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Other Medications
Analgesics
Name | Dose (Adults) | Dose (Paediatric) | Available as | Precautions |
| Tramadol | 50mg- IV- TID | Avoid in severe hepatic/ renal impairment. W/F Dizziness, constipation, emotional lability, avoid with increased IC pressure, head injury, h/o seizures. Avoid operating machines and vehicles, avoid in addiction prone, avoid in obstetric patients | ||
| Pentazocin | 30mg- QID- IV | Renal correction, W/F vomiting, constipation, euphoria Avoid in acute asthma, respiratory depression, bradycardia, head injury, irritable bowel disease, increased ICP, liver disease, infective diarrhoea, cardiac arrythmias, epilepsy, hypotension | ||
| Paracetamol | 650mg- TID | PO/PR- 15mg/kg- TID-QID Inj. 5mg/kg | Tab. 300, 500, 650mg Syp. 125, 250mg/5ml PR. 125, 250mg | Safe, renal correction, hepatotoxic, Caution in alcoholics and G6PD deficiency |
| Ibuprofen | 10mg/kg- QID | Tab. 200, 400mg Susp. 100mg/5ml | ||
| Morphine | Refer "Pain management" section | |||
| Diclofenac | 50mg- TDS | W/F abdominal pain, peptic ulcer, constipation, avoid in blood dyscrasias, Use with caution- bronchospasm, CCF, hypertension, fluid retention | ||
| Gabapentin | 300mg- HS- PO | Renal correction, taper and stop, W/F ataxia and dizziness | ||
| Amitriptyline | 25-50 mg- OD | W/F orthostatic hypotension, causes sedation, Use with caution in cardiac disease, diabetes mellitus, mania, hepatic/renal dysfunction, thyroid dysfunction, seizure disorder W/F Constipation and urinary retention |
GI Medications
Name | Dose (Adults) | Dose (Paediatric) | Available as | Precautions |
| Ranitidine | PO. 3mg/kg- BD IV. 1mg/kg- BD | Tab. 150mg Inj. 50mg | ||
| Pantoprazole | 40mg- OD- IV/PO | W/F Diarrhea | ||
| Ondansetron | 8mg- TID- PO/IV | <4yrs- 2mg- TID 4-11yrs- 4mg- TID >12yrs- 8mg- TID | Tab. 4, 8mg Susp. 2mg/5ml | W/F Headache, diarrhea, constipation, QT prolongation |
| Aprepitant | 125mg stat 1 hr prior to chemo, then 80mg OD on days 2 and 3 | Give along with ondansetron | ||
| Metoclopramide | 10mg- QID- PO | W/F Extrapyramidal signs- Oculogyric crisis- Torticollis, protrusion of tongue, feels swollen, trismus (if present give Phenergan- 50mg- IV-Stat/ diphenhydramine- 50mg- IV-Stat) Contraindicated in GI obstruction, GI haemorrhage, epilepsy Renal correction needed | ||
| Domperidone | 0.2-0.4mg/kg- QID | Susp. 5mg/5ml | ||
| Promethazine | ||||
| Racecadotril | 100mg- TDS- PO | 1.5mg/kg- TID | Sachet- 10mg | W/F Vomiting, constipation |
| Loperamide | 4mg stat, then 2 mg after each stool | Discontinue if no improvement after 48 hrs, contraindicated in bloody diarrhea, infectious diarrhea, high fever, age <2years, ulcerative colitis | ||
| Lactulose | 20ml- HS (Upto 45ml)- PO with full glass of water | 1-2ml/kg- OD-TID | Remain upright for 30min after taking, Contraindicated in intestinal obstruction, W/F diarrhea, hypokalemia, boating | |
| Liquid paraffin | 20ml- HS - PO | Contraindicated in abdominal pain, vomiting, age <3 years |
Anti-Hypertensives
Name | Dose (Adults) | Dose (Paediatric) | Available as | Precautions |
