02 Gastrointestinal System

Chapter 2
GASTRO-INTESTINAL SYSTEM
2.1 Drugs for Dyspepsia and gastrooesophegal refluxp.91
2.1.1 Aluminium and magnesium containing antacids p.92
2.1.2 Compound antacid preparations p.93
2.2 Antispasmodics and other drugs altering gut motility p.94
2.3 Ulcer-healing drugs p.100
2.3.1 H2 receptor antagonistsp.100
2.3.2 Selective antimuscarinics p.103
2.3.3 Proton pump inhibitors p. 103
2.3.4 Chelates and complexes p.110
2.3.5 Prostaglandin analogues p.110
2.3.6 Drugs for eradication of H. pylori p. 111
2.4 Drugs for acute diarrhoea p. 111
2.5 Drugs for chronic diarrhoeap.113
2.6 Laxatives p. 115
2.6.1 Bulk forming laxatives p. 115
2.6.2 Stimulant laxatives p. 116
2.6.3 Faecal softeners p. 116
2.6.4 Osmotic laxatives p. 117
2.7 Preparations for haemorrhoids p. 119
2.7.1 Soothing haemorrhoidal preparations p. 119
2.7.2. Compound haemorrhoidal preparations with corticosteroids p. 119
2.7.3 Rectal sclerosants p. 120
2.7.4 Other Preparations p. 120
2.8 Drugs affecting intestinal secretions p. 120
2.8.1 Drugs acting on gall bladder p. 120
2.8.2 Pancreatin p. 121
Infants withmild or moderate reflux

2.1 DRUGS FOR DISPEPSIA AND without complications can bemanaged
GASTRO-OESOPHEGAL initially by changing the frequency
REFLUX andvolume of feed. A thickened
formulafeed can be used upon advice of
Pregnant woman with gastro- a dietitian. If necessary, a
oesophageal reflux is managed by suitablealginate-containing preparation
dietary and lifestyle changes; if no can be used instead ofthickened feeds.
improvement of symptoms, an antacid Older children with reflux may be
(section 2.1.1) or an alginatemay be managed by life-style changes; if
given. If this is ineffective, necessary by treatment with an
ranitidine(section 2.3.1)may be advised. alginatecontainingpreparation.
However, omeprazole (section2.3.3) is Non-resposive children to the above
reserved for women with severe or measures or whohave problems such as
complicatedreflux disease.Domperidone respiratory disorders or
can be added with caution suspectedoesophagitis need to be
Children withgastro-oesophageal reflux referred to hospital; anH2-receptor
disease is commonin infancy. However, antagonist (section 2.3.1) may be tried
most symptoms resolve withouttreatment toreduce acid secretion. If the
between 12 and 18 months of age. oesophagitis is resistant toH2-receptor
1
2. GASTRO-INTESTINAL SYSTEM
antagonists, the proton pump inhibitor tend to cause diarrhoea and aluminium
omeprazole(section 2.3.3) can be salts cause constipation; so mixtures of
advised. these two preserve normal bowel
Hepatic and renal impairment: function. Some of these preparations
Patients with fluid retention should avoid contain high concentration of sodium
antacids containing large amounts of and should not be given to patients on
sodium. sodium restricted diet.
Interactions: Antacids should preferably
not be taken at the same time as other PREPARATIONS CONTAINING
drugs since they may impair absorption. MIXUTURES OF ALUMINIUM
It may also damage enteric coatings HYDROXIDE AND MAGNESIUM
designed to prevent dissolution in the HYDROXIDE[ED][OTC]
stomach.
Proprietary Preparations
2.1.1 ALUMINIUM-AND MAGNESIUM- Alimag(Asiatic), Tab. Tk. 0.52/Tab.
CONTAINING ANTACIDS Alucil-S(Opsonin),Susp.Tk.
2.1.2 COMPOUND ANTACID 56.39/200mlTab.Tk. 1.50/Tab.
PREPARATIONS Antacid(Popular), Tab. Tk. 0.53/Tab.
Antameal(Alco), Tab. Tk. 0.50/Tab.
Antanil(Ibn Sina), Susp.Tk. 33/200 ml Tab.
Antacids are basic compounds, which Tk. 0.52/Tab.
neutralize hydrochloric acid in the gastric Apcocid(Supreme), Tab. Tk. 0.50/Tab.
secretions; they often relieve symptoms Apedrox(APC), Susp. Tk. 30/200ml
of gastrointestinal disorders associated Biocid(Biopharma), Tab. Tk. 0.50/Tab.
with gastric hyperacidity such as ulcer Biocid MH(Biopharma),Susp.Tk.32.42/200 ml
Cytocid(Central), Susp. Tk.32/200 ml
dyspepsia, non-erosive gastro- Entacyd(Square), Susp. Tk. 55/200 ml Tab.
oesophegal reflux disease and peptic Tk. 0.80/Tab.
ulcer Antacids, sometimes also used in G-Antacid MH(Gonoshasthaya), Tab.
functional (non-ulcer) dyspepsia but the Tk.0.53/Tab
evidence of benefit is uncertain. They Gascon(Popular), Tab. Tk. 1.20/Tab.
are best given usually between meals Jpdrox(Jayson), Susp. Tk. 57/200 ml;
and at bedtime when symptoms occur or Tab. Tk. 0.73/Tab.
Lactameal(Beximco), Tab. Tk.
are expected. Liquid preparations are 0.53/Tab.;Susp. Tk. 33.00/200 ml
more effective than solids and relatively Magnogel(Amico ), Tab. Tk. 0.52/Tab.; Susp.
insoluble antacids are longer acting. Tk.32.00/200 ml
Presence of foods in the stomach can Oxecone(Acme), Susp.Tk. 57.33/200 ml;Tab.
prolong the neutralizing activity. Antacids Tk. 0.73/Tab.
may interact with many other drugs Sugel(Pacific), Susp. Tk. 24.06/200 ml; Tab.
affecting the rate and extent of their Tk. 0.38/Tab.
absorption (see Appendix-2). For this
reason, antacids should preferably not MAGNESIUM TRISILICATE
be taken at the same time with other
drugs. Indications: used as an antacid in dose
upto 2 g by mouth; usually in combi-
2.1.1 ALUMINIUM AND MAGNESIUM nation with aluminium-containing
CONTAINING ANTACIDS antacids.
Cautions:see notes above; patients with
Salts of Aluminium (Aluminium impaired renal functions.
hydroxide gel) and Magnesium Contraindications:see notes above
(Magnesium hydroxide, Magnesium Interactions: see Appendix-2
trisilicate and Magnesium carbonate), Side-effects:diarrhea.
being relatively insoluble in water, are
long-acting and are suitable for use as Proprietary Preparation
antacid. Magnesium-containing antacids Mixtures of 250mg of Dried
2
Aluminium Hydroxide Gel and Magaplus-X(Kemiko),Susp.Tk. 55.00/100 ml;

500mg of Magnesium Trisilicate Tk. 100.00/200 ml
G-Antacid(Gonoshasthaya), Susp. Marlox Plus(Incepta), Tab.Tk. 3.00/Tab.;
Tk.32.00/200ml;Tab. Tk. 0.53/Tab. Susp., Tk. 100.00/200 ml
Novelta(Orion), Tab.Tk. 3.00/Tab.; Tk.
65.00/100 ml; Tk. 100.00/200 ml
2.1.2 COMPOUND ANTACID,
Oxecone-MS(Acme), Susp.Tk.100.00/200 ml
SIMETHICONEAND ALGINATE
PREPARATIONS
ALUMINIUM -AND MAGNESIUM-
CONTAINING ANTACIDS WITH
Compound preparations have no clear ADDITIONAL INGREDIENTS
advantages over simpler preparations;
their neutralising capacity may be the
Simethicone whichacts as a defoaming
same. Complexes containing both
agent has been combined with an
aluminium and magnesium such as
antacid formulation to relieve flatulence.
magaldratehydrotalcite and almasilate
have been used.
ALGINATES
MAGALDRATE
Alginate an anionic polysaccharide is
obtained from brown algae.
Magaldrate (Aluminium Magnesium
Alginatescontaining antacids form a
Hydroxide Sulfate) is a synthetic
viscous gel (raft) that floats on the
combination of aluminium and
surface of stomach contents which
magnesium hydroxides and sulphates. It
impedes reflux and protects
reacts initially rapidly with acid and
oesophageal mucosa from acid attack.
releases aluminium hydroxide, which
Compound antacid preparations contain
then reacts more slowly to provide
alginic acid or sodium alginates with
sustained neutralizing action. Magaldrate
sodium bicarbonate/potassium
may be given in doses of up to 2 g by
bicarbonate, calcium carbonate. Some
mouth.
compounds preparations also contain
alginate/alginic acid with dried aluminium
Marlox(Incepta), Tab. , 400 mg, Tk. hydroxide, magnesium trisilicate and
1.00/Tab.; Susp. 400 mg/5 ml,Tk. 50.00/200 sodium bicarbonate.
ml
Oxecone(Acme), Suspn. 400 mg/5 ml, Tk. Proprietary Preparations
54.36/200ml; Tab. , 400 mg , Tk. 1.00/Tab. Sodium Alginate + Potassium Bicarbonate
Magacil(Opsonin), Tab., 400 mg, Tk. Algicid(Incepta), Susp., 500 mg + 100 mg
0.75/Tab.; Susp., 400 mg/5 ml , Tk. /5ml, Tk. 125.00/200 ml ;Tab. , 500 mg + 100
37.74/200ml mg, Tk. 3.50/Tab.
Magaplus(Kemiko), Susp., 400 mg/5 ml, Tk. Algicon(Leon), Tab. , 500 mg + 100 mg, Tk.
54.20/200 ml 3.00/Tab. ;Susp., 500 mg + 100 mg /5ml,Tk.
125.00/200 ml
Magaldrate 480mg + Simethicone20mg/Tab Asynta(Square), Susp., 500 mg + 100 mg/5
Magaldrate 480mg + Simethicone20mg/5ml ml, Tk. 125.00/200 ml
suspension Gastrocon(Unimed), Tab., 500 mg+100 mg,
Avlocid MS(ACI), Tab., , Tk. 3.00/Tab.; Tk. 4.50/Tab.;Susp., 500mg+100 mg/5ml, Tk.
Susp., Tk. 100.00/200 ml 155.00/200 ml
Digecid Plus(Beximco), Tk. 2.00/Tab.; Susp., Viscocid(Beximco), Susp. 500 mg+100 mg
Tk. 110.00/200 ml /5ml, Tk. 150.00/200 ml
Gastid(Eskayef), Tab., Tk. 3.00/Tab.; Susp.,
Tk. 100.00/200 ml SIMETHICONE
Magacil Plus(Opsonin), Susp.Tk.75.19/200ml
Magalrat Plus(Ibn Sina), Tab., Tk. 3.00/Tab.; (Activated Dimethicone)
Susp., Tk. 100.00/200 ml
Maganta Plus(Square), Tab., Tk. 3.00/Tab.; Simethicone which is also known as
Susp., Tk. 100.00/200 ml Activated Dimethicone has been used
for the relief of the painful symptomos of
3
excess gas in the digestive tract. Such Peptacid(Amico),Tab.,Tk.1/Tab.;Tk.55/200 ml

gas is frequently caused by excessive Recocid Plus(Rephco), Susp., Tk. 75/200 ml;
swallowing of air while eating foods that Tab. Tk. 2/Tab.
disagree, and this may also lead to
indigestion. It has also been used in 2.2 ANTISPASMODICS AND
infantile colic but evidence of benefit is OTHER DRUGS ALTERING
uncertain. GUT MOTILITY
Indications: flatulence, Abdominal
distension, gas and windy colic. Gastrointestinal pain and discomfort may
Simethicone drops are particularly indi- be due to spasm of the smooth muscles
cated in infantile colic which may be associated with dyspepsia
Cautions; Contraindications; Side- irritable bowel syndrome or diverticular
effects: Simethicone is an inert subst- disease. Antispasmodic drugs may be
ance and no adverse effects have been useful as adjunctive treatment and are of
reported after oral administration two types: a) antimuscarinics; and b)
direct smooth muscle relaxant.
Aeropac(Amico), Paed. drops, 67 mg/ml, Tk. ANTIMUSCARINICS
25.00/15 ml
(See also section 8.1.2)
Bloatstop(Acme), Emulsion, 1 gm/100 ml, Tk.
70.00/100 ml The antimuscarinics reduce intestinal
Flacol(Square), Paed. drops, 67 mg/ml,, Tk. spasm, motility and gastric secretions,
30.11/15 ml ;Tab. , 40mg, Tk.1.50/Tab. and may be useful in some forms of
Flatulex(Opsonin), Paed. drops, 67 mg/ml,, 67 dyspepsia, irritable bowel syndrome and
mg/ml, Tk. 22.64/15 ml diverticular disease. Antimuscarinics
Flatunil(Acme), Paed. drops, 67 mg/ml, 67 used in gastrointestinal muscle spasm
mg/ml, Tk. 30.00/15 ml
include the tertiary amines Atropine
Gasnil(Eskayef), Paed. drops 67 mg/ml, Tk.
30.00/15 ml sulphate,Dicycloverine hydrochloride
Lefoam(Incepta), Paed. drops, 67 mg/ml, Tk. and Oxyphencyclimine hydrochloride
30.00/15 ml Trimebutine is a drug with
Neodrop(Beximco), Paed. drops, 67 mg/ml, antimuscarinic and opioid agonist effects
Tk. 30.00/15 ml quarternary ammonium compounds
Pedicon(Orion), Paed. drops, 67 mg/ml, Tk. Hyoscine butylbromide Propantheline
25.09/10 ml;Paed. drops, 67 mg/ml, Tk.
bromide,oxyphenonium bromide,and
30.11/15 ml
Semecon(Drug Int.), Paed.drops, 67 mg/ml, Tiemonium methylsulphate.
Tk. 35.00/15 ml Dicycloverine hydrochloride has much
Simecol(Alco), Paed. drops, 67 mg/ml, Tk. less antimuscarinic action than atropine
28.00/15 ml and may also have some direct action on
Simet(ACI), Paed. drops, 67 mg/ml, Tk. smooth muscle. Hyoscine butylbromide
30.11/15 ml is advised as a gastro-intestinal
antispasmodic, but it is poorly absorbed.
Aluminium hydroxide and magnesium
hydroxide with simethicone Quaternary ammonium compounds are
Antacid MAX(Beximco), Tab. Tk. 2/Tab. less lipid soluble and so are less likely to
Antanil Plus(Ibn Sina), Susp.Tk. 65/200 ml; cross the blood-brain barrier; they are
Tab., Tk. 1.50/Tab. also less well absorbed. Although central
Avlocid Plus(ACI), Tab. Tk. 2/Tab. ;Susp., atropine like side-effects, such as
Tk. 75/200 ml confusion, are thereby reduced,
BIocid Plus(Biopharma), Susp. Tk.
peripheral atropine-like side-effects still
75/200ml;Tab. Tk. 2/Tab.
Entacyd Plus(Square), Susp.Tk. 75/200 ml; remain common. The elderly are
Tab. Tk. 2.00/Tab. particularly susceptible to glaucoma and
Flatameal DS(Beximco), Susp. Tk. 75/200 ml urinary retention.
Kdrox Plus(Kemiko), Tab. Tk. 2/Tab. Antimuscarinics are contraindicated in
Makcid Plus(Maks), Susp. Tk. 64/200 ml myasthenia gravis (but may be used to
Oxecone-S(Acme), Susp.Tk. 75/200 ml;Tab., decrease muscarinic side-effects of
Tk. 2.00/Tab.
anticholinesterases), pyloric stenosis,
4
paralytic ileus, toxic megacolon,and Dose: 10–20 mg 3 times daily; INFANT

prostatic enlargement. It should be used 6–24 months 5–10mg3–4 times daily, 15
with caution in children and in the minutes before feeds;
elderly; in Down’s syndrome, reflux CHILD 2–12years 10mg 3 times daily
oesophagitis, diarrhoea, conditions
associated with cardiac insufficiency and Proprietary Preparations
tachycardia, hypertension,ulcerative Abdorin(Opsonin), Syrup, 10 mg /5 ml, Tk.
colitis,autonomic neuropathy, acute 30.11/50 ml,; Tab. , 10 mg, Tk. 2.01/Tab.
myocardial infarction, pyrexia, individuals Colicon(Square), Syrup, 10 mg/5 ml, Tk.
30.2/50ml,; Tab., 10 mg, Tk. 2.01/Tab.
susceptible toangle-closure glaucoma. Cyclopan(Incepta), Inj. , 20 mg/2 ml, Tk.
Side-effects of antimuscarinic drug 8.00/2ml,; Syrup, 10 mg/5 ml, Tk. 30.00/50ml,;
(especially with high doses) include Tab, 10 mg, Tk. 2.00/Tab.
constipation, transient bradycardia Dirin(Alco), Tab. , 10 mg, Tk. 2.01/Tab.;
(followed by tachycardia, palpitations Syrup, 10 mg / 5ml, Tk. 40.12/50ml
and arrhythmias), reduced bronchial Diverin(ACI), Syrup, 10mg/5ml, Tk. 30.2/50ml
secretions, urinary retention, dilatation of ,; Tab., 10mg, Tk. 2.02/Tab.; 20mg, Tk.
3.52/Tab.
the pupils with loss of accommodation, Ibspa(Pacific), Tab., 10mg/5 ml, Tk.
photophobia, dryness of the mouth and 25.00/50ml,; 10 mg, Tk. 2.00/Tab.
skin, occasional confusion (particularly in Loverin(Beximco), Tab., 10mg, Tk. 2.01/Tab.
the elderly), nausea, vomiting and Robentyl(Healthcare), Syrup, 50ml , Tk.
giddiness. 40.00/Syrup,; 10mg , Tk. 200.00/Tab.
Cyclovin(Somatec), Tab. , 10 mg, Tk.
2.01/Tab.; 10 mg/5 ml, Tk. 30.11/50 ml
ATROPINE SULPHATE[ED] Eraspa(MST), Tab. 10 mg, Tk. 2/Tab.
Spalax(Navana), Syrup, 10 mg/5 ml, Tk.
Indications: Aid in peptic ulcer 30.11/50 ml
treatment, gastrointestinal spasm, renal
and biliary coilc, pre-medication (see HYOSCINE BUTYLBROMIDE[ED]
sec. 8.1.3)
Cautions; Contraindications; Side- Indications: symptomatic relief of
effects:See notes above gastro-intestinal, biliary or genitourinary
Interactions: See Appendix-2 colic (spasmodic pain) and irritable
Dose: See section 8.1.2 bowel syndrome; dysmenorrhoea; as
antispasmodic in endoscopy and
Proprietary Preparations radiological procedures of gut; as an
Atropine(Chemist), Inj.,1mg/ml, Tk. 2.52/1ml adjunct in the treatment of peptic ulcer..
Amp
Atropine-Jayson(Jayson), Inj. 0.6 mg/1ml, Tk.
Cautions; Contraindications; Side-
5.00/1 ml Amp. effects:see notes above
G-Atropine(Gonoshasthaya), Inj.0.6 mg/1ml, Interactions: see Appendix-2
Tk. 3.01/1ml Amp. Dose:by mouth, 10-20 mg 4 times daily;
CHILD 6-12 years, 10 mg 3 times daily.
DICYCLOVERINE HYDROCHLORIDE By intramuscular or intravenous injection
(Dicyclomine hydrochloride) (acute spasm), 20 mg, repeated after 30
minutes if necessary. CHILD not
Indications: Symptomatic relief of recommended
gastro-intestinal disorders characterised
by smooth muscle spasm Proprietary Preparations
Asipan(Asiatic), Tab., 20mg , Tk. 3.00/Tab.
Side effects: See notes above
Buscon(Ibn Sina), Tab., 10 mg, Tk.
Cautions:See notes above 3.00/Tab.; Inj., 20mg/ml, Tk. 29.50/ml Amp
Contra-indications:See notes above; Butapan(Sanofi), Tab., 10mg, Tk. 6.90/Tab.;
also infants under 6 months 20mg, Tk. 13.64/Tab.
Pregnancy:Use only if essential Colik(ACI), Tab., 10mg, Tk.6.90/Tab.; 20mg,
Breast-feeding: Should be avoided, Tk. 6.72/Tab., Inj., 20 mg/ml, Tk. 29.90/Amp,
present in milk; apnoeareported in infant Eziride(Opsonin), Tab. 150 mcg , Tk.
5.00/Tab.
5
Hybucin(Supreme), Tab. 10 mg, Tk. 3.40/Tab. TIEMONIUM METHYLSULPHATE

