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Tuesday, 24 April 2018 06:34

Maxzone

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MAXZON

Ceftriaxone

 

Composition

Maxzon 250 mg IM injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 250 mg and each ampoule contains 2 ml Lidocaine Hydrochloride BP 1% solution.

Maxzon 500 mg IM injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 500 mg and each ampoule contains 2 ml Lidocaine Hydrochloride BP 1% solution.

Maxzon 1 g IV injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 1 g and each ampoule contains 10 ml water for Injection USP.

Maxzon 2 g IV injection: Each vial contains sterile Ceftriaxone Sodium USP equivalent to Ceftriaxone 2 g and also contains 2 ampoules of 10 ml water for Injection USP.

 

Description

Maxzon (Ceftriaxone) is a sterile, semi-synthetic, third generation broad-spectrum cephalosporin antibiotic for intravenous/intramuscular administration. The bactericidal activity of ceftriaxone results from inhibition of cell wall synthesis, Ceftriaxone has a high degree of stability in the presence of beta-lactamases both penicillinases and cephalosporinases of gram-positive and gram-negative bacteria.

 

Pharmacology

Ceftriaxone is most effective against the following microorganisms: Gram-positive bacteria; Staphylococcus aureus (including penicillinase producing strains). S. epidermis, S. pneumoniae &    S. bovis. Gram-negative bacteria: Escherichia coli, Heamophilus influenzae (including penicillinase- producing strains), Neisseria gonorrhoeae, Neisseria meningitidis, Proteus mirabilis & Proteus vulgaris. A remarkable feature of ceftriaxone is its relatively long plasma elimination half-life of about 6 to 9 hours, which makes single or once-daily dosage of the drug appropriate for most patients. Ceftriaxone is not metabolized in the body. About 40-65% of a dose of Ceftriaxone is excreted unchanged in the urine; the remainder is excreted in the bile and ultimately found in the feces as unchanged drug and microbiologically inactive compound. The drug is highly protein bound (95%).

 

Indications

Maxzon is indicated for the treatment of the following major infections when caused by susceptible organisms:

1. Renal and urinary tract infections

2. Lower respiratory tract infections, particularly pneumonia

3. Gonococcal infections

4. Skin, soft tissue, bone and joint infections

5. Bacterial meningitis

6. Serious bacterial infections e.g. septicemia

7. ENT infections

8. Infections in cancer patients

9. Prevention of postoperative infections

10. Perioperative prophylaxis of infections associated with surgery

11. Typhoid fever.

 

Dosage & Administration

Dose and mode of administration should be determined by the severity of infection, susceptibility of causitive organisms and the patient’s condition. Maxzon may be administered by deep intramuscular injection or slow intravenous injection.

 

Adults & Children over 12 years: The usual adult daily dose standard is 1 g given once a day. In case of severe infections, 2-4 g daily, normally as a single dose every 24 hours. The total daily dose should not exceed 4 g.

 

Paediatric Patient (Children under 12 years): should receive a standard therapeutic dose of 20-50 mg/kg body weight once daily. Incase of severe infections, patient should receive up to 80 mg/kg body weight daily. The total daily dose should not exceed 2 g.

 

Preoperative Use (surgical prophylaxis): A single dose of 1 g administered intravenously 30 minutes to 2 hours before surgery is recommended. 

 

Duration of therapy

Generally, Ceftriaxone therapy should be continued for at least 2 days after the signs and symptoms of infection have disappeared. The usual duration of therapy is 4 to 14 days; in complicated infections, longer therapy may be required.

 

Preparation of Solutions for Intravenous/Intramuscular Injections

For Intravenous Injection: 1 g Maxzon dry powder should be dissolved in 10 ml of water for injection USP with vigorous shaking or 2 g Maxzon dry powder should be dissolved in 20 ml of water for injection USP with vigorous shaking. The injection should be administered over 2-4 minutes, directly into the vein or via the tubing of an intravenous infusion.

 

For Intramuscular Injection: 250 & 500 mg Maxzon dry powder should be dissolved in 2 ml of Lidocaine HCL BP 1% solution with vigorous shaking. It should be injected well within the body of a relatively large muscle. It is recommended that not more than 1 g be injected at one site. The lidocaine solution should never be administered intravenously.

 

Side Effect

Ceftriaxone is generally well tolerated. A few side effects such as gastro-intestinal effects including diarrhoea, nausea and vomiting, stomatitis & glossitis; cutaneous reactions including rash, pruritus, urticaria, oedema & erythema multiforme; hematologic reactions including eosinophilia, thrombocytopenia, leucopenia, anemia and neutropenia; hepatic reactions including elevations of SGOT or SGPT, bilirubinemia; CNS reactions including headache, hyperactivity, nervousness, sleep disturbances, confusion, hypertonia and dizziness were reported. Local phlebitis occurs rarely following intravenous administration but can be minimized by slow injections over 2-4 minutes.

