3%),
Vomiting (1-2.2%),Loose stool (1.6%),Candidiasis (1.4%),Vaginitis (1%)
<1%
Hypersensitivity reactions,Anaphylaxis,Anemia,Thrombocytopenia,
<1%
Hypersensitivity reactions,Anaphylaxis,Anemia,Thrombocytopenia,
Leukopenia,Agranulocytosis,Hepatoxicity,AST/ALT elevation,
Pseudomembranous colitis,Serum sickness,Abdominal discomfort,
Cholestatic jaundice,Flatulence
Potentially Fatal: Anaphylactic reaction with CV collapse esp
Potentially Fatal: Anaphylactic reaction with CV collapse esp
with parenteral use.
Broad spectrum penicillins
Category: B
pregnancy_description
pregnancy_description
Clavulanic acid has a high affinity for and binds to certain ?-lactamases
that generally inactivate amoxicillin by hydrolyzing its ?-lactam ring.
Combining clavulanate potassium with amoxicillin extends the antibacterial
spectrum of amoxicillin to include many bacteria normally resistant to
amoxicillin and other penicillins and cephalosporins.
Allopurinol may reduce renal tubular secretion of amoxicillin thus
increasing the serum levels of amoxicillin. Concurrent use may reduce
the efficacy of oral contraceptives.
Per Unit Price: Tk. 135.92,175.51
Package: 60ml,100ml bot
Package: 60ml,100ml bot
Chloramphenicol:
Brand name: Chloramphenicol(Hudson),Opsomycetin(opsonin)
Adult: PO Susceptible infections 50 mg/kg/day in
4 divided doses, may increase to 100 mg/kg/day in
more severe infections.
Hepatic impairment: Dose reduction may be required.
Hepatic impairment: Dose reduction may be required.
PO Susceptible infections
Child: Premature and full-term neonates: 25 mg/kg/day in
Child: Premature and full-term neonates: 25 mg/kg/day in
4 divided doses.
Full-term infants >2 wk: 50 mg/kg/day in 4 divided doses.
Children: 50-75 mg/kg/day in 4 divided doses increased to
Full-term infants >2 wk: 50 mg/kg/day in 4 divided doses.
Children: 50-75 mg/kg/day in 4 divided doses increased to
75-100 mg/kg/day for meningitis or severe infections.
Renal impairment: Dose reduction may be required.
Should be taken on an empty stomach. Take on an empty
stomach 1 hr before or 2 hr after meals.
Tetracycline-resistant cholera, typhoid, brain abscesses, meningitis,
Granuloma inguinale, Anthrax, Listeriosis, Gas gangrene, Whipple's
disease, gastroenteritis, melioidosis, Plague, Psittacosis, Q fever,
Tularaemia
History of hypersensitivity or toxic reaction to the drug; pregnancy,
lactation; porphyria; parenteral admin for minor infections or as
prophylaxis; preexisting bone marrow depression or blood dyscrasias.
<1%
Nightmares,Headache,Rash,Diarrhea,Stomatitis,Enterocolitis,
Nightmares,Headache,Rash,Diarrhea,Stomatitis,Enterocolitis,
Nausea,Vomiting,Bone marrow suppression,Aplastic anemia,
Peripheral neuropathy,Optic neuritis,Gray syndrome
Potentially Fatal: Bone marrow suppression and irreversible
Potentially Fatal: Bone marrow suppression and irreversible
aplastic anaemia. Neutropenia, thrombocytopenia. Grey baby
syndrome. Rarely, anaphylaxis.
Category: C
pregnancy_description
pregnancy_description
Chloramphenicol inhibits bacterial protein synthesis by binding
to 50s subunit of the bacterial ribosome, thus preventing peptide
bond formation by peptidyl transferase. It has both bacteriostatic
and bactericidal action against H. influenzae, N. meningitidis
and S. pneumoniae.
Decreased effects of iron and vitamin B12 in anaemic patients.
Phenobarbitone and rifampin reduce efficacy of chloramphenicol.
Impairs the action of oral contraceptives. Potentially Fatal:
Increases the effect of oral anticoagulants, oral hypoglycaemic
agents, phenytoin. Avoid concomitant administration with drugs
that depress bone marrow function.
Per Unit Price: Tk. 10
Package: 100's pack
Package: 100's pack
Cephradine:
Brand name: Cephran(opsonin)(250/500mgcap)(125mg/5ml syrap)
Dicef(drug)
Adult: PO Susceptible infections
1-2 g/day in 2-4 divided doses.
Max: 4 g/day.
Surgical prophylaxis 1-2 g pre-op.
Surgical prophylaxis 1-2 g pre-op.
Subsequent doses may be given as needed.
Skin and skin structures and respiratory tract infection:
Skin and skin structures and respiratory tract infection:
Usual dose is 250 mg every 6 hours or 500 mg every 12 hours.
Lobar pneumonia: 500 mg every 6 hours or 1 gm every 12 hours.
Urinary tract infection: Usual dose is 500 mg every 12 hours.
Gastro-intestinal tract infection: 500 mg three to four times daily.
IV/IM Severe infections 2-4 g/day in 4 divided doses. Max: 8 g/day.
Lobar pneumonia: 500 mg every 6 hours or 1 gm every 12 hours.
Urinary tract infection: Usual dose is 500 mg every 12 hours.
Gastro-intestinal tract infection: 500 mg three to four times daily.
IV/IM Severe infections 2-4 g/day in 4 divided doses. Max: 8 g/day.
Children: Oral: The usual total dose is 25 to 50 mg/kg/day given
in 2 to 4 equally divided doses.
Injection: 50 to 100 mg/kg/day in 4 equally divided doses. The
Injection: 50 to 100 mg/kg/day in 4 equally divided doses. The
usual total dose may be increased up to 200-300 mg/kg/day.
Perioperative prophylaxis: Recommended dose is 1-2 gm by
Perioperative prophylaxis: Recommended dose is 1-2 gm by
intramuscular or intravenous route; subsequent parenteral or
oral doses are given as appropriate.
Renal impairment: For patients undergoing chronic intermittent
haemodialysis: 250 mg may be given at the start of the session,
repeated after 6-12 hr, then again 36-48 hr after the initial dose,
and again at the start of the next haemodialysis if >30 hr have
elapsed since the previous dose.
CrCl (ml/min)
>20 500 mg every 6 hr.
5-20 250 mg every 6 hr.
<5 250 mg every 12 hr.
CrCl (ml/min)
>20 500 mg every 6 hr.
5-20 250 mg every 6 hr.
<5 250 mg every 12 hr.
May be taken with or without food. May be taken w/ meals to
reduce GI discomfort.
Parenteral doses by deep IM or slow IV inj over 3-5 min or
Parenteral doses by deep IM or slow IV inj over 3-5 min or
by IV infusion.
Reconstitution: IM: Add 2 mL or 4 mL of sterile water for inj or
Reconstitution: IM: Add 2 mL or 4 mL of sterile water for inj or
NaCl 0.9% inj to 500 mg or 1 g vial, respectively.
IV: Add 5 mL of sterile water for inj, dextrose 5% inj, NaCl 0.9%
IV: Add 5 mL of sterile water for inj, dextrose 5% inj, NaCl 0.9%
inj or other suitable soln to 500 mg vial. Shake well the entire soln.