Hybut(Amico), Tab., 10mg, Tk. 3.43/Tab.
Hysomide(Opsonin), Inj., 20 mg/ml, Tk.
29.90/Amp,; Tab. , 10 mg, Tk. 6.90/Tab.; 20 Indications: symptomatic relief of
mg , Tk. 13.64/Tab. gastrointestinal, biliary, renal and
Spanil(Beximco), Tab., 10mg, Tk. 6.90/Tab. genitourinary colic
Spasmozen (Zenith), Tab. 10 mg , Tk. Cautions;Contraindications; Side-
3.44/Tab. effects: see notes above.
Typan(Astra Biopharma), Tab. , 10 mg, Tk.
Interactions: see Appendix-2
3.43/Tab.
Altapan(Albion), Tab., 10 mg, Tk.1.80/Tab. Dose:by mouth 100-300 mg daily in
Asipan(Asiatic), Tab., 20 mg, Tk. 3.00/Tab. divided doses; by intramuscular or slow
Butapan(Sanofi), Tab., 10 mg, Tk. 3.42/Tab.; intravenous injection, 10 mg 2-3 times
20 mg, Tk. 6.00/Tab.;Inj., 20 mg/ml , daily
Tk.7.89/Amp.
Butason(Hudson), Tab., 10mg, Tk.1.75/Tab. Proprietary Preparations
Colipan(Medimet), Inj., 1 mg/ml, Tk.7.85/1 ml Algin(Renata), Inj., 5 mg/2 ml, Tk. 25.00/2 ml
Amp.; Tab., 10mg, Tk.3.00/Tab.; 20mg, Amp., Tab. , 50 mg, Tk. 6.00/Tab., Syrup,
Tk.5.65/Tab. 10mg/5 ml, Tk. 90.00/100ml
G-Hyoscine(Gonoshasthaya), Tab. 10 mg, Aspasom (Kemiko), Tab., 50 mg, Tk.
Tk.3.35/Tab.; Inj., 20 mg/ml, Tk.7.75/Amp. 5.00/Tab., Syrup, 10mg/5 ml, Tk. 90.00/100ml
Spasmoson(Jayson), Tab., 10 mg, Tk. Dysma(Rangs), Tab., 50 mg, Tk. 5/Tab.
3.40/Tab.; Inj., 20 mg/ml, Tk. 7.88/Amp. Emogin(Somatec), Tab., 50 mg, Tk.
5.00/Tab.
OXYPHENONIUM BROMIDE Emonium(Beximco), Inj., 5 mg/2 ml, Tk.
75.00/2ml Amp., Tab., 50mg, Tk. 5.00/Tab.
Monivis(Organic), Tab. , 50 mg, Tk.
Indications: symptomatic relief of 6.02/Tab.
gastro-intestinal, biliary or genitourinary Norvis(Square), Inj., 5 mg/2 ml, Tk. 25.00/2
colic; as an adjunct in the treatment of ml Amp., Syrup, 10mg/5 ml, Tk. 87.26/100ml;
peptic ulcer. Tab. , 50 mg, Tk. 6.02/Tab.
Cautions; Contraindications; Side- Onium(Orion), Syrup, 10mg/5 ml, Tk.
effects:see notes above 50.15/50ml; 10mg/5 ml, Tk. 85.26/100ml;
Tab. , 50 mg, Tk. 6.02/Tab., Inj, 5 mg/2 ml, Tk.
Interactions: see Appendix-2 25.08/2 ml Amp.
Dose:by mouth, 5-10 mg 3 times daily Panium(Navana), Tab., 50 mg, Tk.
5.00/Tab.;Inj., 5 mg/2 ml, Tk. 20.00/amp.
Proprietary Preparations Previp(Genera), Tab. , 50 mg, Tk. 4.02/Tab.
Antrenex(Opsonin), Tab., 5 mg, Tk. 1.25/Tab. Relvis(Biopharma), Inj. , 5 mg/2 ml, Tk.
Antrenyl(Novartis), Tab., 5 mg, Tk. 4.00/Tab. 15.00/2 ml Amp., Tab., 50mg, Tk. 5.00/Tab.
A-Spasm(Acme), Tab., 5 mg, Tk. 1.44/Tab. Spadyl(SMC Enterprise), Tab., 50 mg, Tk.
Isonil(Amico), Tab., 5 mg, Tk. 1.41/Tab. 5.00/Tab.
Spanium(Ziska), Inj., 5 mg/2 ml, Tk. 15/2ml
PROPANTHELINE BROMIDE Amp.; 50 mg, Tk. 4/Tab.
Spason(Astra Biopharma), Tab. , 50 mg,
Spazin (Euro), Tab., 50mg, Tk. 5.00/Tab.
Indications: symptomatic relief of Tiemo (Alco), Tab. , 50 mg, Tk. 4.01/Tab.
gastrointestinal colic, as an adjunct in Tienum(Chemist), Inj. , 2 ml, Tk. 15/2 ml Amp;
the treatment of peptic ulcer; adult Tab. , 50 mg, Tk. 4/Tab.
enuresis and urinary incontinence Timem(Silva), Tab. , 50mg, Tk. 4.02/Tab.
Timoben(Benham), Tab., 50 mg, Tk. 5/Tab.
Cautions; Contra indications; Side-
Timonac(Julpher), Inj., 5 mg/2 ml , Tk.
effects: see notes above 20.00/amp.;Tab., 50 mg, Tk. 6.00/Tab.
Interactions: see Appendix-2 Timonate(Pacific), Inj. , 5 mg/2 ml, Tk. 25.00/2
Dose: 15 mg 3 times daily 1 hour before ml Amp; Tab., 50 mg, Tk. 6.00/Tab.
meals and 30 mg at night, max. 120mg Timonil(Popular), Tab. , 50 mg, Tk.
daily CHILD not recommended 4.02/Tab., Inj, 5 mg/2 ml, Tk. 15.06/2 ml amp.
Timothy(Eskayef), Inj. , 5 mg/2 ml, Tk. 15.00/2
ml Amp., Tab, 50 mg, Tk. 4.00/Tab., 50 mg,
Proprietary Preparation
Tk. 4.00/Tab.
Prokind(Beacon), Tab. 15 mg, Tk. 8.02/Tab.
6
Timozin(Incepta), Tab. , 50 mg, Tk. Dose:200 mg 3 times daily before

6.00/Tab., Inj., 5 mg/2 ml, Tk. 15.00/2 ml Amp. meals.
Tinilux(Sharif), Tab. 50mg, Tk. 6.00/Tab.,
50mg, Tk. 6.00/Tab.
Tinimet (Rephco), Inj.,5 mg/2 ml,Tk.20/amp.;
Timotor(Square), Tab.,100 mg, Tk. 5.01/Tab.
5mg/2ml, Tk. 25/amp.;Tab., 50 mg, Tk. 5/Tab.
Tinium(Acme), Inj., 5 mg/2 ml, Tk. 20.07/2 ml Trimotil(Incepta), Tab.,100 mg, Tk. 5.00/Tab.
Amp., Tab., 50 mg, Tk. 6.00/Tab.
Tino(Delta), Tab. , 50 mg, Tk. 4.00/Tab. OTHER ANTISPASMODICS
Tispa(Concord), Tab. , 50 mg, Tk. 5.00/Tab.
Titos(Novo Health), Tab. , 50 mg, Tk.
Alverine, drotaverine, Mebeverine,
5.00/Tab.
Tium(Ad-din), Tab., 50 mg, Tk. 3.50/Tab. and peppermint oil are believed to
Tivis(Beacon), Tab. , 50 mg, Tk. 5.00/Tab.; directly relax intestinal smooth muscle
Inj., 5 mg/2 ml, Tk. 16.00/amp. and may relieve spasm and pain in
Tivis(Beacon), Tab. , 50mg , Tk. 5.04/Tab., irritable bowel syndrome and diverticular
Inj., 5 mg/2 ml, Tk. 16.05/2 ml Amp. disease. They have no serious adverse
Tynium(ACI), Tab., 50mg , Tk. 6.02/Tab., Inj., effects but like all antispasmodics should
5 mg/2 ml, Tk. 15.11/2ml amp., Syrup,
be avoided in paralytic ileus.
10mg/5 ml, Tk. 56.17/50ml; 10mg/5 ml, Tk.
85.26/100ml
Veralgin(Aristo), Inj. , 5 mg/2 ml, Tk. 25.00/2 ALVERINE CITRATE
ml Amp., 50mg , Tk. 6.00/Tab.
Visarin(Pharmasia), Tab., 50 mg, Tk. 4/Tab. Indications:as an adjunct in gastro-
Viscer(Techno), Inj., 5 mg/2 ml, Tk. 12/amp.
Visceral(Ibn Sina), Tab., 50mg, Tk. 8.00/Tab., intestinal disorderscharacterised by
Inj. , 5 mg/2 ml, Tk. 160.00/2 ml Amp. smooth muscle spasm; dysmenorrhoea
Visegin(UniMed), Tab.,50mg,Tk. 5/Tab. Contra-indications: paralytic
Viset(Healthcare), Syrup, 10mg/5 ml, Tk. ileus,breast-feeding
55.00/Syrup., 10mg/5 ml, Tk. 90.00/Syrup; Caution: pregnancy,
Tab., 50mg, Tk. 7.00/Tab., Inj. , 5 mg/2 ml, Tk. Side-effects: nausea; dyspnoea;
250.00/2 ml Amp headache, dizziness;pruritus, rash;
Visnil(Nipro JMI),Tab., 50 mg, Tk. 4/Tab.
Visnor(Apex), Inj., 5 mg/2 ml, Tk. 15.00/amp; hepatitis also reported
Tab., 50 mg, Tk. 4.00/Tab. Dose:ADULT and CHILD over 12 years,
Visonium(Drug Intl), Inj., 5 mg/2 ml, Tk. 60–120mg 1–3 timesdaily.
25.02/2 ml Amp.; Tab., 50mg, Tk. 5.00/Tab.
Vispazin(Globe), Suspn., 10mg/5 ml, Tk. Proprietary Preparations
90.00/100ml; Inj. , 5 mg/2 ml, Tk. 15.00/2 ml Alve(Orion), Tab., 60 mg, Tk. 5.01/Tab.
Amp.; Tab. , 50 mg, Tk. 5.00/Tab. Alverate(Ibn Sina), Tab., 60mg, Tk. 5.02/Tab.
Visral(Opsonin), Supp, 20 mg , Tk. Dismonal(Opsonin), Tab., 60 mg, Tk.
8.00/Supp., Syrup, 10mg/5 ml, Tk. 5.00/Tab.
80.00/100ml; Tab. , 50 mg , Tk. 6.00/Tab., Pelverin(Popular), Tab., 60mg, Tk. 5.02/Tab.
Inj., 5 mg /2 ml, Tk. 15.10/2ml Amp. Spasverin(Beacon), Tab. , 60mg , Tk.
Xelcom(Radiant), Tab. , 50mg, Tk. 5.02/Tab.
8.00/Tab., Inj, 5 mg/2 ml, Tk. 35.00/2 ml Amp
Zeum(Novartis), Tab., 50 mg, Tk. 6.50/Tab.
DROTAVERINE HYDROCHLORIDE
TRIMEBUTINE MALEATE
Indications: as an antispasmodic in
gastro-intestinal colic,biliary and
Indication: Irritable bowel Syndrome genitourinary colic; tenesmus in
Cautions:Pregnancy,breast dysentery; dysmenorrhoea
feeding,children Cautions and Contraindications:
Contraindication: Should not be taken pregnancy and lactation; impairment of
by anyone who is allergic to trimebutine liver or kidney (Appendix 3 & 4)
Side effects: Abdominal Interactions: see Appendix-2
pain,constipation,diarrhoea,dry Side-effects: flushing, perspiration,
mouth,fatigue, foul taste, headaches, hot palpitation and vertigo are reported
or cold sensations,indigestion nausea, Dose:by mouth 40-80 mg 3 times daily.
rash
7
by subcutaneous or intramuscular Mevin(Square), Tab., 135 mg, Tk. 6.02/Tab.;

injection, 40-80 mg up to three times Cap., 200 mg, Tk.10.03/Cap.
daily Rostil(Beximco), SR Cap., 200 mg, Tk.
10.00/Cap.; Tab., 135 mg, Tk. 7.00/Tab.
by slow intravenous injection in acute Veripel(Beacon), Cap., 200mg , Tk. 9.03/Cap.
renal colic, 40-80 mg Veron(Eskayef), Tab., 135 mg, Tk. 6.00/Tab.;
135 mg, Tk. 6.08/Tab.
Dot(Acme), Tab. , 40 mg, Tk. 1.76/Tab.; Inj.,
OTHER DRUGS ALTERING GUT
40 mg./2 ml, Tk. 7.04/2ml
Dotarin(Popular), Tab., 40 mg, Tk. 1.76/Tab.; MOTILITY
Inj., 40mg/2ml, Tk. 7.03/Amp. (See sectio section 7.8)
Dover(Nipa), Tab. 40 mg, Tk. 1.75/Tab. Gut smooth muscle exhibits intrinsic
Drotapan(Incepta), Tab. 40 mg, Tk. 1.75/Tab. motor activity which is modified by
Drovin(ACI), Inj., 40mg/2ml, Tk.10.07/2ml; autonomic innervation, local reflexes and
Tab., 40 mg, Tk. 1.77/Tab.
gut hormones to produce peristalsis.
Espa(Square), Inj., 40 mg/2 ml, Tk. 7.02/Amp.,
40 mg, Tk.1.75/Tab. Prokinetic drugs which include
N-Aspa(Albion), Tab., 40 mg, Tk. 1.81/Tab. domperidone and metoclopramide
No-Spa(Ambee), Tab., 40 mg, Tk. 1.82/Tab., stimulate the motility of the gut by acting
Inj. 40 mg/2 ml, Tk. 7.98/2 ml amp. at various points within this complex
Rova(Kemiko), Tab., 40 mg, Tk. 2.00/Tab. system to enhance gut movement.
Span(Opsonin), Tab. , 40 mg, Tk. 1.76/Tab.
Tav(Organic), Tab., 40 mg, Tk. 1.76/Tab.
Taverin(Beximco), Tab.,40 mg, Tk. 2.20/Tab. APREPITANT
MEBEVERINE HYDROCHLORIDE It is an antiemetic drug mediates its

effect by blocking the neurokinin 1 (NK1)
Indications: as an adjunct in the receptor.
treatment of symptomatic relief of Indications:as an adjunct to
gastrointestinal colic, irritable bowel dexamethasone and a 5HT3-receptor
syndrome antagonist in preventing nausea and
Cautions; Contraindications :paralytic vomitingassociated with moderately and
ileus, pregnancy and breast-feeding, highly emetogenicchemotherapy
porphyria; should be used with care in Cautions:should not be used
patients with cardiac disorder, hepatic or concurrently with pimozide, terfenadine,
renal insufficiency astemizole, or cisapride. Taking
Interactions: see Appendix-2 aprepitant with these medications could
Side-effects: anorexia, dizziness, result in serious or life-threatening
headache, insomnia, tachycardia have problems
been reported Contra-indications: acute porphyria ,
Dose: ADULT and CHILD above 12 hepatic impairment;pregnancy;breast-
years 135 mg 3 times daily, prefeably 20 feeding, child under 18 years of age.
mins before meals Side-effects: hiccups, dyspepsia,
diarrhoea, constipation, anorexia;
Proprietary Preparations asthenia, headache, dizziness; less
A-Meb(Acme),Tab. 135 mg., Tk. 6.01/Tab. commonly weight changes, dry mouth,
Evarin(Delta),Tab. 135 mg, Tk. 6.00/Tab. colitis, flatulence, stomatitis, abdominal
Iriban(Incepta), Tab., 200 mg, Tk. pain, duodenal ulcer, taste disturbance,
10.00/Tab.; 135 mg, Tk. 6.00/Tab. oedema, bradycardia, palpitations,
Irisyn(Ibn Sina), Tab., 135 mg, Tk. 7.00/Tab. cough, euphoria, anxiety, confusion,
Mave(Opsonin), Cap. , 200 mg , Tk. drowsiness, thirst, abnormal dreams,
10.07/Cap.; Tab., 135 mg, Tk. 7.00/Tab.
chills, hyperglycaemia, polyuria,
Mebeverine(Albion), Tab.,135 mg,Tk. 6/Tab.
Mebiz(Sun), SR Cap., 200 mg, Tk.10/Cap. anaemia, dysuria, haematuria,
Mespa (Ambee), Tab. 135 mg, Tk. 6.02/Tab. hyponatraemia,neutropenia, myalgia,
Meverine(Drug Intl), Tab., 135 mg, Tk. conjunctivitis, pharyngitis, sneezing,
6.05/Tab.; Cap., 200 mg, Tk. 10.05/Cap. tinnitus, sweating, pruritus,rash, acne,
8
photosensitivity, and flushing; dyspnoea, Dedom(Decent), Suspn. , 5mg/5ml, Tk.

