Consists of Ambroxol, Chlorpheniramine, Guaifenesin, Menthol, Phenylephrine
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Oritus-Plus Syrup Uses |
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Consists of Ambroxol, Chlorpheniramine, Guaifenesin, Menthol, Phenylephrine
For use Max Pidek Pharmaceuticals as monotherapy and in combination with clavulanic acid: an infectious-inflammatory diseases caused by susceptible microorganisms, including bronchitis, pneumonia, tonsillitis, pyelonephritis, urethritis, infections of the gastrointestinal tract, gynecological infections, infections of the skin and soft tissue, listeria, leptospirosis, gonorrhea.
For use Max Pidek Pharmaceuticals in combination with metronidazole: chronic gastritis in acute, peptic ulcer and duodenal ulcer in acute, associated with Helicobacter Pylori.
Ambroxol (Oritus-Plus Syrup) is used to treat certain diseases of the respiratory tract and to relieve cough associated with thickened mucous.
Each retard capsule contains Ambroxol (Oritus-Plus Syrup) hydrochloride 75 mg.
Each tablet contains Ambroxol (Oritus-Plus Syrup) hydrochloride 30 mg.
Each 5 mL of syrup contains Ambroxol (Oritus-Plus Syrup) hydrochloride 15 or 30 mg.
Each mL of syrup (infant drops) contains Ambroxol (Oritus-Plus Syrup) hydrochloride 6 mg.
Ambroxol (Oritus-Plus Syrup) hydrochloride is trans-4-[(2-amino-3,5-dibromo-benzyl)amino] cyclohexanol hydrochloride.
It also contains the following excipients: Retard Capsules: Crospovidone collidon CL, carnauba wax, stearyl alcohol, magnesium stearate.
Tablets: Lactose, maize starch, colloidal silica, magnesium stearate.
Syrup: Purified water, sorbitol liquid, glycerol 85%, woodberry aroma (15 mg only), strawberry aroma (30 mg only), hydroxyethylcellulose, benzoic acid, acesulfame potassium, vanilla aroma.
Infant Drops: Hydroxyethylcellulose, sorbitol solution, glycerol 85%, sodium saccharin, pharma flavors, menthol, benzoic acid, propylene glycol.
Sustained-Release Capsule: Adults and Children >12 years: 1 cap once daily after meal with plenty of liquid (sufficient supply of liquid supports the expectorant effect of Ambroxol (Oritus-Plus Syrup)).
Ambroxol (Oritus-Plus Syrup) SR capsule is not suitable for children <12 years.
Tablet: Adults and Children >12 years: 1 tab thrice daily for the first 2-3 days and then 1 tab twice daily or ½ tab thrice daily. Children 6-12 years: ½ tab 2-3 times a day.
Syrup: Adults and Children >12 years: 10 mL thrice daily during the first 2-3 days, them 10 mL twice daily or 5 mL thrice daily. Children 6-12 years: 5 mL 2-3 times a day; 2-5 years: 2.5 mL 3 times a day; <2 years: 2.5 mL 2 times a day.
DS Syrup: Adults and Children >12 years: 5 mL thrice daily for 2-3 days then 5 mL twice daily for 2.5 mL thrice daily. Children 6-12 years: 2.5 mL 2-3 times a day.
Infant Drops: Children 13-24 months: 1.25 mL twice a day; 7-12 months: 1 mL twice a day; ≤6 months: 0.5 mL twice a day.
Amoxicillin may decrease the effectiveness of contraceptives for oral administration.
With the simultaneous use of Max Pidek Pharmaceuticals with bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) appears synergies; with bacteriostatic antibiotic (including macrolides, chloramphenicol, lincosamides, tetracyclines, sulphonamide) - antagonism.
Amoxicillin increases the effects of indirect anticoagulants inhibiting intestinal microflora, reduces the synthesis of vitamin K and prothrombin index.
Amoxicillin reduces the effect of drugs, in the process of metabolism that produce PABA.
Probenecid, diuretics, allopurinol, phenylbutazone, NSAIDs decrease the tubular secretion of amoxicillin, which can be accompanied by an increase in its concentration in blood plasma.
Antacids, glucosamine, laxatives, aminoglycosides, slow down and reduce, and ascorbic acid increases the absorption of amoxicillin.
With the combined use of amoxicillin and clavulanic acid pharmacokinetics of both components unchanged.
Allergic reactions: urticaria, erythema, edema Quincke, rhinitis, conjunctivitis, rarely - fever, joint pain, eosinophilia, in rare cases - anaphylactic shock.
Side effects associated with chemotherapy effect: possible development of super-infection (particularly in patients with chronic diseases or low resistance of the organism).