 

Use In Pregnancy & Lactation

Ceftriaxone has not been associated with adverse effects on fetal development in laboratory animals, but its safety in human pregnancy has not been established. Therefore, it should not be used in pregnancy unless absolutely indicated. Because low conc. of ceftriaxone is distributed into breast milk, the drug should be used with caution in nursing woman.

 

Contraindication

Ceftriaxone should not be given to patients with a history of hypersensitivity to Cephalosporin antibiotics. Serious acute hypersensitivity reaction may require the use of subcutaneous epinephrine and other emergency.

 

Precaution

As with other Cephalosporins anaphylactic shock cannot be ruled out even if a thorough patient history is taken. Anaphylactic shock requires immediate counter measures. The stated dosage should not be exceeded. In severe renal impairment accompanied by hepatic insufficiency, dosage reduction is required.

 

Drug Interaction

No impairment of renal function or increased nephrotoxicity has been observed in man after simultaneous administration of Ceftriaxone with diuretics, or with aminoglycosides. A possible disulfiram-like reaction may occur with alcohol. It doesn't interfere with the protein binding of bilirubin. Simultaneous administration of probenecid doesn't alter the elimination of Ceftriaxone.

 

Storage Condition

The recommended maximum storage temperature for Maxzon (Ceftriaxone) injection is 25º C, preferably between 15º-30º C. Reconstituted solutions retain their stability for 6 hours at room temperature or 24 hours at 5º C.

 

Commercial Pack

Maxzon 250 mg IM Injection: Each box containing one vial 250 mg Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 1 ampoule of 2 ml Lidocaine Hydrochloride BP 1 % solution. It also contains disposable syringe (5 ml), baby needle, alcohol pad and first aid bandage.

Maxzon 500 mg IM Injection: Each box containing one vial 500 mg Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 1 ampoule of 2 ml Lidocaine Hydrochloride BP 1 % solution. It also contains disposable syringe (5 ml), baby needle, alcohol pad and first aid bandage.

Maxzon 1 g IV Injection: Each box containing one vial 1 g Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 1 ampoule of 10 ml water for injection USP. It also contains disposable syringe (10 ml), butterfly needle, alcohol pad and first aid bandage.

Maxzon 2 g IV Injection: Each box containing one vial 2 g Ceftriaxone (as sterile Ceftriaxone Sodium USP) and 2 ampoules of 10 ml water for injection USP. It also contains disposable syringe (20 ml), butterfly needle, alcohol pad and first aid bandage.

 

Nevrona

Vitamin B1, B6 & B12

 

Presentation

Nevrona tablet: Each tablet contains Thiamine Mononitrate BP (100 mg), Pyridoxine Hydrochloride BP (200 mg), Cyanocobalamin BP (200 mcg).

 

 

Description

Nevrona is a special preparation of vitamin B1, B6 and B12. The vitamins B1, B6 and B12 are indispensable for a normal course of the nervous metabolism.

 

 Indication & Uses

Nevrona is indicated for the treatment of B1, B6 and B12 deficiency syndrome. It is also indicated in  the treatment of:

>>Diabetic neuropathy

>>Sciatica

>>Peripheral neuralgia

>>Facial neuralgia

>>Lumbago

>>Intercostal neuralgia

>>Myalgia

>>Spinal pain

>>Optic Neuritis

 

Dosage and Administration

Tablets may be administered in a dose of 1 to 3 tablets per day or as directed by the physician.

 

Side Effects

Generally well tolerated. However, a few allergic reactions may be seen.

 

Precautions

Cyanocobalamin should not be given before a diagnosis has been fully established because of the possibility of masking symptoms of subacute degeneration of the spinal cord. Cyanocobalamin is not a suitable form of Vitamin B12 for the treatment of optic neuropathies associated with raised plasma concentrations of cyanocobalamin.

 

Use in pregnancy & lactation

Oral tablet form is recommended but injectable preparation is not recommended due to presence of benzyl alcohol.

 

Contraindications

Should not be used in the patients on Levodopa therapy and hypersensitivity to any of the active ingredients.

 

Drug Interactions

No such drug interactions have been reported.

 

Overdosage

If there is known overdose then treatment is symptomatic and supportive.

 

Commercial Pack

Nevrona Tablet: Each box contains 3 blister strips of 10 tablets.

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