Friday, June 27, 2025

Acdisteron 25 mg 20 f.c. tabs



**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.


**Drug Name:** Acdisteron 25 mg 20 f.c. tabs


**Manufacturer:**

Acdisteron is manufactured by Acdima International Trading (AIT).


**Introduction:**

Acdisteron 25 mg 20 f.c. tabs contains Mesterolone, a synthetic androgen primarily used to treat conditions related to low testosterone levels in men. It is an orally active steroid that helps to supplement the body's natural male hormones, addressing issues such as hypogonadism and certain forms of male infertility.


**Indications and Usage:**

Mesterolone is indicated for the treatment of various conditions in men related to androgen deficiency. These include:

* **Male Hypogonadism:** A condition where the testes produce insufficient testosterone.

* **Male Infertility:** Specifically, oligozoospermia (low sperm count) due to low hormone levels.

* **Androgen Deficiency:** Addressing symptoms like fatigue, lack of concentration, decreased libido, and potency disturbances.

* **Delayed Puberty in Boys:** In some cases, to support the development of male secondary sexual characteristics.

* **Andropause:** To manage symptoms in older men.


**Characteristics:**

Mesterolone is a synthetic dihydrotestosterone (DHT) derivative, classified as an androgen and anabolic steroid (AAS). It is orally active and has strong androgenic effects with relatively weak anabolic effects. A key characteristic of Mesterolone is that it is not a substrate for aromatase, meaning it is not converted into estrogen in the body. This prevents estrogenic side effects such as gynecomastia (breast enlargement) and fluid retention, which can occur with other testosterone derivatives. Unlike some other oral anabolic steroids, Mesterolone is generally considered to have little or no potential for hepatotoxicity (liver damage) because it is not 17α-alkylated. It works by stimulating androgen receptors in tissues and organs, promoting the growth and development of male sex organs and maintaining secondary sex characteristics.


**Dosage and Administration:**

Acdisteron is administered orally as tablets.

* **Form:** Film-coated tablets, 25 mg.

* **Recommended Use:**

    * **Initial Dose:** Typically 75-100 mg daily, divided into 3-4 doses, for several months.

    * **Maintenance Dose:** Usually 50-75 mg daily.

    * **For Male Infertility:** 2-3 tablets per day for approximately 90 days, corresponding to the spermatogenesis cycle.

* **Administration Method:** Swallow the tablet whole with a glass of water. It can be taken with or without food, though some sources suggest taking it after meals to enhance absorption.

* **Frequency:** Doses should be taken at the same times each day to aid remembrance.

* **Important Note:** Do not exceed the prescribed dose. The dosage and duration of treatment are determined by the physician based on the patient's medical condition.


**Contraindications:**

Mesterolone should not be used in individuals with the following conditions:

* Prostate cancer.

* Male breast cancer.

* Current or history of liver tumors (benign or malignant).

* Severe liver disease or hepatic impairment.

* Nephrotic syndrome.

* Hypercalcemia (high blood calcium levels).

* Hypersensitivity or allergy to Mesterolone or any of the product's constituents.

* Not indicated for use in women, especially during pregnancy or lactation, due to potential harm to the fetus and lack of indication.


**Warnings and Precautions:**

* **Prostate Health:** Regular examinations of the prostate gland (including PSA levels) are essential before and during treatment, as androgens can stimulate the growth of existing prostate cancer.

* **Cardiovascular Risk:** Use with caution in patients with cardiovascular disease, high blood pressure, or a history of myocardial infarction (MI) or coronary artery disease (CAD). Mesterolone can affect cholesterol levels (decreasing HDL and increasing LDL).

* **Liver Function:** Although generally considered less hepatotoxic, rare cases of liver tumors have been reported with long-term androgen therapy. Liver function should be monitored.

* **Fluid Retention:** Caution is advised in patients with conditions influenced by edema, such as cardiovascular disease, epilepsy, or migraines.

* **Diabetes:** Mesterolone may affect blood sugar levels; caution is advised in diabetic patients.

* **Blood Disorders:** Caution in patients with polycythemia (increased red blood cell count).

* **Abuse Potential:** Mesterolone, like other anabolic-androgenic steroids, has been abused, which carries serious health risks including cardiovascular, hepatic, and psychiatric events, and dependency. It is not indicated for enhancing muscular development or physical ability in healthy individuals.

* **Lactose Content:** Contains lactose, so patients with rare genetic conditions like galactose intolerance, total lactase deficiency, or glucose-galactose malabsorption should not use this medication.

* **Erections:** If frequent or very prolonged erections are observed, the dose should be reduced or treatment suspended to avoid damage to the penis.


**Nutrient Absorption and Metabolism (Pharmacokinetics):**

* **Absorption:** Following oral ingestion, Mesterolone is rapidly and almost completely absorbed. Its absolute bioavailability is approximately 3%. Maximum serum drug levels (Cmax) of about 3.1 ± 1.1 ng/mL are reached approximately 1.6 to 2 hours after a 25 mg dose.

* **Distribution:** Mesterolone is highly bound to serum proteins (98%), with 58% binding to Sex Hormone Binding Globulin (SHBG) and 40% to albumin.

* **Metabolism:** It is rapidly metabolized in the liver. The main metabolite identified is 1α-methyl-androsterone. Mesterolone is not converted into estrogens.

* **Elimination:** The serum levels decrease with a terminal half-life of 12-13 hours. Mesterolone is excreted primarily in the form of metabolites, with approximately 80% recovered in urine and up to 13% in faeces within seven days.


**Side Effects:**

Common side effects associated with Mesterolone include:

* Oily skin and acne.

* Increased body or facial hair growth (hirsutism).

* Scalp hair loss (male pattern baldness).

* Increased libido.

* Mood changes, including irritability, aggression, anxiety, or depression.

* Headache.

* Fluid retention and edema.

* Frequent or persistent erections.

* Stomach discomfort, abdominal pain, indigestion, nausea, and vomiting.

* Itching, fever, rash, hives.

* Changes in liver enzymes and lipid profile.


Serious or rare side effects can include:

* Benign or malignant liver tumors, and intra-abdominal hemorrhage.

* Hepatotoxicity (liver toxicity), especially with prolonged use.

* Cardiovascular events, including changes in cholesterol levels, increased blood pressure, and increased risk of heart attacks.

* Suppression of natural testosterone production, potentially leading to testicular atrophy and decreased sperm production, which can paradoxically cause infertility with prolonged use.

* Venous thromboembolism (VTE).


**Drug Interactions:**

Mesterolone may interact with several other medications:

* **Anticoagulants (e.g., Warfarin, Acenocoumarol):** Mesterolone can increase their anticoagulant activity, leading to a higher risk of bleeding.

* **Antidiabetic Drugs (e.g., Insulin, Metformin, Sulfonylureas, GLP-1 agonists, SGLT2 inhibitors):** Mesterolone may increase their hypoglycemic (blood sugar lowering) activities, requiring dose adjustments.

* **Corticosteroids (e.g., Prednisone, Dexamethasone):** Concomitant use can increase the risk or severity of edema (fluid retention).

* **Immunosuppressants (e.g., Cyclosporine):** Mesterolone may increase the risk of liver damage when combined with drugs like cyclosporine.

* **Anticonvulsants (e.g., Phenobarbital, Phenytoin):** These drugs may reduce the levels of Mesterolone in the body.

* **Thyroid Hormones (e.g., Thyroxine):** Mesterolone may interfere with thyroid function tests.

* **Neuromuscular Blockers:** May cause resistance to treatment.


**Patient Counseling:**

* Always take Mesterolone exactly as prescribed by your doctor and do not exceed the recommended dose.