| Amlodipine | 5mg-10mg OD-PO | Hepatic correction | ||
| Nifedipine | 10mg- TDS- PO (Up to 90mg/day) | Caution: MI, CCF, Hypotension, concurrent beta blockers | ||
| Telmisartan | 20-80mg-OD-PO Adjust with BP | Hepatic correction Contraindicated in bilateral renal artery stenosis, correct volume and salt depletion before starting Caution: Renal impairment, CCF, Obstructive jaundice, with ACE inhibitors | ||
| Metoprolol | 25-100mg- OD- PO | Hepatic correction, Contraindicated in ischemic heart disease, asthmatics, bradycardia, heart block, CCF, peripheral vascular disease |
Drugs used for hyperuricemia
Name | Dose (Adults) | Dose (Paediatric) | Available as | Precautions |
| Allopurinol | 300mg- HS- PO | 3mg/kg- TID | Tab. 100mg | Renal correction, decrease dose of azathioprine and 6-MP to 1/3rd, monitor RFT, electrolytes, LFT, stop as early as possible |
| Febuxastat | 40mg- OD | |||
| Rasburicase | 0.15- 0.2 units/kg IV in 50ml NS over 30 min | Donot use in G6PD deficiency, collect samples in prechilled tubes and send on ice. |
Nutritional Supplements
Name | Dose (Adults) | Dose (Paediatric) | Available as | Precautions |
| Ferrous fumarate | 200mg OD | 3mg/kg- BD (2-12 years- 5ml- OD) | Syp. Vitcofol- contains 100mg/5ml | Take on empty stomach if possible, take with lime juice Avoid tetracyclins, flouroquinalones, , antacid syrups W/F- Nausea, constipation, stomach cramps, diarrhea, GI hemorrhage |
| Ferric carboxy maltose | 500mg- in 100ml NS over 30min- OD- for 2-3 days | W/F discoloration at extravasation site, allergic reactions | ||
| Folic acid | 0.5-5mg- OD-PO | Any age- 5mg- OD | Avoid in undiagnosed anemia, Combine with B12 supplementation | |
| Vitamin B12 | 1000mcg in 100ml NS over 15min | Same as adult dose | W/F hypokalemia | |
| Vitamin C | 250mg- OD-PO | Same as adult dose | ||
| Vitamin K | 5-10mg- OD for 3 days | Any age- 5mg- SC/IM | W/F anaphylaxis | |
| Pyridoxine | 10-200mg- OD | <3yrs- 20mg- OD >3yrs- 40mg- OD | Tab. 40mg | |
| Potassium citrate | 10ml contains 1080mg Potassium citrate- 5ml- OD-TDS-PO | |||
| Potassium chloride | Avoid with spironolactone | |||
| Calcium carbonate | 500mg- BD-PO | Osteocalcium syrup <3yrs- 5ml- OD >3yrs- 5ml- BD | Take with meals, W/F constipation and hypercalcemia |
Others
Name | Dose (Adults) | Dose (Paediatric) | Available as | Precautions |
| IV Immunoglobulin | 400mg/kg OD for 5 days or 1gm/kg for 2 days | W/F allergic reactions | ||
| Dapsone | 100mg- OD-PO | 1mg/kg | Tab. 100mg | W/F hemolysis, methemoglobinemia, bacterial or fungal superinfection with prolonged use |
| Levetiracetam | 1gm stat, then 500mg- BD- IV/PO | 10mg/kg- BD- IV/PO | Tab. 250, 500, 750mg Syp. 100mg/5ml | Renal correction, safe, taper and stop |
| Clobazam | 10mg- HS-PO | Given prior to high dose Busulfan, Hepatic correction | ||
| Pheniramine maleate | 4mg- IV/PO- 6th hrly | 0.2mg/kg- IV/PO- TID | Tab. 25, 50mg Inj. 22.5mg | W/F sedation |
| Hydroxazine | 25mg- BD- PO | Avoid handling machines or vehicles | ||
| Cetrizine | 2-6yrs- 2.5mg- BD >6yrs- 5-10mg- BD | Tab. 5, 10mg Syp. 5mg/5ml | ||
