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campral

Campral (Acamprol)

Acamprosate Calcium Generic Alternative at Low Cost


Active substance: Acamprosate
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DescriptionHow to take?Common Side EffectsLatest New'sPhoto's

Acamprosate 333 mg Gastro-resistant Tablets, manufactured by SunPharma, sold under brand name Acamprol, each gastro-resistant tablet contains acamprosate calcium 333.0 mg as the active ingredient. Acamprosate is indicated as therapy to maintain abstinence in alcohol-dependent patients. It should be combined with counselling.

Acamprosate is thought to stabilize the chemical balance in the brain that would otherwise be disrupted by alcoholism, possibly by blocking glutaminergic N-methyl-D-aspartate receptors, while gamma-aminobutyric acid type A receptors are activated. Reports indicate that acamprosate only works with a combination of attending support groups and abstinence from alcohol.

Acamprosate calcium is a synthetic compound with a chemical structure similar to that of the endogenous amino acid homotaurine, which is a structural analogue of the amino acid neurotransmitter γ-aminobutyric acid and the amino acid neuromodulator taurine. Its chemical name is calcium acetylaminopropane sulfonate. Its chemical formula is C H N O S Ca and molecular weight is 400.48. Its structural formula is:

Adults within the age range 18-65 years

– 2 tablets three times daily with meals (2 tablets in the morning, noon and night) in subjects weighing 60kg or more.

– In subjects weighing less than 60kg, 4 tablets divided into three daily doses with meals (2 tablets in the morning, 1 at noon and 1 at night).

The recommended treatment period is one year. Treatment with acamprosate should be initiated as soon as possible after the withdrawal period and should be maintained if the patient relapses.

Acamprosate does not prevent the harmful effects of continuous alcohol abuse. Continued alcohol abuse negates the therapeutic benefit; therefore acamprosate treatment should only be initiated after weaning therapy, once the patient is abstinent from alcohol.

Store at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F).

Certain serious side effects include allergic reactions, irregular heartbeats, and low or high blood pressure, while less serious side effects include headaches, insomnia, and impotence. Acamprosate should not be taken by people with kidney problems or allergies to the drug.

Global Acamprosate Calcium Market 2019 – Merck Group, Zydus Pharmaceuticals, Mylan, TevaMerck Group

 

The Global Acamprosate Calcium Market provides a comprehensive outlook of the Global Acamprosate Calcium Market globally. This report gives a thorough examination of the market and, provides the market size and CAGR value for the forecast period 2019-2023, taking into account the past year as the base year. The report provide a meticulous evaluation of all of the segments(type of product, application, and region) included in the report. The segments are studied keeping in view their market share, revenue, market growth rate, and other vital factors.

The global Acamprosate Calcium market research report involves all the substantial evidence related to this market which every viewer would like to know about the Acamprosate Calcium market. The report occupies the mixture of primary and secondary research of Acamprosate Calcium, which includes company financial year report, product knowledge, Acamprosate Calcium press release, interviews as well few other relevant sources that contribute towards assemble of information. It involves analytical data, statistical data, etc. The major part of the report involves various research methodology, Acamprosate Calcium research finding, conclusion and Appendix and data sources. Also includes distributor channels, sales, demand and supply category, import/export, dealers, and traders.

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The worldwide market for Acamprosate Calcium accounted a relatively optimistic growth, the past four years, market size is estimated from XXX million $ in 2015 to XXX million $ in 2018. The Acamprosate Calcium Market is expected to exceed more than US$ XXX million by 2023 at a CAGR of 15 in the given forecast period. Acamprosate Calcium Market research report also provides an overall analysis of the market share, size, segmentation, revenue forecasts and geographic regions of the Acamprosate Calcium Market along with industry leading players are studied with respect to their company profile, product portfolio, capacity, price, cost and revenue. The Acamprosate Calcium market report presents the competitive scenario of the major market players based on the sales revenue, customer demands, company profile, the business tactics used in Acamprosate Calcium market which will help the emerging market segments in making vital business decisions.

 

Calcium in alcoholism drug may be what prevents relapse

A research team finds calcium ions on acamprosate might be doing the work

Many drugs on the market work in mysterious ways.  Scientists still don’t know how aspirin works. They still don’t know how Prozac works, or any of the antipsychotics. But how a drug works is not necessarily important. When you need to prevent suffering and death, what is important is that the drug works, and works safely. How it works can wait.

But sometimes when a drug mechanism reveals itself, it’s a surprise. That was the case in a recent study of acamprosate, one of four drugs approved in the United States as a pharmacological treatment for alcoholism. It turns out that acamprosate itself might not be the active ingredient. Instead, the calcium ions attached to the drug could be driving its anti-relapse effects.

Rainer Spanagel and his colleagues at the Central Institute of Mental Health and the University of Heidelberg in Mannheim, Germany, were one of the first groups to study acamprosate. Their previous studies showed that long-term abstinence from alcohol could produce increases in glutamate levels in the brain. Glutamate is an amino acid and one of the chemical messengers in the brain. The increase in glutamate creates an excited brain state, and could make alcoholics more likely to relapse and drink again.

Studies with acamprosate, or specifically with the calcium salt of acamprosate, a form of the drug that’s coupled with calcium ions, show that it can reduce relapse after withdrawal in mouse models of alcoholism. It also helps calm down the increases in glutamate in human alcoholics.

Spanagel and his group wanted to understand why acamprosate was able to reduce relapse, and if possible, how they could make the drug more effective. Calcium acamprosate is the approved treatment, but relatively little of it gets into the brain. Spanagel commissioned another form of the drug, sodium acamprosate. In this form, more of the drug reached the brain. But, strangely, it didn’t work. It didn’t reduce alcohol consumption in rats after withdrawal.

Mystified, the scientists dug deeper. They showed that calcium acamprosate doesn’t act on receptors for glutamate, called NMDA receptors, which suggests that acamprosate doesn’t affect the glutamate system. Spanagel and his colleagues began to question whether acamprosate was biologically active at all.

So they went back to the original patent for acamprosate, where they found a clue. The patent states that “the calcium salt may be used as neurotropic agent; the magnesium salt as vasculotropic agent; the potassium salt as antiasthenic agent; the lithium salt may be used in for bipolar patients and the sodium salt in local treatments; the zinc salt may be used in dermatology.” Different salts of the same molecule, with very different functions. Right there in the wording of the patent was the suggestion that the ions — calium, lithium, potassium — could be the active agents.

In further tests, Spanagel and his group showed that calcium acamprosate, and not sodium acamprosate, reduced alcohol intake in booze-deprived rats. Even basic calcium chloride was able to reduce alcohol intake. In addition, the researchers found an association between levels of blood calcium and abstinence in people on acamprosate.

“It’s not every day you find an FDA approved medication where the salt is driving the effect,” says Jeff Weiner, an alcohol addiction researcher at Wake Forest School of Medicine. He notes that there needs to be confirmation of the results before acamprosate is declared inactive. There could be functions of acamprosate, or of calcium acamprosate specifically, that are currently undiscovered. “We’re going to need more data,” he says, “before we throw the drug out with the bathwater.”

Spanagel agrees that the results need to be replicated. “We are not claiming that any of the published results are wrong, the interpretation is wrong,” he says. And there are still many unanswered questions. Calcium levels in blood may not correspond to calcium levels in brain. High levels of calcium dosing can have adverse cardiac side effects. The blood levels of calcium in people being treated with calcium acamprosate normalized after the first month, even though abstinence continued. And the rats in the study showed reduced movement in response to calcium treatment. They might be reducing their alcohol intake because they are simply moving less.

And if calcium is the active agent, there’s still an important unanswered question: Scientists still don’t know how that calcium might be working stop alcoholics from going back to the bottle.

Markus Heilig, a psychiatrist with the National Institute of Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, wrote a commentary on the paper calling for a randomized clinical trial to look at acamprosate, its calcium salt, and calcium alone. “If we could figure out the actual mechanism and find something more specific and more potent, there’s probably something there,” he says. “Whether it’s the calcium or the acamprosate, it’s doing something for some people.”

But Heilig also emphasizes that the paper, while it raises more questions than it answers, “represents some of the best science.” Whether acamprosate will turn out to have effects on its own or whether it all turns out to be calcium, the study helps to further our understanding of how we might prevent relapse. “This is ultimately a story of how science is all about questioning everything,” Helig says, “including the things we think we know.”

Multi-drug approach could be way to treat Alzheimer’s, study suggests

 

A French pharmaceutical company on Jan. 8 said promising results in preliminary research using a combination of existing medications to treat Alzheimer’s could point the way toward someday combating the dementia-causing disease with a drug cocktail.

Pharnext, in interviews with company officials and a study that appears in Nature’s peer-reviewed online journal Scientific Reports, said preclinical studies suggest that combining two approved drugs can have a synergistic impact in alleviating cognitive impairment and protecting the brain’s neurons and blood vessels from Alzheimer’s-related damage.

The drugs, which are not now used to treat Alzheimer’s, include acamprosate calcium, which has been prescribed since 1989 to reduce cravings and alleviate withdrawal symptoms in alcoholics. It was combined with baclofen, a medication that has been used for decades to treat the spastic movements in people suffering from multiple sclerosis.

The findings, which were obtained in laboratory cultures and animal testing, suggest the way forward to treating Alzheimer’s disease could be the same method discovered years ago to treat HIV, a senior company official said.

“Maybe the illusion we had was that we could treat a disease such as Alzheimer’s with a single silver bullet,” Daniel Cohen, an author of the study and a founder of Pharnext, said Wednesday in a telephone interview. “When you fight a complex disease, you have to use a complex treatment.”

Using already known drugs and at lower doses than usual means the cocktail should be safe and could perhaps lead to an approved therapy in a shorter time than it takes to develop new drugs, Cohen said.

