Drug New

S4 - PRESCRIPTION ONLY MEDICINE
PARACETAMOL S2 - PHARMACY MEDICINE

Aniline Analgesics
Indications Pain killer (headache, …) - mild to moderate fever, releave some common cold symptoms (sorethroat,
cough, headache, …)
Adverse/ Skin develops rash (rarely) if overdose, urine colour is dark-brown.

Side Effects
Dosages PAIN RELIEVER (ADULT, ORAL)

1
0.5-1 g q6h. Max 4g/d
PAIN RELIEVER (CHILDREN, ORAL)

2
15 mg/kg q4h or q6h. Max 60 mg/kg/d
Ancillary 13 Do not remove from original packaging until dose required.

Labels
19 Contains Paracetamol. Consult your doctor or pharmacist if taking other paracetamol products.
A SWALLOW WHOLE. Do not chew.
Dose form
* Confirm that the patient is using any other product contains Paracetamol. If so, calculation of required dosage to
be intaken per day is essential. Remember max intake of adult is 4 grams a day.
* Caution regarding excess of alcohol use. (*APF)
* If pain is not relieved in 24 - 48 hours, DO NOT continue to take Paracetamol, seek medical advice.
* Pregnancy: A ; Breastfeeding: May be used.
* S4 when combined.

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GLYCERYL TRINITRATE
Nitrate
Indications Acute Angina or Chronic Angina, Heart Failure
Adverse/ Nausea, diarrhoea, palpitations, hypotention, flushing (*APF)

Side Effects
Dosages Acute Angina , Adult (Ref APF)

1
Sublingual Tab: 300 - 900 mcg ; Sublingual Spray: 400 - 800 mcg (1-2 sprays)
Prevention of Chronic Angina (Ref APF)

2
Patch: 5 - 15 mg up to 14 hours daily

Labels
16 This medicine may cause dizziness especially when you stand up quickly. Ask your doctor or phar
21 Special handling and disposal required - ask your pharmacist.
7b Discard days after opening. Date opened / /
Dose form
* Ancillary Labels: Patches (Label 13, 21, 16) | Tablets (Label 7b, 16, 13) | Spray: 16
* Change to urinary system: dark-brown colour urine.
* Pregnancy: B2; Breastfeeding: Use with caution, monitor side effects of infant.
* Use during or before activity expected to have an angina
* Spray: prime 5 times before first use, spray under tongue
* Tablet: place under tongue, until angina is relieved, spit out, DO NOT swallow to avoid side effects
* Store in bottle, protect from moisture, heat and light
* Discard 3 months after opening.

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AMOXICILLIN
Antibiotics & Penicillin
Indications To kill bacteria (antibiotics, anti-infectives), bites or clenched first injuries
Adverse/ Skin rash, nausea, diarrhoea, gastric upset

Side Effects
Dosages Ault dose

1
ORAL 250 - 500 mg / 8hrs or 1 g twice daily IM/IV 250 mg - 1 g / 6-8hrs
Children dose
2
ORAL 7.5-25 mg/kg / 8hrs IM/IV 10-25 mg/kg 8 hrs. Max 50 mg/kg / 4hrs
Acute otitis media (otitis: painful swelling in ears, cause by infection) Children dose
3
15 mg/kg upto 500 mg / 8 hrs . If compliance, ORAL 30 mg/kg (max 1 g) / 12hrs for 5 days
4
*Compliance: the practice of obeying the rule according to authority
Ancillary D Add the words 'until all used'.

Labels
6 REFRIGERATE. Do not freeze
7a Discard contents after / /
Dose form
* Ancillary Label: For suspension, use label 6, 7a

* Space doses as evenly as possible during waking hours.
* Pregnancy: A ; Breastfeeding: may be used
* Confirm appropriate and antibiotics and dose regime.

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SALBUTAMOL
Beta2 Agonist, Bronchodilator, Cardiovascular Agent
Indications Asthma, exercise-induced asthma
Adverse/ Tachycardia (excessively rapid heartbeat), tremor, electrolyte disturbances (imbalance of ionized salts in
Side Effects
the blood)
Dosages ADULT
1
DPI 200-400 mg tds or qid / MDI 100-200 mg/tds or qid prn or 5-15 mins before exercise
2
ORAL 2-4 mg/tds or qid / NEBULISER 2.5-5 mg/tds or qid prn
CHILDREN
3
MDI 100-200 mg/qqh (every 4 hrs) or q6h (every 6 hrs)
4
NEBULISER < 2yrs, 0.1 mg/kg - 2.5 mg/kg , rpt tds - qid prn , > 2yrs, 2.5-5 mg, rpt tds-qid
5
ORAL 0.15 mg/kg/dose, rpt q6h prn, max single dose is 4 mg/dose
Ancillary 21 Use only with approved or recommended device.
Labels
7b Discard days after opening. Date opened / /
Dose form
* Ancillary Label: 22 (for capsules and nebules), 7b (for foil wrapping)

* Pregnancy: A , Breast-feeding: may be used
* Inhalation device is primed before first use, and again if not use for 2 wks
* PRESCRIPTION ONLY MEDICINE

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OMEPRAZOLE
Proton Pump Inhibitor, Anti-ulcer, Gastrointestinal Agent
Indications Omeprazole is used for treatment of: Peptic Ulcer disease, Zollinger-Allison syndrome, H. Pylori
eradication
Adverse/ Nausea, severe vomiting, epigastric pain, or diarrhoea with blood-stained stools (APF) >>> See doctor
Side Effects
Dosages ADULT DOSE (APF)

1
10-40 g/d
H. pylori eradication (AMH)

2
Oral, 20 mg bd, with 2 antibacterials
Zollinger-Allison syndrome (AMH, APF)

3
Initially, 60 mg ONCE a day, Maintainance: 20-120 mg daily, maximum 80 mg daily
CHILDREN DOSE (APF)

4
<10 kg, 5 mg ONCE d /// 10-20 kg, 10 mg daily, max 20 mg d /// >20 kg, 20 mg d, max 40 mg d

Labels
Dose form
* Precaution if allergic to Omeprazole or Esomeprazole

* Pregnancy: B3. May be used when treatment with antacids and H2 antagonists has failed. If a proton pump
inhibitor is required, omeprazole is preferred. Breastfeeding: Use with caution, excretions in breast milk is expected.
* See doctor instantly if side/adverse effects occur.
* Swallow tablet or capsule whole; do not crush or chew. Alternatively, omeprazole tablets (Losec®, Acimax®,
Omepral®) may be dispersed in water, orange juice or yoghurt; take within 30 minutes.

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SIMVASTATIN
Antihyperlipidemic, HMG-COA Reductase Inhibitor
Indications Hypercholesterolemia, Coronary heart disease (Coronary = connected with the heart)
Adverse/ Muscle pain, tenderness, weakness (APF), headache, insomnia, dizziness (AMH)
Side Effects
Dosages ADULT DOSE (To be taken in the evening)

1
10–80 mg once daily (AMH). Usual dose, 40 mg once daily (AMH)
Child 10–17 years (AMH)

2
Initially 10 mg once daily; range 10–40 mg once daily
Children 2 - 10 years (APF)

3
20 mg/d
Children > 10 years (APF)

4
10-80 mg/d
Ancillary 16 Avoid eating grapefruit or drinking grapefruit juice while being treated with this medicine.
Labels
Dose form
* Take in the evening

* Do exercise and control weight, follow low-fat diet regime
* Seek medical advice if side effects occur
* Pregnancy: D. Breastfeeding: Use contraindicated (If a drug or treatment is contraindicated, there is a medical
reason why it should not be used in a particular situation)

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FLUTICASONE
Adrenal Glucocorticoid , Anti-Inflammatory , Corticosteroid
Indications Maintenance treatment in persistent asthma, Acute asthma, Allergic Rhinitis
Adverse/ dysphonia (disturbance of vocal function), bruising, facial skin irritation following nebulisation
Side Effects
Dosages ADULT DOSE

1
MDI / DPI : 100-250 mcg bd. Use up to 1,000 mcg/d in severse asthma
2
Nebules: 2 mg bd
CHILDREN DOSE
3
MDI / DPI > 1 yrs, 50-100 mcg bd, severse asthma: 500 mcg/d
4
Nebules > 4 years: 1 mg bd for up to 7 days
Ancillary 14 RINSE MOUTH with water after each use.

Labels
Dose form
* THIS MEDICATION IS NOT FOR USE DURING ACUTE ATTACK, but rather a preventive medication
intended for continued and regular use even if no symptoms present.
* Rinse mouth with water after use to prevent oral thrush (infectious disease in mouth) (Label 14 says so)
* Cover eyes during nebulisation because of possible leackage from a mask
* May take more than 1 wk to achieve full benefit
* Pregnancy: B3, Safe to use. Breasf feeding: safe to use

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FRUSEMIDE
Cardiovascular Agent & Loop Diuretics
Indications Hypercalcaemia (high Ca level in blood), congestive heart failure, Renal failure (edema), hypertension,
Adverse/ orthrostatic hypotension, dizziness when standing quickly, dehydration, gout…

Side Effects
Dosages ***APF***ADULT DOSE

1
ORAL, 20-40 mg once or twice daily. May gradually increase to 400 mg/d
Patient with severse renail impairment

2
~1000 mg daily is required
IM / IV
3
20-40 mg every 1-2 hours
CHILDREN DOSE
4
ORAL, 1-2 mg/kg once or twice daily, maximum 6 mg/kg
IM / IV
5
0.5-1 mg/kg every 6-12 hours. Maximum dose 6mg/kg
Ancillary 16 This medicine may cause dizziness especially when you stand up quickly. Ask your doctor or phar
Labels
Dose form
* Pregnancy: C (use not recommended). Breast feeding: Use not recommeded.

