Methocarbamol 1000 mg/10 ml.

Solution for injection.

The injectable form of methocarbamol is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. 
Methocarbamol does not directly relax tense skeletal muscles in man.

Methocarbamol Injection may be administered undiluted directly into the vein at a maximum rate of three mL per minute.

It may also be added to an intravenous drip of Sodium Chloride Injection  or five percent Dextrose Injection; one vial given as a single dose should not be diluted to more than 250 mL for I.V. infusion.

After mixing with intravenous infusion fluids, do not refrigerate. 

Tranexamic acid 500mg/10ml

Solution for injection

Prevention and treatment of haemorrhages due to general or local fibrinolysis in adults and children from one year

The administration is strictly limited to slow intravenous injection.

Piracetam 1000 mg/5 ml.

Solution for injection.

Piracetam is administered intravenously and intramuscularly on serious cerebral diseases, states of coma, as well as for arresting of abstinent, preliminary or delirious states or acute complications occurred in the period of psychopharmacotherapy.

The preparation is administered intramuscularly or intravenously in adults starting with the dose of 2-4 g and then the dose can be immediately increased up to 4-6 g per day. The duration of treatment and the individual dose depend on the disease severity and reverse dynamics speed of the clinical presentation. For treatment of ischemic stroke piracetam is administered drop-by-drop in the doses 4-12 g per day during 2-4 weeks.

Amelioration being achieved, piracetam for oral administration should be prescribed.

For treatment of acute brain injuries piracetam is prescribed in the complex with other disintoxication and rehabilitation therapy, and for treatment of psychiatric diseases – with corresponding psychotropic agents.

Administration of piracetam can be sometimes accompanied by administration of psychotropic, cardiovascular and other medicines.

Neostigmine methylsulfate 0.5mg/ml

Solution for injection

Myasthenia Gravis, antagonist to non-depolarizing neuromuscular blockade, Paralytic Ileus, Post-operative Urinary Retention; Paroxysmal Supraventricular Tachycardia

Neostigmine Methylsulfate should be given very slowly by the IV route. A syringe of Atropine Sulfate should always be available to counteract severe cholinergic reactions should they occur.
Myasthenia Gravis
1 – 2.5mg by IM or SC injection at intervals throughout the day, when maximum strength is needed. The usual duration of action of a dose is two to four hours. The total daily dose is usually 5 – 20mg by injection but higher doses may be needed by some patients.
Neonatal Myasthenia Gravis may be treated with 0.1mg Neostigmine intramuscularly initially. Thereafter, the dose must be titrated individually. But is usually 0.05 – 0.25mg IM or 0.03mg/kg IM, every two – four hours. Because of the self-limiting nature of the disease in neonates, the daily dosage should be reduced until the drug can be withdrawn.
Older Children: (Under 12 years of age)
May be given 0.2 – 0.5mg by injection as required. Dosage requirements should be adjusted according to the response of the patient.
Antagonist to Non-depolarizing Neuromuscular Blockade
Reversal of Neuromuscular blockade with Neostigmine should not be attempted unless there is spontaneous recovery from paralysis.
Adults and Children
A single dose of Neostigmine 0.05 – 0.07 mg/kg body-weight and Atropine 0.02 – 0.03 mg/kg body weight, by slow IV injection over one minute is usually adequate for complete reversal of Non-depolarizing Muscle Relaxants within 5 – 15 minutes. The maximum recommended dose of Neostigmine in adults is 5mg and in children 2.5mg.
Atropine and Neostigmine may be given simultaneously, but in patients with Bradycardia, the pulse rate should be increased to 80 per minute with Atropine before administering Neostigmine.
Other Indications
Adults: 0.5 – 2.5mg Neostigmine Methylsulfate by SC or IM injection.
Children: 0.125 – 1mg by injection. Doses may be varied according to the individual needs of the patient.
Elderly: There are no specific dosage recommendations for Neostigmine Methylsulfate in the elderly.

