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DRUGS & SUPPLEMENTS
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Citric Acid:
Rx Only
The product is a clear, colorless solution containing Uralyt-Kalium (Citric Acid) Acid USP 640 mg/5 mL, and Hydrous Sodium Citrate USP 490 mg/5 mL. It also contains Methylparaben NF and Propylparaben NF as preservatives. These concentrations yield 1 mEq of sodium, equivalent to 1 mEq of bicarbonate per mL of solution.
Oral citrate solution is used as a systemic and urinary alkalinizer. Less than 5% of the citrate is excreted in the urine unchanged, since citrate oxidation is to a great extent complete.
Uralyt-Kalium (Citric Acid)® is indicated for the treatment of metabolic acidosis. This solution is also useful in conditions where long term maintenance of alkaline urine is needed (e.g. uric acid and cystine calculi of the urinary tract). Uralyt-Kalium (Citric Acid)® is also effective in treatment for acidosis of certain renal tubular disorders.
Uralyt-Kalium (Citric Acid)® is contraindicated in patients with severe renal impairment, oliguria or azotemia, untreated Addison's disease, adynamia episodica hereditaria, acute dehydration, heat cramp, anuria, severe myocardial damage, and hyperkalemia.
The citrate solution should be used with caution in patients with impaired renal function to avoid hypernatremia or alkalosis in the presence of hypocalcemia. Periodic determinations of serum electrolyte levels (especially bicarbonate levels) should be done in patients with renal disease to avoid cardiac failure, hypertension, peripheral and pulmonary edema, and toxemia of pregnancy. The solution should be diluted with water and preferably taken after meals to avoid saline laxative effects.
Citrate solution is generally well tolerated when given in recommended doses when the patient has normal renal functions.
The dose of Uralyt-Kalium (Citric Acid)® is 10 to 30 mL, diluted with water, after meals and at bedtime. The dose should be titrated to achieve desired effects.
Uralyt-Kalium ® is supplied in 500 mL bottles (NDC 46287-014-01), 30 mL unit dose bottles, 10 bottles per carton (NDC 46287-014-30), and 15 mL unit dose bottles, 10 bottles per carton (NDC 46287-014-15).
Dispense in well-closed containers.
Store at 20°-25°C (68°-77°F); excursions permitted to 15°-30°C (59°-86°F)..
CMP Pharma, Inc.
Post Office Box 147
Farmville, North Carolina 27828
Revised July 2015
Copyright © CMP Pharma, Inc. 2015
NDC 46287-014-01
500 mL
Uralyt-Kalium (Citric Acid)®
ORAL CITRATE (SHOHL'S) SOLUTION
CONTAINS: Hydrous Sodium Citrate USP 490 mg/5 mL;
Uralyt-Kalium (Citric Acid) Acid USP 640 mg/5 mL; Methylparaben NF;
Propylparaben NF; Alcohol USP 0.25%.
USUAL
Dosage: See package insert.
Dispense in a well-closed container.
Store at 20°-25°C (68°-77°F); excursions permitted
to 15°-30°C (59°-86°F). [See USP Controlled Room
Temperature].
Rx Only
LOT:
EXP:
CMP
PHARMA
Farmville, NC 27828
Potassium Bicarbonate:
Uralyt-Kalium (Potassium Bicarbonate) CHLORIDE EXTENDED RELEASE TABLETS USP 20 mEq K
Rx Only
The Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq product is an immediately dispersing extended release oral dosage form of Uralyt-Kalium (Potassium Bicarbonate) chloride containing 1500 mg of microencapsulated Uralyt-Kalium (Potassium Bicarbonate) chloride, USP equivalent to 20 mEq of Uralyt-Kalium (Potassium Bicarbonate) in a tablet.
These formulations are intended to slow the release of Uralyt-Kalium (Potassium Bicarbonate) so that the likelihood of a high localized concentration of Uralyt-Kalium (Potassium Bicarbonate) chloride within the gastrointestinal tract is reduced.
Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq is an electrolyte replenisher. The chemical name of the active ingredient is Uralyt-Kalium (Potassium Bicarbonate) chloride, and the structural formula is KCl. Uralyt-Kalium (Potassium Bicarbonate) chloride, USP occurs as a white, granular powder or as colorless crystals. It is odorless and has a saline taste. Its solutions are neutral to litmus. It is freely soluble in water and insoluble in alcohol.
Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq is a tablet formulation (not enteric coated or wax matrix) containing individually microencapsulated Uralyt-Kalium (Potassium Bicarbonate) chloride crystals which disperse upon tablet disintegration. In simulated gastric fluid at 37°C and in the absence of outside agitation, Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq begin disintegrating into microencapsulated crystals within seconds and completely disintegrates within 1 minute. The microencapsulated crystals are formulated to provide an extended release of Uralyt-Kalium (Potassium Bicarbonate) chloride.
