ANTROLIN International nonproprietary name No Dosage form Rectal cream 30 g Compound 100 g of cream contain active substances Nifedipine  0.3 g Lidocaine hydrochloride   1.5 g White paraffin, propylene glycol, medium chain triglycerides, macrogol stearate, cetostearyl alcohol, glyceryl monostearate, sodium methyl parahydroxybenzoate, propyl parahydroxybenzoate, purified water. Description Homogeneous yellow cream with a slight characteristic odor. Pharmacotherapeutic group Other antihemorrhoidal drugs for topical use. ATX code C05AX Pharmacological properties Pharmacokinetics The pharmacokinetic properties of ANTROLIN cream for rectal use were studied in healthy volunteers. Determination of active substances in the blood using an analytical method had negative results; Nifedipine was not detected in the blood serum In addition, only minimal traces of lidocaine were detected in 2 of 12 patients. These low concentrations are, however, well below those that are therapeutically effective following systemic administration. Therefore, the systemic effect of ANTROLIN cream as a result of absorption of active substances is excluded. To further confirm this, no adverse reactions caused by systemic absorption of the two active ingredients in the anorectal mucosa were observed during clinical studies. Lidocaine The absorption and bioavailability of lidocaine after rectal administration of the cream and suppository is about 30 and 24%, respectively. T1/2 of lidocaine from blood plasma is 1-2 hours. In the human body, lidocaine is metabolized by oxidative N-dealkylation, hydrolysis of the amide bond and hydroxylation of the aromatic ring with the formation of 4-hydroxy-2,6-xylidine, which is the main metabolite, and with 70% of the drug is excreted in the urine as this metabolite.   Pharmacodynamics The mechanism of action of ANTROLIN cream for rectal use is of the synthetic type. Nifedipine, a dihydropyridine with calcium channel blocker activity, when applied topically, has a relaxing effect on peripheral smooth muscle. Nifedipine acts by reducing hypertonicity of the anal sphincter. Nifedipine acts together with lidocaine, a local anesthetic, which is also included in the drug. Lidocaine Lidocaine is a local anesthetic: pain relief is achieved by suppressing the formation and conduction of nerve impulses along afferent nerve fibers by depolarizing sodium channels. Indications for use - treatment of anal fissures and proctological diseases associated with hypertonicity of the anal sphincter. Directions for use and doses For endorectal and perianal use. Apply the cream twice daily for at least three weeks.   Method of administration Lie on your left side, remove the cap from the tube and secure the cannula, squeeze out a small amount of cream to lubricate the cannula and insert it into the anus. Press the tube to squeeze out approximately one centimeter of cream (one centimeter contains approximately 2.5-3 g of cream).   Contraindications - hypersensitivity to the active substances, in particular to lidocaine (and other local anesthetics of the amide type) or to any other excipients in the composition of the drug - suspected or confirmed pregnancy and breastfeeding - severe hypotension and heart failure - children and adolescents under 18 years of age (due to the lack of efficacy and safety data)     Special instructions Treatment with ANTROLIN rectal cream may cause the effect of antihypertensive drugs due to the presence of nifedipine. Propanol prolongs the plasma half-life of lidocaine and increases plasma levels of nifedipine. Cimetidine may increase plasma levels of nifedipine and lidocaine. Concomitant use of ANTROLIN rectal cream in patients taking digoxin may result in increased plasma digoxin levels. Pregnancy and lactation Nifedipine and lidocaine cross the placental barrier and enter breast milk. Studies in rats and rabbits have shown that nifedipine may be teratogenic. Lidocaine has not been shown to pose any risk to the fetus. However, this drug is not recommended for pregnant and lactating women. Features of the effect of the drug on the ability to drive vehicles or potentially dangerous mechanisms Nifedipine, when taken orally with alcohol, may adversely affect the ability to react. ANTROLIN cream for rectal use is intended for topical use and acts locally. There is no reason to believe that this drug may affect the ability to control machinery. Treatment: in case of accidental ingestion, gastrointestinal lavage is recommended, as well as symptomatic supportive therapy. Release form and packaging 30 g of the drug in an aluminum tube, sealed with a cap. One tube, along with a cannula and instructions for use in the state and Russian languages, is placed in a cardboard box. Storage conditions In a dry place, protected from light, at a temperature not exceeding 25 ° C. Keep out of the reach of children! Shelf life 3 years After opening: 30 days Do not use after the expiration date indicated on the package. Conditions for dispensing from pharmacies On prescription Manufacturer New.Fa.Dem. S.r.l. Viale Ferrovie dello Stato Zona A.S.I., Giugliano in Campania (NA), Italy. Registration Certificate Holder New.Fa.Dem. S.r.l. Viale Ferrovie dello Stato Zona A.S.I., Giugliano in Campania (NA), Italy.      

