Drug dispensing and Patient Counseling of Common drugs

Activity Date: July 1, 2021 @ 1:00 pm

Guidelines:
1. This is an individual activity
2. The list below is the commonly dispensed medications in the community pharmacy. The said list will be used in this activity.
3. Students' names will be encoded in an application called “wheel of names”, which is a random name picker.
4. During the actual presentation, the faculty will announce a specific medication to dispense and this is followed by spinning the wheel of names
5. The name of the student who is randomly picked will perform the dispensing and patient counseling.
6. In a maximum of 3 minutes, the student will deliver a monologue that is intended for a patient receiving the medication. (students can assume that the patient is either taking no other medication or with other
medication).

MEDICATIONS:
 Dose and Dosage Storage
Drug Indication Side Effects Interactions Contraindications Special Precautions Counseling Points
Forms Conditions

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Mefenamic Acid Mefenamic acid is a 250 mg Capsule Heartburn, Alcohol/Liquor Hypersensitivity, ASA Check with your Follow all directions on Room temperature
nonsteroidal anti- stomach pain, gas, allergy, history of doctor right away if your prescription label between 68°F and
BN: Dolfenal, inflammatory drug nausea, vomiting; aspirin triad, GI tract you are having chest and read all medication 77°F (20°C and
Gardan that is used short- diarrhea, ulcer/inflammation, pain or discomfort, guides or instruction 25°C)
term (7 days or less) constipation; or CABG, renal dz, late nausea or vomiting, sheets. It is usually taken
to treat mild to dizziness. pregnancy (may pain or discomfort in with food every 6 hours
moderate pain in cause premature the arms, jaw, back, or as needed for up to 1
adults and children closure of ductus neck, shortness of week.
who are at least 14 arteriosus) breath, slurred Mefenamic acid should
years old. Mefenamic speech, or weakness. not be used for longer
acid is also used to
This medicine may than 7 days. Do not use
treat menstrual pain.
cause bleeding in your mefenamic acid just
stomach or intestines. before or after heart
bypass surgery
(coronary artery bypass
graft, or CABG).

Diclofenac Indicated for mild to 25 mg and 50 mg Gastrointestinal: Diuretics/antihyperte Hypersensitivity Px with GI disorders = Should be taken with Store at
Potassium moderate acute pain; sugar-coated tablet - NV, diarrhea, nsive drugs = dec. inc. risk bleeding, food. Take it immediately temperatures not
acute musculoskeletal (Cataflam®) abdominal pain, antihypertensive As with other ulceration after meals. Swallow exceeding 30°C.
BN: Cataflam, disorders, flatulence effects NSAIDs, use of whole, do not Store in the original
Cataflin osteoarthritis, 50 mg film-coated Hepatobiliary diclofenac during the px with CV Disease = chew/divide. package in order to
rheumatoid arthritis, tablet (Cataflin®) - Increased NSAIDs/Antiplatelets third trimester of inc. risk of MI and protect from light.
25 mg: OTC acute gout, pain and transaminase = inc. risk GI pregnancy is stroke If taken with other
50 mg: Rx inflammation Adult: levels discomfort contraindicated owing NSAIDS, combination
associated with dental Acute pain: 50-150 Skin to the possibility of Patients with hepatic therapy with protective
surgery; migraine; mg/day in divided - Rash, urticaria Methotrexate = blood uterine inertia, fetal and renal impairment. agents (e.g. proton pump
primary doses (25 mg q6h) Nervous system conc. may rise and renal impairment with inhibitors or misoprostol)
dysmenorrhea; Dysmenorrhea: 50 - Headache, may inc. toxicity subsequent should be considered for
postoperative pain mg q8h dizziness oligohydramnios these patients, and also
Migraine: 50 mg and/or premature for patients requiring
initial dose, then take closure of the ductus concomitant use of low-
additional 50 mg if arteriosus dose acetylsalicylic acid
symptoms persist (ASA) or other drugs
after 2 hours. Active gastric or likely to increase
Musculoskeletal, intestinal ulcer, gastrointestinal risk.
pain after dental bleeding or
surgery: 50 mg q8- perforation
12h If GI bleeding or
Renal and hepatic ulceration occurs in
Max: 200 mg daily failure patients receiving
 Diclofenac Potassium
Combination with (Cataflam), the treatment
NSAIDs should be discontinued.

*Pregnant: should not be

used during the first two
trimesters of pregnancy
unless the expected
benefits to the mother
outweigh the risks to the
fetus.

Celecoxib Indicated for the Capsule ● stomach pain, warfarin, apixaban, Hypersensitivity Patients with a history This drug may cause Store below 30°C.
management of the ● heartburn, aspirin, (urticaria, asthma, of gastrointestinal dizziness, vertigo or
BN: Celexib, signs and symptoms gas, glucocorticoids, angioneurotic edema) complications (e.g. somnolence, if affected,
Celebrex of osteoarthritis, Acute pain, ● Diarrhea, other NSAIDs ulceration and do not drive or operate
rheumatoid arthritis, Primary ● constipation - Increased risk of Active peptic bleeding). machinery.
juvenile rheumatoid dysmenorrhoea ● nausea, gastrointestinal ulceration or
arthritis in patients 2 ● Vomiting; ulceration or gastrointestinal hypertension, Your blood pressure
years and older, and Adult: Initially, 400 ● swelling in bleeding bleeding, diabetes mellitus, should be checked
ankylosing spondylitis; mg followed by an your hands or inflammatory bowel hyperlipidaemia, regularly during your
for the management of additional dose of feet ● ACE inhibitors, disease, CHF (NYHA recent MI, and other treatment.
acute pain in adults, 200 mg if necessary ● Dizziness ● angiotensin II II-IV), established CV disease risk
and for the on day 1. ● stuffy nose, receptor ischaemic heart factors (e.g. smoking, Take with food or milk to
management of Subsequently, 200 sneezing, sore ● Antagonists, disease, alcoholism) decrease GI upset.
primary dysmenorrhea mg bid as needed. throat. ● Diuretics, cerebrovascular
● β-blockers disease or peripheral pre-existing asthma Do not take more than
Elderly: Acute pain: ● antihypertensi arterial disease. (without known aspirin 400 mg daily.
<50 kg: Use the ve agents. sensitivity)
lowest Pregnancy (3rd Call your doctor if you
recommended dose ciclosporin trimester) and Dehydrated patient have any unusual
(200mg) - increase the lactation problems while you are
nephrotoxic taking this medication.
effect
Do not let anyone else
take your medication.

Alaxan® FR Relief of mild to Capsule Ibuprofen- Alcohol Patients in whom Ibuprofen and Should be taken with Store at
moderately severe paracetamol, when bronchospasm, paracetamol may food: Take immediately temperatures not
Generic: Ibuprofen pain of Each capsule taken within Ibuprofen, as well angioedema or nasal cause stomach after meals. exceeding 30°C.
+ Paracetamol musculoskeletal origin contains ibuprofen therapeutic levels, as other NSAIDs, polyps are bleeding and liver
eg, myalgia, arthritis, 200 mg and have low incidence co-administered with precipitated by damage. Should be taken for >10
rheumatism, sprain, paracetamol 325 of side effects. anticoagulants (eg, ibuprofen, aspirin & days for pain and for >3
strain, bursitis, mg. warfarin) or other NSAIDs. There is an increased days for fever unless
tendonitis, backache thrombolytic agent risk of GI ulceration, directed by a doctor.
and stiff neck. 1 capsule every 6 (eg, streptokinase) Advanced kidney & bleeding and
hrs or as prescribed may cause bleeding. liver diseases. perforation in patients Discontinue Alaxan FR
Relief of tension by the physician. treated chronically and consult the doctor if
headache, Do not use ibuprofen- with NSAIDs including symptoms did not
 dysmenorrhea, paracetamol during ibuprofen. improve, new symptoms
toothache and pain the last 3 months of occur, pain and fever
after tooth extraction pregnancy unless Monitor kidney and persist or gets worse
and minor surgical specifically directed liver functions during and if redness or
operations. by a doctor, because long-term ibuprofen- swelling is present.
Reduction of fever. it may cause paracetamol therapy.
problems in the Consult a doctor before
unborn child (ie, Use with caution in using Alaxan FR if
premature closure of patients with peptic pregnant or
the ductus arteriosus) ulcer, liver and kidney breastfeeding.
or complications impairment, heart
during delivery. failure and high blood
pressure.

Cough and Cold Preparations

Neozep Forte Tab Relief of clogged nose, Per Neozep Forte GI upsets, Increased toxicity w/ Hypersensitivity. High (1) this product The patient can take 1 Store at a
post nasal drip, tablet Phenylephrine drowsiness, epinephrine & BP, severe heart contains tab every 6 hours with or temperature not
Generic name: headache, body aches HCl 10 mg, dizziness; dry halothane. Risk of disease. Anemia, PARACETAMOL. Do without food. Discuss the exceeding 30C.
Phenylephrine HCl & fever associated w/ chlorphenamine mouth, difficulty in hypertensive crisis w/ kidney or liver not use this with any special precautions to the
+ Chlorphenamine common cold, maleate 2 mg, micturition, amitryptyline, disease. Pregnancy & other medicine patient, its side effects,
Maleate + sinusitis, flu & other paracetamol 500 sweating, reduced imipramine, lactation. containing contraindications, and
Paracetamol minor resp tract mg. appetite; sertraline, paracetamol because interactions.
infections; decongest epileptiform moclobemide. severe liver damage
sinus openings & seizures (large Decreased effect w/ may occur. If the patient missed a
passages. Neozep doses) phenothiazine, (remember, adult can dose, just take the next
Forte Itchy & watery phentolamine, take Paracetamol not dose if still needed for the
eyes, sneezing, propranolol. more than 4g only) condition being treated,
allergic rhinitis. Paracetamol. May and the subsequent
increase harmful (2) one of its side doses at the
effects to the liver w/ effects is drowsiness. recommended time or
phenobarb. Increase Tell the patient to schedule (i.e., every 6
anticoagulation effect observe caution while hours).
of warfarin. driving or performing Do not double the dose.
other tasks requiring
alertness.

(3) If a patient has liver

or kidney damage,
better ask him/her to
consult a doctor.

Dextromethorphan Temporarily relieves Syrup ADR Do not use if Hypersensitivity. Chronic cough eg, Women who are Store at a
Robitussin Syrup cough due to minor currently on or 2 wk occurs w/ smoking or pregnant or temperatures not
throat & bronchial Adult to childn 12 yr: Nausea, vomiting. after stopping the Px taking MAOI, SSRI chronic lung disease breastfeeding should exceeding 25°C,
Robitussin DM ® irritation as may occur 10 mL every 6 hr. Hypersensitivity. medications for or other medications eg, asthma or seek the advice of a away from direct
w/ a cold. Expectorant depression, for depression, emphysema. doctor before using the sunlight
Guaifenesin + action to help loosen Childn 6 to <12 yr: 5 psychiatric or psychiatric or product.
Dextromethorphan phlegm & thin mL every 6 hr. Do emotional conditions, emotional conditions, Discontinue use if
 bronchial secretions to not exceed 4 doses or Parkinson's or Parkinson's cough lasts >10 days, Discontinue use and
**Antitussive make cough more in any 24-hr period. disease eg, MAOI or disease, or for 2 wk comes back or if it consult a healthcare
**Expectorant productive. Helps SSRI. after stopping the occurs w/ fever, rash professional if cough
relieve chest Childn 2 to <6 yr 2.5 medication. or constant lasts more than 10 days,
- Available in congestion. mL/dose. Max: 10 headaches. comes back or if it occurs
60mL and 120 mL mL daily. Childn <2 yr. with fever, rash, or
Pregnancy & lactation. constant headaches.

