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Zoledronic acid 4 mg/100 ml Solution for Infusion Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Zoledronic acid Dosage & Rx Info | Zoledronic acid Uses, Side Effects Zoledronic acid: Indications, Side Effects, Warnings, Zoledronic acid -Drug Information –Taj Pharma, Zoledronic acid dose Taj pharmaceuticals Zoledronic acid interactions, Taj Pharmaceutical Zoledronic acid contraindications, Zoledronic acid price, Zoledronic acid Taj Pharma Zoledronic acid SmPC-Taj Pharma Stay connected to all updated on Zoledronic acid Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Sildenafil Tablet IP 25mg, 50mg, 100mg, Taj Pharma SmPCTajPharmaQC
Sildenafil Tablet IP 25mg, 50mg, 100mg, Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Sildenafil Dosage & Rx Info | Sildenafil Uses, Side Effects, Andrology, Sildenafil : Indications, Side Effects, Warnings, Sildenafil - Drug Information - Taj Pharma, Sildenafil dose Taj pharmaceuticals Sildenafil interactions, Taj Pharmaceutical Sildenafil contraindications, Sildenafil price, Sildenafil Taj Pharma Andrology Sildenafil Powder for Tablet SmPC- Taj Pharma Stay connected to all updated on Sildenafil Taj Pharmaceuticals Taj pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Amiodarone 200 mg tablets smpc taj pharmaceuticalsTaj Pharma
Amiodarone 200mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Amiodarone Dosage & Rx Info | Amiodarone Uses, Side Effects - Amiodarone : Indications, Side Effects, Warnings, Amiodarone - Drug Information - Taj Pharma, Amiodarone dose Taj pharmaceuticals Amiodarone interactions, Taj Pharmaceutical Amiodarone contraindications, Amiodarone price, Amiodarone Taj Pharma anti-arrhythmics Amiodarone 200mg Tablets SMPC- Taj Pharma . Stay connected to all updated on Amiodarone Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Furosemide Injection USP Taj Pharma SmPCTajPharmaQC
Furosemide Injection USP 20mg/2ml, 40mg/4ml, 100mg/10ml Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Furosemide Dosage & Rx Info | Furosemide Uses, Side Effects Furosemide: Indications, Side Effects, Warnings, Furosemide -Drug Information –Taj Pharma, Furosemide dose Taj pharmaceuticals Furosemide interactions, Taj Pharmaceutical Furosemide contraindications, Furosemide price, Furosemide Taj Pharma Furosemide SmPC-Taj Pharma Stay connected to all updated on Furosemide Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Simvastatin 20 mg film coated tablets smpc- taj pharmaceuticalsTaj Pharma
Simvastatin Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Simvastatin Dosage & Rx Info | Simvastatin Uses, Side Effects -: Indications, Side Effects, Warnings, Simvastatin - Drug Information - Taj Pharma, Simvastatin dose Taj pharmaceuticals Simvastatin interactions, Taj Pharmaceutical Simvastatin contraindications, Simvastatin price, Simvastatin Taj Pharma Simvastatin 20mg Film Coated Tablets SMPC- Taj Pharma . Stay connected to all updated on Simvastatin Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
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Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj PharmaTaj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj PharmaDosage & Rx Info | Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj PharmaUses, Side Effects, Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj PharmaIndications, Side Effects, Warnings, Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj Pharma- Drug Information – Taj Pharma, Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj Pharmadose Taj pharmaceuticals Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj Pharmainteractions, Taj Pharmaceutical Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj Pharmacontraindications, Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj Pharmaprice, Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj PharmaTaj Pharma Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj PharmaSMPC- Taj Pharma Stay connected to all updated on Telmisartan Tablets IP 20mg; 40mg; 80mg (Telmisar) Taj PharmaTaj Pharmaceuticals Taj pharmaceuticals Hyderabad. Summary of Product Characteristics, SmPC.
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Candesartan and Hydrochlorothiazide Tablets SmPC Taj PharmaceuticalsTajPharmaQC
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Lisinopril 10mg tablets smpc taj pharmaceuticalsTaj Pharma
Lisinopril 10mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Lisinopril Dosage & Rx Info | Lisinopril Uses, Side Effects - Lisinopril: Indications, Side Effects, Warnings, Lisinopril - Drug Information - Taj Pharma, Lisinopril dose Taj pharmaceuticals Lisinopril interactions, Taj Pharmaceutical Lisinopril contraindications, Lisinopril price, Lisinopril Taj Pharma Lisinopril 10mg Tablets SMPC- Taj Pharma . Stay connected to all updated on Lisinopril Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Olmesartan medoxomil and Amlodipine Tablets Taj Pharma PILTajPharmaQC
Olmesartan medoxomil and Amlodipine Tablets 20mg/5mg, 40mg/5mg, 40mg/10mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan medoxomil and Amlodipine Dosage & Rx Info | Olmesartan medoxomil and Amlodipine Uses, Side Effects Vecuronium bromide: Indications, Side Effects, Warnings, Olmesartan medoxomil and Amlodipine-Drug Information –Taj Pharma, Olmesartan medoxomil and Amlodipine dose Taj pharmaceuticals Olmesartan medoxomil and Amlodipine interactions, Taj Pharmaceutical Olmesartan medoxomil and Amlodipine contraindications, Olmesartan medoxomil and Amlodipine price, Olmesartan medoxomil and Amlodipine Taj Pharma Olmesartan medoxomil and Amlodipine SmPC-Taj Pharma Stay connected to all updated on Olmesartan medoxomil and Amlodipine Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
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Enalapril maleate 5 mg tablets smpc taj pharmaceuticalsTaj Pharma
Enalapril maleate Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Enalapril maleate Dosage & Rx Info | Enalapril maleate Uses, Side Effects -: Indications, Side Effects, Warnings, Enalapril maleate - Drug Information - Taj Pharma, Enalapril maleate dose Taj pharmaceuticals Enalapril maleate interactions, Taj Pharmaceutical Enalapril maleate contraindications, Enalapril maleate price, Enalapril maleate Taj Pharma Enalapril maleate 5 mg Tablets SMPC- Taj Pharma . Stay connected to all updated on Enalapril maleate Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Thalidomide Capsule USP Taj Pharma SmPCTajPharmaQC
Thalidomide Capsule USP 50mg/100mg/200mg/250mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Thalidomide Dosage & Rx Info | Thalidomide Uses, Side Effects Thalidomide: Indications, Side Effects, Warnings, Thalidomide -Drug Information –Taj Pharma, Thalidomide dose Taj pharmaceuticals Thalidomide interactions, Taj Pharmaceutical Thalidomide contraindications, Thalidomide price, Thalidomide Taj Pharma Thalidomide SmPC-Taj Pharma Stay connected to all updated on Thalidomide Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
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Ranolazine Tablets 500mg, 750mg, 1000mg Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Ranolazine Dosage & Rx Info | Ranolazine Uses, Side Effects, Anti-anginal, Ranolazine : Indications, Side Effects, Warnings, Ranolazine - Drug Information - Taj Pharma, Ranolazine dose Taj pharmaceuticals Ranolazine interactions, Taj Pharmaceutical Ranolazine contraindications, Ranolazine price, Ranolazine Taj Pharma Anti-anginal Ranolazine Powder for Tablets SmPC.