INSTRUCTIONS FOR USE OF THE MEDICINE International nonproprietary name: Ampicillin/ Sulbactam Ingredients: ampicillin/sulbactam. Active ingredient: each bottle contains ampicillin sodium/sulbactam sodium in a ratio of 500 mg/250 mg or 1000 mg/500 mg. Excipient: Description: white powder and solvent in an ampoule for the preparation of a solution for intramuscular and intravenous injections in a glass bottle, sterile pyrogen preparation. Pharmacotherapeutic group: Beta-lactamase inhibitor and combination drug of a broad-spectrum penicillin antibiotic. ATS code: JO1CR01 Pharmacological properties: Pharmacodynamics: Semi-synthetic broad-spectrum ampicillin, a derivative of 6-aminopenicillic acid, has a bactericidal effect on gram(+) and gram(-) aerobes, as well as anaerobes. Ampicillin has a bactericidal effect due to inhibition of the mucopeptide layer of the microbial cell. Ampicillin is not resistant to the action of β-lactamases, therefore it is broken down by some microbes that secrete β-lactamases and loses its effect. Sulbactam does not have a bactericidal effect, inhibits the enzyme β-lactamase and enhances the effect of ampicillin on resistant strains. Ampicillin/sulbactam in vitro β-lactamase-secreting and non-secreting Staphylococcus aureus, Staphylococcus faecalis, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, Haemophilus influenzae, Haemophilus parainfluenzae, Neisseria meningitidis, Branhamella catarrhalis, Escherichia coli, K lebsiella s. , Neisseria gonorrhoeae, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Morganella morgani, Citobacter spp. Enterobacter spp., Clostridium spp., non-spore-forming anaerobes, for example, has a high bactericidal effect against microorganisms such as Peptococcus spp., Bacteroides spp., as well as Bacteroides fragilis. Gram-positive bacteria that secrete penicillinase are resistant to ampicillin/sulbactam. Pharmacokinetics: Penetrates into most tissues and body fluids; With inflammation, the permeability of the cerebrospinal fluid to the cerebrospinal fluid increases. Ampicillin and sulbactam accumulate in the blood in high concentrations after intravenous and intravenous administration. 28% of ampicillin and 38% of sulbactam are bound to blood proteins. T1/2 is 1 hour. 70-80% is excreted unchanged by the kidneys, as well as with bile and breast milk. Sulbactam undergoes almost no metabolic changes, is excreted by the kidneys and only 25% in the form of metabolites. ndications for use: - In the treatment of diseases caused by microorganisms sensitive to ampicillin/sulbactam: - infections of the skin and soft tissues (staphylo-streptoderma); - infections of the bones and musculoskeletal system; - Intra-abdominal infections (cholecystitis, pancreatitis, etc.) - gynecological infections (salpingoophoritis, endometritis, inflammatory cysts); - infections present during pregnancy (amnionitis and chorionitis, turbidity of amniotic fluid); - Pyelonephritis during pregnancy; - respiratory tract infections (laryngitis, pharyngitis, tracheitis, pneumonia); - infections of the urinary system (pyelonephritis, cystitis); - bacterial sepsisemia; - gonococcal infections; - Used to prevent infection of surgical operations, as well as to prevent sepsis after abortion and cesarean section. Contraindications: - cases of allergies to ampicillin, sulbactam and other beta-lactam antibiotics; - Infectious mononucleosis, lymphocytic leukemia; - Severe renal and liver failure. Special instructions and precautions: Hypersensitivity reactions may occur during treatment with ampicillin/sulbactam. If an allergic reaction is observed, the use of the drug is stopped, and in such cases antihistamines and corticosteroids are used. Despite the fact that penicillins do not have a toxic effect, during long-term treatment it is necessary to monitor the function of vital organs (kidneys, liver, hemolytic system). interaction with other drugs: The risk of skin reactions increases when taken together with allopurinol. The combined use of ampicillin with aminoglycosides significantly reduces the effect of both drugs. Penicillins enhance the effect of anticoagulants due to their effect on platelet aggregation