With prolonged use at high doses: dizziness, ataxia, confusion, depression, peripheral neuropathy, seizures.
Mostly when Max Pidek Pharmaceuticals used in combination with metronidazole: nausea, vomiting, anorexia, diarrhea, constipation, epigastric pain, glossitis, stomatitis; rarely - hepatitis, pseudomembranous colitis, allergic reactions (urticaria, angioedema), interstitial nephritis, a violation of hematopoiesis.
Mostly when Max Pidek Pharmaceuticals used in combination with clavulanic acid: cholestatic jaundice, hepatitis, rarely - erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis.
Hypersensitivity to Ambroxol (Oritus-Plus Syrup) hydrochloride or to any other excipients of Ambroxol (Oritus-Plus Syrup).
In case of rare hereditary conditions that may be incompatible with an excipient of Ambroxol (Oritus-Plus Syrup), the use of Ambroxol (Oritus-Plus Syrup) is contraindicated.
Chlorpheniramine (Oritus-Plus Syrup) is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.
Chlorpheniramine (Oritus-Plus Syrup) is used to treat runny nose, sneezing, itching, and watery eyes caused by allergies, the common cold, or the flu.
Chlorpheniramine (Oritus-Plus Syrup) may also be used for purposes not listed in this medication guide.
this medicine is indicated for symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites.
Also indicated for the symptomatic relief of itch associated with chickenpox
Use Chlorpheniramine (Oritus-Plus Syrup) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Chlorpheniramine (Oritus-Plus Syrup).
Allergic symptoms, allergic rhinitis, urticaria, pruritus: Perennial and seasonal allergic rhinitis and other allergic symptoms including urticaria, pruritus
Data from a limited number of patients studied suggests that Chlorpheniramine (Oritus-Plus Syrup) may be beneficial in the treatment of motion sickness. Additional data may be necessary to further define its role in this condition.
An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists.
Applies to the following strength(s): 2 mg; 1 mg/5 mL; 16 mg; 4 mg; 12 mg; 10 mg/mL; 8 mg; 2 mg/5 mL; tannate 8 mg; 2 mg/mL; 4 mg/5 mL; 8 mg/5 mL
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Tablets or syrup: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.
Maximum dose 32 mg/day.
Tablets or syrup: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.
Maximum dose 32 mg/day.
Tablets or syrup: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.
Maximum dose 32 mg/day.
Injectable solution:
Allergic reactions to blood or plasma infusions: 10 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.
Anaphylaxis: 10 to 20 mg intravenous injection as a single dose.
Uncomplicated Allergic Conditions: 5 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.
Maximum dose by injection is 40 mg/day.
Tablets or syrup: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.
Maximum dose 32 mg/day.
3 months to 5 months:
Sustained-release syrup: 0.5 mg orally every 12 hours.
6 months to 8 months:
Sustained-release syrup: 1 mg orally every 12 hours.
9 months to 18 months:
Sustained-release syrup: 1 to 1.5 mg orally every 12 hours.
18 months to 6 years:
Sustained-release syrup: 2 mg orally every 12 hours.
2 to 5 years:
Tablets or syrup: 1 mg every 4 to 6 hours.
Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.
Maximum dose 6 mg/day.
6 to 11 years:
Tablets or syrup: 2 mg every 4 to 6 hours.
Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg orally at bedtime or during the day as indicated.
Maximum dose 16 mg/day.
12 years or older:
Tablets or syrup: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed
Maximum dose 32 mg/day.
3 months to 5 months:
Sustained-release syrup: 0.5 mg orally every 12 hours.
6 months to 8 months:
Sustained-release syrup: 1 mg orally every 12 hours.
9 months to 18 months:
Sustained-release syrup: 1 to 1.5 mg orally every 12 hours.
18 months to 6 years:
Sustained-release syrup: 2 mg orally every 12 hours.
2 to 5 years:
Tablets or syrup: 1 mg every 4 to 6 hours.
Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.
Maximum dose 6 mg/day.
6 to 11 years:
Tablets or syrup: 2 mg every 4 to 6 hours.
Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg orally at bedtime or during the day as indicated.
Maximum dose 16 mg/day.
12 years or older:
Tablets or syrup: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed
Maximum dose 32 mg/day.
3 months to 5 months:
Sustained-release syrup: 0.5 mg orally every 12 hours.
6 months to 8 months:
Sustained-release syrup: 1 mg orally every 12 hours.
9 months to 18 months:
Sustained-release syrup: 1 to 1.5 mg orally every 12 hours.
18 months to 6 years:
Sustained-release syrup: 2 mg orally every 12 hours.