Richard Lipton, who heads the Einstein Aging Study at the Albert Einstein College of Medicine and the division of cognitive aging and dementia at Montefiore Medical Center, said after reviewing the company’s study that its data and therapeutic approach sounded promising.

pregabalin

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Active substance: Pregabalin
U.S. Brand: Lyrica
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DescriptionHow to take?Common Side EffectsLatest New'sPhoto's

Pregabalin, marketed under the brand name Lyrica among others, is a medication used to treat epilepsy, neuropathic pain, fibromyalgia, restless leg syndrome, and generalized anxiety disorder. Its use in epilepsy is as an add-on therapy for partial seizures.

Pregabalin capsules, oral solution (liquid), and extended-release (long-acting) tablets are used to relieve neuropathic pain (pain from damaged nerves) that can occur in your arms, hands, fingers, legs, feet, or toes if you have diabetes and postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). Pregabalin capsules and oral solution are also used to relieve neuropathic pain that can occur after a spinal cord injury and to treat fibromyalgia (a long-lasting condition that may cause pain, muscle stiffness and tenderness, tiredness, and difficulty falling asleep or staying asleep). Pregabalin capsules and oral solution are used along with other medications to treat certain types of seizures in adults and children 4 years of age and older. Pregabalin is in a class of medications called anticonvulsants. It works by decreasing the number of pain signals that are sent out by damaged nerves in the body.

Pregabalin comes as a capsule, an oral solution, and as an extended-release tablet to take by mouth. Pregabalin capsules and oral solution are usually taken with or without food two or three times a day. Pregabalin extended-release tablets are usually taken once daily after an evening meal. Take pregabalin at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

  • tiredness
  • dizziness
  • headache
  • dry mouth
  • nausea
  • vomiting
  • constipation
  • gas
  • bloating
  • ”high” or elevated mood
  • speech problems
  • difficulty concentrating or paying attention
  • confusion
  • difficulty remembering or forgetfulness
  • anxiety
  • lack of coordination
  • loss of balance or unsteadiness
  • uncontrollable shaking or jerking of a part of the body
  • muscle twitching
  • weakness
  • increased appetite
  • weight gain
  • back pain

Phase 3 Study Results Announced for Pregabalin in Primary Generalized Tonic-Clonic Seizures

A phase 3 study assessing the use pregabalin as adjunctive therapy for epilepsy patients 5 to 65 years of age with primary generalized tonic-clonic (PGTC) seizures did not meet its primary endpoint to reduce seizure frequency compared with placebo, according to Pfizer.

The 12-week randomized, double-blind, placebo-controlled, multicenter study was conducted at 70 sites in 21 countries and included 219 patients. Patients were randomized in a 1:1:1 ratio to receive placebo, or 1 of 2 fixed doses of pregabalin twice daily. The primary endpoint was the percent reduction of 28 day seizure rate for all PGTC seizures relative to placebo.

Findings from the phase 3 study showed that treatment with pregabalin for PGTC seizures did not result in a statistically significant reduction in seizure frequency versus placebo.

Pregabalin/Lyrica reclassified to a class C drug

A prescription drug linked to 33 deaths in 2017 in Northern Ireland will now be treated as a class C drug.

Pregabalin – also known by the brand name Lyrica, or the street name bud – is an anti-epileptic drug also used to relieve chronic pain.

Northern Ireland has the highest prescription rate for pregabalin in the UK.

It is illegal to have class C drugs without a prescription and illegal to supply or sell them to others.

Meanwhile the mother of a man who took his own life, speaks about her son’s struggle with addiction to prescription drugs.

  • Prescription drug abuse ‘wrecking lives’
  • Life on Lyrica: A user’s perspective

There will also be stronger controls in place to ensure accountability and minimise the chances of pregabalin falling into the wrong hands or being stockpiled by patients.

Deaths relating to the prescription drug are on the rise.

In 2016 eight drug deaths were linked to Lyrica misuse – one year later that figure rose to 33.

Tablets

The Advisory Council for the Misuse of Drugs made the recommendation to reclassify the drug in a letter to ministers, including the then home secretary Theresa May, in January 2016.

The letter cited warnings from the Health and Social Care Board (HSCB), which highlighted “significant misuse and abuse” of the drug.

Where are the drugs coming from?

There is a growing illicit market for the drug in Northern Ireland, with many people purchasing it online from unregulated websites.

It is understood that Lyrica has been coming into Northern Ireland in fairly constant levels for a number of years, along with other prescription drugs including diazepam and temazepam.

Packages of the drug ordered by customers in Northern Ireland are intercepted by the National Crime Agency (NCA) and the UK Border Agency at airports in England every week, according to the Police Service of Northern Ireland (PSNI).

  • Class C call over abuse of ‘bud’ drug
  • Grieving mother’s prescription drug warning

While the drugs are referred to as prescription drugs, they are largely not being prescribed through community pharmacies.

They are illicitly bought or sold and supplied through the internet and largely the individuals are appearing to be using a mixture of drugs.

Joe Brogan, the HSCB’s head of pharmacy and medicines management, described the growing numbers of deaths associated with pregabalin and other prescription drugs as a “scourge”.

He added: “In many cases of pregabalin misuse, it has not been prescribed – it has been sourced through family or friends or bought on the street or via the internet.

“Many such drugs that are bought from illicit sources do not actually contain medicines that they purport to be.

“Any medicine or any drug can be a poison – it all depends on three things: Where you get it from – was it prescribed and supplied from a regulated source?; how much you take – was it taken within accepted dosages?; what you take it with – mixing drugs together and with alcohol can create a toxic mix that is lethal.”

Misuse of pregabalin painkiller has risen 900 per cent in Australia

Australia is the latest country to report an alarming rise in the misuse of the nerve pain drug pregabalin.

Pregabalin is a non-opioid drug that reduces pain through its actions on calcium channels in the brain. It was originally developed as an epilepsy drug but is now approved for treating nerve pain – the prickling, tingling sensation that can accompany conditions like diabetes and multiple sclerosis. In some countries, it is also approved for treating anxiety and fibromyalgia.

Anecdotal evidence suggests that doctors are also increasingly prescribing …

Buy Travoprost Online

Travoprost, sold under the brand name Travatan among others.


Active substance: Travoprost
U.S. Brand: Travatan
Indian Brand: Lupitros
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Strength: 0.004%
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DescriptionHow to take?Common Side EffectsLatest New'sPhoto's

Travoprost, is medications used to treat high pressure inside the eye including glaucoma and ocular hypertension (a condition which causes increased pressure in the eye). Travoprost is in a class of medications called prostaglandin analogs. It lowers pressure in the eye by increasing the flow of natural eye fluids out of the eye.

Specifically it is used for open angle glaucoma when other agents are not sufficient. It is used as an eye drop. Effects generally occur within 2 hours. This medication works by regulating the flow of fluid within the eye to maintain a normal pressure.

To instill the eye drops, follow these steps:

  1. Wash your hands thoroughly with soap and water.
  2. Check the dropper tip to make sure that it is not chipped or cracked.
  3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
  4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
  5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
  6. Brace the remaining fingers of that hand against your face.
  7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
  8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
  9. Place a finger on the tear duct and apply gentle pressure.
  10. Wipe any excess liquid from your face with a tissue.
  11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
  12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
  13. Wash your hands to remove any medication.
  • eye pain or irritation
  • blurred vision
  • dry eyes
  • eye tearing
  • headache

Travoprost eye drops may change the color of your eye (to brown) and darken the skin around the eye. It may also cause your eyelashes to grow longer and thicker and darken in color. These changes usually occur slowly, but they may be permanent. If you use travoprost eye drops in only one eye, you should know that there may be a difference between your eyes after using travoprost eye drops. Call your doctor if you notice these changes.

Ocular Therapeutix still has an eye on approval despite trial failure

Ocular Therapeutix gave itself a low bar to clear in the latest phase III study of OTX-TP, pitting the glaucoma project against placebo rather than an active comparator – but even that was not low enough. The trial failed to show a decrease in intraocular pressure with OTX-TP, an eye insert that delivers travoprost, versus placebo, across the 12-week study. Despite the failure, Ocular still hopes the project has a future, highlighting an analysis of intraocular pressure at individual timepoints that it said showed a significant benefit with OTX-TP on eight of nine occasions. Still, as the primary endpoint was not hit, these findings can only be considered exploratory. And OTX-TP’s effect appeared to wane over time, raising questions about the company’s sustained delivery approach. Ocular will take the latest data to the FDA but even if the agency decides to be lenient, OTX-TP will struggle to find a place in the market – the project previously failed to beat an active comparator, generic timolol. Investors, who had hoped OTX-TP would fare better against placebo, sent Ocular’s stock down 17% in premarket trading today. Today’s failure might also bode ill for Ocular’s next project, OTX-TIC, a bioresorbable travoprost implant that is in phase I.

Ocular Therapeutix’s clinical-stage pipeline
Project Description Indication Status
OTX-TP Travoprost insert Glaucoma and ocular hypertension Failed phase III
OTX-TIC Travoprost implant Glaucoma and ocular hypertension Phase I
OTX-TKI Tyrosine kinase inhibitor implant Wet AMD, DME, RVO Phase I
AMD: Age-related macular degeneration, DME: Diabetic macular edema, RVO: Retinal vein occlusion. Source: EvaluatePharma, company website.
Monday Pharmaceutical Mystery: May 13

JK is a male, age 62 years, in good health. He recently started to take travoprost (Travatan Z, Alcon) 0.004% ophthalmic solution for glaucoma, 1 drop in each eye every evening. JK takes a store brand multivitamin daily, and no other maintenance prescription medications.