and hemocoagulation parameters. When used together with oral contraceptives and estrogen-containing drugs, the effectiveness of these drugs is reduced and can lead to unplanned pregnancy. Ampicillin may increase the toxicity of methotrexate by reducing its clearance. Probenecid may reduce the renal clearance of ampicillin and sulbactam, increase ampicillin serum concentrations and increase the risk of intoxication. Use during pregnancy and lactation: Bactocide is used with caution during pregnancy and lactation. The use of the drug is possible only in cases where it is absolutely necessary. Impact on the ability to drive a vehicle and other potentially dangerous mechanisms: Does not affect. Directions for use and dosage: Adults: daily dose ranges from 1.5 g (1 g ampicillin/0.5 g sulbactam) to 12 g (8 g ampicillin/4 g sulbactam). The maximum daily dose of Sulbactam is 4 g. Depending on the severity of the disease, the drug is administered every 6-8 hours. For moderate infections, the drug is used every 12 hours. In renal failure, the excretion of ampicillin and sulbactam is altered, but plasma levels remain unchanged. In such cases, the following scheme is used:   After the temperature normalizes, treatment should be continued for 48 hours. Typically, treatment is carried out for 5-14 days, but in case of severe disease, the treatment period is extended. In order to prevent infection of a surgical operation, 1.5-3 g is administered every 6-8 hours for 24 hours during anesthesia to create a high concentration of the drug in the tissues. If used with an aminoglycoside, the two drugs should be prepared separately and administered to different parts of the body. Children and infants: the daily dose is 150 mg/kg every 6-8 hours; for premature babies and newborns - 150 mg/kg every 12 hours. After dissolution, the drug is injected into the deep muscle layer; the solution should be used within 1 hour after preparation. Bactoside powder is dissolved in a solution of lidocaine hydrochloride for intramuscular injection and in sterile water for intravenous injection. From the gastrointestinal tract: darkening of the upper surface of the tongue, gastritis, diarrhea, enterocolitis, pseudomembranous colitis, nausea, vomiting; From the skin and soft tissues: skin rash, itching, erythema multiforme, urticaria; From the hematopoietic system: agranulocytosis, hematocrit, decrease in the number of erythrocytes, leukocytes or increase in lymphocytes, eosinophils, platelets. These changes are transient, and blood counts return to normal after stopping the drug. According to laboratory indicators: increased activity of ALT and AST, increased LDH, hyperbilirubinemia; Rarely: convulsions, interstitial nephritis. If unexpected effects occur, consult your doctor! Overdose: Because beta-lactam antibiotics accumulate in high concentrations in the cerebrospinal fluid, neurological reactions, including seizures, may occur. Release form: BACTOSID is packaged in a cardboard box with an insert containing

BIOZYME capsules Compound: Tzyme™ Gut Blend: 442 mg: Lactobacillus plantarum 3 x 109. CFU; Lactobacillus sporogenes 3.8 x 108 CFU; Lactobacillus salivarius 3 x 108 CFU; Bifidumbacterium longum 2 x 108 CFU; Lactobacillus casei 2.25 x 108 CFU; Lactobacillus acidophilus 1 x 109. CFU; Jerusalem artichoke (tuber) 20 mg; Lactoferrin 10 mg. Pharmacological properties: BIOZYM is a natural preparation containing 6 strains of probiotic lactic acid bacteria that restore, maintain and regulate the physiological balance of intestinal microflora: create unfavorable conditions for the reproduction and activity of pathogenic microorganisms. Bifidobacteria and lactobacilli form bacteriocins, which have an antibacterial effect against pathogenic and opportunistic flora and inhibit the growth of tumor cells. BIOZYM bacteria accelerate the breakdown of proteins and carbohydrates in food, stimulate intestinal motility, and are excellent immunomodulators: they activate the synthesis of immunoglobulins, interferon and cytokines. They participate in the synthesis and absorption of vitamin K, B vitamins, folic and nicotinic acids, promote the synthesis of essential amino