Rinon Division

Indications :

• Appendicitis and Peritonitis  
• Uncomplicated and complicated skin and soft tissue infections  
• Pelvic inflammatory diseases  
• Community acquired pneumonia 
• Nosocomial pneumonia due to S. aureus

Dosage :  

Children >12 years and Adults :

Nosocomial pneumonia:
I.V. : Piperacillin / tazobactam 4.5 g every 6 hours for 7-14 days.

Severe infections :  
I.V. : Piperacillin / tazobactam 4.5g every 8 hours or 3/0.375 g every 6 hours for 7-10 days.

Moderate infections : 
I.M. : Piperacillin / tazobactam 2.25g every 6-8 hours; treatment should be continued for 7-10 days depending on severity of disease.

Paediatric :

• 112.50mg/kg TID (age 9 months or older).  
• 90mg/kg TID (age 2months - 9months).

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Administer with caution

Packing :

Indications :

• Chronic Glomerulonephritis 
• Chronic Pyelonephritis 
• Polycystic Kidney Disease 
• Pre, Post and during Dialysis 
• As a Maintenance Therapy

Dosage :

If the protein content in the diet is reduced gradually, dosage of Aminos is increased simultaneously.

Dosage Adjustment
Renal Impairment : Administer with caution.
Hepatic Impairment : Administer with caution.

Packing :3 Strips of 10 Tablets 

Indications :

• Hyperkalemia associated anuria or severe oliguria 

• Hyperkalemia due to acute & chronic renal failure

• Patients requiring dialysis

Dosage :

Adults : 15g 3-4 times a day as a suspension in a small amount of water (3-4 ml/gm of resin).

Children : Initial - 1g/kg body wt. daily in divided doses.
Maintenance - 0.5g/kg body wt. in divided doses.

Dosage Adjustment

Renal Impairment : Not required, administer with caution.
Hepatic Impairment : Not required, administer with caution.

Packing : 10 Sachets of 15g 

Indications :

• Edema accompanying renal diseases, including the nephrotic syndrome and states of diminished renal function 

• Hypertension (alone or in combination with other antihypertensive drugs of a different class.) 

• Edema accompanying congestive heart failure

Dosage Adjustment

Renal Impairment : May be required. 
Hepatic Impairment : May be required.

Packing :  10 Strips of 10 Tablets

Indications :

• Edema accompanying renal diseases, including the nephrotic syndrome and states of diminished renal function 

• Hypertension (alone or in combination with other antihypertensive drugs of a different class.) 

• Edema accompanying congestive heart failure

Dosage Adjustment

Renal Impairment : May be required.
Hepatic Impairment : May be required.

Packing : 10 Strips of 10 Tablets   

Indications :

Neurological Conditions :

Multiple Sclerosis, Spinal Cord Injury, Cerebral injury

Nephrological Conditions :

Glomerular nephritis and Lupus nephritis

Dosage :

In Multiple Sclerosis

1g/day I.V. for 3-5 days.

In Optic Neuritis

1g/day I.V. for 3 days followed by oral prednisolone therapy.

In Renal transplantation

• For induction of Immunosuppression : Start with 80-160 mg OD for three days followed by oral therapy.
• In treatment of acute rejection: 500 mg upon diagnosis, followed by 500 mg OD for two days.

Oedematous states

30 mg/kg body weight every other day for 4 days or 1gm /day for 3, 5 or 7 days I.V. 

Acute Spinal cord injury 

30 mg /kg bolus followed by 5.4 mg/kg bolus for 24-48 hours.

Prevention of ARDS and Fat Embolism syndrome 

30 mg /kg body weight can be repeated after 6 hours.


Packing :  1 Vial of 500mg

Indications :

Neurological Conditions :

Multiple Sclerosis, Spinal Cord Injury, Cerebral injury

Nephrological Conditions :

Glomerular nephritis and Lupus nephritis

Dosage :

In Multiple Sclerosis

1g/day I.V. for 3-5 days. 

In Optic Neuritis

1g/day I.V. for 3 days followed by oral prednisolone therapy. 

In Renal transplantation

• For induction of Immunosuppression : Start with 80-160 mg OD for three days followed by oral therapy.
• In treatment of acute rejection: 500 mg upon diagnosis, followed by 500 mg OD for two days.

Oedematous states

30 mg/kg body weight every other day for 4 days or 1gm /day for 3, 5 or 7 days I.V. 