* Care with NSAIDs, digoxin, lithium, thiazide diuretics
* Sulfonamide: caution allergies
*** This medicine is usually taken once daily in the morning. If you are taking it twice a day, take the first dose in
the morning and the second dose before 6 pm.
*** You may feel dizzy on standing when taking this medicine. Get up gradually from sitting or lying to minimise
this effect; sit or lie down if you become dizzy.

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RANITIDINE
Anti-ulcer, H2 antogonist
Indications Stress ulcer prophylaxis
Adverse/ nausea, severe vomitting, epigastric pain, black or blood-stained stools

Side Effects
Dosages ADULT DOSE

1
ORAL, 150-300 mg daily in 1-2 doses
2
IV, 50 mg over 5 mins every 6-8 hours
CHILDREN DOSE
3
ORAL, 2-4 mg/kg bd, Max 300 mg/d
4
IV, 2-4 mg/kg daily in 3-4 divided doses.
Ancillary
Labels
Dose form
* Pregnancy: B1 (Safe to use), Breast feeding: use with caution, excreted in breast milk and accumulates.
* Bradycardia (a slow heartbeat rate, usually less than 60 beats per minute) with rapid IV administration. Rate
should not exceed 10 mg/minute.
* Renail impairment: dose adjustment may be necessary.
* If symptoms do not improve after 2 wks of treatment, seek medical advice.

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S2 - PHARMACY MEDICINE
LOPERAMIDE
Opioid antidiarrheal
Indications * Diarrhoea, usually short term treatment in adults

* Intestinal stoma (to reduce frequency and fluidity of motions)
Adverse/ abdominal pain and bloating, nausea, vomiting, constipation

Side Effects
Dosages ADULT
1
Initially, 4 mg, then 2 mg after each loose bowel action. Maximum daily dose 16 mg
CHILDREN
2
1 month to 1 year: 0.1-0.2 mg/kg twice daily (maximum 2mg/kg daily)
3
> 1 year, 0.1-0.2 mg/kg (max 2mg/dose) tdd daily, up to 1.25 mg/kg daily in divided dose
4
maximum 16 mg daily.
Ancillary
Labels
Dose form
* Pregnancy: B3, Breast feeding: may be used on short term

* If fever or bloody diarrhoea occur, seek medical advice
* Do not use loperamide as an antidiarrhoeal in children, except under specialist supervision for chronic diarrhoea,
eg short gut syndrome
* Seek medical advice if there is no improvement after 48 hours

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METOCLOPRAMIDE
Dopamine antagonist
Indications ***Nausea and vomiting*** Gastric stasis (eg after gastric surgery, diabetic gastroparesis); Difficult
small intestinal intubation
Adverse/ *APF* involuntary eye, facial or limb movement, *AMH* restlessness, drowsiness, dizziness, headache
Side Effects
Dosages ADULT DOSE

1
Nausea and vomitting: 10 mg three times daily. Maximum 0.5 mg/kg daily
CHILDREN DOSE
2
Nausea and vomitting: 15-20 years, 5-10 mg tdd / 5-14 years: 2.5-5 mg tdd
3
3-5 years, 2 mg 2-3 times daily / 1-3 years: 1 mg 2-3 times daily
4
< 1 year: 1 mg twice daily
Vomitting associated with cancer chemotherapy

5
1-2 mg/kg four-hourly. Maximum 10 mg/kg daily.
Ancillary 1 This medicine may cause drowsiness and may increase the effects of alcohol. If affected, do not dri
Labels
Dose form
* Pregnancy: A (safe to use) / Breast feeding: may be used for short term.
* DO NOT take more than the recommended dose. Can cause dystonic reactions
* Higher does may be used for nausea due to chemotherapy.
* Inquire if any other medicine been lost due to vomitting.
* Seek medical advice if side effects occur.
* CAUTION: May cause depression.
* This medicine may make you feel drowsy or dizzy; do not drive or operate machinery until you know how
metoclopramide affects you.

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IBUPROFEN
Analgesics, Non-selective NSAIDs
Indications Pain (especially caused by inflammation), fever, dysfuntional uterine bleeding, Rheumatoid arthritis and
juvenile rheumatoid arthritis, Osteoarthritis
Adverse/ nausea, dyspepsia, GI ulceration or bleeding, raised liver enzymes, diarrhoea, headache, dizziness, salt
Side Effects
and fluid retention, hypertension
Dosages ADULT DOSE ***APF***

1
200-400 mg 3-4 times daily. Maximum 2,400 mg daily
CHILDREN DOSE > 3 months

2
Pain or Fever, 5-10 mg/kg/dose 6-8 hourly as need
3
Anti-inflammatory, Juvenile rheumatoid arthritis, 10 mg/kg/dose 3-4 times a day.
Topical
4
>12 years, rub 4–10 cm into the affected area if needed, up to 4 times daily.
Combination with codeine

5
Adult, 1–2 tabs (of ibuprofen 200 mg and codeine 12.8 mg) qqh qrn, up to a max of 6 tabs daily.
Ancillary 20 TAKE ONCE WEEKLY ON THE SAME DAY.
Labels
B TAKE WITH OR SOON AFTER FOOD.
Dose form
* Pregnancy: C. Use not recommended during third trimester. Breast feeding: safe to use.
* Maximum response should be seen in 1-3 wks.
* CHECK use of over-the-counter NSAIDs.
* CAUTION with diabetes, hypertension, heart failure, asthm, or peptic ulcer.
* CONSIDER stopping 2-3 days before planned surgery, seek medical advice.
* Ibuprofen may reduce aspirin’s antiplatelet activity.
* If you develop swollen ankles, difficulty in breathing, black stools or dark coffee-coloured vomit, stop taking the
medicine and tell your doctor immediately.
* Do not take aspirin for pain relief as it will increase the risk of side effects with this medicine.

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CELECOXIB
Selective-NSAIDs (COX-2-inhibitor)
Indications Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis, Period pain
Adverse/ nausea, dyspepsia, GI ulceration or bleeding, raised liver enzymes, diarrhoea, headache, dizziness, salt
Side Effects
and fluid retention, hypertension
Dosages ADULT DOSE Osteoarthritis

1
200 mg daily in 1-2 divided dose
Rheumatoid Arthritis
2
100 mg Twice daily. Maybe increased to 200 mg twice daily (short term).
Period Pain
3
400 mg daily in 1 or 2 doses on the first day, then 200 mg 1-2 times daily qrn; max 5 days treatment.
Ancillary 10a Do not take more than one aspirin tablet or capsule each day while being treated with this medicine
Labels
12 This medicine may affect mental alertness and/or coordination. If affected, do not drive a motor ve
Dose form
* Risk of cardiovascular adverse events is dose-related; during long term treatment do not use >200 mg daily.
* AVOID in patients wih sulfanomide allergy
* CAUTION in the presence of diabetes, asthma or a peptic ulcer, hypertension or heart failure.
* CAUTION if taking warafin or other anti-coagulants
* Maximum response should be seen in 1-3 wks
* CONSIDER stopping 2-3 days before planned surgery, seek medical advice
* Pregnancy: B3 (Use not recommended), Breast feeding: Use not recommended
* If you develop swollen ankles, difficulty in breathing, black stools or dark coffee-coloured vomit, stop taking the
medicine and tell your doctor immediately.
* Do not take aspirin for pain relief as it will increase the risk of side effects with this medicine.

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PRESCRIPTION ONLY MEDICINE
DIGOXIN
Cardiac glycoside
Indications heart failure
Adverse/ anorexia, nausea, vomiting, diarrhoea, blurred vision, visual disturbances, confusion, drowsiness,
Side Effects
dizziness, nightmares, agitation, depression
Dosages ADULT DOSE

1
Loading: 250-500 mcg q4h - q6h, max 1.5 mg
2
Maintanance: 62.5-250 mcg/d
CHILDREN DOSE
3
Loading: give 1/2 of the loading dose initiailly, then 1/4 of the dose at 6-12 hrs, then last 1/4 at 12-18 hrs
4
Up to 2 years: ORAL / IV: 30-40 mcg/kg ; > 2 years: 30 mcg/kg
5
Maintanance: ORAL, 5-10 mcg/kg daily in 1 or 2 doses. Maximum 250 mcg/d
Ancillary 17 Ask your doctor or pharmacist before using any other medicine including over-the-counter medicin
Labels
Dose form
*Pregnancy, breast feeding: safe to use

* Digoxin has serious adverse effects including potential to worsen arrhythmia (proarrhythmic effect)
* Digoxin involves in significant drug interaction, be careful
* Concomitant administration of antacids may reduce absorption of digoxin. Digoxin concentration may be
increased by co-administration of verapamil, nifedipine, spironolactone, quinidine or amiodarone.
* Extreme caution with low birth weight infants and in patients with impaired renal function, reduced dosafe and
plasma [ ] monitoring should be used.
* Therapeutic range is a guide only and toxicity may occur within the manufacturer's recommended range for atrial
fibrillation. Anorexia, nausea, vomiting or blurred vision may indicate toxicity.