Inactive Ingredients: Colloidal silicon dioxide, crospovidone, diethyl phthalate, ethyl-cellulose, microcrystalline cellulose.
The Uralyt-Kalium (Potassium Bicarbonate) ion is the principal intracellular cation of most body tissues. Uralyt-Kalium (Potassium Bicarbonate) ions participate in a number of essential physiological processes including the maintenance of intracellular tonicity; the transmission of nerve impulses; the contraction of cardiac, skeletal, and smooth muscle; and the maintenance of normal renal function.
The intracellular concentration of Uralyt-Kalium (Potassium Bicarbonate) is approximately 150 to 160 mEq per liter. The normal adult plasma concentration is 3.5 to 5 mEq per liter. An active ion transport system maintains this gradient across the plasma membrane.
Uralyt-Kalium (Potassium Bicarbonate) is a normal dietary constituent and under steady-state conditions the amount of Uralyt-Kalium (Potassium Bicarbonate) absorbed from the gastrointestinal tract is equal to the amount excreted in the urine. The usual dietary intake of Uralyt-Kalium (Potassium Bicarbonate) is 50 to 100 mEq per day.
Uralyt-Kalium (Potassium Bicarbonate) depletion will occur whenever the rate of Uralyt-Kalium (Potassium Bicarbonate) loss through renal excretion and/or loss from the gastrointestinal tract exceeds the rate of Uralyt-Kalium (Potassium Bicarbonate) intake. Such depletion usually develops as a consequence of therapy with diuretics, primary or secondary hyperaldosteronism, diabetic ketoacidosis, or inadequate replacement of Uralyt-Kalium (Potassium Bicarbonate) in patients on prolonged parenteral nutrition. Depletion can develop rapidly with severe diarrhea, especially if associated with vomiting. Uralyt-Kalium (Potassium Bicarbonate) depletion due to these causes is usually accompanied by a concomitant loss of chloride and is manifested by hypokalemia and metabolic alkalosis. Uralyt-Kalium (Potassium Bicarbonate) depletion may produce weakness, fatigue, disturbances or cardiac rhythm (primarily ectopic beats), prominent U-waves in the electrocardiogram, and in advanced cases, flaccid paralysis and/or impaired ability to concentrate urine.
If Uralyt-Kalium (Potassium Bicarbonate) depletion associated with metabolic alkalosis cannot be managed by correcting the fundamental cause of the deficiency, eg, where the patient requires long-term diuretic therapy, supplemental Uralyt-Kalium (Potassium Bicarbonate) in the form of high Uralyt-Kalium (Potassium Bicarbonate) food or Uralyt-Kalium (Potassium Bicarbonate) chloride may be able to restore normal Uralyt-Kalium (Potassium Bicarbonate) levels.
In rare circumstances (eg, patients with renal tubular acidosis) Uralyt-Kalium (Potassium Bicarbonate) depletion may be associated with metabolic acidosis and hyperchloremia. In such patients Uralyt-Kalium (Potassium Bicarbonate) replacement should be accomplished with Uralyt-Kalium (Potassium Bicarbonate) salts other than the chloride, such as Uralyt-Kalium (Potassium Bicarbonate) bicarbonate, Uralyt-Kalium (Potassium Bicarbonate) citrate, Uralyt-Kalium (Potassium Bicarbonate) acetate, or Uralyt-Kalium (Potassium Bicarbonate) gluconate.
BECAUSE OF REPORTS OF INTESTINAL AND GASTRIC ULCERATION AND BLEEDING WITH CONTROLLED-RELEASE Uralyt-Kalium (Potassium Bicarbonate) CHLORIDE PREPARATIONS, THESE DRUGS SHOULD BE RESERVED FOR THOSE PATIENTS WHO CANNOT TOLERATE OR REFUSE TO TAKE LIQUID OR EFFERVESCENT Uralyt-Kalium (Potassium Bicarbonate) PREPARATIONS OR FOR PATIENTS IN WHOM THERE IS A PROBLEM OF COMPLIANCE WITH THESE PREPARATIONS.
1. For the treatment of patients with hypokalemia with or without metabolic alkalosis, in digitalis intoxication, and in patients with hypokalemic familial periodic paralysis. If hypokalemia is the result of diuretic therapy, consideration should be given to the use of a lower dose of diuretic, which may be sufficient without leading to hypokalemia.