Tramadol 50mg per ml solution for injection or infusion smpc taj pharmaceuti...Taj Pharma
Tramadol - Drug Information - Taj Pharma, Tramadol dose Taj pharmaceuticals Tramadol interactions, Taj Pharmaceutical Tramadol contraindications, Tramadol price, Tramadol Taj Pharma Tramadol 50mg/ml Solution for Injection or Infusion SMPC- Taj Pharma . Stay connected to all updated on Tramadol Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Atorvastatin 40 mg film coated tablets smpc- taj pharmaceuticalsTaj Pharma
Atorvastatin 40mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Atorvastatin Dosage & Rx Info | Atorvastatin Uses, Side Effects - Atorvastatin : Indications, Side Effects, Warnings, Atorvastatin - Drug Information - Taj Pharma, Atorvastatin dose Taj pharmaceuticals Atorvastatin interactions, Taj Pharmaceutical Atorvastatin contraindications, Atorvastatin price, Atorvastatin Taj Pharma anti-arrhythmics Atorvastatin 40 mg film-coated tablets SMPC- Taj Pharma . Stay connected to all updated on Atorvastatin Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Similar to Olmesartan Tablets Taj Pharma SmPC (20)
Telbivudine Tablet 600mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Telbivudine Dosage & Rx Info | Telbivudine Uses, Side Effects Telbivudine: Indications, Side Effects, Warnings, Telbivudine -Drug Information –Taj Pharma, Telbivudine dose Taj pharmaceuticals Telbivudine interactions, Taj Pharmaceutical Telbivudine contraindications, Telbivudine price, Telbivudine Taj Pharma Telbivudine SmPC-Taj Pharma Stay connected to all updated on Telbivudine Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Raltegravir Tablets USP Taj Pharma SmPCTajPharmaQC
Raltegravir Tablet USP 25mg/100mg/400mg/600mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Raltegravir Dosage & Rx Info | Raltegravir Uses, Side Effects Raltegravir: Indications, Side Effects, Warnings, Raltegravir -Drug Information –Taj Pharma, Raltegravir dose Taj pharmaceuticals Raltegravir interactions, Taj Pharmaceutical Raltegravir contraindications, Raltegravir price, Raltegravir Taj Pharma Raltegravir SmPC-Taj Pharma Stay connected to all updated on Raltegravir Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Linezolid Tablets USP 600mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Linezolid Dosage & Rx Info | Linezolid Uses, Side Effects Linezolid: Indications, Side Effects, Warnings, Linezolid -Drug Information –Taj Pharma, Linezolid dose Taj pharmaceuticals Linezolid interactions, Taj Pharmaceutical Linezolid contraindications, Linezolid price, Linezolid Taj Pharma Linezolid SmPC-Taj Pharma Stay connected to all updated on Linezolid Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Digoxin Tablets USP 62.5mcg/125mcg/250mcg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Digoxin Dosage & Rx Info | Digoxin Uses, Side Effects Digoxin : Indications, Side Effects, Warnings, Digoxin -Drug Information –Taj Pharma, Digoxin dose Taj pharmaceuticals Digoxin interactions, Taj Pharmaceutical Digoxin contraindications, Digoxin price, Digoxin Taj Pharma Digoxin SmPC-Taj Pharma Stay connected to all updated on Digoxin Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Digoxin Tablets USP 62.5mcg/125mcg/250mcg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Digoxin Dosage & Rx Info | Digoxin Uses, Side Effects Digoxin : Indications, Side Effects, Warnings, Digoxin -Drug Information –Taj Pharma, Digoxin dose Taj pharmaceuticals Digoxin interactions, Taj Pharmaceutical Digoxin contraindications, Digoxin price, Digoxin Taj Pharma Digoxin SmPC-Taj Pharma Stay connected to all updated on Digoxin Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Ciprofloxacin Tablets USP 250mg/500mg/750mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Ciprofloxacin Dosage & Rx Info | Ciprofloxacin Uses, Side Effects Ciprofloxacin : Indications, Side Effects, Warnings, Ciprofloxacin -Drug Information –Taj Pharma, Ciprofloxacin dose Taj pharmaceuticals Ciprofloxacin interactions, Taj Pharmaceutical Ciprofloxacin contraindications, Ciprofloxacin price, Ciprofloxacin Taj Pharma Ciprofloxacin SmPC-Taj Pharma Stay connected to all updated on Ciprofloxacin Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Azithromycin Tablets USP 250mg/500mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Azithromycin Dosage & Rx Info | Azithromycin Uses, Side Effects Azithromycin: Indications, Side Effects, Warnings, Azithromycin -Drug Information –Taj Pharma, Azithromycin dose Taj pharmaceuticals Azithromycin interactions, Taj Pharmaceutical Azithromycin contraindications, Azithromycin price, Azithromycin Taj Pharma Azithromycin SmPC-Taj Pharma Stay connected to all updated on Azithromycin Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Atomoxetine Capsules USP Taj Pharma SmPCTajPharmaQC
Atomoxetine Capsules USP 10mg/18mg/25mg/40mg/60mg/80mg/100mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Atomoxetine Dosage & Rx Info | Atomoxetine Uses, Side Effects Atomoxetine: Indications, Side Effects, Warnings, Atomoxetine -Drug Information –Taj Pharma, Atomoxetine dose Taj pharmaceuticals Atomoxetine interactions, Taj Pharmaceutical Atomoxetine contraindications, Atomoxetine price, Atomoxetine Taj Pharma Atomoxetine SmPC-Taj Pharma Stay connected to all updated on Atomoxetine Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Vildagliptin Tablets 50mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Vildagliptin Dosage & Rx Info | Vildagliptin Uses, Side Effects Vildagliptin: Indications, Side Effects, Warnings, Vildagliptin -Drug Information –Taj Pharma, Vildagliptin dose Taj pharmaceuticals Vildagliptin interactions, Taj Pharmaceutical Vildagliptin contraindications, Vildagliptin price, Vildagliptin Taj Pharma Vildagliptin SmPC-Taj Pharma Stay connected to all updated on Vildagliptin Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Theophylline Extended-Release Tablets 100mg, 200mg, 300mg, 400mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Theophylline Dosage & Rx Info | Theophylline Uses, Side Effects Theophylline: Indications, Side Effects, Warnings, Theophylline -Drug Information –Taj Pharma, Theophylline dose Taj pharmaceuticals Theophylline interactions, Taj Pharmaceutical Theophylline contraindications, Theophylline price, Theophylline Taj Pharma Theophylline SmPC-Taj Pharma Stay connected to all updated on Theophylline Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
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Nicorandil Tablets BP 10mg, 20mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Nicorandil Dosage & Rx Info | Nicorandil Uses, Side Effects Nicorandil: Indications, Side Effects, Warnings, Nicorandil -Drug Information –Taj Pharma, Nicorandil dose Taj pharmaceuticals Nicorandil interactions, Taj Pharmaceutical Nicorandil contraindications, Nicorandil price, Nicorandil Taj Pharma Nicorandil SmPC-Taj Pharma Stay connected to all updated on Nicorandil Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