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ENALAPRIL
Angiotensin-converting enzyme inhibitor
Indications Hypertension (includes combination with hydrochlorothiazide or lercanidipine), Heart failure,

Asymptomatic left ventricular dysfunction
Adverse/ cough (cough can also be a symptom of heart failure), metallic taste or lack of taste, hypotension,
Side Effects
hyperkalaemia, headache, dizziness, fatigue, nausea, renal impairment
Dosages ADULT DOSE

1
2.5 - 40 mg daily in 1-2 doses
CHILDREN DOSE
2
0.1 mg/kg daily in 1-2 doses, increased gradually to maximum of 1 mg/kg daily.
***ADULT - Hypertension***
3
Adult, initially 5 mg daily, increased at intervals of 1–2 weeks up to 10–40 mg daily as 1 or 2 doses.
***ADULT - Heart failure***

4
Adult, initially 2.5 mg daily, increased up to 10–20 mg daily as 1 or 2 doses.
Ancillary 11 DO NOT TAKE POTASSIUM while being treated with this medicine unless advised by your doct
Labels
Dose form
* Pregnancy: D . Breastfeeding: Use with caution

* You may feel dizzy when you start taking this medicine. Get up gradually from sitting or lying to minimise this
effect; sit or lie down if you become dizzy or light-headed.
* Do not take potassium supplements while you are taking this medicine unless your doctor tells you to.

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NIFEDIPINE
dihydropyridine calcium channel blocker (APF)
Indications Threatened or established preterm labour (<34 weeks gestation) (AMH)
Adverse/
Side Effects
Dosages ADULT DOSE

1
Tabs, 10-40 mg TWICE daily. Controlled release tablets, 20-120 mg daily
CHILDREN DOSE
2
Hypertensive crisis: <2 yrs, 2.5 mg; >2 yrs: 5 mg
**Check blood pressure after 20 minutes and redose if needed

3
Ancillary 9 DO NOT STOP TAKING THIS MEDICINE ABRUPTLY unless otherwise advised by your docto
Labels
18 Avoid eating grapefruit or drinking grapefruit juice while being treated with this medicine.
Dose form
* MODE OF ACTION: Relaxes uterine smooth muscle via blockade of calcium channels.
* Dihydropyridines can cause peripheral oedema (swollen ankle)
* Pregnancy: C.

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PSEUDOEPHEDRINE
oral sympathomimetic decongestant
Indications Relief of nasal congestion associated with acute and chronic rhinitis
Adverse/ CNS stimulation, nervousness, excitability, dizziness, insomnia, tremor

Side Effects
Dosages ADULT DOSE

1
60 mg 4-6 hoursly
CHILDREN DOSE
2
> 2 years, 1mg/kg 3-4 times daily
Ancillary
Labels
Dose form
* Pregnancy: Avoid use, particularly in the first trimester; ADEC category B2. Use not recommended. *
Breastfeeding: Use with caution.

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PHOLCODINE
opioid cough suppressant
Indications Symptom relief in non-productive cough
Adverse/ drowsiness, constipation, nausea, vomiting

Side Effects
Dosages ADULT DOSE

1
10–15 mg 3–4 times daily.
CHILDREN DOSE
2
2–5 years, 2–2.5 mg 3 times daily.
.
3
5–12 years, 2.5–5 mg 3–4 times daily

4
Labels
Dose form
* Pregnancy: Safe to use; ADEC category A.

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CODEINE
opioid analgesic, antidiarrhoeal
Indications Mild-to-moderate pain [includes combination with aspirin, ibuprofen and paracetamol]; Cough
suppression (see Codeine); Diarrhoea
Adverse/ nausea and vomiting, dyspepsia, drowsiness, dizziness, headache, orthostatic hypotension, itch, dry
Side Effects
mouth, miosis, urinary retention, constipation.
Dosages ADULT
1
PAIN: 30-60 mg q4h, max 240 mg in 24 hrs, COUGH SUPPRESSION: 15–30 mg tds or qid.
2
DIARRHOEA: 30-60 mg tds or qid
CHILDREN
3
COUGH SUPPRESSION: 0.25-0.5 mg/kg/dose q6h or q8h
4
PAIN: oral/IV/IM 0.5-1.0 mg/kg/dose q4h prn
Labels
Dose form
* Label 1 is used when dosage is greater than 20 mg

* Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly. (AMH)
* codeine may be used for moderate pain not controlled by non-opioid analgesics; it is frequently used with
paracetamol or aspirin
* 6–10% of Caucasians and 1–2% of Asians lack the enzyme CYP2D6 (necessary for metabolism of codeine to
morphine); these people are therefore unlikely to obtain analgesia with codeine
**** Combinations of codeine 60 mg and paracetamol 1000 mg are more effective for acute pain than paracetamol
1000 mg alone, although the incidence of drowsiness and dizziness is increased.
****RENAL: Use an alternative opioid in renal impairment where possible due to accumulation of active
metabolites. Alternatively, a longer interval between usual doses may be required depending on age and clinical
status.

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MORPHINE
Opioid Analgesic
Indications Moderate to severe Acute and Chronic Pain, Acute pulmonary oedema, Relief of severe dyspnoea
Adverse/ Vomit, nausea, dyspepsia, drowsiness, dizziness, headache, orthostatic hypotension, itch, dry mouth,
Side Effects
miosis, urinary retention, constipation, Respiratory depression (Michael Jackson's death)
Dosages Adult, ORAL

1
Initially 10-30 mg q4h. Controlled Release 30-60 mg q12h
Children, ORAL
2
0.2-0.5 mg/kg q4h - 16h. Controlled Release 0.3-0.6 mg/kg q12h
Labels
Dose form
* Controlled release tablets (MS Contin®) must be swallowed whole; do not crush or chew them.
* Label 16 (from AMH). Label 1, A is from APF
* Do not take Kapanol® capsules with alcohol as it may affect the release of morphine from the capsules and
increase the likelihood of side effects.
* Naloxone may be used to reverse morphine-induced respiratory depression
* Hepatic impairment (severe): Contraindicated
* Renal impairment (severe): Reduce Dose
* Pregnancy: C. High doses or prolonged use or near term may cause respiratory depression. Breasfeeding: use with
caution.

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DIAZEPAM
Benzodiazepine
Indications Epilepsy, Acute treatment of seizures, including status epilepticus, Muscle spasm
Adverse/ 'Morning-after' hangover effect, repiratory disease or sleep apnoea

Side Effects
Dosages Adult, ORAL

1
5-40 mg d in divided dose
Children, ORAL
2
Muscle spasm: 0.05-0.3 mg/kg bds-tds
3
Status epilepticus: IV, 0.1-0.3 mg/kg/dose, rpt every 15-30 mins qrn
4
Rectal, 0.3-0.5 mg/kg/dose
Ancillary 1a This preparation is to aid sleep. DROWSINESS MAY CONTINUE THE FOLLOWING DAY. If a
Labels
1 This medicine may cause drowsiness and may increase the effects of alcohol. If affected, do not dri
9 DO NOT STOP TAKING THIS MEDICINE ABRUPTLY unless otherwise advised by your docto
Dose form Tablet, Injection, Liquid
* Give IV injection slowly at a rate of 2–5 mg/minute.

* Beware: sudden discontinuation of long term treatment
* Beware of sedation, especially when alcohol is consumed.
* Hepatic impairment (severe): Contraindicated
* Renal and hepatic impairment (mild-moderate): Dose reduction
* Pregnancy: C, Breastfeeding: Use with caution.
* Use Label 1 OR 1A

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ZOPICLONE
Non-benzodiazepine hypnotic agent
Indications Short term treatment of insomnia (condition of being unable to sleep)
Adverse/ diarrhoea, bitter taste

Side Effects
Dosages Adult
1
7.5 mg at night for up to 4 wks. Reduce to 3.75 mg if possible
2
Elderly patient: 3.75 mg at night (nocte)
Labels
1A This preparation is to aid sleep. DROWSINESS MAY CONTINUE THE FOLLOWING DAY. If a
Dose form Tablet
* Mode of action: Potentiation of inhibitory effects of GABA.

* Used for minimum requierd period only.
* Hepatic impairment: Starting dose at 5 mg
* What is the Trade name of Zopiclone? Ans: Imovane

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IMIPRAMINE
Tricyclic Antidepressant
Indications Major depression, Nocturnal enuresis (Bed wetting), Panic disorder, Urinary urge incontinence, Second
line treatment in ADHD (Attention deficit hyperreactivity disorder)
Adverse/ fast heart rate, blurred vision, urinary difficulty urinating, dry mouth, constipation, weight gain or loss,
Side Effects
and low blood pressure when standing.
Dosages Adult
1
25-75 mg/d, increasing by 25-50 mg every 2-3 days to 75-150 mg/d, max 300 mg/d
Children
2
ADHD > 5yrs, 10 mg BD as clinically indicated in increments of 0.5 mg/kg/d . Max 3 mg/kg/d
3
Nocturnal enuresis: 7-10 yrs, 10-20 mg 30-60 mins before to bed
4
> 10 years, 25-50 mg 30-60 mins before to bed
Labels
13 Do not remove from original packaging until dose required.
Dose form Tablet
* Elderly: May respond more slowly. Consider a lower starting dose with a more gradual increase. Avoid using low
dose TCAs for sedation as the risks (including falls) outweigh benefit, and sedative effect decreases with time.
* Children: A meta-analysis concluded that TCAs were no better than placebo in treating depression in children. If
used, obtain a baseline ECG and repeat if the dose approaches 2.5 mg/kg/day.
* Cardiovascular: In second or third degree heart block, severe ischaemic heart disease or cardiac instability (eg
after MI) adverse effects on conduction (proarrhythmic effects) and heart rate may be significant.
*Hepatic impairment: half dose in severe impairment
* Pregnancy: C, Breastfeeding: Use with caution
* Renal impairment: Caustion. Minitor clinically.
* Psychiatric: Overdose carries high risk of fatality; avoid prescribing high strengths (>50 mg) to people with
suicidal ideation.
* Urinary urge incontinence: strong and sudden need to urinate.
*** Imipramine also can cause elevated pressure in the eyes of some patients with glaucoma