2. For the prevention of hypokalemia in patients who would be at particular risk if hypokalemia were to develop, eg, digitalized patients or patients with significant cardiac arrhythmias.
The use of Uralyt-Kalium (Potassium Bicarbonate) salts in patients receiving diuretics for uncomplicated essential hypertension is often unnecessary when such patients have a normal dietary pattern and when low doses of the diuretic are used. Serum Uralyt-Kalium (Potassium Bicarbonate) should be checked periodically, however, and if hypokalemia occurs, dietary supplementation with potassium-containing foods may be adequate to control milder cases. In more severe cases, and if dose adjustment of the diuretic is ineffective or unwarranted, supplementation with Uralyt-Kalium (Potassium Bicarbonate) salts may be indicated.
Uralyt-Kalium (Potassium Bicarbonate) supplements are contraindicated in patients with hyperkalemia since a further increase in serum Uralyt-Kalium (Potassium Bicarbonate) concentration in such patients can produce cardiac arrest. Hyperkalemia may complicate any of the following conditions: chronic renal failure, systemic acidosis, such as diabetic acidosis, acute dehydration, extensive tissue breakdown as in severe burns, adrenal insufficiency, or the administration of a potassium-sparing diuretic (eg, spironolactone, triamterene, amiloride) (see OVERDOSAGE ).
Controlled-release formulations of Uralyt-Kalium (Potassium Bicarbonate) chloride have produced esophageal ulceration in certain cardiac patients with esophageal compression due to enlarged left atrium. Uralyt-Kalium (Potassium Bicarbonate) supplementation, when indicated in such patients, should be given as a liquid preparation or as an aqueous (water) suspension of Uralyt-Kalium (Potassium Bicarbonate) Chloride (see PRECAUTIONS: Information for Patients , and DOSAGE AND ADMINISTRATION sections).
All solid oral dosage forms of Uralyt-Kalium (Potassium Bicarbonate) chloride are contraindicated in any patient in whom there is structural, pathological (eg, diabetic gastroparesis), or pharmacologic (use of anticholinergic agents or other agents with anticholinergic properties at sufficient doses to exert anticholinergic effects) cause for arrest or delay in tablet passage through the gastrointestinal tract.
Hyperkalemia (see OVERDOSAGE )
In patients with impaired mechanisms for excreting Uralyt-Kalium (Potassium Bicarbonate), the administration of Uralyt-Kalium (Potassium Bicarbonate) salts can produce hyperkalemia and cardiac arrest. This occurs most commonly in patients given Uralyt-Kalium (Potassium Bicarbonate) by the intravenous route but may also occur in patients given Uralyt-Kalium (Potassium Bicarbonate) orally. Potentially fatal hyperkalemia can develop rapidly and be asymptomatic. The use of Uralyt-Kalium (Potassium Bicarbonate) salts in patients with chronic renal disease, or any other condition which impairs Uralyt-Kalium (Potassium Bicarbonate) excretion, requires particularly careful monitoring of the serum Uralyt-Kalium (Potassium Bicarbonate) concentration and appropriate dosage adjustment.
Interaction with Potassium-Sparing Diuretics
Hypokalemia should not be treated by the concomitant administration of Uralyt-Kalium (Potassium Bicarbonate) salts and a potassium-sparing diuretic (eg, spironolactone, triamterene, or amiloride) since the simultaneous administration of these agents can produce severe hyperkalemia.
Interaction with Angiotensin-Converting Enzyme Inhibitors
Angiotensin-converting enzyme (ACE) inhibitors (eg, captopril, enalapril) will produce some Uralyt-Kalium (Potassium Bicarbonate) retention by inhibiting aldosterone production. Uralyt-Kalium (Potassium Bicarbonate) supplements should be given to patients receiving ACE inhibitors only with close monitoring.
Gastrointestinal Lesions
Solid oral dosage forms of Uralyt-Kalium (Potassium Bicarbonate) chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract. Based on spontaneous adverse reaction reports, enteric-coated preparations of Uralyt-Kalium (Potassium Bicarbonate) chloride are associated with an increased frequency of small bowel lesions (40-50 per 100,000 patient years) compared to sustained release wax matrix formulations (less than one per 100,000 patient years). Because of the lack of extensive marketing experience with microencapsulated products, a comparison between such products and wax matrix or enteric-coated products is not available. Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq is a tablet formulated to provide a controlled rate of release of microencapsulated Uralyt-Kalium (Potassium Bicarbonate) chloride and thus to minimize the possibility of a high local concentration of Uralyt-Kalium (Potassium Bicarbonate) near the gastrointestinal wall.