acids, better absorption of calcium and vitamin D. Lactobacilli produce a number of hydrolytic enzymes, in particular lactase, which breaks down lactose and prevents the development of lactase deficiency. Jerusalem artichoke extract (Jerusalem artichoke) contains up to 77% of the prebiotic inulin. Inulin is a nutrient for beneficial bacteria, promotes their increased reproduction and distribution in the intestines. Lactoferrin is a key factor in innate immunity against pathogenic microorganisms. Lactoferrin is a natural antibiotic and has antibacterial, antiviral, antifungal, antiparasitic and antiallergic activity. It has both bacteriostatic and bactericidal effects. The bacteriostatic effect (suppresses the proliferation of bacteria) is manifested in the binding of iron ions in bacteria, which are necessary for their growth and vital activity. The bactericidal effect (kills bacteria) is based on the fact that it destroys the cell membrane of bacteria, as a result of which they die. Lactoferrin also has activity against Candida fungi, destroying the cell walls of fungi. Lactoferrin, by binding to viruses, prevents their penetration into cells and thus prevents or weakens the development of viral diseases. Indications: To improve the functional state of the intestinal microflora and gastrointestinal tract. Directions for use and dosage: Adults and children over 14 years old: 1-2 capsules 2 times a day on an empty stomach with a full glass of water. Children under 14 years old: 1-2 capsules per day. The minimum course of admission is 10 days. Contraindications: Individual intolerance to individual components of the drug. Release form: Plastic bottle containing 30 capsules. Free of fillers and allergens! Dispensed without a doctor's prescription. Dietary supplement Not a medicine. Storage conditions: Store at room temperature 15-250C, in a dry place, protected from light, out of reach of children. Manufacturer: CJ labs Inc., Miami, USA. The owner of the trademark and certificate of registration is Claus Marsh company, UK. Organization accepting claims in the Republic of Kazakhstan: Altes Pharm LLP, Almaty, st. Tolebi, 83, office 777. Tel: 8 (727) 292 27 08.  

Compound: Every 3 capsules contain: Glucosamine sulfate 1500 mg; Collagen 800 mg; Methylsulfonylmethane 500 mg; Turmeric extract 400 mg; Chondroitin sulfate 200 mg; Boswellia serrata extract (frankincense tree) 200 mg; Cetyl myristoleate 100 mg. Pharmacological properties: Glucosamine is involved in the construction of cartilage tissue, the formation of tendons, joint fluid, connective tissue of the skin, bones, etc. Glucosamine has a low molecular weight and is almost completely absorbed when taken orally. Thanks to this, it is easy to achieve an effective concentration of glucosamine in cartilage tissue. Glucosamines are also precursors to hyaluronic acid, an important component of synovial fluid. Chondroitin is a specific component of cartilage and is found exclusively in cartilage tissue. CHONDROCOL contains low molecular weight fractions of chondroitin sulfate, which are almost completely absorbed into the gastrointestinal tract and, retaining their structure, are embedded in cartilage tissue. Ondroitin sulfate promotes the retention of water in the thickness of the cartilage in the form of water cavities (microspaces - water cushions), which creates good shock absorption, absorbs shock, and ultimately increases the strength of cartilage tissue and inhibits the action of specific enzymes, including lysosomal ones (elastase, cathepsin, interleukin -1, etc.), released as a result of apoptosis of chondrocytes and destroying cartilage tissue. Chondroitin sulfate, like glucosamine, has an anti-inflammatory and analgesic effect, reducing pain in the joints and spine at rest and when walking. Stabilization of radiological parameters, such as the width of the joint space, indicates a stable restoration of the structure of the articular cartilage, which is not possible to obtain with the use of non-steroidal anti-inflammatory drugs alone. Collagen is a necessary protein for the synthesis of connective and fibrous cartilage tissue. If there is insufficient collagen, cartilage