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Cipflox general information

What is Cipflox used for?

Cipflox tablets 750mg are an antibiotic medication used to treat uncomplicated and complicated bacterial infections in adults, caused by a wide range of susceptible bacteria in various parts of the body.  Cipflox tablets 750mg are used to treat pneumonia (community acquired as outpatients), caused by various bacteria, but should not be the antibiotic of first choice for pneumonia caused by Pneumococcus.  Cipflox tablets 750mg are also use to treat infections of the skin and soft tissue, such as impetigo and cellulitis; also of the bones and joints, which can be very painful; and infections of the abdominal cavity such as peritonitis.  Cipflox tablets 750mg are also used to treat infections of the urogenital system, including adnexitis (infection and inflammation of the ovary and the fallopian tubes), prostatitis (infection and inflammation of the prostate), gonorrhoea, infections of the efferent urinary tract like cystitis and pyelonephritis (infection and inflammation of the kidney).  Cipflox tablets 750mg are used to treat sepsis, which is a serious and life-threatening condition that occurs as a result of the body’s response to an infection.  It is caused by chemicals released into the bloodstream to fight the infection, which can result in damage to tissues and organs.  Cipflox tablets 750mg may also be used after inhalation of anthrax spores, as post exposure prophylaxis to reduce risk of pulmonary disease.  Cipflox tablets 750mg are also used to treat acute pulmonary exacerbation of cystic fibrosis caused by the bacteria Pseudomonas aeruginosa; also complicated urinary tract infections or pyelonephritis due to E.coli in children over the age of 5 years.   

How does Cipflox work?

Cipflox tablets 750mg contain the antibiotic ciprofloxacin that belongs to the fluoroquinolones group of antibiotics and is a synthetic broad spectrum antibiotic with antibacterial activity against a wide range of bacteria including, Klebsiella, Haemophilus, Enterobacter, E. coli, Pseudomonas, Legionella, Staphylococcus, Streptococcus, Listeria and Chlamydia.  Ciprofloxacin in Cipflox tablets 750mg works by inhibiting several bacterial enzymes (bacterial topoisomerase IV and DNA gyrase) needed for the bacteria to replicate and repair its DNA.  This action of ciprofloxacin in Cipflox tablets 750mg kills the bacteria by blocking its growth and preventing the spread of infection.  Cipflox tablets 750mg do not work against viruses which use a different mechanism to grow and replicate.  

What does Cipflox contain?

Cipflox tablets 750mg contain the active ingredient ciprofloxacin, a synthetic broad spectrum antibiotic used to treat a wide range of bacterial infections.  They also contain microcrystalline cellulose, maize starch, pregelatinised maize starch, crospovidone, colloidal anhydrous silica, magnesium stearate, titanium dioxide, polydextrose, hypromellose, glycerol triacetate, macrogol.

Treating bacterial infection with Cipflox

Cipflox tablets 750mg contain ciprofloxacin a synthetic broad spectrum fluoroquinolone antibiotic that used to treat uncomplicated and complicated bacterial infections in adults, caused by a wide range of susceptible bacteria in various parts of the body.  Infections that Cipflox tablets 750mg are suitable for include, pneumonia; infections of the skin, soft tissue bones and joints; infections of the urogenital system; infections of the abdominal cavity; sepsis and to reduce risk of pulmonary disease following inhalation of anthrax spores.  Cipflox tablets 750mg are also used to treat acute pulmonary exacerbation of cystic fibrosis and complicated urinary tract infections in children over the age of 5 years.  Ciprofloxacin in Cipflox tablets 750mg works by inhibiting several bacterial enzymes needed for the bacteria to replicate and repair its DNA.  This action of ciprofloxacin in Cipflox tablets 750mg kills the bacteria by blocking its growth and preventing the spread of infection. 

What are the side effects of Cipflox?

The most commonly reported side effects when taking Cipflox tablets 750mg include diarrhoea, nausea, vomiting, abdominal pain, rash, headache, altered taste, arthralgia (joint pain).  Very rarely taking Cipflox tablets 750mg is associated with an increased risk of tendonitis and tendon rupture with increased risk if you are over the age of 60 years, taking systemic steroids or have received a kidney, heart or lung transplant.

