1.

Duloxetine
Duloxetine is a combined serotonin (5-HT) and noradrenaline (NA) reuptake
inhibitor. It weakly inhibits dopamine reuptake, with no significant affinity for
histaminergic, dopaminergic, cholinergic, and adrenergic receptors.
Indications

Treatment of major depressive disorder: 40 mg/day to 60 mg/day.

Maximum Dose:120 mg

Treatment of diabetic peripheral neuropathic pain: 60 mg/day.

Treatment of generalized anxiety disorder: 60 mg/day. Maximum dose:

120 mg/day.

Fibromyalgia: 30 mg/day

Contraindications

Use of a monoamine oxidase inhibitor concomitantly or in close

temporal proximity

Use in patients with uncontrolled narrow-angle glaucoma

Approvals
1. USFDA approved: CYMBALTA
2. Approved in UK and EU: CYMBALTA
3. India: 28-02-2005. DULANE cap (Sun), DULOJOY tab (torrent),
DUMORE cap (Lupin)

2. Cefcapene
Therapeutic category name: Oral cephem antibiotic formulation

Spectrum
Staphylococcus aureus, Streptococcus spp., Streptococcus
pneumoniae, Neisseria gonorrhoeae, Moraxella (Branhamella)
catarrhalis, Escherichia coli, Citrobacter, Klebsiella, Enterobacter,
Serratia, Proteus, Morganella Morugani, Providencia spp., Haemophilus
influenzae, Peptostreptococcus, Bacteroides, Prevotella, acne bacteria
etc.
Indications

Skin and soft tissue infection

Respiratory tract infections including pneumonia, acute
bronchitis.
Urinary tract infections

Dosage
100 mg three times a day in adults
Child: 3mg / kg three times a day.

Contraindications
Patients with a history of hypersensitivity to component or cephem antibiotic
of this drug
Research: 9 clinical trials on Pubmed, 75 research articles.

Approvals
1.
2.
3.
4.

Japan: Approved since 1997

USFDA not approved
Not Approved in UK and EU
India: DCGI. Clinical trial permission on 03.12.2011.

3. Cefotiam (Tab/injection)
Therapeutic category name: Cephem antibiotic formulation
Cefotiam is a second-generation cephalosporin antibiotic
Spectrum

Staphylococcus spp. to Streptococcus spp., Streptococcus pneumoniae,

Escherichia coli, Citrobacter, Klebsiella, Enterobacter, Proteus, Morganella
Morugani, Providencia Rettogeri, Haemophilus influenzae
Indications

Sepsis, prophylaxis for surgical infection,

SSTI

Secondary infection, such as trauma, burns and surgical wounds

Respiratory tract infection

Urinary tract infection

Peritonitis, Cholecystitis, cholangitis

Purulent meningitis

Parenteral
Dose: adults- 0.5 to 2g divided into 2 to 4 times a day
Children: 40~80mg / kg/day in 3 divided dosage
Oral
600-1200mg three times a day in adults
Research: 70 clinical trials on pubmed
Approvals
1. Japan: Cefotiam was launched as Pansporin in February 1981 by
Takeda Pharmaceutical of Japan and has been available as a generic
since February 1993.
2. USFDA not approved
3. UK and EU: Not Approved

4. India: not approved.

4. Cefazedone

Cefazedone is a semisynthetic first-generation cephalosporin with

antibacterial activity
For Parenteral administration

Research: 7 clinical trials and 50 research articles on pubmed

Approvals
1.
2.
3.
4.
5.

Japan: not approved.

USFDA not approved
UK and EU: Not Approved
India: not approved.
Zenocef, Refosporen, Pazeron - South Korea approved

5. Cefbuperazone
Cefbuperazone is a second-generation cephalosporin antibiotic.

Research: 5 clinical trials

Approvals
1.
2.
3.
4.

Japan: not approved.

USFDA not approved
UK and EU: Not Approved
India: not approved.