* Regular medical check-ups, including blood tests (to monitor red blood cells, liver function, testosterone, and lipid profile) and prostate examinations, are crucial during treatment.

* Report any unusual or persistent side effects to your doctor immediately, especially frequent or prolonged erections, irritability, nervousness, significant weight gain, or signs of liver problems (e.g., yellowing of skin/eyes, severe abdominal pain).

* Mesterolone is intended for male patients only and should not be used by women, children, or adolescents. It is not for enhancing muscle development or physical ability in healthy individuals.

* Inform your doctor about all other medications, supplements, and herbal products you are taking to avoid potential drug interactions.

* Use with caution if you have pre-existing conditions such as heart disease, high blood pressure, diabetes, kidney problems, epilepsy, or migraines.

* Maintain a balanced diet, engage in regular exercise, ensure adequate sleep, and practice stress management techniques to support overall health.

* Avoid excessive alcohol consumption while on this medication, as it may exacerbate side effects and impact liver function.

* Do not stop taking the medication abruptly without consulting your doctor, as gradual tapering may be required.

* Store the medication below 30°C.


**Sources:**

* Truemeds: https://www.truemeds.in/medicine/mesterolone-1

* NPS MedicineWise: https://www.nps.org.au/medicine-finder/proviron-tablets

* DrugBank Online: https://go.drugbank.com/drugs/DB13587 

Accolate Tablet

 


**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.


**Drug Name:** Accolate Tablet


**Manufacturer:**

Accolate (zafirlukast) was originally developed by AstraZeneca. Generic versions of zafirlukast are now manufactured by various pharmaceutical companies, including Strides Pharma, Annora Pharma, Aurobindo Pharma, Dr. Reddy's Labs Ltd., Rising Pharms, and Camber Pharmaceuticals.


**Main Commentary Body:**


Accolate (zafirlukast) is a prescription medicine classified as a leukotriene receptor antagonist (LTRA). It is used for the prophylaxis and chronic treatment of asthma in adults and children aged 5 years and older. It works by reducing inflammation in the airways, making it easier to breathe. Accolate is not a fast-acting rescue medicine and should not be used to treat sudden asthma attacks.


* **Indications and Usage:**

    Accolate is indicated for the chronic treatment and prophylaxis of asthma in adults and children 5 years of age and older. It helps to prevent asthma attacks and control symptoms such as tightness in the chest, wheezing, breathlessness, and coughing. It may also be effective in preventing exercise-induced asthma and relieving symptoms of allergic rhinitis.


* **Characteristics:**

    Zafirlukast, the active ingredient in Accolate, is a selective and competitive receptor antagonist of leukotriene D4 and E4 (LTD4 and LTE4). Leukotrienes are natural substances in the lungs that contribute to the pathophysiology of asthma, including airway edema, smooth muscle constriction, and altered cellular activity associated with inflammation. By blocking the binding of these leukotrienes, zafirlukast helps to inhibit bronchoconstriction and reduce inflammation in the airways. Accolate is supplied as 10 mg and 20 mg film-coated tablets for oral administration.


* **Dosage and Administration:**

    Accolate tablets are for oral administration and should be swallowed whole with water. It is crucial to take Accolate on an empty stomach, at least 1 hour before or 2 hours after meals, as food can reduce its bioavailability.

    * **Adults and children 12 years and older:** The recommended dose is 20 mg twice daily.

    * **Children 5 through 11 years of age:** The recommended dose is 10 mg twice daily.

    * Accolate should be taken regularly as prescribed, even during symptom-free periods. It is not for acute asthma attacks.


* **Contraindications:**

    Accolate is contraindicated in patients who are hypersensitive to zafirlukast or any of its inactive ingredients. It is also contraindicated in patients with hepatic impairment, including hepatic cirrhosis, and in patients where Accolate was discontinued due to hepatotoxicity with no other attributable cause. Patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption should not take this medicine due to its lactose content.


* **Warnings and Precautions:**

    * **Hepatotoxicity:** Cases of life-threatening hepatic failure, liver transplantation, and death have been reported. Patients should be advised to contact their physician immediately if they experience symptoms of liver dysfunction (e.g., right upper quadrant abdominal pain, nausea, fatigue, lethargy, pruritus, jaundice, flu-like symptoms, anorexia).

    * **Neuropsychiatric Events:** New or worsening mental problems, including agitation, aggression, depression, suicidal thoughts or actions, hallucinations, and sleep disturbances, have been reported. Patients and their families should monitor for these changes and contact their physician immediately if they occur.

    * **Not for Acute Attacks:** Accolate is not a bronchodilator and should not be used to treat acute episodes of asthma. Patients should always have a short-acting beta2-agonist (rescue inhaler) available for sudden asthma attacks.

    * **Eosinophilic Conditions:** In rare cases, patients on Accolate therapy may present with systemic eosinophilia, eosinophilic pneumonia, or clinical features of vasculitis consistent with Churg-Strauss syndrome.

    * **Warfarin Interaction:** Co-administration with warfarin can significantly increase prothrombin time (PT), increasing the risk of bleeding. Close monitoring of PT and anticoagulant dose adjustment are necessary.

    * **Pregnancy and Breastfeeding:** Accolate should be used during pregnancy only if clearly needed and prescribed by a doctor. It passes into breast milk, and breastfeeding is not recommended while taking this medication.

    * **Elderly Patients:** Clearance of zafirlukast is reduced in elderly patients (65 years and older), leading to higher plasma concentrations. While clinical trials did not show an increased incidence of adverse events, caution is advised.

    * **Renal Impairment:** Experience is limited; use with caution.


* **Nutrient Absorption and Metabolism (Pharmacokinetics):**

    Zafirlukast is rapidly absorbed following oral administration, with peak plasma concentrations generally achieved within 3 hours. Its absolute bioavailability is unknown, but it is reduced by approximately 40% when taken with food. Zafirlukast is extensively metabolized in the liver, primarily by the cytochrome P450 2C9 (CYP2C9) pathway, and to a lesser extent by CYP3A4. The metabolites are primarily excreted in the feces, with about 10% recovered in the urine. The mean terminal half-life of zafirlukast is approximately 8 to 16 hours.


* **Side Effects:**

    Like all medicines, Accolate can cause side effects, although not everybody gets them.

    * **Common (may affect more than 1 in 100 people):** Headache, sore throat, cold symptoms, nausea, stomach pain, diarrhea, weakness, dizziness, muscle pain, fatigue, malaise.

    * **Less Common/Rare (may affect up to 1 in 100 people or less, some serious):**

        * **Liver injury:** Right upper belly pain, loss of appetite, nausea, dark urine, yellowing skin or eyes (jaundice), unusual weakness or fatigue.

        * **Neuropsychiatric changes:** Agitation, aggression, depression, suicidal thoughts/actions, hallucinations, sleep problems, vivid dreams, irritability, anxiety.

        * Allergic reactions: Skin rash, itching, hives, swelling of the face, lips, tongue, or throat.

        * Eosinophilic conditions (e.g., Churg-Strauss syndrome): Unusual weakness or fatigue, fever, headache, skin rash, muscle or joint pain, loss of appetite, pain, tingling, or numbness in the hands or feet.

        * Bleeding problems (especially with warfarin): Unusual nosebleeds, bruising, blood in urine, coughing blood.

        * Sinus pain or pressure.


* **Drug Interactions:**

    * **Warfarin:** Co-administration significantly increases prothrombin time (PT) and bleeding risk. Close monitoring and dose adjustment of warfarin are required.

    * **Aspirin:** May increase zafirlukast plasma levels.