When should Cipflox not be used?

You should not use Cipflox tablets 750mg if you:

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

What medications interact with Cipflox?

Several medications interact with Cipflox tablets 750mg and should either not be taken while you are taking Cipflox or only after discussion and instruction from your doctor:

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

How should Cipflox be taken?

You should take your Cipflox tablets 750mg swallowed whole with a glass of water, with or without food.  The dose you take and how often, depends on what you are being treated for and your doctor’s recommendations, which for most infections is usually one tablet twice daily for 7 to 14 days, but the dose or length of time you need to take your Cipflox tablets 750mg for may be increased depending on the severity of your infection and your response to treatment.  You should not consume dairy products that are high in calcium (milk and yoghurt) or calcium-fortified orange juice, unless they are part of a meal as this may affect the absorption of ciprofloxacin.  Avoid direct exposure to excessive sunlight or UV-light as this can cause photosensitisation (sunburn-like skin reactions).  You should continue to take your Cipflox tablets 750mg for as long as recommended by your doctor.

How long should you take Cipflox?

You should continue to take your Cipflox tablets 750mg for as long as recommended by your doctor.

Missed dose of Cipflox

If you miss a dose of Cipflox tablets 750mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Cipflox be stored?

You should store your Cipflox tablets 750mg below 25°C in a cool dry place.  

Rifakem-550 general information

What is Rifakem-550 used for?

Rifakem 550 is an antibiotic used to treat hepatic encephalopathy (HE) to prevent its recurrence, where other treatments have failed or are contraindicated.  HE is a neuropsychiatric condition in which there is a loss of brain function due to liver damage, such as cirrhosis.  This results in a build-up of toxins like ammonia in the blood, which causes symptoms including confusion, difficulty thinking, loss of fine hand movements, behaviour changes and a musty or sweet smelling breath.  It is thought that an imbalance of the intestinal microbiota (good versus bad bacteria) with a higher proportion of pathogenic bacteria, may contribute to the pathogenesis of several diseases including liver cirrhosis.  Rifakem-550 is effective against a wide range of intestinal bacteria, including those like Streptococcus salivarius that produce ammonia.  Ammonia is a toxin that a healthy liver would convert into urea which is then excreted in the urine, but in a damaged liver this process is impaired.  Rifakem tablets 550mg help restore the balance in the composition of intestinal bacteria and reduce risk of HE and its recurrence¹.  Rifakem-550 cannot be used to treat other infections as it is not absorbed into the blood and therefore, only acts locally in the gastrointestinal tract to kill local bacteria.   

How does Rifakem-550 work?

Rifakem tablets 550mg contain rifaximin, a locally acting antibiotic belonging to the rifamycin class of antibiotics.  It is a non-systemic antibiotic, which means it acts locally in the intestines and is not absorbed into the circulation.  Rifaximin in Rifakem 550 works by binding to the bacterial enzyme DNA-dependent RNA polymerase and this action inhibits bacterial RNA synthesis.  This prevents RNA transcription and thereby the production of bacterial proteins, which inhibits growth of the bacteria.  Rifaximin in Rifakem 550 is effective against bacteria that break down proteins in the intestines by the process of deamination resulting in ammonia production, reducing the high blood levels of ammonia that contribute to the pathogenesis of hepatic encephalopathy^2-5.

What does Rifakem-550 contain?

Rifakem tablets contain the active ingredient rifaximin 550mg, a locally acting antibiotic used to prevent the recurrence of hepatic encephalopathy where other treatments have failed or are contraindicated.  