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Ledipasvir and Sofosbuvir Tablets 90mg/400mg Taj Pharma: Uses, Side Effects, Interactions, Pictures, Warnings, Ledipasvir and Sofosbuvir Dosage & Rx Info | Ledipasvir and Sofosbuvir Uses, Side Effects Ledipasvir and Sofosbuvir: Indications, Side Effects, Warnings, Ledipasvir and Sofosbuvir -Drug Information –Taj Pharma, Ledipasvir and Sofosbuvir dose Taj pharmaceuticals Ledipasvir and Sofosbuvir interactions, Taj Pharmaceutical Ledipasvir and Sofosbuvir contraindications, Ledipasvir and Sofosbuvir price, Ledipasvir and Sofosbuvir Taj Pharma Ledipasvir and Sofosbuvir SmPC-Taj Pharma Stay connected to all updated on Ledipasvir and Sofosbuvir Taj Pharmaceuticals Mumbai. Patient Information Leaflets, SmPC.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
Olmesartan Tablets Taj Pharma SmPC
1. Olmesartan 20mg Film-coated 10mg, 15mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan Dosage & Rx Info | Olmesartan Uses, Side Effects , Olmesartan : Indications, Side Effects, Warnings, Olmesartan - Drug Information – Taj Pharma, Olmesartan dose Taj pharmaceuticals Olmesartan interactions, Taj Pharmaceutical Olmesartan contraindications, Olmesartan price, Olmesartan Taj Pharma Olmesartan 20mg Film-coated 10mg, 15mg Tablets PIL- Taj Pharma Stay connected to all updated on Olmesartan Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
Olmesartan 20mg/40mg Tablets USP
1. Name of the medicinal product
Olmesartan 20mg Film-coated Tablets USP Taj Pharma
Olmesartan 40mg Film-coated Tablets USP Taj Pharma
2. Qualitative and quantitative composition
Olmesartan medoxomil
Each tablet contains
Olmesartan medoxomil USP 20mg
Excipients q.s
Each tablet contains
Olmesartan medoxomil USP 40mg
Excipients q.s
For the full list of excipients, see section 6.1
3. Pharmaceutical form
Film-coated tablet.
Olmesartan 20mg film-coated tablets are white, round, biconvex and
8.5 in diameter, with OL 20 debossed on one side.
4. Clinical particulars
4.1 Therapeutic indications
Adults
Treatment of essential hypertension.
Paediatric population
Treatment of hypertension in children and adolescents from 6 to less
than 18 years of age.
4.2 Posology and method of administration
Posology
Adults
The recommended starting dose of olmesartan medoxomil is 10mg
once daily. In patients whose blood pressure is not adequately
controlled at this dose, the dose of olmesartan medoxomil may be
increased to 20mg once daily as the optimal dose. If additional blood
pressure reduction is required, olmesartan medoxomil dose may be
increased to a maximum of 40mg daily or hydrochlorothiazide
therapy may be added.
The antihypertensive effect of olmesartan medoxomil is substantially
present within 2 weeks of initiating therapy and is maximal by about
8 weeks after initiating therapy. This should be borne in mind when
considering changing the dose regimen for any patient.
Elderly people (65 years or older)
No adjustment of dosage is generally required in elderly people (see
below for dose recommendations in patients with renal impairment).
If up-titration to the maximum dose of 40mg daily is required, blood
pressure should be closely monitored.
Renal impairment
The maximum dose in patients with mild to moderate renal
impairment (creatinine clearance of 20-60 ml/min) is 20mg
olmesartan medoxomil once daily, owing to limited experience of
higher dosages in this patient group. The use of olmesartan
medoxomil in patients with severe renal impairment (creatinine
clearance < 20 ml/min) is not recommended, since there is only
limited experience in this patient group (see sections 4.4 and 5.2).
2. Olmesartan 20mg Film-coated 10mg, 15mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan Dosage & Rx Info | Olmesartan Uses, Side Effects , Olmesartan : Indications, Side Effects, Warnings, Olmesartan - Drug Information – Taj Pharma, Olmesartan dose Taj pharmaceuticals Olmesartan interactions, Taj Pharmaceutical Olmesartan contraindications, Olmesartan price, Olmesartan Taj Pharma Olmesartan 20mg Film-coated 10mg, 15mg Tablets PIL- Taj Pharma Stay connected to all updated on Olmesartan Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
Hepatic impairment
No adjustment of dosage recommendations is required for patients
with mild hepatic impairment. In patients with moderate hepatic
impairment, an initial dose of 10mg olmesartan medoxomil once
daily is recommended and the maximum dose should not exceed
20mg once daily. Close monitoring of blood pressure and renal
function is advised in hepatically-impaired patients who are already
receiving diuretics and/or other antihypertensive agents. There is no
experience of olmesartan medoxomil in patients with severe hepatic
impairment, therefore use is not recommended in this patient group
(see sections 4.4 and 5.2). Olmesartan medoxomil should not be used
in patients with biliary obstruction (see section 4.3).
Paediatric population
Children and adolescents from 6 to less than 18 years of age
The recommended starting dose of olmesartan medoxomil in
children from 6 to less than 18 years of age is 10mg olmesartan
medoxomil once daily. In children whose blood pressure is not
adequately controlled at this dose, the dose of olmesartan medoxomil
may be increased to 20mg once daily. If additional blood pressure
reduction is required, in children who weigh > 35 kg, the olmesartan
medoxomil dose may be increased to a maximum of 40mg. In
children who weigh < 35 kg, the daily dose should not exceed 20mg.
Other paediatric population
The safety and efficacy of olmesartan medoxomil in children aged 1
to 5 years old have not yet been established. Currently available data
are described in sections 4.8 and 5.1 but no recommendation on a
posology can be made.
Olmesartan medoxomil should not be used in children below 1 years
of age because of safety concerns and lack of data in this age group.
Method of administration
For oral use. In order to assist compliance, it is recommended that
Olmesartan Tablets be taken at about the same time each day, with or
without food, for example at breakfast time. The tablet should be
swallowed with a sufficient amount of fluid (e.g. one glass of water).
The tablet should be swallowed whole and not chewed.
4.3 Contraindications
Hypersensitivity to the active substance or to any of the excipients
listed in section 6.1.
Second and third trimesters of pregnancy (see sections 4.4 and 4.6).
Biliary obstruction (see section 5.2).
The concomitant use of Olmesartan Tablets with aliskiren-containing
products is contraindicated in patients with diabetes mellitus or renal
impairment (GFR < 60 ml/min/1.73 m2) (see sections 4.5 and 5.1).
