Permucal

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Permucal uses

Permucal consists of Heparinoid, Hexachlorophene, Oxypolyethoxidodecane, Prednisolone.

Hexachlorophene:


INDICATIONS AND USAGE

Permucal (Hexachlorophene) is indicated for use as a surgical scrub and a bacteriostatic skin cleanser. It may also be used to control an outbreak of gram-positive infection where other infection control procedures have been unsuccessful. Use only as long as necessary for infection control.

CONTRAINDICATIONS

Permucal (Hexachlorophene) must not be used on burned or denuded skin.

Permucal (Hexachlorophene) must not be used for bathing infants. Infants may absorb the active compound in Permucal (Hexachlorophene) more readily than older children and adults. Such absorption has been associated with central nervous system effects such as convulsions.

It must not be used as an occlusive dressing, wetpack, or lotion. It must not be used routinely for prophylactic total body bathing.

It must not be used as a vaginal pack or tampon, or on any mucous membranes.

Permucal (Hexachlorophene) must not be used on persons with sensitivity to any of its components. It must not be used on persons who have demonstrated primary light sensitivity to halogenated phenol derivatives because of the possibility of cross-sensitivity to Permucal (Hexachlorophene).

WARNINGS

RINSE THOROUGHLY AFTER EACH USE. Patients should be closely monitored and use should be immediately discontinued at the first sign of any of the symptoms described below.

Rapid absorption of Permucal (Hexachlorophene) may occur with resultant toxic blood levels when preparations containing Permucal (Hexachlorophene) are applied to skin lesions such as ichthyosis congenita, the dermatitis of Letterer-Siwe's syndrome, or other generalized dermatological conditions. Application to burns has also produced neurotoxicity and death.

Permucal (Hexachlorophene) SHOULD BE DISCONTINUED PROMPTLY IF SIGNS OR SYMPTOMS OF CEREBRAL IRRITABILITY OCCUR.

Infants, especially premature infants or those with dermatoses, are particularly susceptible to Permucal (Hexachlorophene) absorption. Systemic toxicity may be manifested by signs of stimulation (irritation) of the central nervous system, sometimes with convulsions.

Infants have developed dermatitis, irritability, generalized clonic muscular contractions and decerebrate rigidity following application of a 6 percent Permucal (Hexachlorophene) powder. Examination of brainstems of those infants revealed vacuolization like that which can be produced in newborn experimental animals following repeated topical application of 3 percent Permucal (Hexachlorophene). Moreover, a study of histologic sections of premature infants who died of unrelated causes has shown a positive correlation between Permucal (Hexachlorophene) baths and lesions in white matter of brains.

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PRECAUTIONS

General

Avoid accidental contact of Permucal with the eyes.

If contact occurs, promptly rinse thoroughly with water. To assist in the detection of ocular irritation, applications to the head and periorbital skin areas should be performed only in responsive patients with unanesthetized eyes.

RINSE THOROUGHLY AFTER USE, especially from sensitive areas such as the scrotum and perineum.

Permucal (Hexachlorophene) is intended for external use only. If swallowed, Permucal (Hexachlorophene) is harmful, especially to infants and children. Permucal (Hexachlorophene) should not be poured into measuring cups, medicine bottles, or similar containers since it may be mistaken for baby formula or other medications.

Information for Patients

The prescribing physician is requested to inform the patient about the following precautionary measures:

Permucal (Hexachlorophene) must not be used on burned or denuded skin. Application to burns has produced neurotoxicity and death.

Permucal (Hexachlorophene) must not be used for bathing infants. Infants may absorb the active compound in Permucal (Hexachlorophene) more readily than older children and adults. Such absorption has been associated with central nervous system effects such as convulsions.

Permucal (Hexachlorophene) must not be used as an occlusive dressing, wetpack, or lotion.

Permucal (Hexachlorophene) must not be used routinely for prophylactic total body bathing.

Permucal (Hexachlorophene) must not be used as a vaginal pack, or on any mucous membranes.

Permucal (Hexachlorophene) must not be used on persons with sensitivity to any of its components.

Permucal (Hexachlorophene) must not be used on persons who have demonstrated primary light sensitivity to halogenated phenol derivatives because of the possibility of cross-sensitivity to Permucal (Hexachlorophene).