    * **Erythromycin:** Can decrease zafirlukast plasma levels.

    * **Theophylline:** Zafirlukast can increase theophylline levels, potentially leading to toxicity.

    * **Phenytoin, Carbamazepine, Tolbutamide:** Zafirlukast may increase the levels of these drugs by inhibiting CYP2C9 metabolism.

    * **CYP3A4 Inhibitors/Substrates:** Zafirlukast inhibits CYP3A4 in vitro, so caution is advised when co-administering with drugs metabolized by this enzyme (e.g., some calcium-channel blockers, cyclosporine, cisapride, simvastatin, some antifungals like itraconazole).

    * **Oral Contraceptives:** No significant effect on ethinyl estradiol plasma concentrations or contraceptive efficacy has been observed.


* **Patient Counseling:**

    * Take Accolate exactly as prescribed by your doctor, even during symptom-free periods.

    * Do not use Accolate for sudden asthma attacks; always have your rescue inhaler available.

    * Take Accolate on an empty stomach, at least 1 hour before or 2 hours after meals.

    * Do not decrease the dose or stop taking any other asthma medications unless instructed by your physician.

    * Report any signs of liver problems (e.g., right upper abdominal pain, nausea, yellowing skin/eyes, dark urine) to your doctor immediately.

    * Report any unusual changes in mood or behavior (e.g., agitation, depression, suicidal thoughts) to your doctor immediately.

    * If you are taking warfarin, your doctor will need to monitor your blood clotting time closely.

    * Do not breastfeed while taking Accolate.

    * Keep Accolate tablets dry and protected from light and moisture. Store at controlled room temperature.

    * Keep out of reach of children.


**Sources:**

1. RxList - Accolate (Zafirlukast): [https://www.rxlist.com/accolate-drug.htm](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQEbdtDPGsSncL26tWs_J23PFGpPol0f_qgSd7UePfv6hpvJzCaPJOVznOWmoWwwOkY3wFKs5FPXdQc3xqxoFTWZsAah3KZ5ePMo1mBFQdY9KV9wpvFVf3lQyqd4mhszxfTh5w==)

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11. HPRA - PACKAGE LEAFLET: INFORMATION FOR THE USER Accolate: [https://www.hpra.ie/img/uploaded/swedocuments/Licence_PA0822-001-001_28072016104500.pdf](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQHFDFY5IqZPboED0S2_ooRkqrWJMVbELJ4TAd0OliAzt_ztbx_a8ZIDA_N0gKpkkksj1AZ7ZdvqbuuGNAC5JBQrFb2ihzNRhT9xPovlhhJvjBD2ZsWrkFym8f59FaGfPmsJdzzxgDE-nE3_RmaJQrHNN5lXb5Y38ujr2xJ1NMY3q2NXE7UEUYLSMN0rWK9uK5jquBAnoU8LlgrrpU_POhDF8S24aAR1l8Pb_0KgoIbD5mnLkq1MHY4tyNOT3wINnhCxvFNaRaMYjTQeCQ==)

12. 1mg - Acolate Tablet: View Uses, Side Effects, Price and Substitutes: [https://www.1mg.com/drugs/acolate-tablet-66299](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQEHikZ6r5vDE3cbrC3GIV64QtRWqRFvXHuU_V4P8LBpNJmAPfkA3pRlJ5ofo2RHd8t7PO5RG3Dbu4En3Y8c6RJ5ZN2cV0Cvq37j3_EdbOTXL1C4KX6-OvW9uK3IJ8VN1enSkmJhpNxZI4Q=)

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14. 1mg - Accolate 20mg Tablet: View Uses, Side Effects, Price and Substitutes: [https://www.1mg.com/drugs/accolate-20mg-tablet-34202](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQF4MGEtUG-Ig9n_NGvaGIx8S0cw8pNNmXm39JdUupBI4QpG6x6LGr9swFHjEEWiN8XuSmwW-J0wDgVEHnmiuUbgQk_Ql97uqbWeF6iM9LywTOlcUuRYzfJwh1CBUzUiYNMCO-mgfshpBEyS2ioHGPw1)

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18. MedicineNet - zafirlukast (Accolate) for Asthma Side Effects, Dosing, and Uses: [https://www.medicinenet.com/zafirlukast_accolate_for_asthma/article.htm](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQESHCIJW_Yt2ydLJ2-we07j7iN1EJfO-nt16ZTlyyanBUJA9iAd5QHd59u5bTpKbX_GiT4dCt8gxRmWl7ar6TOVfmxs1_AHOGFLt1-QAmmywQi3F5KhaxhqyD1H6RwJpv_gUV3apW7ETkfTwYfx)

19. IndiaMART - Zafirlukast Tablet - Accolate Latest Price, Manufacturers & Suppliers: [https://www.indiamart.com/proddetail/zafirlukast-tablet-20863920991.html](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQHVtGVGwe1MVM6XTFtRzpEago4tKuvqwchm5yHxnI8P6M_JCm0n9z4Zkj0nlJLlXm12cJ_is79p3ZlCW1D_KP2gXi1V5TnYmjCjwgN_fbYyld5cPRl_Qd67ru-R77Kbr-mN-fJzR_3-o3d4NQ==)

20. Camber Pharmaceuticals - Camber Launches Generic Accolate® Tablets: [https://camberpharma.com/news/camber-launches-generic-accolate-tablets/](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQGJ-j3lvfE5lib4jvVZ3at0r0c5fBx85X2bc-kP1ouR_g4Y5IL69RpW2V0tfYy7e_jdAfKBLL0TSPf19m7fTex-gSSvOQWWZrO-2cSS30N6ShmjRtjX6movnkBS3nfKg-T9Vi8Bnto2Rkr4vDF3ZWlqKkcc1wI3BpLhImnQKMe7FA==)

21. Wikipedia - Zafirlukast: [https://en.wikipedia.org/wiki/Zafirlukast](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQE7NpzpujJQT2ZJ4EMCLWHbdlWRpkN-utCWjZ8hgvTs78hf795qu-YsGUsEz6SftWZX357UUfNIx71d0McawBzI-VTUnMuzsBaQaCWLeqV6yf2IzMr5Q_bmIyU7NTyFJmuliW4=)

22. Uniprix - Accolate: [https://www.uniprix.com/en/medication-info/accolate](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQFGikaoHsTtE6rI1TfDAMsM6d3sl5pXfARq0oTGTUhNioX3VPa8N8J7Zdr9ci44FBmTOMj0VVcIAuuRdnictiV88L-PT9MhbIdxmnU9Cmyy5xVP3aydCsBnIHQaVhINa7ojZh8vZlR7CYveFE7eqhW5gmgymA==)

23. Kaiser Permanente - Accolate 10 mg tablet: [https://healthy.kaiserpermanente.org/health-wellness/drug-encyclopedia/drug.zafirlukast-oral](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQF-xzpZAgliMQQDJg8bl2QR7mtsrL1L3Oqp719pQ02NbLVVDjBYqEgWxk0b7k0UmEGfk8RCLNAugPWX2-uHRDYBwRnmSFMMkiUOCdOypx0PMCDJufqTkBO3qYWytCrNoY-J_C_QvnpyAkkkHJoKaT-5cL9lxZZWdNEKppaQtexTTolGnEWfB5eb2-VgCcvYJYfuBVXGmLMM7imbqDmB14UNysM=)

Accofil 30 MIU/0.5ML 5 prefilled syringes

 


**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.


**Drug Name:** Accofil 30 MIU/0.5ML 5 prefilled syringes


**Manufacturer:**

Accofil is manufactured by **Accord Healthcare**.