Pneumonia, Pharyngitis, Susceptible infections, Otitis media, Skin
and Skin-Structure Infections, Rheumatic fever, Tonsillitis,
Respiratory tract infections, Urinary tract infections, Surgical
Prophylaxis, Genitourinary tract infections, Acute prostatitis
Hypersensitivity to cefradine or other cephalosporins; porphyria.
Diarrhoea, nausea, vomiting; leukopenia, neutropenia, eosinophilia,
rash, pruritus; joint pain; increased BUN and creatine; dizziness.
Potentially Fatal: Pseudomembranous colitis.
Potentially Fatal: Pseudomembranous colitis.
First generation Cephalosporins
Category: B
pregnancy_description
pregnancy_description
Cefradine is a 1st generation cephalosporin which inhibits the
final transpeptidation step of the peptidoglycan synthesis in
bacterial cell wall by binding to one or more of the penicillin-binding
proteins (PBPs), thus arresting cell wall synthesis leading to
bacterial cell death.
Increased risk of nephrotoxicity w/ loop diuretics. Decreased
renal clearance w/ probenecid.
Per Unit Price: Tk. 80.55
Package: 100ml bot
Package: 100ml bot
Cefepime:
brand name: Cefa-4(popular)(inj.250mg/500mg/1gm/2gm)
Adult: IV UTI 0.5-1 g 12 hrly for 7-10 days.
Empirical therapy for febrile neutropenia 2 g 8 hrly
Empirical therapy for febrile neutropenia 2 g 8 hrly
for 7 days or until resolution of neutropenia.
Moderate to severe pneumonia 1-2 g 12 hrly for 10 days.
Complicated intra-abdominal infections 2 g 12 hrly for 7-10 days.
Uncomplicated skin and skin structure infections 2 g
Moderate to severe pneumonia 1-2 g 12 hrly for 10 days.
Complicated intra-abdominal infections 2 g 12 hrly for 7-10 days.
Uncomplicated skin and skin structure infections 2 g
12 hrly for 10 days.
Child: IV, IM 100 mg/kg/day q12h
150 mg/kg/day empiric therapy of fever with neutropenia q8h
2 mth - 16 yr: >40 kg: 50 mg/kg every 12 hr for 7-10 days for
150 mg/kg/day empiric therapy of fever with neutropenia q8h
2 mth - 16 yr: >40 kg: 50 mg/kg every 12 hr for 7-10 days for
Uncomplicated and Complicated Urinary Tract Infections
(including pyelonephritis),
Uncomplicated Skin and Skin Structure Infections and
Uncomplicated Skin and Skin Structure Infections and
Pneumonia.. May be given via direct inj over 5 minutes
or infuse over 30 minutes.
For empiric therapy for febrile neutropenic patients 2 mth
For empiric therapy for febrile neutropenic patients 2 mth
16 yr: <40 kg: 50 mg/kg every 8 hr for 7 days or until
neutropenia resolves.
Renal impairment:
Haemodialysis: 1 g on the 1st day of treatment, followed
Haemodialysis: 1 g on the 1st day of treatment, followed
by 0.5 g 24 hrly; dose should be given after haemodialysis
on dialysis days and preferably at the same time each day.
CAPD: Adult dose 48 hrly.
CrCl (ml/min)
<10 0.25-0.5 g 24 hrly.
11-29 0.5-1 g 24 hrly.
30-60 0.5-2 g 24 hrly.
CAPD: Adult dose 48 hrly.
CrCl (ml/min)
<10 0.25-0.5 g 24 hrly.
11-29 0.5-1 g 24 hrly.
30-60 0.5-2 g 24 hrly.
Reconstitution: IV infusion: Add 5 mL, 10 mL, or 10 mL of a
compatible IV soln to a vial labeled as containing 500 mg,
1 g, or 2 g, respectively, to provide soln containing approx
100 mg/mL, 100 mg/mL, or 160 mg/mL of the drug, respectively.
The appropriate dose of the drug should then be added to a
compatible IV soln. IM inj: Add 1.3 mL or 2.4 mL of an appropriate
diluent (e.g. sterile water for inj, NaCl 0.9%) to a vial labeled as
containing 500 mg or 1 g respectively, to provide a soln
containing approx 280 mg/mL.
IV Administration
Infuse intermittently over 30 minutes
IM Administration
Inject deeply
Give IM only in mild-to-moderate UTI due to E coli
IV Administration
Infuse intermittently over 30 minutes
IM Administration
Inject deeply
Give IM only in mild-to-moderate UTI due to E coli
Skin and skin structure infections, Urinary tract infection,
Nosocomial pneumonia, Multiple drug resistant pneumonia,
Neutropenia
Hypersensitivity to cefepime or other cephalosporins.
>10%
Positive Coombs test result without hemolysis (16%)
1-10%
Rash (1-4%),Elevated alanine aminotransferase (3%),Hypophosphatemia
Positive Coombs test result without hemolysis (16%)
1-10%
Rash (1-4%),Elevated alanine aminotransferase (3%),Hypophosphatemia
(3%),Diarrhea (<3%),Eosinophilia (2%),Erythema at injection site (2%),
Normal partial thromboplastin time (PTT) (2%),Nausea or vomiting
(<2%),Fever (1%),Headache (1%),Pain (1%),Pruritus (1%)
<1%
Agranulocytosis,Anaphylactic shock,Anaphylaxis,Coma,Encephalopathy,
<1%
Agranulocytosis,Anaphylactic shock,Anaphylaxis,Coma,Encephalopathy,
Hallucinations,Leukopenia,Myoclonus,Neuromuscular excitability,Neutropenia,
Seizures,Thrombocytopenia
Fourth generation Cephalosporins
Category: B
pregnancy_description
pregnancy_description
Cefepime is a 4th generation cephalosporin which inhibits the final
transpeptidation
step of peptidoglycan synthesis in bacterial cell wall by binding to one
or more of the penicillin-binding proteins (PBPs).
Increased potential for nephrotoxicity and ototoxicity of aminoglycosides.
Increased risk of nephrotoxicity w/ potent diuretics (e.g. furosemide).
Per Unit Price: Tk. 1100
Package: 2gm vial with water
Package: 2gm vial with water
Teicoplanin:
Brand name: Ticonin(square)(200mg/400mg inj)
Parenteral
Severe Gram-positive infections
Adult: Initially, 6 mg/kg on first day, followed by 3 mg/kg/day.
Severe Gram-positive infections
Adult: Initially, 6 mg/kg on first day, followed by 3 mg/kg/day.
Severe infection: 6 mg/kg every 12 hr for the 1st 3 doses
followed by 6 mg/kg/day. Doses may be given via IM inj,
IV bolus or IV infusion over 30 minutes.
Intravenous
Prophylaxis of Gram-positive infection in high-risk patients
Intravenous
Prophylaxis of Gram-positive infection in high-risk patients
undergoing surgery
Adult: 400 mg as single dose at induction of anesth.
Continuous ambulatory peritoneal dialysis (CAPD)-associated
Adult: 400 mg as single dose at induction of anesth.