insomnia, visual disturbances, 28.00/60 ml,; Tab., 10mg, Tk. 1.90/Tab.
dysarthria, urticaria, and Stevens- Deflux(Beximco), Dispersible Tab., 10mg, Tk.
2.50/Tab.; Paed Drops, 5mg/5ml,; Suspn.,
Johnson syndrome also reported. 5mg/5ml, Tk. 38.00/100ml,; Tab., 10mg, Tk.
Dose: ADULT over 18 years 125 mg 1 2.50/Tab.
hour before chemotherapy, then 80mg Doma(Pacific), Suspn. , 5 mg/5 ml, Tk.
daily as a single dose for the next 2 40/100ml ,; 5 mg/5 ml, Tk. 25/60ml ,; Tab., 10
days; consult product literature for dose mg, Tk. 3.00/Tab.
of concomitant corticosteroid and 5HT3- Dometic(One Pharma), Tab., 10 mg , Tk.
receptor antagonist. 2.00/Tab.
Domidon(Ziska), Suspn., 5 mg/5 ml, Tk.
28/60ml,; Tab., 10 mg, Tk. 2/Tab.
Proprietary Preparations Domilin(General), Suspn, 5mg/5ml, Tk.
Emend(Opsonin), Cap., 40 mg , Tk. 40.27/100ml,; Tab., 10mg, Tk. 2.01/Tab.
45.13/Cap. Domilux(Popular), Tab., 10 mg, Tk. 2.00/Tab.;
Emestop (Incepta), Cap., 40 mg, Tk. Suspn., 5mg/5ml,Tk. 35/ 60ml
50.00/Cap. ; 125 mg, Tk. 150.00/Cap. Domin(Opsonin), Supp, 15 mg , Tk.
5.02/15gm,; Suspn., 5mg/5ml, Tk. 28.11/60
DOMPERIDONE ml; Tab., 10 mg, Tk. 2.50/Tab.; Supp, 30 mg ,
Tk. 8.03/ 30 mg ,; Suspn., 5mg/5ml, Tk.
20.08/15 ml
Indications:nausea and vomiting Dominaaf(Naafco), Sunpn., 5 mg/5 ml, Tk.
associated with Levodopa therapy and 30.00/60ml,; Tab., 10 mg, Tk. 2/Tab.
Bromocriptine, functional dyspepsia, Dominat(Nipa), Tab., 10 mg, Tk.2/Tab.
acute Migraine attack Domiren(Renata), Paed. Drops, 5mg/5ml, Tk.
Cautions:renal impairment, pregnancy 25.00/15 ml; Suspn., 5mg/5ml, Tk.
and breast-feeding; not recommended 35.00/Suspn; 5mg/5ml, Tk. 38.00/Suspn.;
Tab., 10 mg, Tk. 2/Tab.
for routine prophylaxis of postoperative
Domperon(Astra Bio, Suspn., 5 mg/5 ml, Tk.
vomiting or for chronic administration 28.00/60 ml,; Tab, 10 mg, Tk. 2.00/Tab.
Interactions:see Appendix-2 Dompi(Alco), Suspn., 5mg / 5ml, Tk.
Side-effects:raised prolactin concen- 40.12/60ml ,; Tab. , 10 mg, Tk. 2.01/Tab.;
trations (possible galactorrhoea and 10mg, Tk. 2.25/Tab.
gynaecomastia), reduced libido reported; Don-A(Acme), Paed Drops, 5mg/5ml, Tk.
rashes and other allergic reactions; 20.13/15ml,; 5mg/5ml, Tk. 25.17/30ml,; Supp,
15 mg., Tk. 5.03/Supp,; 30 mg., Tk.
acute dystonic reactions reported
8.07/Supp,; 5mg/5ml, Tk. 35.11/60ml,; Tab. ,
Dose: 10-20 mg 3 times daily according 10 mg, Tk. 2.01/Tab.
to the requirement. CHILD: Not recomm- Dopadon(Ibn Sina), Paed. Drops, 5mg/5ml,
ended except nausea and vomiting after Tk. 25.00/15ml,; Suspn., 5mg/5ml, Tk.
cytotoxic therapy, 200-400 micrograms/ 30.00/60ml,; Tab., 10mg, Tk. 2.50/Tab.
kg every 4-8 hours Dysnov(UniMed), Tab , 10mg, Tk. 2.50/Tab.;
Paed Drop, 5mg/5ml, Tk. 20.00/15ml,; Suspn.,
5mg/5ml, Tk. 38.00/100ml
Edone(Zenith), Suspn.; 5mg/5ml, Tk.
Adegut(Supreme), Suspn.,100mg/100ml, Tk.
28.11/60ml,; 5mg/5ml, Tk. 38.14/100ml,; Tab.,
28/60ml,; Tab., 10mg, Tk. 2.00/Tab.
10 mg, Tk. 2.01/Tab.; 10 mg, Tk. 5.00/Tab.
Anet (Kemiko), Tab.,10 mg, Tk. 2/Tab.
Efodio(Radiant), Tab. , 10mg, Tk. 4.00/Tab.
Apidone(Team), Suspn., 5mg/5 ml, Tk.
Egut(Euro), Syrup, 5mg/5ml, Tk.
33.00/60ml,; Tab., 10 mg, Tk. 2.20/Tab.
35.00/100ml; Tab., 10 mg, Tk. 2.5/Tab.
Apuldon(Aristo), Paed Drops, 5mg/5ml, Tk.
Emidom(Somatec), Suspn., 5mg/5ml, Tk.
25.00/15ml,30ml,; Supp, 15mg , Tk.
28.11/60ml,; Tab., 10 mg, Tk. 2.50/Tab.
6.00/Supp,; 30mg, Tk. 9.00/Supp,; Suspn.,
Esogut(Biopharma), Paed Drops, 5mg/5ml,
5mg/5ml, Tk. 35.00/60ml,; Tab. , 10mg, Tk.
Tk. 25.00/15ml,; Suspn., 5mg/5ml, Tk.
2.50/Tab.
28.11/60ml,; Tab., 10mg, Tk. 2.50/Tab.
Atidon(Asiatic), Suspn., 5mg/5ml, Tk.
Loridon(Modern), Suspn., 5mg/5ml, Tk.
28.00/60ml,; Tab., 10 mg, Tk. 2.00/Tab.
20.00/15ml,; 5mg/5ml, Tk. 28.00/60ml,; Tab. ,
Bpdon(Bristol), Tab.,10mg, Tk.100/Tab
10 mg , Tk. 2.50/Tab.
Cosy(Orion), Tab., 10 mg, Tk. 2.50/Tab.;
Motifast(Square), Dispersible Tab., 10mg, Tk.
Syrup, 5mg/5ml, Tk. 28.19/60ml,; Syrup,
2.51/Tab.
5mg/5ml, Tk. 38.26/100ml
9
Motigen(Novo Health), Tab. ,10mg, Tk. Meclid(Jayson), Inj., 10 mg/2 ml,Tk. 3.55/2 ml
2.00/Tab.; Suspn, 5mg/5ml, Tk. 38.00/100ml Amp.
Motigut(Square), Paed. Drops, 5mg/5ml, Tk. Metocol(Opsonin), Syrup, 5mg/5ml,
25.08/15ml,; Suspn. , 5 mg/5 ml, Tk. Tk.15.83/100 ml; 5mg/5ml,
35.11/60ml,; Tab., 10 mg, Tk. 2.51/Tab. Tk.10.65/15 ml
Motinorm(Sharif), Tab., 10 mg, Tk.2.00/Tab. Migen(Albion), Syrup, 100 mg/100 ml, Tk.
Motistat(Globex), Suspn.,5mg/5ml, Tk. 13.70/100 ml
40.12/60ml,; Tab., 10 mg, Tk. 2.00/Tab. Motilon(Sanofi), Tab. 10mg,
Noburn(Beacon), Tab.,10mg, Tk. 2.01/Tab. Tk. 0.34/Tab.
Nudon (Organic), Tab., 10 mg, Tk. 2.00/Tab. Nutramid(Acme), Tab., 10 mg,
Omidon(Incepta), Paed. Drops, 5mg/5ml, Tk. Tk. 0.34/Tab.; Syrup, 100 mg/100 ml, Tk.
25.00/15ml,; Suspn., 5mg/5ml, Tk. 10.65/60 ml
35.00/60ml,; Tab. , 10mg, Tk. 2.00/Tab.;
Suspn., 5mg/5ml, Tk. 38.00/100ml,; Tab., 10 2.3 ULCER HEALING DURGS
mg, Tk. 2.00/Tab.
Paridon(Drug Intl), Tab., 10mg, Tk. 2.05/Tab.;
Suspn, 5mg/5ml, Tk. 32.10/100ml 2.3.1 H2 RECEPTOR ANTAGONISTS
Perion(Globe), Suspn., 5 mg /5 ml, Tk. 2.3.2 SELECTIVE ANTIMUSCARINICS
30.00/60 ml,; 5 mg /5 ml, Tk. 38.00/100 ml,; 2.3.3 PROTON PUMP INHIBITORS
Tab, 10 mg, Tk. 2.00/Tab.
2.3.4 CHELATES AND COMPLEXES
Ridon(Eskayef), Sachet, 10mg , Tk.
6.00/Sachet,; Syrup, 5mg/5ml, Tk. 2.3.5 PROSTAGLAND INALOGUES
20.00/15ml,; 5mg/5ml, Tk. 30.00/60ml,; Tab, 2.3.6 DRUGS FOR ERADICATION OF
10 mg, Tk. 2.50/Tab. HELICOBACTER PYLORI
Sagdon(Nuvista), Tab., 10 mg, Tk. 2.00/Tab.
Sandom(Sanofi), Suspn., 5mg/5ml, Tk.
28.18/Vial.; Tab,10mg, Tk. 2.02/Tab.; Paed 2.3.1 H2 -RECEPTOR ANTAGONISTS
Drop, 5mg/ml, Tk. 20.13/Vial.
Vave(ACI), Suspn., 5mg/5ml, Tk. H2-receptor antagonists reduce gastric
35.11/60ml ,; 5mg/5ml, Tk. 40.12/100ml,; acid (both basal and food stimulated)
Tab., 10mg , Tk. 5.02/Tab.; Paed Drops, 5mg
/ml, Tk. 25.08/15ml ,; Tab., 10mg , Tk.
and pepsin output as a result of H2-
2.50/Tab. receptor blockade. They have been used
Virdon(Virgo), Paed Drops, 5mg/5ml, Tk. in peptic ulcer, gastrointestinal reflux
20.00/15ml,; Suspn. , 5mg/5ml, Tk. diseases and in selected cases of
28.00/60ml,; Tab., 10 mg, Tk.200/Tab. persistent dyspepsia. High doses of H2-
Vomino(Monico), Tab., 10mg, Tk. 2.00/Tab.; receptor antagonists have been used in
Suspn., 5mg/5ml, Tk. 28.00/60ml the Zollinger-Ellison syndrome, though a
Xepadon(Amico), Paed Drop, 5mg/ml,
Tk.18.00/15ml,; Suspn., 5mg/5ml, Tk.
proton pump inhibitor (see sec 2.3.3) is
25.00/60ml,; Tab., 10mg , Tk. 2.00/Tab. now preferred.
METOCLOPRAMIDE FAMOTIDINE
HYDROCHLORIDE[ED)
(See section 7.8) Indications:see under Dose
Cautions:see under ranitidine; does not
Indications: See notes above and see inhibit hepatic microsomal drug
section7.8 metabolism
Cautions andSide-effects: See Side-effects:see under ranitidine; dry
section7.8 mouth and anorexia also reported
Interactions: See Appendix-2 Dose: benign gastric and duodenal
Dose:By mouth 10 mg 3 times daily; ulceration; 20 mg twice daily or 40 mg at
IM/IV10 mg 3 times daily over 1-2 night for 4-8 weeks; maintenance 20 mg
minutes. CHILD 1-5 mg 3 times daily. at night. In Zollinger-Ellison syndrome,
20 mg every 6 hours (higher dose in
Proprietary Preparations those who have previously been
Maxocol(Medimet), Syrup, 5mg/5ml, receiving another H2-antagonist)
Tk.15.77/100ml; Tab.,10mg, Tk.0.34/Tab.
10
Famodin(Acme), Tab. 20.00 mg., Tk. feeding. Avoid intravenous injection in

2.00/Tab.; 40 mg., Tk. 4.01/Tab. high dosage (may rarely cause
Famotack(Square), Tab. 20 mg, Tk. arrhythmias) and in cardiovascular
2.00/Tab.; 20mg, Tk. 2.05/Tab.
Famotid(Drug Intl), Tab., 40mg, Tk. 4.05/Tab.
impairment, does not significantly inhibit
Famotidine(Albion), Tab., 20 mg, hepatic micro-somal drug metabolism.
Tk.1.50/Tab.; 40 mg, Tk. 3/Tab. Side-effects:altered bowel habit,
Novatac(ACI), Tab.,40mg, Tk. 4.13/Tab.; dizziness, rash, tiredness; occasionally,
20mg, Tk. 2.27/Tab. gynaecomastia (cimetidine only, and
Servipep(Novartis), Tab., 20 mg, Tk. 4/Tab.; usually only in high dosage), reversible
40 mg, Tk. 6/Tab. confusional states, reversible liver
Yamadin(Beximco), Tab., 20 mg, Tk.
1.90/Tab.; Tab., 40 mg, Tk. 3.82/Tab.
damage, headache; rare reports of
breast swelling and tenderness in men;
bradycardia, AV block and asystole.
NIZATIDINE
Dose:by mouth, 150 mg twice daily
(morning and night), or for patients with
Indications:see under Dose gastric and duodenal ulceration; 300 mg
Cautions: also avoid rapid intravenous as a single daily dose at night for 4 to 8
injection (risk of arrhythmias and weeks, up to 6 weeks in chronic episodic
postural hypotension); dyspepsia, and up to 8 to 12 weeks in
hepatic impairment reflux oesophagitis and NSAID
Interactions:see Appendix-2(histamine associated ulceration; Zollinger-Ellison
H2-antagonists) and notes above synd-rome, 150 mg 3 times daily,
Pregnancy: avoid unless essential increased if necessary to 6 g daily in
Breast-feeding: amount too small to be divided doses.
harmful For maintenance, 150 mg at
Side-effects:see notes above; also night.CHILD, 8-18 years, up to 150 mg
sweating; rarely nausea, fever, twice daily. Gastric acid reduction
vasculitis, hyperuricaemia (prophylaxis of acid aspiration) in
Dose: benign gastric, duodenal or obstetrics, by mouth, 150 mg at onset of
NSAID-associated ulceration, treatment, labour, then every 6 hours.
300 mg in the evening or 150 mg twice By intramuscular injection, 50 mg every
daily for 4–8 weeks; maintenance, 6-8 hours.
150mg at night By slow intravenous injection, 50 mg
Gastro-oesophageal reflux disease, diluted to 20 ml and given over at least 2
150–300 mg twice daily for up to 12 minutes; may be repeated every 6-8
weeks. CHILD not recommended hours.
Renal impairment: use half normal By intravenous injection, 25 mg/hour for
dose if eGFR 20–50 mL/minute/1.73m2; 2 hours; may be repeated every 6-8
use one-quarter normal dose if eGFR hours.
less than 20 mL/minute/1.73m2 Surgical procedures, by intramuscular or
slow intravenous injection, 50 mg 45-60
Generic Preparation minutes before induction (intravenous
Capsule, 150mg injection diluted to 20 ml and given over
at least 2 minutes), or by mouth, 150 mg
RANITIDINE[ED][OTC] 2 hours before induction, and also, when
possible on the preceding evening.
Indications: benign gastric and
duodenal ulceration stomal ulcer, reflux Proprietary Preparations
oesophagitis, Zollinger-Ellison synd- Aceptin-R(Asiatic), Inj., 50 mg/2 ml, Tk.
rome, other conditions where reduction 10.00/2 ml Amp; Tab., 150 mg, Tk. 2.00/Tab.
Acin(Biopharma), Syrup, 75 mg/5 ml, Tk.
of gastric acidity is beneficial.(see notes
45.17/100ml; Tab., 150 mg, Tk. 2.50/Tab.
above) Alin(Rephco), Tab.,150 mg, Tk. 2.50/Tab.
Cautions:renal and hapatic impairment Amurun (Amulet),Tab.,150 mg, Tk. 2/Tab.
(reduce dose); pregnancy and breast- Anitid(Team), Tab., 150 mg, Tk. 2.00/Tab.
11
Antac(Ambee), Syrup, 75mg/5ml, Tk Ranidin(Acme), Inj., 50 mg/2 ml, Tk. 10.03/2

40.15/100 ml; Tab., 150 mg, Tk. 1.81/Tab.; ml Amp; Syrup, 75 mg/5 ml, Tk. 45.29/100ml;
Inj. , 50 mg / 2 ml , Tk. 5.32/2ml Amp Tab., 300 mg , Tk. 4.03/Tab., 50 mg , Tk.
Asinar(Sanofi), Tab., 150mg, Tk. 2.51/Tab. 2.51/Tab.
Astac(Astra Bio), Tab. , 150 mg, Tk. 2.00/Tab. Ranison(Jayson), Inj., 50 mg/1 ml , Tk.
Bentid(Benham), Tab.,150 mg, 10.00/Amp.;Tab. ,150 mg, Tk.1.73/Tab.
Tk.2.00/Tab.;150 mg, Tk.2.00/Tab. Ranisyn(MST), Tab., 150 mg, Tk. 2.10/Tab.
Bristol Neoset(Bristol), Tab. , 150mg , Tk. Ranitid(Opsonin), Syrup, 75 mg/5 ml, Tk.
1.500/Tab. 50.15/100 ml; Inj., 50 mg/2 ml, Tk. 10.00/2 ml
Duran(Techno), Tab., 300 mg , Tk.4.00/Tab.; Amp; Tab. , 150 mg , Tk. 2.51/Tab., 150 mg ,
Syrup, 75 mg/5 ml, Tk. 40/100 ml.; IVInfusion, Tk. 2.51/Tab., 300 mg , Tk. 4.02/Tab.
50 mg/100 ml, Tk. 60.00/100 ml Ranitidine(Albion), Syrup, 75 mg/5 ml, Tk.
Eucon(Pacific), Inj., 50 mg/2 ml, Tk. 10.00/2 40.00/100ml; Tk. 70.00/200ml .;Tab., 150 mg,
ml Amp.; Tab., 150 mg, Tk. 1.90/Tab. Tk.2.00/Tab.
Gastab(Nipro JMI), Syrup, 75 mg/5 ml, Tk. Ranitidine-R(Doctor TIMS), Tab. , 150 mg,
45.17/100 ml; Tab., 150 mg, Tk. 2.00/Tab. Tk.2.50/Tab.
Gastroloc(Beacon), Tab. , 150mg , Tk. Ranitor(Popular), Tab. , 150 mg, Tk. 2.00/Tab.
2.00/Tab. Ranix(Chemist), Inj.,50mg/ 2 ml, Tk. 25.00/2
Gepin(General), Tab. , 150mg, Tk. 2.01/Tab., ml Amp.
Syrup, 75 mg/5 ml, Tk. 50.00/100ml; 75 mg/5 Rantec(Medimet), Tab., 150mg, Tk.2.00/Tab.;
ml, Tk. 95.00/200ml; Inj., 50 mg/2 ml, Tk. 300mg, Tk.3.50/Tab.
10.00/2ml Amp Ranul(Apex), Tab., 150 mg, Tk. 1.00/Tab.
G-Ranitidine(Gonoshasthaya), Tab.,150 mg, Ravia(Pharmasia), Tab.,150 mg, Tk.1.00/Tab.
Tk. 1.40/Tab. Recodin(Concord),Tab.,150 mg, Tk.1.50/Tab.
Hi-Tac(Hudson), Tab., 150mg, Tk.2.00/Tab. Reetac-R(Navana),Tab.,150 mg, Tk.1.50/Tab.
Inran(Monico), Inj., 50 mg/2 ml, Tk. 6.00/2 ml Renete(Euro), Tab., 150 mg, Tk. 2.50/Tab.
Amp; Tab., 150mg, Tk. 2.00/Tab. Resectin(SMC Enterprise), Tab. , 150 mg,
Inseac(Ibn Sina), Syrup, 75 mg/5 ml, Tk. Tk. 2.50/Tab.
55.00/100ml; Tab., 300 mg, Tk. 4.00/Tab, 100 Rhine(Healthcare), Tab., 150mg , Tk.
mg, Tk. 2.50/Tab. 3.00/Tab.
Libret(Libra),Inj.,(IV Infusion), 50 mg/100 ml, Sutac(Supreme), Tab. , 150 mg, Tk.
Tk. 55.21/100 ml 2.00/Tab.
Lumeran(Aristo), Tab., 150mg, Tk. 2.00/Tab. Tinadin(Delta),Tab.150mg,Tk.2.00 /Tab.
Neoceptin(Beximco), Inj., 50 mg/2 ml, Tk. Ulcar(Drug Intl), Tab., 150mg, Tk. 2.55/Tab.,
10.00/2 ml Amp; Infusion, 0.05%, Tk. 300mg, Tk. 8.05/Tab.
101.00/100 ml; Syrup, 75 mg/5 ml, Tk. Ultradin(Globe), Tab. , 150 mg, Tk. 2.50/Tab.
50.00/100ml; Tab., 150mg, Tk. 2.50/Tab. Unitac(G.A.Co), Tab., 150 mg, Tk. 1.81/Tab.
Neotack(Square), Inj., 50 mg/2 ml, Tk. Veridin(Veritas), Tab., 150 mg, Tk.2.50/Tab.
10.03/2ml Amp; Syrup, 75 mg/5 ml, Virdin(Virgo), Tab. , 150 mg , Tk. 2.00/Tab.
Tk.50.15/100ml; 150 mg, Tk.2.51/Tab. Wintack(White Horse), Tab., 150 mg,
Neotin(Nipa), Tab., 150mg, Tk. 2.50/Tab. Tk.2.00/Tab.
Normacid(Kemiko), Tab., 150 mg, Tk. Xantid(ACI), Inj., 50 mg/2 ml, Tk. 7.55/2ml
2.51/Tab., Inj., 50 mg/2 ml, Tk. 6.02/2 ml Amp; Tab., 150mg, Tk. 2.51/Tab., 300mg, Tk.
Amp., Syrup, 75 mg/5 ml, Tk. 45.13/100ml 4.03/Tab., 150 mg, Tk. 1.51/Tab.
Norma-H(Renata), Tab.,150 mg, Tk.2.50/Tab. Zantac(GSK), Tab.,150 mg, Tk.4.07/Tab
Off-H(Organic), Tab.,150mg, Tk.2.51/Tab. Zenidine(Zenith), Tab.,150mg,Tk. 2/Tab.
Ortac(Orion), Inj., 50 mg/2 ml, Tk. 6.04/2ml Zenil(Rangs), Tab., 150mg, Tk. 2/Tab.
Amp; Tab., Tk. 2.01/Tab. Zodin(Somatec), Syrup, 75 mg/5 ml, Tk.
Peptil H(Eskayef), Inj., 50 mg/2 ml, Tk. 6.00/2 40.15/100ml; Tab., 150mg, Tk. 2.01/Tab.
ml Amp; 50 mg/2 ml, Tk. 6.00/2 ml Amp; Liq, Zorep(Amico), Tab., 150mg, Tk. 2/Tab.
100ml, Tk. 45.00/100ml; Tab., 150mg , Tk.
1.80/Tab., 150mg , Tk. 2.00/Tab., 150mg, Tk.
2.00/Tab., Liq, 100ml, Tk. 45.00/100ml
Peptosol(Opso Saline), IV Infusion, 50
mg/100 ml, Tk. 26.41/100 ml 2.3.2 SELECTIVE
Protec-R(Globex),Tab.,150mg,Tk.1/Tab. ANTIMUSCARINICS
Ranbex(Novo),Tab.,150mg,Tk. 1.25/Tab.
Rani (Alco), Tab., 150 mg, Tk. 2.01/Tab. M1 selective antimuscarinic pirenzepine
Ranid(Ziska),Tab.,150mg, Tk. 1.20/Tab.
blocks cholinergic stimulation of gastric
Ranidin(Acme), Inj., 50 mg/1 ml , Tk. 10/Amp.;
Syrup, 75 mg/5 ml, Tk. 45.16/100 ml.; Tab., acid secretion but has some anticholi-
150 mg, Tk.2.01/Tab.; 300 mg , Tk.4.01/Tab. nergic adverse effects. It had been tried
12
in the treatment of peptic ulcer but has Proprietary Preparation

