Drug Lit

ceftazidime
MIMS Class : Cephalosporins

See available brands of ceftazidime
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Indication Listed in Dosage.

Dosage Adult: IV/IM Susceptible infections 1-6 g/day in divided doses. Pseudomonal lung
infections in patients w/ cystic fibrosis 90-150 mg/kg/day in 3 divided doses, up to 9
g/day. Prophylaxis of surgical infection in patients undergoing prostate surgery 1 g at the
induction of anesth, may repeat upon catheter removal.
Click to view Dosage by Indications
Contraindications Hypersensitivity to cephalosporins.
Special Precautions History of penicillin allergy; severe renal impairment; pregnancy, lactation.
Adverse Drug Hypersensitivity, dizziness, diarrhoea, nausea, vomiting, renal impairment, rash, erythema
Reactions multiforme, thrombocytopaenia, superinfection, phloebitis and thrombophloebitis at the site of
injection.
Potentially Fatal: Anaphylactic reactions, nephrotoxicity, pseudomembranous colitis.
Drug Interactions Probenecid may decrease ceftazidime elimination time.
Potentially Fatal: Furosemide and aminoglycosides may increase nephrotoxicity.
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Lab Interference For caution against possible drug interference in lab test results ... click to view
Pregnancy Category
(US FDA)
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there
are no controlled studies in pregnant women or animal-reproduction studies have shown an
adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in
women in the 1st trimester (and there is no evidence of a risk in later trimesters).
Storage For special storage condition to ensure optimal shelf-life of medicine... click to view
Mechanism of Action For details of the mechanism of action, pharmacology and pharmacokinetics and
toxicology ... click to view
MIMS Class Cephalosporins
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ceftriaxone
MIMS Class : Cephalosporins
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Dosage Adult: IV Typhoid fever 2 g once daily for 14 days. IV/IM Susceptible infections 1-2 g/day, up
to 4 g/day for severe infections. Surgical prophylaxis 1 g as a single dose 0.5-2 hr pre-
op. IM Uncomplicated gonorrhoea; Prevention of secondary meningococcal meningitis 250
mg as a single dose.
Contraindications Hypersensitivity to cephalosporins; hyperbilirubinaemic neonates. Do not use calcium or calcium-
containing solutions or products with or within 48 hr of ceftriaxone administration due to risk of
calcium-ceftriaxone precipitate formation.
Special Precautions History of penicillin allergy; severe renal impairment; pregnancy and lactation; superinfection.
Adverse Drug Superinfection; anaphylaxis; diarrhoea; local reactions; blood dyscrasias; rash, fever, pruritus;
Reactions elevated transaminases and alkaline phosphatase; leucopenia, neutropenia.
Potentially Fatal: Pseudomembranous colitis; nephrotoxicity.
Drug Interactions Disulfiram-like reaction with alcohol.
Potentially Fatal: Nephrotoxicity with aminoglycosides and furosemide.
Pregnancy Category
(US FDA)
MIMS Class Cephalosporins
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menuid=mng&name=ceftriaxone&brief=true&h=ceft
riazone&CTRY=PH&searchstring=Ceftriazone
digoxin
MIMS Class : Cardiac Drugs