loses its elasticity and strength, becomes rough and fibers. Boswellia serrata (frankincense tree) has a pronounced anti-inflammatory effect, helps strengthen and restore the walls of blood vessels, thereby facilitating blood access to areas of damage, and softens the signs of inflammation in arthritis. The mechanism of action of boswellia, as well as non-steroidal anti-inflammatory drugs (NSAIDs), is based on blocking the synthesis of leukotrienes, but unlike them, it does not cause side effects (ulceration of the mucous membranes, urticaria, bronchospasm, etc.). Methylsulfonylmethane (MSM) is a natural compound of organic sulfur, which is part of sulfur-containing amino acids, complex and simple proteins, enzymes, and other vital biological substrates of the body. MSM improves the permeability of cell membranes, which increases the bioavailability of the main components of the drug into cartilage tissue MSM promotes the regeneration and restoration of the normal structure of connective tissue, including the valve apparatus of the heart, basement membranes of venous and arterial vessels, articular surfaces, tendons, fascia, ligaments of the knee, hip joints, spine and other most vulnerable tissues of the body.

Trade name: Cyclogest® Active ingredient (INN): progesterone Dosage form: pessaries for vaginal and rectal use Compound: Each pessary contains: active substance: progesterone – 200 mg or 400 mg. excipients: solid fatty base. Description: torpedo-shaped pessaries, almost white, about 30 mm long, about 10 mm in diameter. Pharmacotherapeutic group: sex hormones and modulators of the reproductive system. Progestogens. Derivatives of pregnene. Progesterone ATX code: G03DA04 By stimulating protein lipase, it increases fat reserves and increases glucose utilization. By increasing the concentration of basal and stimulated insulin, it promotes the accumulation of glycogen in the liver and increases the production of gonadotropic hormones of the pituitary gland; reduces azotemia, increases nitrogen excretion in urine. Pharmacokinetics Absorption occurs quickly, a high concentration of progesterone is observed 1 hour after administration. Cmax of progesterone in blood plasma is achieved 2-6 hours after administration. When the drug is administered at a dose of 100 mg 2 times a day, the average concentration remains at 9.7 ng/ml for 24 hours. When administered in doses of more than 200 mg/day, the concentration of progesterone corresponds to the first trimester of pregnancy. Plasma protein binding is 90%. Progesterone accumulates in the uterus. Metabolized to form predominantly 3-alpha, 5-beta-pregnanediol. The concentration of 5-beta-pregnanolone in the blood plasma does not increase. It is excreted in the urine in the form of metabolites, the main part being 3-alpha, 5-beta-pregnanediol (pregnandione). This is confirmed by a constant increase in its concentration (Cmax 142 ng/ml after 6 hours). Indications for use Progesterone deficiency conditions in women: -menopausal hormonal therapy in case of progesterone deficiency with non-functioning (absent) ovaries (egg donation); prevention (prevention) of premature birth in women at risk (with shortening of the cervix and/or anamnestic data of premature birth and/or premature rupture of the membranes); -support of the luteal phase during preparation for in vitro fertilization; - support of the luteal phase in the spontaneous or induced menstrual cycle; -premature menopause; -menopausal hormone therapy (in combination with estrogen-containing drugs); - infertility due to luteal insufficiency; - threatened abortion or prevention of habitual abortion due to progesterone deficiency. Directions for use and doses Pessaries are administered intravaginally or rectally at 200 mg to 400 mg twice daily. Prevention (prophylaxis) of preterm birth in women at risk (with shortening of the cervix and/or history of preterm labor and/or premature rupture of membranes): the usual dose is 200 mg at bedtime, from the 22nd to the 34th week pregnancy. Complete absence of progesterone in women with non-functioning (absent) ovaries (egg donation): against the background of estrogen therapy, 100 mg/day