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Active substance Celexocib
US Brand Celebrex
IN Brand Cobix
Manufacturing by Cipla
Strength 200mg
Form release Blister 10 capsules
Shipping time 7 – 18 days (Depending from the Country)
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Celecoxib is a COX-2 selective nonsteroidal anti-inflammatory drug (NSAID). It is used to treat the pain and inflammation of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain in adults, painful menstruation, and juvenile rheumatoid arthritis in people two years or older.

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.

Celecoxib is used to treat pain or inflammation caused by many conditions such as arthritis, ankylosing spondylitis, and menstrual pain.

Celecoxib is used to treat juvenile rheumatoid arthritis in children who are at least 2 years old. It is also used in the treatment of hereditary polyps in the colon.

Celebrex was one of Pfizer’s “best-selling drugs, amounting to more than $2.5 billion in sales [by 2012], and was prescribed to 2.4 million” people in 2011. By 2012, 33 million Americans had taken Celebrex. As of 2015, the cost for a typical month of medication in the United States is more than $200.

Usual Adult Dose for Pain

Day 1: 400 mg orally once followed by an additional 200 mg orally if needed
Usual dose: 200 mg orally twice a day as needed

Comment: The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.

Use: For the management of acute pain.

Usual Adult Dose for Dysmenorrhea

Day 1: 400 mg orally once followed by an additional 200 mg orally if needed
Usual dose: 200 mg orally twice a day as needed

Comment: Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Use: For the treatment of primary dysmenorrhea.

Usual Adult Dose for Osteoarthritis

Usual dose: 200 mg orally once a day OR 100 mg orally twice a day

Comment: Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Use: For the relief of the signs and symptoms of osteoarthritis.

Usual Adult Dose for Rheumatoid Arthritis

Usual dose: 100 or 200 mg orally twice a day

Comment: Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Use: For the relief of the signs and symptoms of rheumatoid arthritis.

Usual Adult Dose for Ankylosing Spondylitis

Usual dose: 200 mg orally once a day OR 100 mg orally twice a day
-If no effect after 6 weeks, consider increasing dose to 400 mg orally daily
Maximum dose: 400 mg per day

Very common: may affect more than 1 in 10 people:

  • High blood pressure, including worsening of existing high blood pressure*

Common: may affect up to 1 in 10 people:

  • Heart attack*
  • Fluid build-up with swollen ankles, legs and/or hands
  • Urinary infections
  • Shortness of breath*, sinusitis (sinus inflammation, sinus infection, blocked or painful sinuses), blocked or runny nose, sore throat, coughs, colds, flu-like symptoms
  • Dizziness, difficulty sleeping
  • Vomiting*, stomach ache, diarrhoea, indigestion, wind
  • Rash, itching
  • Muscle stiffness
  • Difficulty swallowing*
  • Headache
  • Nausea (feeling sick)
  • Painful joints
  • Worsening of existing allergies
  • Accidental injury

Uncommon: may affect up to 1 in 100 people:

  • Stroke*
  • Heart failure, palpitations (awareness of heart beat), fast heart rate
  • Abnormal liver function, abnormalities in liver-related blood tests
  • Abnormalities in kidney-related blood tests
  • Anaemia (changes in red blood cells that can cause fatigue and breathlessness)
  • Anxiety, depression, tiredness, drowsiness, tingling sensations (pins and needles)
  • High levels of potassium in blood test results (can cause nausea (feeling sick), fatigue, muscle weakness or palpitations)
  • Impaired or blurred vision, ringing in the ears, mouth pain and sores, difficulty hearing*
  • Constipation, burping, stomach inflammation (indigestion, stomach ache or vomiting), worsening of inflammation of the stomach or intestine
  • Leg cramps
  • Raised itchy rash (hives)
  • Eye inflammation
  • Difficulty breathing
  • Skin discolouration (bruising)
  • Chest pain (generalised pain not relating to the heart)
  • Face oedema

Rare: may affect up to 1 in 1,000 people:

  • Ulcers (bleeding) in the stomach, gullet or intestines; or rupture of the intestine (can cause stomach ache, fever, nausea, vomiting, intestinal blockage), dark or black stools, inflammation of the pancreas (can lead to stomach pain), inflammation of the gullet (oesophagus)
  • Low levels of sodium in the blood (a condition known as hyponatraemia)
  • Reduced number of white blood cells (which help protect the body from infection) and blood platelets (increased chance of bleeding or bruising)
  • Difficulty coordinating muscular movements
  • Feeling confused, changes in the way things taste
  • Increased sensitivity to light
  • Loss of hair
  • Hallucinations
  • Bleeding in the eye
  • Irregular heartbeat
  • Flushing
  • Blood clot in the blood vessels in the lungs. Symptoms may include sudden breathlessness, sharp pains when you breathe or collapse
  • Bleeding of the stomach or intestines (can lead to bloody stools or vomiting), inflammation of the intestine or colon
  • Severe liver inflammation (hepatitis). Symptoms may include nausea (feeling sick), diarrhoea, jaundice (yellow discolouration of the skin or eyes), dark urine, pale stools, bleeding easily, itching or chills
  • Acute kidney failure
  • Menstrual disturbances
  • Swelling of the face, lips, mouth, tongue or throat, or difficulty swallowing

Very rare: may affect up to 1 in 10,000 people

  • Serious allergic reactions (including potentially fatal anaphylactic shock)
  • Serious skin conditions such as Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, erythema multiforme and bullous eruption (can cause rash, blistering or peeling of the skin) and acute generalised exanthematous pustulosis (symptoms include the skin becoming red with swollen areas covered in numerous small pustules)
  • A delayed allergic reaction with possible symptoms such as rash, swelling of the face, fever, swollen glands, and abnormal test results (e.g. liver, blood cell (eosinophilia, a type of raised white blood cell count))
  • Bleeding within the brain causing death
  • Meningitis (inflammation of the membrane around the brain and spinal cord)
  • Liver failure, liver damage and severe liver inflammation (fulminant hepatitis) (sometimes fatal or requiring liver transplant). Symptoms may include nausea (feeling sick), diarrhoea, jaundice (yellow discolouration of the skin or eyes), dark urine, pale stools, bleeding easily, itching or chills
  • Liver problems (such as cholestasis and cholestatic hepatitis, which may be accompanied by symptoms such as discoloured stools, nausea and yellowing of the skin or eyes)
  • Inflammation of the kidneys and other kidney problems (such as nephrotic syndrome and minimal change disease, which may be accompanied by symptoms such as water retention (oedema), foamy urine, fatigue and a loss of appetite)
  • Worsening of epilepsy (possible more frequent and/or severe seizures)
  • Blockage of an artery or vein in the eye leading to partial or complete loss of vision
  • Inflamed blood vessels (can cause fever, aches, purple blotches on the skin)
  • A reduction in the number of red and white blood cells and platelets (may cause tiredness, easy bruising, frequent nose bleeds and increased risk of infections)
  • Muscle pain and weakness
  • Impaired sense of smell
  • Impaired sense of taste
Active substance Avanafil
US Brand Generic Stendra
IN Brand AVANA
Manufacturing by Sunrise Remedies
Strength 100mg
Form release Blister 4 tab
Shipping time 7 – 18 days (Depending from the Country)
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DescriptionDosageSide EffectsPhotos
Avanafil is a PDE5 inhibitor approved for erectile dysfunction by the FDA on April 27, 2012  and by EMA on June 21, 2013.

Avanafil acts by inhibiting a specific phosphodiesterase type 5 enzyme which is found in various body tissues, but primarily in the corpus cavernosum penis, as well as the retina. Other similar drugs are sildenafil, tadalafil and vardenafil. The advantage of avanafil is that it has very fast onset of action compared with other PDE5 inhibitors. It is absorbed quickly, reaching a maximum concentration in about 30–45 minutes. About two-thirds of the participants were able to engage in sexual activity within 15 minutes.