Respiratory Medications

Dose and Dosage Storage

Drug Indication Side Effects Interactions Contraindications Special Precautions Counselling Points
Forms Conditions

Salbutamol Therapeutic Dose Common side- Salbutamol and non- Salbutamol sulphate Pregnancy: Explain how to use the Do not store above
inhaler indications Salbutamol Always use this effects selective beta- is contraindicated in Administration of inhaler: 30°C. Store in the
Inhaler is indicated for medicine exactly as ● Headache blocking drugs, such patients with salbutamol during original package.
BN: Ventolin the symptomatic your doctor has told ● Nausea as propranolol, hypersensitivity pregnancy should only Shake the inhaler well
treatment of you. Check with your Shaky or tense should not usually be (allergy) to any of the be considered if the 1) Hold the inhaler
bronchospasm in doctor, nurse or feeling prescribed together. active substances or expected benefit to upright with your thumb
bronchial asthma and pharmacist if you are ● Your heart Salbutamol the excipients. the mother is greater on the base and finger on
other conditions with not sure. beats faster (Ventolin®) is not than any possible risk the push button. Press
associated reversible than usual contraindicated in to the fetus. the dosing button down
airways obstruction Adults and ● Warm feeling patients under Lactation: firmly - once only
adolescents aged 12 (caused by treatment with Salbutamol may be 2) Breathe out as far as is
years and over blood vessels monoamine oxidase secreted in breast comfortable. Note: do not
expanding inhibitors (MAOIs). milk. It is not known blow into the device at
-to relieve asthma: under the skin) whether salbutamol any time.
One or two puffs. ● mouth or has a harmful effect 3) Place the mouthpiece
throat on the neonate and so in your mouth. Close lips
-to prevent asthma: irritation. its use should be firmly around it (do not
Two puffs 10-15 Rare side-effects restricted to situations bite it)
minutes before ● Hyperactivity where it is felt that the 4)Breathe in through your
exercise or exposure in children expected benefit to mouth steadily and
to a “trigger”. ● muscle the mother is likely to deeply, to draw the
cramps outweigh any potential medicine into your lungs.
-for regular risk to the neonate. 5)Hold your breath, take
treatment: Two puffs the inhaler from your
up to 4 times a day. mouth and continue
-the maximum dose holding your breath for
is 8 puffs in a 24 hour about 5 seconds. 6)For
period. the second puff, keep the
inhaler upright and
Children under 12 repeat steps 2-5.
years of age Replace the mouthpiece
cover.
-to relieve asthma:
One puff. Two puffs
if required. Children: One inhalation
is the recommended
 -to prevent asthma: dose for the relief of
One puff 10-15 acute bronchospasm, in
minutes before the management of
exercise or exposure episodic asthma or
to a “trigger”. Two before exercise. If the
puffs if required. response is inadequate,
higher doses than one
-for regular inhalation can be used.
treatment: Two puffs
up to 4 times a day. Tell your doctor your
-the maximum dose medical history,
is 8 puffs in a 24 hour especially of: an
period. overactive thyroid, heart
disease, high blood
pressure, epilepsy,
diabetes, drug allergies.
This medication should
be used only when
clearly needed during
pregnancy. Discuss the
risk and benefits with
your doctor. This drug
may be excreted into
breast milk. Consult your
doctor before breast-
feeding.

Salbutamol indicated for the The usual starting .Most commonly Salbutamol Hypersensitivity to Salbutamol (Ventolin Salbutamol (Ventolin Store below 30°C
nebules routine management dose is 2.5mg as a reported are: taste Nebuliser Solution the active substance Nebules) must only be Nebules) are intended to and protected from
of chronic single dose. This alteration (bad, should be used with salbutamol or to the used by inhalation, to be used undiluted. light.
(Proventil, bronchospasm may be increased to unpleasant and caution in patients excipients (see be breathed in through However, if prolonged
Ventolin) (unresponsive to 5mg. Treatment may unusual taste) and receiving other section 6.1 List of the mouth, and must delivery time is desirable
conventional therapy) be repeated up to application site sympathomimetics. excipients). not be injected or (more than 10 minutes)
and treatment of acute four times a day.. In reaction (mouth Although some forms swallowed. dilution using sterile
severe asthma (status adults higher dosing, and throat irritation, of salbutamol sulfate Patients receiving normal saline as a diluent
asthmaticus). up to 40 milligrams burning sensation Salbutamol and non- have been used in the treatment at home may be required.
per day, of the tongue), fine selective β – management of with Salbutamol The solution must not be
tremor (usually of receptor blocking premature labour, (Ventolin Nebules) injected, or swallowed.
Salbutamol (Ventolin the hands) nausea, drugs should not Salbutamol Nebuliser must be warned that if Delivery of the aerosol
Nebules) Solution for sweating, usually be prescribed Solution should not either the usual relief may be by facemask, 'T'
Inhalation 1 mg/mL restlessness, together. In patients be used for this is diminished or the piece or via an
in concentration of headache, with asthma purpose. Salbutamol usual duration of endotracheal tube.
salbutamol of 0.1% dizziness and administration of β – Nebuliser Solution action reduced, they Intermittent positive
(1 mg salbutamol, as muscle cramps. receptor blocking should not be used in should not increase pressure ventilation may
the sulphate, in 1 These undesirable drugs is associated threatened abortion. the dose or its be used but is rarely
mL). effects may with a risk of severe frequency of necessary. When there is
subside on bronchoconstriction administration, but a risk of anoxia through
Also available in 2.5 continuation of should seek medical hypoventilation, oxygen
 mg/ml treatment within 1- advice. should be added to the
2 weeks. Tricyclic Salbutamol (Ventolin inspired air.
antidepressants may Nebules) should be Salbutamol (Ventolin
increase the risk of used with caution in Nebules) should
cardiovascular side patients known to therefore be
effects. have received large administered in a well
Corticosteroids may doses of other ventilated room,
increase the risk of sympathomimetic particularly in hospitals
hyperglycemia. drugs. when several patients
Salbutamol (Ventolin) may be using nebulisers
should be in the same space at the
administered same time.
cautiously to patients
with thyrotoxicosis.

Symbicort Symbicort Turbohaler Dosage form: Dry Common side Beta-adrenergic Hypersensitivity to Dosing advice TURBUHALER is a SYMBICORT
Turbuhaler is indicated in adults, powder for oral effects are: blockers can weaken Lactose monohydrate multidose inhaler from TURBUHALER
and adolescents aged inhalation: • Headache; or inhibit the effect of (which contains milk Once asthma which very small should be stored at
GN: 12 - 17 years, for the • Trembling; formoterol. proteins). symptoms are amounts of powder are room temperature
budesonide/formot regular treatment of Recommended • Sensation of heart Symbicort should controlled, administered. When you between 15ºC and
erol asthma and doses: beat; therefore not be consideration may be breathe in 30ºC
ymptomatic treatment • Cough; given together with given to gradually through the with the cover
of patients with COPD Adults (18 years • Irritation of mouth beta-adrenergic reducing the dose of TURBUHALER, powder tightened.
with forced expiratory and older): 1 and/or throat; blockers (including Symbicort. Regular is delivered to the lungs.
volume in 1 second inhalation twice • Hoarseness. eye drops) unless review of patients as It
(FEV1) <70% daily. Some patients there are compelling treatment is stepped is therefore important
predicted normal (post may require up to a Uncommon side reasons. down is important. that you inhale as deeply
bronchodilator) and an maximum of 2 effects are: The lowest effective and strongly as
exacerbation history inhalations twice • Nausea; Concomitant dose of Symbicort you can through the
despite regular daily. •Sleep difficulties; treatment with should be used. mouthpiece
bronchodilator • Agitation; quinidine, Patients should be The dosage of the
therapy. Adolescents (12-17 • Restlessness or disopyramide, advised to have components of
years): 1 inhalation nervousness; procainamide, rescue inhaler Symbicort is individual
twice daily. • Dizziness; phenothiazines, available at all times. and should be adjusted
•Muscle cramps. antihistamines Patients should be to the severity of the
(terfenadine) and reminded to take their disease. This should be
Children (6 years Rare side effects tricyclic Symbicort considered not only when
and older): A lower are: antidepressants can maintenance dose as treatment with
strength (100 • Skin bruising; prolong the QTc- prescribed, even combination products is
micrograms/6 • Depression or interval and increase when asymptomatic. initiated but also when
micrograms/inhalati behavioural the risk of ventricular the maintenance dose is
on) is available for disturbances. arrhythmias. Caution with special adjusted.
children 6 - 11 years. diseases
Concomitant Patients should be
Children under 6 treatment with Symbicort should be regularly reassessed by
years: As only monoamine oxidase administered with their prescriber/health
limited data are inhibitors, including caution in patients care provider, so that the
available, Symbicort agents with similar with thyrotoxicosis, dosage of Symbicort
is not recommended properties such as phaeochromocytoma, remains optimal. The
for children younger furazolidone and diabetes mellitus, dose should be titrated to
than 6 years. procarbazine, may untreated the lowest dose at which
precipitate hypokalaemia, effective control of
hypertensive hypertrophic symptoms is maintained.
reactions. obstructive When long-term control
cardiomyopathy, of symptoms is
There is an elevated idiopathic subvalvular maintained with the
risk of arrhythmias in aortic stenosis, severe lowest recommended
patients receiving hypertension, dosage, then the next
concomitant aneurysm or other step could include a test
anaesthesia with severe cardiovascular of inhaled corticosteroid
halogenated disorders, such as alone.
hydrocarbons. ischaemic heart
disease, Symbicort given once
Concomitant use of tachyarrhythmias or daily, when in the opinion
other beta- severe heart failure. of the prescriber, a long-
adrenergic drugs or acting bronchodilator
anticholinergic drugs Interactions with would be required to
can have a other medicinal maintain control.
potentially additive products
bronchodilating Increasing use of a
effect. Concomitant separate rapid-acting
treatment with bronchodilator indicates
Hypokalaemia may itraconazole, ritonavir a worsening of the
increase the or other potent underlying condition and
disposition towards CYP3A4 inhibitors warrants a reassessment
arrhythmias in should be avoided. If of the asthma therapy.
patients who are this is not possible, the
treated with digitalis time interval between
glycosides. administration of the
interacting drugs
Budesonide and should be as long as
formoterol have not possible.
been observed to
interact with any
other drugs used in
the treatment of
asthma.
Seretide Diskus Treatment for: Dose Headache Avoid with non Hypersensitivity Not a relief of acute Explain how to use Do not store above
- Reversible For asthma selective, selective Asthma symptoms. inhaler: 30°C
GN: Fluticasone Obstructive Adults and Mouth and throat B-blockers Using your inhaler
propionate/Salmet airways disease adolescents aged 12 candidiasis Avoid abrupt 1) To open your Diskus,
erol xinafoate (ROAD) years and over withdrawal hold the outer case in
- Asthma Pneumonia in px Increased Plasma one
(combination with Seretide 50/100 with COPD conc. with Ritonavir Possible development hand and put the thumb
bronchodilator and Diskus of pneumonia in px of your other hand on the
inhaled - One inhalation Hoarseness Increased systemic with COPD thumbgrip. Push your
corticosteroid) twice a day ‘ exposure with thumb away from you as
- COPD including Muscle cramps Ketoconazole Monitor height of far
Chronic bronchitis Seretide 50/250 children when used as it will go. You will hear
& Emphysema Diskus long-term as it may a click. This will open
- One inhalation cause growth a small hole in the
twice a day retardation in children mouthpiece.
and adolescent 2) Hold your Diskus with
the mouthpiece towards
Seretide 50/500
DISCONTINUE USE you. You can hold it in
Diskus
IF PARADOXICAL either your right or left
- One inhalation
BRONCHOSPASM hand. Slide the lever
twice a day
OCCURS away from you as far as it
will go. You will hear a
Children 4 to 12 click. This places a dose
years of age of your medicine in the
Seretide 50/100 mouthpiece.
Diskus Every time the lever is
- One inhalation pulled back a blister is
twice a day opened inside and the
powder made ready for
Not for Children 4 you
years of age to inhale. Do not play with
the lever as this opens
the blisters and wastes
medicine.
3) Hold the Diskus away
from your mouth, breathe
out as far as is
comfortable.
Do not breathe into your
Diskus.
4) Put the mouthpiece to
your lips; breathe in
steadily and deeply
through the Diskus, not
through your nose.
Remove the Diskus from
your mouth.
Hold your breath for
about 10 seconds or
for as long as is
comfortable.
 Breathe out slowly.
5) Afterwards rinse your
mouth with water
and spit it out. This may
help to stop you
getting thrush and being
hoarse.
6) To close the Diskus,
slide the thumbgrip
back towards you, as far
as it will go. You
will hear a click.
The lever will return to its
original position
and is reset. Your Diskus
is now ready for
you to use again.