on the 13th and 14th days of the cycle, then 100 mg 2 times/day from the 15th to On the 25th day of the cycle, from the 26th day and if pregnancy is detected, the dose increases by 100 mg/day every week, reaching a maximum of 600 mg/day, divided into 3 doses. The indicated dose is usually used for 60 days. Support of the luteal phase during the in vitro fertilization cycle: it is recommended to use from 200 to 600 mg/day, starting from the day of human chorionic gonadotropin injection during the first and second trimesters of pregnancy. Support of the luteal phase in a spontaneous or induced menstrual cycle, in case of infertility associated with dysfunction of the corpus luteum: it is recommended to use 200-300 mg/day, starting from the 17th day of the cycle for 10 days, in case of delayed menstruation and diagnosis of pregnancy, treatment should to be continued. In cases of threatened abortion or in order to prevent habitual abortion occurring against the background of progesterone deficiency: 200-400 mg/day in 2 divided doses daily in the first and second trimesters of pregnancy. Drug interactions The interaction of progesterone with other drugs when administered intravaginally or rectally has not been evaluated. The simultaneous use of other drugs administered intravaginally or rectally should be avoided to avoid interfering with the release and absorption of progesterone. Release form 5 pessaries are placed in contour packages made of polyvinyl chloride/polyethylene film. 3 contour packages together with instructions for medical use in the state and Russian languages ​​are placed in a cardboard pack. Storage conditions Store in original packaging, protected from light at a temperature not exceeding 30 °C. Keep out of the reach of children. Best before date 4 years. Do not take after the expiration date stated on the package. Conditions for dispensing from pharmacies On prescription. Manufacturer Accord-UK Ltd. Barnstaple, EX32 8NS, UK, under license from L.D. Collins & Co. Ltd.” 1st Floor, Gallery Court, 28 Arcadia Avenue, London, N3 2FG, UK.

Demicalcin A combined drug that regulates the metabolism of calcium and phosphorus. Demicalcin mineral and vitamin complex contains a special combination of calcium with vitamin D3, which promotes the absorption of calcium, and with trace elements such as zinc, copper, manganese and boron, necessary for strong bones and spine. Composition: D3 – 50 ME Zn -2 mg Ca citrate - 842 mg Cu -0.5 mg Ca carbonate - 202 mg Mn- 0.5 mg     Ca -250 mg B- 50mcg Pharmacological properties: DeMiCalcin is a mineral and vitamin complex. Replenishes the deficiency of microelements, calcium and vitamin D3, helps strengthen bones and joints, and prevents diseases of the musculoskeletal system. Calcium is a building component for bone tissue. Calcium is presented in the preparation as carbonate and citrate salts Calcium carbonate contains the maximum amount of elemental calcium. Calcium citrate is well absorbed in the intestine, prevents stone formation in the urinary system even with long-term use, and reduces excess production of parathyroid hormone. Vitamin D (cholecalciferol) promotes adequate absorption of calcium, participates in the processes of regeneration and construction of bone tissue. Zinc is an integral component of various enzymes in the body ( more than 200 species) that synthesize proteins and nucleic acids. Manganese promotes the synthesis of substances that are components of bone and cartilage tissue (glycosaminoglycans). Copper is involved in the formation of elastin and collagen. Helps stop the phenomenon of demineralization of bone structures. Boron normalizes the activity of the parathyroid hormone - parathyroid hormone.. Indications: Rickets Prevention and treatment of osteoporosis Period of intensive growth in childhood and adolescence Disorders of calcium metabolism (pregnancy, lactation, convalescence) Prevention of osteoporosis (including menopause) Bone fractures Dosage Up to 1 year – ¼ tablet 1 time per day 1 – 5 years old – ½ tablet once a day 5 – 12 years old – 1 tablet once a day Over 12 years old and adults – 1 tablet 2 times a day Release form: DeMiCalcin, 30 tablets.