**Main Commentary Body:**


Accofil is a biosimilar medicine containing the active substance filgrastim. Filgrastim is a recombinant human granulocyte colony-stimulating factor (G-CSF), a protein that stimulates the production, maturation, and activation of neutrophils (a type of white blood cell) in the bone marrow. It is primarily used to increase the number of white blood cells in patients who have low counts due to various medical conditions or treatments.


* **Indications and Usage:**

    Accofil is used to stimulate the production of white blood cells (neutrophils) in several clinical situations:

    * **Chemotherapy-induced neutropenia:** To reduce the duration of neutropenia (low neutrophil count) and the incidence of febrile neutropenia (fever associated with low neutrophils) in patients receiving cytotoxic chemotherapy for non-myeloid malignancies.

    * **Bone marrow transplantation:** To reduce the duration of neutropenia in patients undergoing myeloablative therapy followed by bone marrow transplantation.

    * **Mobilization of peripheral blood progenitor cells (PBPCs):** To mobilize PBPCs into the peripheral blood for collection (apheresis) and subsequent autologous (from the patient) or allogeneic (from a donor) transplantation.

    * **Severe chronic neutropenia (SCN):** For long-term treatment of patients with congenital, cyclic, or idiopathic neutropenia to increase neutrophil counts and reduce the incidence and duration of infection-related events.

    * **HIV infection:** For the treatment of persistent neutropenia in patients with advanced HIV infection to reduce the risk of bacterial infections when other treatments are not appropriate.


* **Characteristics:**

    Filgrastim, the active ingredient in Accofil, is a cytokine that regulates the production and release of functional neutrophils from the bone marrow. It binds to specific receptors on myeloid progenitor cells, stimulating their proliferation, differentiation, and maturation into neutrophils. It also enhances the functional activity of mature neutrophils, such as phagocytosis and chemotaxis.


* **Dosage and Administration:**

    Accofil is administered by subcutaneous injection (under the skin) or by intravenous infusion (into a vein). The prefilled syringes are designed for single use. The dosage and administration schedule depend on the specific indication and the patient's condition.

    * **Subcutaneous Injection:** The preferred route for most indications. Patients may be trained to self-administer after initial instruction.

    * **Intravenous Infusion:** May be used for certain indications, diluted in 5% glucose solution.

    * **Typical Doses (examples, exact dose depends on indication and body weight):**

        * **Chemotherapy-induced neutropenia:** 0.5 MIU (5 micrograms)/kg/day.

        * **Bone marrow transplantation:** 1.0 MIU (10 micrograms)/kg/day.

        * **PBPC mobilization:** 1.0 MIU (10 micrograms)/kg/day (for autologous) or 1.0 MIU (10 micrograms)/kg/day (for donors).

    * **Frequency:** Usually once daily.

    * **Duration:** Treatment continues until the neutrophil count recovers to an acceptable level.


* **Contraindications:**

    Accofil should not be used in individuals with:

    * Hypersensitivity to filgrastim or any of the excipients.

    * Patients with severe congenital neutropenia (Kostmann's syndrome) with cytogenetic abnormalities (as there is a risk of myelodysplastic syndrome/leukemia).


* **Warnings and Precautions:**

    * **Splenic Rupture:** Cases of splenic rupture have been reported, some fatal. Patients reporting left upper abdominal pain or shoulder tip pain should be evaluated for splenic enlargement or rupture.

    * **Acute Respiratory Distress Syndrome (ARDS):** ARDS has been reported. Patients developing fever, lung infiltrates, or respiratory distress should be evaluated and treatment discontinued.

    * **Allergic Reactions:** Allergic reactions, including anaphylaxis, have occurred. Discontinue immediately if a serious allergic reaction occurs.

    * **Sickle Cell Disease:** Use with caution in patients with sickle cell trait or sickle cell disease, as severe sickle cell crises have been reported.

    * **Myelodysplastic Syndrome (MDS) / Acute Myeloid Leukemia (AML):** Use in patients with MDS or AML is not recommended outside of clinical trials due to the potential for G-CSF to promote tumor growth.

    * **Thrombocytopenia:** Platelet counts should be regularly monitored, especially during PBPC mobilization.

    * **Aortitis:** Aortitis (inflammation of the aorta) has been reported.

    * **Capillary Leak Syndrome:** Capillary leak syndrome has been reported, which can be life-threatening.

    * **Immunogenicity:** The potential for immunogenicity (development of antibodies) exists, but is generally low.

    * **Bone Pain:** Bone pain is a common side effect.


* **Nutrient Absorption and Metabolism (Pharmacokinetics):**

    * **Absorption:** Following subcutaneous administration, filgrastim is well absorbed, with peak serum concentrations occurring within 3-5 hours.

    * **Distribution:** The volume of distribution is approximately 150 mL/kg.

    * **Metabolism and Excretion:** Filgrastim is primarily eliminated by renal excretion and degradation by neutrophils. The elimination half-life is approximately 3.5 hours after subcutaneous administration. The half-life can be prolonged in patients with severe renal or hepatic impairment.


* **Side Effects:**

    Like all medicines, Accofil can cause side effects, although not everybody gets them.

    * **Very Common (may affect more than 1 in 10 people):** Bone pain, musculoskeletal pain, nausea, vomiting, fatigue, alopecia (hair loss), increased lactate dehydrogenase (LDH), increased uric acid.

    * **Common (may affect up to 1 in 10 people):** Diarrhea, constipation, headache, decreased appetite, cough, dyspnea (shortness of breath), epistaxis (nosebleed), rash, enlarged spleen, thrombocytopenia (low platelet count), leukocytosis (high white blood cell count), anemia, injection site reactions.

    * **Uncommon (may affect up to 1 in 100 people):** Splenic rupture, ARDS, allergic reactions (including anaphylaxis), sickle cell crisis, Sweet's syndrome (acute febrile neutrophilic dermatosis), vasculitis, aortitis, capillary leak syndrome, liver enzyme abnormalities.

    * **Rare (may affect up to 1 in 1,000 people):** Cutaneous vasculitis, glomerulonephritis.


* **Drug Interactions:**

    No formal drug interaction studies have been performed with Accofil.

    * **Chemotherapy:** Accofil should not be used within 24 hours before or after administration of cytotoxic chemotherapy, as rapidly dividing myeloid cells are sensitive to cytotoxic agents.

    * **Lithium:** Lithium may potentiate the myelostimulatory effect of filgrastim.

    * **Other Haematopoietic Growth Factors:** Avoid concomitant use with other haematopoietic growth factors.


* **Patient Counseling:**

    * Follow your doctor's instructions precisely regarding dosage, administration, and duration of treatment.

    * If you are self-administering, ensure you receive proper training from a healthcare professional.

    * Report any unusual pain, especially in the left upper abdomen or shoulder tip, to your doctor immediately, as this could be a sign of splenic enlargement or rupture.

    * Report any signs of allergic reaction (e.g., rash, itching, swelling, difficulty breathing) immediately.

    * Keep all appointments for blood tests, as regular monitoring of blood counts is essential.

    * Store Accofil in the refrigerator (2°C to 8°C). Do not freeze. Protect from light.

    * Do not shake the syringe vigorously.

    * Do not use if the solution is cloudy, discolored, or contains particles.

    * Keep out of the sight and reach of children.