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FLUOXETINE
selective serotonin reuptake inhibitor, antidepressant
Indications Major depression, Obsessive–compulsive disorder, Premenstrual dysphoric disorder, Bulimia nervosa,
Panic disorder, Post-traumatic stress disorder
Adverse/ nausea, agitation, insomnia, drowsiness, tremor, dry mouth, diarrhoea, dizziness, headache, sweating,
Side Effects
weakness, anxiety, weight gain or loss, sexual dysfunction, rhinitis, myalgia, rash
Dosages Adult
1
20-80 mg/d. Doses over 20 mg tds, morning and noon
Children > 5 years

2
0.5-1 mg/kg/d as a single morning dose
Labels
Dose form Tablet, capsule, liquid
* Usually given as a morning dose to activating effects

* Dispersible tablets can be used when difficulty swallowing
* Full benefit may not be seen for several weeks but adverse effects may occur from start of treatment.
* Elderly: Hyponatraemia (is an electrolyte disturbance (disturbance of the salts in the blood) in which the sodium
(Natrium in Latin) concentration in the plasma is too low) may occur.
* Breastfeeding: use not recommended.
* Known Trade Names: Prozac, Lovan

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PHENYTOIN
Antiepileptic
Indications Epilepsy (dong kinh), including simple partial and complex seizures (meaning sudden attack of illness,
especially the brain), and generalised tonic-clonic seizures, Status epilepticus (IV)
Adverse/ dizziness, drowsiness, difficulty focusing (vision), unsteady gate, tiredness, abnormal involuntary
Side Effects
movements, nausea, vomiting, constipation, abdominal pain, and loss of appetite
Dosages Adult, ORAL

1
Initially 300 mg/d, increase to 500 mg/d in small dosage increments
Adult, IV
2
15-20 mg/kg when needs and response of patient
Children, ORAL
3
5–8 mg/kg daily in 1 or 2 divided doses.
Children IV (Status Epilepticus)

4
15–20 mg/kg over 20–30 minutes with cardiac monitoring, then 5–10 mg/kg/d in 2–3 divided doses.
Labels
Dose form Tablet, oral liquid, capsule, injection
* Common Trade Name: DILANTIN Infatabs 50 mg tabs x 200 (chewable) or Dilantin 30 mg Cap x 200
* 100 mg Sodium phenytoin contains 92 mg Phenytoin

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WARFARIN
Anticoagulant
Indications Prevention and treatment of venous thromboembolism (deep venous thrombosis and, pulmonary
embolism), Prevention of thromboembolism in patients with prosthetic heart valves, Primary prevention
of stroke in patients with atrial fibrillation associated with mitral, valvulopathy or other risk factors,
Secondary prevention of stroke in patients with atrial fibrillation, Prevention of thromboembolism
before and after cardioversion, Prevention of stroke in patients with previous myocardial infarction and
increased embolic risk
Adverse/ bleeding
Side Effects
Dosages Adult, ORAL

1
5 mg/d for 2 days. Maintainance: 1-10 mg/d, taken same time each day
Labels
10b DO NOT TAKE ASPIRIN while being treated with this medicine unless advised by your doctor.
Dose form Tablet
* Target INR
3.0–4.5 for older model mechanical heart valves.
2.5–3.5 for newer model, less thrombogenic mechanical heart valves.
2.0–3.0 for all other indications.
* Aspirin, NSAIDs including COX-2 inhibitors, antiplatelet drugs—increased risk of bleeding due to antiplatelet
effect or other unknown mechanism; avoid concurrent use (except in selected patients at high risk for
thromboembolism).

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ASPIRIN S4 - PRESCRIPTION ONLY MEDICINE
Analgesic, anti-inflammatory, antiplatelet, antipyretic
Indications Relief of mild to moderate pain such as headache, dysmenorrhoea, myalgias and dental pain -Fever (>18
years of age) -Symptomatic relief of painful tumour metastases in bone -Migraine and tension headache -
Rheumatoid arthritis, including juvenile rheumatoid arthritis -Osteoarthritis -Rheumatic disorders,
including acute rheumatic fever
Adverse/ nausea, dyspepsia, vomiting, GI ulceration or bleeding, asymptomatic blood loss, increased bleeding
Side Effects
time, headache, dizziness, tinnitus (common with high doses)
Dosages Adult, ORAL

1
1-2 tabs / q4h - q6h prn. Max 8 tabs/d
2
(tab, 300 mg (dispersible, white), 96, Solprin (RC), PBS/DPBS)

Labels
Dose form TABLET, RECTAL, SUPPOSITORY
Q: What happens to aspirin is it is exposed to moisture? A: Degrade rapidly in air and water
Q: What is the aqueous solubility of aspirin? A: Slightly soluble in water; feely soluble in alcohol; soluble in ether
Q: Name two conditions which may be able to be prevented with aspirin. A: -Inhibition of platelet aggregation and -
Prevent bowel cancer by reducing the number of polyps in the large bowel
/ Taking doses AFTER FOOD

/ FORENSICS
Cardiprin® tablets are used for the prevention of stroke and other cardiovascular disease. Can they be obtained
without a prescription?
S2 *the availability of the drug and need for a prescription depends on the other drugs combined with aspirin, if
any, and their strength

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IRBESARTAN
Angiotensin II receptor antagonist
Indications Hypertension, Reduction of renal disease progression in patients with type 2 diabetes, hypertension and
microalbuminuria (>30 mg/24 hours) or proteinuria (900 mg/24 hours)
Note: Proteinuria= the presence in the urine of abnormally large quantities of protein normally albumin
Adverse/ dizziness, headache, hyperkalaemia

Side Effects
Dosages Adult, ORAL

1
75-300 mg/d
Ancillary 11 DO NOT TAKE POTASSIUM while being treated with this medicine unless advised by your doct
Labels
Dose form
* Renail impairment: Reduce dose

* Brand Name: Avapro, Karvea

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GLIBENCLAMIDE
Sulfonylurea antidiabetic agent
Indications Type 2 diabetes : Increase pancreatic insulin secretion; may decrease insulin resistance.
Adverse/ gastrointestinal disturbances – Nausea, vomiting, epigastric fullness or sensation pressure, anorexia,
Side Effects
heartburn, dyspepsia - skin problems, especially those related to light exposure –
Dosages Adult, ORAL

1
2.5 – 20 mg / day
Ancillary 10a Do not take more than one aspirin tablet or capsule each day while being treated with this medicine
Labels
b TAKE WITH OR SOON AFTER FOOD.
Dose form oral
* GLIBENCLAMIDE ( Glee-ben-clam-ide)
* Glibenclamide is interacting with the folllowing drugs
- H2 antagonists (eg cimetidine, ranitidine), sulfonamide antibiotics, ketoconazole, miconazole, MAOIs—may
increase hypoglycaemic effect
- Cyclosporin—may increase plasma cyclosporin concentration and toxicity and possibly increase hypoglycaemic
effect of sulfonylurea
- Drugs which may increase blood glucose concentration: danazol, glucocorticoids, thiazide diuretics (high doses),
oral contraceptives (high doses), phenothiazines (chlorpromazine), beta2 agonists (IV salbutamol, terbutaline),
nicotinic acid, pentamidine, somatropin, atypical antipsychotics (olanzapine, clozapine, quetiapine)

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ALLOPURINOL
xanthine oxidase inhibitor
Indications Gout – a disease associated with an inborn error if uric acid metabolism that increases production or
interferes with excretion of uric acid. Excess uric acid is converted to sodium urate crystals that
precipitate form blood and become deposited in joints and other tissues.
Adverse/ Maculopapular or itchy rash

Side Effects
Dosages Adult ORAL

1
100-300 mg/d. Max 900 mg/d (in divided doses) are used for short periods
Children, ORAL
2
10-20 mg/kg/d in 1-2 divided doses, max 600 mg/d
Ancillary 12 This medicine may affect mental alertness and/or coordination. If affected, do not drive a motor ve
Labels
b TAKE WITH OR SOON AFTER FOOD.
Dose form oral
* ALLOPURINOL ( Aloe-pure-in-ol)
100–300 mg daily, although doses of up to 900 mg daily (in divided doses) are sometimes used
for short time periods
* Hepatic impairment: Dosage adjustment necessary.
* Renal impairment: Dosage adjustment necessary.
* Pregnancy: B2. Use not recommended. Consider symptomatic treatment.