Do NOT use avanafil if:
  • you are allergic to any ingredient in avanafil
  • you have been advised by your doctor to avoid sexual activity
  • you have severe liver or kidney problems, or you are on dialysis
  • you have certain eye problems (eg, a hereditary degenerative retinal disorder, including retinitis pigmentosa)
  • you have certain heart problems (eg, unstable angina, angina during sexual intercourse, severe heart failure), low blood pressure, or uncontrolled high blood pressure
  • you have had a heart attack, stroke, life-threatening irregular heartbeat, or a certain type of heart surgery within the past 6 months
  • you are taking nitrates (eg, isosorbide, nitroglycerin) in any form (eg, tablet, capsule, patch, ointment), or nitroprusside
  • you use certain recreational drugs called “poppers” (eg, amyl nitrate or nitrite, butyl nitrate or nitrite)
  • you take another PDE5 inhibitor (eg, tadalafil, sildenafil) or another medicine for ED
  • you are taking atazanavir, boceprevir, clarithromycin, indinavir, itraconazole, ketoconazole, mifepristone, nefazodone, nelfinavir, ritonavir, saquinavir, telaprevir, telithromycin, or voriconazole

Usual Adult Dose for Erectile Dysfunction

Initial dose: 100 mg orally as needed approximately 30 minutes before sexual activity.
Maintenance dose: 50 to 200 mg orally as needed 30 minutes before sexual activity.
Maximum dose: 200 mg orally once a day

Commonly reported side effects of avanafil include: headache and flushing. Other side effects include: nasopharyngitis.
Active substance Modafinil
US Brand Provigil
IN Brand Modvigil
Manufacturing by HAB Pharmaceutical
Strength 200mg
Form release Blister 10 tabs
Shipping time 7 – 18 days (Depending from the Country)
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Modafinil is a medication that promotes wakefulness.

Modafinil is used to treat excessive sleepiness caused by sleep apnea, narcolepsy, or shift work sleep disorder.

Modafinil may also be used for purposes not listed in this medication guide.

For narcolepsy, take this medication by mouth with or without food as directed by your doctor, usually once daily in the morning. Or, if your doctor directs you to, the total daily dose of modafinil may be divided into a morning dose and a noon dose.

For obstructive sleep apnea, take this medication by mouth with or without food as directed by your doctor, usually once daily in the morning. Continue your other treatment (such as the CPAP machine, mouth device) unless your doctor tells you to stop.

If you are using modafinil for shift work sleep disorder, take it by mouth with or without food as directed by your doctor, usually once a day 1 hour before you start your work shift.

The dosage is based on your medical condition and response to treatment. Take this medication regularly to get the most benefit from it.

Modafinil side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Modafinil can cause skin reactions that may be severe enough to need treatment in a hospital. Stop taking this medicine and get emergency medical help if you have:

  • skin rash or hives, blisters or peeling;
  • mouth sores, trouble swallowing;
  • fever, shortness of breath;
  • swelling in your legs;
  • dark urine, jaundice (yellowing of the skin or eyes); or
  • swelling in your face, eyes, lips, tongue, or throat.

Stop using modafinil and call your doctor at once if you have:

  • depression, anxiety, suicidal thoughts or actions;
  • hallucinations, unusual thoughts or behavior, aggression, being more active or talkative than usual;
  • chest pain, trouble breathing, uneven heart beats; or
  • the first sign of any skin rash, no matter how minor you think it might be.

Common side effects may include:

  • headache, dizziness;
  • feeling nervous or anxious;
  • back pain;
  • nausea, diarrhea, upset stomach;
  • sleep problems (insomnia); or
  • stuffy nose.

 

Active substance Armodafinil
US Brand Nuvigil
IN Brand Artvigil
Manufacturing by HAB Pharmaceutical
Strength 150mg
Form release Blister 10 tablets
Shipping time 7 – 18 days (Depending from the Country)
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Armodafinil (trade name Nuvigil / Waklert / Artvigil) is the enantiopure compound of the wakefulness-promoting agent, or eugeroic, modafinil (Provigil / Modalert / Modvigil). It consists of only the (R)-(−)-enantiomer of the racemic modafinil. Armodafinil is produced by the pharmaceutical company Cephalon Inc. and was approved by the U.S. Food and Drug Administration (FDA) in June 2007.[3][4]In 2016, the FDA granted Mylan rights for the first generic version of Cephalon’s Nuvigil to be marketed in the U.S.

Usual Adult Dose for Narcolepsy

150 to 250 mg orally once a day in the morning

Usual Adult Dose for Obstructive Sleep Apnea/Hypopnea Syndrome

150 to 250 mg orally once a day in the morning

Usual Adult Dose for Shift Work Sleep Disorder

150 mg orally once a day approximately 1 hour prior to the start of the work shift

In placebo-controlled studies, the most commonly observed side effects were headache, xerostomia (dry mouth), nausea, dizziness, and insomnia.