now been discontinued. Delanix(Incepta), Cap., 30 mg, Tk. 9.00/Tab.;
60 mg, Tk. 16.00/Cap.
Desopra(Alco), Cap. , 30 mg, Tk. 10.00/cap.
2.3.3 PROTON PUMP INHIBITORS Dexilant(Ziska), Cap. 30 mg, Tk. 9/Cap.;
60mg, Tk. 16/Cap.
These include Omeprazole, Dexlan(Ibn Sina), Cap. , 60 mg, Tk.
Lansoprazole, Pantoprazole, 18.00/Cap.; 30 mg, Tk. 10.00/Cap.
Rabeprazole and Esmoprazole. They Dexogut(Popular), Cap. , 31.500mg, Tk.
10.00/Cap.; 63.00mg, Tk. 18.00/Cap.
produce profound and sustained
inhibition of gastric acid secretion by
blocking the hydrogen-potassium- LANSOPRAZOLE
adenosine triphosphate enzyme system
(the ‘proton pump’) of the gastric parietal Indications: Gastric ulcer, duodenal
cell. They are effective short-term ulcer, reflux oesophagitis Zollinger-
treatments for gastric and duodenal Ellison syndrome; also used in
ulcers. The response is rapid and conjunction with other drugs in triple
sustained (a single daily dose of therapy for eradication of H. pylori
omeprazole is sufficient to provide Cautions:See notes above;avoid in
effective suppression of gastric acid for a pregnancy and breast-feeding
24 hour period), and thus promotes Interactions:See Appendix-2
better compliance than with other anti Side-effects:See notes above
ulcer drugs. Lansoprazole and Dose: Benign gastric ulcer 30 mg daily
pantoprazole appear to be comparable in the morning before breakfast for a
with omeprazole in efficacy. period of 4 to 8 weeks. For gastric or
Cautions: Proton pump inhibitors should duodenal ulcer associated with H.
be used with caution in patients with liver pyloroi in triple therapy for eradication of
disease, in pregancy and in breast- H. pylori, see section 2.3.6
feeding; they may musk the symptoms of
gastric cancer. Proprietary Preparations
Side-effects: These include Enso(Kemiko), Cap. , 15 mg, Tk. 3.01/Cap. ;
gastrointestinal disturbances (nausea, 30 mg, Tk. 5.02/Cap.
Lanozole(Medimet), Cap., 30 mg,
vomiting, diarrhoea flatulence, abdomi- Tk.5.00/Cap.; 5 mg, Tk.3.00/Cap.
nal pain), hypersensitivity reactions Lansec(Drug Intl), Cap., 30mg, Tk. 6.05/Cap.;
(rash, urticaria, pruritus, angiooedema); 15 mg, Tk. 3.55/Cap.
occasional headache, malaise, muscle Lansina(Ibn Sina), Cap. , 30 mg, Tk.
and joint pain, blurred vision and dry 6.00/Cap.
mouth. Lanso(Square), Cap. , 30 mg, Tk.6.04/Cap.
Lansocon(Biopharma), Cap. , 30 mg, Tk.
6.00/Cap.
DEXLANSOPRAZOLE Lansodin(Acme), Cap. , 15 mg , Tk.
3.52/Cap. ; 30 mg, Tk. 6.04/Cap.
Indications: acid reflux, heartburn, Lansoprazole(Albion), Cap. , 15 mg, Tk.
difficulty swallowing, persistent cough, 3.50/Cap. ;30 mg, Tk. 6.00/Cap.
Lansopril(Amico), Cap. , 30 mg, TK.
stomach ulcers(occasional use)
5.00/Cap.
Cautions :See notes above;liver Lansoprol(Ziska), Cap. , 30 mg, Tk.
disease, bone fracture, shoulder pain, 80.00/Cap.
elderly Lantid(Opsonin), Cap. , 15 mg, Tk.
Side effects: See notes above; diarrhea, 3.01/Cap. ; 30 mg , Tk. 5.02/Cap.
a low magnesium level, persistent Lanz(ACI), Cap., 15mg, Tk.3.03/Cap.; 30mg,
muscle spasms, seizures, abdominal or Tk. 5.04/Cap.
Lap(Ambee), Cap. , 30 mg, Tk. 5.01/Cap
stomach pain, cramping, fever
Lasocon(Biopharma), Cap. , 30 mg, Tk.
Dose: 30 mg/60 mg once daily with or 6.00/Cap.
without food Protolon(Beximco), Cap. , 30mg, Tk.
6.00/Cap.
13
Zoton(General), Cap. , 30mg, Tk. 6.04/Cap. Esmosec(Techno), Tab., 20 mg, Tk. 5/Tab.;
40 mg, Tk. 8/Tab.
Esmotac(G.A.Co), Tab., 20 mg , Tk.
ESOMEPRAZOLE
4.02/Tab.; 40 mg , Tk. 7.03/Tab.
ESO(Asiatic), Tab., 40 mg, TK. 8.00/Tab.; 20
Indications: listed in dosage mg , Tk. 5.00/Tab.
Caution:see notes above; exclude Esobest(Sharif), Tab. , 40 mg, Tk.
gastric malignancy before treatment; 8.00/Tab.; 20 mg, Tk. 10.00/Tab.; Cap, 20
severe hepatic impairment mg , Tk. 7.00/Cap.; 40 mg , Tk. 10.00/Cap.
Esocon(Biopharma), Cap., 40 mg, Tk.
Interactions:see Appendix-2
9.50/Cap.; 20 mg, Tk. 7.00/Cap.; Inj,
Side-effects: headache, abdominal 40mg/Vial, Tk. 65.00/Vial
pain, diarrhoea, nausea, vomiting, Esofour(Albion), Cap., 20 mg, Tk. 6/Cap.;
pruritus, dizziness 20mg, Tk. 6/Cap. Tab., 20 mg, Tk. 5/Tab.;
Dose: erosive reflux esophagitis: 20-40 40mg, Tk. 7/Tab.
mg once daily for 4-8 weeks; mainte- Esogap(Euro), Inj. , 40 mg/Vial, Tk.
nance, 20 mg once daily 100.00/Vial,; Tab., 20 mg, Tk. 5.00/Tab.; 450
mg, Tk. 8.00/Tab.
Symptomatic gastro-esophageal reflux:
Esoge(Organic), Cap. , 20 mg, Tk.
20 mg once daily for 4 weeks 6.50/Cap. ; 40 mg, Tk. 8.03/Cap.
Triple therapy for eradication of H. pylori Esoking(Globex), Cap., 20 mg, Tk. 6.00/Cap.
20 mg twice daily (with 1 g amoxycillin Esolin(Rephco), Tab. 40 mg, Tk. 8.00/Tab. ;
twice daily and 500mg calrithromycin 20 mg, Tk. 4.00/Tab.
twice daily for 7 days Esolok(Ibn Sina), Inj. , 40 mg/vial, Tk.
100.00/Inj.; Cap., 20 mg, Tk. 7.00/Cap.; 40
mg, Tk. 8.00/Cap. Tab., 20 mg, Tk.
5.00/Tab. ; 40 mg, Tk. 8.00/Tab.
Alton(General), Tab. , 20 mg, Tk. 5.01/Tab;
Esomenta(Julpher), Cap., 20 mg, Tk.
40 mg, Tk. 8.03/Tab.Inj., 40mg/Vial, Tk.
7.00/Cap.;Cap., 40 mg, Tk. 10.0/Cap.
100.30/Vial,;
Esomep(ACI), Inj., 40mg, Tk. 90.27/40mg,;
Asector(Novo Healthcare), Cap., 20 mg, Tk.
Cap., 20 mg, Tk. 7.02/Cap.; 40mg, Tk.
7.00/cap.; 40 mg, Tk. 9.00/Cap.; Inj. , 40
9.03/Cap.; Tab., 20mg, Tk. 5.02/Tab.; 40mg,
mg/Vial, Tk. 90.00/Vial
Tk. 8.02/Tab.
Asozit(White Horse), Cap., 20 mg, Tk. 7/Cap.
Esomium(SMC Enterprise), Cap., 40 mg, Tk.
Curacid(Rangs), Cap., 20mg, Tk. 6.00/Cap.;
9.00/Cap.; 20 mg, Tk. 6.00/Cap.
40mg, Tk. 9.00/Cap.
Esomo(Amulet), Cap., 20 mg, Tk. 6.00/Cap.;
Ema(Globe), Cap., 20 mg, Tk. 7.00/Cap.; 40
40 mg, Tk. 8.00/Cap.
mg, Tk. 3.00/Cap.; Inj. , 40 mg/vial, Tk.
Esonaaf(Naafco), Cap., 20 mg, Tk. 2.00/Cap.
3.00/Inj.; Tab. , 20 mg, Tk. 4.75/Tab.; 40 mg,
Esonix(Incepta), Cap., 20 mg, Tk.
Tk. 8.00/Tab.
7.00/Cap.; 40 mg, Tk. 9.00/Cap.; Inj., 40
Emep(Aristopharma), Cap. , 20 mg, Tk.
mg/Vial, Tk. 70.00/Vial,; 40 mg/Vial, Tk.
7.00/Cap.; 40 mg, Tk. 9.00/Cap.; Injection, 40
90.00/Vial,; Powder for Suspn. , 20
mg/Vial, Tk. 90.00/Vial,; Tab., 20mg , Tk.
mg/Sachet, Tk. 7.00/Sachet,; Tab, 20 mg, Tk.
5.00/Tab.
5.00/Tab.; 40 mg, Tk. 8.00/Tab.
Epa(Zenith), Tab., 20 mg, Tk. 4.01/Tab.
Esopra(Alco), Cap., 20 mg, Tk. 6.02/Cap.;
Epizol(Nipa), Cap. , 20 mg, Tk. 7.00/Cap.; 40
40 mg, Tk. 9.03/Cap.; Tab, 20 mg, Tk.
mg, Tk. 9.00/Cap.
4.01/Tab.; 40 mg, Tk. 7.02/Tab.
Eprazol(Labaid), Cap., 20 mg, Tk. 7/Cap.
Esoprex(Beacon), Cap., 40mg , Tk.
E-Proton(Doctor TIMS), Cap., 20 mg, Tk.
9.03/Cap.; 20mg , Tk. 7.02/Cap.; Inj.,
7.00/Cap.
40mg/Vial;, Tk. 100.30/Vial,;
Erazole(Kemiko), Cap. , 40 mg, Tk.
. Esoprol(Ziska), Cap., 20mg, Tk. 5.00/Cap;
10.03/Cap.; 20 mg, Tk. 7.02/Cap .; Tab., 20
40mg, Tk. 8.00/Cap.
mg, Tk. 5.02/Tab.; 40 mg, Tk. 8.03/Tab.
Esoral(Eskayef), Cap. , 20mg , Tk. 7.00/Cap.;
Escap(Sanofi), Cap., 40mg, Tk. 12.00/Cap.;
Inj. , 40mg , Tk. 90.00/Inj. ; Tab, 20mg, Tk.
20mg, Tk. 8.00/Cap.
10.00/Tab.; 20mg , Tk. 5.00/Tab.; 20mg, Tk.
Eslo(Bristol), Cap., 20mg , Tk. 390.00/Cap .;
5.00/Tab.; 20mg, Tk. 5.00/Tab.; 20mg , Tk.
Tab, 40mg , Tk. 335.00/Tab.; 20mg , Tk.
10.00/Tab.; 20mg , Tk. 4.01/Tab.; 20mg , Tk.
225.00/Tab.; 20mg , Tk. 450.00/Tab.
5.00/Tab.; 40mg , Tk. 14.00/Tab.; 40mg, Tk.
Esmax(Concord), Cap., 20 mg, Tk. 6/Cap.;
7.00/Tab.; 40mg , Tk. 8.00/Tab.;
40mg, Tk. 8/Cap; Tab., 20 mg, Tk. 5/Tab.
Esorant(Supreme), Cap, 20mg, Tk.
Esmogel(Biogen), Cap., 20mg , Tk. 6.50/Cap.
6.00/Cap.; 40mg, Tk. 8.00/Cap.
14
Esotac(Navana), Tab., 40 mg, Tk. Prazia(Amico), Cap., 20mg , TK. 7.00/Cap.;
7.03/Tab.;Cap., 20 mg, Tk. 6.00/Cap. 40 mg, 40mg , TK. 10.00/Cap.; Tab., 20mg, TK.
Tk. 8.00/Cap. 5.00/Tab.; 40mg , TK. 8.00/Tab.
Esotem(Team), Cap., 40 mg, Tk. 9.00/Cap. ; Progut(Popular), Cap. , 20mg , Tk.
20 mg, Tk. 6.50/cap. 7.00/Cap. ; , 40 mg, Tk. 9.00/Cap.; Powder for
Esotid(Opsonin), Cap. , 20 mg , Tk. Suspn., 20 mg/Sachet,; Tab. , 20 mg, Tk.
6.04/Cap.; Tab, 20 mg , Tk. 5.03/Tab.; Cap., 5.00/Tab.; Inj., (Popular), Inj. , 40 mg/Vial,
40 mg , Tk. 9.06/Cap. Tab. , 40 mg , Tk. Tk. 90.00/Vial
8.00/Tab.; Vial, 40 mg , Tk. 90.27/ 40 mg Pronex(Drug Intl), Tab., 20mg, Tk. 5.05/Tab.;
Esotor(Nipro JMI), Tab. , 20 mg, Tk. 5.00/Tab. 40mg, Tk. 8.05/Tab.; Cap., 20mg, Tk.
; 40 mg, Tk. 8.00/Tab. 6.00/Cap.; 40mg, Tk. 8.00/Cap.; Inj., 40mg,
Esover(Veritas), Cap. , 20 mg, Tk. Tk. 90.30/Inj.;
7.00/Cap.;40 mg, Tk. 9.00/Cap. SB-Emec(Sunman-Bardem), Cap., 20 mg,
Esovir(Virgo), Cap., 20 mg, Tk. 700.00/Cap. Tk. 7.00/Cap.; 40 mg, Tk. 9.00/Cap.
Esoz(Astra Biopharma), Cap. , 20 mg, Tk. Sergel(Healthcare), Cap., 20mg , Tk.
7.00/Cap.; 40 mg, Tk. 8.00/Cap.; Tab. , 20 700.00/Cap.; 40mg , Tk. 500.00/Cap.; Tab.,
mg, Tk. 5.00/Tab. 40 mg, Tk. 8.03/Tab.. 20mg, Tk. 210.00/Tab.; Inj, 40mg , Tk.
Esprazo(Pacific), Cap., 20 mg, Tk. 7.00/Cap. 100.00/Inj. ; 40mg/Vial, Tk. 100.00/Vial,; Tab.,
Exium(Radiant), Cap., 20mg , Tk. 10.00/Cap.; 40mg , Tk. 270.00/Tab.
40mg , Tk. 14.00/Cap.; 20mg , Tk. 8.50/Cap.; Sompraz(Sun), Tab. , 20 mg, Tk. 6.00/Tab;40
40 mg, Tk. 12.00/Cap. ; Inj., 40mg/Vial, Tk. mg, Tk. 9.00/Tab..;
120.00/Vial. Somprazol(Sharif), Cap. , 20 mg, Tk.
Exmart(MST), Tab., 20 mg, Tk. 5/Cap.; 40 6.00/Cap. ; 40 mg, Tk. 9.00/Cap.
mg, TK. 8/Tab.
Exome(Chemist), Tab., 20 mg, Tk. 5.00/Tab. Esomeprazole + Naproxen
Exor(Orion), Inj, 40 mg, Tk. 100.30/Inj.; Cap., Anaflex(ACI), Tab., 20mg+375mg, TK.
20 mg, Tk. 7.00/Cap.; 40 mg, Tk. 10.00/Cap. 8.02/Tab.; 20 mg + 500 mg, TK. 10.03/Tab.
EZ(Modern), Cap. , 20 mg, Tk. 7.00/Cap. Demovo(Delta), Tab. , 20 mg + 375 mg, Tk.
Gerdo(Nuvista), Cap., 20 mg, Tk. 7.02/Cap. 8.00/Tab. ; 20 mg + 500 mg, Tk. 10/Tab.
iMAX(Delta), Cap. , 20 mg, Tk. 5.00/Cap. Dinovo(Beximco), Tab., 375mg + 20mg, Tk.
Maxima(Acme), Cap., 40 mg , Tk. 8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab.
10.00/Cap.; 20 mg , Tk. 7.00/Cap.; Inj., 40 mg, Emaprox(Globe), Tab. , 375 mg + 20 mg, Tk.
Tk. 90.27/Inj.; Tab., 20 mg, Tk. 5.00/Tab.; 40 3.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab.
mg, Tk. 8.00/Tab. Emaprox(Globe), Tab.,20 mg + 375 mg, Tk.
Maxpro(Renata), Cap., 20 mg, Tk. 8.00/Tab.; 20 mg + 500 mg , Tk. 10.00/Tab.
7.00/Cap.; 40 mg, Tk. 10.00/Cap.; Tab., 20 Esona(Navana), Tab., 20 mg + 375 mg, Tk.
mg, Tk. 5.00/Tab.; 40 mg, Tk. 8.00/Tab.; Inj., 8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab.
40 mg/vial, Tk. 90.00/Inj. Eso-Plus(Asiatic), Tab., 500mg + 20mg, Tk.
Naspro(Popular), Tab. , 20 mg, Tk. 10.00/Tab.; ., 20 mg + 375mg, Tk. 8.00/Tab.
10.00/Tab.; 40 mg, Tk. 8.00/Tab. Esoxen (Organic), Tab, 20 mg + 375mg, mg,
Neptor(Novartis), Cap. , 20 mg, Tk. Tk. 8.03/Tab.; 20 mg + 500 mg, Tk.
8.00/Cap.; Cap., 40 mg, Tk. 12.00/Cap. 10.03/Tab.
Nexcap(UniMed), Cap., 20mg , Tk. 7.00/Cap.; Inflect (Kemiko), Tab., 20 mg + 375mg, mg,
40mg, Tk. 9.00/Cap. Tk. 8.02/Tab.; 20 mg + 500 mg Tk. 10.03/Tab.
Nexcap(Unimed), Cap. , 20 mg, Tk. Locin(Globe ), Tab., 20 mg + 375 mg, Tk.
7.00/Cap.; 40 mg, Tk. 9.00/Cap. 8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab.
Nexe(Apex ), Tab. , 20 mg, Tk. 5.00/Tab.; 40 Nameso(Opsonin), Tab, 20 mg + 375mg,, Tk.
mg, Tk. 8.00/Tab.; Cap., 20 mg, Tk. 6.00/Cap. 8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab.
Nexum(Square), Cap, 20 mg, Tk. 7.02/Cap.; Napexa (UniMed), Tab , 20 mg + 375mg, Tk.
40 mg, Tk. 10.03/Cap.; Inj., 40 mg/vial, Tk. 12.00/Tab.; 20 mg + 500 mg, Tk. 16.00/Tab.
90.27/Inj.; Tab. , 20 mg , Tk. 10.00/Tab. ; 40 Napren ES(Alco), Tab. , 20 mg + 375 mg, Tk.
mg , Tk. 14.00/Tab. ; 40 mg, Tk. 8.07/Tab. 8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab.
Nuloc(Monico), Tab., 20mg, Tk. 5.00/Tab.; Napreso(Euro), Tab., 20 mg + 500 mg, Tk.
40mg, Tk. 90.00/Tab. 10.00/Tab.
Onepro(One Pharma), Cap., 20 mg, Tk. Napro-A Plus(Acme), Tab20 mg + 375mg,,
6.99/Cap.; 40 mg, Tk. 9.00/Cap.; Tab., 20 mg, Tk. 8.03/Tab.; 20 mg + 500 mg mg, Tk.
Tk. 5.00/Tab.; 40 mg, Tk. 7.99/Tab. 10.03/Tab.
Opton(Beximco), Cap., 20mg, Tk. 7.00/Cap. ; Naproflex(Somatec), Tab., 20 mg + 375mg,,
40mg, Tk. 10.00/Cap.; Inj., 40mg, Tk. Tk. 8.00/Tab.; 375 mg + 20 mg, Tk. 10.00/Tab.
110.00/Inj.; Tab., 40mg, Tk. 8.00/Tab.; 20mg, Naprosyn Plus(Radiant), Tab., 20 mg +
Tk. 5.00/Tab. 375mg,, Tk. 16.05/Tab.; 20 mg + 500 mg, Tk.
20.06/Tab.
15
Naprotec(Sharif), Tab., 20 mg + 375mg, mg, Benign gastric or duodenal ulcer