2 to 5 years:
Tablets or syrup: 1 mg every 4 to 6 hours.
Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.
Maximum dose 6 mg/day.
6 to 11 years:
Tablets or syrup: 2 mg every 4 to 6 hours.
Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg orally at bedtime or during the day as indicated.
Maximum dose 16 mg/day.
12 years or older:
Tablets or syrup: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed
Maximum dose 32 mg/day.
Injectable solution:
2 years to 11 years: 0.35 mg/kg/day in divided doses every 4 to 6 hours as needed.
12 years or older:
Allergic reactions to blood or plasma infusions: 10 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.
Anaphylaxis: 10 to 20 mg intravenous injection as a single dose.
Uncomplicated Allergic Conditions: 5 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.
Maximum dose by injection is 40 mg/day.
Tablets or syrup:
2 to 5 years: 1 mg every 4 to 6 hours.
Maximum dose 6 mg/day.
Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.
6 to 11 years: 2 mg every 4 to 6 hours.
Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg at bedtime or during the day as indicated.
Maximum dose 16 mg/day.
12 years or older: 4 mg orally every 4 to 6 hours.
Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed
Maximum dose 32 mg/day.
The elimination of Chlorpheniramine (Oritus-Plus Syrup) may be prolonged in patients with renal dysfunction. These patients should be monitored for excessive sedation and other adverse effects that may result from Chlorpheniramine (Oritus-Plus Syrup) accumulation.
Data not available
Use Chlorpheniramine (Oritus-Plus Syrup) with caution in patients with asthma.
Chlorpheniramine (Oritus-Plus Syrup) should not be used in premature or newborn infants.
Data not available
The 100 mg/mL injection is for IM or subcutaneous use only.
The 10 mg/mL injection is for IV, IM, or subcutaneous use.
See also:
What other drugs will affect Chlorpheniramine (Oritus-Plus Syrup)?
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray), antispasmodics (e.g., atropine, belladonna alkaloids), drugs for Parkinson's disease (e.g., anticholinergics such as benztropine, trihexyphenidyl), scopolamine, tricyclic antidepressants (e.g., amitriptyline).
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.
Chlorpheniramine (Oritus-Plus Syrup) is very similar to dexchlorpheniramine. Do not use medications containing dexchlorpheniramine while using Chlorpheniramine (Oritus-Plus Syrup).
This medication may interfere with certain laboratory tests (including allergy skin testing), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
See also:
What are the possible side effects of Chlorpheniramine (Oritus-Plus Syrup)?
Applies to Chlorpheniramine (Oritus-Plus Syrup): capsules, controlled-release capsules, suspension drops, sustained-release capsules, syrup, tablets
Other dosage forms:
Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.
Seek medical attention right away if any of these SEVERE side effects occur while taking Chlorpheniramine (Oritus-Plus Syrup) (the active ingredient contained in Chlorpheniramine (Oritus-Plus Syrup) (Allergy))
Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; vision changes.
See also:
What is the most important information I should know about Chlorpheniramine (Oritus-Plus Syrup)?
Hypersensitivity to Chlorpheniramine (Oritus-Plus Syrup) maleate or any component of the formulation; narrow-angle glaucoma; bladder neck obstruction; symptomatic prostate hypertrophy; during acute asthmatic attacks; stenosing peptic ulcer; pyloroduodenal obstruction. Avoid use in premature and term newborns due to possible association with SIDS.
OTC labeling: When used for self-medication, do not use to make a child sleep
Guaifenesin (Oritus-Plus Syrup) is used to reduce chest congestion caused by the common cold, flu, or chronic bronchitis.
Guaifenesin (Oritus-Plus Syrup) helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.
There are many brands and forms of Guaifenesin (Oritus-Plus Syrup) available. Not all brands are listed on this leaflet.
Guaifenesin (Oritus-Plus Syrup) may also be used for purposes not listed in this medication guide.
Guaifenesin (Oritus-Plus Syrup) and hydrocodone is used to treat cough and reduce chest congestion caused by the common cold, flu, or allergies.
Use Guaifenesin (Oritus-Plus Syrup) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Guaifenesin (Oritus-Plus Syrup).
Guaifenesin (Oritus-Plus Syrup) is used to treat coughs and congestion caused by the common cold, bronchitis, and other breathing illnesses. This product is usually not used for ongoing cough from smoking or long-term breathing problems (such as chronic bronchitis, emphysema) unless directed by your doctor. Guaifenesin (Oritus-Plus Syrup) is an expectorant. It works by thinning and loosening mucus in the airways, clearing congestion, and making breathing easier.