Rifakem-550 for hepatic encephalopathy

Rifakem tablets 550mg contain rifaximin, a locally acting antibiotic that is used to treat hepatic encephalopathy to prevent its recurrence where other treatments have failed or are contraindicated.  Hepatic encephalopathy is a neuropsychiatric condition in which there is a loss of brain function due to liver damage, such as cirrhosis.  This results in a build-up of toxins in the blood, such as ammonia which causes symptoms including confusion, difficulty thinking, loss of fine hand movements, behaviour changes and a musty or sweet smelling breath.  Rifaximin in Rifakem 550 is effective against bacteria that break down proteins in the intestines by deamination resulting in ammonia production.  A healthy liver would normally convert ammonia into urea which is then excreted in the urine, but in a damaged liver this process is impaired.  Rifaximin in Rifakem-550 inhibits growth of ammonia producing bacteria, reducing the high blood levels of ammonia that contribute to the pathogenesis of hepatic encephalopathy.

What are the side effects of Rifakem-550?

The most commonly reported side effects when taking Rifakem-550 include dizziness, headache, fever, fatigue, abdominal pain, constipation, defecation urgency, diarrhoea, flatulence, bloating and distension, nausea and vomiting, oedema, rash.  Rifakem-550 can result in Clostridium difficile-associated diarrhoea (CDAD), which is a more serious form of diarrhoea ranging in severity from mild to life-threatening and is due to the changes in intestinal flora that happens when taking antibiotics. 

When should Rifakem-550 not be used?

You should not use Rifakem-550 if you:

• are allergic to rifaximin or any ingredients in Rifakem-550
• are pregnant or are breastfeeding
• have severe liver disease, without discussion with your doctor
• have any form of intestinal obstruction
• are taking medicines that interact with Rifakem-550, including other rifamycin antibiotics and the immunosuppressant ciclosporin.  Rifakem-550 reduces the effect of warfarin

How should Rifakem-550 be taken?

For hepatic encephalopathy you should take your Rifakem-550 swallowed whole with a glass of water with or without food twice daily for 6 months.  The dose you take should be as recommended by your doctor.  You should only continue to take your Rifakem-550 beyond 6 months based on your doctor’s recommendation, after evaluation by your doctor of how well you are responding and any side effects you are experiencing.  

How long should you take Rifakem-550?

You should only continue to take your Rifakem-550 beyond 6 months based on your doctor’s recommendation, after evaluation by your doctor of how well you re responding and any side effects you are experiencing. 

Missed dose of Rifakem-550

If you miss a dose of Rifakem-550 take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Rifakem-550 be stored?

You should store your Rifakem-550 below 25°C in a cool dry place. 

References

1. Ponziani FR, Gerardi V, Pecere S, D'Aversa F, Lopetuso L, Zocco MA, Pompili M, Gasbarrini A. Effect of rifaximin on gut microbiota composition in advanced liver disease and its complications. World J Gastroenterol. 2015 Nov 21;21(43):12322-33.
2. Zeng X, Tang XJ, Sheng X, Ni W, Xin HG, et al. Does low-dose rifaximin ameliorate endotoxemia in patients with liver cirrhosis: a prospective study. J Dig Dis 2015 Nov;16(11):665-74.
3. Shayto RH, Abou Mrad R, Sharara AI. Use of rifaximin in gastrointestinal and liver diseases. World J Gastroenterol. 2016 Aug 7;22(29):6638-51.
4. Peleman C, Camilleri M. Rifaximin, Microbiota Biology, and Hepatic Encephalopathy. Clin Transl Gastroenterol 2016 Oct 6;7(10):
5. Iadevaia MD, Del Prete A, Cesaro C, Gaeta L, Zulli C, Loguercio C.  Rifaximin in the treatment of hepatic encephalopathy. Hepat Med 2011; 3: 109–117.

Esomac general information

What is Esomac used for?

Esomac tablets 40mg are used to treat conditions caused by gastric reflux, which is when the acidic contents of the stomach flow back into the oesophagus because the sphincter (muscle at the junction of the oesophagus and stomach) that normally acts as a one-way valve and prevents backflow of stomach contents, does not function properly or is damaged.  Gastroesophageal reflux disease (GORD), as this condition is known, causes symptoms like heartburn and dyspepsia (indigestion and abdominal pain), and can damage the oesophagus causing inflammation (oesophagitis).  Esomac 40 is also used to treat and prevent peptic ulcers in the stomach (gastric ulcers or damage to the stomach lining) and duodenum (duodenal ulcers or damage to the lining of the upper intestine); and gastric ulcers caused by use of nonsteroidal anti-inflammatory drugs (NSAID); also as combination therapy to treat gastric ulcers that are caused by infection of the stomach with the bacterium Helicobacter pylori, in conjunction with using antibiotics.  Esomac 40 is also used to treat symptoms of acid-related dyspepsia that can be caused by eating high fat or acidic foods, or Zollinger-Ellison syndrome in which increased levels of the hormone gastrin causes an excessive production of gastric acid.