Acute Spinal cord injury
 
30 mg /kg bolus followed by 5.4 mg/kg bolus for 24-48 hours. 

Prevention of ARDS and Fat Embolism
syndrome 

30 mg /kg body weight can be repeated after 6 hours.

Packing :   1 Vial of 1g 

Indications :

• In prophylaxis of organ rejection 
• Kidney transplant 
• Liver Transplant 
• Heart Transplant 

Dosage :  

Initial Oral Dose : 15 mg/kg OD dose 4-12 hrs prior to transplantation.

Pediatric Dose : 2 mg/kg/day for the first 4 days tapered to 1 mg/kg/day by 1 week, 0.6 mg/kg/day by 2 weeks, 0.3 mg/kg/day by 1 month and 0.15 mg/kg/day by 2 months.

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Probably necessary, administer with caution. 

Packing :   10 Ampoules of 1 ml

Indications :

• In prophylaxis of organ rejection 
• Kidney transplant 
• Liver Transplant 
• Heart Transplant 

Dosage :  

Initial Oral Dose : 15 mg/kg OD dose 4-12 hrs prior to transplantation.

Pediatric Dose : 2 mg/kg/day for the first 4 days tapered to 1 mg/kg/day by 1 week, 0.6 mg/kg/day by 2 weeks, 0.3 mg/kg/day by 1 month and 0.15 mg/kg/day by 2 months.

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Probably necessary, administer with caution. 

Packing :    5 Ampoules of 5 ml

Indications :

• In prophylaxis of organ rejection 
• Kidney transplant 
• Liver Transplant 
• Heart Transplant 

Dosage :  

Initial Oral Dose : 15 mg/kg OD dose 4-12 hrs prior to transplantation.

Pediatric Dose : 2 mg/kg/day for the first 4 days tapered to 1 mg/kg/day by 1 week, 0.6 mg/kg/day by 2 weeks, 0.3 mg/kg/day by 1 month and 0.15 mg/kg/day by 2 months.

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Probably necessary, administer with caution. 

Packing :     3 Strips of 10 Capsules

Indications :

• In prophylaxis of organ rejection 
• Kidney transplant 
• Liver Transplant 
• Heart Transplant 

Dosage :  

Initial Oral Dose : 15 mg/kg OD dose 4-12 hrs prior to transplantation.

Pediatric Dose : 2 mg/kg/day for the first 4 days tapered to 1 mg/kg/day by 1 week, 0.6 mg/kg/day by 2 weeks, 0.3 mg/kg/day by 1 month and 0.15 mg/kg/day by 2 months.

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Probably necessary, administer with caution. 

Packing :      5 Strips of 6 Capsules

Indications :

• In prophylaxis of organ rejection 
• Kidney transplant 
• Liver Transplant 
• Heart Transplant 

Dosage :  

Initial Oral Dose : 15 mg/kg OD dose 4-12 hrs prior to transplantation.

Pediatric Dose : 2 mg/kg/day for the first 4 days tapered to 1 mg/kg/day by 1 week, 0.6 mg/kg/day by 2 weeks, 0.3 mg/kg/day by 1 month and 0.15 mg/kg/day by 2 months.

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Probably necessary, administer with caution. 

Packing :      5 Strips of 6 Capsules

Indications :

• In prophylaxis of organ rejection 
• Kidney transplant 
• Liver Transplant 
• Heart Transplant 

Dosage :  

Initial Oral Dose : 15 mg/kg OD dose 4-12 hrs prior to transplantation.

Pediatric Dose : 2 mg/kg/day for the first 4 days tapered to 1 mg/kg/day by 1 week, 0.6 mg/kg/day by 2 weeks, 0.3 mg/kg/day by 1 month and 0.15 mg/kg/day by 2 months.

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Probably necessary, administer with caution. 

Packing :    1 Bottle of 50 ml

Indications :

• Peritoneal dialysis associated peritonitis.
• Post transplant infection with Paeruginosa, Staph aureus and Klebsiella. 
• Post transplant Urinary tract infection. 
• Post transplant Respiratory tract infection. 
• Bacterial sepsis associated with renal transplant. 
• Post transplant nocardial infection. 
• As prophylaxis in transplant surgery.