**Sources:**

1. European Medicines Agency (EMA) - Accofil (Filgrastim) EPAR Product Information: [https://bit.ly/ema-accofil](https://www.ema.europa.eu/en/documents/product-information/accofil-epar-product-information_en.pdf)

2. Medicines.org.uk - Accofil 30 MIU/0.5 ml solution for injection in pre-filled syringe: [https://bit.ly/accofil-uk](https://www.medicines.org.uk/emc/product/5800/smpc)

3. National Cancer Institute - Filgrastim: [https://bit.ly/nci-filgrastim](https://www.cancer.gov/publications/dictionaries/cancer-drug/def/filgrastim)

Accent Cream

 


**Drug Name:** Accent Cream


---


**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product’s internal leaflet or consult a healthcare professional before use.


---


### Manufacturer:

Delta Pharma / Pioneer Pharmaceutical Industries, Egypt 0


---


### Introduction:

Accent Cream is a topical **wound‑healing and skin‑repair** formulation widely used in Egypt. Available in 30 g and 50 g tubes, it’s designed to promote faster healing of superficial and deeper wounds, including minor cuts, abrasions, and post-procedural skin lesions 1.


---


### Indications and Usage:

– Speeding up healing of **minor wounds**, abrasions, and superficial cuts  

– Post-surgical or dermatological procedure care  

– Promoting skin regeneration in chronic skin lesions


---


### Characteristics:

– **Dosage Form:** Semi‑occlusive cream  

– **Primary Function:** Promotes tissue repair — likely contains moisturizing and regenerative agents (specific active ingredients not listed in public sources) 2.


---


### Dosage and Administration:

- **Application:** Apply a thin layer to the clean, dry affected area.

- **Frequency:** 1–2 times daily or as directed by a healthcare provider.

- **Important:** Ensure proper wound hygiene before use.


---


### Contraindications:

- Known hypersensitivity to any cream components.

- Not intended for deep puncture wounds, serious burns, or infected wounds (unless advised by a physician).


---


### Warnings and Precautions:

- For **external use only**; avoid contact with eyes, mouth, and mucous membranes.

- If irritation, swelling, or rash occurs, **discontinue use** and consult a physician.

- Apply only to clean wounds to reduce risk of infection.

- Keep children’s hands off treated areas to avoid ingestion or contamination.


---


### Pharmacokinetics (Topical):

- Works **locally** on the skin; systemic absorption is minimal.

- Eliminated via normal skin turnover; no known systemic metabolism or excretion.


---


### Side Effects:

- **Common:** Mild transient stinging or burning sensation.

- **Rare/Serious:** Allergic contact dermatitis, itching, erythema — discontinue if these occur.


---


### Drug Interactions:

- No clinically significant interactions reported due to minimal systemic absorption.

- Avoid combining with other topical agents unless a physician approves.


---


### Patient Counseling:

- Clean and dry the wound before each application.

- Use for the full recommended duration, even if healing seems fast.

- Store at **room temperature**, away from heat and direct sunlight.

- Keep out of children’s reach and check the expiry date before use.

- Report persistent symptoms, signs of infection (e.g., pus, fever), or allergic reaction to your doctor.


---


### Sources:

- [https://bit.ly/3QZ9JdT](https://bit.ly/3QZ9JdT) – EgyptDwa: Accent Cream 50 g by Delta Pharma with classification as wound‑healing 3  

- [https://bit.ly/3RAVGKu](https://bit.ly/3RAVGKu) – DalilAlDwaa: Accent Cream info and manufacturer details 4  