While picking up his supply of OTC vitamins, JK asks you if the multivitamins can cause stomach issues. Upon further discussion with the patient, he tells you that he has been experiencing heartburn, nausea, and constipation. There have been no other changes in his diet or routine, and he has been taking this particular vitamin for at least 10 years.
Mystery: What is causing JK to have gastrointestinal issues, despite no other change in medications, diet, or routine?

Solution: Travoprost has been reported to cause dyspepsia or gastrointestinal disorder in 1% to 5% of patients in clinical studies. Other uncommon nonocular side effects of travoprost include allergy, angina, anxiety, arthritis, back pain, bradycardia, bronchitis, chest pain, cold/flu syndrome, depression, headache, increased cholesterol, hypertension or hypotension, infection, pain, prostate disorder, sinusitis, and urinary incontinence/urinary tract infections.1

A JAMA Ophthalmology article mentions that prostaglandin analogues, such as travoprost, are the first choice in glaucoma treatment.2They work by increasing the outflow of intraocular fluid from the eye and lowering the intraocular pressure. One reason for the popularity of prostaglandin analogues is because of the limited systemic adverse effects.

Although the Travatan package insert lists the GI side effects mentioned above,1 latanoprost (Xalatan, Pfizer), bimatoprost (Lumigan, Allergan), and tafluprost (Zioptan, Akorn), also in the prostaglandin analogue class, do not list GI side effects. However, a few reported case studies showed that patients who had used latanoprost experienced GI effects,2 therefore, any patient who mentions GI upset and is taking a prostaglandin analogue should be evaluated for a correlation between the 2.

JK should speak to his ophthalmologist immediately about changing his glaucoma medication, if possible.

References

  1. Travatan Z Package Insert:  https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/travatan_z.pdf Accessed May 10, 2019
  2. Papachristou G, Ritch R, Liebmann J. JAMA Ophthalmology: Small Case Series: Gastrointestinal Adverse Effects of Prostaglandin Analogues.  Arch Ophthalmol. 2008;126(5):732-733. doi:10.1001/archopht.126.5.732 https://jamanetwork.com/journals/jamaophthalmology/fullarticle/420543Accessed May 10, 2019

Author, Karen Berger, PharmD

Karen Berger, PharmD, graduated from the University of Pittsburgh School of Pharmacy in 2001. She has worked in community pharmacies for over 17 years as a Pharmacist in Charge, staff, and floater pharmacist for a large chain. Currently, she is a pharmacist at an independent pharmacy in Northern NJ. She can be reached at karenmichelleberger@gmail.com

PhIII setback mars Ocular's glaucoma drug/device, though company remains 'encouraged' by data breakdown

Ocular Therapeutix’s latest drug/device — for glaucoma — has flopped in its Phase III study, failing the primary endpoint to significantly reduce intraocular pressure versus placebo.

The treatment, OTX-TP, is an intracanalicular insert designed to deliver a formulation of the drug travoprost with an effect up to 90 days, which Ocular says can solve the adherence issues seen with daily eye drop regimens that patients are typically prescribed.

Michael Goldstein

Investigators tracked the change in IOP from baseline in 554 patients in the study over several months, taking measurements at nine time points: 8 am, 10 am and 4 pm on one day at 2, 6 and 12 weeks following insertion. The first six sessions, the company says, were just fine — recording statistically significant reductions of IOP with p-values as low as 0.001 — but the seventh threw them off.

In fact, as they lay out in a table, that’s the only time point where OTX-TP did not achieve a statistically significant reduction of IOP compared to placebo.

“We are encouraged by the results of this trial which shows OTX-TP’s ability to lower IOP out to 12 weeks with a single insert using this novel dosage form,” said chief medical officer Michael Goldstein, adding that his team will now take the data to the FDA to determine next steps.

Ocular’s relationship with the FDA, though, has not always been smooth. Its first drug/device eye treatment, Dextenza, was rejected twice before nabbing an approval, forcing a restructuring that claimed a fifth of its staff. The company finally managed to sort out the manufacturing issue and began marketing the therapy for post-surgical pain late last year.

Some investors aren’t sticking around. Shares $OCUL are still down 12% (to $3.37) in pre-market trading, following the announcement at Monday close.

AUTHOR & ASSOCIATE EDITOR: Amber Tong
amber@endpointsnews.com

Buy Ganfort Online

We sell Generic Version of Original Ganfort, under brand name Careprost Plus made by Indian company.


Active substance: Bimatoprost + Timolol
U.S. Brand: Ganfort
Indian Brand: Careprost Plus
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Strength: 0.03% + 0.5% w/v 
Form release: 3ml bottle
Shipping time: 7 – 21 days
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DescriptionHow to take?Common Side EffectsLatest New'sPhoto's

Bimatoprost in combination with Timolol is used for treating ocular hypertension (by draining fluid from the eye) or increased pressure in the eye and open-angle glaucoma. It comes in the form of eye drops. Bimatoprost & Timolol released under US brand name: Ganfort, we sell 100% analog/generic brand CAREPROST PLUS is included in a class of medications called prostaglandin analogs, Generic Ganfrort – Careprost Plus made by trusted indian company Sun Pharma.

The drug should be used in the morning. If you miss one dose, continue with the next one.. The eye solution may vary from clear, colorless to slightly yellow in color. The medicine is available in 5 ml white opaque polyethylene bottle. Each bottle contains 3 ml of solution. The bottle should be kept tightly closed. It should be used within 30 days of opening the bottle.

Combination Bimatoprost & Timolol, It is generally advised to be used in the affected eye once daily. Both these drugs work differently to control the increased pressure level in the eye. While using these eye drops, be careful not to touch the tip of the dropper, as it may contaminate the tip as well as the solution. Sometimes, brand or generic Ganfort eye drops may temporarily blur your vision, therefore you are advised not to drive a vehicle or operate machinery for some time after using this drug.

Bimatoprost and timilol maleate may cause your eye color to change, which is completely normal. While you are taking this medication, you should go for regular checkup. This drug may also increase your sensitivity. You should consult your doctor if you have a history of allergies. It is also advised that brand or generic Ganfort eye drops be used cautiously if you have decreased liver or kidney function. You should talk with your doctor if you suffer from closed eye glaucoma.

Bimatoprost sustained-release implant shows positive phase 3 data

A bimatoprost sustained-release implant reduced IOP by approximately 30% over 12 weeks in a phase 3 clinical study, according to an Allergan press release.

The multicenter, randomized, masked, parallel-group study, which included 594 subjects with open-angle glaucoma or ocular hypertension, compared the efficacy and safety of two dose strengths of Bimatoprost SR and timolol eye drops used twice daily for up to 20 months. The study showed the majority of patients treated with Bimatoprost SR were potentially able to be treatment-free for 1 year after the last implant was inserted, the release said.

“Considering that as many as 80% of glaucoma patients fail to administer their drops on a regular basis, Bimatoprost SR has the potential to transform the management of glaucoma in millions of patients,” Bill Meury, chief commercial officer at Allergan, said in the release.

The implant was well tolerated in the majority of patients. Additional safety data from this study, as well as results from a second phase 3 study, are expected to be reported in the first half of 2019, and the company expects to file a new drug application with the FDA in the second half of 2019, according to the release.

Efficacy and safety of fixed-combination bimatoprost/timolol ophthalmic solution

Background: Poor adherence to treatment is a problem in glaucoma, and patient dissatisfaction with topical glaucoma medication is a barrier to adherence. The objective of this study was to evaluate glaucoma patients’ satisfaction with fixed-combination bimatoprost/timolol ophthalmic solution (BTFC).
Methods: This observational, multicenter study was conducted in China in adults with glaucoma treated with BTFC for 1–3 months. Five hundred patients answered a questionnaire concerning their demographic characteristics, history of glaucoma and topical glaucoma treatment, and use of BTFC. The primary endpoint was patient satisfaction with BTFC assessed on a 10-point scale (1= very dissatisfied, 10= very satisfied).
Results: Patients received BTFC alone (65%) or with other treatments (35%), most commonly a carbonic anhydrase inhibitor. Most patients (87%) used BTFC as a replacement for other medication, usually a β-blocker or prostaglandin analog; 13% received BTFC as add-on treatment. Key reasons for initiating BTFC therapy were poor efficacy of previous treatment (72% of patients) and side effects of previous treatment (32% of patients). Most patients agreed or very much agreed that BTFC provided better control of intraocular pressure (85% of patients), had a simpler administration (87% of patients), and was associated with better tolerance and comfort (82% of patients) compared with their previous treatment. Mean satisfaction scores were significantly higher for BTFC than for previous treatments among all patients (7.8 versus 6.0; P<0.0001) and within patient subgroups based on demographic characteristics, pattern of BTFC use, and previous treatment.
Conclusion: Patients were highly satisfied with BTFC used alone or concomitantly with another topical medication. Patients previously treated with a β-blocker, prostaglandin analog, carbonic anhydrase inhibitor, α-adrenergic agonist, or combination of two medications were more satisfied with BTFC than with their previous treatment. Most reported that intraocular pressure control, tolerability, and ease of administration improved with BTFC.

Keywords: bimatoprost, fixed combination, glaucoma, patient compliance, timolol

Old and New Drug Classes Expanding To Include Glaucoma Treatments

Glaucoma is a heterogeneous disease characterized by the development of increased intraocular pressure (IOP) that leads to structural changes and nerve damage within the eye. Manifestations of this disease include chronic progressive open-angle glaucoma (OAG) and acute angle-closure glaucoma (ACG), both of which may be categorized as either primary or secondary, depending on the underlying cause.Glaucoma ranks among the top five causes of moderate to severe visual impairment and is the third leading cause of blindness worldwide.

Global estimates from 2013 suggest that more than 64 million people aged 40 to 80 years have either primary OAG or primary ACG, and with an increasing elderly population, that number is anticipated to reach 76 million by 2020 and 111.8 million by 2040. As ACG is mainly treated through surgery, this review will focus on chronic therapies used to manage OAG.