How does Esomac work?

Esomac tablets 40mg contain esomeprazole, a proton pump inhibitor that is used to treat conditions caused by excess gastric acid, by reducing the amount of gastric acid released into the stomach.  Stomach acid is needed for digestion of proteins in your diet and is made by the parietal cells of the stomach wall.  Gastric acid production is dependent on the action of the enzyme H⁺/K⁺-ATPase, which is the proton pump responsible for pumping positive hydrogen ions out of the cells into the stomach, which increases the acidity of the stomach contents.  Esomeprazole in Esomac 40 inhibits the functioning of the H⁺/K⁺-ATPase, which prevents acid secretion by blocking the source of acid production.  This action of esomeprazole reduces the acidity of the stomach contents, which reduces the acid damage that can be caused by gastroesophageal reflux disease (GORD) and oesophagitis and relieves symptoms caused by excess gastric acid like heartburn and dyspepsia.  By inhibiting gastric acid secretion Esomac 40 also help prevent the formation of gastric (stomach) and duodenal (upper intestine) peptic ulcers and also helps ulcers and damage caused by gastric reflux to heal. 

What does Esomac contain?

Esomac tablets 40mg contain the active ingredient esomeprazole, which is a proton pump inhibitor that is used to treat conditions caused by excess gastric acid secretion. 

Treating gastric reflux with Esomac

Esomac tablets 40mg contain esomeprazole, which is used to treat conditions caused by gastroesophageal reflux disease (GORD).  Gastric reflux is when the acidic contents of the stomach flow back into the oesophagus because the sphincter (muscle at the junction of the oesophagus and stomach) that normally acts as a one-way valve and prevents backflow of stomach contents, does not function properly or is damaged.  Symptoms caused by gastric reflux include heartburn and dyspepsia (indigestion and abdominal pain), and damage to the oesophagus causing inflammation (oesophagitis).  Esomeprazole in Esomac tablets 40mg reduces acid secretion by parietal cells of the stomach wall, by blocking the action of the enzyme H⁺/K⁺-ATPase, which is responsible for acid production.  This action of esomeprazole reduces the acidity of the stomach contents, which reduces the acid damage that can be caused by gastroesophageal reflux disease (GORD) and oesophagitis, relieves symptoms caused by excess gastric acid like heartburn and dyspepsia; as well as helping damaged tissues caused by excess acid to heal.

Esomac for peptic ulcers

Esomac tablets 40mg contain the active ingredient esomeprazole, which is used to treat and prevent prevent peptic ulcers in the stomach (gastric ulcers or damage to the stomach lining) and duodenum (duodenal ulcers or damage to the lining of the upper intestine), caused by excess secretion of gastric acid; and gastric ulcers caused by use of nonsteroidal anti-inflammatory drugs (NSAID).  Esomac tablets 40mg are also used as combination therapy to treat and prevent gastric ulcers that are caused by infection of the stomach with the bacterium Helicobacter pylori, in conjunction with using antibiotics.  Esomeprazole in Esomac tablets 40mg reduces acid secretion by parietal cells of the stomach wall, by blocking the action of the enzyme H⁺/K⁺-ATPase, which responsible for acid production.  This action of esomeprazole reduces the acidity of the stomach contents, which reduces the acid damage to the stomach wall and allows ulcers that have already developed to heal.

What are the side effects of Esomac?

The most commonly reported side effects when taking Esomac include, include: constipation, nausea, vomiting, diarrhoea, wind (flatulence), headache, dry mouth, skin rash, dizziness, sensation of tingling in the skin (paraesthesia), insomnia.