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Dosage Adult: PO Heart failure; Supraventricular arrhythmias<>D> Rapid digitalisation: Loading
dose: 0.75-1.5 mg in the 1st 24 hr. Slow digitilisation: 250 mcg 1-2 times/day. Uusal
maintenance: 125-250 mcg/day. IV Emergency heart failure For patients who have not
received cardiac glycosides in the previous 2 wk: 0.5-1 mg via infusion as a single dose or in
divided doses. Maintenance: Usually via oral admin.
Administration May be taken with or without food.
Overdosage For action to be taken in the event of accidental overdose ... click to view
Contraindications Digitalis toxicity, ventricular tachycardia/fibrillation, obstructive cardiomyopathy. Arrhythmias due
to accessory pathways (e.g. Wolff-Parkinson-White syndrome).
Special Precautions Cardiac dysrhythmias, hypokalaemia, hypertension, IHD, hypercalcaemia, hypomagnesaemia,
electroconversion, chronic cor pulmonale, aortic valve disease, acute myocarditis, congestive
cardiomyopathies, constrictive pericarditis, heart block, elderly, renal impairment, abnormalities
in thyroid function; pregnancy. IV digoxin can only be given to patients who have not received
cardiac glycosides in the preceding 2 wk.
Adverse Drug Extra beats, anorexia, nausea and vomiting. Diarrhoea in elderly, confusion, dizziness,
Reactions drowsiness, restlessness, nervousness, agitation and amnesia, visual disturbances,
gynaecomastia, local irritation (IM/SC inj), rapid IV admin may lead to vasocostriction and
transient hypertension.
Potentially Fatal: Cardiac arrhythmias in combination with heart block.
Drug Interactions Effectiveness reduced by phenytoin, neomycin, sulphasalazine, kaolin, pectin, antacids and in
patients receiving radiotherapy. Metoclopramide may alter the absorption of solid dosage forms
of digoxin. Blood levels increased bycalcium channel blockers, spironolactone, quinidine and
calcium salts.
Potentially Fatal: Electrolyte imbalances such as hypokalaemia and hypomagnesemia (e.g.
admin of potassium-losing diuretics, corticosteroids) can increase the risk of cardiac toxicity.
Food Interaction For caution against potential drug-food interactions ... click to view
Pregnancy Category
(US FDA)
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic
or embryocidal or other) and there are no controlled studies in women or studies in women and
animals are not available. Drugs should be given only if the potential benefit justifies the
potential risk to the foetus.
MIMS Class Cardiac Drugs
ATC Classification C01AA05 - digoxin; Belongs to the class of digitalis glycosides. Used in the treatment of heart
failure.
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ciprofloxacin
MIMS Class : Quinolones, Eye Anti-infectives & Antiseptics, Ear Anti-infectives & Antiseptics
See available brands of ciprofloxacin
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Dosage Adult: PO Susceptible infections 250-750 mg twice daily. Acute uncomplicated cystitis 100
mg twice daily for 3 days. Gonorrhoea 250-500 mg as a single dose. Pseudomonal lung
infections in cystic fibrosis 20 mg/kg twice daily. Max: 750 mg twice daily. Prophylaxis
of meningococcal meningitis 500 mg as a single dose. Surgical prophylaxis 750 mg as a
single dose 60--90 mins pre-op. Acute exacerbations of cystic fibrosis Associated w/ P.
aeruginosa infection: 20 mg/kg bid. Max: 750 mg bid. IV Susceptible infections 100-400 mg
twice daily.Pseudomonal lung infections in cystic fibrosis 400 mg twice daily. Max: 400 mg
3 times/day. Ophth Superficial ophth infections As 0.3% soln: Apply every 15 mins for 6 hr,
followed by every 30 mins for day 1, then hrly on day 2 and 4 hrly for days 3-14. Treatment
duration: ≤21 days. Otic Otitis externa; Otitis media As 0.2 or 0.3% soln: Instill 4 drops twice
daily for 7 days.
Administration May be taken with or without food. (May be taken w/ meals to minimise GI discomfort. Do not
take w/ antacids, Fe or dairy products.)
Contraindications Hypersensitivity. Not to be used concurrently with tizanidine. Avoid exposure to strong sunlight
or sun lamps during treatment.
Special Precautions Epilepsy, history of CNS disorders; severe renal or hepatic dysfunction; G6PD deficiency;
maintain adequate hydration; myasthaenia gravis. Caution when used in patients with QT
prolongation or risk factors e.g. bradycardia, pre-existing cardiac disease or uncorrected
electrolyte disturbances. Discontinue treatment if patients experience tendon pain, inflammation
or rupture. Avoid usage in methicillin-resistant staphylococcus aureus (MRSA) infections due to
high level of resistance. May impair ability to drive or operate machinery. Safety and efficacy
have not been established in pregnant and lactating women. Not to be used in children <18 yr;
except where benefit clearly exceeds risk.
Adverse Drug GI disturbances; headache, tremor, confusion, convulsions; rashes; joint pain; phototoxicity.
Reactions Transient increases in serum creatinine. Haematological, hepatic and renal disturbances.
Vasculitis, pseudomembranous colitis and tachycardia. Phototoxicity.
Potentially Fatal: Anaphylactoid reaction; cardiopulmonary arrest.
Drug Interactions Decreased absorption with concurrent sucralfate, magnesium-aluminum
antacids, calcium, iron, zinc and multivitamins. Increased methotrexate and caffeine levels
when taken concurrently with ciprofloxacin. Probenecid reduces renal clearance
of ciprofloxacin. Potentiates oral anticoagulants and glibenclamide. Concurrent use with
corticosteroids may increase tendon rupture. Concurrent use with ciclosporin may cause
transient increases in serum creatinine. CNS excitation may occur with concurrent admin of
quinolones and NSAIDs. Serum concentrations of theophylline are markedly elevated when co-
administered with ciprofloxacin; monitor serum levels of theophylline.
Potentially Fatal: Concurrent use with tizanidine can cause marked elevation in serum levels of
tizanidine; avoid concurrent usage.
Pregnancy Category
(US FDA)
Category C: Either studies in animals have revealed adverse effects on the foetus
(teratogenic or embryocidal or other) and there are no controlled studies in women or studies
in women and animals are not available. Drugs should be given only if the potential benefit
justifies the potential risk to the foetus.
MIMS Class Quinolones / Eye Anti-infectives & Antiseptics / Ear Anti-infectives & Antiseptics
ATC Classification J01MA02 - ciprofloxacin; Belongs to the class of quinolones, fluoroquinolone. Used in the
treatment of systemic infections.
S01AX13 - ciprofloxacin; Belongs to the class of other antiinfectives. Used in the treatment of
eye infections.
S03AA07 - ciprofloxacin; Belongs to the class of antiinfectives used in ophthalmologic and
otologic preparations.
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clarithromycin
MIMS Class : Macrolides