Tk. 8.03/Tab.; 500mg + 20 mg, Tk. 10.30/Tab. associated with H. pylori, see section
Naprox Plus(Eskayef), Tab, 20 mg + 500 mg, 2.3.6 for eradication therapy.
Tk. 10.00/Tab.; 20 mg + 375mg,, Tk.
8.00/Tab.
Zollinger-Ellison syndrome, initially 60
Naproxen(Zenith), Tab, 20 mg + 375mg,, Tk. mg once daily; usual range 20-120 mg
8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab.; daily (above 80 mg in 2 divided doses).
(Bristol), Tab. , 20 mg + 500 mg, Tk. Erosive reflux oesophagitis, 20 mg daily
10.00/Tab. for 4 weeks, followed by a further 4
Naproxen Plus(Albion), Tab., 20 mg + 500 weeks if not fully healed; 40 mg daily has
mg, Tk. 6.89/Tab. been given for 8 weeks in reflux
Naproxzia(Amico), Tab., 500mg + 20mg, Tk.
10.00/Tab.
oesophagitis refractory to other
Naprozol(General), Tab. , 20 mg + 375 mg, treatment.
Tk. 8.00/Tab.;Tab. , 20 mg + 500 mg, Tk.
10.00/Tab. Proprietary Preparations
Napsec(Drug Intl), Tab., 20 mg + 375mg,, Tk. Anasec(Novo Healthcare), Cap., 40 mg, Tk.
8.05/Tab.; 20 mg + 500 mg Tk. 10.05/Tab. 7.00/Cap.; 20 mg, Tk. 5.00/Cap.; Inj.,
Napxon(Ziska), Tab. ,20 mg + 375mg, mg, Tk. 40mg/Vial, Tk. 70.00/Vial
256.00/Tab.; 500 mg + 20 mg, Tk. 320.00/Tab. Aspra(Apex), Cap. , 20 mg, Tk. 4.00/Cap.;
Nasopain(Julpher ), Tab., 20 mg + 375 mg, AU-20(Decent), Cap., 20mg, Tk. 4.50/Cap.
Tk. 10.0/Tab.; 20 mg + 500 mg, Tk. 12.0/Tab. Cosec(Drug Intl), Cap., 20mg, Tk. 5.05/Cap. ;
Neso(Aristopharma), Tab., 20 mg + 375mg, , 40mg, Tk. 8.05/Cap.; Inj., 40mg/Vial, Tk.
Tk. 8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab. 90.30/Vial
Nesotem(Team), Tab .20 mg + 500 mg mg, Curacid(Rangs), Cap., 20mg, Tk. 6.00/Cap.;
Tk. 9.50/Tab.; 20 mg + 375mg, Tk. 7.50/Tab. 40mg, Tk. 9.00/Cap.
Novoxen(Orion), Tab. ,20 mg + 375mg,, Tk. Deu(Monico), Cap., 20mg, Tk. 5.00/Cap.; Inj.,
8.02/Tab.; 20 mg + 500 mg Tk. 15.03/Tab. 40mg/Vial, Tk. 80.00/Vial
Nupralgin(Ibn Sina), Tab. 20 mg + 500 mg, Ema(Globe), Cap., 20 mg, Tk. 7.00/Cap; 40
Tk. 300.00/Tab.; 20 mg + 375mg,, Tk. mg, Tk. 9.00/Cap.; Tab., 20 mg, k. 4.75/Tab.;
80.00/Tab. 40 mg, Tk. 8.00/Tab.; IV Inj., 40 mg/vial, Tk.
Progesic(Incepta), Tab. 20 mg + 375mg,, Tk. 80.00/Vial
8.00/.Tab.; 20 mg + 500 mg, Tk. 10.00/Tab. Esoprol(Ziska), Cap., 20mg, Tk. 5.00/Cap;
Progut-N(Popular ), Tab. , 20 mg + 375 mg, 40mg, Tk. 8.00/Cap.
Tk. 8.00/Tab.; 20 mg + 500 mg, Tk. 10.00/Tab. Eupi(Pharmasia), Inj., 40 mg/vial, Tk.
Ranoxen Plus(Rangs), Tab., 20 mg + 500 mg, 80.00/Vial; Cap., 20 mg, Tk. 5.00/Cap.
Tk. 10.00/Tab. Exmart(MST), Tab., 20 mg, Tk. 5/Cap.; 40
Solivo(Healthcare), Tab., 20 mg + 375mg,, Tk. mg, Tk. 8/Tab.
390.00/Tab.; 20 mg + 500 mg, Tk. 450.00/Tab. Exome(Chemist), Tab., 20 mg, Tk. 5.00/Tab.
Twist(Chemist), Tab., 20 mg + 500 mg, Tk. Gap(Euro), Inj., 40mg/Vial, Tk. 9.00/Vial;
10.00/Tab. Cap., 20 mg, Tk. 5.00/Cap.; 40mg, Tk.
Xenap(Astra Biopharma), Tab. , 20 mg + 500 8.00/Cap.
mg,; 375mg + 20mg, TK. 8.02/Tab. G-Omeprazole(Gonoshasthaya), Cap.,20mg,
Xenole(Square), Tab. ,20 mg + 375mg,, Tk. Tk 3.00/Cap. ;Inj., 40 mg/vial, Tk. 65.00/Vial
8.03/Tab.; 20 mg + 500 mg Tk.10.03/Tab. Healer(Amico), Cap., 20mg , TK. 4.00/Cap.;
Inhibita(Delta), Cap., 20 mg, Tk. 4.00/Cap.; 40
mg, Tk. 7.00/Cap.
OMEPRAZOLE[ED][OTC]
Inpro(Biopharma), Cap., 20 mg, Tk.
5.00/Cap.; 40 mg , Tk.7.03/Cap.; Inj., 40
Indications:See notes above mg/vial, Tk. 70.00/Vial
Cautions:See notes above; exclude Inpro(Biopharma), Cap., 20mg, Tk. 5.00/Cap.;
malignancy. 40mg , Tk. 7.03/Cap.; Inj., 40mg/Vial, Tk.
Interactions:See Appendix-2 70.00/Vial
I-Proton(Doctor TIMS), Cap., 20 mg, Tk.
Side-effects: See notes above
5.00/Cap.
Dose: Benign gastric and duodenal Losectil(Eskayef), Tab., 20mg , Tk. 4.00/Tab.;
ulcers, 20 mg once daily for 4 weeks in 10mg, Tk. 2.00/Cap.; 40mg , Tk. 7.00/Cap. ;
duodenal ulceration or 8 weeks in gastric Inj, 40mg/vial , Tk. 90.00/Vial; Powder
ulceration; in severe cases increase to forSuspn., 20mg/Sachet , Tk. 5.00/Sachet;
40 mg daily; long term use not 40mg/Sachet , Tk. 8.00/Sachet; Cap, 20mg,
recommended Tk. 4.99/Cap.; 40mg , Tk. 7.00/Cap. ; Inj. ,
40mg/Vial, Tk. 90.00/Vial
16
Losek(Bristol), Cap., 20mg , Tk. 3.50/Cap.; Omitac(G.A.Co), Cap., 20 mg, Tk. 5.00/Cap.
40mg, Tk. 7.00/Cap. Omitin(Nipa), Cap., 40 mg, Tk. 7.00/Cap.; 20
Lotil(Albion), Cap., 20 mg, Tk. 2.95/Cap.; 40 mg, Tk. 4.00/Cap.
mg, Tk. 4.00/ Tab. Omizit(White Horse), Cap., 20 mg, Tk.
Neopra(Supreme), Cap, 20mg, Tk. 5.00/Cap.; 4.00/Cap.
Norain(GSK), Cap., 20 mg, Tk. 5.01/Cap. Omsec(Techno), Cap. , 20 mg, Tk. 4.00/Cap.;
Nuprazol(Nuvista), Cap. , 20 mg, Tk. Inj., 40 mg/vial, Tk. 70.00/Vial
5.00/Cap. OP(Globe), Cap., 20 mg, Tk. 4.75/Cap.; 40
O-20(Asiatic), Cap., 20 mg , Tk. mg, Tk. 8.00/Cap.; Inj. , 40 mg/vial,
5.00/Cap.;40mg , Tk. 7.00/Cap. Tk.70.00/Vial
Ome(Somatec), Cap., 20 mg, Tk. 5.00/Cap.; OP max(Concord), Cap., 20 mg, Tk.
40 mg, Tk. 8.00/Cap. 4.00/Cap.; Cap. , 40 mg, Tk. 7.00/Cap.
Omeben(Benham), Cap. , 20 mg, Tk.5/Cap. Opal(Healthcare), Cap., 20mg , Tk.
Omecron(Nipro JMI), Cap., 20 mg, Tk. 10.00/Cap.; 40mg , Tk. 8.00/Cap.; Inj.,
6.00/Cap.; 40 mg, Tk. 8.00/Cap. 40mg/Vial, Tk. 95.00/Vial
Omegut(Popular), Cap., 20mg, Tk. 5.00/Tab.; Opezen(Zenith), Cap., 20 mg,; 40 mg, Tk.
40 mg, Tk. 7.03/Cap.; Inj., 40mg/Vial, Tk. 7.02/Cap.; Tk. 4.01/Cap.; Powder forSuspn.,
80.00/Vial 20mg/Sachet, Tk. 5.00/Sachet
Omelet(Amulet), Cap., 40 mg, Tk. 7.00/Cap.; Peptral(Labaid), Cap., 20 mg, Tk. 5.00/Cap.
Cap., 20 mg, Tk. 5.00/Cap. Piazol(Globex), Cap., 20 mg, Tk. 4.00/Cap.
Omelock(One Pharma), Cap., 20 mg, Tk. PPI(Acme), Inj., 40mg/Vial, Tk. 90.00/Vial; 20
5.00/Cap.; 40 mg , Tk. 7.99/Cap. mg, Tk. 5.01/Cap.; 40mg, Tk. 8.03/Cap.
Omenaaf(Naafco), Cap., 20 mg, Tk. Prazo(Pacific), Cap., 40 mg, Tk. 7.00/Cap.; 20
5.00/Cap.; 40 mg, Tk. 8.00/Cap. mg, Tk. 5.00/Cap. ; Tab., 20 mg, Tk. 2.50/Tab.
Omenix(Incepta), Inj., 40 mg/vial, Tk. Prazole(Renata), Cap., 20 mg, Tk. 4.02/Cap.
90.00/Vial; Suspn., 40 mg, Tk. 10.00/Sachet; Prazomax(SMC Enterprise), Cap., 20 mg, Tk.
Cap. , 20 mg, Tk. 5.00/Cap.; 20mg/Sachet , 4.00/Cap; 40 mg, Tk. 6.00/Cap.
Tk. 6.00/Sachet Prazover(Veritas), Cap., 20 mg, Tk. 5/Cap.
Omenta(Junphar), Cap., 20 mg, Tk.5.0/Cap.; Prazple(Renata), Cap., 20 mg, Tk. 5.00/Cap.
Inj., 40 mg/vial, Tk. 90.00/Vial Presec(UniMed), Cap., 20mg, Tk. 4.00/Cap.;
Omep(Arist), Inj., 40mg/Vial, Tk. 80.00/Vial; 40 mg, Tk. 7.00/Cap.
Cap., 10mg , Tk. 2.00/Cap.; 20mg , Tk. Prevas(General), Cap., 20mg; 40mg, Tk.
5.00/Cap.; 40mg , Tk. 7.00/Cap. 8.00/Cap.; Tk. 5.00/Cap. ; Inj., 40mg/Vial, Tk.
Omepra (Alco), Cap., 20mg, Tk. 4.01/Cap. ; 80.24/Vial
40 mg, Tk. 7.02/Cap. Probitor(Novartis), Cap., 20 mg, Tk 7.00/Cap.;
Omeprazole(APC), Cap., 20 mg, Tk. 40 mg, Tk. 10.00/Cap.
2.50/Cap. Procap(Orion), Inj , 40 mg/vial, Tk. 90.27/Vial;
Omeprol(Ziska), Cap., 20 mg, Tk. 4.00/Cap.; Cap., 20 mg, Tk. 5.01/Cap.; 40mg, Tk.
40 mg, Tk. 6.12/Cap.; Inj., 40mg/Vial, Tk. 8.02/Cap.
70.00/Vial Proceptins(Beximco), Cap., 20mg, Tk.
Omesil(Silva), Cap., 20mg, Tk. 5.02/Cap.; 40 5.00/Cap.; Cap., 40mg, Tk. 8.00/Cap.; Inj.,
mg, Tk. 7.02/Cap. 40mg/Vial, Tk. 100.00/Vial
Ometac(Navana), Cap., 20 mg, Tk. 4.02/Cap.; Prolok(Ibn Sina), Cap. , 20mg, Tk.
40 mg, Tk. 6.02/Cap. 5.00/Cap.; Inj., 40mg/Vial, Tk. 90.00/Vial;
Ometem(Team), Cap., 20 mg, Tk. 4.75/Cap.; 40mg, Tk. 240.00/Cap.
40 mg, Tk. 7.50/Cap. Promezol(Sharif), Cap. , 20 mg,
Ometid(Opsonin), Cap., 20 mg, Tk. 5.02/Cap.; Tk.5.00/Cap.; 40 mg, Tk. 8.00/Cap.
40 mg , Tk. 7.03/Cap.; Inj., 40mg/Vial, Tk. Prosectil(Pharmacil), Cap. , 20 mg, Tk.
90.27/Vial 5.00/Cap.; Inj., 40 mg/vial, Tk. 90.00/Vial
Ometor(Astra Bio), Cap., 20 mg, Tk. Regerd(Organic), Cap. , 20 mg, Tk.
4.00/Cap.; 40 mg, Tk. 8.00/Cap.; Inj. , 40 5.00/Cap.;40 mg , Tk. 7.00/Cap.
mg/vial, Tk. 80.00/Vial Rome(Rephco), Cap. , 20 mg, Tk. 5.00/Cap.
Ometor(Astra),Cap., 20 mg, Tk. 4.00/Cap. Seclo(Square), Inj.,40mg/Vial, Tk. 80.24/Vial;
Omevir(Virgo), Cap., 20 mg, Tk. 5.00/Cap. Tab. , 20 mg, Tk. 5.02/Tab. ; 40 mg, Tk.
Omex(Kemiko), Cap., 20 mg, Tk. 5.02/Cap; 7.00/Tab. ; Cap., 20 mg, Tk. 5.02/Cap.; Cap.,
40 mg, Tk. 7.02/Cap.; Inj., 40mg/Vial, Tk. 40 mg, Tk. 8.03/Cap.
87.00/Vial Seclogen(Biogen), Cap., 20 mg, Tk.
Omex(Kemiko), Cap., 20 mg, Tk. 5.00/Cap.; 5.00/Cap.
40 mg, Tk. 7.00/Cap. Stosec(Opso Saline), Inj., 40 mg/vial, Tk.
Omidex(Modern), Cap., 20 mg. , Tk. 5.00Cap. 52.83/Vial
Omirex(Jayson), Cap., 20 mg, Tk. Xeldrin(ACI), Cap., 10mg, Tk. 2.02/Cap;
5.00/Cap.;Cap., 40 mg, Tk. 8.00/Cap. Cap., 20mg, Tk. 5.02/Cap.; Cap., 40mg, Tk.
17
8.02/Cap; Inj., 40mg/Vial, Tk. 80.24/Vial; Tab., Panprazo(Pacific), Tab. , 20 mg, Tk.
20mg, Tk. 4.03/Tab.; 4.00/Tab.
Xelopes(Beacon), Cap., 20mg , Tk. 5.02/Cap.; Panpro(Biopharma), Tab., 40mg, Tk.
40mg , Tk. 7.02/Cap.; Inj., 40mg/Vial, Tk. 6.00/Tab., Inj., 40mg/Vial, Tk. 70.00/ Vial,
90.27/Vial 20mg, Tk. 5.00/Tab.
Xerosec(Sanofi), Cap., 10 mg, Tk. 2.51/Cap.; Pansec(Drug Intl), Tab., 20mg, Tk. 5.05/Tab.,
20 mg, Tk.5.00/Cap.; 40 mg, Tk.8.00/Cap. Tab., 40mg, Tk. 7.05/Tab., Inj., 40mg/Vial, Tk.
Zilon(Radiant), Cap. ,20 mg, Tk.5.00/Cap.;40 90.30/ Vial,
mg, Tk. 7.50/Cap. Pansec(Drug Intl), Tab., 20mg, Tk.5.00/Tab.;
40 mg, Tk. 7.00/Tab.; Inj., 40 mg/Vial, Tk.
90.00/Vial
PANTOPRAZOLE
Pansiv(MST), Tab., 20 mg, Tk. 4/Tab.; 40 mg,
Tk. 6/Tab.
Indications: for suppression of acid Pansos(Nipro JMI), Tab., 20mg, Tk.
secretion in gastric or duodenal ulcer, 3.00/Tab.; 40 mg , Tk. 5.00/Tab.
reflux oesophagitis Zollinger-Ellison Pantac(Navana), Tab., 20 mg, Tk. 4.00/Tab.;
syndrome; prophylaxis against acid 40 mg, Tk. 6.00/Tab.
Pantex(ACI), Inj., 40mg/Vial, Tk. 70.47/ Vial,
aspiration syndrome during indcution of
Cap., 20mg, Tk. 4.01/Cap., 40mg, Tk.
anaesthesia. In conjunction with other 6.02/Cap., Tab., 20mg, Tk. 5.02/Tab., 40mg,
drugs, for the eradication of H. pylori Tk. 7.02/Tab.
Interactions: see Appendix-2 Pantid(Opsonin), Inj., 40 mg/Vial , Tk.
Side-effects:see notes above 90.27/Vial, Tab, 20 mg , Tk. 5.02/Tab., 40 mg ,
Dose:by mouth in benign gastric ulcer or Tk. 7.02/Tab.
gastroesophageal reflux disease, 40 mg Pantium(Radiant), Tab, 40mg , Tk.
10.03/Tab., 20mg , Tk. 7.02/Tab.
daily in the morning for 4 weeks,
Panto(Somatec), Tab., 20 mg, Tk. 4.00/Tab.,
followed by further 4 weeks if not fully 40 mg, Tk. 6.00/Tab.
healed. Pantoaid(Novo Health), Tab. , 20 mg, Tk.
Duodenal ulcer or gastritis associated 5.00/Tab.
with H. pylori, 40 mg twice daily (with Pantobex(Beximco), Inj., 40mg/Vial, Tk.
clarithromycin 250mg twice daily and 110.00/ Vial, Tab., 20mg, Tk. 5.00/Tab., 40mg,
metronidazole 400mg twice daily) for 7 Tk. 7.00/Tab.
Pantochem(Chemist), Tab., 20 mg, Tk.
days.CHILD not recommended.
3.00/Tab.; 40 mg, Tk. 5.00/Tab.
Pantodac(Ziska), Tab. , 20 mg, Tk. 4.00/Tab.,
Proprietary Preparations 40 mg, Tk. 6.00/Tab.
Aup(Decent), Tab. 20mg, Tk. 3.00/Tab; Pantogen(General), Tab. , 20mg, Tk.
40mg, Tk. 5.00/Tab. 5.01/Tab., 40mg, Tk. 7.03/Tab.
Europan(Globe), Inj.40 mg/Vial, Tk. 70.00/ Pantogut(Popular), Tab. ,20mg , Tk.
Vial; Tab.20 mg, Tk. 4.00/Tab.; 40 mg, Tk. 5.00/Tab.; 40 mg, Tk. 7.00/Tab.,Inj., 40
6.00/Tab. mg/Vial, Tk. 70.26/ Vial
Exipro(Leon), Tab., 20 mg, Tk. 4.00/Tab.; 40 Pantolok(Ibn Sina), Inj., 40mg/Vial, Tk. 80.00/
mg, Tk. 6.00/Tab. Vial, Tab., 20mg, Tk. 5.00/Tab., 40mg, Tk.
Neopanta(Supreme), Tab., 20mg, 7.00/Tab.
Tk,.4.00/Tab., 40mg, Tk. 6.00/Tab. Pantomax(Pharmacil), Inj. , 40mg/Vial , Tk.
Nixpan(Ad-din), Tab., 20 mg, Tk. 3.00/Tab.; 90.27/Vial
40 mg, Tk. 5.00/Tab. Panton(Bristol Tab, 20mg , Tk. 3.00/Tab.,
P-20 & 40(Asiatic), Tab., 20mg , Tk. 4.00/Tab., 40mg , Tk. 5.00/Tab.
40mg , Tk. 6.00/Tab. Pantonix(Incepta), Inj., 40 mg/Vial, Tk. 90.00/
Pagerd(Organic), Tab, 20 mg, Tk. 4.02/Tab., Vial, Tab, Tk. 5.00/Tab, Tk. 7.00/Tab.
40 mg, Tk. 6.02/Tab. Pantopra(Alco), Tab. , 40mg, Tk. 5.02/Tab.,
Panfast(Monico), Inj., 40mg/Vial, Tk. 20mg, Tk. 3.01/Tab.
90.00/Vial Pantoprazole(Albion), Tab., 20 mg, Tk.
Panoral(Eskayef), Tab, 20 mg, Tk. 5.00/Tab., 3.00/Tab.; 40 mg, Tk. 5.00/Tab.
20 mg, Tk. 5.00/Tab., 40 mg, Tk. 7.00/Tab., 40 Pantoprox(SMC Enterprise), Tab. , 20 mg,
mg, Tk. 7.00/Tab. Tk. 5.00/Tab.
Panotem(Team), Tab., 40 mg, Tk. 6.50/Tab., Pantosec(Techno), Inj., 40 mg/Vial, Tk.
20 mg, Tk. 4.50/Tab. 70.00/Vial
Panoz(Astra Biop), Tab. , 20 mg, Tk. Pantosil(Silva), Tab., 40mg, Tk. 5.01/Tab.,
4.00/Tab., 40 mg, Tk. 7.00/Tab. 20mg, Tk. 4.50/Tab.
18
Pantover(Veritas), Tab., 20 mg, Tk. Dose: erosive or ulcerative gastroesop-