Acetylcysteine Treatment of 1 Acetylcysteine Chest tightness, Antitussive drugs Known Acetylcysteine Dissolve the tablets or Store at
(Fluimucil®) respiratory affections (Fluimucil) 600 mg Rash, Hives, and mucolytic agents hypersensitivity to (Fluimucil) granules in a glass temperatures not
characterized by thick effervescent tablet Itching, like acetylcysteine acetylcysteine or to Effervescent Tablet containing a small exceeding 25°C.
and viscous daily (preferably in Hypotension, should not be any of the excipients. contains aspartame, a quantity of water. Mix if
hypersecretions due the evening). Wheezing, concurrently Acetylcysteine source of necessary, with a spoon.
to acute bronchitis, Shortness of administered (Fluimucil) granules phenylalanine. May be The solution can be
chronic bronchitis and breath, Nausea, because the and tablets are harmful for people drunk directly from the
its exacerbation, Vomiting, reduction in cough contraindicated in with phenylketonuria. glass or in the case of
pulmonary Stomatitis, fever, reflex could lead to patients suffering children, it may be given
emphysema, Nasal cavity, accumulation of from phenylketonuria Patients suffering from with the use of a
mucoviscidosis and Sleepiness, bronchial secretions. due to the aspartame bronchial asthma teaspoon or in a feeding
bronchiectasis Viscosity, content. must be strictly bottle.
Narrowing of the Concurrent Children below 2 monitored during the
small bronchi administration of years of age. therapy. When other oral drugs or
nitroglycerin and antibiotics are required, it
Acetylcysteine has The administration of is advisable to administer
been shown to cause acetylcysteine, mainly the drugs 2 hours apart
significant at the start of from acetylcysteine. This
hypotension and treatment, might does not relate to
enhance temporal fluidify bronchial loracarbef.
artery dilation. secretion and
increase their volume.
Dissolution of If the patient is not
acetylcysteine able to effectively
formulations expectorate, postural
concomitantly with drainage and
other drugs is not bronchoaspiration
recommended. should be performed.
- Caution should be
used when
administering the
product for long-term
 therapy in patients
with histamine
intolerance, since
symptoms of
intolerance can occur
(headache, vasomotor
rhinitis, itching).

Ipratropium used to treat a runny Nasal Dry mouth, Additive history of Patient w/ prostatic To use the nasal spray: Store at 25°C.
bromide (Nasal nose caused by the Rhinorrhoea constipation, bronchodilatory hypersensitivity to hyperplasia/bladder Protect from light or
solution) common cold or associated with tachycardia, effect w/ β- atropine or neck obstruction, - Remove the clear heat
seasonal allergies. It rhinitis palpitations, adrenergic drugs its derivatives, or to myasthenia gravis, plastic dust cap and
BN: Atrovent® works by reducing the Adult: As metered- arrhythmias, and xanthine any of the narrow-angle the green safety clip
amount of fluid/mucus dose nasal spray: nausea and preparations. other ingredients. glaucoma, cystic from the nasal spray
released from inside 42 mcg into each vomiting, fibrosis. pump. The safety
your nose. This nostril 2-3 times dyspepsia, clip prevents the
medication does not daily, up to 84 mcg headaches, Pregnancy and accidental discharge
relieve symptoms of into each nostril 3-4 dizziness, ocular lactation. of the spray when
stuffy nose or times daily for up to complications (e.g. you are not using it.
sneezing. 4 days when mydriasis, narrow- - When you use the
rhinorrhoea is angle glaucoma). spray pump for the
associated w/ Rarely, urinary first time, you must
common cold or up retention, prime the bottle.
to 3 wk when hypersensitivity Pump the bottle 7
associated w/ reactions (e.g. times or until a fine
seasonal allergic urticaria, spray comes out.
rhinitis. angioedema, - Gently blow your
rash); nasal nose before using
Child: As metered- dryness, irritation the spray. Insert the
dose nasal spray: and epistaxis. tip of the bottle into
≥12 yr 42 mcg into your nostril.
each nostril 2-3 - Close the opposite
times daily. nostril with a finger
and lean your head
slightly forward.
- Spray into your
nostril and sniff
deeply through your
nose. Then breathe
out through your
mouth.
- Take the spray
pump out of your
nostril. Lean your
head backward for a
few seconds.
- If a second dose is
needed in the same
nostril, lean the
head slightly
 forward and repeat
the same steps.
- Spray the opposite
nostril using the
same steps.
- Replace the clear
plastic dust cap and
the green safety
clip.
- If the spray pump
gets clogged, hold
the tip of the bottle
under warm running
water for about 1
minute. Dry the
pump and prime it
again.
- If you do not use the
bottle for more than
24 hours, prime it
again by releasing
two sprays.
- If you do not use the
bottle for more than
7 days, clean the
spray tip and prime
it again by releasing
seven sprays.
- Keep track of the
number of sprays
you use. Throw the
bottle away after
you use 345 sprays
(0.03% nasal spray)
even if some liquid
remains in the
bottle.

This drug may cause

dizziness,
accommodation
disorder, mydriasis and
blurred vision, if affected,
do not drive or operate
machinery.

Ophthalmic Preparations

Eye drops For irritated eyes; For Eye drops Stinging/redness in MAO inhibitors Allergic to this Do not use this product Store at a
 quick relief of eye the eye, widened (linezolid, methylene medication or any of for more than 5 days. temperature not
Example: redness and minor Apply 2 to 3 drops in pupils, or blurred blue, moclobemide, the other ingredients exceeding 30°C.
Tetrahydrozoline discomforts caused by each eye, 3 to 4 vision may occur. phenelzine, of this medication Discontinue the use of
HCl (Eye Mo) irritants times daily or as procarbazine, this product if allergic Discard 30 days
needed. rasagiline, Pregnant, planning to reactions occur. after opening unless
Eye Mo Red Eyes safinamide, become pregnant or stated otherwise by
Formula - For selegiline, breastfeeding Do not use this product if the manufacturer.
minor eye isocarboxazid, the solution is colored or
irritations that are tranylcypromine), cloudy.
caused by dust or guanethidine, TCAs
smoke, (e.g., amitriptyline). To avoid eye irritation,
remove contact lens prior
Eye Mo to application of the eye
Moisturizing (Blue) drops and wait at least 30
Formula - For minutes before re-
relief of tired and inserting the contact lens.
dry eyes from long
hours of staring at Apply 2 to 3 drops in
computers, each eye, 3 to 4 times
handheld devices daily or as needed.
or even books

Others: Systane
(for moisturizing),

(Naphazoline-
pheniramine)
Visine (for red
eyes)

Antidiarrheals

Loperamide ACUTE DIARRHEA Dizziness, Some products that Conditions when Patients with AIDS, Take this medication by Store at
(Imodium, Loperamide is used to drowsiness, may interact with this peristalsis inhibition glaucoma, urinary mouth, usually after each temperatures not
Diatabs) treat diarrhea. Also, Adult Dose: tiredness, or drug include: should be avoided bladder neck loose stool, or as directed exceeding 30°C.
used to reduce the 4 mg initially, then 2 constipation may pramlintide, (e.g. constipation, obstruction, pyloric by your doctor.
amount of stool in mg after each loose occur. If any of recent/current abdominal distension, obstruction, significant
people who have an stool; not to exceed these effects antibiotic use, drugs ileus). Acute gastric retention, or In children, dosage is
ileostomy (re-routing 16 mg/day (8 mg/day persist or worsen, that can cause ulcerative colitis, intestinal statis, risk also based on age and
of the bowel through a for self-medication); contact your doctor constipation acute dysentery factors for QT interval weight.
surgical opening in the promptly. (including characterised by prolongation (e.g. Adults should not use
stomach). *Discontinue if no anticholinergics such bloody stools and congenital long QT more than 8 milligrams in
improvement seen as high fever, bacterial syndrome, history of 24 hours if self-treating,
within 48 hours belladonna/scopola enterocolitis caused cardiac arrhythmias or or 16 milligrams in 24
mine, by Salmonella, other heart conditions, hours if under a doctor's
NOTE: Pediatric Dose: antispasmodics such Shigella, and electrolyte direction.
(dosage is also as Campylobacter; abnormalities). Not
Acute diarrhea is based on age and glycopyrrolate/oxybu antibiotic-associated recommended for May be taken with or
weight) tynin, potent opioid colitis, abdominal long-term treatment. without food.
defined as the abrupt pain medicines such pain without Hepatic impairment.
onset of 3 or more First Day of as morphine, certain diarrhoea. Children Children. Pregnancy Diarrhea can cause a
loose stools per day, Treatment antihistamines such <4 years (oral and lactation. serious loss of body
typically lasts 1 or 2 2-6 years (13-20 kg): as diphenhydramine, solution); <12 years water (dehydration).
days and no longer 1 mg q8hr PO tricyclic (cap, orodispersible
Drink plenty of fluids and
than 14 days and goes antidepressants such tab); <18 years
away on its own. as amitriptyline), (patient with irritable minerals (electrolytes) to
6-8 years: (20-30
kg): 2 mg q12hr PO cholestyramine, bowel syndrome). replace what is lost. Tell
Chronic or persistent ritonavir, saquinavir. your doctor right away if
diarrhea is defined as 8-12 years (>30 kg): you develop signs of
an episode that lasts 2 mg q8hr PO dehydration (e.g.,
longer than 14 days. extreme thirst,
CHRONIC decreased urination,
DIARRHEA muscle cramps,
weakness, fainting). You
Adult dose:
may also need to change
4 mg initially, then 2
mg after each loose to a bland diet during this
stool until controlled, time to reduce irritation to
and then 4-8 mg/day your stomach/intestines.
in divided doses
Do not take more than
Pediatric Dose: the recommended dose.
(dosage is also
based on age and This drug may cause
weight) dizziness, drowsiness, or
tiredness, or depressed
0.08-0.24 mg/kg/day level of consciousness, if
PO divided q12hr affected, do not drive or
operate machinery.