Continuous ambulatory peritoneal dialysis (CAPD)-associated
peritonitis
Adult: If the patient is febrile, an initial loading dose of 400 mg
Adult: If the patient is febrile, an initial loading dose of 400 mg
may be given. Teicoplanin is added to the dialysis solution at a
concentration of 20 mg/litre; dose is added into each bag of
solution in the first wk, followed by alternate bags in the
second wk and then in the overnight dwell bag in the third wk.
Parenteral
Severe Gram-positive infections
Child: Loading dose: 10 mg/kg every 12 hr for 3 doses followed by
Severe Gram-positive infections
Child: Loading dose: 10 mg/kg every 12 hr for 3 doses followed by
6-10 mg/kg/day depending on severity of the infection. Neonates:
Loading dose: 16 mg/kg on the 1st day, followed by maintenance
doses of 8 mg/kg/day by IV infusion.
Parenteral
Renal impairment: Usual dose to be given for first 3 days,
Renal impairment: Usual dose to be given for first 3 days,
thereafter adjust dose according to CrCl.
CrCl (ml/min) Dosage Recommendation
40-60 1/2 initial dose given daily or initial dose every 2 days.
<40 1/3 initial dose given daily or initial dose every 3 days.
Intravenous
Renal impairment: Dose adjustment may be required.
CrCl (ml/min) Dosage Recommendation
40-60 1/2 initial dose given daily or initial dose every 2 days.
<40 1/3 initial dose given daily or initial dose every 3 days.
Intravenous
Renal impairment: Dose adjustment may be required.
Gram-positive infection, CAPD-associated peritonitis
Hypersensitivity.
Fever, chills, allergic reactions, GI disturbances, headache,
dizziness, "red-man" syndrome, disturbances in liver enzymes,
renal impairment, ototoxicity, blood dyscrasias. Pain, erythema,
thrombophloebitis, abscess at site of admin.
Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal
Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal
necrolysis.
Category: B
pregnancy_description
pregnancy_description
Glycopeptide antibiotic with spectrum of activity is similar to
vancomycin but teicoplanin may be more active in vitro against
enterococci and some anaerobic organisms but some
coagulase-negative Staphylococci are less sensitive to
teicoplanin than to vancomycin.
Other nephrotoxic and/or neurotoxic drugs.
Per Unit Price: Tk. 200mg(700tk) 400mg(1300tk)
Package:
Package:
Benzathine Penicillin:
Brand name: Benzapen(square-12lace unit)
Lapen(jayson)(6/12 lac unit)
Adult: IM: 0.3 to 1.2 million units up to 2.4 million
units as a single dose repeated every five to seven days.
Specific dosage schedule:
Treatment of group-A beta-haemolytic streptococcal infections:
A single intramuscular dose of 600,000 units.
Prevention of rheumatic fever: Monthly injection of a single
Specific dosage schedule:
Treatment of group-A beta-haemolytic streptococcal infections:
A single intramuscular dose of 600,000 units.
Prevention of rheumatic fever: Monthly injection of a single
dose of 1.2 million units is the most effective regimen for
preventing further attacks of rheumatic fever.
Treatment of acute otitis media: A single injection of 600,000 units.
Treatment of syphilis:
Early syphilis- 2.4 million units as a single dose.
Late syphilis- 2.4 million units weekly for three successive weeks.
Neurosyphilis- Benzylpenicillin, intravenously, 2 to 4 million units
Treatment of acute otitis media: A single injection of 600,000 units.
Treatment of syphilis:
Early syphilis- 2.4 million units as a single dose.
Late syphilis- 2.4 million units weekly for three successive weeks.
Neurosyphilis- Benzylpenicillin, intravenously, 2 to 4 million units
every 4 hours for 10 days, followed by benzathine penicillin
intramuscularly, 2.4 million units weekly for three successive
weeks.
Congenital syphilis: Asymptomatic infants with normal
Congenital syphilis: Asymptomatic infants with normal
cerebrospinal fluid, intramuscularly 50,000 units per
kg in a single dose.
Primary and secondary syphilis have been treated with
Primary and secondary syphilis have been treated with
single injections of 2.4 million units of long acting
benzathine penicillin (Benzapen) weekly for 2 to 4 weeks
with satisfactory results.
Child: IM 50,000 U/kg for newborns and infants,
Child: IM 50,000 U/kg for newborns and infants,
children <60 lb: 300,000–600,000 U,
children >60 lb: 900,000 U
1 dose for treatment
Child: IM 50,000 U/kg for newborns and infants,
children <60 lb: 300,000–600,000 U,
children >60 lb: 900,000 U
1 dose for treatment
Anthrax, Group A Strep. infections, Neurosyphilis, Fusobacterium
infections, Diphtheria, Erysipeloid, Uncomplicated pneumococcal
pneumonia, Rat bite fever, Rheumatic fever, Syphilis, Streptococcal
pharyngitis
Hypersensitivity to penicillins or cephalosporins. IM inj
(ischaemic reactions may occur).
Hypersensitivity reactions including uticaria; fever; joint pains;
rashes; angioedema; serum sickness-like reactions; haemolytic
anaemia; interstitial nephritis; neutropenia; thrombocytopenia;
CNS toxicity including convulsions; diarrhoea; antibiotic-associated colitis.
Potentially Fatal: Anaphylaxis
Potentially Fatal: Anaphylaxis
Long acting penicillin
Category: B
pregnancy_description
pregnancy_description
Benzathine benzylpenicillin has the same antimicrobial action as
benzylpenicillin which exerts its bactericidal action on growing and
dividing bacteria by inhibiting bacterial cell wall synthesis. IM admin
results in a prolonged effect, but because of its relatively low blood
concentrations, its use should be restricted to microorganisms that
are highly susceptible to it.
Probenecid prolongs T1/2 of benzathine benzylpenicillin. Bacteriostatic
drugs e.g. chloramphenicol, tetracyclines; other antibacterials; anticoagulants.
Per Unit Price: Tk. 28.04(12 lac unit),14tk(6 lac unit)
Package: 5's pack
Linezolid:
Brand name: Linez(renata,400&600mg tab)
Linzolid(incepta) (2mg/1ml)(100mg/5ml suspention)
Oral
Uncomplicated skin and skin structure infections
Adult: 400 mg 12 hrly for 10-14 days.
Vancomycin-resistant Enterococcus faecium
Adult: 600 mg 12 hrly for 14-28 days.
Methicillin-resistant Staphylococcus aureus infections
Adult: 600 mg bid for 7-21 days.
Community-acquired pneumonia; Nosocomial pneumonia;
Uncomplicated skin and skin structure infections
Adult: 400 mg 12 hrly for 10-14 days.
Vancomycin-resistant Enterococcus faecium
Adult: 600 mg 12 hrly for 14-28 days.
Methicillin-resistant Staphylococcus aureus
Adult: 600 mg bid for 7-21 days.
Community-acquired pneumonia; Nosocomial pneumonia;
Adult: 600 mg 12 hrly for 10-14 days.
Elderly: No dosage adjustment needed.