Patients with OAG often present with an elevated IOP (normal range: 10–21 mmHg), however, a small subset of patients may develop ocular changes with an IOP < 21 mmHg and are referred to as having normal tension glaucoma. Conversely, some patients with an IOP > 21 mmHg do not go on to develop visual impairment and are referred to as having ocular hypertension (OHT). Control of glaucoma focuses on managing the outflow of the eye’s aqueous humor. The primary exit route is via the trabecular meshwork and through the Schlemm’s canal, also known as conventional outflow, while outflow through the ciliary body and suprachoroidal space, known as unconventional or uveoscleral outflow, accounts for a minor amount of outflow. Topical medications represent the first line of treatment, but if IOP control is inadequate, patients may require escalation to laser-based therapies or surgical procedures.

Several classes of medications are available to treat OAG, but the recommended initial therapy is with a medication from either the beta blocker or prostaglandin analog classes.Prostaglandin analogs work by increasing aqueous humor outflow through the uveoscleral pathway. Beta blockers are believed to act by reducing the production of aqueous humor. A brief overview of the various classes of medications and products available in the United States is provided in Table 1. The usual treatment goal is to achieve a 25%–30% reduction from the patient’s baseline IOP, but other factors such as baseline IOP, pre-existing nerve damage, risk for disease progression, or development of adverse effects may prompt providers to pursue more aggressive or lenient therapeutic goals. Patients may require multiple eye drops from different classes in order to achieve the IOP goal.

Despite the number of effective medications and readily available generic and combination products, there remains a need for new and innovative therapies. One key area for improvement is patient adherence. A survey of patients with glaucoma revealed a number of barriers that prevent effective disease management, including difficulty with effective administration of eye drops, poor medication and disease education, and nonadherence with complex dosing regimens.Some treatments discussed below seek to address adherence through the use of innovative delivery methods that prolong medication activity. Physicians also desire therapies with novel mechanisms that are able to lower IOP more effectively and medications that could provide protection against ocular nerve degeneration.Below (and summarized in Table 2) is a brief overview of several new agents, in no particular order, that have recently been approved or are poised to enter the market in the coming years.

Rhopressa (netarsudil ophthalmic solution)

In December of 2017, the Food and Drug Administration (FDA) approved netarsudil, the first of a new class of medications known as Rho kinase (ROCK) inhibitors. In addition to inhibiting ROCK, this medication also possesses other IOP-lowering mechanisms, such as the inhibition of norepinephrine transport and an ability to reduce episcleral venous pressure. The double-blind, randomized, multicenter trial ROCKET-1 (N=411) compared the efficacy of netarsudil 0.02% dosed once daily at nighttime with timolol maleate 0.5% dosed twice daily. The ROCKET-2 trial (N=756) had a similar design, with an additional netarsudil 0.02% twice-daily dosing arm. Both trials followed patients with OHT or OAG who had an IOP of > 20 mmHg and < 27 mmHg for three months. The primary endpoint in both trials was a reduction in IOP. In ROCKET-1, patients with a baseline IOP < 27 mmHg who received netarsudil demonstrated a 15%–22% reduction in IOP as compared with a 17%–22% reduction in patients who received timolol, but this was not sufficient to demonstrate noninferiority based on prespecified criteria. A post-hoc analysis that focused on patients whose baseline IOP was < 25 mmHg was able to demonstrate noninferiority.

ROCKET-2’s primary efficacy population focused on patients with an IOP < 25 mmHg and was able to demonstrate mean reductions of 3.3–4.6 mmHg and 4.1–5.4 mmHg in patients receiving daily and twice-daily netarsudil, respectively. These reductions were similar to those seen with twice-daily timolol, which produced a 3.7–5.1 mmHg reduction from baseline and demonstrated the noninferiority of netarsudil. In terms of percent reduction in IOP, daily netarsudil was able to achieve a 16%–21% reduction, while twice-daily dosing showed a 22%–24% reduction; twice-daily timolol demonstrated an 18%–23% reduction.

The use of netarsudil appears to be generally well tolerated, with the most common observed adverse effect being conjunctival hyperemia (50%–53%), followed by conjunctival hemorrhage (13%–15%), and cornea verticillata (5%–9%). Other adverse effects including blurred vision, eye pain or erythema, and erythema of the eyelid, were also noted in > 5% of patients.Aerie Pharmaceuticals also conducted the ROCKET-4 trial to demonstrate the six-month safety of netarsudil. Results from this trial, released in April 2017, showed daily netarsudil to be non-inferior to twice-daily timolol. The frequency and severity of effects were seen at similar rates to those in the ROCKET-1 and ROCKET-2 trials.

The entry of netarsudil into the market is exciting as it is a novel, well tolerated, once-daily agent. One limiting factor to this medication is its reduced efficacy in patients with a baseline IOP of 26 mmHg or higher. As Aerie Pharmaceuticals has already obtained approval in the United States, it is anticipated to launch in 2019 in the European Union and in 2021 in Japan.

Roclatan (netarsudil/latanoprost ophthalmic solution)

Roclatan, a combination product containing netarsudil and the prostaglandin analog latanoprost, is also being developed by Aerie Pharmaceuticals. This fixed-dose combination would be administered as a once-daily eye drop in the evening and is formulated as a netarsudil/latanoprost 0.02%/0.005% solution. The IOP-lowering effects of netarsudil are expected to be complemented by increased outflow by way of the uveoscleral pathway, facilitated by latanoprost.

The Mercury 1 trial randomized 718 subjects into three treatment arms: netarsudil monotherapy, latanoprost monotherapy, or netarsudil/latanoprost combination therapy, each dosed once daily. The primary efficacy outcome was mean IOP at three months; patients were observed for 12 months for ocular and systemic safety outcomes. At 90 days, patients who received the combination therapy achieved 1.3–2.5 mmHg lower mean IOP than patients who received latanoprost monotherapy, and 1.8–3.0 mmHg lower mean IOP than patients who received netarsudil monotherapy. Significantly more subjects receiving combination therapy demonstrated a 20% or greater IOP reduction and achieved an IOP of < 18 mmHg. While no serious adverse events were reported, a higher percentage of patients discontinued therapy at three months in the combination (15.5%) and netarsudil monotherapy (17.6%) arms versus latanoprost monotherapy (5.5%), with adverse effects being cited as the most common reason for discontinuation. Conjunctival hyperemia was reported in approximately 50% of patients, with most cases being described as mild. Approximately 5% to 11% of patients reported experiencing conjunctival hemorrhage, pruritus, increased lacrimation, and cornea verticillata.

The Mercury 2 trial evaluated changes in IOP at 90 days in 750 participants receiving netarsudil/latanoprost, netarsudil monotherapy, or latanoprost monotherapy. Similar to the Mercury 1 findings, the combination agent was able to lower IOP an additional 1.5–2.4 mmHg compared with latanoprost monotherapy and an additional 2.2–3.3 mmHg when compared with netarsudil monotherapy. Fifty-six percent of patients receiving netarsudil/latanoprost were able to achieve a diurnal IOP of < 16 mmHg.

An additional clinical trial (Mercury 3) is underway to compare the safety and efficacy of netarsudil/latanoprost with that of the combination bimatoprost/timolol 0.03%/0.5%. This trial, which is still recruiting patients, will aim to enroll 472 participants and evaluate changes in IOP at six months in addition to clinical safety endpoints. Currently, no additional information is available regarding this study, but the anticipated completion date is April 2019. Aerie Pharmaceuticals filed a New Drug Application on May 15, 2018 and expects a decision from the FDA within 10 months.

OTX–TP

Ocular Therapeutix is developing a bio-resorbable canalicular implant that will continuously deliver the prostaglandin analog travoprost for up to 90 days. The active medication is encapsulated in a biodegradable polyethylene-glycol hydrogel that will swell upon implantation to retain its position in the eye. This plug is inserted through noninvasive methods by a specialist and does not require removal as it exits through the nasolacrimal system.This novel delivery system addresses the major issue of poor patient adherence and is poised to be the first of several implantable therapies to enter the major markets.

A phase 2b study evaluated efficacy and safety of a punctum plug of travoprost against timolol maleate 0.5% drops twice daily in 79 patients. Participants were enrolled if they had a diagnosis of OHT or OAG with a mean baseline IOP of ≥ 24 mmHg at Hour 0 and an IOP of ≥ 22 mmHg when checked 4 and 8 hours later. Mean reductions in IOP were evaluated at 30, 60, and 90 days at multiple times each day (8 a.m., 12 p.m., and 4 p.m.). Patients in both groups demonstrated a reduction in IOP from baseline, although those receiving OTX–TP showed a 3.27–3.54 mmHg reduction while those receiving timolol experienced a 5.84–6.29 mmHg reduction. These reductions in IOP were observed at all time points throughout the day. The reported rates of ocular (39.4% vs. 37.5%) and non-ocular (9.1% vs. 7.5%) adverse effects were similar in the OTX–TP and timolol arms, respectively. The most common adverse effects were dacryocanaliculitis (12.1% vs. 10%), acquired dacryostenosis (6.1% vs. 5%), eyelid edema (6.1% vs. 0%) and scar (6.1% vs. 0%) in the OTX–TP and timolol groups, respectively.

Ocular Therapeutix is now enrolling patients for a phase 3, placebo-controlled trial evaluating the efficacy and safety of OTX–TP in the treatment of OAG or OHT. This trial will aim to enroll 550 patients with a primary endpoint of changes in IOP at Weeks 2, 6, and 12, at 8 a.m., 10 a.m., and 4 p.m. Ocular Therapeutix expects to complete this trial in December 2018.While OTX–TP has the advantage of a noninvasive route of administration and is likely to be the first long-acting implant to enter the market, the lower impact on IOP as compared with timolol drops observed in the phase 2b trial and lack of active control in the upcoming phase 3 trial may make some providers unsure of its place in therapy.