Possible side effects also include depression, anxiety, hallucinations, euphoria, extreme increase in activity and talking, anorexia, tremor, thirst, rash, suicidal thoughts, and aggression.

Active substance Pramipexole
US Brand Mirapex
IN Brand Pramipex / Pramirol
Manufacturing by SunPharma / Intas
Strength 0.25mg / 0.5mg
Form release Blister 1 tab
Shipping time 7 – 18 days (Depending from the Country)
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Pramipexole (Mirapex, Mirapexin, Sifrol, Pramipex, Pramirol) is a dopamine agonist of the non-ergoline class indicated for treating Parkinson’s disease (PD) and restless legs syndrome (RLS).

Pramipex / Pramirol tablets contain pramipexole, a nonergot dopamine agonist. The chemical name of pramipexole dihydrochloride is (S)-2-amino-4,5,6,7-tetrahydro-6-(propylamino)benzothiazole dihydrochloride monohydrate. Its empirical formula is C10H17N3S •2HCl•H2O, and its molecular weight is 302.26. The structural formula is:

 

MIRAPEX® (pramipexole dihydrochloride) Structural Formula Illustration

Pramipexole dihydrochloride is a white to off-white powder substance. Melting occurs in the range of 296°C to 301°C, with decomposition. Pramipexole dihydrochloride is more than 20% soluble in water, about 8% in methanol, about 0.5% in ethanol, and practically insoluble in dichloromethane.

Pramipex / Pramirol tablets, for oral administration, contain 0.125 mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, or 1.5 mg of pramipexole dihydrochloride monohydrate. Inactive ingredients consist of mannitol, corn starch, colloidal silicon dioxide, povidone, and magnesium stearate.

Usual Adult Dose for Parkinson’s Disease

Immediate-release:
Initial dose: 0.125 mg orally three times a day
Titration: Increase gradually in small dose increments no more frequently than ever 5 to 7 days
Maintenance dose: 1.5 to 4.5 mg per day based on efficacy and tolerability
Maximum dose: 4.5 mg per day

Comment: The following dose titration was used in clinical trials:
Week 2, 0.25 mg 3 times a day
Week 3, 0.5 mg 3 times a day
Week 4, 0.75 mg 3 times a day
Week 5, 1 mg 3 times a day
Week 6, 1.25 mg 3 times a day
Week 7, 1.5 mg 3 times a day.
-When used in combination with levodopa, the levodopa dose was reduced by an average of 27% from baseline providing a concomitant dose of approximately 800 mg per day.

Extended-release:
Initial dose: 0.375 mg orally once a day
Titration: Increase gradually no more frequently than every 5 to 7 days, first dose increase should be to 0.75 mg once a day followed by incremental increases of 0.75 mg; assess therapeutic response and tolerability at a minimum of 5 days after each dose increase.
Maximum dose: 4.5 mg per day

SWITCHING FROM IMMEDIATE-RELEASE TO EXTENDED-RELEASE:
-Patients may be switched overnight from immediate-release tablets to extended-release tablets at the same daily dose; monitor closely to determine if dose adjustments may be necessary.

Comments:
-If a significant interruption in therapy occurs, re-titration may be necessary; upon discontinuation, doses should be tapered.

Use: Treatment of Parkinson’s disease

Usual Adult Dose for Restless Legs Syndrome

Immediate-release:
Initial dose: 0.125 mg orally once a day 2 to 3 hours before bedtime
Titration: If needed, dose may be titrated upwards by increments of 0.125 mg every 4 to 7 days.
Maximum dose: 0.5 mg orally once a day

Comments:
-Extended-release tablets are not indicated for Restless Legs Syndrome.
-Doses of 0.75 mg once a day were used in clinical trials, but were not found to provide additional benefit as compared to the 0.5 mg dose.

Use: For the treatment of moderate to severe primary Restless Legs Syndrome.