Hepatic impairment: Mild to moderate: No dosage
Oral
For Pediatric Patients
Pneumonia, complicated skin infections,
For Pediatric Patients
Pneumonia, complicated skin infections,
vancomycin resistant enterococci:
Birth–11 y: 30 mg/kg/day q8h
>11 y: 1,200 mg/day q12h
Uncomplicated skin infections:
Birth–5 y: 30 mg/kg/day q8h
5–11 y: 20 mg/kg/day q12h
>11–18 y: 1,200 mg/day q12h
Birth–11 y: 30 mg/kg/day q8h
>11 y: 1,200 mg/day q12h
Uncomplicated skin infections:
Birth–5 y: 30 mg/kg/day q8h
5–11 y: 20 mg/kg/day q12h
>11–18 y: 1,200 mg/day q12h
Renal impairment: No dosage adjustment needed.
May be taken with or without food.
Community-acquired pneumonia, Skin and skin
structure infections, Nosocomial pneumonia
Linzolid formulations are contraindicated for use in
patients who have known hypersensitivity to Linzolid
or any of the other product components. Linzolid should
not be used in patients taking any medicinal product which
inhibits monoamine oxidases A or B (e.g. phenelzine, isocarboxazid)
or within two weeks of taking any such medicinal product. Linzolid
should not be administered to patients with uncontrolled hypertension,
pheochromocytoma, thyrotoxicosis, carcinoid syndrome and/or patients
taking directly and indirectly acting sympathomimetic agents
(e.g. pseudoephedrine), vasopressive agents (e.g. epinephrine,
norepinephrine), dopaminergic agents (e.g. dopamine, dobutamine)
, serotonin re-uptake inhibitors, tricyclic antidepressants,
serotonin 5-HT1 receptor agonists (triptans), meperidine or buspirone.
>10%
Pediatrics
Diarrhea (7.8-10.8%)
1-10%
Headache (5.7-8.8%).Diarrhea (8.2-8.3%),Nausea (5.1-6.6%),
Pediatrics
Diarrhea (7.8-10.8%)
1-10%
Headache (5.7-8.8%).Diarrhea (8.2-8.3%),Nausea (5.1-6.6%),
Vomiting (2-4.3%),Dizziness (1.8-2.6%),Rash (1.1-2.3%),Vaginal
moniliasis (1.1-1.8%),Taste alteration (1-1.8%),Oral moniliasis
(0.5-1.7%),Abnormal LFTs (0.4-1.6%),Fungal infection (0.3-1.5%),
Localized abdominal pain (1.2-1.3%),Tongue discoloration
(0.3-1.3%),Generalized abdominal pain (0.9-1.2%)
Pediatrics
Vomiting (2.9-9.4%),Headache (0.9-6.5%),Anemia (5.6%),
Pediatrics
Vomiting (2.9-9.4%),Headache (0.9-6.5%),Anemia (5.6%),
Thrombocytopenia (4.7%),Nausea (1.9-3.7%),Generalized
abdominal pain (0.9-2.4%),Localized abdominal pain
(0.5-2.4%),Loose stools (1.6-2.3%),Eosinophilia (0.4-1.9%),
Pruritus, other than application site (0.8-1.4%),Vertigo (1.2%)
<1%
Lactic acidosis,Myelosuppression,Peripheral neuropathy,
<1%
Lactic acidosis,Myelosuppression,Peripheral neuropathy,
Disorder of optic nerve,Serotonin syndrome
Potentially Fatal: Reversible myelosuppression including
Potentially Fatal: Reversible myelosuppression including
anaemia, leukopenia, pancytopenia and thrombocytopenia
(particularly if using > 10-14 days), transient ischaemic
attacks, renal failure, Stevens-Johnson syndrome.
Oxazolidinones
Category: C
pregnancy_description
pregnancy_description
Linezolid is a bacteriostatic oxazolidinone which
acts by inhibiting ribosomal protein synthesis. It
is active against gm+ve bacteria including
vancomycin-resistant enterococci and MRSA.
It has limited in vitro activity against gm-ve bacteria.
May reduce serum levels w/ rifampicin and phenytoin.
May cause hypoglycaemia w/ insulin or oral antidiabetics.
May increase risk of seizures w/ tramadol. Potentially Fatal:
Increased risk of serotonin syndrome w/ MAOIs, TCAs,
SNRIs, or other serotonergic drugs (e.g. bupropion,
vilazodone, mirtazapine, amoxapine, buspirone,
maprotiline, meperidine, trazodone, nefazodone).
Significant increase in BP w/ vasopressive agents (e.g.
epinephrine, norepinephrine), sympathomimetic agents
(e.g. pseudoephedrine) and dopaminergic agents (e.g.
dopamine, dobutamine).
Per Unit Price: Tk. 175.00,280.00,420.00
Package: 60ml,100ml,150ml bot
Package: 60ml,100ml,150ml bot
Erythromycin:
Brand name: Rromycin(square),Erymex(IBNSINA)
Preparation: 200MG/5ml P/D,100mg/5ml(suspention),500mg tab
Adults: Usually 250 mg every 6 hours, or 500 mg every
12 hours. May increase up to 4 g/day, according to
severity of infection.
Upper respiratory tract infections of mild to moderate severity:
Upper respiratory tract infections of mild to moderate severity:
250 to 500 mg 4 times a day for 10 days.
Lower respiratory infections of mild to moderate severity:
Lower respiratory infections of mild to moderate severity:
250 to 500 mg 4 times a day for 10 days.
Respiratory tract infections due to Mycoplasma pneumoniae:
Respiratory tract infections due to Mycoplasma pneumoniae:
500 mg 6 hours for 5 to 10 days, treat severe infections for
up to 3 weeks.
Skin and soft tissue infections of mild to moderate severity:
Skin and soft tissue infections of mild to moderate severity:
250 to 500 mg 4 times a day for 10 days.
Pelvic inflammatory diseases (PID), acute due to
Pelvic inflammatory diseases (PID), acute due to
Neisseria gonorrhoeae: 500 mg 4 times a day for 10 to 14 days.
Urogenital infection during pregnancy caused by
Urogenital infection during pregnancy caused by
Chlamydia trachomatis: 500 mg 4 times daily for 7 days or
250 mg 4 times daily for 14 days.
Urethral, endocervical or rectal infections, uncomplicated:
250 mg 4 times daily for 14 days.
Urethral, endocervical or rectal infections, uncomplicated:
500 mg 4 times daily for 7 days or
250 mg 4 times daily for 14 days.
Non-gonococcal urethritis: 500 mg 4 times daily for
250 mg 4 times daily for 14 days.
Non-gonococcal urethritis: 500 mg 4 times daily for
at least 7 days.
Neisseria gonorrhoeae: Uncomplicated urethral, endocervical
Neisseria gonorrhoeae: Uncomplicated urethral, endocervical
or rectal infections and in penicillinase producing N. gonorrhoeae(PPNG):
500 mg 4 times a day for 7 days.
Early syphillis (primary, secondary or latent syphillis of < 1 year duration):
Early syphillis (primary, secondary or latent syphillis of < 1 year duration):
500 mg 4 times a day for 14 days.
Severe or chronic diarrhoea: 500 mg 4 times a day for 7 days. Rheumatic fever:
Severe or chronic diarrhoea: 500 mg 4 times a day for 7 days. Rheumatic fever:
250 mg 2 times daily.