Bimatoprost Sustained-Release Ocular Implant

Allergan is reformulating its prostaglandin analog, bimatoprost, into a sustained-release ocular implant as a way to enhance patient adherence. Bimatoprost SR would continuously deliver medication over six months after being inserted via injection into the anterior chamber of the eye through a noninvasive procedure.

A phase 1/2 prospective, dose-ranging trial that examined 75 patients with OAG demonstrated a rapid and sustained lowering of IOP with bimatoprost SR. Following a washout period, enrollees intracamerally received various doses in the study eye while the other eye was treated with topical bimatoprost 0.03%. Overall mean IOP reductions of 7.2, 7.4, 8.1, and 9.5 mmHg were seen in patients receiving 6, 10, 15, and 20 mcg of bimatoprost SR, respectively, as compared with an 8.4 mmHg reduction with topical bimatoprost. Patients initially reported higher rates of adverse effects such as eye pain, foreign body sensation in the eye, and conjunctival hemorrhage with bimatoprost SR but these symptoms subsided within two days of onset. Following Day 2, the eye receiving bimatoprost SR had less reported conjunctival hyperemia (6.7% vs. 17.3%) than the eye receiving topical bimatoprost, while reports of other adverse effects remained similar between the eyes. When questioned at Day 8, 79.7% of patients reported the procedure to be less burdensome than anticipated and, at Week 12, 77% of patients were very or extremely likely to have another implant procedure.

An ongoing phase 3 trial enrolling 594 patients with OAG or OHT is comparing twice-daily timolol drops to two undisclosed doses of bimatoprost SR administered on Day 1, at Week 16, and at Week 32. The primary outcome will be changes in IOP from baseline to Week 12; however, patients will continue to be followed for a 12-month treatment duration plus an additional eight-month extended follow-up.A second trial, similarly designed, is aiming to enroll 600 patients and has an estimated primary completion date of March 2019. Two additional trials are comparing bimatoprost SR with selective laser trabeculoplasty in patients with OAG or OHT who are unable to be controlled with topical IOP-lowering therapies. In these trials, an undisclosed dose of bimatoprost SR will be administered on Day 1, at Week 16, and at Week 32. The primary outcome will be changes in IOP at Week 24. Investigators seek to enroll 160 patients for each study and have estimated primary completion dates of November 2019 and May 2020.

DE-117

Santen Pharmaceutical is developing a novel agent that acts on a new target in the prostaglandin pathway, the prostaglandin EP2 receptor. While other prostaglandin analogs bind to the F2-alpha receptor, DE-117 activates the EP2 receptor and is thought to lower IOP by regulating outflow through the conventional pathways. This novel mechanism may position DE-117 to be a viable option in patients for whom other prostaglandin analogs have not adequately lowered IOP. In November 2017, Santen filed for approval of DE-117 in Japan while continuing to conduct trials in other markets. There are several clinical trials involving DE-117 for which enrollment is complete but results have not yet been posted.

Among these trials: The phase 2 SEE-1 trial, evaluating five doses of DE-117 against latanoprost among 184 participants in several centers across the United States, was listed as having completed enrollment as of April 2018; a long-term, open-label trial known as RENGE, involving 125 patients and that compared two groups of DE-117 monotherapy with patients receiving the combination DE-117 and timolol ophthalmic solution, was listed as having been completed in November 2017, and the AYAME study, which also evaluated two doses of DE-117 against a placebo arm as well as a latanoprost arm in 253 patients with OAG and OHT.

One trial for which results are available evaluated four varying concentrations of DE-117 against placebo and latanoprost in 91 patients. At the end of 4 weeks, investigators found that a concentration of 0.002% of DE-117 performed the best and matched the IOP-lowering effect of latanoprost. The most commonly observed adverse effects in the 0.002% dosing arm, all seen in approximately 14% of patients, included conjunctival and ocular hyperemia, photophobia, and eye pain.28 The only trial listed as recruiting patients is a phase 3 trial comparing DE-117 directly to latanoprost in patients with OAG or OHT in an anticipated 360 patients. The primary outcome is mean diurnal IOP at three months, and the expected completion date is November 2018.

CONCLUSION

Several other long-acting formulations of established medications are in the early stages of development, which suggests that addressing the issue of poor patient adherence is an area of keen interest. In addition, new medications belonging to established classes, such as prostaglandin analogs, are in early development, as are new therapeutic classes such as guanylate cyclase activators. With these novel treatment options on the horizon, better management of glaucoma looks promising for the near future.

Author bio:
Dr. Kish is an Associate Professor of Pharmacy Practice at Long Island University, LIU Pharmacy (Arnold and Marie Schwartz College of Pharmacy and Health Sciences), in Brooklyn, New York.

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Careprost is made by SunPharma company which is founded in 1983, very trusted company in India, and in the world. Careprost is eyedrops for eyelashes. Active ingredient of Careprost from SunPharma is Bimatoprost with strength 0.03% it’s enoght for eyelashes. Usually this is cosmetic medicine and do not require a prescription, but you should to take Careprost very strictly with instructions. If you search where and how to order generic latisse, or another name: Careprost, we can offer this. We sell careprost many years with best prices and delivery time. We can ship Careprost to United States, United Kingdom, Australia, and many other countries, in wich customs do not strictly, you can contact us with request button, or page on our website: WEMAILMD.COM

Careprost should be applied strictly on the growth line of the TOP eyelashes. Some drop a droplet into the cap, dip the brush in there and already apply directly to the growth line.

The possible side effects is a hyperpigmentation (darkening) of the tissues of the upper eyelid and eyelashes, which persists throughout the period of use of the Careprost. As a rule, after its cancellation, hyperpigmentation disappears completely.

Hypertrichosis (active hair growth) is possible in areas of skin exposed to contact with Careprost solution outside the application areas.

Very rare: eye irritation, conjunctival hyperemia, redness of the eyelids, skin hyperpigmentation, dry eye symptoms.

1 Life-Changing Beauty Hacks That Are Way Cheaper Than Eyelash Extensions

1. A lash serum

Though lash serums seem like they’re all talk, some actually deliver with some seriously great results. Products like Latisse or Careprost can really get your lashes into great, long and dark shape. If you’re coming off extensions, getting used to your natural lashes can be a big adjustment. Serums can help you get that lush natural lash you want without compromising on your lash health. You can grab an affordable one off of Amazon.

How to Grow Your Eyelashes Really, Really Long

How can I stimulate my eyelashes to grow?

If you’ve ever watched TV or opened a magazine, you’ve likely heard of a product called Latissethe only FDA-approved eyelash growth serum on the market. It was originally created as eye drops for glaucoma (high eye pressure), but doctors noticed its other benefit: the ability to grow longer, thicker eyelashes.

After a few iterations and ingredient refinements, Latisse was born, using the active ingredient bimatoprost to help grow your existing lashes and stimulate the growth of new hairs in four to six weeks. Pretty cool, huh? The only little hurdle is that it’s by prescription only, so you gotta go to a derm or doctor to get it.

Which brings us to your next thought: What about the random eyelash serums I see on articles and Instagram? And, ahem, right this way…

Global Eyelashes Enhancing Agents Market Insights Report 2019-2023: Top Manufacturer Estee Lauder, Allergan, Rodan & Fields, Skin Research Laboratories

The “Eyelashes Enhancing Agents Market” globally is a standout amongst the most emergent and astoundingly approved sectors. This worldwide market has been developing at a higher pace with the development of imaginative frameworks and a developing end-client tendency. The worldwide Eyelashes Enhancing Agents market is an enlarging field for top market players Estee Lauder, Allergan, Rodan & Fields, Skin Research Laboratories, ATHENA COSMETICS, Grande Cosmetics, Beauty Essentials. This report gives an exhaustive appraisal of the Eyelashes Enhancing Agents market driving components, which are perceived reliant on the requests of end-client, variable changes in the market, preventive components, and administrative understanding.

The Eyelashes Enhancing Agents market sections are extensively bifurcated on steady data, for example, improvement, quality, dependability, end-client requests, uses, and The strike of the global Eyelashes Enhancing Agents market is mentioned in the part of those areas, It demonstrates various segments Repairing Damaged Eyelashes, Nourishing and sub-segments Bimatoprost, Lash-Building Serum, Skincare Ingredients of the global Eyelashes Enhancing Agents market. The Eyelashes Enhancing Agents market is the cornerstone of the general improvement conditions and desires, as the development of a specific idea needs different analysis, activities, estimates, and philosophies mechanically. We conveyed a point by point outline of the whole key Eyelashes Enhancing Agents market players who have significant score concerning demand, revenue, and deals through their solid administrations. The global Eyelashes Enhancing Agents market report illustrates the profound outline of existing developments, particulars, parameter, and creation. The Eyelashes Enhancing Agents market likewise conveys a total survey of the money related exciting ride in regards to request rate and satisfaction extents.

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cosopt

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Alternative for Cosopt is Dorzox T from Cipla


Active substance: Dorzolamide + Timolol
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Dorzolamide + Timolol (DORZOX  T) is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to beta-blockers (failed to achieve target IOP determined after multiple measurements over time). The IOP-lowering of COSOPT administered twice a day was slightly less than that seen with the concomitant administration of 0.5% timolol administered twice a day and 2% dorzolamide administered three times a day

Dorzox T (COSOPOT) (dorzolamide hydrochloride-timolol maleate ophthalmic solution) is the combination of a topical carbonic anhydrase inhibitor and a topical beta-adrenergic receptor blocking agent. This medication works by decreasing the amount of fluid within the eye. Timolol belongs to a class of drugs known as beta-blockers, and dorzolamide belongs to a class of drugs known as carbonic anhydrase inhibitors. DORZOX T (Dorzolamide + Timolol ) is supplied as a sterile, clear, colorless to nearly colorless, isotonic, buffered, slightly viscous, aqueous solution.