- *Note:* No international monograph found—use based on local Egyptian pharmaceutical data.

```5

Accelafen 30 F.C. Tab

 .
**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.

**Drug Name:** Accelafen 30 F.C. Tab.

**Manufacturer:**
Based on available information, Accelafen 30 F.C. Tab. is manufactured by **True Pharma** in some regions, particularly in Egypt.

**Main Commentary Body:**

Accelafen 30 F.C. Tab. is a film-coated dietary supplement containing a combination of B vitamins: Vitamin B1 (Thiamine), Vitamin B6 (Pyridoxine), and Vitamin B12 (Cobalamin). This combination is primarily used to support the health of the nervous system, aid in energy metabolism, and contribute to overall well-being.

* **Indications and Usage:**
    Accelafen 30 F.C. Tab. is indicated as a dietary supplement to:
    * Support the normal functioning of the nervous system.
    * Help prevent and treat deficiencies of Vitamin B1, B6, and B12.
    * Aid in energy production and metabolism.
    * Contribute to the formation of red blood cells (Vitamin B12).
    * Support nerve regeneration and reduce symptoms associated with nerve damage (e.g., neuropathy, tingling, numbness) that may be linked to B vitamin deficiencies.

* **Characteristics:**
    This supplement combines three essential B vitamins, each playing a crucial role in the body:
    * **Vitamin B1 (Thiamine):** Essential for carbohydrate metabolism and plays a vital role in nerve function, muscle contraction, and heart function.
    * **Vitamin B6 (Pyridoxine):** Involved in over 100 enzyme reactions, primarily in protein metabolism. It is crucial for brain development and function, and for the production of neurotransmitters.
    * **Vitamin B12 (Cobalamin):** Necessary for red blood cell formation, neurological function, and DNA synthesis. It is particularly important for nerve health and the formation of myelin, the protective sheath around nerves.

* **Dosage and Administration:**
    Accelafen 30 F.C. Tab. is for oral administration. The tablets should be swallowed whole with water.
    * **Adults:** The typical recommended dose is one tablet daily, or as directed by a healthcare professional.
    * It can be taken with or without food.
    * Do not exceed the recommended daily dose unless specifically advised by a physician.

* **Contraindications:**
    Accelafen 30 F.C. Tab. should generally not be used in individuals with:
    * Known hypersensitivity or allergy to any of the active ingredients (Vitamin B1, B6, B12) or any of the excipients.
    * Leber's disease (hereditary optic nerve atrophy), as Vitamin B12 may exacerbate the condition.

* **Warnings and Precautions:**
    * **Masking B12 Deficiency:** High doses of Vitamin B6 can sometimes mask the symptoms of pernicious anemia (a type of Vitamin B12 deficiency), potentially leading to irreversible neurological damage if the underlying B12 deficiency is not diagnosed and treated.
    * **Neuropathy (Vitamin B6):** Prolonged use of very high doses of Vitamin B6 (pyridoxine) can lead to peripheral neuropathy, characterized by numbness and tingling in the extremities. Adhere strictly to recommended doses.
    * **Pregnancy and Breastfeeding:** While B vitamins are essential during pregnancy and breastfeeding, consult a healthcare professional before taking any supplements to ensure appropriate dosage and safety.
    * **Underlying Conditions:** Individuals with specific medical conditions (e.g., kidney disease, liver disease) should consult their doctor before taking B vitamin supplements.

* **Nutrient Absorption and Metabolism:**
    * **Absorption:** B vitamins are water-soluble, meaning they are generally well-absorbed from the gastrointestinal tract. Vitamin B12 absorption is complex and requires intrinsic factor, a protein produced in the stomach.
    * **Metabolism:** Once absorbed, B vitamins are converted into their active coenzyme forms, which then participate in various metabolic pathways throughout the body, including energy production, amino acid metabolism, and nucleic acid synthesis.
    * **Excretion:** Since they are water-soluble, excess B vitamins (that are not stored or used by the body) are primarily excreted in the urine. This means regular intake is necessary to maintain adequate levels.

* **Side Effects:**
    B vitamin supplements are generally well-tolerated. However, some individuals may experience mild side effects, especially with higher doses:
    * **Common:**
        * Mild gastrointestinal upset (e.g., nausea, stomach discomfort, diarrhea).
        * Unusual urine odor or bright yellow urine (due to riboflavin, often present in B-complex supplements, though not explicitly listed for Accelafen, it's a common B vitamin effect).
    * **Less Common/Rare (often associated with very high doses or prolonged use):**
        * Peripheral neuropathy (with very high doses of Vitamin B6).
        * Allergic reactions (e.g., rash, itching, swelling) in sensitive individuals.

* **Drug Interactions:**
    While B vitamins generally have few significant drug interactions at recommended doses, some medications can affect B vitamin levels or interact with them:
    * **Certain Antibiotics (e.g., Isoniazid):** Can interfere with Vitamin B6 metabolism.
    * **Levodopa:** High doses of Vitamin B6 can reduce the effectiveness of Levodopa (used for Parkinson's disease), though this interaction is less common with newer formulations of Levodopa that include a decarboxylase inhibitor.
    * **Anticonvulsants:** Some anti-seizure medications can affect B vitamin levels.
    * **Diuretics:** Some diuretics can increase the excretion of B vitamins.
    * **Metformin:** Can reduce Vitamin B12 absorption.

* **Patient Counseling:**
    * Take Accelafen 30 F.C. Tab. as directed by your healthcare professional or as indicated on the packaging.
    * Do not exceed the recommended dose.
    * If you experience any unusual or severe side effects, discontinue use and consult your doctor.
    * Inform your doctor or pharmacist about all other medications, supplements, and herbal remedies you are taking.
    * Store the tablets in a cool, dry place, away from direct sunlight and moisture, and out of reach of children.
    * Remember that supplements are not a substitute for a balanced diet.

**Sources:**
1. Al-Abdellatif Eltarshouby Pharmacy - Accelafen 30 Film Coated Tablets: [https://bit.ly/accelafen-b12](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQG9eDb_k2vmzl7C3-ZpTWBGLR-n73hG53i-t3L2WSBQbvCGC3Y9H4p_CueUDmL9V7O7Nzgdzfs3-_PWgSCvDBtB2GUvOvdN1T8V2k_uUKUkl7WC7Rxy3rzCkuoanJtfdef8kzXv2s6qMk02rqN8ONpuo9RN1m5KSXPFZAG2XKh7iv_QuYpjq1qaSiU8gC7AQMT44qo)
2. دليل دواء مصر - Accelafen 30 f.c.tabs.: [https://bit.ly/accelafen-egypt](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQEvqsUiAAzyBrpL8XgahkyJxX3oE4_mQaAAw1qceRt2qRKFpFMGLvhlWCLT7iWMcc8Ns9Cs362bVV6DDdEwWrAQNqgfjA_puAbNuTC8NsIbN8lX73RCahFg5SBBab0WM0I)
3. MedlinePlus - B Vitamins: [https://bit.ly/medlineplus-b-vitamins](https://medlineplus.gov/bvitamins.html)
4. Mayo Clinic - Vitamin B6: [https://bit.ly/mayoclinic-b6](https://www.mayoclinic.org/drugs-supplements/vitamin-b6/side-effects/drg-20066517)
5. National Institutes of Health (NIH) - Vitamin B12: [https://bit.ly/nih-b12](https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/) 

Acc long 600 mg Effervescent tablets



**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.


**Drug Name:** ACC Long 600 mg effervescent tablets


**Manufacturer:**

ACC Long 600 mg effervescent tablets are primarily manufactured by Sandoz, a company belonging to HEXAL AG.


**Main Commentary Body:**


ACC Long 600 mg effervescent tablets contain acetylcysteine, a mucolytic agent used to thin and loosen viscous mucus in the airways. This action helps to facilitate the clearance of phlegm, making it easier to cough up and relieve congestion associated with various respiratory conditions.


* **Indications and Usage:**

    ACC Long 600 mg effervescent tablets are indicated for the secretolytic therapy of acute and chronic bronchopulmonary diseases that are accompanied by impaired formation and transport of mucus. This includes conditions such as cold-induced bronchitis in adolescents over 14 years of age and adults.


* **Characteristics:**

    The active substance in ACC Long is acetylcysteine, which belongs to a group of medicines called mucolytics. Acetylcysteine works by breaking down the disulfide bonds within the mucopolysaccharide chains in mucus, thereby reducing its viscosity and making it less sticky. This depolymerizing effect helps to liquefy the phlegm, allowing for easier expectoration. Additionally, acetylcysteine has antioxidant properties and contributes to the synthesis of glutathione, which is important for detoxification processes in the body.


* **Dosage and Administration:**

    ACC Long 600 mg effervescent tablets are for oral administration. The tablets should be dissolved completely in a glass of drinking water and consumed immediately after meals.

    * **Adults and adolescents from 14 years of age:** The usual dose is half an effervescent tablet twice daily or one effervescent tablet once daily, equivalent to 600 mg of acetylcysteine per day.

    * **Duration of Use:** ACC Long should not be taken for more than 14 days without medical advice. If symptoms worsen or do not improve after 4-5 days, a doctor should be consulted.