Bacterial endocarditis: 1 g 2 hours prior to procedures, then 500 mg
Bacterial endocarditis: 1 g 2 hours prior to procedures, then 500 mg
6 hours after initial dose.
Acne: 500 mg twice daily for 3 months reduced to 250 mg twice for 3 months.
Hepatic Impairment
Use caution
Acne: 500 mg twice daily for 3 months reduced to 250 mg twice for 3 months.
Hepatic Impairment
Use caution
Children:
PO 50 mg/kg/day q6–8h
PO 50 mg/kg/day q6–8h
Renal Impairment
Dose adjustment not necessary
Dose adjustment not necessary
Should be taken on an empty stomach. Best taken on an empty
stomach at least ½ hr & preferably 2 hr before meals.
Reconstitution: Oral susp: Add 77 mL of water and shake vigorously.
Reconstitution: Oral susp: Add 77 mL of water and shake vigorously.
This makes 100 mL susp.
Susceptible infections, Respiratory tract infections, Enteritis, Pertussis,
Trench fever, Chanroid, Chlamydial infections, Diphtheria, Legionnaire's
disease, Pneumonia, Sinusitis, Bronchitis, Acne, Rheumatic fever,
Neonatal conjunctivitis.
Hypersensitivity; porphyria; hepatic impairment; pregnancy.
1-10%
Abdominal pain (8%),Headache (8%),Nausea (8%),Diarrhea (7%),
Abdominal pain (8%),Headache (8%),Nausea (8%),Diarrhea (7%),
Rash (3%),Vomiting (3%),Dyspepsia (2%),Flatulence (2%),Pain
(2%),Pruritus (1%),Pseudomembranous colitis
Hypertrophic pyloric stenosis,Anaphylaxis,Fever,Mild allergic
Hypertrophic pyloric stenosis,Anaphylaxis,Fever,Mild allergic
reactions,Urticaria,Skin eruptions,Tinnitus
<1%
Cholestatic hepatitis,Confusion,Hallucinations,Hearing loss,
<1%
Cholestatic hepatitis,Confusion,Hallucinations,Hearing loss,
Hypotension,Nervous system effects including seizures,Torsade
de pointes,Ventricular tachycardia,Vertigo
Potentially Fatal: Hepatotoxicity, cholestatic jaundice;
Potentially Fatal: Hepatotoxicity, cholestatic jaundice;
raised serum transaminases; eosinophilia.
Macrolides
Category: B
pregnancy_description
pregnancy_description
Erythromycin inhibits protein synthesis by irreversibly binding to the 50S
ribosomal subunit thus blocking the transpeptidation or translocation reactions
of susceptible organisms resulting in stunted cell growth.
May decrease plasma levels of valproic acid thus, increasing the risk of seizures.
Increased plasma concentrations w/ probenecid.
Per Unit Price: Tk.
Package: 30's / 100's pack
Package: 30's / 100's pack
Piperacillin + Tazobactam:
Brand name: Tazopen(renata)
Intravenous
Nosocomial pneumonia
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam
Nosocomial pneumonia
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam
0.5 g): 4.5 g 6 hrly for 5-14 days by infusion over 30 min.
When used empirically, combination w/ aminoglycoside or
antipseudomonal fluoroquinolone is recommended.
Empiric therapy for febrile neutropenic patients
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g):
Empiric therapy for febrile neutropenic patients
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g):
4.5 g 6 hrly for 5-14 days by infusion over 30 min.
Complicated intra-abdominal infections
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g):
Complicated intra-abdominal infections
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g):
4.5 g 8 hrly for 5-14 days by infusion over 30 min.
Complicated urinary tract infections; Skin and soft tissue infections
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g):
Complicated urinary tract infections; Skin and soft tissue infections
Adult: Each vial contains 4.5 g (piperacillin 4 g and tazobactam 0.5 g):
4.5 g 8 hrly for 5-14 days by infusion over 30 min.
Intravenous
Child: Usually <40 kg: 240–300 mg PIP/kg/day 8 hourly
Alternatively
Nosocomial pneumonia
Child: 2-12 yr 90 mg/kg (piperacillin 80 mg/kg and tazobactam 10 mg/kg)
Child: Usually <40 kg: 240–300 mg PIP/kg/day 8 hourly
Alternatively
Nosocomial pneumonia
Child: 2-12 yr 90 mg/kg (piperacillin 80 mg/kg and tazobactam 10 mg/kg)
6 hrly for 5-14 days by infusion over 30 min.
Max: 4.5 g per dose; >12 yr Same as adult dose.
Empiric therapy for febrile neutropenic patients
Child: 2-12 yr 90 mg/kg (piperacillin 80 mg/kg and tazobactam 10 mg/kg)
Max: 4.5 g per dose; >12 yr Same as adult dose.
Empiric therapy for febrile neutropenic patients
Child: 2-12 yr 90 mg/kg (piperacillin 80 mg/kg and tazobactam 10 mg/kg)
6 hrly for 5-14 days by infusion over 30 min.
Max: 4.5 g per dose; >12 yr Same as adult dose.
Complicated intra-abdominal infections
Child: 2-12 yr 112.5 mg/kg (piperacillin 100 mg and tazobactam 12.5 mg)
Max: 4.5 g per dose; >12 yr Same as adult dose.
Complicated intra-abdominal infections
Child: 2-12 yr 112.5 mg/kg (piperacillin 100 mg and tazobactam 12.5 mg)
8 hrly for 5-14 days by infusion over 30 min.
Max: 4.5 g per dose.
Max: 4.5 g per dose.
Renal impairment: Haemodialysis patients: 2.25 g 12 hrly; additional dose
of 0.75 g after each dialysis session. CAPD: 2.25 g 12 hrly.
CrCl (ml/min) Dosage Recommendation
<20 2.25 g 8 hrly.
20-40 2.25 g 6 hrly.
CrCl (ml/min) Dosage Recommendation
<20 2.25 g 8 hrly.
20-40 2.25 g 6 hrly.
Reconstitution
Reconstitute initially (2.25 g in 10 mL, 4.5 g in 20 mL) w/ water for inj, glucose
Reconstitute initially (2.25 g in 10 mL, 4.5 g in 20 mL) w/ water for inj, glucose
5% or NaCl 0.9%, then further dilute to 50-150 mL w/ compatible infusion soln.
IV Administration
Infusion over 30 min
IV Administration
Infusion over 30 min
Septicaemia, Nosocomial pneumonia
Hypersensitivity.
>10%
Diarrhea (7-11%)
1-10%
Constipation (1-8%),Headache (1-8%),Insomnia (4-7%),Nausea (2-7%),
Diarrhea (7-11%)
1-10%
Constipation (1-8%),Headache (1-8%),Insomnia (4-7%),Nausea (2-7%),
Fever (2-5%),Oral candidiasis (2-4%),Rash (2-4%),Vomiting (2-4%),
Dyspepsia (3%),Pruritus (3%),Pain (2-3%),Hypertension (2%),
Leukopenia (1%),Thrombocytopenia (1.4%)
<1%
Anaphylaxis,Agranulocytosis,Thrombocytopenia,Eosinophilia,
<1%
Anaphylaxis,Agranulocytosis,Thrombocytopenia,Eosinophilia,
Leukopenia,Positive Coombs test,Prolonged PT and PTT,Transient LFT
and creatinine elevations.Seizure,Pulmonary edema,Pulmonary embolism
Other beta-lactam Antibiotics
Category: Not Classified
pregnancy_description
pregnancy_description
Piperacillin has an antimicrobial activity against a wide range of
gm-ve organisms including K. pneumoniae, P. aeruginosa,
Enterobacteriaceae and against gm+ve organisms eg E. faecalis
and B. fragilis. Tazobactam is a penicillanic acid sulfone derivative
with beta-lactamase inhibitory properties. In combination, tazobactam
enhances the activity of piperacillin against beta-lactamase-producing
bacteria.