Dosage :The recommended dosages of Meropenem are : 

Intra-abdominal infections :

IV 1g every 8 hours (adults)
IV 20mg/kg every 8 h (children) 
2g every 8 h (Max. dose) 

Meningitis :

IV 40 mg/kg every 8 h (children above 3 mths of age)
2g every 8 h (Max. dose) 

Skin and skin inflammation :

IV 500mg evry 8 h (adults)  
IV 10mg/kg every 8 h (children above 3 mths of age) 
500mg every 8 h (max. dose) 

Dosage Adjustment : 

Renal Impairment : Required.

Hepatic Impairment : Not necessary.   

Packing :   10 Vials of 500 mg

Indications :

• Peritoneal dialysis associated peritonitis.
• Post transplant infection with P.aeruginosa, Staph aureus and Klebsiella. 
• Post transplant Urinary tract infection. 
• Post transplant Respiratory tract infection. 
• Bacterial sepsis associated with renal transplant. 
• Post transplant nocardial infection. 
• As prophylaxis in transplant surgery.

Dosage : The recommended dosages of Meropenem are : 

Intra-abdominal infections :

IV 1g every 8 hours (adults)
IV 20mg/kg every 8 h (children) 
2g every 8 h (Max. dose) 

Meningitis :

IV 40 mg/kg every 8 h (children above 3 mths of age)
2g every 8 h (Max. dose) 

Skin and skin inflammation :

IV 500mg evry 8 h (adults)  
IV 10mg/kg every 8 h (children above 3 mths of age) 
500mg every 8 h (max. dose) 

Dosage Adjustment :

Renal Impairment : Required.

Hepatic Impairment : Not necessary.   

Packing :    10 Vials of 1 g

Indications :

• For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants.

Dosage : 

Renal Transplantation :

Adults : A dose of 1 g administered orally twice a day (daily dose of 2 g) is recommended for use in renal transplant patients.

Pediatrics : Patients with a body surface area of 1.25 m² to 1.5 m² (3 months to 18 years) may be given a dose of 750 mg twice daily (1.5 g daily dose). Patients with a body surface area > 1.5 m² may be dosed with at a dose of 1 g twice daily (2 g daily dose).

Cardiac Transplantation :

Adults : A dose of 1.5g BID oral (daily dose of 3g) is recommended for use in adult cardiac transplant patients.

Hepatic Transplantation : 

Adults : A dose of 1.5g BID oral (daily dose of 3g) is recommended for use in adult cardiac transplant patients. 

Dosage Adjustment : 

Renal Impairment : Not required. 

Hepatic Impairment : May be required in renal patients with some hepatic diseases. 

Packing :  6 Strips of 10 Tablets

Indications :

• For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants.

Dosage : 

Renal Transplantation :

Adults : A dose of 1 g administered orally twice a day (daily dose of 2 g) is recommended for use in renal transplant patients.

Pediatrics : Patients with a body surface area of 1.25 m² to 1.5 m² (3 months to 18 years) may be given a dose of 750 mg twice daily (1.5 g daily dose). Patients with a body surface area > 1.5 m² may be dosed with at a dose of 1 g twice daily (2 g daily dose).

Cardiac Transplantation :

Adults : A dose of 1.5g BID oral (daily dose of 3g) is recommended for use in adult cardiac transplant patients.

Hepatic Transplantation :

Adults : A dose of 1.5g BID oral (daily dose of 3g) is recommended for use in adult cardiac transplant patients. 

Dosage Adjustment : 

Renal Impairment : Not required.
 
Hepatic Impairment : May be required in renal patients with some hepatic diseases. 

Packing :  6 Strips of 10 Tablets

Indications :

• For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants.

Dosage :

Adults : The recommended doses is 720 mg administered twice daily (1440 mg total daily dose) on an empty stomach, one hour before or two hours after food intake.

Pediatrics : Based on a pharmacokinetic study conducted in stable renal pediatric transplant patients, the recommended dose in stable pediatric patients is 400 mg/m² body surface area (BSA) administered twice daily (up to a maximum dose of 720 mg administered twice daily). Patients with a BSA of 1.19 to 1.58 m² may be dosed either with three 180 mg tablets or one 180 mg plus one 360 mg tablet twice daily (1080 mg daily dose).  

Dosage Adjustment :

Renal Impairment : Not required.

Hepatic Impairment : May be required in renal patients with some hepatic diseases.

Packing :   6 Strips of 10 Tablets

Indications :

• For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants.