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PROPRANOLOL
Non-selective Beta blockers
Indications Hypertension, Angina, Tachyarrhythmias, Control of symptoms (tachycardia, tremor) in anxiety and
hyperthyroidism, Fallot's tetralogy, Myocardial infarction, Prevention of migraine, Essential tremor,
Phaeochromocytoma (with concurrent alpha-blocker)
Adverse/ nausea, diarrhoea, bronchospasm, dyspnoea, cold extremities, exacerbation of Raynaud's

Side Effects
syndrome, *bradycardia*, hypotension, postural hypotension (labetalol), heart failure, heart block,
fatigue, dizziness, abnormal vision, decreased concentration, hallucinations, insomnia, nightmares,
depression, alteration of glucose and lipid metabolism, oedema (carvedilol), Cardiac failure and
nightmares
Dosages Adult
1
20–160 mg/d in divided doses, can increase to 320 mg/day in divided doses.
Children, Migraine prophylaxis

2
initial dose, 10 mg daily increasing to 2 mg/kg daily in 2–3 divided doses.
Labels
Dose form Tablet, IV
* PROPRANOLOL (Pro-pran-o-loll)
*Q: Is it advisable for someone who has asthma to take propranolol? Explain.
*A: No ---- beta-adrenergic blockade of the smooth muscle of bronchi and bronchioles results in an increased
airways resistance

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TIMOLOL
Beta-blockers, ophthalmic*** (non-cardioselective beta blocker)
Indications - Glaucoma -- Reduce aqueous humour formation, probably by blockade of the beta receptors on the
ciliary epithelium.
- Hypertension, Angina Pectoris, Myocardial Infarction, Migraine
Adverse/ stinging on instillation (especially betaxolol solution), bradycardia. Asthma sufferer adverse effects:
Side Effects
bronchospasm
Dosages Conventional drops

1
1 drop of 0.25% once or bds. Max, 1 drop of 0.5% bds
Timoptol-XE®
2
1 drop of 0.25% /d, increase to 1 drop of 0.5% /d if necessary.
Gel 0.1%,
3
1 drop once daily.
Infant <12 months

4
1 drop of 0.25% (of either formulation) once daily.
Combination with brimonidine or dorzolamide

5
1 drop bds
Labels
Dose form Eye drops, capsules
* non-cardioselective beta blocker: Lack intrinsic sympathomimetic and membrane-stabilising activity

* q: Systemic absorption can occur following the use of beta blockers such as timolol in the eye – explain how this
can occur. (AMH)
* a: Reduces intraocular pressure -- Adding topical beta-blocker when taking a systemic betablocker offers some
additional pressure eduction but may increase systemic adverse effects.

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CLOTRIMAZOLE
Drugs for fungal and yeast infections --- Topical imidazoles
Indications Dermatophytoses, Mucocutaneous candidiasis, including paronychia, Pityriasis versicolor, Seborrhoeic

dermatitis, Vaginal candidiasis (see Vaginal candidiasis)
Adverse/ When 1 % bifonazole cream was applied topicaly on a 200 cm2 surface area for 6 hours under, occlusive
Side Effects
dressing, between 2% and 4% of the applied dose was absorbed from inflamed skin. And about 1% of
the dose was absorbed from healthy intact skin.
Dosages Ref: AMH

1
Apply a thin layer 2–3 times a day.
Ancillary E CONTINUE FOR 14 DAYS AFTER SYMPTOMS CEASE

Labels
Dose form Cream, liquid
Dermatophytoses, Mucocutaneous candidiasis, including paronychia, Pityriasis versicolor, Seborrhoeic dermatitis,

Vaginal candidiasis (see Vaginal candidiasis)
Which schedule(s) of the Standard for the Uniform Scheduling of Drugs and Poisons
apply to the following clotrimazole preparations?
- Clotrimazole 1% skin cream – S2
- Clotrimazole 100 mg vaginal pessaries – S2
- Clotrimazole 2% vaginal cream – S2
Apply a thin layer to the affected skin and surrounding area; pay particular attention to skin folds.
For this treatment to be successful you have to use it regularly.
Continue using the treatment for 2 weeks after symptoms have gone.

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FLUCONAZOLE
triazole antifungal agent
Indications Acute or recurrent mucocutaneous candidiasis, Vulvovaginal candidiasis where topical therapy has faile,
Candidiasis due to usceptible strains of Candida (not C. krusei or C. glabrata), Treatment and prevention
of cryptococcal meningitis if amphotericin is not tolerated, or after initial treatment with amphotericin,
Cryptococcosis, Coccidioidomycosis, Histoplasmosis, Primary and secondary prevention of candidal
infection in immunocompromised people, Tinea corporis, cruris or pedis resistant to topical therapy,
Onychomycosis (if alternatives have failed or are not tolerated)
Adverse/ anorexia, fatigue
Side Effects
Dosages ADULT
1
Oropharyngeal/Oesophageal: 50 - 200 mg/d , up to 400 mg in HIV patient
2
Onchomycosis: 150–300 mg weekly for 3–12 months.
CHILDREN
3
Superficial and oral candidiasis: Oral, 6 mg/kg (max 200 mg) on day one, then 3 mg/kg/d
4
Systemic infections: IV/oral, 12 mg/kg (max 400 mg) on day one, then 6 mg/kg/d
Labels
D Add the words 'until all used'.
Dose form Oral, IV
* Renal: Reduce dose in renal impairment.

* Pregnancy: Repeated high dose contraindicated; although single 150 mg dose appears safe, consider alternative
treatment; ADEC category D.
* Tell your doctor if you feel unusually tired, nauseous or are not eating, or if you notice dark urine, pale faeces or
yellowing of the hites of your eyes or skin.

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ONDANSETRON
5HT3 antagonist antiemetic
Indications Nausea and vomiting:

* associated with cancer chemotherapy * postoperative * radiotherapy-induced
Adverse/ constipation, headache, transient rise in hepatic transaminases

Side Effects
Dosages ADULT
1
Oral, IV, rectal, 4–16 mg; maximum 32 mg/24 hours.
CHILD, Post-operative nausea and vomiting > 2 yrs

2
IV, 0.1 mg/kg/dose (up to 4 mg).
CHILD, Cancer chemotherapy > 1 yr

3
IV, 5 mg/m2 (maximum 8 mg) every 8–12 hours or oral 4 mg every 8–12 hours.
Ancillary
Labels
Dose form
* Confirm that no other medicine has been lost due to vomiting.

* Hepatic impairment (moderate–severe): Caution. Maximum daily dose 8 mg.
* Breastfeeding: Use not recommended
* more effective for acute than delayed symptoms of cancer chemotherapy-induced nausea and vomiting
* Give IV doses of 8 mg or less over at least 5 minutes and doses >8 mg over at least 15 minutes. There have been
reports of transient adverse effects with more rapid administration. May be given IM if dose volume is suitable.

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OXYMETAZOLINE
Nasal sympathomimetic decongestants
Indications Relief of nasal congestion associated with acute and chronic rhinitis, common cold, sinusitis
Facilitate intranasal examination
Adverse/ Common: Transient burning, stinging, increased nasal discharge, rebound congestion with prolonged use
Side Effects
(4– 5 days)
Rare: hypertension, nausea, nervousness, dizziness, drowsiness, insomnia, headache
Dosages Adult, child >5 years

1
Nasal spray/drop 0.05%, 1–2 sprays/drops into each nostril up to 3 times daily.
Child 2–5 years

2
Nasal drop 0.025%, 1–2 drops into each nostril up to 3 times daily.
Ancillary NIL
Labels
Dose form Nasal drop, nasal spray
* Rebound congestion: swelling and congestion of the nasal mucosa that follows the vasodilator effects of
decongestant medications
/Q: How would you advise patients to minimize the risk of rebound nasal congestion when using a topical nasal
decongestant such as oxymetazoline?
/A: Keep dose and length of treatment to a minimum (maximum duration of treatment 5 days) to reduce risk of
rebound congestion (may take several weeks to reverse)

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S3 - PHARMACIST ONLY MEDICINE
DEXCHLORPHENIRAMINE
sedating antihistamine
Indications *Allergic upper respiratory conditions, eg rhinitis, Allergic skin conditions, eg urticaria, contact
dermatitis, Pruritus (including insect bites)
Adverse/ sedation, dizziness, tinnitus, blurred vision, euphoria, incoordination, anxiety, insomnia, tremor, nausea,
Side Effects
vomiting, constipation, diarrhoea, epigastric discomfort, dry mouth, cough
Dosages ADULT, Controlled Release

1
6 mg BD (label A)
ADULT, Conventiional Tab

2
2 mg QID
CHILDREN, 6 - 12 years old

3
1 mg QID
CHILDREN, 2 - 6 years old

4
0.04 mg/kg/dose TDS
Labels
Dose form Tablet, Oral Liquid
/Q: Does dexchlorpheniramine commonly produce sedation/ CNS depression?

/A: Yes ( sedation, dizziness, tinnitus, blurred vision, euphoria, incoordination, anxiety, insomnia, tremor, nausea,
vomiting, constipation, diarrhoea, epigastric discomfort, dry mouth, cough)
* Counselling: This medication may make you sleepy; don’t drive or operate machinery if this happens. Avoid
alcohol and other medication which may cause sedation.