If you are self-treating with this medication, it is important to read the package instructions carefully before you start using this product to be sure it is right for you.
Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.
These products do not cure or shorten the length of the common cold. To decrease the risk for side effects, carefully follow all dosage directions. Do not give other cough-and-cold medication that might contain the same or similar ingredients. Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).
Take this medication by mouth with or without food, as directed by your doctor, usually every 4 hours. If you are self-treating, follow all directions on the product package. If you are uncertain about any of the information, ask your doctor or pharmacist.
Guaifenesin (Oritus-Plus Syrup) may have a bitter taste. Do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
For powder packets, empty the entire contents of the packet onto the tongue and swallow. To prevent a bitter taste, do not chew.
Dosage is based on your age, medical condition, and response to treatment. Do not take more than 6 doses in a day. Do not increase your dose or take this drug more often than directed.
Drink plenty of fluids while taking this medication. Fluids will help to break up mucus and clear congestion.
Tell your doctor if your cough is accompanied by fever, severe sore throat, rash, persistent headache, or if it persists, returns, or worsens after 7 days. These may be signs of a serious medical problem. Seek immediate medical attention if you think you may have a serious medical problem.
A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of morphine. It also has a depressant action on the cough center and may be given to control intractable cough associated with terminal lung cancer. Guaifenesin (Oritus-Plus Syrup) is also used as part of the treatment of dependence on opioid drugs, although prolonged use of methadone itself may result in dependence. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1082-3)
Applies to the following strength(s): 200 mg/5 mL; 200 mg; 100 mg/5 mL; 50 mg/5 mL; 600 mg; 1200 mg; 400 mg; 100 mg; 800 mg; 1000 mg; 300 mg; 575 mg; 50 mg
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Immediate release formulation: 200 to 400 mg orally every 4 hours as needed, not to exceed 2.4 g/day
Sustained release formulation: 600 to 1200 mg orally every 12 hours, not to exceed 2.4 g/day
Immediate release formulation:
less than 2 years: 12 mg/kg/day orally in 6 divided doses
2 to 5 years: 50 to 100 mg orally every 4 hours as needed, not to exceed 600 mg/day
6 to 11 years: 100 to 200 mg orally every 4 hours as needed, not to exceed 1.2 g/day
12 years or older: 200 to 400 mg orally every 4 hours as needed, not to exceed 2.4 g/day
Sustained release formulation:
2 to 5 years: 300 mg orally every 12 hours, not to exceed 600 mg/day
6 to 11 years: 600 mg orally every 12 hours, not to exceed 1.2 g/day
12 years or older: 600 to 1200 mg orally every 12 hours, not to exceed 2.4 g/day
Data not available
Data not available
Data not available
Guaifenesin (Oritus-Plus Syrup) should be administered with plenty of fluids.
See also:
What other drugs will affect Guaifenesin (Oritus-Plus Syrup)?
In vitro results suggest that methadone undergoes hepatic N-demethylation by cytochrome P450 enzymes, principally CYP3A4, CYP2B6, CYP2C19 and to a lesser extent by CYP2C9 and CYP2D6. Coadministration of methadone with CYP inducers of these enzymes may result in a more rapid metabolism and potential for decreased effects of methadone, whereas administration with CYP inhibitors may reduce metabolism and potentiate methadones effects. Although antiretroviral drugs such as efavirenz, nelfinavir, nevirapine, ritonavir, lopinavir+ritonavir combination are known to inhibit CYPs, they are shown to reduce the plasma levels of methadone, possibly due to their CYP induction activity. Therefore, drugs administered concomitantly with methadone should be evaluated for interaction potential; clinicians are advised to evaluate individual response to drug therapy.
As with other mu-agonists, patients maintained on methadone may experience withdrawal symptoms when given opioid antagonists, mixed agonist/antagonists, and partial agonists. Examples of such agents are naloxone, naltrexone, pentazocine, nalbuphine, butorphanol, and buprenorphine.
Abacavir, amprenavir, efavirenz, nelfinavir, nevirapine, ritonavir, lopinavir+ritonavir combination - Coadministration of these anti-retroviral agents resulted in increased clearance or decreased plasma levels of methadone. Guaifenesin (Oritus-Plus Syrup)-maintained patients beginning treatment with these antiretroviral drugs should be monitored for evidence of withdrawal effects and methadone dose should be adjusted accordingly.
Didanosine and Stavudine - Experimental evidence demonstrated that methadone decreased the AUC and peak levels for didanosine and stavudine, with a more significant decrease for didanosine. Guaifenesin (Oritus-Plus Syrup) disposition was not substantially altered.