4.00/Tab.; Inj., 40 mg/Vial, Tk. 70.00/Vial hageal reflux disease, 20 mg daily for 4-
Pantozol(G.A.Co), Tab., 20 mg , Tk. 8 weeks; may be extended for further 8
3.01/Tab., 40 mg , Tk. 5.02/Tab.
Pantrol(Apex), Tab., 20 mg, Tk. 3.00/Tab.
weeks if necessary; maintenance, 20 mg
Panzer(Sun), Tab., 20 mg, Tk. 4.00/Tab.; 40 daily.
mg, Tk. 6.00/Tab. Duodenal ulcer, 20mg daily for 4 weeks.
Panzol(Amico), Tab., 20mg , TK. 3.50/Tab., Pathological hypersecretory conditions
40mg , TK. 5.50/Tab. including Zollinger-Ellison syndrome,
Patanix(Nipa), Tab. , 20 mg, Tk. 4.60/Tab. initially 60 mg once daily, may be
Pentosa(Pharmasia), Tab., 20 mg, Tk. increased to 100-120 mg daily.
4.00/Tab.; 40 mg, Tk. 6.00/Tab.
P-Lock(One Pharma), Tab, 20 mg, Tk.
5.00/Tab., 40 mg, Tk. 6.99/Tab. Proprietary Preparations
Pramax(Concord), Tab., 20 mg, Tk. Acifix(Beximco), Tab., 20mg , Tk. 5.00/Tab.
4.00/Tab.; 40 mg, Tk. 6.00/Tab. Finix(Opsonin), Tab., 20 mg , Tk. 5.03/Tab.
Prazolin(Rephco), Tab., 20 mg, Tk. Nexrab(UniMed), Tab., Tk. 8.00/Tab.
4.00/Tab.; 40 mg, Tk. 6.00/Tab. Paricel(ACI), Cap., 20mg, Tk. 8.00/Cap.,
Pregel(Healthcare), Tab., 40mg, Tk. Tab., 20mg, Tk. 5.04/Tab., 10mg, Tk.
7.00/Tab., 20mg , Tk.5.00/Tab., Inj, 3.51/Tab.
40mg/Vial, Tk. 90.00/Vial, Profast(Renata), Tab. , 20mg Tk. 5.00/Tab.
Protium(UniMed), Tab , 20mg, Tk. 5.00/Tab., Prompton(Radiant), Cap. , 20mg , Tk.
40mg, Tk. 9.00/Tab. 8.02/cap.
Protocid(Acme), Inj., 40 mg/Vial, Tk. 90.00/ R- 20(Asiatic), Tab., 20mg , Tk. 5.00/Tab.
Vial, Tab, 20 mg, Tk. 5.00/Tab., Tab, 40 mg , Rabe(Aristopharma), Tab., 20mg , Tk.
Tk. 7.00/Tab. 5.00/Tab.
Protoloc(Beacon), Tab., 20mg , Tk. .00/Tab., Rabeca(Square), Tab. , 20 mg, Tk. 5.02/Tab.
40mg , Tk. 7.00/Tab. Rabecon(Biopharma), Tab., 20mg, Tk.
Proton(Aristo), Inj., 40mg/Vial,Tk. 80.00/ Vial, 5.00/Tab.
Tab. 45.10g+ 40mg , Tk. 7.00/Tab. Rabemax(General), Tab. , 20mg, Tk.5.00/Tab.
Protonil(Renata), Tab., 20mg, Tk. 4.00/Tab., Rabepes(Beacon), Cap., 20mg , Tk.
40mg, Tk. 6.00/Tab. 8.00/Cap., Tab., 20mg, Tk. 5.02/Tab.
Proton-P(Aristo), Tab., 20mg , Tk. 5.00/Tab. Rabepra(Euro), Tab., 20mg, Tk. 5.00/Tab.
Protozin(Euro), Tab., 20mg, Tk. 5.00/Tab., Rabesec(Drug Intl), Tab., 20mg, Tk. 5.05/Tab.
40mg, Tk. 7.00/Tab. Rabetem(Team), Tab., 20 mg, Tk. 4.50/Tab.
Pz(Modern), Tab., 20 mg, Tk. 4.00/Tab., 45.10 Rabifast(Eskayef), Tab., 20 mg., Tk.
mg, Tk. 6.00/Tab. 5.00/Tab., 20mg, Tk. 5.00/Tab., 20 mg., Tk.
Topra(Jayson), Tab., 20 mg, Tk.3.00/Tab.; 40 5.00/Tab., 20mg, Tk. 5.00/Tab.
mg, Tk.5.02/Tab. Rabigut(Popular), Tab., 20mg, Tk. 5/Tab.
Trupan(Square), Inj. , 40 mg/vial, Tk.80.24/ Rabipep(Organic), Tab.,20 mg, Tk. 5/Tab.
Vial, Tab, 20 mg, Tk.5.02/Tab., 40 mg, Rabizol(Acme), Tab., 20.00 mg, Tk. 5.01/Tab.
Tk.7.02/Tab. Rabonac(Sharif), Tab., 20 mg, Tk. 5.01/Tab.
Zenopan(Zenith), Tab. , 20 mg, Tk. 5.00/Tab. Rabprazo(Pacific), Tab., 20 mg, Tk. 5/Tab.
Zopan(Kemiko), Tab., 20 mg, Tk. 4.01/Tab., Rasonix(Incepta), Cap., 20 mg, Tk. 3.50/Cap.,
40 mg, Tk. 6.02/Tab. 30 mg, Tk. 8.00/Cap., Tab., 20mg, Tk.
5.00/Tab.,
Rasoz(Astra Biopharma), Tab., 20 mg, Tk.
RABEPRAZOLE SODIUM 5.00/Tab.
Razole(Kemiko), Tab., 20 mg, Tk. 5.00/Tab.
Indications: listed in dose Respite(Sanofi), Tab. , 20mg, Tk. 6.02/Tab.
Cautions: see notes above;exclude RP-20(Globe), Tab., 20 mg, Tk. 5.00/Tab.
Xorel(Ibn Sina), Cap. , 20mg, Tk. 4.00/Cap.,
gastric malignancy before starting
Tab., 20mg, Tk. 3.00/Tab.
treatment
Contra-indications:pregnancy and
breast-feedings 2.3.4 CHELATES AND COMPLEXES
Side-effects: chest pain, neck rigidity, Tripotassium dicitratobismuthate is a
Hypertension, Abnormal ECG, GI bismuth chelate, which promotes healing
diturbances, anxiety, insomnia. of gastric and duodenal ulcers. It may
act by coating the ulcer or by stimulating
bicarbonate secretion. As it is also likely
19
to adhere to food rather than to the top Cautions: conditions where hypoten-
the surface of the ulcer, patients should sion might precipitate severe complica-
be advised to avoid large food, antacids, tions (e.g. cerebrovascular disease,
and large quantities of milk when taking cardiovascular disease)
bismuth chelate. Contraindications: pregnancy or
Sucralfate is a complex of aluminium planning pregnancy (increases uterine
hydroxide and sulphated sucrose and tone). Should not be used in women of
has minimal antacid properties. It has child-bearing age unless the patient
been used for gastric and duodenal requires NSAID therapy and is at high
ulcers and may act by protecting the risk of NSAID induced ulceration; patient
mucosa from acid pepsin attack. Long must be advised of the risks of taking
term use needs further assessment misoprostol if pregnant
because some aluminium may be Interactions:see Appendix-2
absorbed. Side-effects: diarrhoea (may be severe,
reduced by giving single dose not
SUCRALFATE exceeding 200 micrograms and by
avoiding magnesium containing
Indications: palliative treatment of antacids); also reported: abdominal pain,
benign gastric and duodenal ulceration; dyspepsia, flatulence, nausea and
chronic gastritis vomiting, abnormal vaginal bleeding
Cautions: renal disease (including intermenstrual bleeding,
Interactions:see Appendix-2; antacids menorrhagia, and post menopausal
should not be taken half an hour before bleeding)
or after a dose Dose: benign gastric and duodenal
Side-effects: constipation; gastric dis- ulceration, 800 micrograms daily (in 2-4
comfort reported. divided doses) with breakfast (or main
Dose: 2g twice daily (on rising and at meals) and at bedtime; treatment should
bedtime) or 1g 4 times daily 1 hour be continued for at least 4 weeks and
before meals and at bedtime, taken for 4 may be continued for up to 8 weeks if
weeks or in resistant casees up to 8 required. Prophylaxis of NSAID induced
weeks; max. 8g daily. peptic ulcer, 200 micrograms 2-4 times
daily according to condition of patient.
Antepsin(Kemiko), Tab., 1000 mg, Tk. Proprietary Preparations
5.52/Tab. Cytomis(Incepta), Tab., 200 mcg, Tk.
Gastalfet(Beximco), Tab., 1000 mg, Tk. 15.00/Tab.
6.00/Tab., 500 mg, Tk. 4.02/Tab. G-Misoprostol(Gonoshasthaya), Tab., 200
Ulsec(Asiatic), Tab., 1000 mg , Tk. 5.50/Tab. mcg, Tk.10.00 /Tab.
Indula(Renata), Tab., 200 mcg, Tk. 15.00/Tab.
Isovent(Square), Tab., 200 mcg, Tk.
2.3.5 PROSTAGALNDIN 15.10/Tab. ; 600 mcg, Tk. 40.13/Tab.
ANALOGUES Misoclear(Acme), Tab., 200 mcg, Tk.
15.04/Tab.
Misoprostol, a synthetic analogue of Misoclear(Acme), Tab., 200 mcg, Tk.
15.00/Tab.
prostaglandin E1 (alprostadil) inhibits
Misopa(Beximco), Tab., 200mcg, Tk.
gastric acid secretion promoting healing 15.00/Tab.
of gastric and duodenal ulcer. It can Misopil(General), Tab., 200mcg, Tk.
protect against NSAID associated gastric 15.00/Tab.
ulcers but not dyspepsia. Misoprostol(Amico), Tab., 200mcg, Tk.
15.00/Tab.
Misotab(Euro), Tab., 200mcg, Tk. 15.00/Tab.
MISOPROSTOL[ED]
Misotec(Sharif), Tab., 200 mcg, Tk.
15.04/Tab.
Indications:see notes above and under Misotol(Ziska), Tab., 200 mcg, Tk. 15.00/Tab.
dose
20
2.3.6 DRUGS FOR ERADICATION

OF HELICOBACTER PYLORI Pantoprazole 40mg twice daily+
Clarithromycin 500mg twice daily+
Amoxycillin 1g twice daily
The causal role of H. pylori in gastric and
duodenal ulcer is now widely accepted. Ranitidine bismuth citrate 400 mg twice daily +
Long-term healing of gastric and Clarithromycin 500mg twice daily +
duodenal ulcers can be achieved by Amoxicillin 1 g twice daily
eradicating H. pylori, and after such
eradication the incidence of relapse TRIPLE THERAPY COMBINED
decreases. Studies have shown that with PREPARATIONS
H. pylori eradication only 5-10% patients
experienced relapse within a year Proprietary Preparations
compared to 85% of patients who do not Lansoprazole 30 mg + Clarithromycin 500 mg
have H. pylori eradication, and the benifit + Amoxycillin 1 g
appeared to continue for about 7 years. H.Pylori (Acme), Cap. , Tk. 55.16/Cap.
Helicon kit (General), Cap., Tk. 55.37/Cap
It is recommended that the presence of Pylopac(Beximco), Tab., Tk.45.00/blister strip
H. pylori be confirmed before starting Pylotrip (Square), Cap. , Tk. 55.16/Cap.
eradication treatment.
One week’s triple therapy containing a Omeprazole 20 mg + Clarithromycin 500mg +
proton pump inhibitor (omeprazole) and Metronidazole 500mg
clarithromycin with either metronidazole Neo Kit(Beximco), Tab. Tk.55.00/ blister strip
or amoxicillin produces eradication in Amoxicillin + Clarithromycin + Rabeprazole
Sodium
over 90% of patients. Clarithromycin Pylocure (Opsonin), Kit, Tk. 55.36/Tab.
may be substituted with both metroni- Esomeperazole 20mg Cap. 1pc+Amoxacillin
dazole and amoxicillin. Ranitidine or 50mg tab 2 pcs. + Clarithoromycin 500mg tab.
bismuth chelate may be used in place of Maxpro (Renata), Tk. 13.75/Kit
omeprazole. Two weeks’ triple therapy
regimen may give higher eradication rate
but adverse effects are common and 2.4 DRUGS FOR ACUTE
compliance is poor. DIARRHOEA
Recommended regimens for H. pylori Diarrhoea is characterized by increased

eradication (7-day course) volume and frequency of liquid stools. It
is commonly associated with infection,
Omeprazole 20 mg twice daily +
but may result from accumulation of non-
Clarithromycin 500 mg twice daily +
Amoxicillin 1 g twice daily absorbed osmotically active solute in gut
such as in lactose deficiency, or when
Lansoprazole 30 mg twice daily + intestinal motility or morphology is
Clarithromycin 500 mg twice daily + altered. Diarrhoea is a symptom of
Amoxicillin 1 g twice daily gastroenteritis and of most intestinal
infections. The first line of treatment in
Omeprazole 20 mg twice daily +
acute diarrhoea is oral rehydration
Metronidazole 400 mg twice daily therapy (ORT).
Lansoprazole 30 mg twice daily + ORAL REHYDRATION SALTS[ED] [OTC]

Metronidazole 400 mg twice daily
Each sachet of the proprietary
Lansoprazole 30 mg twice daily+ preparations contains: sodium chloride
Metronidazole 400 mg twice daily+ 1.75 g, potassium chloride 0.75 g,
Amoxicillin 1 g twice daily trisodium citrate dihydrate 1.45 g and
anhydrous dextrose 10 g. This is the
Omeprazole 20 mg twice daily + WHO approved formulation for ORS.
Metronidazole 400 mg thrice daily +
Amoxicillin 500 mg thrice daily
21
Contents of one sachet are dissolved in Cholera Saline (Opsosaline), IVInfusion