Interacts w/ high doses of heparin, oral anticoagulants or other drugs
that affect blood coagulation or thrombocyte function. Prolongs the
neuromuscular blockade of vecuronium and non-depolarising muscle
relaxants. Prolongs half-lives w/ probenecid. Increased risk of methotrexate toxicity.
Per Unit Price: Tk. 1000
Package: 1's pack
Package: 1's pack
Tetracycline :
Brand name: A tetra(ACME),Tetrax(square)
Preparation: 250/500 cpsule
Ophthalmic
Adults: Apply every two to four hours.
Adults: Apply every two to four hours.
Ophthalmic
Children: Apply every two to four hours.
Children: Apply every two to four hours.
First, wash hands. Then pull the lower eyelid
away from the eye to form a pouch. Squeeze a
thin strip of ointment into the pouch. A 1-cm
(approximately 1/3-inch) strip of ointment is usually
enough. Gently close the eyes and keep them closed for
1 or 2 minutes to allow the medicine to come into contact
with the infection.
Bacterial Conjunctivitis
Hypersensitivity; pregnancy, lactation, children; renal impairment.
Burning, irritation, visual disturbances, superinfections,
photosensitivity, hypersensitivity,
Ophthalmic Anti-bacterial products
Category: D
pregnancy_description
pregnancy_description
Tetracycline exhibits its bacteriostatic action by reversibly binding to the
30S subunits of the ribosome, thus preventing protein synthesis and
arresting cell growth. It has a broad spectrum of antimicrobial activity
including Chlamydiaceae, Mycoplasma spp., Rickettsia spp., spirochaetes,
many aerobic and anaerobic gm+ve and gm-ve pathogenic bacteria
and some protozoa.
Impaired absorption w/ antacids containing divalent and trivalent cations
(e.g. Al, Ca, Mg), Fe, Zn and Na bicarbonate preparations, kaolin-pectin,
bismuth subsalicylate, sucralfate, strontium ranelate, colestipol and
colestyramine. May interfere w/ the bactericidal action of penicillin.
May potentiate the effect of anticoagulants. May decrease efficacy
of oral contraceptives. Nephrotoxic effects may be exacerbated by
diuretics or other nephrotoxic drugs. May increase the hypoglycaemic
effect of insulin and sulfonylureas in patients w/ DM. May increase toxic
effects of ergot alkaloids and methotrexate. Potentially Fatal: Concurrent
methoxyflurane may result to fatal renal toxicity. Increased risk of benign
intracranial HTN w/ vit A or retinoids (e.g. acitretin,isotretinoin, tretinoin).
Per Unit Price: Tk. 11.58
Package: 1's Pack
Package: 1's Pack
Brand name: Cebuten(400mg),butibac(drug internation)
Cefaten(SKF)
Oral
Respiratory tract infections, Urinary tract infections
Adult: 400 mg once daily for 10 days.
Respiratory tract infections, Urinary tract infections
Adult: 400 mg once daily for 10 days.
Child:
<6 months: Safety and efficacy not established
6-12 years old or <45 kg: 9 mg/kg PO qDay;
<6 months: Safety and efficacy not established
6-12 years old or <45 kg: 9 mg/kg PO qDay;
400 mg/day PO for 10 days maximum
>12 years old or >45 kg: As in adults
>12 years old or >45 kg: As in adults
Renal impairment:
CrCl (ml/min)
30-49 200 mg once daily.
5-29 100 mg once daily.
CrCl (ml/min)
30-49 200 mg once daily.
5-29 100 mg once daily.
Susp: Should be taken on an empty stomach.
Take 2 hr before or 1 hr after meals.
Cap: May be taken with or without food.
Cap: May be taken with or without food.
Respiratory tract infections, Urinary tract infections
Hypersensitivity to cephalosporins.
1-10%
Increased BUN (4%),Nausea (4%),Diarrhea (3%),Headache
Increased BUN (4%),Nausea (4%),Diarrhea (3%),Headache
(3%),Increased eosinophils (3%),Decreased hemoglobin
(2%),Dyspepsia (2%),Thrombocytosis (2%),Abdominal pain
(1%),Dizziness (1%),Increased ALT (1%),Increased bilirubin
(1%),Vomiting (1%)
<1%
Anorexia,Candidiasis,Constipation,Dysuria,Agitation,Fatigue,
<1%
Anorexia,Candidiasis,Constipation,Dysuria,Agitation,Fatigue,
Insomnia,Irritability,Paresthesia,Rigors,Diaper rash,Urticaria,
Dry mouth,Dyspnea,Nasal congestion,Increased transaminases,
Increased creatinine,Leukopenia
Potentially Fatal: Pseudomembranous colitis.
Potentially Fatal: Pseudomembranous colitis.
Third generation Cephalosporins
Category: B
pregnancy_description
pregnancy_description
Ceftibuten inhibits bacterial cell wall synthesis. It is stable to
hydrolysis by many beta-lactamases and has greater activity
than 1st or 2nd generation cephalosporins against gm-ve bacteria.
It is less active in vitro than cefexime against S. pneumoniae.
Enhanced nephrotoxicity of aminoglycosides. Increased serum
concentration w/ probenecid. Decreased serum concentration w/ zinc salts.
Per Unit Price: Tk. 120
Package: 8's Pack
Package: 8's Pack
Cefpodoxime:
Brand: Cefdox(ACI),CEFOMIN(popular)cefobid(unimed)
Acute Bronchitis & Acute Exacerbations
of Chronic Bronchitis, Acute Maxillary Sinusitis
200 mg PO q12hr for 10 days
Acute Community-Acquired Pneumonia
200 mg PO q12hr for 14 days
Pharyngitis/Tonsillitis
100 mg PO q12hr for 5-10 days
Skin/Skin Structure Infections
400 mg PO q12hr for 7-14 days
Uncomplicated gonorrhoea
200 mg as a single dose
Uncomplicated Urinary Tract Infections
100 mg PO q12hr for 7-14 days
Hepatic impairment
Dosage adjustment not necessary
200 mg PO q12hr for 10 days
Acute Community-Acquired Pneumonia
200 mg PO q12hr for 14 days
Pharyngitis/Tonsillitis
100 mg PO q12hr for 5-10 days
Skin/Skin Structure Infections
400 mg PO q12hr for 7-14 days
Uncomplicated gonorrhoea
200 mg as a single dose
Uncomplicated Urinary Tract Infections
100 mg PO q12hr for 7-14 days
Hepatic impairment
Dosage adjustment not necessary
Child : PO 10 mg/kg/day, max 400 mg/day q12h
6 months - 2 years : 40 mg every 12 hours
3 - 8 years : 80 mg every 12 hours
over 9 years : 100 mg every 12 hours
6 months - 2 years : 40 mg every 12 hours
3 - 8 years : 80 mg every 12 hours
over 9 years : 100 mg every 12 hours
Renal impairment: Patients on haemodialysis: Dose
should be given after each dialysis session.