Common side effects of pramipexole may include:

  • Headache
  • Peripheral edema (Tan EK, Ondo W. Clinical characteristics of pramipexole-induced peripheral edema. Arch Neurol.
  • Hyperalgesia (body aches and pains)
  • Nausea and vomiting
  • Sedation and somnolence
  • Decreased appetite and subsequent weight loss
  • Orthostatic hypotension (resulting in dizziness, lightheadedness, and possibly fainting, especially when standing up)
  • Insomnia
  • Hallucinations (seeing, hearing, smelling, tasting or feeling things that are not there)
  • Twitching, twisting, or other unusual body movements
  • Unusual tiredness or weakness
Active substance Bromocriptine Mesylate
US Brand Parlodel
IN Brand Proctinal / Sicriptin
Manufacturing by GSK / Serum
Strength 1.25mg / 2.5mg
Form release Blister 10 tab
Shipping time 7 – 18 days (Depending from the Country)
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Bromocriptine (INN; trade names Parlodel, Cycloset, Brotin (Pakistan)), an ergoline derivative, is a dopamine agonist that is used in the treatment of pituitary tumors, Parkinson’s disease (PD), hyperprolactinaemia, neuroleptic malignant syndrome, and type 2 diabetes.

Amenorrhea, female infertility, galactorrhea, hypogonadism, and acromegaly may all be caused by pituitary problems, such as hyperprolactinaemia, and therefore, these problems may be treated with this drug. Bromocriptine has completely treated gestational macromastia eliminating the need for reduction surgery, in a recent case. It has also been used in treating nonpuerperal mastitis. Since the late 1980s it has been used, off-label, to reduce the symptoms of cocaine withdrawal. In 2009, bromocriptine mesylate was approved by the FDA for treatment of type 2 diabetes under the trade name Cycloset (VeroScience). It is currently unknown how this drug improves glycemic control, but it has been shown to reduce HbA1c by ~0.5 percentage points.

Usual Adult Dose for Hyperprolactinemia

Initial: 1.25 mg to 2.5 mg orally daily.
Titration: Add 2.5 mg orally, as tolerated, to the treatment dosage every 2 to 7 days.
Maintenance: 2.5 mg to 15 mg orally daily.

Usual Adult Dose for Acromegaly

Initial: 1.25 mg to 2.5 mg orally once daily, with food, at bedtime for 3 days.
Titration: Add 1.25 mg to 2.5 mg orally, as tolerated, to the treatment dosage every 3 to 7 days.
Maintenance: 20 mg to 30 mg orally daily

The maximum dosage should not exceed 100 mg/day.

Usual Adult Dose for Parkinson’s Disease

Initial: 1.25 mg twice daily with meals.
Titration: Add 2.5 mg/day, with meals, to dosage regimen every 14 to 28 days.
Maximum dosage: 100 mg/day.

Usual Adult Dose for Diabetes Type 2

For the Cycloset (R) trade name of bromocriptine only:

Initial: 0.8 mg orally daily taken within two hours after waking in the morning with food
Titration: Increase by 0.8 mg weekly as tolerated
Maintenance: 1.6 to 4.8 mg orally daily taken within two hours after waking in the morning with food

The maximum dosage should not exceed 4.8 mg daily.

Most frequent side effects are nausea, orthostatic hypotension, headaches, and vomiting through stimulation of the brainstem vomiting centre.

Vasospasms with serious consequences such as myocardial infarction and stroke that have been reported in connection with the puerperium, appear to be extremely rare events.

Peripheral vasospasm (of the fingers or toes) can cause Raynaud’s Phenomenon. Bromocriptine use has been anecdotally associated with causing or worsening psychotic symptoms (its mechanism is in opposition of most antipsychotics, whose mechanisms generally block dopamine).

Pulmonary fibrosis has been reported when bromocriptine was used in high doses for the treatment of Parkinson’s disease.

Active substance Cilostazol
US Brand Pletal
IN Brand Pletoz
Manufacturing by Cipla
Strength 50mg / 100mg
Form release Blister 10 tabs
Shipping time 7 – 18 days (Depending from the Country)
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Cilostazol is a quinolinone-derivative medication used in the alleviation of the symptoms of intermittent claudication in individuals with peripheral vascular disease. It is manufactured by Otsuka Pharmaceutical Co. under the trade name Pletal.

Although drugs similar to cilostazol have increased the risk of death in patients with congestive heart failure, studies of significant size have not addressed people without the disease.