Resources: webmd, rxlist,

The dose is one drop of Dorzolamide + Timolol in the affected eye(s) two times daily. If more than one topical
ophthalmic drug is being used, the drugs should be administered at least five minutes apart.

Storage
Store COSOPT at 20° to 25°C (68° to 77°F). Protect from light.

More common
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Can Glaucoma be Treated With Cosopt Loaded Contact Lenses?

The University of Florida has announced a study to determine whether drug eluting contact lenses can be used to treat glaucoma.

The contact lens will be loaded with Cosopt (i.e., timolol maleate and dorzolamide hydrochloride), as well as vitamin E ((+) ?-tocopherol) as an additive for achieving extended release of the drugs.

Effectiveness will be measured as a drop in IOP after using the lenses.

Eye Drop Shortage Concerns Glaucoma Patients

A nationwide shortage of a special kind of eye drop to treat glaucoma has hit close to home for one Franklin teenager.

On January 24, the Food and Drug Administration placed Dorzolamide Hydrochloride and Timolol Maleate (Cosopt) Ophthalmic Solution on its FDA Drug Shortage list .

The manufacturer said it may not have it available until June because a certain substance used to make Cosopt has run low.

Jacob Cuomo, 18, was diagnosed with congenital glaucoma at one month old. He has been without the eye drops for about a week after running out of his prescription.

He said he’s starting to feel more pressure around his eyes daily and concerned about the possibility of going blind.

“You can’t stop thinking about it because the medication is what you need. You’re so use to having it, it’s like what you need and when it changes it ruins the whole cycle,” he said.

Jacob takes another eye drop medication, but Cosopt is the one he needs more.

He attends Centennial High School and said juggling Advanced Placement and honor classes, plus managing a computer science club, causes a lot of strain on his eyes. He is also a member of the Junior ROTC program.

“I just make sure that I stay in contact with everybody so they know what’s wrong with me. Communication is key to make sure that everything runs smoothly,” he said. “When you don’t take your eye drops say like for a week like it has been for me, you’ll start to feel your eyes start to get bigger. When you lose your vision that’s when you really start to wonder like okay, things are starting to change now.”

Jacob’s mother, Christine, said she’s called pharmacies around Middle Tennessee to see if they have Cosopt.

“I’m just hoping that we can get the drop for him or some alternative or something for him,” Christine said.

The family said they hope Jacob’s doctor can give them the ‘OK’ to receive an important ingredient used in Cosopt soon.

The FDA lists Cosopt-PF, an alternative, as available.

Glaucoma: 3 Ways to Treat a Sneaky Disease

Glaucoma, a group of eye conditions in which the pressure in one or both of your eyes increases and damages your optic nerve, is a sneaky disease with no symptoms in its early stages.

If it’s left untreated, you can lose your sight. Although there is no cure, if it’s detected and treated early, treatment can usually stop or significantly slow down vision loss. Because glaucoma is progressive, the best treatment for you will depend on what stage of the disease you’re in, but the choices are pretty straightforward: eye drops, laser therapy and surgery.

Eye Drops

Eye drops are typically the most common treatment and the one your doctor will likely start with. There are several different types of eye drops that each help decrease the pressure in your eye in different ways. They also have different side effects, though most people don’t notice these.

1. Prostaglandin analogs: “Prostaglandins are the No. 1 prescribed medication, the gold standard,” says Steven Anderson, MD, an ophthalmologist and glaucoma specialist at Sanford Eye and Optical in Fargo, ND. “The beauty of a prostaglandin analog is that it has fewer systemic side effects, it’s a once-a-day drug that lasts for 24 hours, and it’s very effective.” Prostaglandin analogs such as Xalatan (latanoprost) and Travatan (travoprost) lower eye pressure by increasing the outward flow of the fluid in your eye. Possible side effects include eye irritation, dry eye, blurry or cloudy vision and headache.

2. Beta blockers: Once the gold standard before the advent of prostaglandins, these drops lower eye pressure by reducing the amount of fluid your eye produces, slowing down the flow. Examples include Alphagan (brimonidine) and Timoptic (timolol). Possible side effects include eye irritation, fatigue, double vision, headache and dizziness. Barbara Roman, 65, had to switch from Alphagan and Timoptic because both made her extremely tired and drowsy. She’s now on Azopt (brinzolamide), a carbonic anhydrase inhibitor (see #5), and Xalatan (Prostaglandin, #1), and doesn’t notice any side effects at all.

3. Alpha adrenergic agonists: Lopidine (apraclonidine) and Propine (dipivefrin) are 2 types. These drops lower eye pressure by reducing the amount of fluid your eye produces and increasing the outward flow of fluid. Potential side effects include eye irritation, swelling or pain, blurry vision, fatigue and dry mouth. These drops often cause an allergic reaction.

4. Miotic or cholinergic agents: These eye drops force your pupil to become smaller and help fluid drainage. Examples include Isopto Carpine (pilocarpine) and Phospholine Iodide (echothiophate). They can cause nearsightedness and blurry or dim vision.

5. Carbonic anhydrase inhibitors: Trusopt (dorzolamide) and Azopt (brinzolamide) are eye drops that reduce your eye’s fluid production, though they aren’t used often. This type can also be given as an oral medication like Diamox (acetazolamide) or Neptazane (methazolamide). “I usually use oral medication as a bridge for getting to surgery or when I’m really limited for medication options,” says Dr. Anderson. “The problem is that they can cause a lot of side effects like rashes, lethargy, loss of appetite, a metallic taste in your mouth, electrolyte imbalances and tingling in your hands and feet.”

6. Combination eye drops: These drops use 2 drug types in one drop to get even better results. Examples include Cosopt (dorzolamide [#5] and timolol [#2]), Xalacom (latanoprost [#1] and timolol [#2]), Simbrinza (brinzolamide [#5] and brimonidine [#2]) and Combigan (brimonidine [#2] and timolol [#2]).

Laser Therapy

Laser therapy is the most commonly used procedure for glaucoma and its effect is equivalent to using a single glaucoma medication, says Dr. Anderson.

“It’s an option for a patient who doesn’t want to do drops or who may have a hard time using them,” he says. “You may do it as a first-line agent, or you may use it as an adjunct [supplemental] agent.”

Laser therapy can also be used for people whose medication is creating significant side effects or who are already on 2 or 3 eye drops and still aren’t achieving lower pressure. While the procedure alone may effectively control your eye pressure, you may need one or more glaucoma medications as well.

Laser procedures are performed on an outpatient basis in your ophthalmologist’s office with numbing drops, a contact lens and specific laser targets. Though the procedure usually results in decreased eye pressure, how long the effects last depends on your age, other medical conditions and the type of glaucoma you have. Additional procedures may be necessary later.

Trabeculoplasty: “The most popular [laser therapy] now is the selective laser trabeculoplasty [SLT], which is a newer version of the old argon laser trabeculoplasty. It treats the area within the eye where the fluid filters out,” says Dr. Anderson. “The SLT laser cleans up any pigment and debris that’s clogging up the filter and stimulates the body’s own immune system to come in there and clean up the filter to get better flow in a more natural way.”

One big difference between the SLT laser and the argon laser is that the latter tends to cause scar tissue, reducing its ability to be repeated, and over time becoming less effective. “The SLT laser is a different frequency and so it doesn’t really scar the filtering mechanism, meaning that you can repeat [the procedure] more effectively,” Dr. Anderson says.

Other types: Other types of laser treatments include laser peripheral iridotomy, cyclophotocoagulation and scatter panretinal photocoagulation. The side effects of laser therapy are minimal. Inflammation and discomfort do occur, but they’re generally mild and easily treated with drops. Eye pressure spikes are a risk, but rare. This did happen to Roman after one of many laser treatments, and she had to have an emergency needle procedure to get the pressure down.

Mary Gordon, 70, was diagnosed with acute angle-closure glaucoma 15 years ago and has had multiple trabeculoplasties, as well as many laser peripheral iridotomies, in which one or more holes are made in your iris with a laser. “The procedures were easy, done at the office, and there was no pain and no recovery time,” she says.

Roman was diagnosed with early-onset open-angle glaucoma when her kids were still young. “It was a shock to get this diagnosis at such a young age and I hadn’t noticed any symptoms,” she says. “Understandably, I now crusade friends and family to get checked.”

Her glaucoma is thought to be one outcome from the chemotherapy, radiation and prednisone she had for stage 4 lymphoma in 1983. She has also had multiple laser treatments “hoping to arrest progression, but unfortunately, glaucoma continues to progress,” she says. “It was surprising to me that laser treatments have been quick, easy and painless.”

Surgery

Glaucoma surgery is usually reserved for patients for whom medications and laser treatments haven’t worked. “When you’re judging a patient with glaucoma, you think, ‘What is the ideal pressure for this patient?’ If they’re above that ideal pressure either on drops or after having laser therapy, then surgery is considered because we’re trying to prevent irreversible vision loss,” says Dr. Anderson. Most of these surgeries will involve a hospital or surgery center and recovery may take a few weeks.

Minimally invasive glaucoma surgery (MIGS): This surgery uses “microscopic metal or synthetic tubes in the eye to provide another pathway for the fluid to get out to lower the pressure,” Dr. Anderson says. It’s being researched and developed as a safer way to treat glaucoma than traditional surgery, while also potentially lessening your need for eye drops. One type of MIGS involves a device called a trabectome, which uses heat to cut away tiny amounts of tissue from the mesh inside of your eye, lowering the buildup of fluid and eye pressure.

Last year, Gordon had a procedure in her left eye called endocyclophotocoagulation (ECP) along with her cataract surgery.