4.4 Special warnings and precautions for use
Intravascular volume depletion
Symptomatic hypotension, especially after the first dose, may occur
in patients who are volume and/or sodium depleted by vigorous
diuretic therapy, dietary salt restriction, diarrhoea or vomiting. Such
conditions should be corrected before the administration of
olmesartan medoxomil.
Other conditions with stimulation of the renin-angiotensin-
aldosterone system
In patients whose vascular tone and renal function depend
predominantly on the activity of the renin-angiotensin-aldosterone
system (e.g. patients with severe congestive heart failure or
underlying renal disease, including renal artery stenosis), treatment
with other drugs that affect this system has been associated with
acute hypotension, azotaemia, oliguria or, rarely, acute renal failure.
3. Olmesartan 20mg Film-coated 10mg, 15mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan Dosage & Rx Info | Olmesartan Uses, Side Effects , Olmesartan : Indications, Side Effects, Warnings, Olmesartan - Drug Information – Taj Pharma, Olmesartan dose Taj pharmaceuticals Olmesartan interactions, Taj Pharmaceutical Olmesartan contraindications, Olmesartan price, Olmesartan Taj Pharma Olmesartan 20mg Film-coated 10mg, 15mg Tablets PIL- Taj Pharma Stay connected to all updated on Olmesartan Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
The possibility of similar effects cannot be excluded with
angiotensin II receptor antagonists.
Renovascular hypertension
There is an increased risk of severe hypotension and renal
insufficiency when patients with bilateral renal artery stenosis or
stenosis of the artery to a single functioning kidney are treated with
medicinal products that affect the renin-angiotensin-aldosterone
system.
Renal impairment and kidney transplantation
When olmesartan medoxomil is used in patients with impaired renal
function, periodic monitoring of serum potassium and creatinine
levels is recommended. Use of olmesartan medoxomil is not
recommended in patients with severe renal impairment (creatinine
clearance < 20 ml/min) (see sections 4.2 and 5.2). There is no
experience of the administration of olmesartan medoxomil in
patients with a recent kidney transplant or in patients with end-stage
renal impairment (i.e. creatinine clearance < 12 ml/min).
Hepatic impairment
There is no experience in patients with severe hepatic impairment
and therefore use of olmesartan medoxomil in this patient group is
not recommended (see section 4.2 for dosage recommendations in
patients with mild or moderate hepatic impairment).
Hyperkalaemia
The use of medicinal products that affect the renin-angiotensin-
aldosterone system may cause hyperkalaemia.
The risk, that may be fatal, is increased in elderly, in patients with
renal insufficiency and in diabetic patients, in patients concomitantly
treated with other medicinal products that may increase potassium
levels, and/or in patients with intercurrent events.
Before considering the concomitant use of medicinal products that
affect the renin-angiotensin-aldosterone system, the benefit risk ratio
should be evaluated and other alternatives considered. (see also
below section “Dual blockade of the renin-angiotensin-aldosterone
system (RAAS)”).
The main risk factors for hyperkalaemia to be considered are:
- Diabetes, renal impairment, age (> 70 years)
- Combination with one or more other medicinal products that affect
the renin-angiotensin-aldosterone system and/or potassium
supplements. Some medicinal products or therapeutic class of
medicinal products may provoke a hyperkalaemia: salt substitutes
containing potassium, potassium-sparing diuretics, ACE inhibitors,
angiotensin II receptors antagonists, non steroidal anti-inflammatory
drugs (including selective COX-2 inhibitors), heparin,
immunosuppressor as ciclosporin or tacrolimus, trimethoprim
- Intercurrent events, in particular dehydration, acute cardiac
decompensation, metabolic acidosis, worsening of renal function,
sudden worsening of the renal condition (e.g. infectious diseases),
cellular lysis (e.g. acute limb ischemia, rhabdomyolysis, extended
trauma).
Close-monitoring of serum potassium in at risk patients is
recommended (see section 4.5).
Dual blockade of the renin-angiotensin-aldosterone system (RAAS)
There is evidence that the concomitant use of ACE-inhibitors,
angiotensin II receptor blockers or aliskiren increases the risk of
hypotension, hyperkalaemia and decreased renal function (including
acute renal failure). Dual blockade of RAAS through the combined
use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren is
therefore not recommended (see sections 4.5 and 5.1).
4. Olmesartan 20mg Film-coated 10mg, 15mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan Dosage & Rx Info | Olmesartan Uses, Side Effects , Olmesartan : Indications, Side Effects, Warnings, Olmesartan - Drug Information – Taj Pharma, Olmesartan dose Taj pharmaceuticals Olmesartan interactions, Taj Pharmaceutical Olmesartan contraindications, Olmesartan price, Olmesartan Taj Pharma Olmesartan 20mg Film-coated 10mg, 15mg Tablets PIL- Taj Pharma Stay connected to all updated on Olmesartan Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
If dual blockade therapy is considered absolutely necessary, this
should only occur under specialist supervision and subject to
frequent close monitoring of renal function, electrolytes and blood
pressure.
ACE-inhibitors and angiotensin II receptor blockers should not be
used concomitantly in patients with diabetic nephropathy.
Lithium
As with other angiotensin-II receptor antagonists, the combination of
lithium and olmesartan medoxomil is not recommended (see section
4.5).
Aortic or mitral valve stenosis; obstructive hypertrophic
cardiomyopathy
As with other vasodilators, special caution is indicated in patients
suffering from aortic or mitral valve stenosis, or obstructive
hypertrophic cardiomyopathy.
Primary aldosteronism
Patients with primary aldosteronism generally will not respond to
antihypertensive drugs acting through inhibition of the renin-
angiotensin system. Therefore, the use of olmesartan medoxomil is
not recommended in such patients.
Sprue-like enteropathy
In very rare cases severe, chronic diarrhoea with substantial weight
loss has been reported in patients taking olmesartan few months to
years after drug initiation, possibly caused by a localized delayed
hypersensitivity reaction. Intestinal biopsies of patients often
demonstrated villous atrophy. If a patient develops these symptoms
during treatment with olmesartan, and in the absence of other
apparent etiologies, olmesartan treatment should be immediately
discontinued and should not be restarted. If diarrhoea does not
improve during the week after the discontinuation, further specialist
(e.g. a gastro-enterologist) advice should be considered.
Ethnic differences
As with all other angiotensin II antagonists, the blood pressure
lowering effect of olmesartan medoxomil is somewhat less in black
patients than in non-black patients, possibly because of a higher
prevalence of low-renin status in the black hypertensive population.
Pregnancy
Angiotensin II antagonists should not be initiated during pregnancy.
Unless continued angiotensin II antagonists therapy is considered
essential, patients planning pregnancy should be changed to
alternative anti-hypertensive treatments which have an established
safety profile for use in pregnancy. When pregnancy is diagnosed,
treatment with angiotensin II antagonists should be stopped
immediately and, if appropriate, alternative therapy should be started
(see sections 4.3 and 4.6).