CrCl (ml/min) Dosage Recommendation
10-39 Increase dosing intervals to 24 hrly.
<10 Increase dosing intervals to 48 hrly.
CrCl (ml/min) Dosage Recommendation
10-39 Increase dosing intervals to 24 hrly.
<10 Increase dosing intervals to 48 hrly.
Should be taken with food. Take after meals.
Reconstitution: Reconstitute powd for oral susp at the time
Reconstitution: Reconstitute powd for oral susp at the time
of dispensing by adding the amount of water specified on the
container to provide a susp containing 50 mg or 100 mg per 5 mL.
Add water in 2 equal parts and shake the bottle vigorously after
each addition.
Pharyngitis, Acute otitis media, Community-acquired pneumonia,
Sinusitis, UTI, Cystitis, Gonorrhea, Skin and skin structure infections,
Tonsillitis, Respiratory tract infections, Acute Maxillary Sinusitis,
Acute bacterial exacerbation of chronic bronchitis
Hypersensitivity.
>10%
Diarrhea in infants and toddlers (15.4%),Diaper rash (12.1%)
1-10%
Diarrhea (7.4%),Nausea (3.8%),Vaginal infection (3.1%),Vomiting
Diarrhea in infants and toddlers (15.4%),Diaper rash (12.1%)
1-10%
Diarrhea (7.4%),Nausea (3.8%),Vaginal infection (3.1%),Vomiting
(1.1-2.1%),Abdominal pain (1.6%),Rash (1.4%),Headache (1.1%)
Potentially Fatal: Pseudomembranous colitis; nephrotoxicity.
Potentially Fatal: Pseudomembranous colitis; nephrotoxicity.
Third generation Cephalosporins
Category: B
pregnancy_description
pregnancy_description
Cefpodoxime binds to one or more of the penicillin-binding proteins
(PBPs) which inhibits the final transpeptidation step of peptidoglycan
synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting
cell wall assembly resulting in bacterial cell death.
Antacids or H2-blockers may decrease the absorption of cefpodoxime.
Probenecid inhibits renal excretion. Potentially Fatal: Monitor renal
function during admin. Additive nephrotoxic effects with furosemide.
Per Unit Price: Tk. 22
Package:
Package:
Vancomycin:
Brand name: Covan(renata),vanmycin(incepta)
preparation; 500mg/1gm injection
Intravenous
Severe staphylococcal or other Gram-positive
Severe staphylococcal or other Gram-positive
infections, Endocarditis
Adult: 500 mg 6 hrly, infused over at least 60 min or
Adult: 500 mg 6 hrly, infused over at least 60 min or
1 g 12 hrly, infused over at least 100 min.
Elderly: Dosage adjustment needed.
Elderly: Dosage adjustment needed.
Intravenous
Children
Severe staphylococcal or other Gram-positive infections,
Children
Severe staphylococcal or other Gram-positive infections,
Endocarditis
<1 month: 15 mg/kg followed by 10 mg/kg IV q12hr for
<1 month: 15 mg/kg followed by 10 mg/kg IV q12hr for
neonates in first week of life and q8hr thereafter up to 1 month
of age; longer dosing intervals recommended in premature infants
>1 month: 10 mg/kg/day IV divided q6hr; individual dose not to
>1 month: 10 mg/kg/day IV divided q6hr; individual dose not to
exceed 1 g
Renal impairment: Patient on intermittent haemodialysis: Loading dose:
15-25 mg/kg on day 1, followed by 5-10 mg/kg maintenance dose after
each dialysis run. Anuric patient (w/o kidney function) on dialysis: Initially,
15 mg/kg. Maintenance: 1.9 mg/kg 24 hrly.
CrCl (ml/min) Dosage Recommendation
<20 Longer intervals; determine by serum concentration monitoring.
20-49 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 24 hrly.
>50 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 8-12 hrly.
CrCl (ml/min) Dosage Recommendation
<20 Longer intervals; determine by serum concentration monitoring.
20-49 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 24 hrly.
>50 Initially, 15-20 mg/kg/dose (usual: 750-1,500 mg) 8-12 hrly.
IV Preparation
Add 10 mL of SWI to 500-mg vial and 20 mL of SWI to 1-g vial to yield
Add 10 mL of SWI to 500-mg vial and 20 mL of SWI to 1-g vial to yield
50 mg/mL solution; further dilution is required, depending on method of
administration
Intermittent infusion: Dilute 500 mg with ?100 mL of diluent and 1 g with ?
Intermittent infusion: Dilute 500 mg with ?100 mL of diluent and 1 g with ?
200 mL of diluent (NS or D5W)
Continuous infusion: Dilute in sufficient amount to permit
Continuous infusion: Dilute in sufficient amount to permit
infusion over 24 hours
IV Administration
Intermittent (preferred): Administer over 60 minutes; not to
IV Administration
Intermittent (preferred): Administer over 60 minutes; not to
exceed 10 mg/min
Continuous: Administer over 24 hours
Continuous: Administer over 24 hours
Septicaemia, Soft tissue infections, Osteomyelitis, Enterocolitis,
Colitis, Serious staphylococcal or other Gm +ve infections,
Bacterial endocarditis
Hypersensitivity to the drug; history of impaired hearing; IM
administration.
>10%
Erythematous rash on face and upper body (red neck or red
Erythematous rash on face and upper body (red neck or red
man syndrome; related to infusion rate),Hypotension
accompanied by flushing
1-10%
Chills,Drug fever,Eosinophilia,Rash,Reversible neutropenia,
1-10%
Chills,Drug fever,Eosinophilia,Rash,Reversible neutropenia,
Phlebitis
<1%
Nephrotoxicity,Ototoxicity (especially with large doses),
<1%
Nephrotoxicity,Ototoxicity (especially with large doses),
Stevens-Johnson syndrome,Thrombocytopenia,Vasculitis
Potentially Fatal: Stevens-Johnson syndrome; toxic
Potentially Fatal: Stevens-Johnson syndrome; toxic
epidermal necrolysis, blood dyscrasias such as neutropenia or
thrombocytopenia.
Category: Not Classified
pregnancy_description
pregnancy_description
Vancomycin binds tightly to D-alanyl-D-alanine portion cell wall
precursor causing blockage of glycopeptide polymerisation which
produces immediate inhibition of cell wall synthesis and secondary
damage to the cytoplasmic membrane.
General anaesth may enhance the adverse effects of vancomycin.
Increased risk of ototoxicity and nephrotoxicity w/ aminoglycosides,
polymyxins, ciclosporin, cisplatin and loop diuretics. Increased
potential of neuromuscular blockade w/ suxamethonium or vecuronium.