ECP is a type of minimally invasive surgery and uses a laser to cause inflammation and scarring, which in turn decreases your eye pressure. About 2 months after ECP and using dorzolamide HCL and timolol maleate, a combination eye drop, twice a day in both eyes, Gordon’s eye pressure is within normal limits. She recently had ECP in her right eye as well with similar results. After having pressure in the 30s for years, she’s thrilled with the improvement.

Filtering surgery: This may be a trabeculectomy or a trabeculectomy with an EX-PRESS shunt. In a trabeculectomy, small amounts of tissue from the mesh inside of your eye are removed, but it’s more invasive than the trabectome procedure and may have more side effects.

The EX-PRESS shunt is “a stainless steel tube that’s placed in the eye that provides a pathway for the fluid to get out,” says Dr. Anderson. “In my practice, it’s my go-to surgery in many cases. I find it very effective in getting pressures where I want. It gives me a lot of control and good results.” Because trabeculectomy can result in scarring, an anti-scarring medication like mitomycin-C is used to prevent this from happening.

Aqueous shunt surgery: This is typically done with a Baerveldt, Molteno or Ahmed shunt, which are “implants that are designed to provide better outflow and reduce the risk of scarring,” Dr. Anderson says. “The shunts are for more severe glaucoma and for people who’ve failed other surgeries.” Roman is in the process of getting a consult to have an Ahmed shunt placed in her right eye “in an attempt to keep it from deteriorating to the same condition as my left eye,” which is in the severe stage, she says.

The Marijuana Controversy

You may have heard that marijuana helps glaucoma. However, the American Academy of Ophthalmology does not recommend using marijuana as a glaucoma treatment. Marijuana can lower your blood pressure, causing decreased blood flow to your optic nerve, which increases your risk of vision loss. Although marijuana does lower the pressure in your eye, this effect only lasts for a few hours, whereas eye drops last a lot longer.

For the effects to be long-lasting, you would need to use marijuana every few hours, day and night, which is harmful to your body and limits your daily activities, such as driving. “I don’t think you want to live a lifestyle where you’re inhibited by the drug all day,” notes Dr. Anderson. “I don’t prescribe it.”

New and Upcoming Treatments

In 2017, two new eye drops were approved for glaucoma. Vyzulta (latanoprostene bunod) is the first medication for glaucoma to contain nitric oxide, a chemical that may affect blood flow to the optic nerve. It also contains a prostaglandin analog, so the potential side effects are similar to that of prostaglandins. Rhopressa (netarsudil) is in a new class of eye drops called rho-associated protein kinase inhibitors. It improves fluid drainage and decreases fluid production.

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Dorzolamide is is an eye care medication.


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DescriptionHow to take?Common Side EffectsLatest New'sPhoto's

Dorzolamide is sold under various trade names, some of which are Trusopt (us brand) and Dorzox (made by Cipla). Dorzolamide is used to treat high pressure inside the eye due to glaucoma (open angle-type) or other eye diseases (e.g., ocular hypertension). Dorzolamide in India available under brand name Dorzox wich is made by Cipla, trusted company, we offer to buy from us this medication at one of  best prices on the market, we offer two ways of shipping to US, UK, AU, just contact us for future information regarding Generic Trusopt eye-drops with cheap prices.

Ophthalmic dorzolamide comes as a solution (liquid) to instill in the eye. Dorzolamide eye drops are usually instilled three times a day.

To instill the eye drops, follow these steps:

  1. Wash your hands thoroughly with soap and water.
  2. Check the dropper tip to make sure that it is not chipped or cracked.
  3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
  4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
  5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
  6. Brace the remaining fingers of that hand against your face.
  7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
  8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
  9. Place a finger on the tear duct and apply gentle pressure.
  10. Wipe any excess liquid from your face with a tissue.
  11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
  12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
  13. Wash your hands to remove any medication.

Use this medication regularly in order to get the most benefit from it.

https://medlineplus.gov/druginfo/meds/a697049.html

  • burning or stinging in your eye;
  • mild eye discomfort; or
  • a bitter taste in your mouth.

Dorzolamide Hydrochloride Market Key Driving Factor, Challenge and Opportunities To 2023

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Drug availability, pricing negatively affect the practice of glaucoma

Better education on price and more competition in the drug marketplace are needed to help bring down the cost of glaucoma medications.

Physicians, insurers, pharmacists, regulators, and patients should all be part of the mix in making glaucoma medications more affordable, said Joshua D. Stein, MD. This can be challenging, and prices for many glaucoma medications continue to increase, said Dr. Stein, University of Michigan, Ann Arbor, MI.

The main reasons for high medication prices in the United States are market exclusivity and limited competition. New agents typically are awarded 7 years of market exclusivity by the FDA.

However, the actual median length of market exclusivity is 12 years for most medications and more than 14 years for first-in-class medications. This is because that time period of exclusivity can extend due to regulatory review, clinical trials, or testing done in children, Dr. Stein said.

“For glaucoma medications, the time of patent exclusivity ranges from 7 to 15 years for common agents,” Dr. Stein said.

Drug shortages also can affect patient use of drugs. Some contributing factors for this include a lack of raw ingredients, which was the reason cited for a limited supply of dorzolamide and dorzolamide-timolol, Dr. Stein explained.

https://www.ophthalmologytimes.com/article/drug-availability-pricing-negatively-affect-practice-glaucoma

Important Medication in Short Supply for Glaucoma Patients

An important medication for glaucoma patients is in short supply. Patients like Ronald Webb rely on a prescription medication called “Dorzolamide” to see. He uses the eye drops twice a day.

“One of my eyes is almost gone,” Webb said. “It doesn’t matter if you hold two fingers up or whatever, I can’t see anything.”


Glaucoma (According to the National Eye Institute)

  • A group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness.

Who is at risk?

  • African Americans over age 40
  • Everyone over age 60, especially Mexican Americans
  • People with a family history of glaucoma

Symptoms of Glaucoma

  • At first, open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal. Glaucoma can develop in one or both eyes.
  • Without treatment, people with glaucoma will slowly lose their peripheral (side) vision.
  • Over time, central vision (straight-ahead) may decrease over time until no vision remains.

But suddenly Dorzolamide wasn’t available at his pharmacy, or anywhere else he checked.  According to the FDA website, the drug has been in shortage since January 24th. Instead, Webb says he’s been prescribed an alternative drug called “Azopt” which is much more expensive.

“It costs $190, compared to the $18 I was paying before,” he said. “A big price difference.”

According to one of the pharmaceutical companies that makes Dorzolamide, the drug is on backorder and unclear when it will be readily available.

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DescriptionHow to take?Common Side EffectsLatest New'sPhoto's

We sell Generic Bimatoprost under brand name: Bimat. Bimat availalbe at wemailmd.com with brush or without brush, you need to contact us if you need brush, usually we ship bimat without brush. Original brand of bimatoprost 0,03% is Latisse, Latisse brand is not cheap, so we recommend to buy cheaper bimat version of bimatoprost. Bimat made by Ajanta Pharma is popular and trusted company in India, they made various medecines. Bimatoprost eye drop is an award-winning ophthalmic solution that not only lowers intraocular pressure deep within the eye but also helps your eyelashes grow naturally. Also we can say that Bimat is good alternative for Careprost This product makes your eye lid organ capable enough of getting attractive lashes.

Basicaly, Bimat is recommended to use up to 16 weeks  up to  good changes in your eyelashes. It has to be applied once a day for 14 weeks and thereafter can be adjusted to 1-3 times a week. Consult your physician before stop using or start the solution.

  1. Make sure your face is clean. Remove your makeup and remove your contact lenses if you wear them. Wash your hands to prevent germs from getting on or near your eyes.
  2. Remove the applicator from the tray that it is packaged in. Hold the applicator horizontally. Gently squeeze the bottle allow one drop of Latisse to come out onto the applicator. Do not put it on the very tip, but the area right before the tip. You will not want to waste any drops, as it is expensive.
  3. Draw the applicator with the Latisse on it along the base of the upper eyelashes starting from the inner part of your eyelash line to the outer part. Do not apply to the lower lid. Do not instill Latisse into the eye. (You don’t need to use much Latisse to make your lashes grow.)
  4. Blot any excess Latisse that may be on the eyelid with a tissue. Try not to allow the Latisse to enter your eyes.

Source

  • Redness of the thin tissue over the white part of the eye (conjunctiva)
  • Itchy, red eyes.
  • Dry eyes.

How to Grow Your Eyelashes Really, Really Long

here is an article from popular website:

How can I stimulate my eyelashes to grow?

If you’ve ever watched TV or opened a magazine, you’ve likely heard of a product called Latissethe only FDA-approved eyelash growth serum on the market. It was originally created as eye drops for glaucoma (high eye pressure), when doctors noticed its other benefit: the ability to grow longer, thicker eyelashes.

After a few iterations and ingredient refinements, Latisse was born, using the active ingredient bimatoprost to help grow your existing lashes and stimulate the growth of new hairs in four to six weeks. Pretty cool, huh? The only little hurdle is that it’s prescription only, so you gotta go to a derm or doctor to get it.

Which brings us to your next thought: What about the random eyelash serums I see on articles and Instagram? And, ahem, right this way…

Do OTC eyelash growth serums really work?

Not to further complicate a topic that’s already complicated enough, but this question is a loaded one. If your friends have been using OTC lash serums and *swear* they’ve gotten longer, thicker lashes, it’s very possible they’re using a product that contains an ingredient comparable to bimatoprost.

image
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There are some non-prescription lash serums that contain similar growth ingredients, like isopropyl cloprostenate, but these aren’t FDA-regulated or approved,” says Dr. Haberman. So just because you can buy them from your mom’s best friend, it doesn’t mean these lash serums are totally harmless to try. As with any medication, there are side effects to take into consideration before painting your whole eye with the stuff.

