Supply:10IU/1ml/Amp(PITON-SR)
Use:Used in induction of labor, uterine inertia, postpartum bleeding.
Contraindication:Toxemia abruption placenta, undilated cervix over distended uterus, abnormal presentation, and cardiovascular or renal disease.
Adverse effect:Nausea, vomiting, cardiac arrhythmia, fetal bradycardia, postpartum hemorrhage, afibrinogenemia, pelvic hematoma, water intoxication.
Usual dosage:Dosage is determined by uterine response:
Induction of labor: IV infusion: 10 unit diluted with 1000ml isotonic saline or dextrose and staring at 0.01 unit per minute. the dosage can be doubled every 30-45 minutes. IM: initial dose 0.1 unit increasing to 0.2, 0.4, 0.8 unit etc every 30 minutes intervals.Control postpartum bleeding: 20-40 unit diluted with 1000ml isotonic saline or dextrose IV infusion. Stimulation of lactation 2 iu IM.Treatment of incomplete abortion 2-5 iu IM every 30-60 mins or IV infusion in adequate dose.
Special precautions:Careful monitoring essential. Existence of scars of the uterus & cervix. Hypotension.
RITODRINE CHL B
Supply:10mg/Tab(YUTOPARR), 10mg/ml/Amp(ANPOR)
Use:Premature labour (after 20th week), prevention of premature labour after gynecological operations, acute fetal distress during labour if caused by hypermotility of the uterus or compression of the umbilical cord.
Contraindication:Patients with heavy blood loss per vaginam, maternal cardiac disease, chorioamnionitis.
Adverse effect:Palpitation, increase maternal pulse rate, tachycardia, flushing, sweating, tremor, nausea, vomiting.
Usual dosage:Premature labor: IV, initial dose 0.05mg/min to be gradually increased according to the results by 0.05mg/min every 10 minutes. The effective dosage: 0.15-0.35mg/min. The infusion should be continued for 12 to 48 hours after the uterine contraction have ceased. Tab 1-2 tab 2-6 hrly. Max: 120mg daily. Usually 80-120 mg equally divided over the day
Special precautions:Patients with potential cardiac risk & cardiac abnormalities. Careful monitorong of patients with suspected cardiac disorders. Occult cardiac disease may be unmasked. Diabetic patients or those receiving K-depleting diuretics.Monitor patient's state of hydration, avoid fluid overload. IV treatment for greater than or equal to 2-3 wk may lead to leucopenia &/or agranulocytosis with complete recovery after discontinuation of treatment
Adrenal corticosteroids
DEXAMETHASONE PHOSPHATE C
Supply:5mg/ml/Amp(METHASONER)
Use:Rheumatic arthritis, certain leukemia, lymphoma, soft tissue inflammation, head injury, hemolytic anemia and other collagen diseases.
Contraindication:Systemic fungal infections.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:PO, 0.75-9mg/day.
HYDROCORTISONE SODIUM SUCCINATE C
Supply:100mg/Vial(SOLU-CORTEFR)
Use:Cortisone is used for replacement therapy in chronic adrenocortical insufficiency, salt-losing forms of congenital adrenal hyperplasia syndromes, and as an anti-inflammatory agent.
Contraindication:Systemic fungal infection.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:20-240mg/day, IM or IV.
METHYLPREDNISOLONE SODIUM SUCCINATE C
Supply:4mg/Tab(MEDNINR), 125mg/Vial(MEDASONR), 40mg/Vial(STERILE SOLU-MEDROLR)
Use:Endocrine disorders, severe shock, collagen disease, bronchial asthma and dermatologic disease.
Contraindication:Systemic fungal infections.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:Usual dose 4-48mg/day IV over one to several minutes; high dose therapy, 30mg/kg IV over 10-20 minutes, may be repeated Q4H or Q6H for 48 hours.
PREDNISOLONE B
Supply:5mg/Tab(PRECONINR)
Use:Endocrine and rheumatic disorders; collagen, dermatological ophthalmic, respiratory and GI disease, exacerbation of multiple sclerosis, trichinosis associated with neurological or myocardial involvement.
Contraindication:Systemic fungal infection.
Adverse effect:Sodium and fluid retention, loss of potassium, muscle weakness, steroid myopathy, osteoporosis, peptic ulcer, pancreatitis, impaired wound healing.
Usual dosage:5-60mg/day, maximum dose: 250mg/day.