Other
As with any antihypertensive agent, excessive blood pressure
decrease in patients with ischaemic heart disease or ischaemic
cerebrovascular disease could result in a myocardial infarction or
stroke.
This medicinal product contains lactose. Patients with rare hereditary
problems of galactose intolerance, the Lapp-lactase deficiency or
glucose-galactose malabsorption should not take this medicinal
product.
4.5 Interaction with other medicinal products and other forms of
interaction
Interaction studies have only been performed in adults.
Effects of other medicinal products on olmesartan medoxomil
5. Olmesartan 20mg Film-coated 10mg, 15mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan Dosage & Rx Info | Olmesartan Uses, Side Effects , Olmesartan : Indications, Side Effects, Warnings, Olmesartan - Drug Information – Taj Pharma, Olmesartan dose Taj pharmaceuticals Olmesartan interactions, Taj Pharmaceutical Olmesartan contraindications, Olmesartan price, Olmesartan Taj Pharma Olmesartan 20mg Film-coated 10mg, 15mg Tablets PIL- Taj Pharma Stay connected to all updated on Olmesartan Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
Other antihypertensive medications:
The blood pressure lowering effect of olmesartan medoxomil can be
increased by concomitant use of other antihypertensive medications.
ACE-inhibitors, angiotensin II receptor blockers or aliskiren
Clinical trial data has shown that dual blockade of the renin-
angiotensin-aldosterone-system (RAAS) through the combined use
of ACE-inhibitors, angiotensin II receptor blockers or aliskiren is
associated with a higher frequency of adverse events such as
hypotension, hyperkalaemia and decreased renal function (including
acute renal failure) compared to the use of a single RAAS-acting
agent (see sections 4.3, 4.4 and 5.1).
Potassium supplements and potassium sparing diuretics:
Based on experience with the use of other drugs that affect the renin-
angiotensin system, concomitant use of potassium-sparing diuretics,
potassium supplements, salt substitutes containing potassium or
other drugs that may increase serum potassium levels (e.g. heparin)
may lead to increases in serum potassium (see section 4.4). Such
concomitant use is therefore not recommended.
Non-steroidal anti-inflammatory drugs (NSAIDs):
NSAIDs (including acetylsalicylic acid at doses> 3 g/day and also
COX-2 inhibitors) and angiotensin II receptor antagonists may act
synergistically by decreasing glomerular filtration. The risk of the
concomitant use of NSAIDs and angiotensin II antagonists is the
occurrence of acute renal failure. Monitoring of renal function at the
beginning of treatment should be recommended as well as regular
hydration of the patient.
Additionally, concomitant treatment can reduce the antihypertensive
effect of angiotensin II receptor antagonists, leading to their partial
loss of efficacy.
Bile acid sequestering agent colesevelam
Concurrent administration of the bile acid sequestering agent
colesevelam hydrochloride reduces the systemic exposure and peak
plasma concentration of olmesartan and reduces t1/2. Administration
of olmesartan medoxomil at least 4 hours prior to colesevelam
hydrochloride decreased the drug interaction effect. Administering
olmesartan medoxomil at least 4 hours before the colesevelam
hydrochloride dose should be considered (see section 5.2).
Other compounds:
After treatment with antacid (aluminium magnesium hydroxide), a
modest reduction in bioavailability of olmesartan was observed.
Coadministration of warfarin and digoxin had no effect on the
pharmacokinetics of olmesartan.
Effects of olmesartan medoxomil on other medicinal products:
Lithium:
Reversible increases in serum lithium concentrations and toxicity
have been reported during concomitant administration of lithium
with angiotensin converting enzyme inhibitors and angiotensin II
antagonists. Therefore use of olmesartan medoxomil and lithium in
combination is not recommended (see section 4.4). If use of the
combination proves necessary, careful monitoring of serum lithium
levels is recommended.
Other compounds:
Compounds which have been investigated in specific clinical studies
in healthy volunteers include warfarin, digoxin, an antacid
(magnesium aluminium hydroxide), hydrochlorothiazide and
pravastatin. No clinically relevant interactions were observed and in
particular olmesartan medoxomil had no significant effect on the
6. Olmesartan 20mg Film-coated 10mg, 15mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan Dosage & Rx Info | Olmesartan Uses, Side Effects , Olmesartan : Indications, Side Effects, Warnings, Olmesartan - Drug Information – Taj Pharma, Olmesartan dose Taj pharmaceuticals Olmesartan interactions, Taj Pharmaceutical Olmesartan contraindications, Olmesartan price, Olmesartan Taj Pharma Olmesartan 20mg Film-coated 10mg, 15mg Tablets PIL- Taj Pharma Stay connected to all updated on Olmesartan Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
pharmacokinetics or pharmacodynamics of warfarin or the
pharmacokinetics of digoxin.
Olmesartan had no clinically relevant inhibitory effects on in
vitro human cytochrome P450 enzymes 1A1/2, 2A6, 2C8/9, 2C19,
2D6, 2E1 and 3A4, and had no or minimal inducing effects on rat
cytochrome P450 activities. Therefore in vivo interaction studies
with known cytochrome P450 enzyme inhibitors and inducers were
not conducted, and no clinically relevant interactions between
olmesartan and drugs metabolised by the above cytochrome P450
enzymes are expected.
Paediatric population:
Interaction studies have only been performed in adults. It is not
known if the interactions in children are similar to those in adults.
4.6 Fertility, pregnancy and lactation
Pregnancy
The use of angiotensin II antagonists is not recommended during the
first trimester of pregnancy (see section 4.4). The use of angiotensin
II antagonists is contraindicated during the second and third trimester
of pregnancy (see sections 4.3 and 4.4).
Epidemiological evidence regarding the risk of teratogenicity
following exposure to ACE inhibitors during the first trimester of
pregnancy has not been conclusive; however a small increase in risk
cannot be excluded. Whilst there is no controlled epidemiological
data on the risk with angiotensin II antagonists, similar risks may
exist for this class of drugs. Unless continued angiotensin receptor
blocker therapy is considered essential, patients planning pregnancy
should be changed to alternative anti-hypertensive treatments which
have an established safety profile for use in pregnancy. When
pregnancy is diagnosed, treatment with angiotensin II antagonists
should be stopped immediately, and, if appropriate, alternative
therapy should be started.
Angiotensin II antagonists therapy exposure during the second and
third trimesters is known to induce human fetotoxicity (decreased
renal function, oligohydramnios, skull ossification retardation) and
neonatal toxicity (renal failure, hypotension, hyperkalaemia) (See
also section 5.3).
Should exposure to angiotensin II antagonists have occurred from the
second trimester of pregnancy, ultrasound check of renal function
and skull is recommended.
Infants whose mothers have taken angiotensin II antagonists should
be closely observed for hypotension (see also sections 4.3 and 4.4).