When should Esomac not be used?

You should not use Esomac 40 if you:

• are allergic to esomeprazole or any ingredients in Esomac
• are taking medicines that interact with Esomac including: the antifungals ketoconazole and itraconazole, the anticoagulant warfarin, phenytoin for epilepsy, the antiretroviral atazanavir, the antibiotic clarithromycin, the immunosuppressive tacrolimus, the sedative diazepam

How should Esomac be taken?

You should take your Esomac tablets 40mg with a glass of water at least one hour before a meal.  You should continue to take your Esomac tablets 40mg for as long as recommended by your doctor, usually for a few weeks to 6 months, depending on the condition you are being treated for. 

How long should you take Esomac?

You should continue to take your Esomac tablets 40mg for as long as recommended by your doctor, usually for a few weeks to 6 months, depending on the condition you are being treated for. 

Missed dose of Esomac

If you miss a dose of Esomac 40 take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Esomac be stored?

You should store your Esomac 40 below 25°C in a cool dry place. 

Amaryl general information

What is Amaryl used for?

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

How does Amaryl work?

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

What does Amaryl contain?

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

Treating type 2 diabetes with Amaryl

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

What are the side effects of Amaryl?

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

What is hypoglycaemia (hypo)

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

When should Amaryl not be used?

You should not use Amaryl tablets 2mg if you:

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

What medications interact with Amaryl?

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

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

How should Amaryl be taken?

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

How long should you take Amaryl?

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

Missed dose of Amaryl

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

How should Amaryl be stored?

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

Vaclovir general information

What is Vaclovir used for?

Vaclovir tablets 500mg are used to treat infections of the skin and mucous membranes caused by Herpes Simplex Virus (HSV), including cold sores (herpes labialis); also initial and recurrent episodes of genital herpes in people with a healthy immune system, and can prevent lesions when taken as soon as symptoms of an HSV recurrence appears.  Vaclovir tablets 500mg are also used for suppression of recurrent genital herpes infections in people with an active immune system (immunocompetent) and to reduce the transmission of genital herpes to others.  In HIV-infected patients who are immunocompromised, Vaclovir tablets 500mg are used for prevention (prophylaxis) of herpes infections.  Vaclovir tablets 500mg are also used to treat cold sores in children who are at least 12 years old, and to treat chickenpox, caused by the closely related Varicella Zoster Virus (VZV) in children who are at least 2 years old.  Vaclovir tablets 500mg are also used to treat Herpes zoster (shingles) caused by VZV in immunocompetent adults, provided the infection is less than 72 hours duration.  Vaclovir tablets 500mg are also used to prevent opportunistic infection with cytomegalovirus (CMV) and other herpes virus infections (HSV, VZV) following organ transplantation

How does Vaclovir work?

Vaclovir tablets 500mg contain valacyclovir, a prodrug of acyclovir that is more readily absorbed and is converted to acyclovir by the liver.  Valacyclovir in Vaclovir tablets 500mg then works in the same way as acyclovir, as an antiviral agent that is highly active against both types of herpes simplex virus, HSV-I, that causes cold sores and HSV-II that causes genital herpes; and also against the closely related varicella zoster herpes virus that causes chicken pox and shingles.  Acyclovir inhibits the action of a viral enzyme (DNA polymerase), blocking viral DNA synthesis without affecting normal cellular processes.  This prevents the virus replicating and therefore, stops the growth and spread of the virus, relieving symptoms of the infection and helping the body to fight off the infection.  Vaclovir tablets 500mg will not cure a herpes infection, as the virus can lie dormant in infected cells until reactivated when immunity is low due to stress or other illness or even exposure to sunlight, causing new infections like cold sores and shingles; but it does reduce pain and help the sores caused by the infection to heal faster.

What does Vaclovir contain?

Vaclovir tablets 500mg contains the active ingredient valacyclovir 500mg, an antiviral used to treat herpes virus infections.  They also contain microcrystalline cellulose and magnesium stearate in the tablet core and hypromellose, titanium dioxide and polyethylene glycol in the film coat.