Tell your doctor if your

diarrhea does not
improve after 2 days, if
your condition worsens,
or if you develop new
symptoms.

If you miss a dose, just

take the next dose if still
needed for diarrhea. Do
not double dose.

Antihypertensives
Amlodipine Amlodipine is a Generic: Amlodipine The following very CYP3A4 inhibitors Amlodipine is Patients with cardiac Amlodipine can have Keep the container
second generation 2.5mg, 5mg, 10mg common side (protease inhibitors, contraindicated in failure, patients with minor or moderate tightly closed in a
BN: Norvasc calcium channel oral tablet effect has been azole antifungals, patients with: hepatic impairment, influence on the ability to dry and well-
blocker that may be reported. macrolides, elderly and pediatric drive and use machines. ventilated place.
used alone or in Branded: Norvasc - Edema (fluid verapamil or • Hypersensitivity to patients, patients with If patients taking Store bottles at
combination with other 2.5mg, 5mg, 10mg retention) diltiazem) may give dihydropyridine renal impairment amlodipine suffer from controlled room
antihypertensive and oral tablet rise to significant derivatives & dizziness, headache, temperature, 59 deg
antianginal agents for The following increase in amlodipine fatigue or nausea the to 86 °F (15 deg to
the treatment of the Dosage for HTN common side amlodipine exposure ability to react may be 30 °C) and dispense
effects have been • Severe
following conditions: Adult dosage (18-64 resulting in an hypotension. impaired. Caution is in tight, light-
Hypertension, years) reported. increased risk of recommended especially resistant containers.
Coronary artery -Typical starting hypotension. • Shock (including at the start of treatment.
disease, Chronic dosage: 5mg q.d. -Headache, cardiogenic) shock.
stable angina, -Maximum dosage: dizziness, CYP3A4 inducers This medicine can be
Vasospastic angina 10mg q.d. sleepiness may change the • Obstruction of the used before or after food
(Prinzmetal’s or (especially at the plasma outflow-tract of the and drinks. You should
Variant angina), Child dosage (6-17 beginning of concentration of left ventricle (e.g. take your medicine at the
Angiographically years) treatment) amlodipine. high grade aortic same time each day with
documented coronary -Typical dosage: 2.5- -Palpitations stenosis). a drink of water. Do not
(awareness of your Grapefruit juice:
artery disease in 5mg PO q.d. increases • Hemodynamically take Amlodipine with
patients without heart heart beat), grapefruit juice.
flushing bioavailability of unstable heart failure
failure or an ejection Senior dosage (65 amlodipine, leading after acute
fraction < 40% years and older) - Abdominal pain, If you forget to take a
feeling sick to increased myocardial infarction.
-Typical dosage: hypotensive effects tablet, leave out that
2.5mg PO q.d. (nausea) dose completely. Take
- Altered bowel Decreased plasma your next dose at the
Dosage for CAD habits, diarrhoea, concentrations with right time. Do not take a
and Angina constipation, St. John’s Wort double dose to make up
Adult dosage (18-64 indigestion for a forgotten dose.
years) - Tiredness, Other hypertensive
-Typical starting weakness agents, simvastatin
dosage: 5mg q.d. - Visual
-Maximum dosage: disturbances,
10mg q.d. double vision Lab interference:
- Muscle cramps may result to false-
Senior dosage (65 - Ankle swelling positive
years and older) aldosterone/renin
-Typical dosage: ratio (ARR)
5mg PO q.d.
Losartan Hypertension - cold or flu Drug Interactions: Concomitant use with Patient with history of May be taken with or Store at 25°C.
(Cozaar) Losartan is used to Adult: 50 mg daily. symptoms such as May potentiate aliskiren-containing angioedema, volume- without food. Protect from light.
treat high blood Dosage is stuffy nose, hypotensive effect products in patients and/or Na-depletion, This drug may
pressure individualised and sneezing, sore with other with diabetes mellitus heart failure, occasionally cause
(hypertension). It is may be increased to throat, fever; antihypertensive or renal impairment unstented dizziness or drowsiness,
also used to lower the 100 mg once daily - dry cough; agents. May increase (GFR <60 mL/min). unilateral/bilateral if affected, do not drive or
risk of stroke in certain according to clinical - muscle cramps; risk of hypotension Severe hepatic renal artery stenosis, operate machinery.
people with heart response. Patients - pain in your legs as an adverse impairment. aortic or mitral
disease. with intravascular or back; reaction of Pregnancy (2nd-3rd stenosis, cirrhosis. Monitoring Parameters
volume depletion: - stomach pain, antipsychotics and trimester). Black race. Renal Monitor blood pressure,
Losartan is used to Initially, 25 mg daily. diarrhea; amifostine. impairment and mild renal function, and
slow long-term kidney Child: 6-18 years - headache, Decreased plasma to moderate hepatic electrolytes level e.g.
damage in people with >20-<50 kg: 0.7 dizziness; concentration with impairment. Children serum K, urinalysis.
type 2 diabetes who mg/kg once daily (up - tired feeling; or rifampicin and and elderly. Lactation. Correct volume depletion
also have high blood to a total of 25 mg). - sleep problems fluconazole. prior to therapy. Assess
pressure. Max: 50 mg daily, as (insomnia) Increased serum K for signs of angioedema.
necessary. >50 kg: levels and enhance
Same as adult dose. hyperkalaemic effect
Losartan may also be Adjust dose based with K-sparing
used for purposes not on blood pressure diuretics (e.g.
listed in this response. amiloride,
medication guide. Elderly: >75 years 25 spironolactone), K
mg daily. supplements or K-
Diabetic containing salt
nephropathy in Type substitutes (e.g.
2 diabetes mellitus heparin). May
Adult: Initially, 50 mg increase serum
daily, may increase lithium
to 100 mg daily concentrations and
depending on blood toxicity. May
pressure response. increase risk of renal
Elderly: >75 years 25 impairment and may
mg daily. decrease
Heart failure hypotensive effect
Adult: Initially, 12.5 with NSAIDs.
mg daily, may titrate Potentially fatal:
dose at weekly Increased risk of
intervals. Max dose: hypotension,
150 mg daily. hyperkalaemia, and
Elderly: >75 years 25 nephrotoxicity with
mg daily. ACE-inhibitors or
aliskiren.

Food Interaction
Decreased
absorption with food.

Furosemide It is used to treat high 20 mg tablet ● nausea or Increased risk of Hypersensitivity to Furosemide is May be taken with or Store between 15-
blood pressure. It’s vomiting hyperkalaemia with furosemide and removed from your without food. May be 30°C. Protect from
BN: Lasix, Furose, also used to treat Adult: Alone or in ● diarrhea K-sparing diuretics sulfonamides. body by your kidneys. taken w/o meals for light.
Furosan edema, which is combination with ● constipation (e.g. amiloride, If you have kidney better absorption. May be
swelling caused by other ● stomach spironolactone) and Anuria, renal failure problems, more of the taken w/ meals to reduce
fluid buildup in your antihypertensives: cramping K salts. with anuria not drug may stay in your GI discomfort.
body. 40-80 mg daily, ● feeling like you responding to body longer. This can
adjusted according or the room is Diuretic effects may furosemide cause dangerous side This drug may cause
to patient response. spinning be antagonised by effects. Your doctor reduced mental
(vertigo) NSAIDs (e.g. may start you on a alertness, dizziness, and
Alternatively, a usual ● dizziness indometacin, lower dose and blurred vision, if affected,
maintenance dose ● headache ketorolac), monitor how well your do not drive or operate
of 20-40 mg daily ● blurred vision kidneys are working to machinery.
may be given. ● itching or rash May cause severe make sure this drug is
hypotension with safe for you. Ask if px has other health
Elderly: Initiate at ACE inhibitors or conditions (can’t be given
lower doses. angiotensin II to px with kidney
receptor antagonists. conditions)

Increased risk of Ask if px is taking other

cardiotoxicity with medications
cardiac glycosides,
antihistamines, Ask age
antipsychotics (e.g.
pimozide, Mild side effects can go
risperidone). away within a couple of
days. If symptoms
persist, consult your
doctor.

Ask px responsiveness
with the drug (check
dose)

Antidiabetes

Metformin Indicated for type II 500 mg tablet ● Common: ● Beta-blockers ask hypersensitivity, ● Renal Impairment ● Metformin should be Store in a closed
diabetes, particularly Initially: 500 mg Gastrointestinal the symptoms of chronic heart failure, ● Hepatic Impairment taken with meals to help container at room
BN: in overweight patients, orally twice a day, disorders: hypoglycemia metabolic acidosis ● Use in elderly reduce stomach or temperature, away
Glucophage - 500 when diet and given with meal Nausea, vomiting, ● Increased risk of with or without coma, ● Heart Failure bowel side effects - from heat, moisture,
mg; 850 mg tablet exercise provide stomach upset, hypoglycemia with diabetic ketoacidosis ● Administration of most people take and direct light.
inadequate control. 800 mg tablet diarrhea other (DKA), severe renal iodinated contrast metformin with
Glucophage XR For use either alone, Initially: 850 mg ○ Metallic taste in hypoglycemic disease, abnormal media breakfast and dinner.
500 mg tablet with other oral orally once a day, mouth agents or insulin creatinine clearance ● Surgery ● If you miss a dose of this
(extended release) hypoglycemic agents given with meal ○ weakness ● Increased risk of resulting from shock, ● Alcohol medicine, take it as
or insulin. lactic acidosis with septicemia, or ● Use in children soon as possible.
Generic Adjust dose after ● Serious: alcohol, myocardial infarction ● Periodic assessment However, if it is almost
counterpart is 10-15 days ○ Lactic Acidosis cimetidine, and lactation. of renal, hepatic and time for your next dose,
available according to ○ Hypoglycemia topiramate, ACE cardiovascular skip the missed dose
response; up to a inhibitors function is and go back to your
maximum dose of ● Reduced efficacy recommended during regular dosing
2550 mg per day, of metformin with prolonged periods of schedule. Do not double
 given in divided Phenothiazine, treatment with doses.
doses. Hormone drugs, metformin. ● Regularly monitor blood
isoniazid, ● Patients receiving sugar level
Extended-Release Phenytoin, continuous ● May take up to 2 weeks
500 mg extended nicotinic acid metformin therapy of regular dosing for the
release tablet should have an maximum effects of
Initially: 500 mg annual estimation of metformin to develop.
orally once daily vitamin B12 levels ● Avoid drinking alcohol
with the evening because of reports of as this may cause lactic
meal. decreased vitamin acidosis
Increase the dose B12 absorption.
in increments of
500 mg weekly on Page 3
the basis of https://www.medsafe.
glycemic control govt.nz/profs/datashe
and tolerability, up et/m/Metformintab.pdf
to a maximum of
2000 mg once daily
with the evening
meal.