Breastfeeding
Olmesartan is excreted in the milk of lactating rats but it is not
known whether olmesartan is excreted in human milk. Because no
information is available regarding the use of Olmesartan Tablets
during breast-feeding, Olmesartan Tablets is not recommended and
alternative treatments with better established safety profiles during
breast-feeding are preferable, especially while nursing a newborn or
preterm infant.
4.7 Effects on ability to drive and use machines
Olmesartan Tablets has minor or moderate influence on the ablility
to drive and use machines. Dizziness or fatigue may occasionally
occur in patients taking antihypertensive therapy, which may impair
the ablility to react.
4.8 Undesirable effects
Summary of the safety profile
The most commonly reported adverse reactions during treatment
with olmesartan are headache (7.7%), influenza-like symptoms
(4.0%) and dizziness (3.7%).
7. Olmesartan 20mg Film-coated 10mg, 15mg Tablets Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Olmesartan Dosage & Rx Info | Olmesartan Uses, Side Effects , Olmesartan : Indications, Side Effects, Warnings, Olmesartan - Drug Information – Taj Pharma, Olmesartan dose Taj pharmaceuticals Olmesartan interactions, Taj Pharmaceutical Olmesartan contraindications, Olmesartan price, Olmesartan Taj Pharma Olmesartan 20mg Film-coated 10mg, 15mg Tablets PIL- Taj Pharma Stay connected to all updated on Olmesartan Taj Pharmaceuticals Taj pharmaceuticals Hyderabad. Patient Information Leaflets, PIL.
In placebo-controlled monotherapy studies, the only adverse drug
reaction that was unequivocally related to treatment was dizziness
(2.5% incidence on olmesartan medoxomil and 0.9% on placebo).
The incidence was also somewhat higher on olmesartan medoxomil
compared with placebo for hypertriglyceridaemia (2.0% versus
1.1%) and for raised creatine phosphokinase (1.3% versus 0.7%).
Tabulated list of adverse reactions
Adverse reactions from olmesartan in clinical trials, post-
authorisation safety studies and spontaneous reporting are
summarized in the below table.
The following terminologies have been used in order to classify the
occurrence of adverse reactions very common (≥1/10); common
(≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000
to <1/1,000); very rare (<1/10,000).
System Organ Class Adverse Reactions Frequency
Blood and lymphatic
system disorders
Thrombocytopenia Uncommon
Immune system
disorders
Anaphylactic reaction Uncommon
Metabolism and
nutrition disorders
Hypertriglyceridaemia Common
Hyperuricaemia Common
Hyperkalaemia Rare
Nervous system
disorders
Dizziness Common
Headache Common
Ear and labyrinth
disorders
Vertigo Uncommon
Cardiac disorders Angina pectoris Uncommon
Vascular disorders Hypotension Rare
Respiratory, thoracic
and mediastinal
disorders
Bronchitis Common
Pharyngitis Common
Cough Common
Rhinitis Common
Gastrointestinal
disorders
Gastroenteritis Common
Diarrhoea Common
Abdominal pain Common
Nausea Common
Dyspepsia Common
Vomiting Uncommon
Sprue-like enteropathy
(see section 4.4)
Very rare
Skin and
subcutaneous tissue
disorders
Exanthema Uncommon
Allergic dermatitis Uncommon
Urticaria Uncommon
Rash Uncommon
Pruritus Uncommon
Angioedema Rare
Musculoskeletal and
connective tissue
disorders
Arthritis Common
Back pain Common
Skeletal pain Common
Myalgia Uncommon
Muscle spasm Rare
Renal and urinary
disorders
Haematuria Common
Urinary tract infection Common
Acute renal failure Rare
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Renal insufficiency Rare
General disorders
and administration
site conditions
Pain Common
Chest pain Common
Peripheral oedema Common
Influenza-like symptoms Common
Fatigue Common
Face oedema Uncommon
Asthenia Uncommon
Malaise Uncommon
Lethargy Rare
Investigations Hepatic enzymes increased Common
Blood urea increased Common
Blood creatine
phosphokinase increased
Common
Blood creatinine increased Rare
Single cases of rhabdomyolysis have been reported in temporal
association with the intake of angiotensin II receptor blockers.
Additional information on special populations
Paediatric population:
The safety of olmesartan was monitored in 361 children and
adolescents, aged 1-17 years old during 2 clinical trials. Whilst the
nature and severity of the adverse events are similar to that of the
adults, the frequency of the following is higher in the children:
- Epistaxis is a common adverse event in children (i.e. ≥ 1/100 to <
1/10) that has not been reported in adults.
- During the 3 weeks of double blind study, the incidence of
treatment emergent dizziness and headache nearly doubled in
children 6-17 years of age in the high olmesartan dose group.
The overall safety profile for olmesartan in paediatric patients does
not differ significantly from the safety profile in adults.
Elderly (age 65 years or over):
In elderly people the frequency of hypotension is slightly increased
from rare to uncommon.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the
medicinal product is important. It allows continued monitoring of the
benefit/risk balance of the medicinal product.
4.9 Overdose
Only limited information is available regarding overdosage in
humans. The most likely effect of overdosage is hypotension. In the
event of overdosage, the patient should be carefully monitored and
treatment should be symptomatic and supportive.
No information is available regarding the dialysability of olmesartan.
5. Pharmacological properties
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Angiotensin II antagonists,
Mechanism of action/ Pharmacodynamic effects
Olmesartan medoxomil is a potent, orally active, selective
angiotensin II receptor (type AT1) antagonist. It is expected to block
all actions of angiotensin II mediated by the AT1 receptor, regardless
of the source or route of synthesis of angiotensin II. The selective
antagonism of the angiotensin II (AT1) receptors results in increases
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in plasma renin levels and angiotensin I and II concentrations, and
some decrease in plasma aldosterone concentrations.
Angiotensin II is the primary vasoactive hormone of the renin-
angiotensin-aldosterone system and plays a significant role in the
pathophysiology of hypertension via the type 1 (AT1) receptor.
Clinical efficacy and safety
In hypertension, olmesartan medoxomil causes a dose-dependent,
long-lasting reduction in arterial blood pressure. There has been no
evidence of first-dose hypotension, of tachyphylaxis during long-
term treatment, or of rebound hypertension after cessation of therapy.
Once daily dosing with olmesartan medoxomil provides an effective
and smooth reduction in blood pressure over the 24 hour dose
interval. Once daily dosing produced similar decreases in blood
pressure as twice daily dosing at the same total daily dose.
With continuous treatment, maximum reductions in blood pressure
are achieved by 8 weeks after the initiation of therapy, although a
substantial proportion of the blood pressure lowering effect is
already observed after 2 weeks of treatment. When used together
with hydrochlorothiazide, the reduction in blood pressure is additive
and coadministration is well tolerated.
The effect of olmesartan on mortality and morbidity is not yet
known.