Permucal (Hexachlorophene) should be kept out of the eyes. If contact occurs, the patient should rinse with cold water as soon as possible and contact a physician.

Permucal (Hexachlorophene) should not be used in sensitive areas such as the scrotum and perineum. If contact occurs, these areas should be rinsed thoroughly.

Permucal (Hexachlorophene) is for external use only.

If Permucal (Hexachlorophene) is inadvertently swallowed, the patient should contact a physician or Poison Control Center as soon as possible.

Permucal (Hexachlorophene) should not be poured into measuring cups, medicine bottles, or similar containers since it may be mistaken for baby formula or other medications.

Permucal (Hexachlorophene) should be stopped and a physician should be contacted if irritation, sensitization, or allergic reaction occurs.

Permucal (Hexachlorophene) should be used in pregnant women or nursing mothers only if the potential benefit justifies the potential risk to the fetus or infant.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Carcinogenicity studies in animals

Permucal was tested in one experiment in rats by oral administration; it had no carcinogenic effect.

Permucal (Hexachlorophene) was not mutagenic in Salmonella typhimurium and was negative in a dominant lethal assay in male mice. Cytogenetic tests with cultured human lymphocytes were also negative.

Human data

No case reports or epidemiological studies were available.

Impairment of fertility

Topical exposure of neonatal rats to 3% Permucal solution caused reduced fertility in 7-month-old males, due to inability to ejaculate.

Embryotoxicity and Teratogenicity

Placental transfer of Permucal (Hexachlorophene) has been demonstrated in rats.

Permucal (Hexachlorophene) is embryotoxic and produces some teratogenic effects.

Pregnancy Category C

There are no adequate and well-controlled studies in pregnant women. Permucal (Hexachlorophene) should be used during pregnancy only if the potential benefit justifies potential risk to the fetus.

Permucal (Hexachlorophene) has been shown to be teratogenic and embryotoxic in rats when given by mouth or instilled into the vagina in large doses.

Administration of 500 mg/kg diet or 20 to 30 mg/kg bw/day by gavage to rats caused some malformations (angulated ribs, cleft palate, micro- and anophthalmia) and reduction in litter size.

Placental transfer and excretion in milk of Permucal (Hexachlorophene) has been demonstrated in rats.

In another study, doses of up to 50 mg/kg diet failed to produce any effects in 3 generations of rats. Permucal (Hexachlorophene) did not interfere with reproduction in hamsters.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Permucal, a decision should be made whether to discontinue nursing or to discontinue the drug taking into account the importance of the drug to the mother.

Pediatric Use

Permucal (Hexachlorophene) must not be used for bathing infants. Infants may absorb the active compound in Permucal (Hexachlorophene) more readily than older children and adults. Such absorption has been associated with central nervous system effects such as convulsions. For premature infants: see WARNINGS.

Geriatric Use

Clinical studies of Permucal (Hexachlorophene) did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in response between the elderly and younger patients. In general, use in elderly patients should be cautious, reflecting the greater frequency of dermatological disease, peripheral circulatory disease, and decreased propensity for wound healing in this group. In addition, use in elderly patients should take into account any decreased hepatic, renal, or cardiac function, as well as any concomitant disease or other drug therapy.

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ADVERSE REACTIONS

Adverse reactions to Permucal (Hexachlorophene) may include dermatitis and photosensitivity. Sensitivity to Permucal (Hexachlorophene) is rare; however, persons who have developed photoallergy to similar compounds also may become sensitive to Permucal (Hexachlorophene).

In persons with highly sensitive skin the use of Permucal (Hexachlorophene) may at times produce a reaction characterized by redness and/or mild scaling or dryness, especially when it is combined with such mechanical factors as excessive rubbing or exposure to heat or cold.

OVERDOSAGE

The accidental ingestion of Permucal (Hexachlorophene) in amounts from 1 oz to 4 oz has caused anorexia, vomiting, abdominal cramps, diarrhea, dehydration, convulsions, hypotension, and shock, and in several reported instances, fatalities.