If glycemic control is
not achieved with
GLUCOPHAGE XR
2000 mg once daily,
consider a trial of
GLUCOPHAGE XR
1000 mg twice daily.
If higher doses are
required, switch to
GLUCOPHAGE at
total daily doses up
to 2550 mg
administered in
divided daily doses,
as described above.

Antibacterials

Amoxicillin Bacterial sinusitis, Tablet Significant: Decreased renal Hypersensitivity or Patient with reduced May be taken with or Store between 20-
otitis media, ear, nose One tablet every 8 Convulsion (high tubular secretion history of severe urine output, history of without food. May be 25°C. Protect from
BN: Amoxil, and throat infection, hours prn for pain. doses), Jarisch- resulting in increased allergic reactions seizures, treated taken w/ meals for better moisture and light.
Trimox genitourinary Herxheimer and prolonged serum (e.g. anaphylaxis, epilepsy or meningeal absorption & to reduce GI Reconstituted oral
infections, skin and reaction (in concentration with Stevens-Johnson disorders; lymphatic discomfort. susp: Store below
soft tissue infections treatment of Lyme probenecid. syndrome) to leukaemia. Atopic 25°C or between 2-
disease). Rarely, Increased risk of amoxicillin or other β- individuals. Renal and 8°C.
crystalluria (high allergic reactions lactams (e.g. hepatic impairment.
parenteral doses); (e.g. rashes) with penicillins, Children. Pregnancy Do not freeze.
prolonged allopurinol. cephalosporins, and lactation.
 prothrombin time. Tetracyclines, carbapenems,
chloramphenicol, monobactams).
Gastrointestinal macrolides, and Infectious
disorders: Nausea, sulfonamides may mononucleosis
diarrhoea, interfere with the (suspected or
vomiting; tooth bactericidal effect of confirmed).
discolouration amoxicillin. May
(brown, yellow, prolong prothrombin PRECAUTIONS:
grey) particularly in time or increase INR Patient with reduced
children. when used with oral urine output, history
anticoagulants (e.g. of seizures, treated
warfarin, epilepsy or meningeal
acenocoumarol). disorders; lymphatic
May reduce the leukaemia. Atopic
excretion and individuals. Renal
increase the toxicity and hepatic
of methotrexate. impairment. Children.
May reduce the Pregnancy and
efficacy of oral lactation.
contraceptives (e.g.
estrogen/progestero
ne combination).

BN: Pediamox Amoxicillin powder ● nausea. Probenecid Serious Patients with reduced Ask px on who’ll take the STORE FOR NOT
for Oral ● vomiting. decreases the renal hypersensitivity urine output, history of med, then ask the age MORE THAN 7
For the treatment of Suspension: ● diarrhea. tubular secretion of reaction (e.g., seizures, treated DAYS (25- 30 C)
the following infections 125 mg/5 mL, 200 ● stomach pain. Amoxicillin. anaphylaxis or epilepsy or meningeal Oral suspension AND NOT MORE
caused by susceptible mg/5 mL, 250 mg/5 ● vaginal itching or Stevens-Johnson disorders reconstitution: THAN 14 DAYS
microorganisms: Ear, mL, 400 mg/5 mL. discharge. Oral syndrome) to - Atopic individuals UNDER
nose, throat, ● headache. Anticoagulants Amoxicillin or to other (people that have Carefully add cool boiled REFRIGERATION
genitourinary tract Each 5 mL of β-lactam antibiotics exaggerated immune water to about half the (2-8 C)
infections; reconstituted fruity Allopurinol (e.g., penicillins and response to foreign height of the final
flavored suspension The concurrent cephalosporins). antigens) marking on the bottle. Protect from light
Uncomplicated skin contains 125 mg, administration of Close the cap. Shake the
and skin structure 200 mg, 250 mg or allopurinol and bottle until all the powder
infections; Acute otitis 400 mg Amoxicillin Amoxicillin increases is thoroughly mixed.
media; Lower as the trihydrate. the incidence of Allow the suspension to
respiratory tract rashes stand for about 2-5
infections. minutes to rid the air
Oral bubbles in the bottle.
Contraceptives
Amoxicillin may SEE PIC:
affect the gut flora,
leading to lower https://www.mims.com/p
estrogen hilippines/drug/info/pedia
reabsorption and mox?type=full
reduced efficacy of
combined oral https://mimsshst.blob.cor
estrogen/progestero e.windows.net/drug-
ne contraceptives. resources/PH/html/info/P
 ediamoxT3_PH_2c_v1.p
ng

Amoxicillin/ Augmentin Infections Augmentin susp Diarrhoea, nausea, Decreased renal Hypersensitivity to β- Hypersensitivity At time of use, the dry Co-amoxiclav
Clavulanic Acid of upper & lower resp Children vomiting tubular secretion w/ lactams eg, reactions to powder should be powder for
Susp tract, GUT, skin & soft Skin & soft tissue (uncommon for IV probenecid. penicillins & penicillins, reconstituted to form an suspension should
(Augmentin®) tissue, bone & joint, infection, recurrent powd for inj), Increased allergic cephalosporins. cephalosporins or oral suspension, as be stored at
septic abortion, tonsillitis 20-40 mucocutaneous skin reactions w/ other allergens prior detailed below: temperatures not
puerperal sepsis, mg/kg/day tid or 25- candidiasis. allopurinol. History of co- to initiation of therapy. • Invert and shake the exceeding 25°C.
intra-abdominal 45 mg/kg/day bid. amoxiclav-associated bottle to loosen powder. The reconstituted
sepsis, dental Otitis media, May affect the gut jaundice/hepatic Suspected infectious • Add volume of water suspension should
infection (for oral sinusitis, lower flora leading to lower dysfunction. mononucleosis. (indicated below). Invert be stored and kept
prep), female genital resp tract estrogen Overgrowth of and shake well. in a refrigerator (2-
infections, septicemia, infection, UTI 40-60 reabsorption & History of penicillin nonsusceptible • Alternatively, fill the 8°C) and used
peritonitis & post- mg/kg/day tid or 45- reduced efficacy of hypersensitivity. organisms in bottle with water to just within 7 to 10
surgical infections; 70 kg/mg/day bid. combined OCs. prolonged use. below the mark on the (maximum days).
prophylaxis against Pseudomembranous bottle label. Do not freeze.
infections associated Increased INR w/ colitis. Invert and shake well,
w/ major surgical acenocoumarol or then top up with water to
procedure (for IV warfarin, Concomitant use w/ the mark. Invert and
presentations) mycophenolate anticoagulants. shake again.
mofetil, Hepatic dysfunction. • Allow to stand for 5
methotrexate. Renal impairment. minutes to ensure full
dispersion.
Pregnancy & lactation • Shake well before
taking each dose

May be given without

regard to meals. Best
taken at the start of
meals for better
absorption and to reduce
GI discomfort.

Azithromycin For treatment of acute Adult: Initial dose: - May exacerbate - Increased risk of - Hypersensitivity to - Patients with - Complete the therapy Store at
Azemax®, Bronchitis; severe 500 mg once daily myasthenia gravis prolonged QT macrolides myasthenia gravis for full 7 days, with temperatures not
Azithcor®) Campylobacter for 3 days - Headache, interval with Class IA - History of hepatic - Px with electrolyte reduced dosage (250 exceeding 30°C
enteritis; Legionnaire’s Following dose: 250 dizziness, and III dysfunction, and disturbances mg) starting at day 4
disease and other mg once daily for paraesthesia antiarrhythmics cholestatic jaundice - History of torsades - May be taken with or
Legionella infections; further 4 days - Diarrhea, - Increased serum following previous de pointes without food; may be
mild to moderately vomiting, concentrations of antibiotic use - Children, pregnant taken with meals to
severe CAP; abdominal pain, digoxin, colchicine, women, breastfeeding reduce GI discomfort
diphtheria nausea, flatulence and ciclosporin - Should not be given - Take the medicine at
- May potentiate the long-term to prevent the same time everyday
effects of oral bronchiolitis obliterans
anticoagulants (e.g., syndrome in patients
warfarin) with blood cancers
Cotrimoxazole For the treatment of: Child: Diarrhea For Hypersensitivity to Cotrimoxazole should Co-trimoxazole is a Store in a cool,dry
(Bactrim®, Urinary tract 6-12 years: (5 mL) Headache Sulfamethoxazole: trimethoprim or not be given to combination of two place.
Septrin®, infections, one teaspoonful Rash The action of sulfonamides patients with history of antibacterial medicines -
Zolmed®) bactericidal, three times a day or Nausea sulfonamides may be sensitivity to it or to a sulfonamide medicine
respiratory tract as prescribed by the antagonized by p- Patients documented sulphonamide or called sulfamethoxazole,
infections, gastro- physician. aminobenzoic acid with megaloblastic trimethoprim and to and trimethoprim. It is
intestinal infections, and its derivatives, anemia patients with actual or prescribed for infections
infections by Adult: particularly K+ possible folate which can occur in
Pneumocystis carinii, aminobenzoate and G6PD deficiency deficiency, during people who have a
prophylaxis in 800/160 mg Tablet: the procaine group of pregnancy, and in problem with their
neutropenic patients, One (1) tablet every local anesthetics. patients receiving immune systems. It
genital infections and 12 hours after meals. Sulfamethoxazole trimethoprim. works by killing the
miscellaneous 400 mg/80 mg and other germs (bacteria)
infections. sulfonamides may responsible for causing
capsule: one (1) to potentiate the effects the infection.
two (2) capsule of some drugs, such
every 12 hours after as oral The leaflet will provide
meals or as anticoagulants, you information about the
prescribed by the methotrexate, and drug, with a full list of side
physician. phenytoin; this may effects.
be due to
displacement of the Take co-trimoxazole
drug from plasma exactly as your doctor
protein binding sites tells you to. As a guide, it
or to inhibition of is usual to take two doses
metabolism. of co-trimoxazole daily
(12 hours apart) to treat
For Trimethoprim: an infection, but make
Trimethoprim may sure you read the
increase serum directions on the label, as
concentrations of your dose may be
some drugs, different to this. If co-
including phenytoin, trimoxazole has been
digoxin, prescribed for your child,
procainamide, it is likely that you will be
rosiglitazone, and supplied a liquid
repaglinidine, medicine - the dose will
potentiating their depend upon the age of
effect. This may be the child. Read the
due to competitive directions on the label
inhibition of renal carefully and make sure
excretion, decreased you measure out the
metabolism, or both. correct dose.
It has been
suggested that Remember to take co-
trimethoprim may trimoxazole regularly so
potentiate the effects that you keep a steady
of warfarin. level of the medicine in
Trimethoprim has your body. Try to avoid
been reported to missing any doses
reduce the renal .
 excretion and Co-trimoxazole is best
increase blood taken with food or a drink.
concentrations of
zidovudine, If you forget to take a
zalcitabine, and dose, take it as soon as
lamivudine. you remember. If it is
Trimethoprim and almost time to take your
dapsone increase next dose when you
each other's serum remember, skip the
concentrations, missed dose and take
whereas rifampicin your next dose when it is
may decrease due. Do not take two
trimethoprim doses together to make
concentrations. up for a forgotten dose.