Prospective trials have been conducted in normal human volunteers in which the upper gastrointestinal tract was evaluated by endoscopic inspection before and after 1 week of solid oral Uralyt-Kalium (Potassium Bicarbonate) chloride therapy. The ability of this model to predict events occurring in usual clinical practice is unknown. Trials which approximated usual clinical practice did not reveal any clear differences between the wax matrix and microencapsulated dosage forms. In contrast, there was a higher incidence of gastric and duodenal lesions in subjects receiving a high dose of a wax matrix controlled-release formulation under conditions which did not resemble usual or recommended clinical practice (ie, 96 mEq per day in divided doses of Uralyt-Kalium (Potassium Bicarbonate) chloride administered to fasted patients, in the presence of an anticholinergic drug to delay gastric emptying). The upper gastrointestinal lesions observed by endoscopy were asymptomatic and were not accompanied by evidence of bleeding (Hemoccult testing). The relevance of these findings to the usual conditions (ie, non-fasting, no anticholinergic agent, smaller doses) under which controlled-release Uralyt-Kalium (Potassium Bicarbonate) chloride products are used is uncertain; epidemiologic studies have not identified an elevated risk, compared to microencapsulated products, for upper gastrointestinal lesions in patients receiving wax matrix formulations. Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq should be discontinued immediately and the possibility of ulceration, obstruction, or perforation should be considered if severe vomiting, abdominal pain, distention, or gastrointestinal bleeding occurs.
Metabolic Acidosis
Hypokalemia in patients with metabolic acidosis should be treated with an alkalinizing Uralyt-Kalium (Potassium Bicarbonate) salt such as Uralyt-Kalium (Potassium Bicarbonate) bicarbonate, Uralyt-Kalium (Potassium Bicarbonate) citrate, Uralyt-Kalium (Potassium Bicarbonate) acetate, or Uralyt-Kalium (Potassium Bicarbonate) gluconate.
The diagnosis of Uralyt-Kalium depletion is ordinarily made by demonstrating hypokalemia in a patient with a clinical history suggesting some cause for Uralyt-Kalium (Potassium Bicarbonate) depletion. In interpreting the serum Uralyt-Kalium (Potassium Bicarbonate) level, the physician should bear in mind that acute alkalosis per se can produce hypokalemia in the absence of a deficit in total body Uralyt-Kalium (Potassium Bicarbonate) while acute acidosis per se can increase the serum Uralyt-Kalium (Potassium Bicarbonate) concentration into the normal range even in the presence of a reduced total body Uralyt-Kalium (Potassium Bicarbonate). The treatment of Uralyt-Kalium (Potassium Bicarbonate) depletion, particularly in the presence of cardiac disease, renal disease, or acidosis requires careful attention to acid-base balance and appropriate monitoring of serum electrolytes, the electrocardiogram, and the clinical status of the patient.
Physicians should consider reminding the patient of the following: To take each dose with meals and with a full glass of water or other liquid. To take each dose without crushing, chewing, or sucking the tablets. If those patients are having difficulty swallowing whole tablets, they may try one of the following alternate methods of administration:
1. Place the whole tablet(s) in approximately 1/2 glass of water (4 fluid ounces).
2. Allow approximately 2 minutes for the tablet(s) to disintegrate.
3. Stir for about half a minute after the tablet(s) has disintegrated.
4. Swirl the suspension and consume the entire contents of the glass immediately by drinking or by the use of a straw.
5. Add another 1 fluid ounce of water, swirl, and consume immediately.
6. Then, add an additional 1 fluid ounce of water, swirl, and consume immediately.
Aqueous suspension of Uralyt-Kalium (Potassium Bicarbonate) Chloride that is not taken immediately should be discarded. The use of other liquids for suspending Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq is not recommended.
To take this medicine following the frequency and amount prescribed by the physician. This is especially important if the patient is also taking diuretics and/or digitalis preparations.
To check with the physician at once if tarry stools or other evidence of gastrointestinal bleeding is noticed.
When blood is drawn for analysis of plasma Uralyt-Kalium it is important to recognize that artifactual elevations can occur after improper venipuncture technique or as a result of in vitro hemolysis of the sample.
Potassium-sparing diuretics, angiotensin-converting enzyme inhibitors (see WARNINGS ).
Carcinogenicity, mutagenicity, and fertility studies in animals have not been performed. Uralyt-Kalium is a normal dietary constituent.
Animal reproduction studies have not been conducted with Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq. It is unlikely that Uralyt-Kalium (Potassium Bicarbonate) supplementation that does not lead to hyperkalemia would have an adverse effect on the fetus or would affect reproductive capacity.