Brand Names

Tomiporan- Hanall Biopharma, South Korea

Zinperazone- Kukje, South Korea

6. Cefmetazole
Cefmetazole is a cephamycin antibiotic usually grouped with the secondgeneration cephalosporins.
It has a broad spectrum of activity comparable to that of the secondgeneration cephalosporins, covering gram-positive, gram-negative, and
anaerobic bacteria. Unlike the second-generation cephalosporins,
cephamycins such as cefmetazole are usually active against Bacteroides
fragilis.
Cefmetazole is also active against beta-lactamase-producing organisms that
are resistant to first-generation cephalosporins or penicillins.
Spectrum
Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus,
Morganella Morugani, Providencia spp., Peptostreptococcus, Bacteroides,
Prevotella (except Prevotella Bibia)
Indications
Sepsis, acute bronchitis, pneumonia, lung abscess, empyema, secondary
infection of chronic respiratory disease, cystitis, pyelonephritis, peritonitis,
cholecystitis, cholangitis, intrauterine infection, uterine adnexitis, cellulitis
Dosage
Normal adult: 1-2g twice a day.
Children: 25-100mg / kg/ day divided into 2-4 dosages.

Research: >500 research articles and >60 clinical trials on pubmed

Approvals
1.
2.
3.
4.
5.
6.
7.

Japan: approved-Cefmetazon (Daiichi Sankyo, Japan, China)

China approved-Bi Li Shu
Taiwan approved
South Korea- Ceftacin (Shin Poong, South Korea)
USFDA not approved
UK and EU: Not Approved
India: not approved.

7. Cefroxadine
Cefroxadine (CXD), an orally active cephalosporin antibiotic, has a
broad spectrum and a bactericidal action
Spectrum: Staphylococcus spp., Streptococcus spp., Streptococcus
pneumoniae, Escherichia coli, Klebsiella, Proteus mirabilis,
Haemophilus influenzae
Indication
Superficial skin infections, deep skin infections, Pharyngitis,
laryngitis, tonsillitis, acute bronchitis, secondary infection of chronic
respiratory disease, cystitis, Pyelonephritis, sty, Otitis media, scarlet
fever.
Dosage
Infants and children: 30mg/kg divided into three times a day
Approvals

Japan: approved, Orasupoa pediatric dry syrup 10%

South Korea: Tiroxin- Samjin, South Korea
Research: >80 research articles and 10 clinical trials on pubmed

8. Ceftizoxime
Ceftizoxime is a third-generation cephalosporin available for parenteral
administration.
Ceftizoxime has a spectrum of activity in vitro that is very similar to that of
cefotaxime, except that it is less active against S. pneumoniae and more
active against B. fragilis.
The t1/2 is somewhat longer, 1.8 hours, and the drug thus can be
administered every 8-12 hours for serious infections. Ceftizoxime is not
metabolized, and 90% is recovered in urine.
Spectrum
Streptococcus pneumoniae, Escherichia coli, Citrobacter, Klebsiella,
Enterobacter, Serratia, Proteus, Morganella Morugani, Providencia spp.,
Haemophilus influenzae, Peptostreptococcus, Bacteroides, Prevotella
Meraninojenika
Indications
Acute bronchitis, pneumonia, secondary infection of chronic respiratory
disease, cystitis, pyelonephritis
Research: >225 clinical trials on pubmed.
Approvals
1. USFDA: discontinued from US Market since 2007

2. Japan: approved- Eposerin. (Choseido Pharmaceutical Co., Ltd.)

3. UK and EU: Not Approved
4. India: not approved.

Zinc-carnosine
Zinc carnosine (ZnC) is an artificially produced derivative of carnosine, where zinc and
carnosine are linked in a onetoone ratio to provide a polymeric structure.
Polaprezinc (Promac(), Zeria Pharmaceutical Co., Ltd.), a chelate compound
consisting of zinc and L-carnosine, is a zinc-related medicine approved for
the first time in Japan (since 1994), which has been clinically used to treat
gastric ulcers.
Mechanism of action
Its mechanism of action is believed to oxygen radical scavenging, antioxidation, and acceleration of wound healing.
This product is currently marketed by several companies as a zinc dietary
supplement with added value for gastric health. Combining zinc with
carnosine could theoretically provide added benefits over simple zinc
supplementation as carnosine is a dipeptide (comprising alanine and l

histidine) that is naturally present in longliving cells such as muscle and

nerves, where, among other actions, it probably has a role as an antioxidant.
Benefits