Cefalexin used to treat certain Oral - Diarrhea Renal excretion may Hypersensitivity to Patients with a history - Cefalexin is a - Store at room
(Ceporex®, infections caused by Skin and soft - GI be inhibited by cephalosporins. of carbapenem or medicine used to temperature in
Cefalin®) bacteria such as tissue infections, disturbances probenecid resulting Acute porphyria. penicillin allergy treat certain a cool, dry
pneumonia and other Uncomplicated (nausea, in increased plasma (especially IgE- bacterial infection place. Do not
respiratory tract urinary tract vomiting, concentration of mediated reactions), - It is a cephalosporin keep in the
infections; and infections abdominal cefalexin. and seizure disorder. antibiotic bathroom
infections of the bone, Adult: 250 mg 6 discomfort) Children. Renal - Use this medicine as - Keep out of
skin, ears, , genital, hourly or 500 mg 12 - allergic May increase plasma impairment. directed by your reach of
and urinary tract. hourly. Max: 4,000 reaction (rash, concentration of Pregnancy and physician children and
mg daily in 2-4 urticaria, metformin. lactation. - Take at the same pets
divided doses. angioedema) time each day. Do
Child: 25-50 mg/kg - Genital and Increased risk of not miss doses of
daily in divided anal pruritus nephrotoxicity with this medicine
doses administered - Genital amphotericin, loop - Take until you finish
12 hourly. candidiasis diuretics, the medicine (7-14
- Vaginitis aminoglycoside, days depending on
Oral - Vag discharge capreomycin or the physician’s
Acute dental - Dizziness vancomycin. order). Take it even
infections, Acute - Fatigue if you are feeling
prostatitis, Bone - Headache May increase risk of better.
and joint - Agitation hyperkalemia with - Take with or with
infections, - Confusion gentamicin (in food. If upset
Genitourinary - Hallucinations patients taking stomach, take it with
infections, - Arthralgia cytotoxic drugs for food
Respiratory tract - Arthritis leukaemia). If a patient miss a dose:
infections - Joint disorder - If you miss a dose,
Adult: 1,000-4,000 - Eosinophilia May decrease take the missed
mg daily in divided - Neutropenia efficacy of dose as soon as you
doses; most - Thrombocytop oestrogen- think about it
infections respond to enia containing oral - If it is almost time for
500 mg 8 hourly. - Slight contraceptives. your next dose skip
Child: <5 years 125 elevations in the missed dose and
mg 8 hourly; ≥5 AST/Vulvovag go back to your
years 250 mg 8 initis normal dose time
hourly. Dose may be - Do not take 2
doubled in severe doses at the same
infections. Usual time or extra doses
dose: 25-50 mg/kg
daily in divided Side effects that could
doses. possibly occur:
- Headache, joint
Oral pain, dizziness
Streptococcal - Upset stomach,
pharyngitis diarrhea, vomiting
Adult: 250 mg 6 - Call your doctor
hourly or 500 mg 12 right away if you
hourly for at least 10 have stomach pain
days. Max: 4,000 mg or cramps, very
daily in divided loose or watery
doses. stools, or bloody
Child: 25-50 mg/kg stools. Do not try to
daily in divided treat loose stools
doses administered without first
12 hourly for at least checking with your
10 days. doctor
- For women, vaginal
Oral yeast infection.
Otitis media Report itching or
Child: 75-100 mg/kg discharge to your
daily in 4 divided doctor
doses.
Drug interaction:
- Do not start new
prescriptions, over-
the counter
medicines, or herbal
and dietary
supplements without
telling your doctor

Things that patients need

to be aware:
- allergic to
cephalexin, any
penicillin, or if you
have any other
allergies
- If the patient is
taking a blood
thinner, they may
need to have your
blood work
checked more
frequently while
taking this
 medicine. Talk with
the doctor
- Birth control pills
may not work as
well to prevent
pregnancy. Use
some other kind of
birth control like
condoms while
taking this
medicine. Talk with
your doctor - Tell
your doctor if you
are pregnant, plan
to become
pregnant, or are
currently
breastfeeding

Clindamycin for For serious infections ORAL (CAPSULES) There are many DRUG ● Hypersensitivity. For Oral intake: Capsule: Cap/Oral
Acne caused by susceptible possible side INTERACTION Patients with history of May be taken with or solution/Cream/Lo
staphylococci (both Adult effects of May enhance the ● Topical and gastrointestinal without food. Swallow tion/Foam/Gel:
Brand: DALACIN- penicillinase- and non- Moderately severe: clindamycin action of vaginal: History of disease (e.g. colitis); whole w/ a full glass of Store between 20-
C (capsule) penicillinase- 150-300 mg every 6 neuromuscular inflammatory bowel atopic individuals. water & in an upright 25°C.
producing), hours. nausea. blocking agents. disease, regional position.
streptococci (except vomiting. enteritis, ulcerative
Streptococcus Severe: 300-450mg unpleasant or May antagonise the colitis or antibiotic-
faecalis), every 6 hours. metallic taste in the effects of associated colitis. Clindamycin (DALACIN-
pneumococci, and mouth. parasympathomimeti C) is put inside a capsule
anaerobic pathogen: In cases of β- cs. because it is meant to be
haemolytic taken ORALLY. Applying
streptococcal May competitively it on the skin as a topical
infection: Continue inhibit the effects of remedy doesn't
for at least 10 days to macrolides, guarantee 100% cure
prevent subsequent ketolides, from acne.
rheumatic fever or streptogramins,
glomerulonephritis. linezolid and Misuse of antibiotics
chloramphenicol leads to resistance.

Child: <12 years May increase May

3-6 mg/kg every 6 decrease therapeutic
hours. effect with rifampicin.

Topical May reduce

clearance with
Adult: CYP3A4 and
CYP3A5 inhibitors
Lotion/solution:
Apply a thin film bid
 to the affected area

Gel/foam:
Apply once daily to
the affected area

Antituberculosis Medications

Rifampicin + For the initial phase Usual adult dose: fever, loss of Anticholinergics, Rifampicin, Isoniazid Hypersensitivity to Take medication on a Store at
Isoniazid + treatment of all forms Orally, once daily, appetite, malaise, opioids, salicylates, and Pyrazinamide rifampicin, isoniazid, regular basis; avoid temperatures not
Pyrazinamide + of pulmonary and either one hour nausea and oral anticoagulants, have been associated pyrazinamide, and missing doses. Do not exceeding 30°C
Ethambutol HCl extrapulmonary before or two hours vomiting, darkened barbiturates, with liver dysfunction. ethambutol, or to any discontinue therapy
(QuadTab®) tuberculosis. after a meal. urine, yellowish benzodiazepines, ingredient of the except on advice of a
discoloration of the beta-blockers, oral or Use with caution and product. physician.
skin and eyes, pain other systemic under strict medical Medication may cause a
or swelling of the hormonal supervision in Jaundice or severe reddish-orange
joints contraceptives, patients with impaired liver disease. discoloration of the urine,
corticosteroids. liver function. stools, saliva, tears,
Antiretroviral drugs. Concurrent sweat and sputum. This
Oral hypoglycemics, Carefully monitor liver administration of is to be expected and is
antacids, function [i.e., (ALT) saquinavir and not harmful. Soft contact
ketoconazole. and (AST)] prior to ritonavir. lenses may be
Anticonvulsants. therapy and then permanently stained.
Aluminum salts. every 2 to 4 weeks Acute liver disease. Notify the physician
Concomitant use during therapy. promptly if any of the
with other antibiotics. Discontinue product if History of previous following symptoms are
signs of isoniazid-associated experienced: fever, loss
FMI: hepatocellular liver injury. of appetite, malaise,
https://www.mims.co damage occur. nausea and vomiting,
m/philippines/drug/in History of severe darkened urine,
fo/quadtab/drug- adverse reactions to yellowish discoloration of
interactions Isoniazid, including the skin and eyes, pain or
severe swelling of the joints.
hypersensitivity
reactions or drug
fever, chills, and
arthritis.

Acute gout.

Pre-existing optic
neuritis from any
cause.

Lozenges

Benzydamine - Relief from the Lozenge Common Hypersensitivity to ● If a sore throat is ● Suitable for adults and Lozenges: Store at
hydrochloride symptoms of sore throat, ● Lacking or benzydamine, either caused or children 6 years and temperatures not
(Difflam®) tonsillitis, inflammatory deficient of complicated by a over. exceeding 30°C.
 conditions such as mouth 1 loz to be sucked 1- physical aspirin, or other bacterial infection, ● Sugar-free
3 Flavors: ulcers, swelling, redness 2 hourly. sensation of the NSAIDs. appropriate ● Gluten-free
1. Difflam Mint - and inflammatory Max: 12 loz/day for mouth (oral antibacterial ● Lactose-free
conditions, pain following
anti- ≤7 days numbness) therapy should be ● Do not exceed 12
throat or mouth surgery,
inflammatory or pain following dental ● Occasional considered in lozenges a day.
lozenges for procedures. burning or addition to the use ● Do not take Difflam
soothing pain stinging of Difflam. Lozenges continuously
relief *contain active sensation *The clinical efficacy for more than seven
2. Difflam ingredients to relieve of an antibacterial days.
Orange, and pain due to sore Uncommon (stop agent in lozenges and ● If you have any
Difflam throat, tonsillitis and using this an antiseptic agent in concerns, do seek your
Eucalyptus & other inflammatory medication and oral solutions in doctor's advice
Menthol - anti- conditions in the seek medical reducing the severity ● Care should be taken
inflammatory mouth and throat. The attention or duration of throat when consuming hot
and antiseptic active, anti- immediately if you infections have not food or drink following
lozenges to inflammatory experienced the been clinically use of Difflam
relieve pain ingredient side effects stated established. Anaesthetic,
and helps fight (Benzydamine HCI) below.) ● Pregnancy: Antibacterial and Anti-
minor infection reduces pain and ● An allergic Schedule 2 inflammatory
swelling, while the reaction towards ● Use in children: Lozenges, as the local
antiseptic ingredient Difflam Sugar- Because of the lack anaesthetic may dull
(Cetylpyridinium CI) Free Lozenges of sufficient clinical the sensation of heat
helps fight the minor such as difficulty experience, Difflam and pain. It is
infection that causes in breathing, is not recommended to avoid
sore throat and other rash or swollen recommended in hot food or drink for
conditions. of the lips or children <6 years. one to two hours
mouth following use.
● Dryness or thirst
● Warm feeling of
the mouth
● Changed in
sense of taste
● Nausea
● Vomiting
● Dizziness
● Headache
● Drowsiness

Antiviral

Acyclovir Used to treat 2 to 5 times a day Nausea, diarrhea, Drugs that may The only absolute Drink plenty of fluids Keep this
infections caused by as directed by your headache, or cause kidney contraindication to while you are taking or medication in the
BN: Zovirax. viruses. doctor vomiting may problems (including acyclovir is using acyclovir. container it came in,
occur. If any of nonsteroidal anti- hypersensitivity. tightly closed, and
- cold sores around these effects inflammatory Take the missed dose as out of reach of
mouth (caused by persist or worsen, drugs-NSAIDs such Cautions include soon as you remember it children. Store it at
herpes simplex) tell your doctor or as ibuprofen, renal and take any remaining room temperature
-shingles (caused by pharmacist naproxen). failure/impairment, doses for that day at and away from
herpes zoster) immunocompromised evenly spaced intervals. excess heat and
 -chickenpox promptly. Acyclovir is very host, potential risk of However, if it is almost moisture (not in the
similar to thrombotic time for the next dose, bathroom)
Can also be used to valacyclovir. Do not thrombocytopenic skip the missed dose and
treat genital herpes use medications purpura (TTP), and continue your regular
containing hemolytic uremic dosing schedule. Do not
valacyclovir while syndrome (HUS)). take a double dose to
using acyclovir. make up for a missed
one.