Neostigmine methylsulfate 0.25mg/ml

Solution for injection

Myasthenia Gravis, antagonist to non-depolarizing neuromuscular blockade, Paralytic Ileus, Post-operative Urinary Retention; Paroxysmal Supraventricular Tachycardia

Neostigmine Methylsulfate should be given very slowly by the IV route. A syringe of Atropine Sulfate should always be available to counteract severe cholinergic reactions should they occur.
Myasthenia Gravis
1 – 2.5mg by IM or SC injection at intervals throughout the day, when maximum strength is needed. The usual duration of action of a dose is two to four hours. The total daily dose is usually 5 – 20mg by injection but higher doses may be needed by some patients.
Neonatal Myasthenia Gravis may be treated with 0.1mg Neostigmine intramuscularly initially. Thereafter, the dose must be titrated individually. But is usually 0.05 – 0.25mg IM or 0.03mg/kg IM, every two – four hours. Because of the self-limiting nature of the disease in neonates, the daily dosage should be reduced until the drug can be withdrawn.
Older Children: (Under 12 years of age)
May be given 0.2 – 0.5mg by injection as required. Dosage requirements should be adjusted according to the response of the patient.
Antagonist to Non-depolarizing Neuromuscular Blockade
Reversal of Neuromuscular blockade with Neostigmine should not be attempted unless there is spontaneous recovery from paralysis.
Adults and Children
A single dose of Neostigmine 0.05 – 0.07 mg/kg body-weight and Atropine 0.02 – 0.03 mg/kg body weight, by slow IV injection over one minute is usually adequate for complete reversal of Non-depolarizing Muscle Relaxants within 5 – 15 minutes. The maximum recommended dose of Neostigmine in adults is 5mg and in children 2.5mg.
Atropine and Neostigmine may be given simultaneously, but in patients with Bradycardia, the pulse rate should be increased to 80 per minute with Atropine before administering Neostigmine.
Other Indications
Adults: 0.5 – 2.5mg Neostigmine Methylsulfate by SC or IM injection.
Children: 0.125 – 1mg by injection. Doses may be varied according to the individual needs of the patient.
Elderly: There are no specific dosage recommendations for Neostigmine Methylsulfate in the elderly.

Naloxone 0.4mg/ml.

Solution for injection.

Complete or partial reversal of CNS depressive effects, especially respiratory depression, caused by natural or synthetic opioids and partial agonist/antagonist opioids.

Diagnosis of suspected acute opioid overdose or intoxication.

The medicinal product can be injected intravenously (i.v.), intramuscularly (i.m.) or can be given via intravenous infusion.

The i.m. administration of naloxone hydrochloride should only be used in cases where an i.v. administration is not possible.

The most rapid effect is obtained by means of i.v. administration, which is why this method of administration is recommended in acute cases.

Mecobalamin 500mcg/ml

Solution for injection

Peripheral neuropathies Megaloblastic anemia caused by vitamin B12 deficiency

Posology
Adult Dosage
Injection 500µg
• Peripheral neurophathies
The usual dosage for adults is 1 ampoule (500 µg of mecobalamin) daily, administered intramuscularly or intravenously 3 times a week. The dosage may be adjusted depending on the patient’s age and symptoms.
• Megaloblastic anemia
The usual dosage for adults is 1 ampoule (500 µg of mecobalamin) daily, administered intramuscularly or intravenously 3 times a week. After about 2 months of medication, the dose should be reduced to a single administration of 1ampoule at 1 to 3 months intervals for maintenance therapy.
Method of Administration
Intramuscular, intravenous
 

Hyoscine butylbromide 40mg/2ml

Solution for injection

The relief of acute genitourinary or gastrointestinal spasm (e.g., renal or biliary colic), or to produce smooth muscle relaxation prior to radiological procedures such as pyelography or other diagnostic procedures where spasm may be a problem (e.g., gastro-duodenal endoscopy).

Adults:
One ampoule (40 mg) intramuscularly or intravenously, repeated after half an hour if necessary. Intravenous injection should be performed 'slowly' (in rare cases a marked drop in blood pressure and even shock may be produced by Buscopan). When used in endoscopy this dose may need to be repeated more frequently.
Maximum daily dose of 100mg.
Elderly: No specific information on the use of this product in the elderly is available. Clinical trials have included patients over 65 years and no adverse reactions specific to this age group have been reported.
Paediatric population: Not recommended for children.
Hyoscin should not be taken on a continuous daily basis or for extended periods without investigating the cause of abdominal pain.
Diluent: Hyoscin may be diluted with dextrose or with sodium chloride 0.9% injection solutions.

Folinic acid (as  calcium folinate) 50 mg/5 ml

Solution for injection

Indicated for:
- Diminish the toxicity and counteract the action of folic acid antagonists such as methotrexate in cytotoxic therapy and overdose in adults and children
- In combination with 5-fluorouracil in cytotoxic therapy.