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FEXOFENADINE
less-sedating antihistamine
Indications Allergic rhinitis and conjunctivitis

Chronic urticaria
Adverse/ drowsiness, fatigue, headache, nausea, dry mouth

Side Effects
Dosages ADULT, Rhinitis

1
120 mg daily in 1–2 doses or 180 mg once daily.
ADULT, Urticaria
2
180 mg once daily.
CHILD, 6–11 years

3
30 mg twice daily.
Ancillary nil
Labels
Dose form
* This medication makes some people sleepy; don’t drive or operate machinery if this occurs.
* FEXOFENADINE (Fex-o-fen-a-deen)
* Chronic urticaria, symptom relief (a pruritic skin eruption characterized by transient wheals of varying shapes and
sizes with well-defined erythmatous margins and pale centers— caused by capillary dilation in the dermis that
results from the release of vasoactive mediators, including histamine
* Renal impairment: Reduce dose

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DOXYCYCLINE
Tetracycline antibacterial
Indications Acne, Infections caused by M. pneumonia, Community-acquired pneumonia, Exacerbation of chronic

bronchitis, Acute bacterial sinusitis, Chlamydial (including lymphogranuloma venereum) and other non-
gonococcal genital tract infections,PID, Rickettsial infections, Melioidosis (with other agents), Sexually
acquired epididymo-orchitis (with ceftriaxone), Chronic prostatitis, Prophylaxis of malaria in areas of
widespread mefloquine or chloroquine resistance, or in people in whom mefloquine is not tolerated,
Treatment of P. falciparum malaria with quinine
Adverse/ nausea, vomiting, diarrhoea, epigastric burning; tooth discolouration, enamel dysplasia, reduced bone
Side Effects
growth (in children <8 years); photosensitivity (depends on tetracycline, dose and degree of sun
exposure)
Dosages ADULT, Acute Infection

1
200 mg as a first dose, thereafter 100 mg daily
ADULT, Severe infections

2
100 mg 12 hourly.
ADULT, Acne and bronchiectasis

3
50–100 mg daily,
ADULT, Malaria prophylaxis

4
100 mg daily, beginning 2 days before and continued for 4 weeks after exposure
CHILDREN, Malaria prophylaxis

5
2 mg/kg up to 100 mg daily, beginning 2 days before and continued for 4 weeks after exposure.
Ancillary 4 Do not take dairy products, antacids, iron or calcium supplements within two hours of each dose of
Labels
8 Avoid excessive skin exposure to sunlight and sunlamps while being treated with this medicine.
Dose form Tablets and capsules
* DOXYCYCLINE (Dox-e-sigh-klin)
* Renal: Tetracycline and demeclocycline are not recommended in renal impairment; doxycycline and minocycline
can be used without dose adjustment.
* Hepatic: Hepatotoxicity more likely to occur in hepatic impairment; avoid high doses.
* Treatment with hepatotoxic drugs may increase risk of hepatotoxicity.
* Children: Contraindicated in children <8 years as tetracyclines discolour teeth and cause enamel dysplasia which
increases the risk of dental caries. They are also deposited in bone, causing deformities and inhibiting bone growth.
* Pregnancy: Safe if used during the first 18 weeks of pregnancy (16 weeks post-conception); after this they are
contraindicated as they may discolour the baby’s teeth; ADEC category D.
* Breastfeeding: Courses of 7–10 days are considered safe.

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ROXITHROMYCIN
Macrolide antibacterial
Indications Upper and lower respiratory tract infections

Community-acquired pneumonia
Recurrent tonsillitis
Skin infections
Adverse/ nausea, vomiting, diarrhoea, abdominal pain and cramps, headache, dyspnoea, cough, candidal infections
Side Effects
Dosages ADULT
1
150 mg BID, or 300 mg/d. Max 300 mg/d
CHILDREN
2
2.5–4 mg/kg BID
Severe hepatic impairment, ADULT

3
150 mg/d
Ancillary 3B Take on an EMPTY STOMACH at least half an hour before food or two hours after food.
Labels
Dose form Tablet
* ROXITHROMYCIN (Rox-ith-ro-my-sin)
* Severe hepatic impairment: Reduce dose to 150 mg/d
* Roxithromycin is absorbed best if you take it at least 15 minutes before a meal. If it makes you feel sick then you
can take it with food.

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NICOTINE
<no drug class is found>
Indications Nicotine dependence, aid to stopping smoking
Adverse/ dizziness, headache, nausea, vomiting, hiccups, indigestion, abdominal pain, myalgia, cough (inhaler),
Side Effects
vivid dreams (especially 24-hour patch)
Dosages GUM, High nicotine dependence

1
usually 6–10 pieces of 4 mg gum/d. Avoid >1 piece/hour After 4–8 wks reduce to 2 mg, then stop or
taper use over a further 4 wks to zero.
2
GUM, Moderate nicotine dependence
usually 8–12 pieces of 2 mg gum daily.
3
INHALER,
6–12 cartridges inhaled /d, according to craving or withdrawal symptoms, for 8 wks. Then gradually
reduce use over next 4 wks to zero.
4
PATCH, Moderate-to-high nicotine dependence

apply 1 patch daily of either 21 mg/24 hours or 15 mg/16 hours. Stop (abruptly or by reducing strength
5
of patches) within 12 weeks.
Ancillary nil
Labels
Dose form Gum, Inhaler, Lozenge, Patch, Sublingual Tablet
/Q: How do you used the commercially available pharmaceuticals which contains nicotine? What advice would you
give to patients?
/A: - continue smoking while using Nicabate, may experience increased adverse effects
- use of Nicabate beyond 3 months by patients who stop smoking should be discouraged, because the chronic
consumption of nicotine by any route can be harmful and addicting

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BETAMETHASONE
corticosteroid
Indications Inflammatory skin conditions

Combination with calcipotriol: Psoriasis vulgaris, chronic stable plaque type
Adverse/ folliculitis, steroid rosacea, perioral dermatitis, skin atrophy, delayed wound healing, striae, purpura,
Side Effects
depigmentation, telangiectasia, acneiform eruptions
Dosages ADULT
1
IM, 5.7–11.4 mg.
CHILDREN
2
IM, <1 year: 1 mg; 1–5 years: 2 mg; 6–12 years: 4 mg.
3
* Note: Monitor development and growth carefully in children on long-term therapy.
Ancillary nil
Labels
Dose form Creams/ Ointments/ Lotion
* BETAMETHASONE (Beta-meth-a-sone)
/Q: In Australia, betamethasone is usually used for treatment of skin conditions. List some of the skin conditions
which can be treated with topical betamethasone.
/A: Rosacea = a chronic inflammatory disease – has two components – erythema (redness) and acneiform papules
and pustules
Acne vulgaris = acne
Allergy to corticosteroids or preservatives in vehicle
Ulcerative conditions and/or impaired circulation
Uncontrolled infection in area to be treated
/Q: Can topically applied corticosteroids such as betamethasone be absorbed in sufficient amounts to produce
systemic effects (i.e. effects on the whole body)?
/A: Yes – systemic circulation will increase if extensive body surface areas are treated
* Changes to Faeces: Pink, red, black faeces may indicate medicine-induced gastrointestinal bleeding.
* Trade names: Eleuphrat, prosone

N.T.P

PREDNISOLONE
Corticosteroids
Indications ••• Where corticosteroids are indicated, eg acute asthma, autoimmune or inflammatory disease, acute
transplant rejection, acute gout and croup
••• Autoimmune diseases to suppress an overactive immune system.
••• According to specialist protocol, eg for multiple myeloma, lymphoma, some leukaemias
Adverse/ Nausea (feeling sick), Oedema (swelling), High blood pressure, Abdominal pain, Headache, Dizziness,
Side Effects
Muscle weakness, Vomiting, Increased appetite, Blurred vision, Skin rashes
Dosages ADULT, Autoimmune or Inflammatory Disease

1
Initially 5-60 mg/d. Maintenance: 2.5-15 mg/d
ADULT, Acute asthma, oral

2
40-50 mg/d for at least FIVE days.
ADULT, Rheumatoid arthritis

3
5–10 mg/d
CHILDREN, Autoimmune or inflammatory disease

4
initially 1–2 mg/kg/d (max 60 mg), reduce dose ip appropriate.
CHILDREN, Acute asthma

5
1–2 mg/kg (maximum 40 mg) once daily for 3–5 days.
Labels
Dose form ORAL (tablet & liquid)
••• This medication may affect your mood, eg you may feel more happy or sad than usual. It may also cause
problems with sleeping; talk to your doctor if you have any concerns.
••• Tell all doctors, surgeons and dentists treating you that you are taking corticosteroids (or have taken them in the
past) because if you become ill or are going to have surgery your dose of medicine may need to be increased.
••• Consider wearing a Medic Alert® bracelet and carrying a card with the details of your treatment.
••• Take in the morning if a once-daily dosing is ordered.
••• May cause reduced wound healing.
••• The general recommended doses are (SOLONE 5 mg, 25 mg)
Adult: 10mg to 100mg daily in divided doses
Children: 1-5 years: 2.5mg to 10mg twice a day
Children: 6-12 years: 5mg to 20mg twice a day

N.T.P

PREDNISONE
Corticosteroids
Indications * Prednisone/Prednisolone
* Where corticosteroids are indicated, eg acute asthma, autoimmune or inflammatory disease, acute
transplant rejection, acute gout and croup
* Autoimmune diseases to suppress an overactive immune system.
* According to specialist protocol, eg for multiple myeloma, lymphoma, some leukaemias
Adverse/ Nausea (feeling sick), Oedema (swelling), High blood pressure, Abdominal pain, Headache, Dizziness,
Side Effects
Muscle weakness, Vomiting, Increased appetite, Blurred vision, Skin rashes
Dosages ADULT
1
5-60 mg/d
Labels
Dose form Tablet (ORAL)
••• This medication may affect your mood, eg you may feel more happy or sad than usual. It may also cause
problems with sleeping; talk to your doctor if you have any concerns.
••• Tell all doctors, surgeons and dentists treating you that you are taking corticosteroids (or have taken them in the
past) because if you become ill or are going to have surgery your dose of medicine may need to be increased.
••• Consider wearing a Medic Alert® bracelet and carrying a card with the details of your treatment.
••• Take in the morning if a once-daily dosing is ordered.
••• May cause reduced wound healing.
••• The general recommended doses are (SOLONE 5 mg, 25 mg)
Adult: 10mg to 100mg daily in divided doses
Children: 1-5 years: 2.5mg to 10mg twice a day
Children: 6-12 years: 5mg to 20mg twice a day