Remember that your

doctor has prescribed
this medication because
he or she has judged that
the benefit to you is
greater than the risk of
side effects. Many people
using this medication do
not have serious side
effects. If serious side
effects occur,
automatically visit your
doctor.

Oral Contraceptives

Trust® Pills Indicated for 1 tablet daily Some women may Taking drugs for Make sure the patient Regular Take one pill daily, Store at a
contraception and experience side infection (such as is not pregnant before consultation with a beginning on the first day temperature not
Ethinyl Estradiol + treatment of menstrual effects such as ampicillin, taking Ethinyl healthcare provider of menstrual bleeding or exceeding 30°C.
Levonorgestrel + disorders such as headache, gastric chloramphenicol, Estradiol + is recommended any day as long as the
Ferrous Fumarate dysmenorrhea, upsets, nausea, neomycin, penicillin Levonorgestrel + patient is not pregnant
premenstrual vomiting, V, nitrofurantoin, Ferrous Fumarate
while taking Ethinyl and use a back-up
syndrome, and abdominal cramps, sulfonamides, (TRUST PILL). Estradiol + method such as a
menorrhagia changes in tetracycline and Patient should inform Levonorgestrel + condom for the next
appetite, breast isoniazid) and pain the healthcare Ferrous Fumarate seven days as a
tenderness, (analgesic, anti- provider if she has the (TRUST PILL). If precaution to avoid
change in body migraine and following conditions: patient suffers from pregnancy. Start with the
weight and libido, tranquilizer) with liver disorders, diarrhea and/or pill marked number "1".
depressive moods, contraceptive pill clotting disorders, vomiting, its efficacy Follow the arrows
or interference with may decrease the breast and cervical may be reduced. indicated on the pack.
liver functions. contraceptive's cancer, sickle-cell The interval between two
efficacy. anemia, hormone-
Inform the pills should be 24 hours.
Taking contraceptive active tumors, healthcare provider A pack is good for 28
pills and anti- hyperlipidemia, if the patient is days.
infective drugs (such severe suffering from the Start a new pack the next
as clarithromycin, cardiovascular following conditions: day after taking the last
erythromycin, diseases, previous or diabetes mellitus, brown pill regardless
itraconazole, existing high blood whether the patient's
 ketoconazole, thromboembolic pressure, varicose menstrual bleeding has
ritonavir) or diseases, idiopathic veins, multiple stopped or not. Patient's
grapefruit juice may jaundice. It is not sclerosis, epilepsy, menstrual period will
inhibit cytochrome P- recommended for migraine, return to normal two days
450 isoenzyme 3A4. pregnant after finishing the
Taking
ophthalmological ochreous pills and while
contraceptives and problems, tetany. taking the brown pills.
troleandomycin may Missed Pills: If the
increase the risk of patient missed one
cholestatic jaundice. ochreous pill, take it as
soon as remembered.
Take the pill due for the
day at the regular time
even if it means taking
two pills in one day. Keep
taking one pill each day
at the usual time. Missing
two or more ochreous
pills consecutively
increases the probability
of getting pregnant. Take
the most recently missed
ochreous pill as soon as
remembered and discard
all remaining previously
missed pills. Resume
taking the next scheduled
pill and either abstain
from sex or use condoms
for the next seven days.

Corticosteroids

Dexamethasone Dexamethasone, a Inflammation Significant: Antibiotics: Systemic fungal Use dexamethasone Ophth: This drug may Store at 20° to 25°C
(Decadron, corticosteroid, is 0.75-9 mg/day Adrenal Macrolide antibiotics infections; systemic with caution during cause blurring of vision, (68° to 77°F)
Dexasone, similar to a natural IV/IM/PO divided suppression; have been reported infection unless being pregnancy if benefits Remove contact lenses
Solurex, and hormone produced by q6-12hr Kaposi sarcoma; to cause a significant treated with specific outweigh risks. prior to ophthalmic Do not freeze. Do
Baycadron) your adrenal glands. It Intra-articular, myopathy; perineal decrease in anti-infectives. Animal studies show administration and after not use if solution
often is used to intralesional, or irritation, corticosteroid Perforation of drum risk and human 15 minutes. contains a
replace this chemical soft tissue: 0.2-6 psychiatric clearance membrane (otic). studies are not precipitate.
when your body does mg/day disturbance, Administration of live available, or neither Dexamethasone may Dispense only in
not make enough of it. immunosuppressio Antidiabetics: virus vaccine. animal nor human cause an upset stomach. this bottle and only
It relieves Multiple Sclerosis n (e.g. secondary Because studies were done Take dexamethasone with the calibrated
inflammation (Acute infections, corticosteroids may DO NOT TAKE IF with food or milk dropper provided.
(swelling, heat, Exacerbation) activation of latent increase blood YOU ARE Do not take when Discard opened
redness, and pain) 30 mg/day PO for 1 infections, mask glucose ALLERGIC mother plans to bottle after 90 days.
and is used to treat week; follow by 4-12 acute infection); concentrations, breastfeed
certain forms of mg/day for 1 mo increased dosage adjustments
Using too much of
arthritis; skin, blood, intraocular of antidiabetic
this medicine or using
kidney, eye, thyroid, Cerebral Edema pressure, open- agents may be it for a long time may
and intestinal 10 mg IV, then 4 mg angle glaucoma required. increase your risk of
disorders (e.g., IM q6hr until clinical and cataracts. having adrenal gland
colitis); severe improvement is Rarely, Nonsteroidal Anti- problems.
allergies; and asthma. observed; may be anaphylactoid Inflammatory
Dexamethasone is reduced after 2-4 reactions Agents (NSAIDS): Using this medicine
also used to treat days and gradually Endocrine Concomitant use of may increase your
certain types of discontinued over 5- disorders: Growth aspirin (or other risk of cancer
cancer. 7 days retardation in nonsteroidal
children. antiinflammatory
Shock Eye disorders: agents) and
1-6 mg/kg IV once Bacterial keratitis, corticosteroids
or 40 mg IV q2-6hr eye irritation and increases the risk of
PRN pruritus, burning gastrointestinal side
Alternative: 20 mg sensation, ocular effects.
IV, then 3 mg/kg/day discomfort.
by continuous IV General Estrogens,
infusion disorders and including Oral
High-dose treatment admin site Contraceptives:
not to be continued conditions: Estrogens may
beyond 48-72 hours Impaired wound decrease the hepatic
healing. metabolism of
Inflammatory eye Investigations: certain
disorders Weight gain. corticosteroids,
Adult: As 0.1% Metabolism and thereby increasing
solution: Instill 1 nutrition their effect
drop 4-6 times daily. disorders:
Severe conditions: Cushing’s SUMMARY:
Instill 1 drop hourly, syndrome, obesity. anticoagulants
then reduced to 1 Musculoskeletal arthritis medications,
drop 4 hourly as the and connective aspirin, cyclosporine,
inflammation tissue disorders: digoxin, diuretics,
subsides. Osteoporosis. ephedrine, estrogen
Nervous system , ketoconazole , oral
disorders: contraceptives,
Headache, muscle phenobarbital,
atrophy. phenytoin , rifampin ,
Psychiatric theophylline , and
disorders: vitamins.
Euphoria,
depression,
suicidal
tendencies.
Skin and
subcutaneous
tissue disorders:
Skin fragility

Laxatives
Bisacodyl Tablet For use in patients Sugar-Coated ● Abdominal ● Diuretic drugs ● Ileus Pregnancy and Do not take with milk STORAGE
(Dulcolax®) suffering from tablet discomfort ● Adrenocorticost ● Intestinal children products because it will
constipation. ● diarrhea eroids obstruction increase risk of ORAL
Adult/Pediatric ● Acute surgical Patient with dyspepsia and gastric Between 20-25°C
For preparation of suppositories Increase risk of abdominal inflammatory bowel irritation. Protect from
diagnostic electrolyte imbalance conditions disease. humidity
procedures, in pre- Constipation ● Severe If you are taking antacids,
and postoperative Adult dehydration Patient with renal wait at least 1 hour RECTAL
treatment and in - 1-2 tablet/s, ● Appendicitis impairment. before taking bisacodyl. Below 30°C
conditions which relief in 6- ● Acute - it will decrease
require defecation to 12hr. inflammatory Lactation mother. therapeutic use and
be facilitated. bowel diseases increase risk of
Complete bowel dyspepsia and gastric
clearance irritation.
Adult & children >10
yr.
- 2-4 tab the Avoid prolonged use for
night before more than 5 days.
<10 yr.
- 1 tab the night
before

Glycerin (Rhea - For managing - 1.955 grams rectal - Rectal - No known drug - Hypersensitivity to - Do not use when - Do not use for longer Store between 8°C
Glycerin constipation suppository irritation/burning interactions glycerin abdominal pain, than 1 week to 15°C. DO NOT
Suppository) - Have the infant lie - Abdominal - Severe fecal nausea, or vomiting - Do not use this product FREEZE.
on their side with the discomfort/ cramps impaction (large, present (unless more than once daily
lower leg - Small amounts of hard mass of stool directed by physician) - If the suppository is too Keep the container
straightened out and mucus in the stool that gets stuck so - Do not use if there is soft to insert, chill in the tightly closed in a
upper leg bent badly in your colon or GI obstruction refrigerator for 30 cool, dry place.
toward the stomach rectum that you can't minutes or run cold
- Gently insert the push it out) water over it before
suppository using removing the foil
the finger, pointed wrapper
end first - If desired, the
- Have the baby lie suppository may be
down for 15-20 moistened with
minutes if possible, lukewarm water
to keep the - Do not use petroleum
suppository from jelly or mineral oil
coming out - FOR RECTAL USE
ONLY