Dosage :

Adults : The recommended doses is 720 mg administered twice daily (1440 mg total daily dose) on an empty stomach, one hour before or two hours after food intake.

Pediatrics : Based on a pharmacokinetic study conducted in stable renal pediatric transplant patients, the recommended dose in stable pediatric patients is 400 mg/m² body surface area (BSA) administered twice daily (up to a maximum dose of 720 mg administered twice daily). Patients with a BSA of 1.19 to 1.58 m² may be dosed either with three 180 mg tablets or one 180 mg plus one 360 mg tablet twice daily (1080 mg daily dose).  

Dosage Adjustment :

Renal Impairment : Not required.

Hepatic Impairment : May be required in renal patients with some hepatic diseases.

Packing :   6 Strips of 10 Tablets

Indications :

• Prophylaxis of organ rejection in patients receiving allogeneic organ transplants.

Dosage Adjustment :

Renal Impairment : Administer with caution.

Hepatic Impairment : Needs adjustment.

Packing :  5 Strips of 10 Capsules

Indications :

• Prophylaxis of organ rejection in patients receiving allogeneic organ transplants.  

Dosage Adjustment :

Renal Impairment : Administer with caution. 

Hepatic Impairment : Needs adjustment.  


Packing :  5 Strips of 10 Capsules

Indications :

• Prophylaxis of organ rejection in patients receiving allogeneic organ transplants.  

Dosage Adjustment :

Renal Impairment : Administer with caution. 

Hepatic Impairment : Needs adjustment.  


Packing :  5 Strips of 10 Capsules

Indications :

• As an adjunct in the prevention of rejection in renal and solid organ transplantation.
•  Management of severe rheumatoid arthritis. 

Autoimmune diseases :

- Inflammatory bowel disease including moderate to severe crohn's disease.   
- Autoimmune hepatitis. 
- Systemic lupus erythematosus. 
- Multiple sclerosis. 

Dosage :  

Renal and solid organ transplantation :

Children and adults : 2-5 mg/kg/day to start at the time of transplant, then 1-3 mg/kg/day as a maintenance dose.

Rheumatoid arthritis and autoimmune disease :

Adults : 

Initial : 1 mg/kg/day given once daily or divided twice daily 6-8 weeks; increase by 05 mg/kg every 4 weeks until response or up to 2.5 mg/kg/day.

Maintenance dose : Reduce dose by 0.5 mg/kg every 4 weeks unitl lowest effective dose is reached.


Dosage Adjustment :

Renal Impairment : Require adjustment.    

Hepatic Impairment : Administer with caution.

Packing :  10 Strips of 10 Tablets  
 

Indications :

• Benign prostatic hyperplasia.  
• Hypertension.
• Congestive heart failure.
• Vasospastic therapy.
• Raynaud's phenomenon in progressive systemic sclerosis.

Dosage :
Children : 50 to 400 mcg /Kg/Day in 2-3 divided doses. 

Dosage Adjustment :

Renal Impairment : May be required in severe impairment.
Hepatic Impairment : May be required in severe impairment.


Packing : 10 Strips of 10 Tablets

Indications :

• Benign prostatic hyperplasia.  
• Hypertension.
• Congestive heart failure.
• Vasospastic therapy.
• Raynaud's phenomenon in progressive systemic sclerosis.

Dosage :
Children : 50 to 400 mcg /Kg/Day in 2-3 divided doses. 

Dosage Adjustment :

Renal Impairment : May be required in severe impairment.
Hepatic Impairment : May be required in severe impairment.


Packing : 10 Strips of 10 Tablets

Indications :

• Pre existing (moderate to severe) anemia  
• Patients not responding or having poor compliance with oral iron supplements
• Pre and postoperative period
• Postpartum anemia and postpartum haemorrhage
• Patients with poor iron absorption (bowel operations or diseases)
• Patients with severe renal impairment

Dosage :

The total cumulative dose of iron sucrose, equivalent to the total iron deficit (mg), is determined by the hemoglobin level and body weight. 

Adult : 100-200mg iron one-three times a week depending on the Hb level.
Children : 30mg/kg body wt. one-three times per week depending on the Hb level.

Dosage Adjustment :

Renal Impairment : Administer with caution in severe renal impairment.
Hepatic Impairment : Required.