Zidovudine - Experimental evidence demonstrated that methadone increased the area under the concentration-time curve (AUC) of zidovudine which could result in toxic effects.
Guaifenesin (Oritus-Plus Syrup)-maintained patients beginning treatment with CYP3A4 inducers should be monitored for evidence of withdrawal effects and methadone dose should be adjusted accordingly. The following drug interactions were reported following coadministration of methadone with inducers of cytochrome P450 enzymes:
Rifampin - In patients well-stabilized on methadone, concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms.
Phenytoin - In a pharmacokinetic study with patients on methadone maintenance therapy, phenytoin administration (250 mg b.i.d. initially for 1 day followed by 300 mg QD for 3 to 4 days) resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. Upon discontinuation of phenytoin, the incidence of withdrawal symptoms decreased and methadone exposure increased to a level comparable to that prior to phenytoin administration.
St. Johns Wort, Phenobarbital, Carbamazepin/strong>Administration of methadone along with other CYP3A4 inducers may result in withdrawal symptoms. Since the metabolism of methadone is mediated primarily by CYP3A4 isozyme, coadministration of drugs that inhibit CYP3A4 activity may cause decreased clearance of methadone. The expected clinical results would be increased or prolonged opioid effects. Thus, methadone-treated patients coadministered strong inhibitors of CYP3A4, such as azole antifungal agents (e.g., ketoconazole) and macrolide antibiotics (e.g., erythromycin), with methadone should be carefully monitored and dosage adjustment should be undertaken if warranted. Some selective serotonin reuptake inhibitors (SSRIs) (e.g., sertraline, fluvoxamine) may increase methadone plasma levels upon coadministration with methadone and result in increased opiate effects and/or toxicity. Voriconazole - Repeat dose administration of oral voriconazole (400mg Q12h for 1 day, then 200mg Q12h for 4 days) increased the Cmax and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose (30 to 100 mg QD). The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively. Increased plasma concentrations of methadone have been associated with toxicity including QT prolongation. Frequent monitoring for adverse events and toxicity related to methadone is recommended during coadministration. Dose reduction of methadone may be needed. Monoamine Oxidase (MAO) Inhibitors - Therapeutic doses of meperidine have precipitated severe reactions in patients concurrently receiving monoamine oxidase inhibitors or those who have received such agents within 14 days. Similar reactions thus far have not been reported with methadone. However, if the use of methadone is necessary in such patients, a sensitivity test should be performed in which repeated small, incremental doses of methadone are administered over the course of several hours while the patients condition and vital signs are under careful observation. Desipramine - Blood levels of desipramine have increased with concurrent methadone administration. Extreme caution is necessary when any drug known to have the potential to prolong the QT interval is prescribed in conjunction with methadone. Pharmacodynamic interactions may occur with concomitant use of methadone and potentially arrhythmogenic agents such as class I and III antiarrhythmics, some neuroleptics and tricyclic antidepressants, and calcium channel blockers. Caution should also be exercised when prescribing methadone concomitantly with drugs capable of inducing electrolyte disturbances (hypomagnesemia, hypokalemia) that may prolong the QT interval. These drugs include diuretics, laxatives, and, in rare cases, mineralocorticoid hormones. Guaifenesin (Oritus-Plus Syrup) may be expected to have additive effects when used in conjunction with alcohol, other opioids or CNS depressants, or with illicit drugs that cause central nervous system depression. Deaths have been reported when methadone has been abused in conjunction with benzodiazepines. Anxiety - Since methadone as used by tolerant patients at a constant maintenance dosage does not act as a tranquilizer, patients who are maintained on this drug will react to life problems and stresses with the same symptoms of anxiety as do other individuals. The physician should not confuse such symptoms with those of narcotic abstinence and should not attempt to treat anxiety by increasing the dose of methadone. The action of methadone in maintenance treatment is limited to the control of narcotic withdrawal symptoms and is ineffective for relief of general anxiety. Acute Pain - Maintenance patients on a stable dose of methadone who experience physical trauma, postoperative pain or other acute pain cannot be expected to derive analgesia from their existing dose of methadone. Such patients should be administered analgesics, including opioids, in doses that would otherwise be indicated for non-methadone-treated patients with similar painful conditions. Due to the opioid tolerance induced by methadone, when opioids are required for management of acute pain in methadone patients, somewhat higher and/or more frequent doses will often be required than would be the case for non-tolerant patients. Abrupt opioid discontinuation can lead to development of opioid withdrawal symptoms. Presentation of these symptoms have been associated with an increased risk of susceptible patients to relapse to illicit drug use and should be considered when assessing the risks and benefit of methadone use. Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Physical dependence is manifested by withdrawal symptoms after abrupt discontinuation of a drug or upon administration of an antagonist. Physical dependence and/or tolerance are not unusual during chronic opioid therapy. If methadone is abruptly discontinued in a physically dependent patient, an abstinence syndrome may occur. The opioid abstinence or withdrawal syndrome is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate. In general, chronically administered methadone should not be abruptly discontinued. Guaifenesin (Oritus-Plus Syrup) should be given with caution and the initial dose reduced in certain patients, such as the elderly and debilitated and those with severe impairment of hepatic or renal function, hypothyroidism, Addisons disease, prostatic hypertrophy, or urethral stricture. The usual precautions appropriate to the use of parenteral opioids should be observed and the possibility of respiratory depression should always be kept in mind. See also: Applies to Guaifenesin (Oritus-Plus Syrup): oral liquid, oral packet, oral solution, oral syrup, oral tablet, oral tablet extended release Along with its needed effects, Guaifenesin (Oritus-Plus Syrup) (the active ingredient contained in Guaifenesin (Oritus-Plus Syrup)) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects of Guaifenesin (Oritus-Plus Syrup) may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Less common or rare Managing side effects (general information) See also: Guaifenesin (Oritus-Plus Syrup) is contraindicated in patients with a known hypersensitivity to methadone hydrochloride or any other ingredient in DOLOPHINE. Guaifenesin (Oritus-Plus Syrup) is contraindicated in any situation where opioids are contraindicated such as: patients with respiratory depression (in the absence of resuscitative equipment or in unmonitored settings), and in patients with acute bronchial asthma or hypercarbia. Guaifenesin (Oritus-Plus Syrup) is contraindicated in any patient who has or is suspected of having a paralytic ileus. Relieving minor pain caused by conditions such as arthritis, backache, bruising, bursitis, cramping, muscle strains or sprains, and tendonitis. It may also be used for other conditions as determined by your doctor. Menthol (Oritus-Plus Syrup) is a topical analgesic. It works by temporarily relieving minor pain. Nasal congestion; Throat irritation Adult: As a loz (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 loz every 3 hr, to be sucked slowly. Child: >6 yr: As a lozenge (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 lozenge every 3 hr, to be sucked slowly. Muscular aches and pains Adult: As an ointment/cream (usually in combination with camphor, clove oil or methyl salicylate): Apply and rub gently onto the affected skin areas 2-3 times daily. Use Menthol (Oritus-Plus Syrup) as directed by your doctor. Check the label on the medicine for exact dosing instructions. Ask your health care provider any questions you may have about how to use Menthol (Oritus-Plus Syrup). Pharmaceutical Aid Menthol (Oritus-Plus Syrup) is a covalent organic compound made synthetically or obtained from peppermint or other mint oils. It is a waxy, crystalline substance, clear or white in color, which is solid at room temperature and melts slightly above. The main form of Menthol (Oritus-Plus Syrup) occurring in nature is (-)-Menthol (Oritus-Plus Syrup), which is assigned the (1R,2S,5R) configuration. Menthol (Oritus-Plus Syrup) has local anesthetic and counterirritant qualities, and it is widely used to relieve minor throat irritation. Nasal congestion; Throat irritation Adult: As a loz (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 loz every 3 hr, to be sucked slowly. Child: >6 yr: As a lozenge (usually in combination with eucalyptus oil or cetylpyridinium chloride): 1 lozenge every 3 hr, to be sucked slowly. Muscular aches and pains Adult: As an ointment/cream (usually in combination with camphor, clove oil or methyl salicylate): Apply and rub gently onto the affected skin areas 2-3 times daily. Tell your doctor of any over-the-counter or prescription medication you may take including: blood thinners. Do not start or stop any medicine without doctor or pharmacist approval. See also: May cause hypersensitivity reactions such as cutaneous dermatitis. Ingestion of large amount of Menthol (Oritus-Plus Syrup) may cause GI effects such as severe abdominal pain, nausea, vomiting, vertigo, ataxia, drowsiness and coma. See also: Not to be used in No known conditions. This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately. Phenylephrine (Oritus-Plus Syrup) (Phenylephrine (Oritus-Plus Syrup)) is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose). Phenylephrine (Oritus-Plus Syrup) is used to treat nasal and sinus congestion, or congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes. Phenylephrine (Oritus-Plus Syrup) may also be used for purposes not listed in this medication guide. Phenylephrine (Oritus-Plus Syrup) is used for the temporary relief of stuffy nose, sinus, and ear symptoms caused by the common cold, flu, allergies, or other breathing illnesses (e.g., sinusitis, bronchitis). This medication works by decreasing swelling in the nose and ears, thereby lessening discomfort and making it easier to breathe. Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely. Use Phenylephrine (Oritus-Plus Syrup) drops as directed by your doctor. Check the label on the medicine for exact dosing instructions. Ask your health care provider any questions you may have about how to use Phenylephrine (Oritus-Plus Syrup) drops. Hypotension/shock: Treatment of hypotension, vascular failure in shock. Note: Not recommended for routine use in the treatment of septic shock; use should be limited until more evidence demonstrating positive clinical outcomes becomes available (Rhodes 2017). Guideline recommendations: Cardiogenic shock: The 2017 American Heart Association (AHA) scientific statement for the Contemporary Management of Cardiogenic Shock recommends Phenylephrine (Oritus-Plus Syrup), if needed, be considered for initial vasoactive management of cardiogenic shock due to aortic stenosis, mitral stenosis, or dynamic left ventricular outflow tract (LVOT) obstruction (AHA [van Diepen 2017]). Hypotension during anesthesia: As a vasoconstrictor in regional analgesia Nasal congestion: As a decongestant [OTC] Phenylephrine (Oritus-Plus Syrup) is a pure alpha1 agonist that will increase systemic vascular resistance without increasing heart rate or contractility. This is advantageous in patients with obstructive hypertrophic cardiomyopathy and hypotension since increases in both heart rate and contractility may cause the obstruction to worsen, leading to a decrease in cardiac output. Other vasopressors like dopamine, epinephrine, and norepinephrine may increase contractility and/or heart rate. Additional trials may be necessary to further define the role of Phenylephrine (Oritus-Plus Syrup) in this condition. Based on the American Urological Association guidelines for the management of priapism, due to the low risk of cardiovascular side effects intracavernous injection of Phenylephrine (Oritus-Plus Syrup) is recommended for ischemic priapism that persists following aspiration/irrigation. Phenylephrine (Oritus-Plus Syrup) is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. It is mainly used to treat nasal congestion, but may also be useful in treating hypotension and shock, hypotension during spinal anaesthesia, prolongation of spinal anaesthesia, paroxysmal supraventricular tachycardia, symptomatic relief of external or internal hemorrhoids, and to increase blood pressure as an aid in the diagnosis of heart murmurs. Generic name: Phenylephrine (Oritus-Plus Syrup) HYDROCHLORIDE 10mg in 1mL Dosage form: injection The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist. Phenylephrine (Oritus-Plus Syrup) (Phenylephrine (Oritus-Plus Syrup) hydrochloride) Injection, 10 mg/mL must be diluted before administration as an intravenous bolus or continuous intravenous infusion to achieve the desired concentration: Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not use if the solution is colored or cloudy, or if it contains particulate matter. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions. Discard any unused portion. During Phenylephrine (Oritus-Plus Syrup) administration:Cytochrome P450 Inhibitors
Others
Potentially Arrhythmogenic Agents
Interactions with Alcohol and Drugs of Abuse
Risk of Relapse in Patients on Guaifenesin (Oritus-Plus Syrup) Maintenance Treatment of Opioid Addiction
Tolerance and Physical Dependence
Special-Risk Patients
Guaifenesin (Oritus-Plus Syrup) side effects
What are the possible side effects of Guaifenesin (Oritus-Plus Syrup)?Side effects requiring immediate medical attention
Side effects not requiring immediate medical attention
Guaifenesin (Oritus-Plus Syrup) contraindications
What is the most important information I should know about Guaifenesin (Oritus-Plus Syrup)?What is Menthol (Oritus-Plus Syrup)?
Menthol (Oritus-Plus Syrup) indications
Oral
Topical/Cutaneous
How should I use Menthol (Oritus-Plus Syrup)?
Uses of Menthol (Oritus-Plus Syrup) in details
Menthol (Oritus-Plus Syrup) description
Menthol (Oritus-Plus Syrup) dosage
Oral
Topical/Cutaneous
Menthol (Oritus-Plus Syrup) interactions
Menthol (Oritus-Plus Syrup) side effects
What are the possible side effects of Menthol (Oritus-Plus Syrup)?Menthol (Oritus-Plus Syrup) contraindications
What is the most important information I should know about Menthol (Oritus-Plus Syrup)?What is Phenylephrine (Oritus-Plus Syrup)?
Phenylephrine (Oritus-Plus Syrup) indications
How should I use Phenylephrine (Oritus-Plus Syrup)?