Biological Preparations

Tetanus vaccine Passive immunization Adult & Children - Injection-site - May reduce the - Hypersensitivity to - Previous systemic - Dispense with ice to Store at 2°C to 8°C.
(Sero-Tet®: vial) against infection - 250 IU for reactions: pain, efficacy of live human tetanus allergic reactions to continue the cold chain DO NOT FREEZE.
(Tetagam P®: pre- caused by Clostridium prophylaxis soreness, and vaccines immunoglobulin or immune globulin management of the
filled syringe) tetani. - Not <5,000 IU for tenderness - Increased risk of human - Patients with biologicals. Keep the container
treatment - Increased body bleeding with immunoglobulin coagulation disorders - Advise the patient to in the outer carton
[Tetanus immune - IM use temperature, anticoagulants or thrombocytopenia have a working in order to protect
globulin, human] nephritic - DO NOT thermometer inside the its contents from
- 250 IU/mL vial, syndrome, ADMINISTER container (with ice) to light.
pre-filled syringe anaphylactic shock INTRAVENOUSLY. monitor the temperature
- Pregnancy category
C

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

Aspirin (Aspilet®) For primary prevention Take each dose - increased Acetazolamide: Known Gastrointestinal This medicine should be Store at
of thromboembolic (80mg) of aspirin bleeding tendency Increased serum hypersensitivity to Bleeding Warning: used on an as-needed temperatures not
disorders and with a full glass of - indigestion acetazolamide aspirin. This product contains basis exceeding 30°C.
cardiovascular events: water unless the - Loss of hearing concentrations and Patients with asthma, an NSAID, which may The tablet must be
Ischemic stroke; patient is fluid - Severe bleeding toxicity due to rhinitis, and nasal cause severe swallowed whole with a
Transient ischemic restricted. in the stomach or competition at the polyps. Aspirin may gastrointestinal glass of water. Do not
attack (TIA); Acute Aspirin maintenance intestines renal tubule for cause severe bleeding. chew, crush, or bite the
myocardial infarction should be initiated - Fast heartbeat secretion. urticaria, Coagulation enteric-coated tablet
(MI). once hypertension is - Lyell's syndrome Anticoagulant angioedema, or Abnormalities: Aspirin since this may cause
Aspilets: Prevention of controlled. Rarely: therapy (Heparin, bronchospasm. can inhibit platelet inappropriate release
recurrent MI; Unstable -difficulty in Warfarin): Increased Avoid use in children function leading to an and absorption of the
angina pectoris; Dosage for short- breathing risk of bleeding or teenagers for viral increase in bleeding drug
Chronic stable angina skin rash because of drug-drug infections, with or time. Avoid its use in Patients who consume
term chest pain
pectoris. viral infections of interactions and the without fever, patients with inherited three or more alcoholic
Recommended: 75- the nose and throat effect on platelets. because of the risk of (hemophilia) or drinks every day should
160 mg once daily Beta-blockers: Reye's syndrome with acquired (liver disease be counseled about the
Diminished concomitant use of or vitamin K bleeding risks involved
Dosage for hypotensive effects aspirin in certain viral deficiency) bleeding with chronic, heavy
of beta-blockers due illnesses. disorders. alcohol use while taking
unexpected chest
to inhibition of renal General: Do not use in aspirin.
pain prostaglandins, patients with severe
Recommended: 75- leading to decreased renal failure
160 mg once daily renal blood flow, and (glomerular filtration
salt and fluid rate >10 mL/minute)
retention. and severe hepatic
Dosage for stroke or Diuretics: Diminished insufficiency.
mini-stroke (also effectiveness of Avoid aspirin use one
called, TIA) diuretics in patients week prior to and
Recommended: 75- with underlying renal during labor, delivery,
325 mg once daily or cardiovascular and any surgical
disease due to procedure because it
inhibition of renal can result in excessive
Dosage for heart prostaglandins, blood loss.
attack leading to decreased
renal blood flow and
Recommended:
salt and fluid
150-450 mg as soon
retention.
as possible after
 symptoms of a heart Methotrexate:
attack are seen Salicylate may inhibit
renal clearance of
Dosage for methotrexate,
leading to bone
prevention of
marrow toxicity,
complications after especially in the
heart surgery elderly or renal
Recommended: 75- impaired.
160 mg once daily NSAIDs: Increased
bleeding or may lead
to decreased renal
Dosage for function.
prevention of heart Oral hypoglycemics:
attack Moderate doses of
aspirin may increase
Recommended: 75-
the effectiveness of
160 mg once daily
oral hypoglycemic
drugs, leading to
Minimum Age hypoglycemia.
16 years

Plavix® Prevention of Recent MI & stroke diarrhoea, Increased risk of Hypersensitivity. Monitor blood cell May be taken with or Store at
atherothrombotic or established abdominal pain, bleeding: oral count; cross reactivity. without food. Try to take temperatures not
Generic Name: events in recent peripheral arterial indigestion, anticoagulants Active pathological it at the same time each exceeding 30°C
Clopidogrel MI/stroke or disease: 75 mg as a vomiting, (warfarin) , bleeding eg, peptic Patients at risk of day.
bisulfate established peripheral single daily dose. constipation, Injectable ulcer or intracranial increased bleeding
arterial disease. nausea, headache, anticoagulants hemorrhage. from trauma, surgery Clopidogrel must be
Other Brands: Patients w/ non-ST Patient w/ non-ST- dizziness, and glycoprotein IIb/IIIa or other pathological taken regularly for it to be
Clopiwin-75® segment elevation segment elevation numbness or inhibitors, heparin, conditions & those effective. Continue taking
RiteMED acute coronary acute coronary tingling sensation thrombolytics, receiving aspirin, this medicine even when
Clopidogrel® syndrome (unstable syndrome (unstable in the hands and NSAIDs. heparin, glycoprotein you feel better. Do not
Artehogrel® angina or non-Q wave angina/non-Q-wave feet. IIb/IIIa inhibitors, stop taking it unless
MI) & for patients w/ MI: Single 300-mg Increased occult GI NSAIDs, SSRIs or instructed by the doctor.
ST segment elevation loading dose, then Alert your doctor blood loss w/ thrombolytics.
acute MI in continued at 75 mg quickly if you naproxen. If you miss a dose and it
combination w/ once daily. Should experience any of Discontinue use 5-7 is within less than 12
acetylsalicylic acid be initiated & the following: May affect platelet days prior to surgery. hours of your usual time,
(ASA). Prevention of continued w/ ASA fever, red or purple activation & take the missed dose and
atherothrombotic & (75 mg up to 325 spots on the skin, increase risk of Px who have lesions return to your normal
thromboembolic mg once daily). unexplained bleeding w/ SSRIs. w/ a propensity to dosing schedule.
events in atrial extreme tiredness, bleed (ie, GI &
fibrillation in Patient w/ ST- confusion Reduced drug intraocular); recent If you missed your dose
combination w/ ASA. segment elevation yellowing of the levels of active transient ischemic for more than 12 hours,
acute MI: 75 mg skin or eyes metabolite w/ strong attack or stroke; skip the missed dose and
Clopidogrel is a blood- once daily in rashes, or moderate thrombotic return to your normal
thinning medicine. It is combination w/ ASA breathlessness, CYP2C19 inhibitors thrombocytopenic dosing schedule.
used on its own or (w/ or w/o swollen face, eyes, (eg, omeprazole); purpura; acquired
together with other thrombolytics). mouth or throat proton pump hemophilia; CYP2C19 DO NOT double a dose
medicines (e.g. inhibitors. poor metabolizers w/ under any
 aspirin) to prevent Atrial fibrillation: acute coronary circumstances.
blood clots. 75 mg as a single Increased plasma syndrome or
daily dose. Should conc of CYP2C8 undergoing If you often forget to take
Blood clots that form in be initiated & substrate drugs percutaneous your medicine, let your
a blood vessel can continued w/ ASA (eg, repaglinide, coronary intervention; doctor and pharmacist
cause a heart attack or (75-100 mg daily). paclitaxel). cross-reactivity know.
a stroke. This among
medicine helps reduce Cross-reactivity on thienopyridines. Avoid alcohol.
the risk of harmful thienopyridines (eg,
blood clots in your ticlopidine & Galactose intolerance, Avoid excessive
body. prasugrel). Lapp lactase consumption of
deficiency or glucose- grapefruit or grapefruit
galactose juice
malabsorption.

Renal & hepatic

impairment.

Should not be used

during pregnancy.
Lactation.

Childn.

Vitamins and Supplements

Storage
Drug Indication Dose Side Effects Interactions Contraindications Special Precautions Counselling Points
Conditions

Food supplements Food supplement 500 mg capsule MX3 has no over Anticoagulant and N/A For adult use only. One capsule 2x a day Store at
(MX3 Capsule) dosage because it antiplatelet (taking Not intended for with a glass full of water. temperatures not
is a natural food MX3 with these children, pregnant, exceeding 30°C.
supplement, it has drugs may slow and lactating women.
no side effects and blood clotting and
no adverse increase bleeding
reaction time) - may lead to
bruising and
bleeding.
Mangosteen
products have
antioxidant effects
and may interfere
with the action of
some chemotherapy
agents and with
radiotherapy.
 Vitamin C (Poten- Treatment & 500 mg tab per day. Significant: Increased absorption Renal, urinary or Patients with diabetes May be taken with or Oral: Store below
Cee tablet) prevention of vit C May increase to 1 Acute or chronic of Fe. Increased gallbladder stones. mellitus, G6PD without food. 25°C. Protect from
deficiency disorders. g/day. oxalate excretion of Fe with deficiency, light and moisture.
nephropathy desferrioxamine. haemochromatosis, Onset: 2 days to 3 weeks
(prolonged use; Induced tissue history of renal stones (reversal of scurvy
large doses). desaturation with (e.g. oxalate kidney symptoms).
aspirin, nicotine, Fe, stones),
GI disorders: phenytoin, predisposition to Excretion: Via urine (with
Diarrhoea, nausea, tetracycline, recurrent renal calculi. high concentrations)
vomiting, estrogen in oral Renal impairment.
heartburn. contraceptives, some Children (<2 years of Overdosage:
appetite age) and elderly. Symptoms: Diarrhoea,
Nervous system suppressants and Pregnancy and formation of renal oxalate
disorders: anticonvulsants. May lactation. calculi.
Dizziness, increase the Management: Supportive
headache. absorption of Al- and symptomatic
Vascular disorders: containing antacids. treatment.
Flushing. May diminish the
activity of In most cases, lowering
anticoagulants (e.g. or eliminating Vitamin C
warfarin). May in supplement form
increase the serum should be enough to
concentration of eliminate most or all
estrogen derivatives. overdose symptoms.
May decrease the Drinking more water
serum concentration should also help to flush
of amphetamines. out your body and help
you recover from an
Alcohol may overdose.
decrease ascorbic
acid levels.

Replacing branded drugs with generics:

Scenario: walay ing ato nga brand sa pharmacy

: Good Morning ma’am, I am chichay, the pharmacy in charge for today. How may I help you?

“gets the prescription”

: Ma’am, we actually don’t have Ambrolex but we have RiteMed AMBROXOL, which is the generic counterpart of Ambrolex. They are completely the same and RiteMed Ambroxol
is more affordable.

“Is that effective?”

: RiteMed Ambroxol contains the same active ingredient as Ambrolex. Their strength and dose is the same and generic drugs are as effective as branded drugs.