Calcium Folinate Rescue in methotrexate therapy: 

Dosage and duration of use of Calcium folinate primarily depend on the type and dosage of methotrexate therapy, the occurrence of toxicity symptoms, and the individual excretion capacity for methotrexate. As a rule, the first dose of Calcium folinate is 15 mg (6-12 mg/m²) to be given 12-24 hours (24 hours at the latest) after the beginning of the methotrexate infusion. The same dose is given every 6 hours throughout a period of 72 hours. After several parenteral doses treatment can be switched over to the oral form.

In combination with 5-fluorouracil in cytotoxic therapy: 

Bimonthly regimen:

Calcium folinate 200mg/m² by intravenous infusion over two hours, followed by an intravenous bolus of 400 mg/m² of 5-Fluorouracil and a 22-hour intravenous infusion of 5-Fluorouracil (600 mg/m²) for 2 consecutive days, every 2 weeks on days 1 and 2.

Weekly regimen:

Calcium folinate 20mg/m² by intravenous bolus. injection or 200 to 500 mg/m² intravenous. infusion over a period of 2 hours, plus 500 mg/m² 5-fluorouracil as an intravenous bolus injection in the middle, or at the end, of the calcium folinate infusion.

Monthly regimen:

Calcium folinate 20 mg/m² by bolus i.v. injection or 200 to 500 mg/m² as i.v. infusion over a period of 2 hours immediately followed by 425 or 370 mg/m² 5-fluorouracil as an intravenous bolus injection over five consecutive days.

For the use of calcium folinate in combination with 5-fluorouracil, modification of the 5-fluorouacil dosage and the treatment-free interval may be necessary depending on patient condition, clinical response and dose limiting toxicity as stated in the product information of 5-fluorouracil. A reduction of calcium folinate dosage is not required.

Adenosine 3mg/ml

Solution for injection

Rapid conversion to a normal sinus rhythm of paroxysmal supraventricular tachycardias, including those associated with accessory by-pass tracts (Wolff-Parkinson-White Syndrome).
Paediatric population
Rapid conversion to a normal sinus rhythm of paroxysmal supraventricular tachycardia in children aged 0 to 18 years.
Diagnostic indications
Aid to diagnosis of broad or narrow complex supraventricular tachycardias. Although adenosin will not convert atrial flutter, atrial fibrillation or ventricular tachycardia to sinus rhythm, the slowing of AV conduction helps diagnosis of atrial activity.
Sensitisation of intra-cavitary electrophysiological investigations.

It should be administered by rapid IV bolus injection according to the ascending dosage schedule below. To be certain the solution reaches the systemic circulation administer either directly into a vein or into an IV line. If given into an IV line it should be injected as proximally as possible, and followed by a rapid saline flush.

BFS-Adenosin should only be used when facilities exist for cardiac monitoring. Patients who develop high-level AV block at a particular dose should not be given further dosage increments.

Paracetamol 1000mg/10ml

Concentrated solution for infusion

Indicated for the short-term treatment of moderate pain, especially following surgery, and for the short-term treatment of fever

Adults: Adults and adolescents weighing under 50 kg: the recommended dosage of acetaminophen
injection is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single
dose of acetaminophen injection of 15 mg/kg, a minimum dosing interval of 4 hours, and a
maximum daily dose of acetaminophen of 75 mg/kg per day.
Children: Children 2 to 12 years of age: the recommended dosage of acetaminophen injection is 15
mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of acetaminophen injection of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of acetaminophen of 75 mg/kg per day.
 

Atropine sulfate 0.25mg/ml

Solution for injection

Atropine and anti-muscarin drugs are used to inhibit the effects of the parasympathetic nervous system in many cases:
- Gastrointestinal disorders.
- Gastric or duodenal ulcer: Inhibits the ability of gastric acid secretion.
- Irritable bowel syndrome: Decreased bowel spasm, reduces fluid secretion.

Atropine Injection 0.25mg/ml may be administered undiluted by IV (intravenous) injection.
In adults: It is recommended that three (3) doses be available for use in each person at risk for nerve agent or organophosphate insecticide poisoning; one (1) for mild symptoms plus two (2) more for severe symptoms as described below. No more than three (3) doses injections should be used unless the patient is under the supervision of a trained medical provider.
Different dose strengths are available depending on the recipient’s age. The following doses of atropine 0.25mg are recommnded like below:
- Adults and children weighing over 90 lbs (41 kg) or generally over 10 years of age:    2mg
- Children weighing 40 lbs to 90 lbs (18 – 41 kg) or generally 4 to 10 years of age:    1mg
- Children weighing 15 lbs to 40 lbs (7 – 18 kg) or generally 6 months to 4 years of age:    0.5mg
- Infants weighing less than 15 lbs (7 kg) or generally less than 6 months of age:    0.25mg