Daonil

Generic: glibenclamide

Class: sulfonylurea

Indications: NIDDM

C/I: treatment with bosartan, IDDM, ketoacidosis

Dose: 2.5mg - 20mg in 1-2 doses

SIDE EFFECTS:

Common:

weight gain, hypoglycaemia

Infrequent:

nausea, diarrhoea, rash, headache, metallic taste

Rare:

blood disorders, allergy, stevens-johnsons, photosensitivity, hetatotoxicity

Amaryl

Generic: glimepiride

Class: sulphonylurea

Indication: NIDDM

Contraindication: ketoacidosis and IDDM

Dose: initially 1mg, increasing in 1mg increments up to 4mg daily

SIDE EFFECTS:

Common:

hypoglycaemia, weight gain

Infrequent:

Metallic taste, diarrhoea, nausea, headache, rash

Rare:

Hepatotoxitiy, photosensitivity, stevens-johnsons, allergy, blood disorders

Generic: gliclazide

Class: sulfonylurea

Indications: NIDDM

Contraindications: ketoacidosis, IDDM

Dose: 40mg - 320mg in 1-2 doses

Common:

Hypoglycaemia, weight gain

Infrequent:

Metallic taste, headache, rash, diarrhoea, nausea

Rare:

Blood disorders, hepatotoxitity, photosensitivity, stevens-johnsons syndrome, allergy

Generic: glipizide

Class: sulphonylurea

Indication: NIDDM

Contraindication: IDDM, ketoacidosis

Dose: 2.5mg - 40mg daily in 1-2 doses

SIDE EFFECTS

Common:

Hypoglycaemia, weight gain

Infrequent:

Metallic taste, headache, rash, diarrhoea, nausea

Rare:

Blood disorders, hepatotoxitity, photosensitivity, stevens-johnsons syndrome, allergy

Generic: pioglitazone

Class: thiazolidinediones

Indications: NIDDM

Contraindications:

IDDM, ketoacidosis, heart failure class III and IV

Dose: 15mg - 45mg daily

SIDE EFFECTS

Common:

peripheral oedema, headache, dizziness, weight gain, arthralgia, decreased haemoglobin and haematocrit,

Infrequent:

distal limb fracture (females)

Rare:

increased hepatic enzymes, hepatocellular injury, heart failure, pulmonary oedema

Generic: rosiglitazone

Class: thiazolidinediones

Indications: NIDDM
Contraindications: ketoacidosis, IDDM and heart failure class III and IV

Dose: 4mg - 8mg in 1 - 2 doses.

SIDE EFFECTS

Common:

increase in HDL and LDL cholesterol, peripheral oedema, weight gain, headache, dizziness, arthralgia, decrease in haemoglobin and haematocrit

 Infrequent:

distal limb fracture (females)

 

Rare:

cardiac ischaemic disease, macular oedema, increased hepatic enzymes, hepatocellular injury, pulmonary oedema

Glucobay

Generic: acarbose

Class:

Indication: NIDDM
C/I: inflammatory bowel disease, partial intestinal blockage, major hernia, GI disorders with malabsorption

Dose: 50mg daily, increased to 50mg tds.  max 600mg

SIDE EFFECTS

Common: flatulence, diarrhoea, abdominal pain, distention

Infrequent: increased transaminase concentrations

Rare: ileus, hepatotoxity, rash, oedema, anaemia, erythema multiforme

Diabex

Generic: metformin 

Class: biguanides

Indication: NIDDM and anovulation secondary to PCOS that is resistant to clomiphene alone

Contraindication: respiratory failure, ketoacidosis, IDDM, severe trauma or infection, dehydration, alcohol misuse

Dose: 500mg - 3000mg daily in divided dose (unless CR formulation)

SIDE EFFECTS

Common:

B12 malabsorption, nausea, vomitting, diarrhoea, anorexia

Infrequent:

Rash

Rare:

Lactic acidosis, acute hepatitis

Generic: T4

Class: thyroid hormone

Indications: hypothyroidism

Contraindications: untreated hyperthyroidism

Dose: 50 - 200 mcg daily, titrated according to blood test

SIDE EFFECTS

Corresponds to symptoms of hyperthyroidism:

tachycardia, arrhythmia, insomnia, sweating, flushing, excitability, diarrhoea, excessive weight loss

Generic: carbimazole 

Class: antithyroid drugs

Indications: graves disease, thyroid storm, short term treatment before surgery/radiotherapy

Contraindications: agranulocytosis with antithyroid drug

SIDE EFFECTS:

Common:

Itch, mild leucopenia, arthralgia, nausea, vomitting, rash, headache, gastric discomfort

Rare:

agranulocytosis, bleeding and hyproprothrombonaemia, myositosis, hepatotoxitity, lupus-like syndrome, vasculitis

Dose: initial 20 - 40mg, maintenance 5 - 15 mg but can range from 2.5mg - 40mg. 

Propylthiouracil

Class: antithyroid drugs

Indication: hyperthyroidism, throid storm, prior to surgery/radiotherapy

Contraindication:

Agranulocytosis with antithyroid drug

Dose: 200mg - 400mg in 2-4 doses initially.  Maintenance 25mg - 300mg daily

Generic: alendronate

Class: bisphosphonate

Indication:

Treatment/prevention osteoporosis, hypercalcaemia of malignancy, paget's disease

Contraindication

Oesophageal disorders, inability to remain upright for 30 minutes, hypocalceamia

Dose:

5 or 10mg daily or 70mg weekly.  Paget's disease is 40mg daily for 6 months

SIDE EFFECTS

Common:

Nausea, vomitting, diarrhoea, headache, musculoskeletal pain

Infrequent:

Oesophogeal ulcers and erosions, oesophagitis, gastritis, duodenitis, glositis, iritis, uveitis, scleritis, rash

Rare:

Osteonecrosis of the jaw, heart failure, renal impairment

Generic: risedronate

Class: bisphosphonate

Indications:

Treatment/prevention osteoporosis, paget's disease, hypercalcaemia of malignancy

Contraindications:

Inability to stay upright for 30 minutes, hypocalcaemia

Dose:

5mg daily or 35mg weekly

SIDE EFFECTS

Common:

Nausea, vomitting, diarrhoea, headache, musculoskeletal pain

Infrequent:

Oesophogeal ulcers and erosions, oesophagitis, gastritis, duodenitis, glositis, iritis, uveitis, scleritis, rash

Rare:

Osteonecrosis of the jaw, heart failure, renal impairment

Generic: Vitamin D

Indications: treatment of hypocalcaemia, treatment of osteoporosis, prevention of corticosteroid-induced osteoporosis

Contraindications: hypercalcaemia 

Dose: 0.25mg twice daily

SIDE EFFECTS:

Signs of hypercalcaemia.  Early signs of hypercalcaemia are:

nausea, vomiting, constipation, anorexia, apathy, thirst, headache, polyuria, sweating

Caltrate

Generic: calcium

Indications:

hypocalcaemia, hyperphosphataemia of renal failure, hyperkalcaemia, magnesium toxicitiy

Contraindication:

Digitoxin toxicity, hypercalcaemia, hypercalciuria

Dose:

800mg - 1500mg depending on gender and age

SIDE EFFECTS

Common:

flatulence, belching, constipation, abdominal distention

Infrequent:

Hypercalcaemia, alkalosis, hypophosphonaemia

Rare:

Renal calculi, milk-alkali syndrome

Evista

Generic: raloxetine

Class: selective estrogen receptor modulator

Indications: prevention and treatment of postmenopausal osteoporosis

Contraindications: History of DVT

Dose: 60mg daily

SIDE EFFECTS

Common:

Hot flushes, sweating, leg cramps, peripheral oedema, sleep disorders

Infrequent:

deep vein thrombosis, pulmonary emboli, retinal vein thrombosis

Protos

Generic: strontium

Indications: treatment of postmenopausal osteoporosis

Dose: 2 g once daily at bedtime

SIDE EFFECTS

Common:

nausea, diarrhoea, headache, dermatitis, increased creatinase kinase concentrations