Treating herpes infection with Vaclovir

Vaclovir tablets 500mg contain valacyclovir, an antiviral agent which is highly active against both types of herpes simplex virus, HSV-I, that causes cold sores and HSV-II that causes genital herpes and also against the closely related varicella zoster herpes virus that causes chicken pox and shingles.  HSV Infections are characterised by blisters which form in the mucous membranes of the mouth, lips or genitals and crust over to form a scab as they heal.  Vaclovir tablets 500mg stop the virus in infected cells from being able to replicate and spread, helping to relieve symptoms and heal the blisters. 

Treating shingles with Vaclovir-500

Vaclovir tablets 500mg contain valacyclovir, an antiviral agent which is highly active against both types of herpes simplex virus, HSV-I, that causes cold sores and HSV-II that causes genital herpes and also against the closely related varicella zoster herpes virus that causes chicken pox and shingles.  Herpes zoster or shingles is caused by the same type of herpes virus that causes the common childhood infection chicken pox (varicella).  The blisters associated with chicken pox are characteristic of the initial infection with varicella zoster virus (of the herpes family) which migrate to nerve cells and remain dormant (not replicating) once chicken pox blisters have gone.  Years later, the virus can be activated by stress, other illness or even exposure to sunlight, causing the virus to travel down the nerve and infect the skin again, replicating and causing the painful rash of blisters associated with shingles as well as nerve pain or post-herpetic neuralgia.  Vaclovir tablets 500mg can help reduce the duration and severity of acute symptoms and rash as well as reduce zoster-associated pain.  

Vaclovir for genital herpes

Vaclovir tablets 500mg contain valacyclovir, an antiviral agent which is highly active against both types of herpes simplex virus, HSV-I, that causes cold sores and HSV-II that causes genital herpes, although HSV-I can also cause genital herpes, which is a sexually transmitted disease characterised by painful sores and blisters around the genital areas.  Genital herpes can recur several times, particularly if your immune system is low or compromised.  Vaclovir tablets 500mg can be used to treat an initial infection of genital herpes and reduce painful symptoms; and is also used for suppression to prevent the infection recurring.

What are the side effects of Vaclovir?

The most commonly reported side effects when taking Vaclovir tablets 500mg include headache, nausea, photosensitivity.

When should Vaclovir not be used?

You should not use Vaclovir tablets 500mg if you:

• are allergic to valacyclovir or any ingredients in Vaclovir
• are pregnant or are breastfeeding
• have kidney or liver disease
• have had a bone marrow transplant
• are taking medicines that interact with Vaclovir-500, without discussion with your doctor, including probenecid (a treatment for gout), cimetidine for ulcers, methotrexate for cancer treatment, the immunosuppressant ciclosporin, the antiviral foscarnet, aminoglycoside antibiotics.

What medications interact with Vaclovir?

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

• Drugs that affect Vaclovir: probenecid (a treatment for gout), cimetidine for ulcers, methotrexate for cancer treatment, the immunosuppressant ciclosporin, the antiviral foscarnet, aminoglycoside antibiotics

How should Vaclovir be taken?

You should take your Vaclovir tablets 500mg swallowed whole with a glass of water with or without food, once, twice or three times daily depending on what you are being treated for and your doctor’s recommendations.  You should start taking your Vaclovir tablets 500mg as soon as possible after the first appearance of symptoms, such as tingling, burning, blisters.  The dose you take, how often and for how long depends on what you are being treated for and your doctors recommendations.  Your course of treatment may last for 3 to 10 days for an initial infection or longer, depending on your condition and whether you are taking Vaclovir tablets 500mg for initial or recurrent infection or for prevention. 

How long should you take Vaclovir?

You should continue to take your Vaclovir-500 for as long as recommended by your doctor, which may be for 3-10 day, or longer depending on your condition and what you are being treated for.

Missed dose of Vaclovir

If you miss a dose of Vaclovir tablets 500mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Vaclovir be stored?

You should store your Vaclovir tablets 500mg below 25°C in a cool dry place.