500 ml of drinking water for ready use. Tk.69.94/500ml; Tk. 91.72/1000ml
Dianak(Orion), IVInfusion Tk.49.78/500ml Tk.
65.50/1000 ml
Proprietary Preparations Diasol(Libra), IVInfusion TK. 52.60 /500ml;
ACI ORS(ACI), ORS, Tk. 5.00/Sachet; TK. Tk. 65.74/100ml
4.60/Sachet Koloride(Beximco), IVInfusion Tk.
Asaline(Apex), ORS, Tk. 4.58/Sachet 70.14/500ml; Tk. 91.99/1000ml
Easy ORS(Central), ORS, Tk. 4.58/Sachet Kolosal (Popular), IV Infusion, Tk.
G-ORS(Gonoshasthaya), ORS, Tk 4/Sachet 70.14/500ml, Tk. 92.00/1000ml
K-SALINE FRUITY(Kemiko), ORS, Tk.
5.00/Sachet
K-SALINE N (Kemiko), ORS, Tk. 4.58/Sachet CEREAL BASED ORS
Naafco ORS(Naafco), ORS, Tk.5.00/Sachet
Neorice ORS(Eskayef), ORS, Tk. 12.00/ It contains sodium chloride 3.5 g, pota-
Sachet
ssium chloride 1.5 g, sodium bicarbonate
Neosaline(Eskayef), ORS, Tk. 5.00/ Sachet;
Tk. 5.00/Sachet; Tk. 5.00/Sachet; Tk. 2.5 g and 50 g boiled rice powder to be
5.00/Sachet dissolved in 1 litre of boiled drinking
O Fruity(Zenith), ORS, Tk. 4.58/Sachet water.
O Saline(Zenith),ORS, Tk. 3.44/Sachet; Tk.
3.22/Sachet Proprietary Preparations
OR Saline(Popular), ORS, Tk. 5.00/ Sachet Easy ORS Plus Saline(Central), ORS, Tk.
Oralsaline(Albion),ORS, Tk. 5/Sachet 12.00/Sachet
Oralsaline Sweety(Albion) ORS,Tk. 5/Sachet Rice ORS(Square), ORS, Tk. 10/500 ml
Orasol(Sonear), ORS, Tk. 3.20/Sachet Sachet ;Tk. 6.00/250mlSachet
ORS(Popular), ORS, Tk. 4.58/Sachet Rice Saline(General), ORS, Tk.
Rice ORS(General), ORS, Tk. 10.00/Sachet; 15/500mlSache,Tk. 9.00/250mlSachet
Tk. 15.05/Sachet; Tk. 9.03/Sachet; Tk. Neorice(Eskayef), ORS, Tk. 12.00/Sachet
17.00/Sachet
R-Saline(Rephco), ORS, Tk. 3.20/Sachet
R-Saline N(Rephco), ORS, Tk. 4.50/Sachet ANTIDIARRHOEAL DRUGS WHICH
Saline(Renata), ORS, Tk. 5.00/Sachet REDUCE MOTILITY
Saline R(Renata), ORS, Tk. 4.58/Sachet
SOS(Supreme), ORS, Tk. 4.58/Sachet
LOPERAMIDE HYDROCHLORIDE
SOS(Supreme), ORS, Tk. 5.00/Sachet; Tk.
5.00/Sachet
SOS Plus Mango(Supreme), ORS, Tk. Indications: acute diarrhoea in adults
5.00/Sachet and children over 4 years (see notes
Super (Amico), ORS, TK. 4.60/Sachet above); chronic diarrhoea in adults only
Super Saline(Amico), ORS, Tk. 4.57/Sachet Side-effects: occasional rashes
Unisaline(Ibn Sina), ORS, Tk. 5.00/Sachet;
Tk. 5.00/Sachet; Tk. 5.00/Sachet; Tk.
Dose: acute diarrhoea, 4 mg initially
5.00/Sachet followed by 2 mg after each loose stool
Unisaline Fruity(Ibn Sina), ORS, Tk. for up to 5 days; usual dose 6-8 mg
5.00/Sachet daily, max. 16 mg daily; CHILD 4-8 years
Virgos(Virgo), ORS, Tk. 4.58/Sachet 1 mg 4 times daily for up to 3 days only,
Zenith(Zenith), ORS, Tk. 5.00/Sachet 9-12 years 2 mg 4 times daily for up to 5
Zeosaline(Sharif), ORS, Tk. 4.58/Sachet days
Ziska(Ziska), ORS, Tk. 5.00/ Sachet
Chronic diarrhoea in adults, initially, 4-8
mg daily in divided doses, subsequently
IV REHYDRATION THERAPY adjusted according to response and
given in 2 divided doses for maintenance
Cholera Saline: Proprietary Preparations
Usual strength for IV infusion, potassium Imotil(Square), Cap., 2 mg, Tk.1/Cap.
chloride 0.1% sodium chloride 0.5% ;and Lopamid(Acme), Cap., 2 mg, Tk. 1/Cap.
sodium acetate 0.393% Loperin, (Opsonin), Cap., 2 mg, Tk. 1/Cap.
Cholenak (Square), IV Infusion, Tk. Nomotil(Ziska), Cap, 2mg, Tk.0.60/Cap.
92/1000ml; , Tk. 70.15/500ml
22
RACECADOTRIL a high fibre diet with bran or other agents

which increase stool bulk, if necessary.
Indications: is used in the treatment of In some patients there may be important
diarrhoea. It is used, when fluid and psychological aggravating factors, which
dietary measures are not sufficiently respond to reassurance. Anti-diarrhoeal
effective to control diarrhoea. drugs such as loperamide may some-
CautionsandContraindications: times be necessary but prolonged use
hypersensitivity to the may aggravate the condition. Anti-
Racecadotril,blood in spasmodics may relieve the pain.
stools,breastfeeding,diarrhea,pregnance, INFLAMMATORY BOWEL DISEASES
Renal insufficiencySevere liver or kidney Chronic inflammatory bowel diseases
diseaseUncontrolled vomiting include ulcerative colitis and Crohn’s
Side Effects:nausea, disease. Drug treatment consists of
headache ,angioedema,rashes, aminosalicylates (sulphasalazine,
Pain,Swelling of the eyelid, Skin mesalazine, balsalazine, olsalazine)
redness,Vomiting, Constipation, Chronic and corticosteroids (hydrocortisone,
diarrhoea budes-onide and prednisolone).
Dose: In infant less than 9 kg:one 10 mg Maintenance of nutrition is important.
sachet 3 times daily. Severe chronic active disease may
In infant from 9 kg to 13: kg two 10 mg require surgery.
sachets 3 times daily MALABSORPTION SYNDROME :
individual conditions need specific
Proprietary Preparations treatment and also general nutritional
Racetril(Incepta), Cap.,100 mg, Tk. 6.00/Cap., consideration. Thus coeliac disease
Suspn.,10 mg, Tk. 7.00/Suspn., 30 mg, Tk. (gluten enteropathy) usually needs a
10.00/Suspn. gluten free diet and pancreatic
Racedot(Square), Cap., 100 mg, Tk.8.03/Cap. insufficiency needs pancreatin supple-
Rehydril(Ibn Sina), Cap., 100mg, Tk. ments.
195.00/Cap.
ULCERATIVE COLITIS : for acute mild
Radola(ACI), Cap.,100mg,Tk. 6.00/Cap.
to moderate diseases affecting rectum or
sigmoid colon, topical corticosteroid
2.5 DRUGS FOR CHRONIC treatment such as prednisolone enemas
DIARRHOEAS or suppositories will induce remission;
foam preparations are especially useful
Chronic diarrhoea may be associated where patients have difficulty retaining
with underlying diseases and therefore liquid enemas. More extensive diseases
symptomatic relief is less appropriate may be treated with an aminosalicylate
than treatment of disease itself. Where but may require oral corticosteroid
the disease process responsible for treatment. Severe extensive or fulminant
chronic diarrhoea can not be disease may need hospital admission,
satisfactorily suppressed, symptomatic intravenous corticosteroid administration,
relief with antimotility drugs such as intravenous fluid and electrolyte
loperamide or diphenoxylate with replacement and/or blood transfusion,
atropine may be appropriate. Bulk parenteral nutrition and antibiotics.
laxatives such as ispaghula (Isop gul), Corticosteroids are unsuitable for
methylcellulose bran etc. have also been maintenance treatment because of side-
used for symptomatic treatment because effects. Sulphasalazine mesalazine
of their absorptive capacity. Opioids with and olsalazine all have value in preven-
a central action (e.g. codeine) are better ting relapse and choice is related in part
avoided because of the risk of to their different side-effects. In resistant
dependence. cases azathioprine(see section 14.2.1)
IRRITABLE BOWEL SYNDROME: This 2 mg/kg daily, given under close
can present with pain, constipation, or supervision may be helpful.
diarrhoea, all of which may benefit from
23
Laxatives are required to facilitate bowel DIVERTICULAR DISEASE: This is

movement when proctitis is present but a treated with a high fibre diet, bran
high fibre diet and bulk forming drugs supplements and bulk forming laxatives.
such as methylcellulose or ispaghula Antispasmodics may provide
(Isop gul) are more useful in adjusting symptommatic relief when colic is a
faecal consistency. problem. Antibiotics should be used only
Symptoms of mild ulcerative colitis may when the diverticula in the intestinal wall
be relieved with antidiarrhoeal drugs become infected. Antidiarrhoeal drugs
such as codeine or loperamide but they which slow the intestinal motility (e.g.
should be used with caution in severe codeine, diphen-oxylate and loperamide)
cases as paralytic ileus and toxic could possibly exacerbate the symptoms
megacolon may be precipitated. For of diverticular disease and are therefore
similar reasons antispasmodics should contra-indicated.
not be used in ulcerative colitis.
CROHN’S DISEASE: Treatment AMINOSALICYLATES
particularly of colonic diseases is similar
to that for ulcerative colitis. In small
MESALAZINE
bowel disease sulphasalazine is of
doubtful value. Oral corticosteroids (e.g.
prednisolone) suppress inflammation, Indications: maintenance of remission
and metronidazole may be beneficial in ulcerative colitis
possibly through antibacterial activity. Cautions: elderly, renal impairment,
Other antibacterials should be given if pregnancy and breast-feeding; avoid
specifically indicated and for managing administration with lactulose.
bacterial overgrowth in the small bowel. Contraindications: salicylate hypersen-
Infliximab, a monoclonal antibody sitivity; severe renal impairment.
inhibiting pro-inflammatory cytokines, Side-effects: nausea, diarrhoea, and
and TNF-alpha has recently been abdominal pain; headache; exacerbation
indicated for severe Crohn’s disease of symptoms of colitis; rarely reversible
refractory to corticosteroids, but may be pancreatitis; reversible myocarditis also
associated with development of reported
extrapulmonary tuberculosis. Dose: by mouth, 1.2-2.4 g daily in
In both colitis and Crohn’s disease divided doses.
general nutritional care and appropriate
supplements are essential. Proprietary Preparations
Canasa(Drug Intl), Tab., 400mg, Tk. 5/Tab.
Cholestyramine and aluminium Mesagut(Aristo), Tab., 400mg, Tk. 7.60/Tab.
hydroxide mixture, bind unabsorbed bile Pentasa(I)
salts and provide symptomatic relief of (Feering),Sachet,1gm,Tk.69.19/Sachet,2gm,T
diarrhoea following ileal disease or k.131/Sachet
resection, in bacterial colonisation of the
small bowel and in post-vagotomy SULPHASALAZINE[ED]
diarrhoea.
PSEUDOMEMBRANOUS COLITIS: This Indications: induction and maintenance
is due to colonisation of the colon with of remission in ulcerative colitis;
Clostridium difficile that may develop treatment of active Crohn’s disease
after antibiotic therapy. Ampicillin, Cautions: pregnancy; hepatic and renal
clindamycin and lincomycin have been disease, glucose 6-phosphate
implicated most frequently but few dehydrogenase (G6PD) deficiency
antibiotics are free of this side-effect. It is including breast-feeding of affected
usually of acute onset, but may run a infants; slow acetylator status; withdraw
chronic course. Oral vancomycin or treatment if blood disorders,
metronidazole has been advocated as hypersensitivity reactions, or other
specific treatment. serious disorders occur; upper
gastrointestinal side-effects are common
24
with doses over 4g daily; blood counts, These relieve constipation by increasing
liver function, and rheumatoid arthritis, faecal mass which stimulates peristalsis,
see section 9.1.3 but patients should be told that the full
Contraindications: salicylate and effect may take some days to develop.
sulphonamide hypersensitivity; porphyria They are useful in the management of
Interactions:see Appendix-2 patients with colostomy, ileostomy,
Side-effects: nausea, vomiting, haemorrhoids, anal fissure, chronic
epigastric discomfort, headache, rashes; diarrhoea associated with diverticular
occasionally, fever, minor haemato- disease, irritable bowel syndrome, and
logical abnormalities such as Heinz body ulcerative colitis. Adequate fluid intake
anaemia, reversible neutropenia, folate must be maintained to avoid intestinal
deficiency; reversible azospermia; rarely: obstruction.
pancreatitis, exacerbation of colitis, Methylcelluloseispaghula (Isop gul),
thrombo-cytopenia, agranulo-cytosis, and sterculia are useful in patients who
Steven’s-Johnson syndrome, neuroto- cannot tolerate bran. Methylcellulose
xicity, photo-sensitisation, lupus erythe- also acts as a faecal softener.
matosus like syndrome, and pneu-
monitis; proteinuria and crystalluria; ISPAGHULA HUSK
urine may be orange coloured; soft (Isop Gul husk or ‘bhushi’)
contact lenses may be stained
Dose:by mouth, acute attack 1-2 g 4 Indications:See notes above
times daily (but see Cautions) until Cautions: adequate fluid intake should
remission occurs (if necessary, be maintained to avoid intestinal
corticosteroids may also be given), obstruction; ulcerative colitis.
reducing to a maintenance dose of 500 Contraindications: Intestinal obstruct-
mg 4 times daily; CHILD over 2 years, tion, colonic atony, faecal impaction
acute attack 40-60 mg/kg daily, Side-effects: Flatulence, rarely abdo-
maintenance dose 20-30 mg/kg daily. minal distension
By rectum, as suppositories, alone or in Dose: ADULT 3.5g in water twice daily
conjunction with oral treatment 0.5-1 g preferably after meals; CHILD over 6
morning and night after a bowel years half the adult dose
movement. As an enema, 3 g at night, COUNSELING: Preparations that swell
retained for at least 1 hour. in contact with liquid should always be
carefully swallowed with water and
Proprietary Preparations should not be taken immediately before
Reumazin(Aristo), Tab., 500 mg, Tk.
going to bed
5.20/Tab.
Salazine(Opsonin), Suppository, 500 mg , Tk.
10.00/Supp.; Tab., 500 mg, Tk. 5.23/Tab. Proprietary Preparation
Sulfacol(Drug Intl), Tab., 500 mg, Tk. Albi-Tasty Ispaghul(Albion), Powder 3.5 gm,
5.05/Tab. Tk. 4.00/Sachet
Sulfazin(Popular), Tab., 500 mg, Tk. Fiberlax(Incepta), Effervescent Granules Tk.
5.22/Tab. 400.00/20 gm Container
Zulfidin(UniMed), Tab, 500 mg , Tk. 7.00/Tab Ispergul(Square), Powder, 0, Tk. 395/120gm
Container
2.6 LAXATIVES LUBIPROSTONE
2.6.1 Bulk forming drugs Indications: chronic constipation in

2.6.2 Stimulant laxatives adults, irritable bowel syndrome
2.6.3 Faecal softeners Side effects:nausea, diarrhea,
2.6.4 Osmotic laxatives headache,flatulence
Contraindications: liver and kidney
2.6.1 BULK FORMING LAXATIVES disease; chronic diarrhea, bowel
obstruction,diarrhea-predominant IBS
25
Dose:25 microgram twice daily to treat cedures, endoscopy, and surgery; acts
constipation; 8 microgram twice daily to in 8-12 hours.
treat IBS in women 18 years of age and Cautions;Contraindications and Side-
older effects: See notes on stimulant
laxatives
Lubistone(Incepta), Cap. , 8 mcg, Tk. Proprietary Preparation
15.00/Cap. ; 24 mcg, Tk. 40.00/Cap. Laxenna(GSK),Tab. 12mg, Tk. 1.25/Tab.
Lubilax(Beacon), Cap., 24 mcg, Tk.
40.12/Cap.; 8 mcg, Tk. 15.05/Cap SALINE LAXATIVE
METHYL CELLULOSE Proprietary Preparation

Fleetenema(I)(CBFleet)Tk.214.24/133ml.,
Indications: see notes above Tk,214.24/66ml
Cautions; Contraindications; Side-
effects; Counseling:see under 2.6.3 FAECAL SOFTENERS
Ispaghula Husk
Dose: 800-1600g twice daily with at
Liquid paraffin the classical lubricating
least 300 ml water
agent, has disadvantages (see below).
Bulk laxatives, non-ionic surfactant
Celulose(Acme), Tk.0.82/Tab.
“wetting” agents e.g. docusate sodium,
and glycerol suppositories also have
softening properties. Such drugs are
2.6.2 STIMULANT LAXATIVES
useful in the management of
haemorrhoids and anal fissure.
BISACODYL Enemas containing 130 ml of arachis oil
(ground-nut oil) would lubricate and
Indications: see under Dose; tablets act soften impacted faeces and promote
in 10-12 hours; suppositories act in 20- bowel movement. For children above 6
60 minutes years, the dose has to be reduced in
Cautions; Contraindications; Side- proportion to body-weight; not recomm-
effects: see notes on stimulant ended for children under 6 years.
laxatives; tablets, griping; suppositories,
local irritation LIQUID PARAFFIN
Dose:By mouth for constipation, 10 mg Indication: constipation
at night; occasionally necessary to Cautions: avoid prolonged use; should
increase to 15-20 mg; CHILD 5 mg not be taken immediately before going to
By rectal suppositories, for constipation bed
10 mg in the morning; CHILD 5 mg. Side-effects: anal seepage of paraffin
Before radiological procedures and and consequent anal irritation after
surgery, 10 mg by mouth at bedtime for prolonged use, granulomatous reactions
2 days before examination, and if caused by absorption of small quantities
necessary, a 10 mg suppository 1 hour of liquid paraffin (especially from the
before examination. emulsion), lipoid pneumonia, and
interference with the absorption of
Proprietary Preparations fatsoluble vitamins
Bisacodyl(Albion), Tab. , 5 mg, Tk. 0.70/Tab. Dose:by mouth 10-30 ml of the oral
Duralax(Opsonin), Tab., 5 mg, Tk. 0.71/Tab.
emulsion (see below) as required
SENNA[ED]
Generic Preparation
Liquid Paraffin Oral Emulsion BP, Oral
Indications: Constipation; bowel evacu- Emulsion, contains liquid paraffin 5 ml,
ation before abdominal radiological pro-
26
vanillin 5 mg, chloroform 0.025 ml, Interactions:See Appendix-2