Cilostazol is a phosphodiesterase inhibitor with therapeutic focus on cyclic adenosine monophosphate (cAMP). It inhibits platelet aggregation and is a direct arterial vasodilator. Its main effects are dilation of the arteries supplying blood to the legs and decreasing platelet coagulation.

Cilostazol is used for:

Reducing symptoms of intermittent claudication (pain, cramping, numbness, or weakness in the legs) that may occur with walking. It may also be used for other conditions as determined by your doctor.

Cilostazol is a phosphodiesterase type 3 inhibitor. Cilostazol works by widening blood vessels to increase blood flow. It also decreases the ability of platelets to stick together and form clots.

Do NOT use cilostazol if:

  • you are allergic to any ingredient in cilostazol
  • you have heart failure, bleeding problems or a disorder that causes the inability to form blood clots, or active bleeding (eg, bleeding peptic ulcer, bleeding in the brain)

Contact your doctor or health care provider right away if any of these apply to you.

Dosage Forms & Strengths

tablet

  • 50mg
  • 100mg

Peripheral Vascular Disease

100 mg PO q12hr 30 minutes before or 2 hours after meals

Dosing considerations

  • CYP2C19 or CYP3A4 inhibitors: Reduce dosage to 50 mg PO q12hr

Thrombotic Complications of Coronary Angioplasty (Off-label)

100 mg q12hr 30 minutes before or 2 hours after meals

Dosing considerations

  • May be administered alone or in combination with aspirin 81 mg/day

Renal Impairment

CrCl< 25 mL/min: Use caution

Hepatic Impairment

Moderate to severe: Use caution

Possible side effects of cilostazol use include headache (the most common), diarrhea, severe heat intolerance, abnormal stools, increased heart rate, and palpitations.
Active substance Levetiracetam
US Brand Keppra
IN Brand Levipil / Levera
Manufacturing by Sun Pharma / Intas
Strength 750mg
Form release Blister 10 tab
Shipping time 7 – 18 days (Depending from the Country)
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Levetiracetam has been approved in the United States as add-on treatment for partial (focal), myoclonic, and tonic-clonic seizures. Levetiracetam has been approved in the European Union as a monotherapy treatment for epilepsy in the case of partial seizures, or as an adjunctive therapy for partial, myoclonic, and tonic-clonic seizures.  Levipil has been shown to reduce partial (focal) seizures by 50% or more as an add-on medication. It is also used in veterinary medicine for similar purposes.

Levetiracetam is sometimes used off-label to treat status epilepticus  or to prevent seizures associated with subarachnoid hemorrhages.

Levetiracetam has potential benefits for other psychiatric and neurologic conditions such as Tourette syndrome,  anxiety disorder, and Alzheimer’s disease. However, its most serious adverse effects are behavioral, and its benefit-risk ratio in these conditions is not well understood.

Levetiracetam has not been found to be useful for treatment of neuropathic pain, nor for treatment of essential tremors. Levetiracetam has not been found to be useful for treating autism, but is an effective treatment for partial, myoclonic, or tonic-clonic seizures associated with autism spectrum disorder.

Usual Adult Dose for Epilepsy

PARTIAL ONSET SEIZURES:
-IV: 1000 mg daily given as 500 mg 2 times a day: increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL IMMEDIATE-RELEASE: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL EXTENDED-RELEASE: 1000 mg once a day; increase in increments of 1000 mg every 2 weeks to the maximum daily dose of 3000 mg

MYOCLONIC SEIZURES IN PATIENTS WITH JUVENILE MYOCLONIC EPILEPSY:
-IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg/day. The effectiveness of doses lower than 3000 mg/day has not been studied.

PRIMARY GENERALIZED TONIC-CLONIC SEIZURES:
IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Uses:
-Adjunct therapy in the treatment of partial onset seizures in patients with epilepsy
-Adjunctive therapy in the treatment of juvenile myoclonic epilepsy
-Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with idiopathic generalized epilepsy

Usual Adult Dose for Seizures

PARTIAL ONSET SEIZURES:
-IV: 1000 mg daily given as 500 mg 2 times a day: increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL IMMEDIATE-RELEASE: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. There is no evidence that doses greater than 3000 mg/day confer additional benefit.
-ORAL EXTENDED-RELEASE: 1000 mg once a day; increase in increments of 1000 mg every 2 weeks to the maximum daily dose of 3000 mg

MYOCLONIC SEIZURES IN PATIENTS WITH JUVENILE MYOCLONIC EPILEPSY:
-IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg/day. The effectiveness of doses lower than 3000 mg/day has not been studied.