Are lash serums safe?

Yes, no, and possibly. There’s good reason (well, actually, reasons plural) why you need a prescription to get your hands on Latisse: It’s an actual drug (for glaucoma!), which means an actual doctor needs to make sure it won’t interfere with other medications you’re taking or have a negative side effect on your eyes.

And you know all those rumors about someone’s eye color changing from using an eyelash serum? Yeah, that’s a possibility if you’re using a formula with growth ingredients. According to Dr. Haberman, if the serum gets inside the eye, those with lighter eyes could notice a change in the color of their irises after repeat exposure. In other words, your baby blues could end up brown if you’re not applying the product carefully, thinly, and only to your lash line.

Other risks: A growth serum can also cause discoloration of the skin and/or irritation and puffiness of the lid if it seeps into your eye. Of course, like all side effects, these are a possibility, not a guarantee—some people can use lash serums without any issues, but this is still a good reminder to always read the ingredients list and talk to your doctor, first.

Long Lashes Without Prescription, but With Risks

If women want to grow longer, fuller, darker eyelashes, Brooke Shields suggests on a ubiquitous television advertisement that they ask their doctors if Latisse is right for them.

But in the case of Latisse, which has sold more than a million bottles to date and gained something of a cult following, it turns out to be easy to bypass a doctor’s prescription or visit.

Some salon workers dispense it to clients who go in for facials. Web sites in the United States and abroad sell it outright with few questions asked. Even doctors are getting into the act: for example, Dr. Anshul V. Gambhir, a former primary care doctor, runs www.latisse.bz, which boasts that it is the “largest Latisse retailer.” All it takes to get Latisse mailed out — without ever seeing him — is filling out a medical history, which he reviews, and typing in a valid credit card number.

“We are doing a ton of business,” said Dr. Gambhir, who also offers Latisse at his three offices in Pennsylvania.

Most people use Latisse, a topical solution, with few, if any, complaints. But the drug can cause redness, itchiness and irritation, which go away if use is discontinued. Less common is eyelid discoloration, which Allergan, the manufacturer, says “may be reversible.” A rare side effect that has captured the most attention is the chance that one’s hazel or blue eyes could turn brown — forever.

The Natural Way to Get Longer Lashes (That Actually Works)

Latisse lash serum is a popular solution to help you grow longer eyelashes, but studies have shown that it can cause irritation to the eye for certain people. The FDA warns that in addtion to eye irritation, Latisse can also cause skin discoloration and even potentially change your eye color permanently. Yep.

Unfortunately, other over-the-counter products that promise eyelash growth aren’t much better.

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DescriptionHow to take?Common Side EffectsLatest New'sPhoto's

Kamagra is a well-known medicine for treating erectile dysfunction. The action of the drug is based on its active ingredient sildenafil, which is also the main component of the famous Viagra. Kamagra Oral Jelly is the form of Kamagra that acts like the regular drug but has few distinctive features like pleasant flavors and different dosage guidelines. Kamagra Oral jelly sells on wemailmd.com many years. Manufacturer Kamagra Oral Jelly is ajanta pharma are the trusted company from India. We recommend to buy Kamagra using wemailmd.com, – fully guarantee safely delivery and payment process.

It is recommended to administer this medicine no more than once a day, so the next time the jelly should be taken no earlier than 24 hours after the last use of the medication.Consume one sachet of Kamagra Oral Jelly as needed, recommended to take it 30 to 60 minutes before sex. One sachet per day can be taken of Kamagra Oral Jelly and another dose can be repeated only after 24 hours.  Kamagra Oral Jelly starts working up to 10 times faster than Viagra. Take Kamagra jelly within 30-45 minutes before the intended sexual intercourse. To ensure the best effect of the drug do not consume alcohol and fatty food with it.

What if you overdose?

Overdose may lead to extreme dizziness, fainting, or painful or prolonged erection.

What are the Side Effects of the drugs?

  • Dizziness
  • Nausea
  • Pain
  • Numbness

Do not take Sildenafil if you have heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye troubles, and who over smoke or are over 50 years of age.

What is it?

Kamagra oral jelly from Ajanta 100mg – it is an effective remedy having a nice flavor, which has been created in order to improve male potency. This is one of the best solutions for those who have already forgotten what long and high-quality sex is. Despite a large number of disagreements and fundamentally different opinions about the remedy intake and its effect this product made a real break through in pharmacology.

The top 1 medications that are popular amongst men

If you’re tired of swallowing those large male tablets that are difficult to swallow, Kamagra Oral Jelly might just be what you need. This liquid jelly gets absorbed swiftly (within 20 minutes of ingestion) and works effectively for about 4 to 6 hours. Sildenafil Citrate, the active compound found in this performance-enhancing medication, efficiently dilates the body’s blood vessels – especially those located in your genitals. Consequently, you experience a sturdier blood flow that supports long-lasting erections. Kamagra Oral Jelly comes in a variety of flavours such as banana, mango, chocolate, mint and strawberry. These different flavours are sent to you upon ordering.

Common use of Jelly
Kamagra Oral Jelly Vol-1 is a new easy snap pack including 7 assorted flavors: pineapple, orange, strawberry, vanilla, banana, black currant and butterscotch. Kamagra Oral Jelly Vol-1 is a new easy snap pack including 7 assorted flavors: pineapple, orange, strawberry, vanilla, banana, black currant and butterscotch.
Sildenafil is the main component of Kamagra Oral Jelly.
Sildenafil affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.
Sildenafil is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.

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Kamagra Gold is an effective drug used in the treatment of erectile dysfunction. The new formulation with few side effects will eliminate all sexual health issues. Buy Kamagra Gold online at alldaychemist.com at the most attractive price and enjoy intimacy with your partner. Kamagra is currently available in several forms and strengths, 100mg being the most potent one. The effect of Kamagra on the body happens between 30 to 60 minutes after ingestion. Kamagra Gold 100mg tablets is manufacturing by ajanta pharma in India. Kamagra Tablets can be shipped only from India, to USA, UK, AU, France, Spain, just contact us for any question regaring how to order and buy kamagra items, we have best offers and discount prices.

The maximum daily dose of Kamagra with healthy patients should be 100 mg. However, when a patient takes Kamagra for the first time, the dosage should be limited to 50 mg.

Please, remember that you are not supposed to take more than 100mg of Kamagra at a time or take it more than once within 24 hours. For a specific category of patients (For example, men 65 and over, patients with renal dysfunction, liver or cardiovascular diseases, etc.). The daily dose of Kamagra should be reduced to 25 mg.  If you also feel that a lower dose (25 or 50mg) is enough to give you an erection of desired strength and duration, there’s no need to go for higher amounts.

  • Redness of the skin related to increased blood circulation
  • Headache
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  • Pain in head, back and muscles
  • Visual disturbances
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US FDA issues import ban on Ajanta Pharma’s Kamagra tablets

An import ban is issued when evidence exists for the marketing or promotion of unapproved drugs into the US

Mumbai: The US Food and Drug Administration has issued an import alert on Ajanta Pharma Ltd’s generic male erectile dysfunction tablet Kamagra, which is manufactured at the company’s facility at Paithan in Maharashtra, according to details on the US drug regulator’s website.

The US regulator has issued import alert 66-41 on Kamagra. This import ban is issued when evidence exists for the marketing or promotion of unapproved drugs into the US.

Shares of Ajanta Pharma which plunged 14% on the news recouped some losses later, and were trading 5.22% lower at Rs1,690.55 at 2.00 PM on the BSE, while the benchmark Sensex was up 0.73% at 27315.58 points.

In a filing to stock exchanges, Ajanta Pharma said there is no import alert on the company’s Paithan unit and that it continues to supply to the US market. The company did not specify if there is an import ban on the drug in question. “We do not sell this product in the US,” a company spokesperson told Mint.

Kamagra tablets, which contain sildenafil citrate, were banned by the US drug regulator in 2009 as well.

According to a research analyst, Ajanta Pharma’s drug does not have US FDA approval and so, if it is entering the US, it would be through some unofficial channels. Hence, there will not be any financial impact on the company because of this action by the regulator, said the analyst, who did not wish to be named citing company policy.

Ajanta Pharma manufactures tablets, capsules and dry powder at the Paithan facility. Besides, it has five other manufacturing plants.

Ajanta Pharma is scaling up its business in the US market. As of September-end, 2016, the company had received 15 product approvals, while 12 abbreviated new drug applications (ANDAs) were pending with the US FDA for approval. It plans to file 8-12 ANDAs with the US FDA every year.

The benefits of buying Viagra from a pharmacy, over the counter

In New Zealand, most men in need of assistance for sexual performance can walk into a pharmacy and buy their Viagra over the counter.

Men in Australia can’t do this. They need to visit their GP to obtain a script, with repeats, and when these run out they need a new script.

Like men across the globe, however, they may buy their drugs over the internet. But there are risks.

VIAGRA NOW AVAILABLE OVER THE COUNTER WITHOUT PRESCRIPTION IN UK

Viagra Connect has become available to buy over the counter without a prescription in the UK for the very first time.

In November last year, it was announced that Viagra pills would be sold over the counter in the near future in an effort to stop men illegally purchasing knock-off versions online.

Now, men with impotence will be able to obtain the drug exclusively from Bootspharmacies and online for the next two weeks, before it is then also rolled out across other pharmacies.

The product is geared towards men with erectile problems, which constitutes approximately one fifth of the male British population.

This amounts to 4.3 million men in the UK, according to a 2010 study conducted by Kantar TNS.

Viagra Connect manufacturer Pfizer hopes that this news will encourage men to be more proactive and seek help for erectile dysfunction.

“The launch of Viagra Connect offers men a new and convenient route of access to treat the symptoms of erectile dysfunction,” said Kristie Sourial MRPharmS, medical manager for Pfizer.