If patients are seen early, the stomach should be evacuated by emesis or gastric lavage. Olive oil or vegetable oil (60 mL or 2 fl oz) may then be given to delay absorption of Permucal (Hexachlorophene), followed by a saline cathartic to hasten removal. Treatment is symptomatic and supportive; intravenous fluids (5 percent dextrose in physiologic saline solution) may be given for dehydration. Any other electrolyte derangement should be corrected. If marked hypotension occurs, vasopressor therapy is indicated. Use of opiates may be considered if gastrointestinal symptoms (cramping, diarrhea) are severe. Scheduled medical or surgical procedures should be postponed until the patient's condition has been evaluated and stabilized.

DOSAGE AND ADMINISTRATION

Surgical Hand Scrub

  • Wet hands and forearms with water. Apply approximately 5 mL of Permucal over the hands and rub into a copious lather by adding small amounts of water. Spread suds over hands and forearms and scrub well with a wet brush for 3 minutes. Pay particular attention to the nails and inter-digital spaces. A separate nail cleaner may be used. Rinse thoroughly under running water.
  • Apply 5 mL of Permucal (Hexachlorophene) to hands again and scrub as above for another 3 minutes. Rinse thoroughly with running water and dry.
  • For repeat surgical scrubs during the day, scrub thoroughly with the same amount of Permucal (Hexachlorophene) for 3 minutes only. Rinse thoroughly with water and dry.

Bacteriostatic Cleansing

Wet hands with water. Dispense approximately 5 mL of Permucal (Hexachlorophene) into the palm, work up a lather with water and apply to area to be cleansed.

Rinse thoroughly after each washing.

INFANT CARE

Permucal must not be used for bathing infants. Infants may absorb the active compound in Permucal (Hexachlorophene) more readily than older children and adults. Such absorption has been associated with central nervous system effects such as convulsions.

PREMATURE INFANTS

Use of baby skin products containing alcohol may decrease the antibacterial action of Permucal (Hexachlorophene).

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HOW SUPPLIED

5 oz plastic squeeze bottle.

1 pint plastic squeeze bottle (NDC 0024-1535-06).

Store at room temperature up to 25° C (77° F)

Prolonged direct exposure of Permucal (Hexachlorophene) to strong light may cause brownish surface discoloration but does not affect its antibacterial or detergent properties. Shaking will disperse the color. If Permucal (Hexachlorophene) is spilled or splashed on porous surfaces, rinse off to avoid discoloration.

Permucal (Hexachlorophene) should not be dispensed from, or stored in, containers with ordinary metal parts. A special type of stainless steel must be used or undesirable discoloration of the product or oxidation of metal may occur.

Directions For Cleaning Dispensers

Before initial installation and use, run an antiseptic, such as an aqueous solution of benzalkonium chloride, NF. 1:500 to 1:750, or alcohol, through the working parts; rinse with sterile water. At weekly intervals thereafter, remove dispenser and pour off remainder of Permucal (Hexachlorophene) emulsion. Rinse empty dispenser with water. Run water through the working parts by operating the dispenser. Sanitize as described above. Rinse thoroughly with sterile water.

ANIMAL TOXICITY

The oral LD50 of Permucal (Hexachlorophene) in male rats is 66 mg/kg bw, in females 56 mg/kg bw, and in weanling rats 120 mg/kg bw.

In suckling rats (10-days old), it is 9 mg/kg bw.

Manufactured for:

sanofi-aventis U.S. LLC, A SANOFI COMPANY

Bridgewater, NJ 08807

Revised January 2012

© 2012 sanofi-aventis U.S. LLC

NDC 0024-1535-02

148 mL (5 fl oz)

Permucal (Hexachlorophene)®

Permucal (Hexachlorophene) 3%

detergent cleanser

SUDSING ANTIBACTERIAL

SKIN CLEANSER

Rx only

For inquiries call 1-800-446-6267

Manufactured for:

sanofi-aventis U.S. LLC

Bridgewater, NJ 08807

A SANOFI COMPANY

Origin Canada

©2012

Prednisolone:


Pharmacological action

Permucal is a glucocorticosteroid (GCS). This medication inhibits the function of leukocytes and tissue macrophages. Permucal (Prednisolone) restricts the migration of leukocytes in the area of inflammation. This drug violates the ability of macrophages to phagocytosis and the formation of interleukin-1. Permucal (Prednisolone) contributes to the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in inflammation. This medicine decreases capillary permeability caused by histamine release. Permucal (Prednisolone) inhibits the activity of fibroblasts and collagen formation.