PRIMARY GENERALIZED TONIC-CLONIC SEIZURES:
IV: 1000 mg daily given as 500 mg 2 times a day; increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.
-ORAL IMMEDIATE-RELEASE: 1000 mg/day, given as twice daily dosing (500 mg 2 times a day); increase in increments of 1000 mg/day every 2 weeks to the maximum daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Uses:
-Adjunct therapy in the treatment of partial onset seizures in patients with epilepsy
-Adjunctive therapy in the treatment of juvenile myoclonic epilepsy
-Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients with idiopathic generalized epilepsy

  • hallucinations, unusual thoughts or behavior;
  • bruising, severe tingling, numbness, pain, muscle weakness;
  • feeling very weak or tired;
  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • problems with walking or movement;
Active substance Zonisamide
US Brand Zonegran
IN Brand Zonisep / Zonimid
Manufacturing by SunPharma / Intas
Strength 100mg
Form release Blister 10 capsules
Shipping time 7 – 18 days (Depending from the Country)
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DescriptionDosageSide EffectsPhotos
Zonisamide is used with other medications to prevent and control seizures (epilepsy). Zonisamide is a sulfonamide anticonvulsant and a carbonic anhydrase inhibitor.Zonisamide is a sulfonamide anticonvulsant approved for use as an adjunctive therapy in adults with partial-onset seizures; infantile spasm, mixed seizure types of Lennox–Gastaut syndrome, myoclonic, and generalized tonic clonic seizure.

Table 1. Adults – recommended dosage escalation and maintenance regimen

Treatment Regimen

Titration Phase

Usual Maintenance Dose
Monotherapy – Newly diagnosed adult patients Week 1 + 2 Week 3 + 4 Week 5 + 6  

300 mg per day

(once a day).

If a higher dose is required: increase at two-weekly intervals in increments of 100 mg up to a maximum of 500 mg.

100 mg/day

(once a day)

200 mg /day

(once a day)

300 mg / day

(once a day)

Adjunctive therapy

– with CYP3A4-inducing agents

(see section 4.5)

Week 1 Week 2 Week 3 to 5 300 to 500 mg per day

(once a day or two divided doses).

50 mg/day

(in two divided doses)

100 mg /day

(in two divided doses)

Increase at weekly intervals in increments of 100 mg
– without CYP3A4-inducing agents; or with renal or hepatic impairment Week 1 + 2 Week 3 + 4 Week 5 to 10 300 to 500 mg per day

(once a day or two divided doses).

Some patients may respond to lower doses.

50 mg/day

(in two divided doses)

100 mg / day

(in two divided doses)

Increase at two-weekly intervals in increments of up to 100 mg
Dizziness, drowsiness, trouble sleeping, lack of coordination, lightheadedness, loss of appetite, diarrhea, or double vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Active substance Topiramate
US Brand Topamax
IN Brand Topamac / Topaz / Topirol
Manufacturing by J&J / Intas / SunPharma
Strength 50 mg / 100mg
Form release blister 10 tablets
Shipping time 7 – 18 days (Depending from the Country)
Availability & Order
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DescriptionDosageSide Effects

Treating seizures in certain patients. It may be used alone or with other medicines. It is also used to prevent migraine headaches. It may also be used for other conditions as determined by your doctor.

Topiramate is an anticonvulsant that is also effective for preventing migraine headaches. It works by affecting several chemicals in the brain that help to reduce seizure activity and prevent migraine headaches from occurring.

The initial dose for Topiramate should be either 12.5 or 25 milligrams taken either once or twice a day. This dose increases by 12.5 or 12 milligrams each week until it reaches the final level, which depends on the use of the drug and how the patient is responding. A typical final dosage is between 100 and 200 mg per day, although some patients benefit from no more than 50 mg. The case of PTSD entails a final dose of approximately 175 mg per day and generally not exceeding 500 mg per day.
The five side effects that were most likely to cause people to discontinue use of Topiramate were psychomotor slowing, fatigue, memory problems, confusion, and somnolence. In rare cases, approximately one person of patients develop kidney stones and a very few develop acute glaucoma.