The Randomised Olmesartan and Diabetes Microalbuminuria
Prevention (ROADMAP) study in 4447 patients with type 2
diabetes, normo-albuminuria and at least one additional
cardiovascular risk factor, investigated whether treatment with
olmesartan could delay the onset of microalbuminuria. During the
median follow-up duration of 3.2 years, patients received either
olmesartan or placebo in addition to other antihypertensive agents,
except ACE inhibitors or ARBs.
For the primary endpoint, the study demonstrated a significant risk
reduction in the time to onset of microalbuminuria, in favour of
olmesartan. After adjustment for BP differences this risk reduction
was no longer statistically significant. 8.2% (178 of 2160) of the
patients in the olmesartan group and 9.8% (210 of 2139) in the
placebo group developed microalbuminuria.
For the secondary endpoints, cardiovascular events occurred in 96
patients (4.3%) with olmesartan and in 94 patients (4.2%) with
placebo. The incidence of cardiovascular mortality was higher with
olmesartan compared to placebo treatment (15 patients (0.7%) vs. 3
patients (0.1%)), despite similar rates for non-fatal stroke (14
patients (0.6%) vs. 8 patients (0.4%)), non-fatal myocardial
infarction (17 patients (0.8%) vs. 26 patients (1.2%)) and non-
cardiovascular mortality (11 patients (0.5%) vs. 12 patients (0.5%)).
Overall mortality with olmesartan was numerically increased (26
patients (1.2%) vs. 15 patients (0.7%)), which was mainly driven by
a higher number of fatal cardiovascular events.
The Olmesartan Reducing Incidence of End-stage Renal Disease in
Diabetic Nephropathy Trial (ORIENT) investigated the effects of
olmesartan on renal and cardiovascular outcomes in 577 randomized
Japanese and Chinese type 2 diabetic patients with overt
nephropathy. During a median follow-up of 3.1 years, patients
received either olmesartan or placebo in addition to other
antihypertensive agents including ACE inhibitors.
The primary composite endpoint (time to first event of the doubling
of serum creatinine, end-stage renal disease, all-cause death)
occurred in 116 patients in the olmesartan group (41.1%) and 129
patients in the placebo group (45.4%) (HR 0.97 (95% CI 0.75 to
1.24); p = 0.791). The composite secondary cardiovascular endpoint
occurred in 40 olmesartan-treated patients (14.2%) and 53 placebo-
treated patients (18.7%). This composite cardiovascular endpoint
included cardiovascular death in 10 (3.5%) patients receiving
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olmesartan versus 3 (1.1%) receiving placebo, overall mortality 19
(6.7%) versus 20 (7.0%), non-fatal stroke 8 (2.8%) versus 11 (3.9%)
and non-fatal myocardial infarction 3 (1.1%) versus 7 (2.5%),
respectively.
Paediatric population
The antihypertensive effects of olmesartan medoxomil in the
paediatric population were evaluated in a randomized, double-blind,
placebo-controlled study in 302 hypertensive patients aged 6 to 17
years. The study population consisted of an all black cohort of 112
patients and a mixed racial cohort of 190 patients, including 38
blacks. The aetiology of the hypertension was predominantly
essential hypertension (87% of the black cohort and 67% of the
mixed cohort). Patients who weighed 20 to <35 kg were randomized
to 2.5mg (low dose) or 20mg (high dose) of olmesartan medoxomil
once daily and patients who weighed ≥35 kg were randomized to
5mg (low dose) or 40mg (high dose)of olmesartan medoxomil once
daily. Olmesartan medoxomil significantly reduced both systolic and
diastolic blood pressure in a weight-adjusted dose-dependent
manner. Olmesartan medoxomil at both low and high doses
significantly reduced systolic blood pressure by 6.6 and 11.9 mmHg
from the baseline, respectively. This effect was also observed during
the 2 weeks randomized withdrawal phase, whereby both mean
systolic and diastolic blood pressures demonstrated a statistically
significant rebound in the placebo group compared to olmesartan
group. The treatment was effective in both, paediatric patients with
primary and secondary hypertension. As observed in adult
populations, the blood pressure reductions were smaller in black
patients.
In the same study, 59 patients aged 1 to 5 years who weighed ≥ 5 kg
received 0.3mg/kg of olmesartan medoxomil once daily for three
weeks in an open label phase and then were randomized to receiving
olmesartan medoxomil or placebo in a double-blind phase. At the
end of the second week of withdrawal, the mean systolic/diastolic
blood pressure at trough was 3/3 mmHg lower in the group
randomized to olmesartan medoxomil; this difference in blood
pressure was not statistically significant (95% C.I. -2 to 7/ -1 to 7).
Other information
Two large randomised, controlled trials (ONTARGET (ONgoing
Telmisartan Alone and in combination with Ramipril Global
Endpoint Trial) and VA NEPHRON-D (The Veterans Affairs
Nephropathy in Diabetes)) have examined the use of the combination
of an ACE-inhibitor with an angiotensin II receptor blocker.
ONTARGET was a study conducted in patients with a history of
cardiovascular or cerebrovascular disease, or type 2 diabetes mellitus
accompanied by evidence of end-organ damage. VA NEPHRON-D
was a study in patients with type 2 diabetes mellitus and diabetic
nephropathy.
These studies have shown no significant beneficial effect on renal
and/or cardiovascular outcomes and mortality, while an increased
risk of hyperkalaemia, acute kidney injury and/or hypotension as
compared to monotherapy was observed. Given their similar
pharmacodynamic properties, these results are also relevant for other
ACE-inhibitors and angiotensin II receptor blockers.
ACE-inhibitors and angiotensin II receptor blockers should therefore
not be used concomitantly in patients with diabetic nephropathy.
ALTITUDE (Aliskiren Trial in Type 2 Diabetes Using
Cardiovascular and Renal Disease Endpoints) was a study designed
to test the benefit of adding aliskiren to a standard therapy of an
ACE-inhibitor or an angiotensin II receptor blocker in patients with
type 2 diabetes mellitus and chronic kidney disease, cardiovascular
disease, or both. The study was terminated early because of an
increased risk of adverse outcomes. Cardiovascular death and stroke
were both numerically more frequent in the aliskiren group than in
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the placebo group and adverse events and serious adverse events of
interest (hyperkalaemia, hypotension and renal dysfunction) were
more frequently reported in the aliskiren group than in the placebo
group.
5.2 Pharmacokinetic properties
Absorption and distribution
Olmesartan medoxomil is a prodrug. It is rapidly converted to the
pharmacologically active metabolite, olmesartan, by esterases in the
gut mucosa and in portal blood during absorption from the
gastrointestinal tract.
No intact olmesartan medoxomil or intact side chain medoxomil
moiety have been detected in plasma or excreta. The mean absolute
bioavailability of olmesartan from a tablet formulation was 25.6 %.
The mean peak plasma concentration (Cmax) of olmesartan is reached
within about 2 hours after oral dosing with olmesartan medoxomil,
and olmesartan plasma concentrations increase approximately
linearly with increasing single oral doses up to about 80mg.
Food had minimal effect on the bioavailability of olmesartan and
therefore olmesartan medoxomil may be administered with or
without food.