Uses of Phenylephrine (Oritus-Plus Syrup) in details
Use: Labeled Indications
Off Label Uses
Hypotension in patients with obstructive hypertrophic cardiomyopathy
Phenylephrine (Oritus-Plus Syrup) description
Phenylephrine (Oritus-Plus Syrup) dosage
Phenylephrine (Oritus-Plus Syrup) Dosage
General Dosage and Administration Instructions
The following are the recommended dosages for the treatment of hypotension during anesthesia.
For bolus intravenous administration, prepare a solution containing a final concentration of 100 mcg/mL of Phenylephrine (Oritus-Plus Syrup):
For continuous intravenous infusion, prepare a solution containing a final concentration of 20 mcg/mL of Phenylephrine (Oritus-Plus Syrup) in 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP:
The Pharmacy Bulk Vial is intended for dispensing of single doses to multiple patients in a pharmacy admixture program and is restricted to the preparation of admixtures for infusion. Each closure shall be penetrated only one time with a suitable sterile transfer device or dispensing set that allows measured dispensing of the contents. The Pharmacy Bulk Vial is to be used only in a suitable work area such as a laminar flow hood (or an equivalent clean air compounding area). Dispensing from a pharmacy bulk vial should be completed within 4 hours after the vial is penetrated.
See also:
What other drugs will affect Phenylephrine (Oritus-Plus Syrup)?
Acetaminophen: May increase the serum concentration of Phenylephrine (Oritus-Plus Syrup) (Systemic). Monitor therapy
Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy
AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Consider therapy modification
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy
Chloroprocaine: May enhance the hypertensive effect of Phenylephrine (Oritus-Plus Syrup) (Systemic). Monitor therapy
CloZAPine: May diminish the therapeutic effect of Phenylephrine (Oritus-Plus Syrup) (Systemic). Monitor therapy
Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification
Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy
Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination
FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy
Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy
Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Oritus-Plus Syrup) (Systemic). Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of Phenylephrine (Oritus-Plus Syrup). Use of hyaluronidase for other purposes in patients receiving Phenylephrine (Oritus-Plus Syrup) may be considered as clinically indicated. Avoid combination
Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Avoid combination
Ioflupane I 123: Phenylephrine (Oritus-Plus Syrup) (Systemic) may diminish the diagnostic effect of Ioflupane I 123. Monitor therapy
Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification
Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid. Avoid combination
Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification
Propacetamol: May increase the serum concentration of Phenylephrine (Oritus-Plus Syrup) (Systemic). Management: Monitor patients closely for increased side effects of Phenylephrine (Oritus-Plus Syrup) if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. Monitor therapy
Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Tricyclic Antidepressants: May enhance the therapeutic effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the therapeutic effect of Alpha1-Agonists. Monitor therapy
See also:
What are the possible side effects of Phenylephrine (Oritus-Plus Syrup)?
Applies to Phenylephrine (Oritus-Plus Syrup): intravenous solution
In addition to its needed effects, some unwanted effects may be caused by Phenylephrine (Oritus-Plus Syrup) (the active ingredient contained in Phenylephrine (Oritus-Plus Syrup)). In the event that any of these side effects do occur, they may require medical attention.
If any of the following side effects occur while taking Phenylephrine (Oritus-Plus Syrup), check with your doctor or nurse immediately:
Incidence not known:
If any of the following symptoms of overdose occur while taking Phenylephrine (Oritus-Plus Syrup), get emergency help immediately:
Symptoms of overdose:
Some of the side effects that can occur with Phenylephrine (Oritus-Plus Syrup) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
Incidence not known:
See also:
What is the most important information I should know about Phenylephrine (Oritus-Plus Syrup)?
Minims Phenylephrine (Oritus-Plus Syrup) hydrochloride should not be used in patients with severe hypertension, ventricular tachycardia, or in patients who are hypersensitive to it or to any of the components.
Ambroxol/Chlorpheniramine/Guaifenesin/Menthol/Phenylephrine
Unit description / dosage (Manufacturer) | Price, USD |
Oritus-Plus Syrup (Orn Remedies Pvt Ltd) | $ 1.08 |
List of Oritus-Plus Syrup substitutes (brand and generic names): | |
Ambroxol/Chlorpheniramine/Guaifenesin/Menthol/Phenylephrine | |
BAROHIST P | |
BAROHIST P SYRUP 1 bottle / 100 ML syrup each (Baroda Pharma Pvt Ltd) | $ 0.76 |
ESIRESP PLUS | |
ESIRESP PLUS SYRUP 1 bottle / 100 ML syrup each (Mac Millon Pharmaceuticals Pvt Ltd) | $ 0.79 |
SOTHREX PLUS | |
SOTHREX PLUS SYRUP 1 bottle / 100 ML syrup each (Psychotropics India Ltd) | $ 0.92 |
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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