Androgens and anabolic steroids
METHYLTESTOSTERONE X
Supply:10mg/Cap(METHYLTESTOSTERONER)
Use:Eunuchism, eunuchoidism, male climacteric or impotence, postpubertal cryptorchidism with evidence of hypogonadism, postpartum breast pain and engorgement, advanced inoperable androgen after having stopped medication.
Contraindication:Male breast carcinoma, hypercalcemia, easily stimulated patients carcinoma of the prostate, hepatic impairment, cardiac, hepatic or renal decompensation, prepubertal males.
Adverse effect:Skin reactions, anaphylactoid reactions; acne, decreased ejaculatory volume, cholestatic jaundice, edema, hypercalcemia.
Usual dosage:PO, 10-40mg/day for eunuchism, 30mg/day for postpubertal cryptochidism, 80mg/day for 3-5 days for postpartum breast pain and engorgement, 200mg/day for advanced inoperable androgen responsive breast cancer in females.
CYPROTERONE ACETATE
Supply:50mg/Tab(ANDROCURR)
Use:Cyproterone acetate is an antiandrogen with progestogenic activity. Use alone or in combination with estrogens has demonstrated some degree of efficacy in a variety of conditions, including advanced prostatic carcinoma, hypersexual behavior disorders, endometriosis, hirsutism, acne, post-orchiectomy hot flashes, and lupus erythematosus; low doses of the drug with estrogen have been evaluated in postmenopausal replacement therapy.
Contraindication:It should not be used in patient previous hypersensitivity to cyproterone acetate, malignant diseases other than prostatic carcinoma, patients with a history of thromboembolic disorders, acute liver disease. Other precautions include: patient with severe chronic depression or immature youth (potential for delayed bone maturation and testicular development). Don't use with alcohol.
Adverse effect:Skin reaction, weight change , headache, anaemia, gynaecomastia, abnormal spermatozoa, nausea, hair pattern, infertility, gastrointestinal disturbance, decrease renal function.
Usual dosage:50mg BID, if necessary after 4 weeks, increase to 200-300mg/day
*ESTANDROM PROLONGATUMR X
Content:per ml Estradiol benzoate 1 mg, estradiol phenylpropionate 4 mg, testosterone propionate 20mg, testosterone phenylpropionate 40mg, testosterone isocaproate 40 mg
Use:Estrogen deficiency symptoms associated with natural or surgical menopause
Adverse effect:GI upsets; BP rise, thrombosis; erythema nodosum, acne, hirsutism; headache, migraine, mood changes; breast tendermess, pain, enlargement & secretions; body weight changes; intermenstrual bleeding, enlarged clitoris.
Usual dosage:1 ml every 3-4 week or longer interval, depending on the clinical need. By IM inj only
Estrogens, Progestins & Drugs used for infertility
CONJUGATED ESTROGEN X
Supply:0.625mg/Tab(PREMARINR)
Use:Severe vasomotor symptoms associated with the menopause; primary ovarian failure; atrophic vaginitis.
Contraindication:Breast cancer; estrogen dependent neoplasia, pregnancy, active thrombophlebitis, or thromboembolic disorders, abnormal vaginal bleeding.
Adverse effect:Breast tenderness, enlargement and secretion; melasma, erythema multiforme erythema nodosum, migraine, dizziness, mental depression and chorea.
Usual dosage:
Moderate to severe vasmotor symptoms associated with the menopause: 1.25mg/day. If the patient is menstruating, begin administration on day 5 of bleeding.
Atrophic vaginitis and kraurosis vulvae: 0.3 to 1.25mg or more per day.
Female hypogonadism: 2.5-7.5mg/day, TID for 20 days, followed by a rest period of 10 days.
Female castration and primary ovarian: 1.25mg/day.
Mammary carcinoma (for palliation): 10mg TID for at least 3 months.
Prevention of postpartum breast engorgement: 3.75mg Q4H for 5 doses or 1.25mg Q4H for 5 days.
DANAZOL X
Supply:200mg/Cap(CYCLOLADYR)
Use:Endometriosis, fibrocystic breast disease, menorrhagia.
Contraindication:Abnormal genital bleeding; impaired hepatic, renal or cardiac function; pregnancy and breast feeding.
Adverse effect:Acne, edema, mild hirsutism, decrease in breast size, weight gain and testicular atrophy.
Usual dosage:Endometriosis: make sure the patient is not pregnancy, administer 800mg/day BID for 3-6 months, up to 9 months. Fibrocystic breast disease: 100-400mg BID.
DYDROGESTERONE
Supply:5mg/Tab(DUPHASTONR)
Use:Dysmenorrhea, endometriosis, infertility, threatened abortion, secondary amenorrhoes and functional uterine bleedings.