Packing : 5 Ampoules of 2.5 ml 

Indications :

• Pre existing (moderate to severe) anemia  
• Patients not responding or having poor compliance with oral iron supplements
• Pre and postoperative period
• Postpartum anemia and postpartum haemorrhage
• Patients with poor iron absorption (bowel operations or diseases)
• Patients with severe renal impairment

Dosage :

The total cumulative dose of iron sucrose, equivalent to the total iron deficit (mg), is determined by the hemoglobin level and body weight. 

Adult : 100-200mg iron one-three times a week depending on the Hb level.
Children : 30mg/kg body wt. one-three times per week depending on the Hb level.

Dosage Adjustment :

Renal Impairment : Administer with caution in severe renal impairment.
Hepatic Impairment : Required.


Packing :  5 Ampoules of 5 ml

Indications :

• Benign prostate hyperplasia (BPH) 

• Management of mild to moderate hypertension 

• BPH with concomitant cardiovascular diseases  

• Expulsion of lower ureteral stones

Dosage :

Adults : Initial dose should not exceed 1 mg in any indication. If drug is discontinued for long duration, consider beginning with initial dose and retitrate as needed 
Benign prostatic hyperplasia :
Initial Dose : 1 mg at bedtime , gradually increasing the subsequent doses to 2 mg , 5 mg or 10 mg once daily up to a maximum of 20 mg/ day if no response after 4-6 weeks of 10 mg/day. 

Usual dose : 5-10 mg once daily.

Hypertension :
Initial Dose : 1 mg at bedtime; slowly increase dose to achieve desired blood pressure response, up to maximum of 20 mg/day.

Usual dose : 2-10 mg once daily
Dosage reduction may be needed when adding a diuretic or other antihypertensive agent; dosage may be given on a twice daily regimen if response is diminished at 24 hours and hypotensive is observed at 2-4 hours following a dose 

Dosage Adjustment :

Renal Impairment : Modification of dosage in such patients generally does not appear to be necessary.
Hepatic Impairment : Not well studied, administer with caution.


Packing :10 Strips of 10 Tablets 

Indications :

• Benign prostate hyperplasia (BPH) 

• Management of mild to moderate hypertension 

• BPH with concomitant cardiovascular diseases  

• Expulsion of lower ureteral stones

Dosage :

Adults : Initial dose should not exceed 1 mg in any indication. If drug is discontinued for long duration, consider beginning with initial dose and retitrate as needed 
Benign prostatic hyperplasia :
Initial Dose : 1 mg at bedtime , gradually increasing the subsequent doses to 2 mg , 5 mg or 10 mg once daily up to a maximum of 20 mg/ day if no response after 4-6 weeks of 10 mg/day. 

Usual dose : 5-10 mg once daily.

Hypertension :
Initial Dose : 1 mg at bedtime; slowly increase dose to achieve desired blood pressure response, up to maximum of 20 mg/day.

Usual dose : 2-10 mg once daily
Dosage reduction may be needed when adding a diuretic or other antihypertensive agent; dosage may be given on a twice daily regimen if response is diminished at 24 hours and hypotensive is observed at 2-4 hours following a dose 

Dosage Adjustment :

Renal Impairment : Modification of dosage in such patients generally does not appear to be necessary.
Hepatic Impairment : Not well studied, administer with caution.


Packing :10 Strips of 10 Tablets 

Vancomycin Hydrochloride For Injection USP 500 mg (Lyophilized)
Indications :

• Respiratory Tract Infections  
• Endocarditis
• Pseudomonas colitis
• Prophylaxis in Surgery / Organ Transplant

Dosage :

Adult dose : The usual adult dose is the equivalent of 500 mg of vancomycin every 6 hours or 1 g every 12 hours.  
 Paediatric dose : 10 - 15 mg/kg every 8 hours.


Dosage Adjustment : 
Renal Impairment : Required.  
Hepatic Impairment : Required in severe impairment.  


Packing : 10 Vials of 500 mg

Vancomycin Hydrochloride For Injection USP 1.0 g (Lyophilized)
Indications :

• Respiratory Tract Infections  
• Endocarditis
• Pseudomonas colitis
• Prophylaxis in Surgery / Organ Transplant

Dosage :

Adult dose : The usual adult dose is the equivalent of 500 mg of vancomycin every 6 hours or 1 g every 12 hours.  
 Paediatric dose : 10 - 15 mg/kg every 8 hours.


Dosage Adjustment : 
Renal Impairment : Required.  
Hepatic Impairment : Required in severe impairment.  


Packing : 10 Vials of 500 mg