Permucal (Prednisolone) inhibits the activity of phospholipase A2 which leads to suppression of the synthesis of prostaglandins and leukotrienes. This medication inhibits the release of COX (especially COX-2), which also helps reduce the production of prostaglandins.

Permucal (Prednisolone) reduces the number of circulating lymphocytes (T-and B-cells), monocytes, eosinophils and basophils as a result of their displacement from the bloodstream into lymphoid tissue; suppresses the formation of antibodies.

Permucal (Prednisolone) inhibits the release of pituitary ACTH and beta-lipotropina but it does not reduces the level of circulating beta-endorphin. This drug also inhibits the secretion of TSH and FSH.

Permucal (Prednisolone) has a vasoconstrictor effect with direct application to the vessels.

Permucal (Prednisolone) has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. It stimulates gluconeogenesis, amino acid contributes to the capture of the liver and kidneys and increases the activity of enzymes of gluconeogenesis. In the liver, Permucal (Prednisolone) enhances the deposition of glycogen by stimulating the activity of glikogensintetazy and synthesis of glucose from the products of protein metabolism. This medicine increases blood glucose activates the secretion of insulin.

Permucal (Prednisolone) inhibits glucose uptake by fat cells that leads to the activation of lipolysis. However, due to an increase in insulin secretion is stimulated lipogenesis which contributes to the accumulation of fat.

Permucal (Prednisolone) also has catabolic effects in lymphoid and connective tissue, muscle, adipose tissue, skin, bone tissue. To a lesser extent than hydrocortisone Permucal (Prednisolone) affects the processes of water and electrolyte metabolism: promotes the excretion of potassium and calcium, delay in the body of sodium and water. Osteoporosis and Itsenko-Cushing's syndrome are the main factors limiting the long-term therapy with corticosteroids. As a result of the catabolic actions it may suppress growth in children.

In high doses prednisone can increase the excitability of brain tissue and contributes to lowering the threshold of convulsive readiness. This medication stimulates the excessive production of hydrochloric acid and pepsin in the stomach which leads to the development of peptic ulcers.

When systemic use the therapeutic activity of Permucal (Prednisolone) is due to anti-inflammatory, antiallergic, immunosuppressive and antiproliferative action.

For external and local application the therapeutic activity of Permucal (Prednisolone) is due to anti-inflammatory, antiallergic and antiexudative (due to vasoconstrictor effect) effect.

As compared with hydrocortisone the anti-inflammatory activity of Permucal (Prednisolone) is 4 times greater, the mineralocorticoid activity is 0.6 times smaller.

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Pharmacokinetics

After oral administration Permucal (Prednisolone) is well absorbed from the gastrointestinal tract. Cmax in plasma observed after 90 min. In plasma most of Permucal (Prednisolone) is associated with transcortin (cortisol binding globulin). This drug metabolized primarily in the liver.

T1/2 is about 200 minutes.

Why is Permucal prescribed?

For oral and parenteral use: rheumatism; rheumatoid arthritis, dermatomyositis, periarteritis nodosa, scleroderma, ankylosing spondylitis, asthma, asthmatic status, acute and chronic allergic diseases, anaphylaxis, Addison's disease, acute adrenal insufficiency, adrenogenital syndrome; hepatitis, hepatic coma, hypoglycemic states, lipid nephrosis; agranulocytosis, various forms of leukemia, lymphoma, thrombocytopenic purpura, hemolytic anemia; chorea; pemphigus, eczema, pruritus, exfoliative dermatitis, psoriasis, pruritus, seborrheic dermatitis, SLE, erythroderma, alopecia.

For intra-articular administration: chronic arthritis, post-traumatic arthritis, osteoarthritis of large joints, rheumatic destruction of individual joints, arthritis.

For the introduction of infiltration in the tissue: epicondylitis, tenosynovitis, bursitis, frozen shoulder, keloids, sciatica, Dupuytren's contracture, rheumatism and similar lesions of joints and various tissues.