    * **Children:** Due to the high content of the active substance, ACC Long 600 mg is generally not recommended for children under 14 years of age. Lower doses or different formulations are available for younger children.


* **Contraindications:**

    ACC Long 600 mg effervescent tablets should not be used in individuals with:

    * Hypersensitivity or allergy to acetylcysteine or any of the other ingredients.

    * Active peptic ulceration or a history of stomach ulcers.

    * Children under 2 years of age, as mucolytics can lead to airway blockage in this age group due to their limited ability to cough up mucus.


* **Warnings and Precautions:**

    * **Asthma:** Use with caution in asthmatic patients, as acetylcysteine can induce bronchospasm. If bronchospasm occurs, discontinue use immediately and seek medical attention.

    * **Gastrointestinal Issues:** Caution is advised in patients with a history of stomach ulcers, as there is a theoretical risk that mucolytics may disrupt the gastric mucosal barrier.

    * **Histamine Intolerance:** Prolonged treatment should be avoided in patients with histamine intolerance, as acetylcysteine affects histamine metabolism and may cause symptoms like headache, runny nose, or itching.

    * **Sugar Content:** The effervescent tablets contain lactose and sorbitol. Patients with rare hereditary conditions of lactose/fructose or galactose intolerance should not take this medicine. It may also affect blood sugar control in diabetic patients.

    * **Sodium Content:** The tablets contain sodium, which should be considered by patients on a controlled sodium diet or those with kidney disease.

    * **Increased Secretions:** At the beginning of treatment, the thick phlegm may become more fluid, and its volume may increase. If unable to efficiently cough up this fluid, medical consultation is necessary.

    * **Pregnancy and Breastfeeding:** Use during pregnancy and breastfeeding is generally not recommended due to limited data and should only be considered if clearly necessary and advised by a healthcare professional.

    * **Severe Skin Reactions:** Very rare cases of severe skin reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported. If new skin or mucosal changes occur, discontinue use and seek immediate medical advice.


* **Nutrient Absorption and Metabolism (Pharmacokinetics):**

    Following oral administration, acetylcysteine is rapidly and almost completely absorbed. It is then metabolized in the liver to cysteine, which is the pharmacologically active metabolite, as well as other disulfides. Due to a significant first-pass effect, the oral bioavailability of acetylcysteine is relatively low (approximately 10%). Maximum plasma concentrations are typically achieved within 1-3 hours. The mean terminal half-life in adults is about 5.6 hours. Acetylcysteine is largely protein-bound (66-97%), mainly to albumin. It is primarily eliminated via the urine, with a small portion recovered in feces.


* **Side Effects:**

    Like all medicines, ACC Long can cause side effects, although not everybody gets them.

    * **Common (may affect up to 1 in 10 people):** Nausea, vomiting, diarrhea, abdominal pain, stomatitis (inflammation of the mouth).

    * **Uncommon (may affect up to 1 in 100 people):** Hypersensitivity reactions (e.g., rash, itching, urticaria, angioedema), headache, fever, hypotension (low blood pressure).

    * **Rare (may affect up to 1 in 1,000 people):** Dyspnea (difficulty breathing), bronchospasm (tightening of airways).

    * **Very Rare (may affect up to 1 in 10,000 people):** Severe skin reactions (e.g., Stevens-Johnson syndrome, Lyell's syndrome), severe allergic reactions (anaphylactic shock), bleeding.


* **Drug Interactions:**

    * **Cough Suppressants:** Combined use with cough-relieving agents (antitussives) is not recommended, as it may lead to a dangerous accumulation of secretions due to the reduced cough reflex.

    * **Nitroglycerin:** Acetylcysteine may enhance the vasodilatory effects of nitroglycerin, potentially leading to significant hypotension and headaches.

    * **Activated Charcoal:** High doses of activated charcoal (used as an antidote) can reduce the effectiveness of acetylcysteine by decreasing its absorption.

    * **Antibiotics:** It is advisable to take antibiotics at least two hours before or after ACC Long, as acetylcysteine can affect the efficacy of some antibiotics.

    * **Other Medications:** Do not dissolve ACC Long effervescent tablets simultaneously with other medications in the same glass of water.


* **Patient Counseling:**

    * Always dissolve the effervescent tablet completely in a glass of water before taking it.

    * Take the medicine after meals.

    * Do not exceed the recommended daily dose, as this can lead to gastrointestinal irritation.

    * If symptoms persist or worsen after 4-5 days, or if you experience any severe side effects, consult your doctor or pharmacist immediately.

    * Inform your healthcare provider about all other medications, supplements, or herbal remedies you are taking to avoid potential interactions.

    * Store the tablets in a dry place below 25°C and keep them out of reach of children.


**Sources:**

1. Sandoz Patient Information Leaflet ACC® 600 (effervescent tablets): [https://bit.ly/acc600pil](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQFvxnDF-sVFmnPuOY7ZqabJkly14VmoLgyoAfC9q1KZPSGscPzeTfEfKH1uRzgwgcqJZiHnA9B8aN-pks9vZLYT38NXp2zC4B1AVaE5KYavlF0R4ASJnfDlUwpZ0BEzxeRu9yOQpzUTn7rDa96uL17IczsWWXYXRuf0t9M46CrDO4BaW2CvAWrfzYm2QUakq7cP_v_msZg=)

2. MIMS Philippines - ACC: Dosages and Ingredients: [https://bit.ly/mimsacc](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQETf7EFVmi8ZiYZx0nbtdm1JjO3MU3zea5kj8de7r2gda0A5PG88LsCGbheWCS4N-wwUxu5k40CwgLhPUw7URhNDFtr5yXHwbnOQsx1PBDd8U77GNBgA4tUj7TP60mvqbMWj0s4Mz7K8MmHMefh5r7PJ5o=)

3. Sandoz - ACC® 600 (effervescent tablets) PIL (South Africa): [https://bit.ly/acc600sandoz](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQHEdUcjtmY1EukqCt3RYdnZo4v8WxX_YucdpRWuQCWPp86Dell5S7f4US11_ZhrndEzZ5a0CsPZ5qslHKUCA8eppm2KovcGE-3iYLS7D4W6vUf6js6mh9Xs8NMlxC1y_LNnGXKt_L0Z4hR8j_BEHd3AoG0YjqakFcxt7JP7EHzyYBzZCMDrOeGBIdR1NmaMIBlKfTE=)

4. Nahdi - ACC Long 600mg Effervescent Tablets: [https://bit.ly/nahdiacclong](https://vertexaisearch.cloud.google.com/grounding-api-redirect/AUZIYQEXeVr-GQhl--Mkmat43XJWsbKZh94jnJG3ZknUJx2WyfBao2diSyVIoZM428-g1cynWQ4j0i_1aS3wvyBBQCM8yG9jvvKHzEDsPwIUT9-c82hs3r3qF2YlMqT4LSroEmeSz5S5tnkx4XHRNlDSJWXLihn6Dfkg0ud7lp8Wl1TX3lD0XTAIMu4sGDny4goNrs0HSRg=)

Acc 200 mg sachets

**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.


**Drug Name:** ACC 200 mg sachets


**Manufacturer:**

ACC 200 mg sachets are primarily manufactured by Sandoz, a global pharmaceutical company. Other manufacturers may also produce generic versions of acetylcysteine in sachet form. Always refer to the product packaging for the specific manufacturer details.


**Main Commentary Body:**

ACC 200 mg sachets contain Acetylcysteine, a mucolytic agent used to thin and loosen mucus in the respiratory tract. This facilitates easier expectoration and helps relieve symptoms associated with various respiratory conditions characterized by thick, viscous mucus. It is commonly used in both acute and chronic bronchopulmonary diseases.


**Indications and Usage:**

ACC 200 mg sachets are indicated for the liquefaction of bronchial secretions and to facilitate expectoration in diseases of the respiratory system associated with the formation of very viscous mucus. These conditions include:

* Acute and chronic bronchitis

* Cystic fibrosis

* Bronchiectasis

* Emphysema

* Other bronchopulmonary diseases with thick mucus

It is also used as an antidote for paracetamol (acetaminophen) overdose, though this commentary focuses on its mucolytic use.


**Characteristics:**

Acetylcysteine, the active ingredient in ACC 200 mg sachets, is a derivative of the amino acid cysteine. Its mucolytic action is attributed to its ability to break down disulfide bonds in mucoproteins, thereby reducing the viscosity of mucus. This makes the mucus thinner and easier to clear from the airways. Acetylcysteine also possesses antioxidant properties, which may contribute to its therapeutic effects in respiratory diseases.


**Dosage and Administration:**

ACC 200 mg sachets are for oral administration. The contents of one sachet should be dissolved in a small amount of water and taken immediately after dissolution. The typical dosage is as follows:

* **Adults and adolescents (14 years and older):** 200 mg (1 sachet) two to three times daily, or 600 mg (3 sachets of 200 mg or 1 sachet of 600 mg if available) once daily. The maximum recommended daily dose is 600 mg.

* **Children (6 to 14 years):** 200 mg (1 sachet) two times daily (corresponding to 400 mg of acetylcysteine per day).

* **Children (2 to 5 years):** 100 mg (half a sachet) two to three times daily (corresponding to 200-300 mg of acetylcysteine per day). Use in children under 2 years should be under medical supervision.


**Contraindications:**

ACC 200 mg sachets should not be used in individuals with:

* Hypersensitivity to acetylcysteine or any of the excipients.

* Active peptic ulcer disease (due to the potential for increased risk of gastrointestinal bleeding).

* Children under 2 years of age for mucolytic use, unless specifically directed and monitored by a physician.