Adverse effect:GI disturbances and mild leukocytosis. Breakthrough bleeding (increase dosage)
Usual dosage:Infertility 10 mg bid from day 11-25 of the cycle. Duration:3 mouth. Threatened abortion 40mg at once then 10 mg 8 hrly until symptom remit. Habitul abortion 10 mg bid until the 20th wk of pregnancy. Duration:3 mouth.Primary dysmenorrhea 10 mg bid from day 5-25 of the cycle. Duration:3-6 mouth. Endometriosis 10mg bid-tid from day 5-25 of the cycle or continuously. Duration:3-9 mouth Premenstrual syndrome 10 mg bid from day 11-25 of the cycle.Duration:3-6 mouth. Secondary amenorrhea An estrogen once daily from day 1-25 of the cycle with 10 mg dydrogesterone bid from day 11-25 of the cycle. Duration: 3 mouth.Dysfunctional uterine bleeding To stop bleeding :10mg bid with an estrogen once daily for 5-7 days. To prevent bleeding:10mg bid with an estrogen once daily from day 11-25 of the cycle. Duration:3 mouth
Warning:Breakthrough bleeding may occur in a few patients. It can be prevented by increasing the dosage.
OESTROGEL
Supply:Cream 30g/Tube, each gram content 17-ß estradiol 0.6mg
Use:Oestrogel is indicated in estrogen deficiency following the decrease in ovarian activity, vaginal dryness and atrophy.
Contraindication:Malignant tumors of the breast or uterus, pituitary tumors, avoid in women with past or present thromboembolic disease.
Adverse effect:Increase the risk of endometrial cancer, nausea, high dose may produce hypertension
Usual dosage:Topical 2.5g QD over the largest area of both arms, or forearms, or shoulder, but avoiding the area of the breast and vulvar mucosa.
*COVINA X
Content:estradiol 2mg, norethisterone 1mg
Use:Estrogen deficiency syndrome, prevention of bone mineral content loss, in post menopausal women at increased risk of developing fractures.
Adverse effect:Breast tenderness, nausea, headache, edema.
Usual dosage:1 tab daily
*SEVINA X
Content:12 blue tab each containing estradiol 2 mg,10 white tab each containing estradiol 2mg, noresthisterone acetate 1mg. 6 orange tab each containing estradiol 1 mg
Use:Estrogen deficiency. Prevention of menopausal osteoporosis.
Adverse effect:Unscheduled bleeding. Alopecia, skin hypersensitivity, visual disturbances
Usual dosage:1 tab daily. Women on hormone replacement therapy or menstruating 1 tab from day 5 of the cycle
MEDROXYPROGESTERONE ACETATE D
Supply:5mg/Tab(ProveraR)
Use:Treatment of secondary amenorrhea and abnormal uterine bleeding caused by hormonal imbalance in patients without underlying organic pathology such as fibrosis or uterine cancer.
Contraindication:Patients with thrombophlebitis, thromboembolic disorders, cerebral apoplexy, undiagnosed vaginal bleeding, missed abortion.
Adverse effect:Changes in menstrual flow, spotting, amenorrhea, changes in cervical erosion and secretions, edema, weight gain or loss, cholestatic jaundice, breast tenderness, gastrointestinal disturbances, galactorrhea, and dermatologic effects.
Usual dosage:Treatment of secondary amenorrhea and abnormal uterine bleeding, usual oral dosage is 5-10mg daily for 5-10 days.
Mammary carcinoma, prostate carcinoma, renal carcinoma: 100-1000mg/day in 2-3 divided doses, may be combined with other antineoplastic agents.
NORETHISTERONE ACETATE
Supply:5mg/Tab(NORETONER, PRIMOLUT-NORR)
Use:Primary and secondary amenorrhoea, premenstrual syndrome, uterine hypoplasia, progressive carcinoma of the breast.
Contraindication:Pregnancy, severe liver disease, Dubin-Johnson syndrome, Rotor syndrome.
Adverse effect:Cholestatic liver changes (in high dose).
Usual dosage:10-20mg/day.
Content:Cyproterone acetate 2 mg, ethinylestradiol 35µg
Use:Androgen-dependent disease in women
Adverse effect:Headache; gastric upset; nausea; breast tension; changes in body weight & libido; intermenstrual bleeding; depressive moods; chloasma; rarely, poor tolerance of contact lenses, fluid retention.
Usual dosage:1 tab daily for 21 days, starting on the 1st day of the cycle, then 7 tab-free days
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