benzoic acid solution 0.2 ml, Side-effects: Flatulence, cramps, and
methylcellulose-20 200 mg, saccharin abdominal discomfort.
sodium 500 micrograms, water to 10 ml. Dose: Expressed in terms of an oral
Liquid Paraffin and Magnesium solution containing lactulose 3.35 g/5ml
Hydroxide Oral Emulsion BP, Oral Constipation, ADULT initially 15 ml twice
Emulsion, 25% liquid paraffin in acquous daily, gradually reduced according to
suspension containing 6% hydrated patient’s needs; CHILD under 1 year 2.5
magnesium oxide. Dose:for ml, 1-5 years 5 ml, 6-12 years 10 ml
constipation, 5-20 ml as and when twice daily, gradually reduced.
required. Hepatic encephalopathy, 30-50 ml 3
times daily, subsequently adjusted to
Proprietary Preparations produce 2-3 soft stools daily.
Frelax (Beximco), Oral emulsion,Tk. 95/100ml
Magfin(Incepta), Oral emulsion Tk. 95/100ml Proprietary Preparations
Nesifin(Opsonin), Oral emulsion,Tk. Actilac(Healthcare), Oral Solution, 68%, Tk.
83.57/100ml 230.00/5ml,; 68%, Tk. 125.00/5ml
Asilac(Asiatic), Oral Solution, 68%, Tk.
2.6.4 OSMOTIC LAXATIVES 120.00/100ml,; 68%, Tk. 230.00/200ml
Avolac(Aristopharma), Oral Solution, 68%,
Tk. 140.00/100ml, Tk. 250.00/200ml
Osmotic laxatives are drugs, which act Avolose(Team), Oral Solution, 68%, Tk.
by retaining fluid in the bowel by the 135.00/100ml,; 68%, Tk. 245.00/200ml
mechanism of osmosis. They may also Conlax(UniMed), Oral Solution, 68%, Tk.
act by changing the pattern of water 140.00/100ml
distribution in the faces. Dlac(Drug Intl), Oral Solution, 68%, Tk.
120.40/100ml,; 68%, Tk. 220.70/200ml,;
68%, Tk. 70.25/50ml
LACTITOL Ezylax(Orion), Oral Solution, 68%, Tk.
140.00/100ml,; 68%, Tk. 65.00/50ml
Indications : to promote gut motility in Glovolac(Globex), Oral Solu., 3.40 gm/5 ml,
chronic constipation Tk. 120.00/100 ml
Hepalac(Supreme), Oral Solution, 67%, Tk.
120.00/100ml & Tk. 230.00/200ml
Proprietary Preparations Inolac(Incepta), Oral Solution, 68%, Tk.
Fibolac(Radiant), Powder, 10 gm/Sachet , Tk. 120.00/100ml
40.00/10 gm Sachet Laclose(Opsonin), Oral Solution, 68%, Tk.
Lacticon(ACI), Powder, 10 gm/Sachet, Tk. 120.37/100ml
25.00/10gm Sachet Lactolax(Pharmasia), Oral Solu.,, 3.40 gm/5
Laxitol(Eskayef), Liquid, 3.3335 gm /5 ml, Tk. ml, Tk. 100.00/100 ml
120.00/100ml,; Powder, 10 gm/Sachet, Tk. Lactomose(Monico), Oral Solution, 68%, Tk.
12.00/10 gm Sachet,; 3.3335 gm /5 ml, Tk. 140.00/100ml
120.00/100ml,; 3.3335 gm /5 ml, Tk. Lactu(Biopharma), Oral Solution, 68%, Tk.
65.00/50ml,; Powder, 10 gm/Sachet, Tk. 140.00/100ml,; 68%, Tk. 250.00/200ml
12.00/10 gm Sachet Lactulose-H(Hudson), Oral Solu, 3.35gm/5ml,
Maxilax(Opsonin), Liquid, 3.3335 gm /5 ml, Tk.110.00/100 ml
Tk. 120.00/100 ml ,; 3.3335 gm /5 ml, Tk. Laxativ(Rangs), Oral Solu, 3.35gm/5ml, Tk.
65.00/50 ml,; Powder, 10 gm/Sachet, Tk. 100/100ml, Tk. 200/200ml
12.00/10gm Sachet Laxol(Navana), Oral Solu., 3.40 gm/5 ml, Tk.
Sinalax(Ibn Sina), Powder, 10 gm/Sachet, Tk. 50.19/50 ml; Tk. 120.00/100 ml; Tk.
13.00/10 gm Sachet 200.75/200 ml
Laxolac(Globe), Oral Solution, 68%, Tk.
LACTULOSE[ED] 140.00/100ml
Leaxe(Alco), Oral Solution, 68%, Tk.
140.42/100ml ,; 68%, Tk. 250.75/200ml
Indications: Constipation (may take up Livax(Pacific), Oral Solution, 68%, Tk.
to 48 hours to act), hepatic (portal 140.00/100ml ,; 68%, Tk. 250.00/200ml
systemic) encephalopathy. Livoton(Kemiko), Oral Solution, 68%, Tk.
Contraindications: Galactosaemia, 120.00/100ml ,; 68%, Tk. 70.21/50ml
intestinal obstruction.
27
Loctoz(Amico), Oral Solution, 68%, TK. Mom(Opsonin), Suspen., 400 mg /5 ml, Tk.
100.00/100ml 60.18/100 ml
Niprolac(Nipro JMI), Oral Solu., 3.40 gm/5 ml, Magmil(Pacific), Suspn. , 400 mg /5 ml, Tk.
Tk. 120.00/100 ml 80.00/100ml ,; 400 mg /5 ml, Tk.
Onlac(One Pharma), Oral Solution, 68%, Tk. 120.00/200ml
140.00/100ml Magnason(Jayson), Susp.,Tk. 50.00/100 ml
Oralax(Somatec), Oral Solution, 68%, Tk.
140.00/100ml MAGNESIUM SULPHATE[ED]
Osmolax(Square), Oral Solution, 68%, Tk.
250/200ml,; Tk. 140/100ml
Premesis(Globe), Oral Solu., 3.40 gm/5 ml, Indications: Rapid bowel evacuation
Tk. 15.00/100 ml (acts in 24 hours when given by
Regulose(General), Oral Solution, 67%, Tk. mouth);injection preparation is used in
201.35/200ml,; 67%, Tk. 120.36/100ml eclampsia and pre eclampsia.
Relacs(ACI), Oral Solution, 68%, Tk.
(See section16.2.2.3)
65.45/100ml.
Serelose(Beximco), Oral Solution, 70%, Tk. Cautions;Contraindications:See under
130.00/100ml Magnesium Hydroxide; hepatic
Sinalac(Ibn Sina), Oral Solution, 68%, Tk. impairment.
140.00/100ml,; 68%, Tk. 230.00/200ml,; Side-effects: Nausea, bloating,
68%, Tk. 70.00/60ml abdominal cramps (usually transient
Sivolac(Sharif), Oral Solution, 68%, Tk. reduced by taking more slowly); rarely
120.37/100ml
vomiting, anal irritation; urticaria,
Softner(Rephco), Oral Solu., 3.40 gm/5 ml,
Tk. 75.00/100 ml; Tk. 125.00/200 ml rhinorrhoea and dermatitis reported.
Tulac(Eskayef), Oral Solution, 68%, Tk. Dose: For rapid bowel evacuation (in 2-4
140.00/100ml,; Tk. 230.00/200ml,; , Tk. hours), 5-10 g in a glassful of water
65.00/50ml, preferably before breakfast.
Tulac(Eskayef), Oral Solu., 3.40 gm/5 ml, Tk.
65.00/50 ml; Tk. 120/100 ml; Tk. 230/200 ml Proprietary Preparation
Tulos(Acme), Oral Solution, 68%, Tk. Mag Sulph(Gonoshasthaya),
230.69/200ml,; Tk. 120.37/100ml Inj.4%Tk3.00/5ml,
Veelac(Albion), Oral Solu., 3.40 gm/5 ml, Tk. Nlepsin(Beximco), I.V. Infusion, Mag.sulph
100.00/100ml; Tk. 195.00/200ml 4%+Nacl 0.45/%+Dextrose 5%,Tk.70.8/100ml
Xylose(Delta), Oral Solu., 3.40 gm/5 ml, Tk. Magsum (Renata)Inj.2.5g/5ml,Tk.18.06
120.00/100 ml
Zenilac(Zenith), Oral Solution, 68%, Tk.
120.00/100ml POLY ETHYLENE GLYCOL
(Macrogol)
MAGNESIUM HYDROXIDE
Indications:chronic constripation
Indications: Mild constipation (acts in 2- Caution,Contraindications:see under
4 hours) Magnisum hydroxide;breast
Cautions: Use only occasionally; the feeding,pregnancy;cardiovascular
elderly; renal impairment; hepatic impairment
impairment Side-effects: flatulence, cramps, and
Contraindication: Intestinal obstruction abdominal discomfort
Interactions:See Appendix-2 (Antacids Dose:chronic constipation, ADULT and
and absorbents) CHILD over 12years, 25mL 1–3 times
Dose: Aqueous suspension containing daily usually for up to 2
about 8% hydrated magnesium oxide, weeks;maintenance, 25mL 1–2 times
25-50 ml as and when required. daily
Proprietary Preparations Proprietary Preparation

Acme’s Milk of Magnesia(Acme), Suspen., Aqualax(Incepta), Susp., 17g/240ml,
400 mg /5 ml, Tk. 60.18/114ml,; (Orion), Tk.120/240ml
Suspen., 400 mg /5 ml, Tk. 50.15/100ml
Modern Milk of Magnesia(Modern), Suspen.,
400 mg /5 ml, Tk. 60.00/100ml
28
Local anaesthetics are used to relieve

pain associated with haemorrhoids anal
fissure, and pruritus but good evidence
2.7 PREPARATIONS FOR is lacking. Lignocaine gel and ointment
HAEMORRHOIDS are best applied on a plastic dilator
2.7.1 SOOTHING HAEMORRHOIDAL which ensures contact with the base of
PREPARATIONS the fissure. Alternative local anaesthetics
2.7.2 COMPOUND include amethocaine, cinchocaine, and
HAEMORRHOIDAL pramoxine, but they are more irritant.
PREPARATIONS WITH Local anaesthetics should be used for
CORTICOSTEROIDS short periods only (no longer than 1-2
2.7.3 RECTAL SCLEROSANTS weeks) since they may cause
2.7.4 OTHER PREPARATIONS sensitisation of the anal skin.
ADMINISTRATION. Unless otherwise
2.7.5 RECTAL SCLEROSANTS indicated a suppository is usually
Anal and perianal pruritus, soreness, inserted into the rectum at night and
and excoriation are best treated by morning or after a bowel movement.
application of bland ointments, Rectal ointments and creams are applied
suppositories or dusting powders. These at night and morning or after a bowel
conditions occur commonly in patients movement, externally by rectum using a
suffering from haemorrhoids, fistulas, rectal nozzle.
and proctitis. Careful local toilet, as well Note. Local anaesthetic ointments can
as, adjustment of the diet to avoid hard be absorbed through the rectal mucosa
stools, taking of bulk forming materials therefore excessive application should
such as bran (section 2.6.1) and a high be avoided, particularly in infants and
residue diet are also helpful. In proctitis children.
these measures may supplement
treatment with corticosteroids or 2.7.2 COMPOUND PREPARATIONS
sulphasalazine. WITH CORTICOSTEROIDS
When necessary topical preparations
containing local anaesthetics or Corticosteroids are often combined with
corticosteroids are used provided antiseptics, antibiotics, local anaesth-
perianal thrush has been excluded. etics and soothing agents. They are
Perianal thrush is best treated with suitable for occasional short term use
nystatin by mouth and by local after exclusion of infections, such as
application. herpes simplex; see section 12.3 for
general comments on topical corticos-
2.7.1 SOOTHING HAEMORRHOIDAL teroids.
PREPARATIONS Antibiotics may do little more than
encourage the growth of resistant
Bland soothing preparations containing bacteria and should be avoided.
mild astringents such as bismuth
subgallate zinc oxide and hamamelis Proprietary Preparations
Cinchocaine HCl 0.5% + Hydrocortisone 0.5% +
may give symptomatic relief in Neomycin sulphate 1% + Esculin 1%;
haemorrhoids. Many proprietary Anustat(Beximco), RectalOint.,Tk.70.00/15g.
preparations also contain lubricants Anorel(Popular), RectalOint.,Tk.80.30/15g
vasoconstrictors or mild antiseptics Erian (Square),Supp
Prolonged application of preparations Tk.8/supp;RectalOintment, Tk. 68.00/15g
containing resorcinol should be avoided Methovate(Gaco), Rectal Ointment,
because it may interfere with thyroid Betametdhasone Valerate0.05 %++Lignocain
Hydrochloride 2.5%Tk.30.00/15gm
function. Heparinoids are claimed to
promote the resorption of local oedema
and extravasated blood.
29
Sangril(Healthcare), Tab. Tk. 10.00/Tab.

Daflon(I)(Servier),Tab.Tk.12/Tab
2.7.3 RECTAL SCLEROSANTS 2.8 DRUGS AFFECTING
INTESTINAL SECRETIONS
Oily phenol injection is used to inject 2.8.1 DRUGS ACTING ON THE
haemorrhoids particularly when those GALL BLADDER
are unprolapsed. 2.8.2 PANCREATIN
2.8.1 DRUGS ACTING ON THE
PHENOL GALL BLADDER
Indications: injection of hemorrhoids The bile acids chenodeoxycholic acid

Side-effects: irritation, tissue necrosis and ursodeoxycholic acid are used in
Dose: 2-3 ml of oily phenol injection into selected patients to dissolve cholesterol
the submucosal layer at the base of the gallstones as an alternative to surgery.
pile; several injections may be given at
different sites, max. total injected 10 ml URSODEOXYCHOLIC ACID
at any one time
Indication: dissolution ofcholesterol rich
Generic Preparation gallstone, primary biliary cirrhosis.
Oily Phenol Injection BP, contains Cautions: see notes above
phenol 5% in a suitable fixed oil Contra-indications: chronic liver
disease, peptic ulcer disease, non-
2.7.4 OTHER PREPARATIONS functioning gall bladder, inflammatory
bowl disease, pregnancy, radio-opaque
DIOSMIN WITH HESPERIDIN stone and other conditions of the small
intestine, colon and liver which interfere
with entro-hepatic circulation of bile salts
Indications: treatment of organic and
idiopathic chronic venous insufficiency of
Side-effects: nausea, vomiting, diarrhea
the lower limbs with the following
and other gastrointestinal disturbance,
symptoms: heavy legs; pain; nocturnal
gallstone calcification; pruritus.
cramps. Treatment of hemorrhoids and
Dose: dissolution of gallstone,8-12mg/kg
acute hemorrhoidal attacks
daily as a single dose at bedtime or in
Side effects: some cases of monor
two divided doses; for up to 2 years;
gastrointestinal and autonomic disorders
treatment is continued for 3-4 months
have been reported, but these never
after stones dissolve. Primary biliary
required cessation of treatment
cirrhosis 10-15mg/kg daily in 2-4 divided
Dose: in venous disease: 2 tablets daily.
doses.
In acute hemorrhoidal attacks: the
dosage can be increased up to 6 tablets
daily as prescribing information may vary
Antigall(Incepta), Tab. , 150 mg, Tk.
from country to country. 13.00/Tab., 300 mg, Tk. 22.00/Tab.
Bilicir(ACI), Tab., 150mg , TK. 11.00/Tab.,
Proprietary Preparations 300mg, TK. 20.00/Tab.
Diosmin 450mg with Hesperidin 50mg Liconor(Opsonin), Liquid, 250 mg/5 ml, Tk.
Alvenor(Beacon), Tab. Tk. 10.00/Tab. 180.68/50ml; Tab, 150 mg , Tk. 11.04/Tab.,
Ardium(Drug Intl), Tab.Tk.8.00/Tab. 300 mg, Tk. 21.00/Tab.
Avonoid(UniMed), Tab. Tk. 8.00/Tab. Livacor(Albion), Tab.,150 mg, Tk. 10.00/Tab.;
Daflon(ACI), Tab., Tk. 13.00/Tab. 300 mg, Tk. 20.00/Tab.
Diohes(Opsonin), Tab. Tk. 8.06/Tab. Liveric(Beximco), Tab., 150mg, Tk.
Diorin(Incepta), Tab. Tk. 8.00/Tab. 11.00/Tab., 300mg, Tk. 20.00/Tab.
Hemoral(Aristopharma), Tab. Tk. 8.00/Tab. Oxycol(UniMed), Tab , 300mg, Tk.
Hemorif(Square), Tab. Tk. 8.06/Tab. 36.00/Tab.; 150mg, Tk. 20.00/Tab.
Normanal(Renata), Tab. Tk. 8.03/Tab. Stener(Healthcare), Tab., 150mg , Tk.
Pilestop(Acme), Tab. Tk. 8.07/Tab. 15.00/Tab.; 300mg , Tk. 25.00/Tab.
30
Udca(Biopharma), Tab., 300mg , Tk. Pancreatin may irritate the skin around
20.00/Tab. mouth and anus, particularly if
Udihep(Mundipharma), Tab. , 150 mg, Tk. preparations are retained in the mouth or
12.67/Tab.; S.R Tab. 300 mg, Tk. 23.50/Tab.
Uliv(Acme), Tab. , 150.00 mg , Tk.
dosage is excessive. Hypersensitivity
12.09/Tab. ; 300 mg, Tk. 20.13/Tab. reactions occur occasionally and may
Urso(Square), Tab. , 150 mg, Tk. 15.00/Tab., affect those handling the powder.
300 mg, Tk. 25.00/Tab. Dosage is adjusted according to size,
Ursocol(Sun), Tab., 150 mg, Tk. 11.05/Tab.; needs and number/consistency of stools,
Tab., Tk. 20.10/Tab. so that the patient thrives; extra
Ursodil(General), Tab. , 300mg, Tk. allowance may be needed if heavy
25.00/Tab., 150mg, Tk. 15.00/Tab.
Ursolic(Drug Intl), Suspn., 250mg/5 ml, Tk.
snacks are taken between meals.
180.55/50ml; Tab., Tk. 11.05/Tab.; 300mg, Tk.
20.10/Tab. Proprietary Preparations
A-Zyme(Acme), Tab., 325mg, Tk. 3.51/Tab.
Crezyme(Opsonin),Tab., 325mg, Tk.3.50/Tab
2.8.2 PANCREATIN Suzyme(Square),Tab., 325mg, Tk. 3.51/Tab.
Zymet(Beximco), Tab., 325mg, Tk. 3.50/Tab.
Supplements of pancreatin are given by
mouth to compensate for reduced or
absent exocrine secretion in cystic
fibrosis, and following pancreatectomy,
total gastrectomy, or chronic
pancreatitis. They assist the digestion of
starch, fat, and protein.
Pancreatin is inactivated by gastric acid;
therefore pancreatin preparations are
best taken with food (or immediately
before or after food). Gastric acid
secretion may be reduced by giving
cimetidine or ranitidine an hour
beforehand. Con-current use of antacids
also reduces gastric acidity. The newer
enteric coated preparations enclosing
enteric coated granules (or minitablets)
can deliver a higher enzyme
concentration in the duodenum provided
these are swallowed whole without
chewing.
31

02 Gastrointestinal System

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02 Gastrointestinal System

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Chapter 2

Infants withmild or moderate reflux

Aluminium Hydroxide Gel and Magaplus-X(Kemiko),Susp.Tk. 55.00/100 ml;

excess gas in the digestive tract. Such Peptacid(Amico),Tab.,Tk.1/Tab.;Tk.55/200 ml

paralytic ileus, toxic megacolon,and Dose: 10–20 mg 3 times daily; INFANT

Hybucin(Supreme), Tab. 10 mg, Tk. 3.40/Tab. TIEMONIUM METHYLSULPHATE

Timozin(Incepta), Tab. , 50 mg, Tk. Dose:200 mg 3 times daily before

by subcutaneous or intramuscular Mevin(Square), Tab., 135 mg, Tk. 6.02/Tab.;

MEBEVERINE HYDROCHLORIDE It is an antiemetic drug mediates its

photosensitivity, and flushing; dyspnoea, Dedom(Decent), Suspn. , 5mg/5ml, Tk.

Famodin(Acme), Tab. 20.00 mg., Tk. feeding. Avoid intravenous injection in

Antac(Ambee), Syrup, 75mg/5ml, Tk Ranidin(Acme), Inj., 50 mg/2 ml, Tk. 10.03/2

in the treatment of peptic ulcer but has Proprietary Preparation

Naprotec(Sharif), Tab., 20 mg + 375mg, mg, Benign gastric or duodenal ulcer

Pantover(Veritas), Tab., 20 mg, Tk. Dose: erosive or ulcerative gastroesop-

2.3.6 DRUGS FOR ERADICATION

Recommended regimens for H. pylori Diarrhoea is characterized by increased

Lansoprazole 30 mg twice daily + ORAL REHYDRATION SALTS[ED] [OTC]

Contents of one sachet are dissolved in Cholera Saline (Opsosaline), IVInfusion

RACECADOTRIL a high fibre diet with bran or other agents

Laxatives are required to facilitate bowel DIVERTICULAR DISEASE: This is

2.6 LAXATIVES LUBIPROSTONE

2.6.1 Bulk forming drugs Indications: chronic constipation in

METHYL CELLULOSE Proprietary Preparation

vanillin 5 mg, chloroform 0.025 ml, Interactions:See Appendix-2

Proprietary Preparations Proprietary Preparation

Local anaesthetics are used to relieve

Sangril(Healthcare), Tab. Tk. 10.00/Tab.

Indications: injection of hemorrhoids The bile acids chenodeoxycholic acid

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