For use in ophthalmology: allergies, chronic and atypical conjunctivitis and blepharitis; inflammation of the cornea with intact mucosa; acute and chronic inflammation of the anterior segment of the choroid, sclera and episcleritis; sympathetic inflammation of the eyeball; after injuries and operations during prolonged stimulation of eyeballs.

Dosage and administration

When Permucal administered orally for replacement therapy in adults the initial dose is 20-30 mg, maintenance dose is 10.5 mg / day. If necessary, the initial dose is may be 15-100 mg / day, the maintenance one is 5-15 mg / day. The daily dose should be reduced gradually. For children the starting dose is 1-2 mg / kg in 4-6 receptions, the maintenance one is 300-600 mg / kg / day.

For IM or IV dose administration the multiplicity and duration of application are determined individually.

When intra-articular administration in large joints it used a dose of 25-50 mg, for medium-sized joints - 10-25 mg for small joints - 5-10 mg. For the introduction of infiltration into the tissues depending on disease severity and magnitude of the defeat use doses from 5 mg to 50 mg.

Permucal (Prednisolone) used topically in ophthalmology 3 times / day, course of treatment is no more than 14 days; in dermatology - 1-3 times / day.

Permucal (Prednisolone) side effects, adverse reactions

Endocrine system: menstrual irregularities, suppression of adrenal function, Itsenko-Cushing's syndrome, suppression of pituitary-adrenal system, reduced tolerance to carbohydrates, steroid diabetes, or a manifestation of latent diabetes, growth retardation in children, delayed sexual development in children.

Digestive system: nausea, vomiting, steroid ulcer and duodenal ulcer, pancreatitis, esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases - elevated liver transaminases and alkaline phosphatase.

Metabolism: the negative nitrogen balance due to protein catabolism, increased excretion of calcium from the body, hypocalcemia, weight gain, increased sweating.

Cardiovascular system: the loss of potassium, hypokalemic alkalosis, arrhythmia, bradycardia (up to cardiac arrest); steroid myopathy, heart failure (the development or worsening of symptoms), ECG changes typical of hypokalemia, increased blood pressure, hypercoagulability, thrombosis. In patients with acute myocardial infarction - the spread of necrosis, slowing the formation of scar tissue that can lead to rupture of the heart muscle.

Musculoskeletal system: slowing growth and ossification processes in children (premature closure of epiphyseal growth zones) and osteoporosis (very rarely - pathological fractures, aseptic necrosis of the humeral head and femoral), rupture of tendons of muscles, muscle weakness, steroid myopathy, loss of muscle mass (atrophy).

CNS: headache, increased intracranial pressure, delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor cerebellum, and seizures.

Vision: the rear subcapsular cataracts, increased intraocular pressure (with the possible damage to the optic nerve), trophic changes of the cornea, exophthalmos, the propensity to develop secondary infections (bacterial, fungal, viral).

Dermatological reactions: petechiae, ecchymosis, thinning and fragility of the skin, hyper- or hypopigmentation, acne, stretch marks, susceptibility to the development of pyoderma and candidiasis.

Reactions due to immunosuppressive effect: slow process of regeneration, reduced resistance to infections.

For parenteral administration: in rare cases of anaphylactic and allergic reactions, hyper- or hypopigmentation, atrophy of skin and subcutaneous tissue, exacerbation after intrasinovialnogo applications such as Charcot arthropathy, sterile abscesses, when injected into pockets on the head - blindness.

Permucal contraindications

For short-term use for health reasons - increased sensitivity to Permucal (Prednisolone).

For intra-articular injection and injection directly into the lesion: previous arthroplasty, abnormal bleeding (endogenous or caused by the use of anticoagulants), intra-articular fracture, infection (sepsis) inflammation in the joints and periarticular infections (including in history), as well as general infectious disease marked juxta-articular osteoporosis, lack of signs of inflammation in the joints ("dry" joint, such as osteoarthritis without synovitis), severe bone destruction and deformity of the joint (a sharp narrowing of joint space, ankylosis), the instability of the joint as a result of arthritis, aseptic necrosis of the epiphyses of bones forming the joint.