N.T.P

CIPROFLOXACIN
Quinolone Antibacterial
Indications Severe Salmonella enteritis, Typhoid, paratyphoid (enteric fever), Shigellosis, Complicated UTIs, Bone
or joint infections, Epididymo-orchitis, Meningococcal prophylaxis, P. aeruginosa infections, eg in
cystic fibrosis, Prostatitis, Febrile neutropenia (follow-up treatment in low risk patients, with
amoxycillin with clavulanic acid), Keratitis or severe bacterial conjunctivitis, Chronic suppurative otitis
media.
Adverse/ nausea, vomiting, diarrhea, abdominal pain, rash, headache, and restlessness
Side Effects
Dosages ADULT, Uncomplicated urinary tract infection

1
250 mg 12-hourly.
ADULT, Complicated urinary tract infection

2
500 mg 12-hourly.
ADULT, Respiratory, skin, gastrointestinal and more complicated infections

3
500–750 mg 12-hourly
CHILDREN
4
5–10 mg/kg 12-hourly.
CHILDREN, Cystic fibrosis

5
15 mg/kg (max 750 mg) 12-hourly.
Labels
3B Take on an EMPTY STOMACH at least half an hour before food or two hours after food.
4 Do not take dairy products, antacids, iron or calcium supplements within two hours of each dose of
Dose form tablet, oral suspension
* Ciprofloxacin stops the multiplication of bacteria by inhibiting the reproduction and repair of their genetic
material (DNA)
* Brand Name: Cipro, Cipro XR, Proquin XR
* Serious allergic reaction to quinolones, including nalidixic acid (Negram®, a discontinued quinolone)
—contraindicated.
* History of corticosteroid use—increases risk of tendon damage.
* Kidney, heart or lung transplant—increases risk of tendon damage.
* Athletes in training—at increased risk of tendon damage.
* Pregnancy: Quinolones best avoided due to potential for fetal arthropathy; ADEC category B3.
* Breastfeeding: Use alternatives when possible; short courses are acceptable (may cause loose bowel actions in the
baby).
* Ciprofloxacin is absorbed best if you take it 1 hour before, or 2 hours after, meals; drink plenty of fluids while
taking it.
* Dairy products, antacids, iron, zinc or calcium supplements may reduce the absorption of ciprofloxacin; do not
take them within 2 hours of a ciprofloxacin dose.
* It may increase the effects of caffeine in some people; you may need to reduce your caffeine intake.
* Avoid sun exposure, wear protective clothing and use sunscreen.

N.T.P

ABACAVIR
Nucleoside reverse transcriptase inhibitor
Indications * HIV infection, with other antiretrovirals

* Combination with lamivudine: HIV infection, with other antiretrovirals
* Combination with lamivudine and zidovudine: HIV infection
Adverse/ headache, nausea, vomiting, anorexia, myalgia, peripheral lipoatrophy, asymptomatic hyperlactataemia,
Side Effects
HYPERSENSITIVITY (usually in first 6 weeks. Symptoms include fever, GI symptoms (nausea,
vomiting, diarrhoea, abdominal pain), rash, lethargy, malaise, myalgia, arthralgia, respiratory symptoms
in about 20% (dyspnoea, sore throat, cough, abnormal chest x-ray), rarely adult respiratory distress
syndrome and respiratory failure)
Dosages ADULT
1
300 mg BID or 600 mg QD (QD = once daily, BID = twice daily)
CHILDREN, 3 months - 12 years old

2
8 mg/kg TWICE daily. Maximum 600 mg daily.
Ancillary 12 This medicine may affect mental alertness and/or coordination. If affected, do not drive a motor ve
Labels
Dose form
* IF HYPERSENSITIVITY OCCURS, STOP USING IMMEDIATELY, DO NOT CHALLENGE.

* MODE OF ACTION: NRTIs are converted by cellular enzymes to active phosphorylated metabolites that inhibit
viral reverse transcriptase and viral DNA synthesis, preventing HIV replication. The specific site of action differs
for each drug; these differences are exploited in combination regimens.
* Report fever, nausea, vomiting, diarrhoea, rash, tiredness, difficulty in breathing, sore throat or cough.
* Should be taken in combination with other antiretrovirals.
* Sometimes this medicine can cause lactic acid to build up in your body and cause symptoms. Tell your doctor
immediately if you have nausea, vomiting, stomach pain, fatigue or weakness.
* Patients with liver disease should be cautious about using abacavir because of the possibility that it can aggravate
the condition.

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ISOTRETINOIN
oral retinoid
Indications * Cystic acne, severe (isotretinoin)

* Psoriasis, severe (acitretin)
* Keratinisation disorders, severe forms (acitretin)
* Brand name: Oratane capsules
Adverse/ Mild acne flare

Side Effects
Dosages ADULT, CHILD > 12 YRS

1
0.5–1 mg/kg daily in 1–2 doses. Maximum accumulated dose is 120–150 mg/kg over 4–6 months.

Labels
Dose form
* A mild flare of acne commonly occurs after 2–4 weeks of treatment, but improves after 1–2 months of continued
treatment; severe flares occur infrequently and require dermatologist review
* Avoid using topical anti-acne preparations as local irritation may increase
* Most patients remain disease-free after a single course or have long remissions; approximately 10–20% of
patients relapse; repeat courses of isotretinoin are recommended if recurrence is severe
* Allow at least 2 months after completing a course to see whether further treatment is necessary, as improvement
may continue for several months after stopping
* Do not donate blood during treatment and for 8 weeks after stopping treatment.
* Female patients, it is important that you use adequate contraception before, during and for 1 month after,
treatment, because birth defects can occur during this time.
* This medicine is absorbed best if taken with food.
* This medicine often causes dry lips, mouth and eyes. Use white soft paraffin, eg Vaseline®, to treat dry lips;
* Avoid waxing and dermabrasion during, and for 6 months after stopping, treatment as they could cause scarring
or irritation of your skin.
* Protect skin from sunlight with protective clothing or a broad spectrum sunscreen (preferably 30+, containing a
physical barrier, eg titanium dioxide or zinc oxide). Avoid sunlamps and tanning beds.
* Avoid waxing and dermabrasion during, and for 6 months after stopping, treatment as they could cause scarring
or irritation of your skin.

N.T.P

PHENOBARBITONE
barbiturate, antiepileptic
Indications * Epilepsy, including simple and complex partial seizures, generalised tonic-clonic seizures, neonatal
and febrile seizures
* Status epilepticus unresponsive to benzodiazepines and phenytoin (phenobarbitone)
Adverse/ sedation, confusion, depression, cognitive impairment, altered mood and behaviour, paradoxical
Side Effects
insomnia, hyperactivity and aggression (particularly in children), rash
IV, hypotension, respiratory depression
Dosages ••••••EPILEPSY••••••
1
Adult, oral 60–240 mg once daily at bedtime.
2
Child, initially, oral 3–4 mg/kg/d; up to 8 mg/kg/d is required to achieve therapeutic plasma [conc]
••••••STATUS EPILEPTICUS••••••
3
Give at rate <30 mg/minute; may be repeated after 6 hours if necessary.
4
Adult, IV, 10–20 mg/kg.
5
Child, IV, 15–20 mg/kg.
Labels
5 Ask your doctor or pharmacist before using any other medicine including over-the-counter medicin
Dose form
* MODE OF ACTION: Prolong inhibitory postsynaptic potential by increasing the mean chloride channel opening
time and hence the duration of GABA-induced cell membrane hyperpolarisation.
* This medicine may cause drowsiness and affect your ability to drive or operate machinery; avoid these activities
until you know how it affects you.
* Avoid taking alcohol as it may worsen the side effects of phenobarbitone/primidone.
* This medicine interacts with many other drugs; ask your doctor or pharmacist before using any other medicine
including herbal and over-the-counter products.
* Do not stop taking this medicine suddenly unless your doctor tells you to.
* steady-state plasma concentration may not be achieved for 2–4 weeks
* tolerance to sedation develops with continued administration
* consider BMD monitoring, and vitamin D and calcium supplements to prevent osteomalacia and osteoporosis, in
patients on long term treatment, particularly those at higher risk, eg elderly patients

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ZANAMIVIR
Neuraminidase inhibitors
Indications Treatment and prevention of influenza A and B (e.g. Swine flu)

* Influenza A, the seasonal flu, is the common infection which usually outbreaks in the winter months
* Influenza B has a more complicated presence than Influenza A
Adverse/ bronchospasm or worsening respiratory function may occur.

Side Effects
Dosages Adult, child 5 years and over, oral inhalation

1
10 mg (2 inhalations) BID 5/7
Prevention of influenza, Adult, child 5 years and over, oral inhalation

2
10 mg (2 inhalations) QD for 10 days. This may be extended up to 28 days if necessary.