The normal Uralyt-Kalium ion content of human milk is about 13 mEq per liter. Since oral Uralyt-Kalium (Potassium Bicarbonate) becomes part of the body Uralyt-Kalium (Potassium Bicarbonate) pool, so long as body Uralyt-Kalium (Potassium Bicarbonate) is not excessive, the contribution of Uralyt-Kalium (Potassium Bicarbonate) chloride supplementation should have little or no effect on the level in human milk.
Safety and effectiveness in pediatric patients have not been established.
Clinical studies of Uralyt-Kalium (Potassium Bicarbonate) Chloride 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 responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.
This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection; and it may be useful to monitor renal function.
One of the most severe adverse effects is hyperkalemia (see CONTRAINDICATIONS , WARNINGS , and OVERDOSAGE ). There have also been reports of upper and lower gastrointestinal conditions including obstruction, bleeding, ulceration, and perforation (see CONTRAINDICATIONS and WARNINGS ). The most common adverse reactions to oral Uralyt-Kalium (Potassium Bicarbonate) salts are nausea, vomiting, flatulence, abdominal pain/discomfort, and diarrhea. These symptoms are due to irritation of the gastrointestinal tract and are best managed by diluting the preparation further, taking the dose with meals or reducing the amount taken at one time.
The administration of oral Uralyt-Kalium (Potassium Bicarbonate) salts to persons with normal excretory mechanisms for Uralyt-Kalium (Potassium Bicarbonate) rarely causes serious hyperkalemia. However, if excretory mechanisms are impaired or if Uralyt-Kalium (Potassium Bicarbonate) is administered too rapidly intravenously, potentially fatal hyperkalemia can result (see CONTRAINDICATIONS and WARNINGS ). It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum Uralyt-Kalium (Potassium Bicarbonate) concentration (6.5-8.0 mEq/L) and characteristic electrocardiographic changes (peaking of T-waves, loss of P-waves, depression of S-T segment, and prolongation of the QT-interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9-12 mEq/L).
Treatment measures for hyperkalemia include the following:
In treating hyperkalemia, it should be recalled that in patients who have been stabilized on digitalis, too rapid a lowering of the serum Uralyt-Kalium (Potassium Bicarbonate) concentration can produce digitalis toxicity.
The extended release feature means that absorption and toxic effects may be delayed for hours.
Consider standard measures to remove any unabsorbed drug.
The usual dietary intake of Uralyt-Kalium (Potassium Bicarbonate) by the average adult is 50 to 100 mEq per day. Uralyt-Kalium (Potassium Bicarbonate) depletion sufficient to cause hypokalemia usually requires the loss of 200 or more mEq of Uralyt-Kalium (Potassium Bicarbonate) from the total body store.
Dosage must be adjusted to the individual needs of each patient. The dose for the prevention of hypokalemia is typically in the range of 20 mEq per day. Doses of 40-100 mEq per day or more are used for the treatment of Uralyt-Kalium (Potassium Bicarbonate) depletion. Dosage should be divided if more than 20 mEq per day is given such that no more than 20 mEq is given in a single dose.
Each Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablet USP, 20 mEq provides 20 mEq of Uralyt-Kalium (Potassium Bicarbonate) chloride.
Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq should be taken with meals and with a glass of water or other liquid. This product should not be taken on an empty stomach because of its potential for gastric irritation (see WARNINGS ).
Patients having difficulty swallowing whole tablets may try one of the following alternate methods of administration:
Aqueous suspension of Uralyt-Kalium (Potassium Bicarbonate) Chloride that is not taken immediately should be discarded. The use of other liquids for suspending Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq is not recommended.
Uralyt-Kalium (Potassium Bicarbonate) Chloride Extended Release Tablets USP, 20 mEq are available in bottles of 100 (NDC 62037-999-01), bottles of 500 (NDC 62037-999-05), and bottles of 1000 (NDC 62037-999-10). Potassium Chloride Extended Release Tablets USP, 20 mEq are capsule shaped, white to off-white tablets, with “ABRS-123” imprinted on one side and scored on the other side for flexibility of dosing.
Storage Conditions
Keep tightly closed. Store at controlled room temperature, 20°-25°C (68°-77°F).
Manufactured by:
Eurand, Inc.
Vandalia, OH 45377 USA
Distributed by:
Watson Pharma, Inc.
Rev. Date (01/09) 173714
Uralyt-Kalium (Potassium Bicarbonate) chloride 20 Meq
Depending on the reaction of the Uralyt-Kalium after taken, if you are feeling dizziness, drowsiness or any weakness as a reaction on your body, Then consider Uralyt-Kalium 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 Uralyt-Kalium 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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The information was verified by Dr. Rachana Salvi, MD Pharmacology