| Levocetrizine | 5mg- OD- PO | Avoid in CRF, narrow angle glaucoma, BPH | ||
| Mesna | ||||
| Folinic acid | 15mg/m2- QID- IV/PO | Continue till methotrexate levels <0.05micromol/L | ||
| Zoledronic acid | 4mg- IV- over 15 min stat | Renal correction, W/F bone pain, hypokalemia, hypotension | ||
| Denosumab | 120mg SC- once in 4 weeks | Can cause hypocalcemia, combine with calcium and vitamin D3. | ||
| Ibandronate | 150mg- Stat | |||
| Amiodarone | 400mg- TDS- PO for 1-3 weeks then OD | Monitor RFT, LFT W/F peripheral neuropathy Avoid in bradycardia and AV block Correct K and Mg prior to starting | ||
| Norethisterone | 5mg- 2-2-2 | Strict contraindication- Pregnancy W/F breakthrough bleed, DVT Avoid in liver disease, undiagnosed vaginal bleed, uncontrolled diabetes, hypertension, vascular disease, H/O migraine, asthma, epilepsy | ||
| Albendazole | 400mg- PO Stat | 1-2yrs- 200mg- stat >2yrs- 400mg- Stat | Tab- 200, 400mg Syp- 200mg/5ml | Safe drug |
| Haloperidol | 2-10mg- depending on degree of agitation May continue 2mg- 6rhly | W/F QTc prolongation, Contraindicated with procainamide, amiodarone W/F Extrapyramidal symptoms |
Note:
Grading of peripheral neuropathy:
Sensory:
0- No change
1- Loss of DTR/ Mild paresthesia
2- Paresthesia interfering with function but not ADL
3- Paresthesia that interferes with ADL
4- Disability
Motor:
0- No change
1- Weakness only on examination
2- Symptomatic, but not affecting ADL
3- Interferes with ADL
4- Life threatening/ Disabilities
(ADL- Activities of daily living)
Drugs causing QTc Prolongation and torsades de pointes:
- Antiarrythmics: Amiodarone, Sotalol, Quinidine, Procainamide, Ibutilide, Defetilide
- Antimicrobials: Levofloxacin, Ciprofloxacin, gatifloxacin, Moxifloxacin, Clarithromycin, Erythromycin, Ketoconazole, Itraconazole
- Antidepressants: Amitryptaline, Desipramine, Imipramine, Doxepin, Fluoxitine, Sertraline, Venlafaxine
- Antipsychotics: Haloperidol, droperidol, Quetiapine, Thioridazine
- Antihistaminics: Terfenadine, astemizole
- Others: HCQS, Cisapride, Sumitriptan, Zolmitriptan, Arsenic, Dolasetron, Methadone
Pregnancy categories:
A- No risk on fetus in 1st or later trimesters (Adequate studies)
B- No risk on fetus in 1st or later trimesters (No adequate studies)
C- Potentially harmful drug- Use only if benefits overweigh the risks
D- Positive evidence of fetal risk (During investigation/ marketing)
X- Completely contraindicated as risks involved in use of drug completely over weigh potential benefit.
CYP3A Inhibitors (Lead to increased exposure of other drugs):
- Antifungals: Ketaconazole, Fluconazole, Itraconazole
- Antibiotics: Clarythromycin, Erythromycin
- Calcium channel blockers: Verapamil, Nicardipine
- Glucocorticoids: Methylprednisolone
- HIV Protease inhibitors: Saquinavir, Indinavir, Nelfinavir, Ritonavir
- Grapefruit (Type of orange)
CYP3A Inducers (Lead to decreased exposure of other drugs):
- Antibiotics: Nafcillin, Rifampicin, Rifabutin
- Anticonvulsants: Phenobarbital, Phenytoin, Carbamazepine
- St. John wort
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