For external use only: bacterial, viral, fungal skin diseases, tuberculosis, skin, cutaneous manifestations of syphilis, skin tumors, post-vaccination period, violation of the integrity of the skin (ulcers, wounds), children's age (up to 2 years, with itching in the anal area - up to 12 years), rosacea, acne vulgaris, perioral dermatitis.

For use in ophthalmology: bacterial, viral, fungal eye diseases, tuberculosis eye disease, trachoma, violating the integrity of ocular epithelium.

Using during pregnancy and breastfeeding

During pregnancy Permucal (Prednisolone) is used only for health reasons. If necessary use of Permucal (Prednisolone) during lactation should carefully weigh the potential benefits of treatment for both mother and child at risk.

Special instructions

With care use for parasitic and infectious diseases of viral, fungal or bacterial origin - herpes simplex, herpes zoster (viraemic phase), chicken pox, measles, amoebiasis, strongyloidiasis, systemic mycosis, active and latent tuberculosis.

Be wary of up to 8 weeks before and 2 weeks after vaccination, and lymphadenitis after BCG, with immunodeficiency (including AIDS or HIV infection).

Be wary of diseases in gastrointestinal tract: gastric ulcers and duodenal ulcers, esophagitis, gastritis, acute or latent peptic ulcer, the newly created anastomosis intestinal ulcerative colitis with the threat of perforation or abstsedirovaniya, diverticulitis. Be wary of Permucal (Prednisolone) use in diseases of the cardiovascular system, including after recent myocardial infarction, with decompensated congestive heart failure, hypertension, hyperlipidemia, with endocrine diseases - diabetes mellitus, hyperthyroidism, hypothyroidism, pituitary basophilia, with severe chronic renal and / or liver failure, nefrourolitiaze, with hypoalbuminemia, with systemic osteoporosis, myasthenia gravis, acute psychosis, obesity III-IV stage, in poliomyelitis, open- and closed-angle glaucoma.

If necessary, intra-articular injection with caution in patients with severe general condition, failure (or brevity) of the 2 previous injections (with regard to individual properties apply GCS). During treatment (especially long-term) it needed to monitor at eye specialist, blood pressure control and water-electrolyte balance, and the pattern of peripheral blood glucose levels; to reduce the side effects can be assigned anabolic steroids, antibiotics, and increase the flow of potassium in the body (diet, potassium containing medications).

It is recommended to clarify the need for injection of ACTH after treatment with prednisone (after a skin test).

When Addison's disease should avoid the simultaneous use of barbiturates.

After cessation of treatment it may be experience a withdrawal syndrome, adrenal insufficiency and exacerbation of the disease, about which he was appointed Permucal (Prednisolone) Rotexmedica.

When intercurrent infections, septic conditions, and tuberculosis, must be simultaneous antibiotic therapy.

The children in the period of growth GCS should be used only if absolutely indicated and under close medical supervision.

Externally Permucal (Prednisolone) should not be used for more than 14 days. In case of application for ordinary or pink acne perhaps exacerbation.

Permucal drug interactions

Simultaneous administration of Permucal (Prednisolone) with:

  • salicylates may increase the likelihood of bleeding;
  • diuretics possible aggravation of violations of electrolyte metabolism;
  • hypoglycemic agents reduced the rate of decrease in blood glucose levels;
  • cardiac glycosides increases the risk of glycoside intoxication;
  • rifampin may weaken the therapeutic action of rifampicin;
  • antihypertensive drugs may reduce their effectiveness;
  • coumarin derivatives may weaken the anticoagulant effect;
  • rifampin, phenytoin, barbiturates, may weaken the effect of Permucal (Prednisolone);
  • hormonal contraceptives - strengthening of Permucal (Prednisolone);
  • acetylsalicylic acid may reduce the content of salicylates in blood;
  • praziquantel can reduce its concentration in the blood;
  • m-choline blockers (including antihistamines, tricyclic antidepressants), nitrate promotes increase in intraocular pressure;The appearance of hirsutism and acne it promotes the simultaneous use of other corticosteroids, androgens, estrogens, oral contraceptives, and anabolic steroid. The risk of developing cataracts increases with the use of corticosteroids against antipsychotic drugs, carbutamide and azathioprine.

    Permucal in case of emergency / overdose

    Risk of overdose increases with prolonged use of prednisone, particularly in large doses.