See available brands of clarithromycin
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Dosage Adult: PO Resp tract infections; Skin and soft tissue infections; Susceptible infections 250
mg twice daily, up to 500 mg twice daily for severe infections, for 7-14 days. Mycobacterium avium
complex infections W/ other antimycobacterials: 500 mg twice daily. Leprosy As part of multidrug
therapy: 500 mg/day. H. pylori infection W/ another antibacterial and either a proton pump inhibitor
or H2 antagonist: 500 mg twice daily for 7-14 days. IV Resp tract infections; Skin and soft tissue
infections; Susceptible infections 500 mg twice daily for 2-5 days.
Administration Standard release tab: May be taken with or without food.
Oral susp: May be taken with or without food.
XL & MR tab: Should be taken with food. (Swallow whole, do not chew/crush.)
Contraindications Hypersensitivity. Patients receiving terfenadine, astemizole, pimozide, cisapride and ergot
derivatives. Pregnancy; history of acute porphyria.
Special Precautions Renal and hepatic impairment; macrolide cross-resistance; lactation, children.
Adverse Drug GI upset, glossitis, stomatitis, altered taste; headache, dizziness, hallucinations, insomnia, other
Reactions CNS effects; rash; hepatic dysfunction,
Potentially Fatal: Pseudomembranous colitis, anaphylaxis, Stevens-Johnson syndrome.
Drug Interactions May potentiate oral anticoagulant action. May elevate serum digoxin concentration.
Potentially Fatal: Increases plasma concentrations of terfenadine or astemizole. Increases the risk
of ventricular arrhythmias in patients with preexisting cardiac diseases.
Pregnancy Category
(US FDA)
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or
embryocidal or other) and there are no controlled studies in women or studies in women and
animals are not available. Drugs should be given only if the potential benefit justifies the potential
risk to the foetus.
Mechanism of Action For details of the mechanism of action, pharmacology and pharmacokinetics and toxicology ... click
to view
MIMS Class Macrolides
ATC Classification J01FA09 - clarithromycin; Belongs to the class of macrolides. Used in the treatment of systemic
infections.
menuid=mng&name=clarithromycin&brief=true&h=clarithromycin&CTRY=PH&searchstring=clarithromycin
paracetamol
MIMS Class : Analgesics (Non-Opioid) & Antipyretics
See available brands of paracetamol
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Indication Mild to moderate pain and fever.

Dosage Adult: PO/Rectal 0.5-1 g 4-6 hrly when needed. Max: 4 g/day. IV >50 kg: 1 g 4-6 hrly (Max: 4
g/day); <50 kg: 15 mg/kg 4-6 hrly (Max: 60 mg/kg/day).
Administration May be taken with or without food.
Special Precautions Renal or hepatic impairment; alcohol-dependent patients; G6PD deficiency.
Adverse Drug Nausea, allergic reactions, skin rashes, acute renal tubular necrosis.
Reactions Potentially Fatal: Very rare, blood dyscrasias (e.g. thrombocytopenia, leucopenia, neutropenia,
agranulocytosis); liver damage.
Drug Interactions Reduced absorption of cholestyramine within 1 hr of admin. Accelerated absorption
with metoclopramide. Decreased effect with barbiturates, carbamazepine,
hydantoins, rifampicin and sulfinpyrazone. Paracetamol may increase effect ofwarfarin.
Potentially Fatal: Paracetamol increases the risk of liver damage in chronic alcoholics.
Increased risk of toxicity with other hepatotoxic drugs or drugs which induce microsomal
enzymes e.g. barbiturates, carbamazepine, hydantoins,rifampicin and sulfinpyrazone.
Pregnancy Category
(US FDA)
MIMS Class Analgesics (Non-Opioid) & Antipyretics
ATC Classification N02BE01 - paracetamol; Belongs to the class of anilide preparations. Used to relieve pain and
fever.
menuid=mng&name=paracetamol&brief=true&h=paracetamol&CTRY=PH&searchstring=paracetamol

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ceftazidime

MIMS Class : Cephalosporins

See related ceftazidime information

Indication Listed in Dosage.

See related ceftriaxone information

Indication Listed in Dosage.

MIMS Class : Cardiac Drugs

Indication Listed in Dosage.

See related ciprofloxacin information

Indication Listed in Dosage.

MIMS Class : Macrolides

See related clarithromycin information

Indication Listed in Dosage.

See related paracetamol information

Indication Mild to moderate pain and fever.

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