Per Unit Price: Tk. 483.25
Package: 1gm vial X 1's pack
Package: 1gm vial X 1's pack
Doxycycline:
Brand name: Doxicap(drug int)
Doxin(opsonin)
Preparation; 50/100 capsule
Oral
Susceptible infections
Adult: 200 mg on day 1 as a single or in divided doses,
Susceptible infections
Adult: 200 mg on day 1 as a single or in divided doses,
followed by 100 mg once daily. Severe infections:
Maintain initial dose throughout the course of treatment.
Sexually Transmitted Diseases
Uncomplicated gonococcal infection of the cervix, urethra,
Sexually Transmitted Diseases
Uncomplicated gonococcal infection of the cervix, urethra,
and rectum, Uncomplicated urethral, endocervical, or rectal
infection caused by Chlamydia trachomatis, Nongonococcal
urethritis caused by C. trachomatis and U. urealyticum
100 mg PO q12hr for 7 days
Syphilis (early): Patients who are allergic to penicillin should
100 mg PO q12hr for 7 days
Syphilis (early): Patients who are allergic to penicillin should
be treated with doxycycline 100 mg PO BID x 2 weeks
Syphilis >1 year duration: Patients who are allergic to
Syphilis >1 year duration: Patients who are allergic to
penicillin should be treated with doxycycline
100 mg PO BID x 4 weeks
Acute epididymo-orchitis caused by N. gonorrhoeae or
100 mg PO BID x 4 weeks
Acute epididymo-orchitis caused by N. gonorrhoeae or
C trachomatis:
100 mg PO BID x least 10 days
Acne, Rosacea
Adult: 50 mg daily for 6-12 wk.
Malaria
Indicated for prophylaxis of malaria due to Plasmodium falciparum
100 mg PO BID x least 10 days
Acne, Rosacea
Adult: 50 mg daily for 6-12 wk.
Malaria
Indicated for prophylaxis of malaria due to Plasmodium falciparum
in short-term travelers (ie, <4 months) to areas with chloroquine
and/or pyrimethamine-sulfadoxine resistant strain
Prophylaxis: 100 mg PO qDay; begin taking 1-2 days before travel
Prophylaxis: 100 mg PO qDay; begin taking 1-2 days before travel
and continue daily during travel and for 4 weeks after traveler leaves
malaria infested area
Intestinal Amebiasis, Respiratory Tract Infections
Indicated for adjunctive therapy to amebicides for acute intestinal
Intestinal Amebiasis, Respiratory Tract Infections
Indicated for adjunctive therapy to amebicides for acute intestinal
amebiasis
100 PO q12hr on day 1, then 100 mg PO qDay
Rickettsial Infections
Indicated for Rocky Mountain spotted fever, typhus fever and the
100 PO q12hr on day 1, then 100 mg PO qDay
Rickettsial Infections
Indicated for Rocky Mountain spotted fever, typhus fever and the
typhus group, Q fever, rickettsial pox, and tick fevers caused by
Rickettsiae
100 PO q12hr on day 1, then 100 mg PO qDay
Brucellosis
Brucellosis due to Brucella species
100 mg PO twice daily for 6 weeks with rifampin or streptomycin
Cholera
Indicated for cholera caused by Vibrio cholerae
300 mg PO once; adjunct to fluid and electrolyte replacement
Acute Bacteria Rhinosinusitis
200 mg/day PO qDay or divided BID for 5-7 days
Anthrax
Postexposure prophylaxis: 100 mg PO BID for 60 days
Infective Endocarditis
Suspected Bartonella infection with a negative culture: 100 mg
100 PO q12hr on day 1, then 100 mg PO qDay
Brucellosis
Brucellosis due to Brucella species
100 mg PO twice daily for 6 weeks with rifampin or streptomycin
Cholera
Indicated for cholera caused by Vibrio cholerae
300 mg PO once; adjunct to fluid and electrolyte replacement
Acute Bacteria Rhinosinusitis
200 mg/day PO qDay or divided BID for 5-7 days
Anthrax
Postexposure prophylaxis: 100 mg PO BID for 60 days
Infective Endocarditis
Suspected Bartonella infection with a negative culture: 100 mg
PO BID x 6 weeks in combination with gentamicin and ceftriaxone
Positive culture Bartonella infection: 100 mg PO BID x 6 weeks
Positive culture Bartonella infection: 100 mg PO BID x 6 weeks
in combination with gentamicin or rifampin
Children: PO >8 y, <45 kg: 2–4 mg/kg/day q12h
May be taken with or without food. Take w/ a full glass of water &
remain upright for at least ½ hr. Take w/ food or milk if GI irritation occurs.
Acne, Susceptible infections, Syphilis, Uncomplicated gonorrhoea,
Relapsing fever, louse-borne typhus, Scrub typhus
It is contraindicated to patients with known hypersensitivity to any of
the tetracyclines. It is also contraindicated in severe hepatic disorder
and patients with systemic lupas erythematosus. Concomitant intake
of alkalis, antacids and iron may interfere with the absorption of
Doxycycline. It is advisable to avoid giving doxycycline in conjunction
with penicillin. Doxycycline should not be used in pregnant women
unless, in the judgment of the physician, it is essential for the
welfare of the patient.
Hypotension, pericarditis, angioneurotic oedema, dyspnoea, serum
sickness, peripheral oedema, tachycardia, urticaria, haemolytic anaemia,
thrombocytopenia, neutropenia, porphyria, eosinophilia, brown-black
microscopic discolouration of thyroid tissue, headache, bulging fontanelles
in infants and benign intracranial HTN in adults, blurring of vision, scotomata
, diplopia, tinnitus, abdominal pain, stomatitis, anorexia, nausea, vomiting,
diarrhoea, dyspepsia, oesophageal ulceration, discolouration of teeth,
enamel hypoplasia, transient increases in LFT and BUN, jaundice,
pancreatitis, rashes, exfoliative dermatitis, photo-onycholysis, photosensitivity,
arthralgia, myalgia, vaginitis.
Potentially Fatal: Anaphylactoid reactions, Stevens-Johnson syndrome,
Potentially Fatal: Anaphylactoid reactions, Stevens-Johnson syndrome,
toxic epidermal necrolysis, Clostridium difficile-associated disease (CDAD),
hepatotoxicity.
Tetracycline Group of drugs
Category: Not Classified
pregnancy_description
pregnancy_description
Doxycycline inhibits bacterial protein synthesis by binding to the 30S
ribosomal subunit. It has bacteriostatic activity against a broad range
of gm+ve and gm-ve bacteria.
Concomitant use w/ isotretinoin is known to cause pseudotumour cerebri.
Prolonged prothrombin time w/ anticoagulants (e.g. warfarin). May interfere
w/ the bactericidal action of penicillin. Impaired absorption w/ antacids
containing Al, Ca, or Mg, oral Zn, Fe salts, and bismuth preparations.
Increased metabolism w/ phenobarbital, carbamazepine, primidone and phenytoin.
Risk of breakthrough bleeding w/ oral contraceptives. Increased plasma
concentration of ciclosporin. Decreased half-life w/ hepatic enzymes
inducers (e.g. rifampicin). Potentially Fatal: Concurrent use w/ methoxyflurane
may result to fatal renal toxicity.
Per Unit Price: Tk. 2.2
Package: 100's pack
Package: 100's pack