No clinically relevant gender-related differences in the
pharmacokinetics of olmesartan have been observed.
Olmesartan is highly bound to plasma protein (99.7 %), but the
potential for clinically significant protein binding displacement
interactions between olmesartan and other highly bound
coadministered drugs is low (as confirmed by the lack of a clinically
significant interaction between olmesartan medoxomil and warfarin).
The binding of olmesartan to blood cells is negligible. The mean
volume of distribution after intravenous dosing is low (16 - 29 L).
Biotransformation and elimination
Total plasma clearance was typically 1.3 L/h (CV, 19 %) and was
relatively slow compared to hepatic blood flow (ca 90 L/h).
Following a single oral dose of 14
C-labelled olmesartan medoxomil,
10 - 16 % of the administered radioactivity was excreted in the urine
(the vast majority within 24 hours of dose administration) and the
remainder of the recovered radioactivity was excreted in the faeces.
Based on the systemic availability of 25.6 %, it can be calculated that
absorbed olmesartan is cleared by both renal excretion (ca 40 %) and
hepato-biliary excretion (ca 60 %). All recovered radioactivity was
identified as olmesartan. No other significant metabolite was
detected. Enterohepatic recycling of olmesartan is minimal. Since a
large proportion of olmesartan is excreted via the biliary route, use in
patients with biliary obstruction is contraindicated (see section 4.3).
The terminal elimination half life of olmesartan varied between 10
and 15 hours after multiple oral dosing. Steady state was reached
after the first few doses and no further accumulation was evident
after 14 days of repeated dosing. Renal clearance was approximately
0.5 - 0.7 L/h and was independent of dose.
Pharmacokinetic/ s in special populations:
Paediatric population
The pharmacokinetics of olmesartan was studied in paediatric
hypertensive patients aged 1 to16 years. The clearance of olmesartan
in paediatric patients was similar to that in adult patients when
adjusted by the body weight.
There is no pharmacokinetic information available in renally
impaired paediatric subjects.
Elderly people (age 65 years or older)
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In hypertensive patients, the AUC at steady state was increased by ca
35 % in elderly patients (65 - 75 years old) and by ca 44 % in very
elderly patients (≥75 years old) compared with the younger age
group. This may be at least in part related to a mean decrease in renal
function in this group of patients.
Renal impairment
In renally impaired patients, the AUC at steady state increased by 62
%, 82 % and 179 % in patients with mild, moderate and severe renal
impairment, respectively, compared to healthy controls (see sections
4.2, 4.4).
Hepatic impairment
After single oral administration, olmesartan AUC values were 6 %
and 65 % higher in mildly and moderately hepatically impaired
patients, respectively, than in their corresponding matched healthy
controls. The unbound fraction of olmesartan at 2 hours post-dose in
healthy subjects, in patients with mild hepatic impairment and in
patients with moderate hepatic impairment was 0.26 %, 0.34 % and
0.41 %, respectively. Following repeated dosing in patients with
moderate hepatic impairment, olmesartan mean AUC was again
about 65 % higher than in matched healthy controls. Olmesartan
mean Cmax values were similar in hepatically-impaired and healthy
subjects. Olmesartan medoxomil has not been evaluated in patients
with severe hepatic impairment (see sections 4.2, 4.4).
Drug interactions
Bile acid sequestering agent colesevelam
Concomitant administration of 40mg olmesartan medoxomil and
3750mg colesevelam hydrochloride in healthy subjects resulted in
28% reduction in Cmax and 39% reduction in AUC of olmesartan.
Lesser effects, 4% and 15% reduction in Cmax and AUC respectively,
were observed when olmesartan medoxomil was administered 4
hours prior to colesevelam hydrochloride. Elimination half life of
olmesartan was reduced by 50-52% irrespectively of whether
administered concomitantly or 4 hours prior to colesevelam
hydrochloride (see section 4.5).
5.3 Preclinical safety data
In chronic toxicity studies in rats and dogs, olmesartan medoxomil
showed similar effects to other AT1 receptor antagonists and ACE
inhibitors: raised blood urea (BUN) and creatinine (through
functional changes to the kidneys caused by blocking AT1 receptors);
reduction in heart weight; a reduction of red cell parameters
(erythrocytes, haemoglobin, haematocrit); histological indications of
renal damage (regenerative lesions of the renal epithelium,
thickening of the basal membrane, dilatation of the tubules). These
adverse effects caused by the pharmacological action of olmesartan
medoxomil have also occurred in preclinical trials on other
AT1 receptor antagonists and ACE inhibitors and can be reduced by
simultaneous oral administration of sodium chloride.
In both species, increased plasma renin activity and
hypertrophy/hyperplasia of the juxtaglomerular cells of the kidney
were observed. These changes, which are a typical effect of the class
of ACE inhibitors and other AT1 receptor antagonists, would appear
to have no clinical relevance.
Like other AT1 receptor antagonists olmesartan medoxomil was
found to increase the incidence of chromosome breaks in cell
cultures in vitro. No relevant effects were observed in several in
vivo studies using olmesartan medoxomil at very high oral doses of
up to 2000mg/kg. The overall data of a comprehensive genotoxicity
testing suggest that olmesartan is very unlikely to exert genotoxic
effects under conditions of clinical use.
Olmesartan medoxomil was not carcinogenic, neither in rats in a 2
year study nor in mice when tested in two 6 month carcinogenicity
studies using transgenic models.
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In reproductive studies in rats, olmesartan medoxomil did not affect
fertility and there was no evidence of a teratogenic effect. In
common with other angiotensin II antagonists, survival of offspring
was reduced following exposure to olmesartan medoxomil and
pelvic dilatation of the kidney was seen after exposure of the dams in
late pregnancy and lactation. In common with other antihypertensive
agents, olmesartan medoxomil was shown to be more toxic to
pregnant rabbits than to pregnant rats, however, there was no
indication of a fetotoxic effect.
6. Pharmaceutical particulars
6.1 List of excipients
Tablet core:
Cellulose, microcrystalline, Lactose monohydrate,
Hydroxypropylcellulose, Low substituted hydroxypropylcellulose,
Magnesium stearate
Film-coating:
Opadry II White , Titanium dioxide, Hypromellose, Lactose
monohydrate, Macrogol, Triacetin
6.2 Incompatibilities
Not applicable.
6.3 Shelf life
2 years.
6.4 Special precautions for storage
This medicinal product does not require any special storage
conditions.
6.5 Nature and contents of container
Aluminium/aluminium blister pack.
Packs of 7, 10, 14, 28, 30, 56, 60, 84, 90, 98 and 100 film-coated
tablets.
Not all pack sizes may be marketed
6.6 Special precautions for disposal and other handling
No special requirements
7. Manufactured By:
Taj Pharmaceuticals Ltd.
at: Plot. No. 220, Mahagujarat
Industrial Estate, At & Post-Moraiya,
Tal-Sanand, Dist- Ahmedabad Gujarat (India)