Labels
Dose form Dry Power Inhaler (DPI)
* MOA: Reduce influenza virus replication by inhibiting the viral surface enzyme neuraminidase, preventing
release of new virus from cells.
* Start treatment as early as possible after symptoms occur, but not >48 hours after onset of initial symptoms of
infection.
* Treatment, this medicine is intended to shorten the time you have symptoms, such as fever, headache, sore
muscles, cough and sore throat.
* Otherwise healthy people should treat uncomplicated influenza by resting, drinking plenty of fluids and using
paracetamol for symptom relief
* Neuraminidase inhibitors have no effect in treating or preventing influenza-like illness

N.T.P

OSELTAMIVIR
Neuraminidase inhibitors
Indications Treatment and prevention of influenza A and B
Adverse/ nausea, vomiting, diarrhoea, abdominal pain, headache

Side Effects
Dosages ••••••ADULT, CHILD > 13 YRS••••••

1
75 mg twice daily for 5 days.
••••••CHILD > 1 YEAR••••••

2
<15 kg, 30 mg twice daily for 5 days.
3
15–23 kg, 45 mg twice daily for 5 days.
4
23–40 kg, 60 mg twice daily for 5 days.
5
>40 kg, 75 mg twice daily for 5 days.
Ancillary A SWALLOW WHOLE. Do not chew.
Labels
Dose form Capsules, Oral Liquid
* Take with food to reduce stomach upset.

* Prevention of influenza: Begin treatment within 2 days of exposure (close contact with an infected person).
* Treatment, this medicine is intended to shorten the time you have symptoms, such as fever, headache, sore
muscles, cough and sore throat.
* Otherwise healthy people should treat uncomplicated influenza by resting, drinking plenty of fluids and using
paracetamol for symptom relief
* Neuraminidase inhibitors have no effect in treating or preventing influenza-like illness
* MOA: Reduce influenza virus replication by inhibiting the viral surface enzyme neuraminidase, preventing
release of new virus from cells.

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DOCUSATE
Stool softener
Indications –– Constipation (includes combination with senna)

–– Prevent straining following rectal surgery and acute perianal disease
Adverse/ Rare: abdominal cramps, diarrhoea, nausea, rash

Side Effects
Dosages ADULT, Oral

1
100–150 mg QD or BID; max to 480 mg/d in divided doses may be used q.r.n
ADULT, Rectal
2
5 mL when required to relieve constipation.
CHILD 6–12 years

3
Oral 50–120 mg daily.
CHILD 3–6 years

4
Oral 50 mg daily.
Ancillary NIL
Labels
Dose form
* Take tablets with plenty of fluid.

* Onset of action is 1–3 days with oral administration and 5–20 minutes following rectal administration
* Poloxamer (Coloxyl Drops®) is preferred for children <3 years

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VANCOMYCIN
Glycopeptide Antibacterial
Indications Treatment of serious infections caused by susceptible organisms resistant to penicillins (MRSA and
multi-resistant S. epidermidis, MRSE) or in people with serious allergy to penicillins. Clostridium
difficile-associated disease (relapse or unresponsive to metronidazole treatment). Antibacterial
prophylaxis for endocarditis before certain procedures in penicillin-hypersensitive people at high risk.
Surgical prophylaxis for major procedures involving implantation of prostheses (eg cardiac and vascular
procedures) in institutions with a high rate of MRSA or MRSE
Adverse/ Oral vancomycin may cause indigestion, nausea, vomiting, diarrhoea and chills.
Side Effects
IV, local pain (may be severe), thrombophlebitis
Dosages ADULT
1
IV, 500 mg six-hourly or 1 g 12-hourly.
Pseudomembranous colitis
2
250–500 mg six-hourly.
CHILD
3
IV, 10-15 mg/kg six-hourly.
Pseudomembranous colitis
4
oral, 5–10 mg/kg six-hourly

Labels
Dose form
* used with an aminoglycoside for serious systemic enterococcal infections (but increased potential for
nephrotoxicity with combination)
* reserve oral vancomycin for serious cases of Clostridium difficile-associated disease or relapses unresponsive to
metronidazole
* stop vancomycin if tinnitus occurs

N.T.P

TRIMEPRAZINE
Sedating Antihistamines
Indications • Allergic upper respiratory conditions, eg rhinitis

• Allergic skin conditions, eg urticaria, contact dermatitis
• Pruritus (including insect bites)
• Nausea and vomiting
• Sedation, eg premedication
Adverse/ sedation, dizziness, tinnitus, blurred vision, euphoria, incoordination, anxiety, insomnia, tremor, nausea,
Side Effects
vomiting, constipation, diarrhoea, epigastric discomfort, dry mouth, cough
Dosages ADULT
1
10 mg 3–4 times daily; maximum 100 mg daily.
CHILD, 3 - 12 YEARS OLD

2
Sedation, 1–2 mg/kg at night; maximum 50 mg.
CHILD, 3 - 12 YEARS OLD

3
Allergy, 0.1–0.25 mg/kg 4 times daily; maximum 6.25 mg/dose.
Labels
Dose form Oral Liquid
* PRECAUTION: Epilepsy—trimeprazine lowers the seizure threshold. Respiratory depression—may worsen.

N.T.P

CITALOPRAM
selective serotonin reuptake inhibitor
Indications * Major depression

* Anxiety disorders, eg panic disorder, obsessive compulsive disorder (OCD)
* Bulimia nervosa
* Premenstrual dysphoric disorder
Adverse/ nausea, agitation, insomnia, drowsiness, tremor, dry mouth, diarrhoea, dizziness, headache, sweating,
Side Effects
weakness, anxiety, weight gain or loss, sexual dysfunction, rhinitis, myalgia, rash
Dosages ADULT
1
20 mg QD, gradually increasing after 2-4 wks if necessary to 60 mg/d
Labels
Dose form Oral (tablet)
* Indications other than depression include obsessive compulsive disorder, anxiety, panic and eating disorders.
* Full benefit may not be seen for several weeks but adverse effects may occur from start of treatment.
* Usually given as a morning dose due to activating effects, although occasionally may cause somnolence and can
be taken at night.
* The efficacy and safety of citalopram for the treatment of major depressive disorder has not been established in
individuals aged less than 18 years.

N.T.P

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S4 - PRESCRIPTION ONLY MEDICINE

PARACETAMOL S2 - PHARMACY MEDICINE

Adverse/ Skin develops rash (rarely) if overdose, urine colour is dark-brown.

Dosages PAIN RELIEVER (ADULT, ORAL)

PAIN RELIEVER (CHILDREN, ORAL)

Ancillary 13 Do not remove from original packaging until dose required.

Indications Acute Angina or Chronic Angina, Heart Failure

Adverse/ Nausea, diarrhoea, palpitations, hypotention, flushing (*APF)

Dosages Acute Angina , Adult (Ref APF)

Prevention of Chronic Angina (Ref APF)

Ancillary 13 Do not remove from original packaging until dose required.

Indications To kill bacteria (antibiotics, anti-infectives), bites or clenched first injuries

Adverse/ Skin rash, nausea, diarrhoea, gastric upset

Dosages Ault dose

Ancillary D Add the words 'until all used'.

* Ancillary Label: For suspension, use label 6, 7a

Indications Asthma, exercise-induced asthma

* Ancillary Label: 22 (for capsules and nebules), 7b (for foil wrapping)

Dosages ADULT DOSE (APF)

H. pylori eradication (AMH)

Zollinger-Allison syndrome (AMH, APF)

CHILDREN DOSE (APF)

Ancillary 13 Do not remove from original packaging until dose required.

* Precaution if allergic to Omeprazole or Esomeprazole

Dosages ADULT DOSE (To be taken in the evening)

Child 10–17 years (AMH)

Children 2 - 10 years (APF)

Children > 10 years (APF)

* Take in the evening

Indications Maintenance treatment in persistent asthma, Acute asthma, Allergic Rhinitis

Dosages ADULT DOSE

Ancillary 14 RINSE MOUTH with water after each use.

Adverse/ orthrostatic hypotension, dizziness when standing quickly, dehydration, gout…

Dosages ***APF***ADULT DOSE

Patient with severse renail impairment

* Pregnancy: C (use not recommended). Breast feeding: Use not recommeded.

Indications Stress ulcer prophylaxis

Adverse/ nausea, severe vomitting, epigastric pain, black or blood-stained stools

Dosages ADULT DOSE

Indications * Diarrhoea, usually short term treatment in adults

Adverse/ abdominal pain and bloating, nausea, vomiting, constipation

* Pregnancy: B3, Breast feeding: may be used on short term

Dosages ADULT DOSE

Vomitting associated with cancer chemotherapy

Dosages ADULT DOSE ***APF***

CHILDREN DOSE > 3 months

Combination with codeine

Indications Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis, Period pain

Dosages ADULT DOSE Osteoarthritis

Indications heart failure

Dosages ADULT DOSE

*Pregnancy, breast feeding: safe to use

Indications Hypertension (includes combination with hydrochlorothiazide or lercanidipine), Heart failure,

Dosages ADULT DOSE

***ADULT - Heart failure***

* Pregnancy: D . Breastfeeding: Use with caution

Indications Threatened or established preterm labour (<34 weeks gestation) (AMH)

Dosages ADULT DOSE

**Check blood pressure after 20 minutes and redose if needed

Adverse/ CNS stimulation, nervousness, excitability, dizziness, insomnia, tremor

Dosages ADULT DOSE

Indications Symptom relief in non-productive cough

Adverse/ drowsiness, constipation, nausea, vomiting

Dosages APFADULT DOSE

Dosages ADULT DOSE APF

ADULT - Heart failure