**Warnings and Precautions:**

* **Asthma:** Patients with asthma should be closely monitored during treatment with acetylcysteine due to the risk of bronchospasm. If bronchospasm occurs, treatment should be discontinued immediately.

* **Gastric Ulcers:** Caution is advised in patients with a history of gastric or duodenal ulcers.

* **Cough Reflex Suppression:** Concomitant use with antitussives (cough suppressants) is not recommended, as this may lead to a dangerous accumulation of mucus due to suppressed cough reflex.

* **Sulfur Odor:** Acetylcysteine may have a slight sulfur odor, which is normal and does not indicate product degradation.

* **Pregnancy and Lactation:** Consult a healthcare professional before use during pregnancy or breastfeeding.


**Nutrient Absorption and Metabolism:**

Following oral administration, acetylcysteine is rapidly and almost completely absorbed from the gastrointestinal tract. It undergoes extensive first-pass metabolism in the liver, where it is deacetylated to cysteine and then further metabolized. Peak plasma concentrations are typically achieved within 1 to 2 hours after a 200-400 mg oral dose. Acetylcysteine and its metabolites are primarily excreted via the kidneys. The elimination half-life is approximately 5.6 hours in adults.


**Side Effects:**

Common side effects of ACC 200 mg sachets are generally mild and may include:

* Nausea

* Vomiting

* Diarrhea

* Abdominal pain

* Heartburn

* Headache

* Tinnitus (ringing in the ears)


Less common or rare but serious side effects can include:

* Allergic reactions (e.g., rash, itching, hives, bronchospasm, angioedema)

* Anaphylactoid reactions

* Severe skin reactions (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis)

If any severe or persistent side effects occur, discontinue use and seek immediate medical attention.


**Drug Interactions:**

* **Antitussives:** Concomitant use with cough suppressants may lead to mucus accumulation.

* **Antibiotics:** Acetylcysteine may reduce the efficacy of certain antibiotics (e.g., tetracyclines, aminoglycosides). It is advisable to administer antibiotics at least 2 hours before or after acetylcysteine.

* **Nitroglycerin:** Concomitant administration of acetylcysteine with nitroglycerin may potentiate the vasodilating and antiplatelet effects of nitroglycerin.


**Patient Counseling:**

* Dissolve the contents of the sachet completely in a glass of water before drinking.

* Do not exceed the recommended dose. Overdosing can lead to serious side effects.

* If symptoms do not improve or worsen after 4-5 days, consult a doctor.

* Inform your doctor or pharmacist about all other medications, supplements, and herbal products you are taking.

* If you experience any signs of an allergic reaction or difficulty breathing, stop taking the medication and seek immediate medical help.

* Keep out of reach of children.

* Store in a cool, dry place, away from direct sunlight.


**Sources:**

* [bit.ly/acc200_sandoz](https://www.acc-1.com/me-en/home/)

* [bit.ly/acetylcysteine_pil](https://www.medicines.org.uk/emc/product/2488/pil)

* [bit.ly/acetylcysteine_drugbank](https://go.drugbank.com/drugs/DB06151) 



Acavio Massage Gel


**Important Disclaimer:** This summary is for educational and informational purposes only and should not, under any circumstances, replace direct consultation with a qualified physician or pharmacist. Always refer to the product's internal leaflet or consult a healthcare professional before use.


**Drug Name:** Acavio Massage Gel


**Manufacturer:**

Based on available information, Acavio Massage Gel is associated with Alaa Pharma. It's important to note that specific manufacturers for topical gels can vary by region and product line. Always refer to the product packaging for precise manufacturer details.


**Main Commentary Body:**

Acavio Massage Gel is a topical preparation designed for external use, primarily for massage and localized relief. It typically contains active ingredients such as camphor, menthol crystals, and eucalyptus, which are known for their counter-irritant and analgesic properties. This gel aims to provide a soothing and warming or cooling sensation, often used to alleviate muscle discomfort, minor aches, and promote relaxation during massage.


**Indications and Usage:**

Acavio Massage Gel is typically indicated for the temporary relief of minor aches and pains of muscles and joints associated with:

* Simple backache

* Arthritis

* Strains

* Bruises

* Sprains

It is also used to facilitate massage, providing a soothing sensation that can aid in muscle relaxation and comfort.


**Characteristics:**

Acavio Massage Gel is a topical preparation formulated with active ingredients such as camphor, menthol crystals, and eucalyptus. These ingredients are commonly used in topical analgesics and counter-irritants. Camphor and menthol provide a cooling sensation followed by a warming effect, which helps to distract from pain and increase blood flow to the applied area. Eucalyptus oil is often included for its aromatic properties and perceived soothing effects. The gel base allows for easy application and spread during massage, facilitating absorption of the active components into the superficial layers of the skin.


**Dosage and Administration:**

Acavio Massage Gel is for external use only. The typical dosage and administration involves:

* **Form:** Gel for topical application.

* **Recommended Use:** Apply a small amount of gel to the affected area.

* **Administration Method:** Gently massage the gel into the skin until it is fully absorbed.

* **Frequency:** Use as needed, typically 2-3 times daily, or as directed by a healthcare professional. Always wash hands thoroughly before and after application.


**Contraindications:**

Acavio Massage Gel should not be used in the following situations:

* Hypersensitivity or allergy to any of the ingredients (e.g., camphor, menthol, eucalyptus, or other excipients).

* On broken, irritated, or damaged skin, open wounds, or mucous membranes.

* Near the eyes or other sensitive areas.

* In children under a certain age (specific age may vary by product, but generally not recommended for infants or very young children due to camphor/menthol content).


**Warnings and Precautions:**

* For external use only. Do not ingest.

* Avoid contact with eyes, mucous membranes, and sensitive areas. If contact occurs, rinse thoroughly with water.

* Do not apply to wounds or damaged skin.

* Discontinue use if excessive irritation, redness, or rash develops.

* Keep out of reach of children. In case of accidental ingestion, seek professional assistance or contact a Poison Control Center immediately.

* Consult a doctor before use if you have sensitive skin or any pre-existing medical conditions.

* Do not bandage tightly or use with a heating pad.


**Nutrient Absorption and Metabolism:**

As a topical massage gel, Acavio Massage Gel's active ingredients (such as camphor, menthol, and eucalyptus) are primarily absorbed percutaneously (through the skin). The extent of absorption can vary depending on factors like the concentration of ingredients, the area of application, skin integrity, and duration of contact. Once absorbed, these compounds are metabolized by the liver and subsequently excreted, primarily via the kidneys. Systemic absorption is generally minimal when used as directed, reducing the likelihood of widespread systemic effects compared to orally administered drugs.


**Side Effects:**

When used as directed, Acavio Massage Gel is generally well-tolerated. However, some individuals may experience side effects, which are usually mild and localized:

* Skin irritation, redness, or rash at the application site.

* Burning or stinging sensation.

* Allergic reactions (rare), such as itching, hives, or swelling.

If any severe or persistent side effects occur, discontinue use and consult a healthcare professional.


**Drug Interactions:**

Due to its topical application and minimal systemic absorption, Acavio Massage Gel is generally considered to have a low risk of significant drug interactions with orally administered medications. However, caution should be exercised when using it concurrently with other topical products on the same area, as this could potentially alter absorption or increase the risk of local skin irritation. Always inform your healthcare provider about all medications and topical products you are using.


**Patient Counseling:**

* Read the label and package insert carefully before use.

* Use only as directed. Do not exceed recommended frequency or duration of use.

* Apply only to intact skin. Do not apply to open wounds, cuts, or irritated skin.

* Avoid contact with eyes and mucous membranes. If accidental contact occurs, rinse thoroughly with water.

* Wash hands thoroughly after each application.

* Keep out of reach of children and pets.

* Store at room temperature, away from direct sunlight and heat.

* If symptoms persist for more than 7 days, worsen, or if new symptoms appear, consult a healthcare professional.

* If you experience any signs of an allergic reaction (e.g., rash, itching, swelling), discontinue use immediately and seek medical attention.


**Sources:**

* [bit.ly/camphor_info](https://www.medicalnewstoday.com/articles/camphor-oil)

* [bit.ly/menthol_info](https://www.webmd.com/drugs/2/drug-2243/cool-hot-topical/details)

* [bit.ly/eucalyptus_info](https://www.healthline.com/health/9-ways-eucalyptus-oil-can-hel

p)