Supports the mucosal lining, the natural defense of the stomach and GI track

Remarkable relief of occasional heartburn, acid indigestion, gas and nausea

Structurally inhibits harmful bacteria associated with stomach irritation

Synergistic combination of elemental zinc and L-Carnosine, a natural occurring

dipepetide, for potent anti-oxidant and tissue-healing properties.

Dosage
The most common dosage of zinc-carnosine used in the published research is 75 mg twice daily.
Adverse Effects, Cautions, and Contraindications
While there is only 16 mg of zinc in one capsule of a 75 mg zinc-carnosine pill, it may be wise to
increase copper intake due to zincs inhibition of copper absorption.
Summary
Zinc-carnosine is a unique product that appears to enhance the stomachs mucosal defenses,
providing significant improvements in gastric ulcer patients. It also supports small intestinal

mucosal integrity and inhibits the inflammatory responses in H. pylori. Zinc-carnosine may be
helpful in patients who do not have gastric ulcers, but have heartburn or other symptoms as a
result of gastroesophageal reflux.
Available brands in India with Rabeprazole

Rabez- Z: Hetero Healthcare Ltd

Happi XT: German Remedies (Zydus Cadila Healthcare Ltd.)

Rablet Z-Lupin Laboratories Ltd.

The NDAC (Gastroenterology & Hepatology) rejected the proposals on

02.04.2012 for rabeprazole (EC)+Zinc Carnosine. The committee opined that
there is no rationality in combining rabeprazole (EC) with zinc carnosine. The
safety profile of the combination is also not known. The committee opined
that the proposal cannot be considered.
Clinical research: 20 clinical studies and around 100 articles on pubmed.
Approvals
Japan: approved brands

Product name

Generic name

Drug efficacy

Puromakku D Tablets 75
(Zeria Pharmaceutical)

Porapurejinku
polaprezinc

Zinc-containing ulcer agent

Puromakku granules 15%

(Zeria Pharmaceutical)

Porapurejinku
polaprezinc

Zinc-containing ulcer agent

Porapurejinku OD Tablets 75mg "JG"

(Choseido Pharmaceutical Co., Ltd.)

Porapurejinku
Polaprezinc

Zinc-containing ulcer agent

Porapurejinku granules 15% "NS" (generic)

( Polaprezinc Granules 15% "NS")
(Nisshin Pharma - Yamagata)

Porapurejinku
Polaprezinc

Zinc-containing ulcer agent

Porapurejinku granules 15% "YD" (generic)

( POLAPREZINC GRANULES)
(YoSusumudo)

Porapurejinku
Polaprezinc

Zinc-containing ulcer agent

Porapurejinku granules 15% "Taiyo" (generic)

( POLAPREZINC )
(Daxing Pharmaceutical Co., Ltd.)

Porapurejinku
Polaprezinc

Zinc-containing ulcer agent

Porapurejinku granules 15% "SN" (generic)

( Polaprezinc )
(Shionokemikaru)

Porapurejinku
polaprezinc

Zinc-containing ulcer agent

Porapurejinku granules 15% "Pfizer" (generic)

( POLAPREZINC Granules 15% [Pfizer])
(Mylan Pharmaceutical)

Porapurejinku
Polaprezinc

Zinc-containing ulcer agent

Porapurejinku OD Tablets 75mg "Sawai" (generic)

( POLAPREZINC OD)
(Sawai Pharmaceutical)

Porapurejinku
Polaprezinc

Zinc-containing ulcer agent

Porapurejinku granules 15% "CH" (generic)

(Choseido Pharmaceutical Co., Ltd.)

Porapurejinku
Polaprezinc

Zinc-containing ulcer agent