Rare:

Deep vein thrombosis, pulmonary embolism, CNS disturbances including disturbed conciousness, memory loss or seizure

Generic: cortisone

Class: glucocorticosteroid

Indications:

glucocorticoid replacement in adrenal insufficiency, where corticosteroids are indicated but other corticosteroids are prefered

Dose:

10 - 25mg/m2 or 10 - 37.5mg daily in adults in 2 divided doses

SIDE EFFECTS

Common:

dyspepsia, suseptibility to infection, masking infection, hyperglycaemia, hypokalaemia, hypertension, osteoporosis, spontaneous fractures, delayed wound healing, skin atrophy, growth retardation in children, myopathy, muscle weakness and wasting, fat redistribution, amenorrhoea, psychosis, euphoria, depression, adrenal suppression, bruising

Generic: nafarelin

Class:  gonadotrophin-releasing hormone agonist

Indication: endometriosis, uterine fibroids, pituitary downregulation prior to IVF, breast cancer, advanced prostate cancer, precocious puberty

Contraindications:

undiagnosed vaginal bleeding

Dose: 200mcg or 400mcg bd

SIDE EFFECTS

Common

Irritation of nasal membrane, hot flushes, sweating, amenorrhoea, withdrawal bleed, sexual dysfunction, reduced libido, vaginal dryness, changes in breast size, breast tenderness, arthralgia, myalgia, peripheral oedema, dizziness, headache, mood changes, paraesthesis, nausea, vomiting, constipation, thromoembolism, decreased bone mass,

Infrequent:

bronchospasm, rash

clomid

Generic: clomiphene

Class: ovulatory stimulants

Indications:

anovulatory infertility

Contraindications:

abnormal uterine bleeding

endometrial carcinoma

Dose:

50-100mg daily for days 1-6 of cycle

SIDE EFFECTS:

Common:

hot flushes, abdominal discomfort, visual disturbances, reversible ovarian enlargement and cyst formation

Infrequent:

abnormal bleeding, nausea, vomitting

Rare:

reversible hair loss, ovarian hyperstimulation

Generic: fludrocortisone

Class: mineral corticoid

Indications: salt-losing congenetic adrenal hyperplasia, mineral corticoid replacement in adrenal insufficiency.  Both indications used in conjuction with a glucocorticoid

Accepted for orthostatic hypotension.

Dose: 50 - 100 mcg once or twice daily.  up to 200mcg daily

SIDE EFFECTS

Usually indicate that dose is too high.

Common: sodium and water retention, oedema, hypokalaemia, hypertension

 Rare:

hypokalaemic alkaloisis, heart failure

Minirin

Generic: desmopressin

Class: antidiuretic hormone analogue

Indications: nocturnal enuresis, pituitary diabetes insipidous, control of bleeding in patients with certain platelet disorders and haemophilia

Contraindications: heart failure, hyponaturaemia, SIADH

Dose:

intranasal: 10-40mcg in 1-2 divided doses. 

Oral: 100 - 200 mcg tds (range 0.2 - 1.2 g daily)

SIDE EFFECTS

Common:

headache, nausea, hyponatraemia, abdominal cramps

Infrequent:

Seizures, water intoxication

Generic: bromocriptine

Class: dopamine agonist

Indication: hyperprolactinaemia, parkinson's disease, prevent milk production,

Contraindications:

pre-eclampsia, post-partum hypertension

SIDE EFFECTS

Common:

erythromylagia, leg cramps, nausea, vomiting, abdominal pain, constipation, headache, dizziness, orthostatic hypotension, fatigue, weakness, nasal congestion, digital vasospasm, drowsiness, sudden sleep onset, psychiatric disorders (eg compulsive disorders, hallucinations, confusion)

Rare:

hypertension, seizure, stroke, MI, syncope, peripheral oedema, fibrotic effects, alopecia, rash

Dose:

1.25mg - 30mg at night