    Symptoms: increased blood pressure, peripheral edema, increased side effects of the drug.

    Treatment of acute overdose: an immediate gastric lavage or induction of vomiting, specific antidote is not found.

    Treatment of chronic overdose: should reduce the dose of the drug.

  • Permucal pharmaceutical active ingredients containing related brand and generic drugs:

    Active ingredient is the part of the drug or medicine which is biologically active. This portion of the drug is responsible for the main action of the drug which is intended to cure or reduce the symptom or disease. The other portions of the drug which are inactive are called excipients; there role is to act as vehicle or binder. In contrast to active ingredient, the inactive ingredient's role is not significant in the cure or treatment of the disease. There can be one or more active ingredients in a drug.


    Permucal available forms, composition, doses:

    Form of the medicine is the form in which the medicine is marketed in the market, for example, a medicine X can be in the form of capsule or the form of chewable tablet or the form of tablet. Sometimes same medicine can be available as injection form. Each medicine cannot be in all forms but can be marketed in 1, 2, or 3 forms which the pharmaceutical company decided based on various background research results.
    Composition is the list of ingredients which combinedly form a medicine. Both active ingredients and inactive ingredients form the composition. The active ingredient gives the desired therapeutic effect whereas the inactive ingredient helps in making the medicine stable.
    Doses are various strengths of the medicine like 10mg, 20mg, 30mg and so on. Each medicine comes in various doses which is decided by the manufacturer, that is, pharmaceutical company. The dose is decided on the severity of the symptom or disease.


    Permucal destination | category:

    Destination is defined as the organism to which the drug or medicine is targeted. For most of the drugs what we discuss, human is the drug destination.
    Drug category can be defined as major classification of the drug. For example, an antihistaminic or an antipyretic or anti anginal or pain killer, anti-inflammatory or so.


    Permucal Anatomical Therapeutic Chemical codes:

    A medicine is classified depending on the organ or system it acts [Anatomical], based on what result it gives on what disease, symptom [Therapeutical], based on chemical composition [Chemical]. It is called as ATC code. The code is based on Active ingredients of the medicine. A medicine can have different codes as sometimes it acts on different organs for different indications. Same way, different brands with same active ingredients and same indications can have same ATC code.


    Permucal pharmaceutical companies:

    Pharmaceutical companies are drug manufacturing companies that help in complete development of the drug from the background research to formation, clinical trials, release of the drug into the market and marketing of the drug.
    Researchers are the persons who are responsible for the scientific research and is responsible for all the background clinical trials that resulted in the development of the drug.


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    References

    1. Dailymed."PHISOHEX (HEXACHLOROPHENE) EMULSION [SANOFI-AVENTIS U.S. LLC]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
    2. Dailymed."PREDNISTAB (PREDNISOLONE) TABLET [LLOYD, INC. OF IOWA]". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).
    3. Dailymed."PREDNISOLONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailym... (accessed August 28, 2018).

    Frequently asked Questions

    Can i drive or operate heavy machine after consuming Permucal?

    Depending on the reaction of the Permucal after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Permucal not safe to drive or operate heavy machine after consumption. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. As prescribed by a pharmacist, it is dangerous to take alcohol while taking medicines as it exposed patients to drowsiness and health risk. Please take note of such effect most especially when taking Primosa capsule. It's advisable to consult your doctor on time for a proper recommendation and medical consultations.

    Is Permucal addictive or habit forming?

    Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. Addictive Medicine is categorically called Controlled substances by the government. For instance, Schedule H or X in India and schedule II-V in the US are controlled substances.

    Please consult the medicine instruction manual on how to use and ensure it is not a controlled substance.In conclusion, self medication is a killer to your health. Consult your doctor for a proper prescription, recommendation, and guidiance.

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    Review

    sdrugs.com conducted a study on Permucal, and the result of the survey is set out below. It is noteworthy that the product of the survey is based on the perception and impressions of the visitors of the website as well as the views of Permucal consumers. We, as a result of this, advice that you do not base your therapeutic or medical decisions on this result, but rather consult your certified medical experts for their recommendations.

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    The information was verified by Dr. Rachana Salvi, MD Pharmacology

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